NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
407
APP. VI. J Measures in the Bombay Presidency and Sind.
were associated the Lady Doctors, Miss Duggan and Miss Nash, and
one or two nurses. And in every possible way the Lady Doctors
were most helpful—in searches, in treating the very few pardah sick,
and in giving confidence by their mere presence.
The successful exertions of Mr. M. D. Mackenzie and Mr.
Vaughan, I.C S., at Tatta, when they were well aided by Diwan
Shiwandas, the Vice-Président of the Municipality, and of Mr. Brayson
at Kotri, where Seth Lalchand, a Municipal Commissioner, maintained
the camp at his own cost, have been narrated.
To Seth Vishindas of Karachi, a very special tribute is due, both
for building and maintaining at his own charges a temporary hospital
where all castes were welcomed, and which was well managed to the
last, and also for establishing grain shops in the camps and in several
parts of the city at a time when, owing to the flight of the Banias, or
petty shop-keepers, grain was getting dangerously scarce. This bene-
volent gentleman sold the grain at cost price, and personally supervised
both shops and hospital, and is entitled to the special notice of Govern-
ment. The Acting Commissioner tenders to him his hearty thanks.
And also to another gentleman, Mr. Motiram Advani, is special re-
cognition due, who in an incredibly short time produced ample funds
for the Plague Relief Fund, and then rendered the signal service of
expending the money in the most judicious and careful way, so that the
sick and the nurses lacked nothing, and, so far as he could ascertain ;
the indigent and the orphan were helped.
Passing to other districts, Mr. Dodgson, I.C.S., the Collector of
Hyderabad, worked with an energy and judgment that had already
won the Acting Commissioner's high commendation, when the over-
strain, to some extent, caused by the attitude of the upper classes
who failed in the commencement to understand that plague results
from the transgression of certain laws, obliged him to take furlough
and leave his unfinished task.
Mr. C. E. S. Steele, who acknowledges in unqualified terms the
assistance he received from Mr. Gloster, took charge of the Collector-
ate, and carried his heavy and extensive charge safely through the
crisis, displaying qualities that won him general confidence. With
him were associated Surgeon-Lieutenant-Colonel Henderson, of whom
mention has been frequently made. Major Price, Commanding the
Baluch Regiment, and Surgeon-Captain Cater Jones, A.M.S.,
Major Price rendered the full assistance of the military, and himself
took charge of a part of the town. Surgeon-Captain C. Jones organised
and managed the camps. Of both officers the Collector speaks
highly, and also of Mr. Hiranand Khemsing, the President of the
408
Measures in the Bombay Presidency and Sind. [ APP. VI.
Municipality. To Mr. Hiranand it was specially due that the
plague measures were supported by the Municipality, and that
the opposition already alluded to quickly subsided. These offi-
cers were assisted by Mr. Knight, I.C.S., the Judge, who took
charge of a quarter, Mr. Rieu, I.C.S., who also is specially mentioned
by Mr. Steele as having prepared the Hyderabad report, by Captains
Fowler, Tighe and Southey, and by Lieutenant Dyke, by Mr. Divatia,
by Messrs. Hesketh and Bayliss, and by Surgeon-Major Avetoom
and Surgeon-Captain Jackson. Several Municipal Commissioners also
helped, among whom Mr. Kauramal did specially good work. The
Collector also favourably notices the work done by Diwans Manghirmal
and Thawardas, Mr. Rozare, Abkari Inspector, Mr. Chuharmal,
Public Prosecutor, Mr. Contractor, Head Master, Mr. Kotwal,
Municipal Secretary, and Messrs. Tarachand and Poredi, Health
Officers. Of the work of the Revd. A. Canney, C.M.S., and of
Miss Pigott, Zenana Mission, in Mr. Dayaram's Plague Hospital notice
has been taken.
