NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
APP. VI. ] Measures in the Bombay Presidency and Sind,
353
stationed as guards at the hospital and segregations camps and (from
April 26th) those who did duty as watchmen at the burial and burn-
ing grounds. When the work of the military search, fumigation and
limewashing parties ceased, the majority of the troops employed
returned to military duty and the camp at Parvati was broken up.
The native infantry who were retained for segregation and death
registration work were moved to the General Segregation Camp,
while the few men of the cavalry and the British regiments who
remained on plague duty were allowed to live in their regimental
lines.
3. Appendix 54 shows the chief alterations made from time to
time in the constitution and strength of the search, fumigation and
limewashing divisions, and gives other particulars regarding the
employment of the troops. Appendices 55, 56 and 57 are tabular
statements relating to guards on hospitals and camps, night picquets,
and transport and ambulance respectively.
4. Disciplinary powers over the troops employed on the operations
were vested in Major Paget, Commandant of the Plague Duty Camp.
That officer's report, dated 20th May 1897, on the conduct and health
of the troops is annexed (Appendix 58). The members of the Plague
Committee concur with Major Paget in the high opinion he has express-
ed on the conduct of the troops, both Native and British. The discip-
line of the troops when at work in the city was excellent and the
utmost consideration was shown both by officers and men for the reli-
gious and social customs of the inhabitants. I may mention that
reports on the conduct of the men who worked under them were
called for from the officers commanding the various working parties,
and that the reports received were without exception favourable as
regards both British and Native troops.
5. That the conduct of the men when engaged on plague work
was so good is doubtless chiefly clue to the fact that they were under
the immediate command of British officers who were responsible for
their discipline and good conduct just as they would have been if they
had been employed on military duty. In the case of the search divi-
sions, the supervision was particularly close. Jt was one of the prin-
ciples of the search that the parties of a division should be kept
together as much as possible, and the officer commanding the division
was therefore seldom far away from any of the parties under him.
In the case of the fumigation and limewashing divisions the
supervision was not so close, as the exigencies of their work often
compelled the parties of a division to work at a distance from each
other. The limewashing and fumigation parties were, however,
visited from time to time in the course of their morning's work by
b 45
354
Measures in the Bombay Presidency and Sind. [ APP. VI.
the officer commanding them. A statement of the orders issued to
the troops from time to time regarding their work and conduct will
be found in Appendix 59.
6. During the first few days of the work of the troops in the
city many applications, written and verbal, relative to the operations,
were, as might be expected, made to myself and the other members of
Plague Committee. Most of these related to inconveniences or losses
alleged to have been caused to individuals by the work of the troops.
Some of the inconveniences pointed out were inseparable from the
operations which we were conducting, while others we were able
to prevent the recurrence of by the issue of standing orders. When
complaints of theft were made and the information necessary to trace
the culprits was not given, the applicants were referred to the police.
As our rules got to be understood by the people of Poona and our
organization got more perfect, the number of applications diminished,
and during the latter stages of the operations comparatively few
complaints were received by us regarding the work of the troops.
In order to check the making of false and frivolous complaints and
at the same time to facilitate inquiries into complaints that might
be well founded, we published a notification on March 26th (vide
Appendix 4) to the effect that all complaints relating to the behaviour
of the men employed on searching, fumigating and limewashing should
be made on the spot to the officers commanding the divisions to which
the men complained against belonged. The officers have been alive
to the necessity of maintaining a high standard of conduct among
their when, and it has never //ill/ alleged to the Committee that an
officer "as failed to inquire in //ill/ reasonable complaint which had
been made to him.
7. The offences brought home to the troops engaged on plague
duty are specified in Major Page: 3 report. The complaints made
to the officers commanding search divisions, which were found to be
false, included three of theft. Besides these a few minor complaints
of such matters as entering god-rooms and cook-rooms unnecessarily
were made to the officers, but where the men had offended the
prejudices of the people in this way they appeared to have done so
through ignorance. One unproved complaint of theft was made to
the officer commanding a fumigation division and another to the
officer commanding the main picquet. Some complaints of the
needless destruction of property, as rubbish, were made against the
limewashers to the officer commanding the division, but they were
generally found by him to be untenable. The orders passed to
prevent needless destruction of property have already been referred
to. It was a matter of great satisfaction to the members of the
App. VI. ] Measures in the Bombay Presidency and Sind.
