NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
APP, II.]
Previous history of plague in India.
83
1755. Moscow was the scene of an outbreak in 1770, and in 1813
the disease prevailed at Malta and in 1834 at Cairo.
In India the disease has ever had a home, and prevails off and on
till the present day in British Garhwal and Kumaun. In 1813
the plague was present in Central India and Rajputana, Kutch and
Kattywar and was first noticed at Kumtakole, and spread throughout
Wagar during January, February and March 1816, and by the end of
that year had extended to Scinde where the mortality was great.
The disease was still prevalent in Central India in 1819 and dis-
appeared in 1821. Nothing more was heard of the disease in Central
India till July 1836, when it broke out at Pali, a town of Marwar,
whence it spread to Jodhpore. It prevailed at Deoghur, in Meywar,
in March 1837, and thereafter extended to Jalia and Ramghat in the
district of Ajmere. The disease all but disappeared towards the end
of 1837, but in November of that year it again broke out in epidemic
form at Pali, and continued till February the following year.
It is more than probable that the plague was introduced into Pali
and Rajputana in 1837 from the Levant, as the " Chhipis," who
printed the pieces of plain cloth brought from the coast from Bhow-
nagar and Surat. were the first effected,
D
*
3. The Himalayan districts of the North-Western Provinces in
which the disease occurs comprise—
(1) Garhwal bounded on the north by Tibet, on the east by
Kumaun, on the south by Bijnor and on the west by
Tehri and Dehra Dun, and
(2) Kumaun now divided into two revenue districts, Almora
and Naini Tal, bounded on the north by Tibet, on the
east by Nepal, on the west by Garhwal and on the
south by the Tarai.
These contiguous districts lie between north latitude 28° 14' 15"
and 31° 5' 30", and east longitude 76° 6' 30" and 80° 58' 15", and
embrace an area of 11,038 square miles.
4. The population numbers close on 1,000,000 souls with an aver-
age of 72 to 76 persons to each square mile, living at elevations from
1,500 to over 11,000 feet above sea-level. For practical purposes the
entire population may be classed as Hindu, as very few Musalmans,
etc., are natives of the hills. The greater proportion of the popula-
tion live at from 3,000 to 6,000 feet above sea-level, overlooked by the
crowning peaks rising from 20,000 to over 25,000 feet of the great
Himalayan range.
5. Outbreaks of the plague in these Himalayan hill tracts, the
most mountainous in the world, are of two kinds—
1st, spontaneous outbreaks ;
2nd, outbreaks caused by importation of the disease.
Previous history of plague in India.
[ APP, II.
Spontaneous outbreaks are frequently associated with, and some-
times preceded by, a great mortality among rats, mice and other
rodents, etc,
6. The plague or pestilence of the hill tracts is distinguished from
all other fatal febrile malignant diseases by its extreme virulence,
rapid course, fatality, and by the enlargement of the lymphatic
(inguinal, axillary, cervical, etc.) glands,—the characteristic lesion of
the disease when death does not ensue within the first three days
from extreme virulence and direct shock of the great nerve centres,
It has the shortest period of incubation probably of all known diseases,
and it may prove fatal within 24 to 48 hours after exposure to infec-
tion, and there is clear evidence that the disease is communicable
from the sick to the healthy.
7. The disease appears ever and anon in village or hamlet situat-
ed " on precipitous mountain side, in gorges reached only by means
of a cradle swung on a rope above a boiling flood of snow water low
down in a hill valley, in secluded spots reached by dubious pathways
winding up a wooded glen starting from the river far below, or up-
land slope close to the sources of a river formed by a waterfall, in
secluded places, wilder it would be hard to find in all the hills reach-
ed by a footpath winding over a high mountain and near where the
Margari stream arises in cuplike valley surrounded by high moun-
tains, on a spur hillock-shaped, on the slopes of opposing mountains,
on hills of moderate height, in bends of a river hemmed in by the
hills, on three sides on the brow of a hill which stands out from the
mountain behind it, on the slope of a great mountain overlooking
the valley in which the river runs, on green hillock backed by high
mountains, and on a spur of rock jutting into a narrow valley,"
overlooked by the highest Himalayan peaks capped with the eternal
snow. Here, where the atmosphere and climate are the finest and
purest in the world, and at heights where the germs and microbes of
disease are kept within a narrow sphere, exists a disease which in its
infectious nature and fatality surpasses all others in virulence, and
ever threatens to break bounds and spread and be disseminated far
and wide as in past times throughout Christendom. Cholera spares
some of the household, but the plague often reaps each one of the many
members of the upland home. So dreaded is the disease, that family
ties in its presence are suddenly broken, and the father and mother
flee from their children and abandon each other, seeking the lone
mountainside in despair for a time of all human association.