In the Shikarpur District, Mr. W. H. Lucas, I.C.S., did a
splendid bit of work. The Collector awards him high praise. Surgeon-
Major Corkery and Mr. Ingle, the Secretary to the Municipality,
both Members of the Plague Committee, of which the Collector was
President, worked unsparingly. Mr. Mountford, at Rohri, conducted
the operations most successfully, and with an amount of personal
labour that secured to him the sympathy of the town. He was well
assisted by Mr. Tiloksing Jethsing, the Municipal Secretary, of whom
Mr. Mountford speaks highly. Surgeon-Lieutenant King, whose
management of the Plague Hospitals has been noticed, was helped
by the Sisters Seraphina, Isabel and Louisa, by Nurse Murray, and
by Miss Driscoll and the other Zenana Mission ladies. Among
other helpers in the operations are mentioned Mr. Bahadurji,
Sub-Judge, the late Mr. Harrison, of the Indus Conservancy, a
very earnest worker, Mr. Hayter, Assistant Superintendent of
Police, Mr. Dracup, Mr. Rochiram, the City Magistrate, who
deserves credit for taking his son to hospital and his family to the
Camp, Mr. D'Abreo and Rao Bahadurs Choithram Girdhardas and
Chandumal and Khan Bahadur Pir Baksh, Deputy Collectors
Rao Saheb Kimatsing, Mukhtyarkar, Seths Suliman and Motandas
the only two Municipal Commissioners who stayed to aid, Sanitary
Inspector Marker and Hospital Assistant Benjamin. Mr. Cook }
District Superintendent of Police, and Mr. Marston, Assistant
Superintendent, conducted the Police duties well. Rao Bahadur
Shaukiram, the Divisional Forest Officer, was very active in looking
after the comfort of the camps. Lieutenant Beadon and the men
409
APP. VI. ] Measures in the Bombay Presidency and Sind.
of the Wiltshire Regiment deserve special thanks, as do also
Lieutenants Leith, Hislop, and Bailey.
The Acting Commissioner cannot forget the support rendered
by the Principal Medical Officer, Sind District, at a time of great
anxiety, and begs to thank him for it,
Mr. E. Giles, Educational Inspector, merits special thanks for
the full assistance of his Department; and to Messrs. Dayaram
Gidumal and M. B. Tyabji cordial acknowledgment of their voluntary
service must also be conveyed.
The able and willing assistance afforded by Surgeon-Major Baker
has been frequently acknowledged by the Acting Commissioner, and
to Surgeon-Captain Borradaile also thanks are given for his readi-
ness to assist.
The Acting Commissioner would also beg permission to thank
Colonel Brackenbury, R. E., the Manager of the North-Western
Railway, and the officers of the railway, Messrs. Tickner, Bean,
Rickie, Strong, and Gwyther, for unstinted active practical help.
To Captain Finney, R.I.M., the Port Officer, the thanks of
the Acting Commissioner are also due.
The Collector of Karachi speaks of much help received from
K. B. Framroz, E. Panthaki, the Mukhtyarkar of Karachi, and Mr.
Phillipowsky, of the Customs, was a good Supervisor.
Many names have been left out. Where all Departments united
forces, it is difficult to mention everyone, and the Acting Commis-
sioner is aware that, even where plague never appeared, Deputy
Collectors and Mukhtyarkars worked hard to protect their charges.
The Acting Commissioner has endeavoured to present a picture
of the whole, but with this report must be read the report of the
Karachi Plague Committee, in which General Cooke describes with
fuller knowledge the operations subsequent to the formation of the
Plague Committee.
To the troops employed, to the Royal Artillery, to the Wiltshire
Regiment, to the Baluch Regiments at Karachi and Hyderabad, to
all ranks, the thanks of Government are due, not only for doing
unusual work well, but for mixing among the people kindly. General
Cooke set an example of personal courtesy that was followed by all.
That the contact has raised the British soldiers in the estimation of
the people there can be no doubt whatever.
The European population of Karachi met the approach of plague
without fear or clamour, with a quite helpfulness and confidence
that were of the utmost assistance in allaying panic among the
natives.
b 52
410
Measures in the Bombay Presidency and Sind. [App. Vî.
To the people the Acting Commissioner would offer his thanks
for the patient trustfulness with which the plague measures were
tolerated, and the general submission with which inconveniences were
put up with.
