NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
93
" the enclosed Memorandum dealing with Malaria in Bombay with especial
" reference to the steps which in my opinion should be undertaken by the
" Municipality with a view to mitigating the disease during the present
" season and eventually attempting its complete control.
Memorandum.
" The Investigation into the distribution of Malaria within the City of
" Bombay has shown the disease to be prevalent over a very large area.
"In particular it appears to be present in a persistent form in—
" Ward A.—Lower Colaba and
Middle Colaba.
South Fort.
North Fort.
Esplanade.
Ward B.—Mandvi.
Chakla.
Umarkhadi.
Dongri.
Ward C.—Market.
Dhobi Talao.
Fanaswadi.
Bhuleshwar.
Khara Talao.
" Ward D.—Walkeshwar (and to a less
extent Chaupati).
Girgaum.
" Ward E.—Tardeo.
2nd Nagpada.
Byculla.
Tarwadi.
Mazagon.
" It may be observed that it thus affects the most densely populated
" portion of the City involving an area with a population of over 650,000
" people. It is not suggested that other parts of the Island are Malaria
" free, for this is very far from being the case and there is evidence to
" show that cases of Malaria occur in practically every part of Bombay
" during certain times of the year, but it may be broadly stated that, in
" the abovementioned areas Malaria exists to such an extent as to give
" indications of its presence throughout the year. The incidence of Malaria
"is especially marked along the whole of the east coast of the Island
" between Kasara Basin, Mazagon, and the Sassoon Dock, Colaba, but it is
" also prevalent in the west coast where a centre occurs in Walkeshwar
" in an area below the Malabar Hill Reservoir. Broadly speaking, severe
" Malaria may be said to exist over an area including—
Mazagon—south of Gunpowder
Road.
Tarwadi—south of Nesbit Road.
Dongri.
Umarkhadi.
Khara Talao.
Mandvi.
Chakla.
Market.
Dhobi Talao.
Esplanade.
North Fort.
South Port.
Lower Colaba.
Portions of Walkeshwar.
" The population of this area numbers over 375,000 persons or very
" nearly two-fifths of that resident upon the whole Island of Bombay, and
" out of this population the proportion actually suffering from Malaria must
" be very large.
" A recent miscroscopical examination made by myself of specimens
" of blood taken from nearly 700 residents in North Port and Esplanade
" Sections, a portion of the intensely malarious area, has shown that 35 per
" cent. to over 50 per cent. of the adults are infected with Malaria
" parasites, while among children the rate may be even higher. In one
" instance in a mixed community of adults and children the examination
" of 63 (46 adults and 17 children) showed that no less than 44 or nearly
" 70 per cent. were harbouring the infection. A statement showing the
" admissions for Malaria among some 1,8S2 Bombay Police daring 1908,
" kindly supplied to me by Dr. Powell, throws further light upon the
" morbidity caused by Malaria in Bombay.
B 136—24
109
" improperly drained and levelled, are a great danger if permanent breeding
" places of Neocellia stephensi exist in their vicinity; and there are places
" of this kind in the very heart of the City which undoubtedly serve to
" increase the malaria in their neighbourhood. These places should be
" dealt with. But whatever is attempted should be carried through.
" systematically, section by section, or ward by ward.
" (y) Miscellaneous Breeding Places.—In certain places, notably in
" Frere Road and Manson Road, near Prince's and Victoria Docks and at
" Colaba, near the Apollo Press, collections of machinery afford numerous
" breeding places for N. stephensi during the monsoon. In certain other
"places collections of old tins, tubs, etc., provide breeding places for
" mosquitoes of all kinds, N. stephensi, the malaria-carrier, among them.
" At Jamsetjee Bandar in Colaba, earthenware vessels and tubs of dye used
" by fishermen for colouring their nets have been found to afford excellent
" breeding places for N. stephensi and other mosquitoes.
" (z) In regard to all such breeding places attempts at preventing
" their formation or controlling them will be futile, unless it is clearly
" understood that neglect on the part of those responsible will entail a
" penalty. Owners of machinery should be compelled to stack it in
"such a way that it will not afford opportunities for the breeding of
" mosquitoes. Owners of empty tins, etc., should likewise be compelled
" to take due precautions."
B 136—28
113
295. The monthly returns show that the fall in fever admissions has been
most marked in October and November.
Admissions for Malaria, Municipal Dispensary No. 1 at Frere Road,
Fort Section, A. Ward.
