NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
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to persons evacuating their houses whether as a result of
such an order or of their own free will. Many may not be
able to provide themselves with shelter at short notice and
it is advisable, therefore, that arrangements should be made
beforehand so that hutting materials shall be either in stock
or readily procurable and shall, when evacuation is actually
in progress, be issued in reasonable quantities, free of charge
to those who really cannot afford to pay for them, and to
others at cost price. Sites for camps should not be more
remote than is necessary to prevent invasion by infected
rats ; they should be selected with due regard to water-
supply and sanitation and there should be as little interference
as possible with the avocations of the people. Police should
be employed to protect the evacuated houses against burglary
and to patrol the approved camps ; and arrangements may
be made for the custody, free of charge, of the effects of
persons who have left their houses.
Treatment of
plague pati-
ents ;
and
plague hos-
pitals.
7. A plague patient like any other sick person should
receive the most careful attention and all efforts should be
directed towards making him as comfortable as possible. A
person suffering from bubonic plague is no more a source of
danger than any other person who may carry infected fleas.
It is unnecessary therefore to construct special plague
hospitals or to locate them in places remote from human
habitation. Patients can be treated best in the ordinary
hospitals, special wards being set apart for the purpose and
additional temporary accommodation being constructed if
necessary : nor is there any objection to a patient being
treated in his own house if he prefers to stay there and his
friends and relations are prepared to take proper care of him.
Patients suffering from pneumonic plague should not be
taken to the general ward of a hospital but should be treated
in an isolation ward if there is one.
Where private committees or individuals wish to establish
hospitals for particular communities, the Government will
contribute half the actual cost of construction and mainte-
nance provided—
(a) that the cost of construction is considered reasonable
and the buildings are erected on sites approved by the Col-
lector or plague officer acting under his control ; [in any
case of doubt or dispute the Government will have the right
to have the value of the work done estimated by the
Public Works Department.]
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(b) that the arrangements for sanitation and the supply
of food meet with the approval of the Collector ;
(c) that such hospitals remain under the general super-
vision of Government officials and all instructions that may be
given by the Sanitary Commissioner or the Surgeon-General
are observed ; and
(d) that the sale-proceeds of such hospitals, when they
are dismantled, are divided proportionately between the
Government and the committee or individuals concerned.
The amounts will be paid monthly in arrears to the
manager or managers approved by the Collector.
8. It is most important that early information should be
received of the appearance of infection in any place, both in
order that remedial measures may be adopted in that place
and in order that it may not be allowed to become a focus
for the spread of infection. If the rats in a town or village
are infected, they may spread infection to other places before
any case of human plague occurs ; and if a case of indigenous
human plague occurs, it may be regarded as certain that the
local rats have been infected for some time. It is the duty
of heads of villages and all other local authorities to watch
the residences of persons arriving from infected areas and
to report at once any mortality of rats or any human case of
plague. Regulation 9 lays upon every householder and
medical practitioner the duty of informing the local authority
of rat mortality or of any illness with the appearance of
plague which comes to his notice ; but in towns or villages
which have been, or are likely to be infected, the local author-
ities must themselves be vigilant. If the local authority
becomes aware of rat falls or of a human case in a place not
already declared infected, he should report the fact at once
to the chairman in the case of a municipality, and to the
tahsildar in the case of any other town or village, and also
to the plague inspector of the circle if there is one. Pending
the arrival of one of those officers or a medical officer, he
should, if any human being has been attacked, arrange as far
as he can for proper attendance on the patient. Thereafter
he should, on any day on which a seizure or death takes
place, report the number of seizures and deaths to the
chairman or tahsildar as the case may be.
Action to be
taken by
local officers
on the out-
break of
plague.
9. On receipt of information of rat mortality or human
infection, the municipal chairman or the tahsildar, as the case
may be, should report the fact to the Revenue Divisional
Officer, the District Medical and Sanitary Officer and
12
the Collector by the quickest possible means, and should
proceed at once to the spot, if possible with a medical officer,
and verify the facts. If he finds the information to be correct
and a detailed report has not already been submitted by the
plague inspector to the Collector, he should see that such a
report is submitted without delay and make arrangements for
the care of the patient or patients, if any, and for the protec-
tion, so far as may be possible, of the population generally.
He should keep the Collector informed from day to day of
the number of seizures and deaths occurring within his juris-
diction with the wards (in the case of municipalities) or the
villages (in the case of a taluk) in which they have occurred.
Appointment
of plague
inspectors.
