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plague measures, and very special credit is due to those few who have
of their own free will assisted the authorities in evacuating their own
chawls, or carried out suggestions for the improvement of their buildings.
It had been stated that people accepted evacuation without much
trouble ; as a rule they accepted as inevitable the necessity of removing
plague patients to hospital, when once the case came to the notice of
the authorities ; but deliberate concealment of plague cases continued
to occur, and though, in the absence of such an organised house-to-
house visitation as obtained in the past, mere silence often sufficed to
keep the authorities in ignorance, yet the assistance of the volunteers
and the various methods adopted to obtain information of sickness
forced those who could not bear the idea of sending their relatives
to hospital to extraordinary devices. It twice happened that
the District Staff, on going to remove a patient upon information
received, found he had disappeared and eventually discovered him
concealed in a tobacco shop among the tobacco leaves. It frequently
happened that information was received of a plague case in a house
with numerous rooms, and that all the rooms were carefully searched
without result, until nothing remained except a few locked up on the
outside, the tenants of which were said to have gone out to their work.
These locked rooms had then to be opened, and the patient was often
found in one of them : and it sometimes happened that when a house
was evacuated and every hole and corner turned out, patients were
found concealed in unsuspected lofts. Lt. Warneford's remarks on this
subject are very interesting, and are given in full.
" All persons suffering from plague would, I think, be kept concealed and hidden
in their own homes were it not for the fear of the many direct und indirect agencies
that we have for discovering them. So, taking this as my opinion, to the question,
"to what extent are cases of plague now concealed" ? I would answer that "every
case is concealed," and it is only the knowledge that (through house owners, or
neighbours, or friends, or medical attendants, or plague volunteers, or others), the
plague officers will probably get to know about the sickness, and will come round
to the house and see the sick person and probably remove him to a hospital ; it is, I
think, only the knowledge and the fear of this that makes some of the people (a small
proportion) remove their plague-stricken friends or relatives to a hospital at once.
This is the class of case which we ordinarily call a "voluntary" removal, and such
cases, in my experience, now number about 20 to 30 per cent, of the total of plague
cases. A year ago, I do not think there were 5 per cent, of such cases, so in a sense
things have improved in this respect, and there are now more of what are called
"voluntary removals to hospitals." All other cases whether they come to the
knowledge of the District Officer while still alive, or when dead, are what I would
call strictly speaking concealed cases, that is to say—70 to 80 per cent, of the total.
In my opinion this desire for concealment results from the wish of the patient
himself to stay at home, and of his relatives (particularly the women of the family)
to keep the patient at home under their own care and their own eyes. They do not
understand, and they do not believe in the advantage to their relation of removal to
a hospital—they consider that he has much more chance of recovery if they look
after him, and keep him undisturbed in his own home. Whether plague infection
remains with them and attacks the rest of the family or other persons in the house