Month.
January
February
March
April
May
June
July
August
September
October
November
December
Total ..
1906.
350
339
402
306
259
277
397
555
480
512
571
404
4,852
1907.
379
268
356
329
457
531
606
806
759
992
578
523
6,584
1908.
360
249
375
466
769
618
560
718
851
1,088
739
391
7,173
1909.
254
232
267
249
321
418
408
479
567
420
355
271
4,241
3910.
*212
215
205
238
288
322
457
465
373
510
387
342
4,012
* It must be noted that in 1909 (from August to December 31st) over 4,000 people residing in the area covered by
this dispensary were receiving house to house treatment with quinine. This was discontinued during 1910.
296. Mortality.—The areas which have undoubtedly been influenced
by malaria owing to their proximity to the Dock Works are—
Esplanade.
Mandvi.
Chakla.
North Fort (a portion).
The total deaths recorded in these sections during the past four years
are as follows :—
Esplanade
Mandvi
Chakla
North Fort
1907.
611
1,661
1,811
1,125
190S.
801
1,566
1,240
1,144
1909.
679
1,309
1,088
1,033
1910.
626
1,374
1,096
1,126
297. The deaths by quarters in each of these sections during the past four
years are shown below:—
Section.
Esplanade
Mandvi
Chakla
North Port
Year.
1907
1908
1909
1910
1907
1908
1909
1910
1907
1908
1909
1910
1907
1908
1909
1910
1st
quarter.
154
229
219
183
517
371
309
391
442
366
329
302
347
295
310
269
2nd
quarter.
134
196
171
185
393
426
429
317
346
283
232
287
230
342
276
321
3rd
quarter.
127
137
131
134
365
343
253
304
212
243
200
248
277
217
203
285
4th
quarter.
196
239
158
124
386
426
338
335
281
254
227
259
271
292
244
251
B 136—29
114
298. October deaths recorded in these sections are given below.
1907
1908
1909
Esplanade.
67
98
48
Mandvi.
152
178
125
Chakla.
92
109
92
North Fort.
91
103
80
Total.
402
488
345
299. The total of October and November deaths for these four sections
together since 1905 are as follows:—
1905.
594
1906.
696
1907.
747
1908.
846
1909.
649
These figures all show a considerable reduction in mortality in 1909 as
compared with both 1907 and 1908.
300. Still more interesting are the mortality figures of a large chawl
situated within the affected area. This chawl, which belongs to the Bombay City
Improvement Trust, lies between Palton Road and the Railway Yards, and
overlooks the New Dock Works. The population of the chawl is about 1,203.
In 1907 and 1908 the residents suffered very severely from malaria. Early in
1909 the spleen census among children living there showed 58 per cent. with
enlarged spleen, and the blood examination of a large number of adults and
children showed an infection index of nearly 40 per cent.
During 1909 quinine was administered to about 800 man, women and
children in this chawl. At the commencement of the treatment quinine pills
were used, but they proved unsatisfactory and when sugar-coatel tablets became
available it was found that they were much more readily accepted than pills.
At first only children with enlarged spleen were treated, but as blood
examination showed that both children and adults with no palpable splenic
enlargement were infected in nearly as great a proportion as those with enlarged
spleen, it was decided to extend treatment to everyone who would accept it,
and by the end of August 1909 over 800 men, women and children were in
receipt of the remedy. The drug was discontinued during 1910, but the
anti-mosquito measures begun in August 1909 in the New Docks, the adjoining
Railway Yards and in the neighbourhood of the chawls were continued.
301. The mortality in these chawls during the past four years has
been as follows :—
Year.
1907
1908
1909
1910
Mean
population.
859
1,154
1,234
1,197
Deaths
among adults.
*12
38
36
27
Deaths among
children.
*5
28
24
10
Total deaths.
*17
66
60
37
Death-rate
per 1,000
per annum.
*59.3
57.3
48.6
30.9
* Deaths in 1907 from September only.
302. The total deaths by months during the past four years has been
as follows : —
Month.
January
February
March
April
May
June
July
August
September
October
November
December
Total ...
1907.
1
5
4
17
1908.
2
3
4
1
8
4
7
6
9
7
9
66
1909.
5
7
8
5
3
4
7
2
6
2
7
4
60
1910.
4
4
1
5
3
2
6
3
2
2
2
3
37
115
303. Taking the period from August to December for each of the three
complete years we find the deaths have been as follows :—
Year.