The co-operation of the people was the main factor in any suc-
cess attending the plague measures, and the plague, though it has
doubtless left many sore hearts, has left few bitter ones, and the
Acting Commissioner trusts many grateful ones. It has represented
the Government to the people in a new and striking attitude, send-
ing forth its officers of all Departments to heal the sick and stand
between the pestilence and the population, and the effect must be
to draw the ties closer, and awaken new thoughts in the minds of
the multitude.
To Mr. J. Sladen, I.C.S., Assistant
Commissioner, Mr.
Wingate is deeply indebted, and latterly also to Mr. H. S. Lawrence,
I.C.S., for bearing with marked ability a great share of the burden
of the work of the province, besides assisting in the special work
caused by the plague. They were ably helped by the Assistant
Commissioners, Mr. Whittle and Rao Bahadur Choithram, who
worked unceasingly to get necessary work through and avoid arrears
accumulating. To the Head Clerk, Mr. Cross, and to the whole
office who have worked so hard, and who do credit to the training
they have received in past years, the thanks of the Acting Commis-
sioner are given, and specially to Mr. Tahilram, the Plague Clerk.
Upon Mr. Quanbrough, the Superintendent of the Commissioner's
Press, and his staff, devolved very heavy work, which they, like the
Commissioner's Office, most cheerfully undertook.
In conclusion, the Acting Commissioner would desire to say
that, if any success has been attained, it is due to the magnificent
sense of duty which has inspired all officers. If this report fails to
convey the admiration and thankfulness which the Acting Commis-
sioner feels towards the very fine body of officers serving in Sind,
it is the fault of his pen. He is conscious of an earnest desire as
the events pass in rapid succession to name those chiefly associated
with each detail of the operations.
Karachi, 21st September 189*7.
411
APP. VI. ] Measures in the Bombay Presidency and Sind.
No. 3.
Other papers regarding Karachi.
LETTER FROM THE GOVERNMENT OF INDIA, No. 367,
DATED THE 6TH JANUARY 1897.
I am directed to forward, for the information of His Excellency
the Governor in Council, a copy of a note written by Surgeon-Major-
General Cleghorn, Sanitary Commissioner with the Government of
India, on his recent visit to Karachi.
2. His Excellency in Council will observe that the facts elicited
by Dr. Cleghorn's investigation have led him to the conclusion that in
Karachi, as in Bombay, the disease is only slightly, if at all, either
contagious or infectious in the common acceptation of these terms,
and that the incidence of the disease is mainly due to local causes.
3. The Government of India notice with great satisfaction the
success that has been achieved by the authorities at Karachi in
preparing and arranging for the sanitation of camps of huts in the
open, and in securing the removal of the inhabitants of the infected
quarters of the city to these camps, and they trust that these measures
will help greatly in checking the disease. They are sure that the
Government of Bombay will agree with them that the zealous
endeavours made 'to bring about these ends by Mr. Wingate, the
Commissioner in Sind, Mr. Giles, the Collector and Magistrate, Mr.
Strahan, the Secretary to the Municipal Committee, and Dr. Kaka, the
Health Officer, are deserving of great credit.
4. The Governor General in Council desires specially to commend
to the consideration of the Government of Bombay the following
suggestions made in Dr. Cleghorn's note :—
(a) That Dr. Arnim, the Deputy Sanitary Commissioner now in
Karachi, should be placed in medical charge of the
different camps, in which Dr. Cleghorn points out that
the population will require careful supervision.
(b) That a house evacuated should not be re-occupied until its
interior has been thoroughly cleansed, disinfected
and whitewashed, and that these measures should be
extended as widely as possible.
(c) That permission should be refused to the re-occupation of a
house or room until it is placed in a proper state for
habitation.
(d) That overcrowding in houses and rooms should be pre-
vented.
412
Measures in the Bombay Presidency and Sind, [ APP. VI.
(e) That a Commissioned Medical Officer should inspect the
railway passenger traffic at Karachi City Station, accom-
pany the trains to the Cantonment Station and inspect
passengers who may enter at that station.
5. In conclusion, I am to say that the Government of India will
place more medical officers at the disposal of the Government of
Bombay if His Excellency in Council considers that more officers are
needed.