355
Plague Comrnitte that no credible complaint that the modesty of
r. woman had been intentionally insulted was ever made either to
themselves or to the officers under whom the troops worked.
8. The troops at the plague duty camp were under the medical
charge of Surgeon-Lieutenant Kiddle. The men were paraded daily
before they left the camp for plague duty, and men found not to be
In thoroughly good health were not allowed by the medical officer to
proceed. The health of the troops is reported by Surgeon Lieutenant
Kiddle to have been excellent, a result which is no doubt due to
regular hours, good feeding and the careful supervision which he
exercised. Not a single case of plague occurred among the troops
employed. The total number of admissions to hospital from March
12th to May 19th was among British troops 70 and among Native
troops 19. The majority of the admissions were due to minor ail.
ments, and only 19 cases (12 among British and 7 among Natives) were
of sufficient importance to call for the transfer of the patients from
camp to a regular hospital. The only case that ended fatally was
one of heat-apoplexy. The victim was a man of the Royal Irish
Rifles who is believed to have contracted his illness through his own
imprudence.
9. I have much pleasure in acknowledging on behalf of my col-
leagues on the Plague Committee as well as on my own account the valu-
able assistance which we have received throughout the operations from
Major Paget. His unfailing tact and courtesy have contributed in no
small degree to the success of our measures. In the opinion that he has
recorded regarding the officers and men engaged on the operations
we fully concur. In addition to the good work that he has acknow-
ledged we desire to place on record our appreciation of the work clone
by Lieutenant Mackenzie and subsequently by Lieutenant Owen
Lewis in connection with death registration and the supervision of
burial and burning grounds. We consider that the work that has
been carried out by Major Paget and the officers and troops under
him has been most successfully performed, and that it is chiefly due
to their exertions that the plague in Poona has been practically
stamped out.
XV.—FINANCIAL.
The time has not arrived for making up complete accounts of the
expenditure on the plague operations at Poona. I will therefore
confine myself to showing theallotments which were made by Govern-
ment up to the 31st of May to meet the cost of the operations, and
the disbursements which were made therefrom up to that date.
356
Measures in the Bombay Presidency and Sind. [ APP. VI.
2. The following statement shows the allotments that have been
made to myself and the Poona Plague Committee :—
Number and date of Government Resolution sanctioning allotment.
1216/716.P. of 6th March 1897
1782/1242.P.1st
April 1897
1903/1319.P. 7th April 1897
2536/1956.P.10th
May 1897
TOTAL
Amount.
Rs.
10,000
20,000
60,000
40,000
1,30,000
3. The disbursements made from the abovementioned allot-
ments up to 31st May 1897 are shown below: —
Item.
:
Advances—
To Camp Commandant for pay of troops, etc....
To Chairman, Suburban Municipality, for main-
tenance of General Plague Hospital, etc.
To City Police Inspector
To Medical Officers ...
To Secretary, City Municipality ...
TOTAL
Establishments (including day labourers)—
Conservancy
...
...
Sanitary ...
Nurses
Medical Officer on inoculation duty
Inoculation (subordinate establishment)
Plague office
Female searchers
...
...
Warehouse
...
Burial-grounds
Corporal sent to Bombay
Plague Police
Store-house and work-shop
Bombay Inspector lent for duty at Poona
TOTAL
Amount.
Rs. A. P.
56,999 11 4
22,000 o o
100 o o
185 o o
50 11 o
79.335 6 4
14,321 2 8
993 8 4
564 10 10
425 12 11
46 7 8
49 13 2
952 10 11
32 8 3
265 5 4
21 4 o
153 7 8
659 13 8
118 4 o
18,704 13 5
APP. VI.] Measures in the Bombay Presidency and Sind.
357
Item.
General Segregation Camp (construction)
,,
,,
,,
(maintenance)
Railway charges
...
...
...
Cooly hire
Cart hire
...
Conveyance hire
General Plague Hospital (construction)
Mahomedan do.
(grant-in-aid)
Water-supply charges
Burial charges
...
...
...
Compensation
Disinfectants
...
Telegraph charges
...
...