190S
1909
1910
Deaths.
38
21
12
August to December.
The deaths among young children during this period is as follows:—
Year.
190S
1909
1910
Deaths.
21
8
0
August to December.
" "
Comparing the total mortality for the fourth quarter of the year for each
year since 1907 we get:—
1907.
16
1908.
25
1909.
13
1910.
7
304. When considering all the evidence which points to a mitigation of
malaria having taken place in the area near the New Docks it must be borne
in mind that, the reduction in the spleen rate, the admissions for fever, and the
deaths during the malarious season of the year, have occurred, not after the
completion of work upon the Docks, which in itself would be certain to lead to
such a reduction, but while the work is still in progress. Up to the end of 1910
only 65 per cent. of the excavation work upon the new docks and 65 per cent.
of the masonry had been completed and it will probably be another two years
before the work is finished.
305. Climatic conditions too have not been favourable, for the rainfall of
the past five years has been as follows :—
1906
1907
1908
1909
1910
56.30 inches.
100.78
„
53.51
„
71.22
„
67.86
„
Thus in 1909 and 1910 the rainfall has been heavier than in 1908 when malaria
was at its maximum.
306. The only favourable influence, apart from the preventive measures
adopted, has been a fall in the price of food. The average prices of wheat,
jawar, bajri and rice during the past five years have been as follows :—
Seers of grain for the Rupee.
Year.
1906
1907
1908
1909
1910
Wheat.
9.44
9.39
6.54
6.63
6.78
Jawar.
11.78
12.22
9.83
10.79
11.46
Bajri.
11.94
13.23
9.83
10.97
10.79
Rice.
827
8.12
6.64
8.30
9.08
The rise in prices during 1908 undoubtedly produced considerable stress
among the poorer classes and this acting upon a malaria-infected population
was probably one of the factors which helped to bring about the epidemic of
1908 ; but the fall of prices in 1909 and 1910 though an ameliorating influence
would not account for the whole of the improvement recorded above.
307. Results of work in other areas.—It is at present impossible to point
to the effects of the preventive work in other parts of the City, but the follow-
ing paragraphs extracted from the Health Officer's reports gives some idea of
the work that has been done.
117
Extract from the Executive Health Officer's Report for the second
quarter ending 30th June 1910.
" As in the second quarter of 1909, Malarial Fever occasioned 42
deaths in the period under review, being 22 less
Malaria.
than in the preceding quarter.
" Anti-malarial measures were continued during the quarter. Premises
" were visited; wells, tanks, cisterns, etc., examined, and wherever mosquitoes
" were found breeding in wells letters were addressed to parties to remedy
" the situation, with the result that 58 wells were covered and 24 filled in.
"In accordance with the orders of the Standing Committee 118 wells
" were reported to them as being ' the most objectionable cases,' out of
" which 15 wells were visited and inspected by the Sub-Committee, who
" recommended 7 of them to be hermetically sealed or filled up ; and these
" are under action; lists of remaining cases have been returned to this
" Department to ascertain the objections, if any, of the owners to comply
"with the requisitions of this Department."
Extract from the Executive Health Officer's Report for the third
quarter ending 30th September 1910.
" In my previous Quarterly Reports I have dwelt on the anti-
malarial work done during each period under
Anti-malarial work.
review. But as it is now exactly a year since
"the anti-malarial operations were commenced (1st October 1909) with the
" aid of a special staff, the work done during the 12 months has been
" tabulated below :—
Wells examined and re-examined for Mosquito Larvae
Cisterns
„
„
„
Tanks
„
„
„
Wells in which larvae were found
Cisterns
„
„
Tanks
„
„
Cases in which letters of requisition were addressed to parties
Cases in which they were complied with
Cases in which sanction of the Standing Committee to take action
under section 381 of the Act was applied for
Cases reported as " most objectionable"
Notices issued against parties
"
complied with
Prosecutions undertaken
5,075
8,516
389
2,630
994
117
2,128
713
282
167
99
21
24
" I have in my First Quarterly Report for the year pointed out the
"limitations under which this work is proceeding; progress under such
" conditions must be slow. During the quarter under report only 13 wells
" were filled in and 41 hermetically covered. Seven wells were mentioned in
" my Second Quarterly Report as being then under action; the owners of the
" three of these wells were prosecuted for non-compliance with the demands
" of this Department but the proceedings were withdrawn as our requirements
" were in the meanwhile complied with; in one case the party was warned
" and discharged and three are pending.