10. In any district in which any town or village has been
declared infected, or with the sanction of Government in any
district threatened with plague, the Collector may appoint
pingue inspectors who should, if possible, be certificated
sanitary inspectors, for the purpose of observation. In
municipal areas it will generally be desirable to appoint an
inspector for each ward, though it may not always be neces-
sary if the wards are small ; and a separate inspector should
ordinarily be appointed for each non-municipal town with a
population of 5,000 or more. Elsewhere each inspector
should be placed in charge of a circle of a size which will
admit of his visiting every portion of it within ten days or
less. Subject to the control of the Collector the inspectors
will work under the orders of the plague officer having
jurisdiction over their circles.
Duties of
plague
inspectors.
11. In the absence of special orders from the Collector,
the duties of a plague inspector are—
(1) to patrol the area under his charge for the purpose
of obtaining early information of rat mortality or of human
plague ;
(2) to proceed at once to any place from which infec-
tion is newly reported; and, in the absence of a medical
officer, to see that the best possible arrangements are made
for the comfort and treatment of any patients whose relations
cannot take care of them themselves ;
(3) within 24 hours of receiving the first intimation, to
submit a detailed report (in the form given in Appendix B)
to his immediate superior and to the Collector with regard
to every imported case and with regard to each of the first
three indigenous cases in the village ;
(4) to examine any dead rats that may be found in a
place not already declared infected and, if he finds any
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enlarged glands and has been instructed how to take smears,
to send spleen or liver smears to the King Institute at Guindy
for examination ;
(5) to visit frequently all infected areas in his range,
to encourage the people to get themselves inoculated and to
leave their houses and camp in some place where they will be
away from the neighbourhood of infected rats ;
(6) to advise the people generally on the means of
avoiding plague, and especially as to the removal of all food
and garbage from places accessible to rats, and as to the
destruction of rats ; and
(7) when so directed by the Collector or plague officer
to conduct or assist in conducting a campaign for the
destruction of rats.
12. When a case of plague, genuine or suspected, is first
discovered in any place not declared infected, the Collector
or, in his absence, any gazetted officer at the headquarters
station of the district, should immediately telegraph the fact
to the Sanitary Commissioner, stating whether the case was
indigenous or imported, if the latter whence it was imported,
ho\v the case was discovered, and any other further particu-
lars, with dates, which may appear necessary. In the case
of ports whence vessels sail for Europe, it should also be
stated in the telegram whether any plague or unusual morta-
lity among rats was observed. Names of hamlets should not
be telegraphed but only the names of villages to which such
hamlets belong.
Report to be
sent by Col-
lectors to the
Sanitary
Commissioner
on the occur-
rence of the
first case of
plague.
13. All attacks and deaths should be reported daily by
the Collector to the Sanitary Commissioner in the form
prescribed in G.O. No. 485 P., dated 10th March 1904.
These reports may be sent by post, unless, owing to a breach
on a railway or any other cause, they are not likely to be
received within 43 hours, when they should be telegraphed.
Telegraphic reports should however be sent to the Govern-
ment and the Sanitary Commissioner of—
Report of
plague cases
to be sent
by Collectors
to Govern-
ment and
Sanitary
Commis-
sioner.
(a) the first indigenous case occurring in a district
previously free from plague,
(b) the first three indigenous cases occurring in a town
of 10,000 inhabitants or more, and
(c) the first three indigenous cases occurring in any
port.
Collectors should also send telegraphic reports to the
medical officers of the Ceylon Government stationed at Tuti-
corin and Mandapam, of the first indigenous case occurring
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in a district previously free from plague. The cost of these
telegrams will be debited to the Ceylon Government by the
Accountant-General.
Monthly
report on
plague to be
sent by
Collectors
to the
Sanitary
Commis-
sioner.
14. The Collector of every district affected with indigenous
plague should forward to the Sanitary Commissioner by the
15th of every month a report for the previous month, show-
ing whether the epidemic was increasing or decreasing, what
measures were taken to combat it and with what degree of
success, the attitude of the people towards those measures,
and what steps they were taking to help themselves and any
other matters of interest.
Communica-
tion of in-
formation
regarding
plague cases
to adjoining
districts and
native
states.
15. Collectors of infected districts should send daily
reports of plague to the Collecters and District Medical and
Sanitary Officers of adjoining districts in the form prescribed
by G.O. No. 83 P., dated 16th January 1904.
The Collectors of Nellore, North Arcot, Ohittoor, South
Arcot and Chingleput should send a copy of the daily plague
report to the President of the Madras Corporation, and
should also report to him by telegram immediately on its
occurrence any case of plague or suspected plague that may
occur in any new place within their districts.