8. The earliest record of the disease in the hill tracts is embodied
in a report, dated 25th April 1836, by Mr. Gowan, the Commissioner
of Kumaun, in which it is stated that mahamari, which was thought
APP. II. ]
Previous history of plague in India.
85
communicable by contact with articles in use in an infected tract, first
appeared at Kedarnath in 1823. It originated, it was affirmed, in the
person of the Rawal or the high priest of the celebrated temple there
who, having in that year deviated from the rules prescribed in the
Shastras for the performance of the religious ceremony called the
" Home," was smitten with this new form of disease and died together
with the Brahmans who assisted at the offering. From Kedarnath the
disease spread to the villages in religious assignment to the temple,
and afterwards appeared in other parganas of Garbwal. Others said
that the disease came into existence for the first time at the Hardwar
Fair.
9. In 1834-35 the appearance of the disease in the parganas of
Nagpur and Badhan Garhwal was preceded by a great mortality
among the rats in a village. The disease was characterised, it is
stated, by fever terminating fatally in two, three or four days, and
associated with an eruption of bubos or swellings.
10. During 1837 the disease was alarmingly prevalent in the par-
gana of Badhan along the higher parts of the Pindar river, and in
1846-47 it found its way to the sources of the Ramganga and almost
entirely swept away the population of Sarkot, situated at 7,000 feet
on a high easterly spur of the great mountain Duder Ka Toli in patti
Lobha, and also to a village near the source of the Kosi in patti Bora-
rau, Kumaun proper. In 1847 a village, 15 miles west of Almora,
situated among the pine forest of Siyahi Devi range, was attacked,
and in the latter end of 1848 a few villages along the fatal line of the
Pindar river were threatened with a return of the disease. During
the rainy season of 1849 it broke out with great virulence in patti
Chaprakot, pargana Chadpur, and proved very fatal in the villages of
Marora and Dadoli, and the Senior Assistant Commissioner of Garh-
wal, Mr. Strachey, now Sir John Strachey, in a report, dated
22nd December 1849, gave particulars of the outbreak. Mr. Strachey
writes—"For about 30 years past there has existed in Kumaun and
Garhwal a disease known by the local name of mahamari, apparently
identical with the plague of Syria and Egypt, the characteristic
symptoms being violent fever of the most contagious nature, always
accompanied with swellings in the armpit, the disease ordinarily seem-
ing to reach its crisis on the third day."
II, Dr. Renny on the 9th May 1850 commenced a local inves-
tigation into the disease at Dadoli village, patti Chaprakot, and saw
two cases on the 10th and two more cases on the 13th. He des-
cribed the disease as an infectious fever,of a malignant kind and of
a typhus character, accompanied by glandular tumours and gener-
ally terminating in death in three or four days. The mortality from
the disease in 1849-50 was 113 in nine villages.
86
Previous history of plague in India.
[ APP. II.
Mahamari was again prevalent in 1851, and in a joint report on
the disease, dated 1st December 1851, by Dr. Pearson and Sub-
Assistant Surgeon Sri Nath Mukerji, it is described as typhus fever
of contagious and infectious type. In a subsequent report, however,
dated 17th May 1852, on the continuance of the disease into April
and May, these officers, after extended observations, recorded the
opinion that the disease was plague, associated with characteristic
glandular swellings and distinctly contagious in its nature. It still
existed in August of that year. There was an ascertained total of
633 deaths during the epidemic of 1834-35, and in 1851-52, 567
deaths were recorded in 77 villages.
In 1852-53, Drs. Francis and Pearson were actively engaged in
the investigation of the disease and recorded the post-mortem
appearances in four cases of which the principal were congestion of
the brain, a diseased condition of the blood, and effusion into the
serous cavities.