" During the quarter 49 wells have been reported to the Standing
" Committee as being the ' most objectionable cases', but no orders have
" yet been received from that body."
Extract from the Executive Health Officer' s Report for
the fourth quarter of 1910.
Anti-malarial operations.
" Anti-malarial investigations were continued, during the quarter as
in the past, and 29 wells were reported to the
Standing Committee as being ' worst cases.'
118
" 33 wells were hermetically covered and 14 filled in as under : —
Ward.
B. ...
C. D. ...
E. ...
P. ...
No. of wells
heremetically
covered.
15
3
6
8
1
No. of wells
filled in.
6
3
5
" During the period under review the Malaria Sub-Committee of the
"Standing Committee issued their third and fourth reports, both of
u which were adopted by the Standing Committee: the latter embodies
" definite measures to be taken against 70 of the wells reported against
" by this Department."
308. Protection of Wells.—From information received recently it appears
that up to the end of 1910 the total number of wells reported as dealt with by
the Health Department was as follows :—
Wards.
Pilled in
Covered
with
masonry
or
wire gauze
Total ...
A.
22
63
S5
*B.
22
32
54
•0.
22
64
86
D.
31
86
117
E.
20
27
47
F.
1
1
G.
1
...
1
Total.
118
273
391
* In the list received a number of wells situated in C. Ward were given as belonging to B. Ward, and it is quite
possible the figures for these two Wards are not quite accurate although the total is given correctly.
It may be mentioned that the above list appears to include a certain
number of wells filled in some years ago; and in other cases wells described as
filled in or covered are still open.
The Executive Health Officer in a communication respecting the wells
dealt with remarks—
" It may be stated here that consequent upon the unavoidable delay
" that was caused in the issue of definite orders by the Standing Committee,
"as regards the preventive measures to be adopted in respect of wells
" breeding larvae of malaria-carrying mosquitoes, some of the wells which
" were formerly covered were reopened during the interval."
126
338. It may not be out of the place to mention in this connexion certain
facts in regard to the working of some of the Ordinances and Regulations against
the breeding of mosquitoes in force in the West Indies. The following notes are
recorded by Sir Rubert Boyce in his recent book on " Health Progress and
Administration in the "West Indies":—
(1) In Barbados, during the period March to May 1909, 99 persons
" were fined sums varying from one to forty shillings for breeding mosquitoes
" on their premises.
(2) Trinidad.—Return of prosecutions under Anti-mosquito Regula-
"tions from 1st April to 8th December 1909 :—
Total number of informations laid
...
...
Number fined (all convictions, with one exception)...
Number reprimanded and discharged—
(The summons was served by mistake on the owner
of on the occupier)
...
...
Kind of receptable in which larvae were found :—
Antiformicas
...
...
...
Barrels
...
...
Tubs
Disused tins
...
Eaves-gutters
Bottles
...
...
...
Amount paid in fines ...
...
152
151
instead
1
70
64
13
2
2
1
152
£28-8-6
" The fines varied from 1s. to 10s.
" Return of cases prosecuted by the Acting Sanitary Officer for breach of
" regulations, tinder Order 188 of January 16, 1908 :—
1.
2.
3.
4.
6.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
Date of offence.
March 5, 1909...
"
17, 1909...
April 17, 1909
„ 20, 1909 ...
" "
" 19, 1909 ...
" "
" "
" "
" "
" "
" "
" "
" "
" "
" "
" "
„ 21, 1909 ...
" "
" "
" "
" "
„ 20, 1909 ...
„ 22,1909 ...
„ 23, 1909 ...
" "
" "
" "
„ 28,1909 ...
Offence.
Stagnant water in bar-
rels.
Stagnant water in bar-
rels and tubs, with
mosquito larvae.
" "
" "
" "
" "
" "
" "
" "
" "
" "
" "
" "
" "
" "
" "
" "
" "
" "
" "
" "
" "
" "
" "
" "
" "
" "
" "
" "
Date heard.
March 16, 1909 ...
„ 26, 1909 ...
April 23, 1909
„ 29, 1909
...
" "
" "
" "
" "
" "
" "
" "
" "
" "
" "
" "
" "
" "
" "
" "
" "
" "
" "
" "
May 3, 1909
„
5, 1909
" "
" "
" "
„
7, 1909
Judgment.