Inasmuch as the Mysore Darbar has instructed the
amildars and deputy amildars in charge of taluks and sub-
taluks of Mysore which border on British districts to give
immediate information of the occurrence of plague within
their jurisdiction direct fco the tahsildars of the neighbouring
British taluks, and as the Deputy Commissioners have been
similarly requested to keep the Collectors of adjoining British
districts promptly informed of the occurrence of plague in
the neighbouring districts in Mysore, Collectors of British
districts bordering on Mysore will accordingly arrange to
give similar information direct to the officials of the Darbar.
Similar arrangements are in force with regard to districts
bordering on the Nizam's Dominions.
Control of
Collector
over medical
subordinates
on plague
duty.
16. The Collector may fine or suspend subordinates of
the Government medical department who are employed on
plague duty within his district, but against such punishment
there shall be a right of appeal to Government through the
Surgeon-General. Before passing any order regarding the
punishment of a medical subordinate, the Collector should
consult the District Medical and Sanitary Officer. A copy of
every such order should forthwith be communicated to the
Surgeon-General who may, in any case in which he considers
that the fault ascribed to the subordinate is one which
15
touches his professional conduct only, require that the order
shall not be carried into effect pending reference to Govern-
ment. No appeal to the Government will be entertained
unless preferred within three months from the date of the
order appealed against.
17. The Collector may grant casual or privilege leave to
subordinates of the Government medical department whose
services have been lent to local boards or municipalities for
plague duty. Intimation of the application should, however,
be made to the Surgeon-General before privilege leave is
sanctioned. Leave of all other descriptions, such as furlough
or sick leave, is granted by the Burgeon-General.
18. Subject to the Collector's approval and general
control, a plague officer may appoint, fine, suspend, or
remove from plague duty any member of the plague staff
except a medical subordinate.
Control of
plague
officers over
the plague
staff.
19. The order of any Collector or plague officer dispens-
ing with the services of a, temporary plague subordinate shall
have general effect throughout the Presidency. The Collec-
tor's order of suspension or dismissal shall be final with
regard to officers lower in rank than that of certificated
sanitary inspector. Certificated sanitary inspectors shall
have a right of appeal to Government. The appeal should
be forwarded to Government through the Collector and the
Sanitary Commissioner. There shall be an appeal to the
Collector against any order of suspension or dismissal passed
by a plague officer.
Right, of
appeal of
the plague
staff.
20. In connexion with measures to combat plague,
expenditure will ordinarily be necessary only on the following
objects :—
(1) observation, including the pay of plague inspectors ;
(2) inoculation ;
(3) the provision of shelter for persons leaving their
houses ;
(4) police, to guard evacuated houses and approved
camps ;
(5) rat destruction, including the cost of traps and
poison and the pay of any staff employed ;
(6) hospitals, appliances and staff for the care of
patients ; and
(7) measures taken to ensure the breaking of bulk of
consignments of grain.
Expenditure on the first four items will be borne from
Provincial funds. The cost of the fifth and sixth will be
Distribution
of plague
charges.
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borne by municipal funds in municipal areas and by local
funds in rural areas. That of the seventh will fall on Pro-
vincial funds if the measures are undertaken by the Collector
under regulation 8 and on the municipal or local authority
concerned if they are carried out under regulation 10.
Powers of
Collectors
to incur
expenditure
on plague.
21. Collectors are authorized to incur expenditure up to
Rs. 5,000 in anticipation of the sanction of Government
when prompt action is necessary under regulation 7 or regu-
lation 8 or when, in consequence of an outbreak of plague, it
becomes necessary urgently to provide hutting materials for
persons evacuating their houses, or to pay compensation for
damage to property. Any expenditure so incurred should
be reported immediately and, except as provided in this order,
no expenditure should be incurred from Provincial funds
without previous sanction.
Where a local board or municipal council finds it neces-
sary to incur at short notice expenditure on the care and
accommodation of the sick or on rat destruction, which has
not been foreseen or provided for in its budget, it should
take immediate steps to rearrange its budget so that funds
may be available,
Sanction
for the
employment
of plague
establish-
ments.
22. All appointments in connexion with plague require
the sanction of Government. In the case of additional
police required for plague duty the application for sanction
should be forwarded, through the Inspector-General of
Police, to the Secretary to Government, Home (Judicial)
Department. In other cases applications should be for-
warded to the Secretary to Government, Local and Muni-
cipal (Plague) Department. Sanctions for establishments
employed under this rule will remain in force to the end of
the following March or September, whichever is earlier,
unless for special reasons a different date is specified in the
order in any particular case. On the 1st of March and on
the 1st of September each Collector will submit in a single
communication proposals for the retention of such of the
establishments as, in his opinion, should be retained in the
ensuing half-year, clearly explaining the necessity in each
case. Such proposals should be accompanied by three
copies of a statement showing all existing plague establish-
ments in the form in Appendix C, two copies of the state-
ment being forwarded at the same time to the Accountant-
General and one copy to the Sanitary Commissioner.