Printing charges
...
Service stamps
,..
Maps and stationery ...
...
Deadstock and furniture
...
...
Oil
Warehouse rent
Conservancy expenses
Inoculation expenses
...
...
TOTAL
Amount.
Rs.
6,814
3.465
292
8
1,090
1,321
7,000
1,000
458
308
1.333
2,518
676
142
60
53
986
99
7
1,402
53
1.27,133
A. P.
o o
11 5
8 3
10 3
10
0
0 0
0 0
0 0
11
11
8 9
9 o
10
0
1 0
2
0
0 0
7 o
7 8
5 1
10 3
14 4
3 o
5 8
XVI.—CONCLUSION.
Paragraphs I to 3 missing.
4. In conclusion I would record my opinion that if a reasonably
high standard of sanitation is to be maintained in the city of Poona,
and the work that has been done there under Surgeon-Major Barry's
supervision is to have lasting results, European control will for some
time to come be absolutely necessary. The exact shape that control
should take is a matter of detail, but I am convinced of the futility
of expecting that the sanitation of the city will be better in the near
future than it has been in the past, unless it is under the direction of
a supervising authority that possesses practical knowledge and
appreciation of Euorpean standards of cleanliness.
353
Measures in the Bombay Presidency and Sind. [ APP. VI.
Report on Sind by Mr. Wingate, Acting Commis-
sioner.
First protective
measures.
Sea quarantine.
On the 3rd October 1896 the Karachi Chamber of Commerce
addressed the Commissioner in Sind through their Chairman, the
Honourable Mr. McLellan, suggesting that precautionary measures
against the introduction of plague from Bombay should be taken,
such as subjecting the passengers of vessels arriving to a medical
examination. The imposition of quarantine was not recommended.
Next day a letter was received by the Commissioner in Sind front
the Principal Medical Officer, Sind District, inquiring as to the state
of the law in respect to dealing with vessels and passengers infected
with plague. The Honourable Mr. James on the 5th idem com-
municated with Government by telegram, and under Notification,
dated 13th October 1896, No. 4530, Government published rules for
quarantine against plague in the port of Karachi. Under these
rules, no communication with the shore was permitted till the
Health Officer of the Port had ascertained by inquiry from the
Commander whether any person on board had suffered from plague.
If there had been no plague, pratique was granted. If there had
been plague, the passengers and crew were to be removed to the
quarantine station for a period varying from 8 to 15 days.
No. 2.
Quarantine
arrangements.
The Commissioner in Sind immediately took steps, in consulta-
tion with the Principal Medical Officer, Sind District, and the
officers of the port, to increase the accommodation at the quarantine
station at Manora and to provide extra police for enforcing the
restrictions imposed. To consider these questions, a meeting of
officers assembled at Government House on the 10th October under
the presidency of the Honourable Mr. James, and it was arranged
to fit up the hulk Manora for Europeans and to erect sheds for 300
native passengers in addition to the accommodation for 100 already
existing, the expenditure to be divided between Government, the
Port Trust, and the Municipality. The two latter bodies subse-
quently intimated their consent to contribute one-third share each.
The operations were entrusted to Mr. Jackson, the Officiating Port
Engineer, and, with commendable despatch, he reported on the
24th October that everything was ready for occupation.
Rs.
* Spent by the Port Engineer 6,517
Spent by the Health Ofiicer 5,136
These proceedings were reported to Government, and by Gov-
ernment Resolution No. 5202, dated 26th November 1896, General
Department, Government sanctioned the estimated expenditure for
temporary quarantine accommodation
and also the expenditure for estab-
lishment and other expenses to be
incurred by the Principal Medical Officer, the cost* to be divided as
Apr. VI ] Measures in the Bombay Presidency and Sind.
359
proposed. Government approved the entertainment of the addi-
tional police, the exact strength and cost being finally sanctioned by
Government Resolution No. 1672, dated 2nd March, 1897, Judicial
Department. The Port Trust placed a steam-launch at the disposal
of the District Superintendent of Police.
Ships in quaran-
tine.
; First case.
The rules required that healthy ships to secure pratique must
carry a medical man. One or two coasting steamers neglected this
rule, and on board other steamers death from plague had occurred.