10s. fine or 7 days'
imprisonment.
£3 or 14 days.
28. 6d. or 7 days.
" "
" "
" "
" "
" "
" "
" "
" "
" "
" "
" "
" "
" "
" "
" "
" "
" "
" "
" "
58. or 7 days.
" "
" "
" "
" "
£1 or 14 days.
127
Summary of Prosecutions from 5th March to 28th April 1909,
" Twenty-nine prosecutions for keeping stagnant water in barrels or with
" mosquito larvae :—
]
1
1
20
1
5
29
heard on March
„
April
" "
"
May
" "
16, 1909.
26, 1909.
23, 1909.
29, 1909.
3, 1909.
5, 1909.
Convictions were obtained in all cases.
In 1 case a fine of 10s. was imposed.
1
1
5
20
"
"
"
"
"
"
"
£3
£1
58.
2s.
"
"
were imposed.
6d. „
"The fines were paid in all cases except that in which a fine of £3 was
" imposed. The defendant elected to go to prison for 14 days."
Total fines paid £5 5s.
The following paragraph appeared in the Port of Spain Gazette of 6th
August 1909 :—
" For failing to keep their premises free from stagnant water liable to
" breed mosquitoes, four persons were prosecuted at the City Police Court
"yesterday. In each case a conviction was secured and the fine imposed of
" 5s. or seven days' imprisonment."
339. It will be seen from these notes that the majority of convictions
and fines inflicted were for allowing mosquitoes to breed in antiformicas, barrels
and tubs. Antiformicas, it may be mentioned, are small shallow vessels
containing water, which are placed under the legs of tables, etc., to prevent
ants from ascending.
340. There is no section in the present City of Bombay Municipal Act which
would allow the authorities responsible for the health of the City to proceed
against owners or occupiers of premises containing breeding places of this nature;
and until an enactment is passed laying down clearly and inclusively that the
breeding of mosquitoes in any and every collection of water is a breach of the
law, and giving power to the sanitary authorities themselves to abate such
nuisances, it is difficult to see how mosquito breeding is to be prevented
in Bombay.
135
379. From these figures it would appear that the cost of filling in or
efficiently protecting the dangerous house wells so common in the North Fort and
Dhobi Talao should not amount to more than from Us. 15 to Rs. 50 per well. It
is probable that nearly all the most dangerous wells in these two sections could be
dealt with at cost of Its. 50,000 and for a total expenditure of about Us. 1,00,000
two-thirds of the dangerous wells in the south of the island could be prevented
from remaining breeding places of Neocellia stephensi.
380. In regard to the prevention of dangerous anopheles from breeding in
the reservoirs and filter-beds at Malabar Hill and Mazagaon, it may be stated
that the cost of efficiently protecting all the ventilators, skylights and exits at
Malabar Hill water works should not be very great. It is probably that a sum
of less than Rs. 2,000 would amply suffice to meet the cost of the wire gauze
required and the work of placing it in position. As regards the provision of an
efficient waste water drain along the ravine west of Malabar Hill reservoir,
a budget grant sufficient for the estimated expenditure upon this work appears
to have been already sanctioned.
381. At Mazagaon, the filter-beds being open, nothing short of covering
them will effectively prevent the breeding of mosquitoes. The roofing of the
water works at Malabar Hill appears to have cost about Rs. 50,000, but as the
reservoirs at Mazagaon are below ground, only the filter-beds being 'exposed,
it is probable that a smaller sum than this would suffice for the work.
There is no data available to show the probable cost of the few small recla-
mations required at Nepean. Sea Road, other parts of the foreshore at Malabar
Hill and also at Colaba. But no great sum of money would be needed and
the value of the reclaimed land would amply cover the expenditure incurred.
382. In connexion with general mosquito prevention it may be remarked
that storm-water entrances and catch-pits, although they have no influence
on the spread of malaria, form ideal breeding places for Culex fatigans ; and
just after the monsoon, when they contain water and in the dry weather, when
owing to the watering of the streets a little water finds its way into them,
swarms of larvae of Culex fatigans are present in many of them. The provision
of covers for these entrances, which could be placed in position after the rains,
would materially reduce the number of mosquitoes in the City; and although
it is not a measure of anti-malarial sanitation, it would help to abate a serious
nuisance. There are about 6,000 of these storm entrances in the City; and
recently a proposal has been made to cover them with an improved lid, at a
cost of nearly Rs. 5,00,000.