12. Mahamari descended to the plains as late as 1853. In that
year it appeared in an epidemic form in the towns of Thakurdwara and
Afzalgarh and in the district of Moradabad. Dr. Stiven, Civil Surgeon
of the district, reported on this outbreak in the plains. " It seems,'' he
states, "that in December 1853, Ali Bakhsh, a resident of Mehidpur,
a village in the Bijnor district, between Thakurdwara and Afzalgarh,
where the disease was prevalent at the time, went to the latter town
to see a nautch ; that he returned to his home in Mehidpur ; and
that three days afterwards his brother, Muhammad, became ill and
died on the third day of his illness. Ali Bakhsh's cousin also took
ill and died in three days, having had, as described to me, swellings-of
the glands in the groin. AH Bakhsh's wife and sister living in the
same house also died." Dr. Stiven attributed the origin of the
disease to contagion brought by Ali Bakhsh in a latent form from
Mehidpur. Dr. Stiven referred to the fact that paharis brought
down goods for barter to Chilkia, a very important mart near Kashi-
pur, and surmised that the disease was introduced by hill people in
intimate intercourse with the people of the district.
The disease was very prevalent also in Kashipur early in 1853, and
lingered in the Moradabad district till 1854. Dr. Stiven saw a few
cases which were characterised by high fever and swelling of the
glands of the right groin or of the armpit. It also prevailed in
Rampur at this time ; and it is stated that about 8,000 deaths
occurred from the disease.
Dr. Stiven's conclusions were :—
' (i) that mahamari is identical with the incomplicated or simple
form of glandular plague as found in Egypt ;
APP. II.]
Previous history of plague in India.
87
(2) that it can be conveyed to any town by contagion, and be
propagated by endemic causes, as filth, bad ventilation,
poverty and uncleanliness of the inhabitants.
13. In September 1859 mahamari again broke out in the north-
ern parganas of the hill tracts, and in 1860 it was noted that close
upon 1,000 persons had died of the disease.
An outbreak of the disease occurred at Sarkot on 20th September
1870, and continued till the 9th of November.
14. Dr. Richardson in a report, dated 4th October 1875, on
mahamari at Siti, patti Danpur-Bichla, after stating that the last
of six cases occurred on gth September, says that " the first victims
were a little girl, aged 8, and her father, Kusalli, aged 30. They were
attacked about 1,000 feet above the village of Siti and near the edge
of the oak forest. Both were seized with fever, vomited once or
twice, had large swellings in the groins, and both died on the fifth
day after seizure. The bodies were thrown into a stream below.
On the day the bodies were disposed of, two other persons living
in the same building were attacked after disposing of the bodies
and remained at Siti. They were taken or sent into the jungle
and died there, and were buried where they died ; but their graves
must have been shallow, for their bones were afterwards found
scattered about, Thus of the six deaths, four were among persons
occupying the same building. The two last were Gujuali, aged 45,
and Dhanali, aged 45, husband and wife. The next victim was a man,
28 years of age. He had severe fever for two days when large swell-
ings were observed in the armpits. He vomited twice during the
illness like others. He died on the fifth day and his house was
burnt and the body with it. The last who died was a boy Mulaki,
son of Dharam Singh. He was taken ill and died about a mile from
Siti in the jungle.
Dr. Pearson, in a report, dated 22nd June 1876, states that he
inspected villages in patti Bisaud, where 50 deaths from mahamari
had been reported.
15. In November and December 1876 the disease was prevalent
m certain villages in Kumaun and prevailed in Balt and Bintola
within four miles of Almora and within five miles of Ranikhet. Dr.
Planck inspected 40 villages affected by the disease, and recorded 277
deaths and confirmed the opinion that the disease was the pestis or
plague of medical writers, and was readily communicable from the
sick to the healthy. The villages included 9 in pargana Khas Pavja,
88
Previous history of plague in India.
[ APP. IÍ.
12 in Bora-ki-Rao, 2 in Attargoli, and 17 in pargana Danpur, as
follows :—
Parganas.
Khas Par ja
L
r
Bora-ki-Rao ,,,
Village3.
Bait.
Bintola.
S i rar.
Nainoli.
Gajula.
Salla.
B irau ra.
Maichor.
Matoli.
Banuri.
Tanda.
Sajol i.
Phalianti.
Chain.
Behta Talla.
Kausani.
Kajuli.
Mangalta.
Ajula.
Tailihat.
Kururah.
Parganas.
r
Attargoli
l
r
Danpur
...
l
Villages.
Bhandargaon.
D ugora.
Parsali.
Sungarh.
Baret.
Nankori.
Sama.
Bandahar.
Gaula.
Bhamangaon.
Dor.
Chachena.
Birtang.
Darkot.
Alam.
Bothi.
Basankot.
Kasiabara.