Thus a considerable number, between 600 and 700 persons at a
time, were detained in quarantine, necessitating increased accommo-
dation. The Collector of Karachi, at the instance of the Honourable
Mr. James, early in December, made arrangements for the supply
by private charity of food to those persons in quarantine who were
indigent. The administration of the quarantine rules and arrange-
ments was supervised by the Principal Medical Officer, Sind District.
On the 16th December, while on tour, the Acting Commissioner
in Sind received intimation from the Health Officer through the
Collector of Karachi of what was reported to be a " doubtful " case
of plague. A Brahman cook, aged 16 years, resident for 9 months
in Karachi, stated to have taken ill about the 4th December, was
reported on the 8th to the Health Officer to be suffering from
bubonic fever, There was high temperature and a bubo. The same
evening the patient was removed from Rampart Road, Bandar
Quarter, to a house in Maoji Street, Ranchor Quarter, where next
morning he died. Thus early began that removal from place to
place which to the last was difficult to deal with.
Disease breaks
out in Karachi.
The Acting Commissioner directed definite medical inquiry, but
on the 18th he received the Health Officer's report, dated the 12th,
which left no doubt that the disease had broken out in Karachi, and
the facts narrated below were reported to Government.
An old servant of the firm of Radhakishn Tejbhandas & Co.
died on the 11th December after, it was said, a 12 days illness.
Another servant of the firm, aged 28, also living in the old town
quarter, was seen by the Health Officer on the 11th and found to
have a temperature of 103° and swellings in both groins. In a
house close by, in which four persons had died in the course of a
few days, including a child seen by the Health Officer on the 11th,
another child, aged 5 years, was found sick. On the morning of the
12th the Health Officer took the Deputy Sanitary Commissioner,
Sind Registration District, to view the cases.
Plague declared
epidemic in
Karachi.
On the 19th December, at their usual weekly meeting, the
Medical Board declared plague epidemic in Karachi. Their report-
360
Measures in the Bombay Presidency and Sind [ APP. VI.
reached the Acting Commissioner on the 22nd, and was the same
day communicated to Government by telegram, and the Principal
Medical Officer was asked for daily reports of attacks and deaths.
These facts leave little doubt that, from the beginning of De-
cember 1896, the disease had got a footing in Karachi. There was
nothing in the mortality statistics to indicate the presence of the
disease.
Mortality statis-
tics.
-
Week ending
6th October 1896
13th
20th
„
,,.
...
27th
3rd November
...
...
10th
„
...
...
17th
24th
„
...
1st December
...
8th
15th
„
22nd
„
DEATH FROM ALL
CAUSES.
Total.
6l
59
54
59
72
74
85
86
104
average.
7
9
8
8
8
AVERAGE DEATHS OP
S YEARS
ENDING
1895.
Total,
65
56
58
58
62
65
69
67
82
Daily
average.
9
8
8
8
9
9
Undetected
cases.
Alterations of
quarantine rules.
The usual deaths amongst cases classed " imported " are want-
ing in the history of the introduction of plague into Karachi. Since
October there had been numerous arrivals from Bombay in Karachi.
The Health Officer states that there was medical examination of
passengers on board healthy vessels, but there was nothing to pre-
vent persons slightly affected with the disease walking ashore. The
quarantine rules had failed to protect Karachi, and it was useless
to maintain them. The question was mooted by the Principal
Medical Officer in his letter to the Commissioner in Sind, dated 4th
January 1897, and was brought to the notice of the Government of
India a little later by Messrs. Mackinnon, Mackenzie & Co.
APP. VI.] Measures in the Bombay Presidency and Sind.
361
The municipality were in favour of more stringency, by imposing
ten days' detention on all arrivals, and the Principal Medical Officer
and the majority of the Managing Committee of the Chamber of
Commerce were in favour of maintaining the existing rules. After care-
fully considering these questions; the Acting Commissioner informed
Government that the disease was thoroughly established locally, and
that there was no evidence of any imported cases occurring, and there-
fore the imposition of a more rigid quarantine was uncalled for. In
his opinion, a searching medical examination of passengers departing
from Bombay, and an equally rigorous scrutiny at Karachi, should be
substituted for the present rules. It was singular that, notwithstand-
ing the detention of between 1,500 and 1,600 persons arriving at
Manora, not a single case of plague had been detected. Government
approved these suggestions, and by Notification No. 592, dated 3rd
February, 1897, the rules of 13th October, 1896, were amended so as to
introduce compulsory individual medical inspection, and the compul-
sory isolation of any sick discovered, and the segregation of persons in
immediate contact with the sick or with any one who had died, and
suspicion was made sufficient authority for action.