No. 4.
NOTE BY SURGEON-MAJOR-GENERAL CLEGHORN ON
KARACHI.
The first case of the disease was reported to, and observed by,
Dr. Kaka, the Health Officer, on the 10th December. The indivi-
dual attacked was a cook to a Hindu merchant, whose house was
situated in the Bunder quarter of the city. He was said to have
landed from Bombay on the 8th or 9th December, but the evidence on
this point is certainly not clear, was attacked with fever on the latter
date, and died on the 10th, with all the symptoms of plague. When
the fever declared itself, the man was removed from the house in the
Bunder quarter, to another in the Ranchore quarter, where he died.
No other case has occurred in either of these houses.
The second observed case appeared on the nth December in the
old town quarter in the person of a broker, whose office is in the
Bunder quarter in close proximity to the house in which the first
case occurred, but his residence was situated in the Old Town
quarter.
Beyond the above there appears to be no clear and distinct evi-
dence of the importation of the disease into Karachi by human inter-
course, but it is admitted that cases may have occurred previous to
those noted, although not reported.
As in Bombay, the appearance of the disease was followed by a
great mortality among rats.
The population of the City of Karachi according to the census of
1891 amounted to 98,195, one-fifth of that number may be added for
natural increase, which will bring the present population up to 117,834.
The town, excluding Cantonments and Harbour, is divided into 31
quarters or wards, and up to 24th January 606 deaths have been
reported from 14 of these wards; the remaining 17 have been entirely
4î3
APP. VI. 1 Measures in the Bombay Presidency and Sind.
free. The incidence of these deaths in the fourteen wards was as
follows :—-
No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
Quarters.
Ranchore ...
...
...
...
Old Town
...
,.,
...
Machi Miani
,.,
...
...
Market
...
...
...
Bunder
,.,
...
•••
...
Napier
...
...
...
Lyari
...
Serai
...
...
...
...
Garden ...
...
...
...
Sadar Bazaar
...
...
...
Ramswamy
,.,
...
...
Rambagh ...
...
...
...
Civil Lines
i..
...
»,.
Jail (the quarter so called)
...
,.,
Total
Number
of
deaths.
5
407
66
49
22
18
13
2
10
1
I
I
I
10
606
Estimated
population.
8,986
11,489
3.721
8,107
1,277
10,274
27,056
4,916
7,494
9.087
1,777
3,758
1,394
4,565
...
The worst parts of the town are the quarters named Old Town,
Machi Miani, Market, and Bunder, where the greatest mortality has
occurred. The two former face the bed of a dry stream, extending
backwards until they become contiguous with the other quarters.
Many of the houses I visited in the quarters abovenamed were quite
unfit for human habitation, there were no openings for the admission
of air and light, the rooms were overcrowded, and the inmates lived in
complete darkness. The Old Town is the worst in these respects,
but the overcrowding in houses and of ground area is common to all.
Of the 59 ascertained deaths from plague which were reported up
to 31st December, 49 or 83'1 per cent, occurred in the Old Town,
and of the total 606 deaths, 407 or 67'1 per cent, were reported
from the same quarter.
It must also be noted that many of the deaths reported from other
quarters occurred in fugitives from the Old Town.
414
Measures in the Bombay Presidency and Sind. [ App. VI.
The death-rate from plague in Karachi City has, therefore, been
only 0'52 per cent, of estimated population, and in the worst quarter
where the greatest mortality has occurred, only 3'5 per cent, on the
estimated population of that quarter. This, T think, proves that the
disease, as in Bombay, can only be slightly, if at all, either contagious
or infectious in the common acceptation of these terms, and the follow-
ing additional facts warrant me, I think, in coming to the conclusion
that the incidence of the disease is due to local conditions.
1. No death has as yet been reported from any of the houses on
the exposed edge of the town, i.e., on the one with a frontage to the
dry bed of the stream.
2. Comparatively slight extension in the other quarters, and that
only in the worst houses.