Gadera.
Return of deaths from mahamari, 30th June to 16th July 1877.
District.
Kumaun
.
Pargana.
Baratnandal ...
Danpur
Patti.
Athagali
Danpor Talla }
Village.
Bhandergaor...
Gadera
Total
NUMBER OF DEATHS REPORTED.
Men.
...
1
i
Women.
...
1
i
Children.
5
..
a
Total.
5
a
4
APP. II. ]
Previous history of plague in India.
89
The Commissioner of the Kumaon Division, writing under date
the 19th July 1877, says the recent epidemic seems to have come to
an end, and states that the area affected has been in Garhwal, the
parganas of Nagpur, Chandpur, Budhan, Chandkot, and Dewalgarh,
and in Kumaon the parganas of Danpur, Johar, and Baramandal, the
total deaths up to date being 535.
District.
Kumaon
...
Garhwal
Total
Men,
105
199
304
Women.
69
73
1-42
Children.
64
35
89
Total.
238
297
535
Remarks.
Last report, 2oth June,1 death.
Ditto
9th July, 5 deaths.
Return of deaths from mahamari, 3rd April to 14th May 1878.
District.
Kumaon
...
Pargana.
Baramandal
Ditto ...
Patti.
Khasparja...
Ditto ...
Village.
Bhulyara ...
Bintola ...
Total
...
NUMBER OF DEATHS REPORTED.
Men.
3
1
4
Women.
3
2
5
Children.
1
1
Total.
6
4
10
16. Dr. Richardson reported that typhus fever, identical with
mahamari, prevailed more or less throughout the year 1884 in the
Kumaon Division, and in 1885 he visited certain villages, Sirka,
Rung, etc., in patti Chaudans, pargana Darma, where the disease had
been prevalent.
17. In 1886 the same officer visited villages in patti Giwar, pargana
Pali, in which 13 deaths took place from the same cause, and was in
formed on 13th October that 10 persons had died of mahamari in
Seri, Danpur. He noted also that "a great number of deaths from
mahamari took place in Garhwal during the year 1886." Dr.
Thomson also reported on the outbreak of mahamari, identical with
typhus fever, in April and May 1886, but the reports of these out
breaks are very meagre.
On the 28th March 1887, the disease was reported at Khatiari
adjoining the military station of Almora. On the 5th April, at Gonja
Jali in Bhabar Chhakata, on 27th May 14 deaths were reported from
Bijapur village, patti Dora Mulla, pargana Pali, and on 14th June
three deaths in Nakutta village, patti Tikhun Mulla, The Collector
b 12
90
Previous history of plague in India.
[ APP. II.
of Kumaon on the nth October 1887 gave a summary of deaths
from mahamari in Danpur as follows :—
Date.
24th August to27thSeptember
3oth September ...
4th to 29th September
...
25th to 30th
Name of village.
Dasauli in Pungraun
Lohathal
do.
Sorkali in Nakuri
Ghali
Songroli
Total
Number of deaths.
31
3
7
3
1
45
Dr. Thomson, who reported on this outbreak on 13th June 1888,
states that the first case at Dasauli occurred in the person of one
Gungia Patak, who it is stated recovered. The first case noted in
the neighbouring village of Lohathal, on the 18th September, was in
the person of a resident of Dasauli. A second case took place in the
same house in which two more persons died in October.
An outbreak occurred at Gangoli, Kumaun, on the 4th October.
Under date the 24th October the following deaths from mahamari
were reported :—
Date.
8th October
9th „
15th „
Name of tillage.
Lohathal in Pimgraun
...
Dasauli
do.
...
Surbali in Nakuri
...
...
Dhari
„
Total
Number of deaths.
1
IO
1
1
13
On the 2nd November five more deaths had occurred from the
disease in Dasauli, and on the same date four deaths in pargana
Chaugarkha, Salan Talla. On the 19th November 14 deaths from
mahamari were reported between 24th and 31st October in Dasauli
village, patti Pungraun, pargana Danpur ; and on the 5th December
mahamari had again made its appearance, one death being noted in
Surkali, patti Nakuri, pargana Danpur.
On 29th March 1888 two fatal cases were noted in Kaurea near
Dasauli, and on 5th April a woman died of the disease in Khitauli,
and on 8th idem the husband of the woman died. On the latter date
a boy died in Lohathal. The house in which former cases had
occurred had stood empty for some months, the owners living a short
way off in chappars. But this boy knew of the existence of " gur"
in, and was observed taking some from, the house. On May 9th two
deaths occurred at Singor.