The Port Officer, Commander Shopland, had questioned
whether much faith could be placed on the class of medical officers
that could be procured for a temporary job on board a steamer for
Rs. 100 per mensem, and he had little doubt that plague had been
introduced through allowing vessels to land passengers freely when
no case of sickness was reported, The voyage from Bombay need
not take longer than 36 hours.
Course of
epidemic up to
end of December,
Up to the end of December 1896,63 cnses of plague, all local,
reported in Karachi. Fifty-one of these cases occurred in the old
town. The deaths reported were as under:—
During week ending l0th December
„
„
1 7th
„
„
„
21th
„
„
3 1st
„
.
1
9
21
...
28
Inspection of
passengers by
rail.
or a total of 59. In a telegram received on 1st January 1897, Gov-
ernment directed that arrangements should be made for medical ins-
pection of passengers at Karachi and the principal rail way stations
in Sind. The Principal Medical Officer was requested to arrange for
efficient inspection, and on the same date, the 1st, all district
officers were required to adopt, in consultation with the medical
and railway officers, such measures as might be possible to prevent
infection spreading.
On the same date, the Collector of Karachi was asked to return
from his tour to Karachi, to supervise measures necessary to prevent
b 46
362
Measures in the Bombay Presidency and Sind. [ APP. VL
infected persons leaving and the disease spreading, whether within
or without Karachi, and Mr. Giles most promptly responded and
remained at headquarters throughout the epidemic.
Municipal work.
Dr. Kaka's sug-
gestions.
Conference.
Segregation.
Meanwhile, the Municipality of Karachi had not been idle. It
appears that early in October, 1896, the Health Officer, Dr. Kaka,
called attention to the necessity for special sanitary vigilance, and
on the 16th December following he addressed a letter to the President
of the Municipality, representing that he had already experienced
opposition, and the residents of houses where cases had occurred had
flatly refused to permit disinfection of the rooms occupied by the sick.
Dr. Kaka, therefore, strongly urged the necessity for increased
powers, advocating (1) compulsory notification of sickness by the
inmates of the house and by the medical attendant, (2) compulsory
segregation of the sick in specially provided hospitals for each com-
munity, (3) compulsory disinfection and limewashing, (4) destruction
of infected articles, as clothing, bedding, etc. Next day, a conference
was held at the house of Rao Bahadur Alumal Trikamdas, B.A., Deputy
Educational Inspector, where several of the headmen of the Hindu sects
were present, and at which the President, Engineer and Secretary, and
the Health Officer of the Municipality attended. Here Dr. Kaka's
proposals underwent considerable alteration. Dr. Kaka said he would
not object to allow patients to be segregated in their own houses,
"but in the case of the very poor and in the case of tenement houses
where more than one family resided," it would be absolutely necessary
to remove the patients to isolation hospitals. On the 21st and 23rd
December the Corporation passed resolutions omitting compulsory
notification of sickness by residents and limiting compulsory removal
to hospital of cases where, in the opinion of the Health Officer or of any
duly qualified medical practitioner, the sick person was without proper
segregation accommodation. Where the Health Officer or any such
medical practitioner certified there was proper segregation, the patient
was to remain in the house.
Detection of
cases and
segregation.
The Deputy Sanitary Commissioner, Surgeon-Captain Arnim,
who had been active in visiting cases, on the 19th December reported
the existence of plague in Karachi to the Sanitary Commissioner with
the Government of Bombay, and also wrote to the Municipality,
suggesting that every effort should be made to procure information of
sickness, and that, " where possible and in cases where accommoda-
tion is unsatisfactory, attempts should be made to isolate the patient."
The Sanitary Commissioner, Surgeon-Lieutenant-Colonel Clarkson,
writing on 25th December, strongly advocated compuslory isolation of
the sick. The attention of Surgeon-Captain Arnim and of the Karachi