NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
APP. II, ]
Previous history of plague in India.
6 7
• houses, and they declare that after this no person was attacked with
the disease. This is a curious and singular fact, affording a rare
instance of a measure dictated by fear, and carried into effect with-
out reason or reflection, being attended with complete success. Jn
fact it corresponds very nearly with what has been recommended to
be done, by one of our best writers, Dr. Adams, on such an occasion
and is a very good practical illustration of the measures which, with so
much care, deliberation and strict induction from the facts before
him he laid down, and thought likely to be successful.
In the town of Sura I was told that a travelling merchant had
come thither and died, after six days' illness, from a fever accompa-
nied with bubos. His wife had not been affected and left the
village shortly after ; after the lapse of a month, a woman of the caste
who had taken care of cows was seized with the same disease and died
in six days. She lived in a different part of the village to that where
the merchant died. Eight or ten days after her death, a woman of
the same caste and living in the same compound was likewise seized
with this disease and died on the third day. Her death had occurred
about twelve days before the time of my visiting the village, and up
to this period no other person had been attacked. There were a
great number of people living in the same compound, and both
women had a number of children ; the last who died had suckled an
infant till the time of her death.
Then a Banyan's boy, who had come from Moolee, which is twenty
miles distant, was here attacked with this disease and died, but did
not communicate it to any other person. The people of the province
say that this year the disease appeared first in Limree, afterwards in
Wudoran, from which it came to Sila and Moolee. I visited the two
last named places.
Moolee is a large and very populous town, the inhabitants being
nearly all Rajpoots. It is surrounded with an old ruinous wall, full
of breaches, which are all carefully stufied with thorns, and every
house has a wall of the same material, much higher than a man's
head. No better means could possibly have been adopted completely
to exclude ventilation, if this had been the sole object of the inha-
bitants, and it might fairly be made subject for dispute whether in
shutting out their enemies, they have not shut in one far more power-
ful than the whole of them together. It is situated on the bank of a
river, even now almost dried up, and the water of which is perfectly
brackish. The disease had carried off in one month about 80
people and was still prevailing. I saw a great number who had
bubos, without any fever, and was told that upwards of 120 had
suffered in this way. These people walked about without either
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Previous history of plague in India.
[App. II.
alarm or inconvenience for none had died, and not many of the
bubos suppurated. Not one with fever had survived. There was
a description of cases here, distinguished by fever and hemor-
rhage, apparently, from the lungs, without bubos, which was reported
to be as surely and even more speedily fatal than those with fever
and bubos. It had been the most common form of the disease at
first, and lately had but rarely appeared, but fortunately one case
came under my observation. I say fortunately, for I had frequently
heard it described both at Wuccaneer and Morvee, without being
able to understand what was meant: every narrator so mixing his
account of appearances and actual facts, with what he supposed to
be their causes, and with the internal changes which he supposed to
take place and immediately to produce death as involved all his des-
criptions in a cloud of utter confusion.
In this man the heat of the body was not much increased, nor the
pulse greatly accelerated; his bowels were not disordered, nor did his
tongue indicate much febrile irritation. He was able to walk about
and converse, answering questions distinctly. No persons would
have thought him in danger, but there existed in the patient's mind
a degree of alarm and anxiety altogether disproportioned to the
apparent symptoms. He had only been attacked that morning; all
his consideration seemed absorbed with a pain in his chest. He
answered to my questions whether he had not other pain, as in his
head, his back or limbs, that these were slightly painful ; but he
immediately recurred to his chest, dwelling upon that with a look of
the most painful distress, and if not questioned about other symptoms,
it seems as if he would not have mentioned them. He had besides a
very slight cough, so slight that it might easily have escaped unnoticed,
and this was accompanied with a discharge of blood from the mouth.
The following clay he was delirious, had a burning skin, with a very
quick pulse. I searched for, but found no bubos. He died in the
course of the succeeding night, i.e., in less than forty-eight hours from
the first attack. The characteristic symptoms of this variety are slight
cough, pain oí the chest, and hemorrhage from the mouth, attended
with fever, but no bubos.
I saw four other cases of the disease, all of which were marked
by a low typhus fever, bubos in the groin or armpit (and in one case
in the seat of the parotid and submaxillary glands of one side). In
all there was the greatest debility; and in one a universal tremor of
all the muscles of the body, giving a very singular appearance. All
complained of great thirst, the tongue was covered with a white fur in
the centre, through which and at the edges were seen the papillae of a
shining fiery-red appearance, In none were either petichlae or
APP. II, ]
Previous history of plague in India.