A death from mahamari in village Lagor, patti Pungraun, was
reported on the 15th May 1888; and the disease was said to be
present in Uskot and Rithagarh, pargana Chaugarkha, at same time.
APP. II.]
Previous history of plague in India.
91
Dr. Thomson in his report of the outbreak states that the disease
was mahamari, gola rog or phutkia, hill plague, or a severe type of
typhus fever highly contagious and bred and fostered by filth. On
the 13th September 1888 a statement was furnished by the Senior
Assistant Commissioner, Garhwal, showing that five deaths from
mahamari had occurred in Nagpur, and 16 in Dewalgarh mortuary
circles, five in Badhan and two in Nagpur.
18. The history of the disease in its incidence among the people
of the hill tracts from 1887 onwards is imperfect, owing, it is presumed,
to the confusion arising from adopting the view that mahamari and
sanjar, or typhus fever, were identical diseases.
19. No cases of mahamari were reported in Garhwal or Kumaun
in 1889 or 1890. In 1891 six deaths from the disease occurred in
patti Karrakot, pargana Badhan, between 27th June and 21st July
(two deaths in June and four in July). The record is blank in 1892.
20. In 1893 two limited but associated outbreaks of mahamari
occurred, in July and September, in mauzas Surkali and Suni, patti
Nakori, pargana Danpur, a few miles off the Bageswar-Berenag road
and about two marches from Bageswar.
The first outbreak occurred on the 8th July, and the second on the
I3th September, and these outbreaks were associated, and each case
was connected with some other preceding case or cases.
The extremely infectious and fatal nature of the disease is evi-
denced by the fact that it was communicated direct from the sick to
the healthy, and that all those attacked died.
The affected families in both outbreaks occupied houses situated
in a large gently-sloping horseshoe-shaped valley, at an elevation of
about 6,000 feet above sea-level.
The houses in the locality are dotted round the upper margin of an
extensively cultivated and terraced area, and form no collection that
can be called a village.
The families affected were comparatively well-to-do people, and
poverty or destitution had nothing to do with the outbreaks. The site
and natural surroundings of the dwellings are exceptionally healthy;
and the families undoubtedly lived in a naturally and exceptionally
healthy climate, but under conditions which favoured the onset and
dissemination of zymotic disease in its most intense form.
These two families occupied the end rooms of an isolated block of
three houses, the centre house having remained empty for the previous
six months, and the families had been resident in Surkali for years.
The first case occurred in the person of a girl whose father, it is
stated, died seven years before of the same disease ; and of the two
whole households of Kuna Sah and Ratan Lal, which were affected,
all the members, numbering eleven souls ? succumbed to the disease.
92
Previous history of plague in India.
[APP. II.
The scene of the second was less than a mile from that of the first
outbreak, and although the occurrences were fewer, they were no less
fatal.
The first case in the second outbreak occurred in the person of a
man by name Tejgir, who helped to fire the infected shed where lay the
dead of the disease in the first outbreak. After a certain interval he
succumbed, having previously affected those about him, and a visitor
from a distant village who, on his return to his home, took ill and died
of the disease.
The father of the first affected is said to have died of mahamari
seven years before ; but there is no evidence to show any connection
between the events, or that the recrudescence of the disease was due
to any circumstance connected with the prevalence in the same locality
in 1887.
The following summary shows the dates of the occurrences and
connection between the outbreaks, and indicates the malignant
character of the disease:—
Mahamari in patti Nakori, pargana Danpur } in 1893.
Mauza Surkau. Persons, Banias.
Date of attack, 8th
Date of death, l0th
July, 10th.
„ 11th, I4th, 15th, 16th, 17th, 1st, 2nd, 3rd August
July.
gust.
On the 17th August
Tejgir helped to
fire the shed in
/
which the dead bodies lay.
/
Mauza Snnl. Persons, Jogis.
Date of attack. :3th
Date of death. i8th
Tejgir.
September.
,.
Monagir
I7th.
2 1st.
Gopalgir.
22nd
2 6th.
Female.
22nd
25th
Pnnaglr visited Tejgir when the latter was ill of the fever.
Mauza Maghera.
Person, Jog!.
Date of attack.
Date of death.
Punagir.
I3th.
15th
The persons who succumbed in the mauza Surkali comprised the
members of two whole households those in mauza Suni were of one