Special sanction should be obtained for all additional esta-
blishments which it may be found necessary to employ in
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the course of the half-year, but in the absence of special
instructions to the contrary all such sanctions will expire at
the end of the half-year. Collectors will also effect from
time to time such reductions in establishments as may be
feasible.
23. The Government of India have authorized the grant
of special allowances to medical officers for plague duty per-
formed in addition to their ordinary work in cases where it
is sufficiently arduous to deserve special remuneration. The
Local Government may also sanction duty allowances to
officers of other classes, provided their plague work lies
entirely outside their ordinary and legitimate duties. The
Secretary of State has also sanctioned the grant of extra-
ordinary pension to the families of police men who die of
plague contracted in the execution of their duties in plague-
stricken localities, provided such duties entail imminent risk
from plague.
Allowances
to officers
en plague
duty
24, The special allowances given to certain classes of
officers for plague duty and the salaries attached to special
temporary appointments created on account of plague are
shown in Appendices D and E. All questions relating to the
grant-of extra allowances should be referred for the orders
of Government.
Board of Revenue (Laud 3-A. Land Revenue,
Revenue).
Sanitary Commissioner.
24-B. Sanitation.
Surgeon-General
... 24-A. Medical.
Inspector-General
of '20. Police.
Police and the Commis-
sioner of Police.
25. The Board of Revenue (Land Revenue"), the Sanitary
Commissioner, the Sur-
geon-General, the Inspect-
or-General of Police and
the Commissioner of
Police are required to
include in their Provincial
budgets under the respective major and minor heads (vide
margin) consolidated estimates of plague expenditure debit-
able to Provincial funds. The Board of Revenue (Land
Revenue) will obtain the estimates for the districts from the
Collectors, and the Sanitary Commissioner and the Surgeon-
General the estimates for the districts and the City of Madras
from the Collectors and the President, Corporation of
Madras, respectively. The figures relating to plague charges
should appear under a separate sub-head " Plague expendi-
ture."
Estimates of
plague
expenditure,
Similarly each district board or municipal council should
enter in its budget under a separate sub-head the provision
it makes for plague expenditure.
2
18
Transfer of
funds.
26. The Board of Revenue (Land Revenue), the Inspect-
or-General of Polico and the Surgeon-General can sanction
reappropriation of funds from one minor head to another
within the same major head, provided (a) that the expendi-
ture is entirely ander their control ; (b) that the transfer does
not involve reappropriation either from or to the group head
Salaries; and (c) that savings on non-recurring expenditure
are not reapprppriated in order to provide for additional
recurring expenditure.
The Commissioner of Police, the Sanitary Commissioner
and Collectors can sanction reappropriation of funds within
the same minor head where the expenditure is entirely under
their control, subject to the following conditions :—
(1) the total of the grants under their control shall not
be exceeded ;
(2) savings under Salaries shall not be reappropriated
to other classes of expenditure ; and
(3) savings on non-recurring expenditure under Supplies
and Services, Contingencies and other detailed heads shall
not be reappropriated in order to provide for additional
recurring expenditure under Salaries, Establishment, or on
any other account.
Fines.
27, Fines recovered in prosecutions under the Plague
Regulations should be credited to the head XVI-Ab.—LAW
AND JUSTICE—Courts of Law—General fees, fines and for-
feitures.
Final
accounts of
plague
charges.
*Items 3 and 4 nnrler
group R.F. XXXV-D.
Plague in Appendix XII
to the Madras Stationery
Manual.
28, The Accountant-General should submit in the
prescribed form* final accounts of
plague charges under Provincial (direct
and indirect) and Local funds for the
preceding financial year so as to reach
Government on the 15th September.
District boards and municipal councils should continue to
show in the accounts attached to their administration reports
the expenditure incurred by them on plague measures.
Classifica-
tion of
pingue
charges.
29. * Direct ' plague expenditure is that exhibited in the
Provincial accounts under the head 24-Bc. Sanitation—
Expenses in connexion with bubonic plague.
'Indirect'
plague expenditure includes all other extra expenditure due
to plague but brought to account under the ordinary appro-
priate service heads.
(i) All officers who draw bills for indirect plague
expenditure should write conspicuously at the head of each
such bill, beside the account head, the word 'Plague' in