3. Lyari, a suburb, containing an estimated population of 27,000
locally said to be 30,000, situated a quarter to half a mile from the
Old Town, Machi Miani and market, is in constant communication with
these quarters and receiving fugitives from them. Only 13 deaths up
to 24th January. The houses in this suburb are scattered over a large
area, and are as a rule of small size. There are numerous gardens
and open spaces in the area.
4. Khudder, a village, with a population of 2,000, chiefly fisher-
men, situated half a mile from the town—women of the village,
proceed daily to the town to sell fish, but there were only two deaths
up to 26th January. The village consists of huts, each occupied by
a single family.
5. Keamari, a village near the port, with a population of 2,378.
No deaths from plague.
6. No deaths reported among coolies connected with the ship-
ping.
7. Eighty police employed in the city during the 24 hours. No
deaths.
8. The immunity enjoyed by officers and subordinates of Health
Department.
The houses in which a death has occurred are marked thus
,
and the mark is repeated for each death. In visiting
parts of the
city with the officers of the Health Department I was struck with the
localization of these marks and their absence from the better class of
houses.
The measuers which have been taken, and are still in progress
towards arresting the spread of the disease, are cleansing and disin-
fection of houses in which a death has occurred, greater attention to
general cleanliness and, when possible, removal of the healthy from
infected houses.
415
APP. VI. ] Measures in the Bombay Presidency and Sind.
On the nth January the construction of mat huts on a large
space of open ground near the town was commenced, but the people
could not be induced to occupy them until the 24th, when the head-
men of the Hindus living in the Old Town agreed to the exodus. On
the 27th January, there were nearly 400 huts erected, which were
then occupied by 2,500 to 3,000 people.
The huts are built separately and arranged along wide streets,
water is laid on and all sanitary arrangements are attended to,
The Muhammadans and Kutchers have also agreed to turn out of
their houses, and huts are now in course of construction for their occu-
pation.
A population living under these conditions will require careful
supervision, a Civil Officer has been detailed for the duty. I also
recommend that the Deputy Sanitary Commissioner, Dr. Arnim, now
in Karachi, should be placed in medical charge of the different camps.
The Bombay Government might be informed that, if further
medical assistance is required, officers can be supplied on application
to Government of India.
A house evacuated is not to be re-occupied until its interior has
been thoroughly cleansed, disinfected and whitewashed, and these
measures should be extended to the other houses in the city.
In addition to these measures it appears to me to be necessary for
the future safety of the city that all houses, declared by the local
medical authority to be unfit for human habitation, should be demolish-
ed, and the ground acquired by the Municipality.
That the local authorities should be authorised to refuse permission
to the re-occupation of a house or room until it is placed in a proper
state for habitation, and a law should be passed to prevent overcrowd-
ing in houses and rooms.
*
*
*
*
*
*
It is, I think, generally accepted that the limit of incubation of
the plague in a human being is eight to nine days. The facts which
have come to my notice support this view, and I would recommend that
quarantine should be limited to ten days.
It was suggested to me when in Karachi, that as the Municipal
Committee is making such great endeavours to stop the progress of
the disease, their efforts might be frustrated by allowing passengers
from Bombay to land immediately on arrival of the ships, and they
think that a quarantine of ten days from date of departure from Bombay,
when no case has occurred on board, might be imposed on all arrivals.
The cargo to be landed in the ordinary course. This appears to
be appropriate and justifiable, but Mr. Wingate, the Commissioner,
declines to recommend its adoption until it can be clearly proved that
arrivals are followed by fresh importation of the disease.
416
Measures in the Bombay Presidency and Sind. [ APP. VI.
The inward passenger traffic by rail is carefully watched by
medical subordinates on the main line, and on those to Quetta and
Hyderabad, but I think it advisable that a Commissioned Medical
Officer should inspect at Karachi City Station and accompany the train
to the cantonment station and inspect passengers who may enter at
that station.
This Medical Officer would be under the orders of the Commis-
sioner or Magistrate, and would be available for any other duty
connected with the plague.
The arrangements now being made at Karachi will be watched with
interest, as if the removal of a whole or portion of the inhabitants to
huts proves ultimately successful, the procedure may be followed with
advantage elsewhere.
*
*
*
*
*
*
*
2nd February 1897.