69
carbuncles to be seen ; and I may observe that I have neither seen nor
heard described either of these symptoms, nor any other cuticular
affections except bubos. Petichise might easily escape common ob-
servation ; carbuncles could not possibly do so. In general there is
no more than one bubo, although in one of the above cases, where
only one was visible, I distinctly felt hard knotty swellings in both
armpits and in the opposite groin.
All the above cases, as well as those of two females of rank,
which were not shewn to me, terminated fatally during first and
second day of my visit, and no other cases occurred during my stay.
They had not the slightest opinion in the place of the disease
being contagious; indeed they were determinately of opinion that it
was not so ; one man, the Thakoor's brother, confidently assured me
that contagion was not the cause of the disease ; affirming boldly
that no man could be a better judge of the question, for that none had
had greater experience ; he having lost in his own family eight women
and one boy. No, no, said he, " Oorta juda." Contagion is quite a
different thing. Another woman died, in this man's house, while I
was here, making a total of ten in his house. Nothing can shew
more clearly the evil arising from bigotted prepossession than the
case of this man's family. It is difficult to conceive what he would
have considered as satisfactory proof of the reality of contagion. To
the unprejudiced observer, the probability will appear very strong
that these women caught the disease one from the other, and that the
boy got it likewise from them, or which is the same thing, that the
atmosphere of the apartment where they lived, being rendered infec-
tious by the effluvia of the disease, proved afterwards the source of
disease and death to those who are living continually under its influ-
ence. These were women of rank, and the seclusion to which they
have been doomed by the force of opinion and custom is well known.
It operated so far as to prevent my seeing the two women mentioned
above as having died, one of which belonged to this family. They
sometimes said that this was no disease, but an order from the
Almighty to remove whomsover it attacked. They therefore probably
thought all resistance wicked or vain, and it is to be feared that this
belief in fatalism will prove an insurmountable bar to the execution of
those measures which alone promise to be effectual in checkino- the
progress of this scourge. I tried and exhausted all the means of
argument and persuasion at this place without the smallest benefit.
Nothing, I am afraid, but the strong arm of power will avail, and of
direct authority in these towns we possess none. Sila is a large
walled town in the neighbourhood of an extensive tank which supplies
excellent water. The disease had prevailed here about two months
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Previous history of plague in India.
[App. II.
and a half. At first it had been very severe and general, but lately
it had become more partial in its attacks. The same class of people,
viz., the Borahs, that had suffered so much at Wuccaneer, were
likewise the first attacked here, and had suffered, in a proportion,
greatly beyond that of the other classes ; one hundred and twenty
were said to have died, of which sixty were Borahs. In some particular
houses the loss had been very great, some losing five, and others
eight or nine of their inhabitants ; at one time they thought the disease
contagious, for that people returning from funerals had been suddenly
attacked and carried off, but lately it had lost, in their opinion, that
character. One of those houses said to have suffered particularly was
an oilman's; five people died in it. It was told in Moollee that one man
of the same profession had died. The total number of people of this
description living in Sila is said to be fifty, in Moollee thirty. I was
here shewn the cases of four people in advanced stages of the
disease ; they were the only survivors, and only one appeared to be
in any danger, or rather in any doubt, for in her case even the danger
appeared to be nearly over.
She was in the ninth day of the disease, had a bubo in the upper
part of each thigh, both very painful to the touch, which came on
the second or third day of a fever which had deprived her, for a time,
of her senses ; even at this time her mental powers so weak that she
found it difficult to command attention to any subject, and her
memory seemed frequently to fail her ; she was exceedingly weak in
body as well as mind ; her eyes had a glassy appearance, and one
was partially suffused with blood ; a very severe purging had just
terminated after some days' duration ; she had likewise suffered much
from copious and universal sweats : but both these symptoms, from
the period of their appearance, seem to have been the prelude to
improvement. She is ignorant as to the cause of her disease ; it
was not in her immediate neighbourhood at the time, and has not
apparently been communicated to any other person. She lies in a
veranda, the front part of which is closed up with a wall of kirby
stalks, and several calves, as well as men, women, and children, are
companions in this apartment. Second case, a poor woman, in a very
low and wretched hovel, with only one small aperture for entrance.
She had suffered severely from fever, but is now free from it, has no
recollection of anything that befell her for several days : has one bubo
a little below the groin. She had attended a woman who died of
the same disease ; has not communicated the disease to any other
person, but appears to live almost entirely alone.
Third case, a boy with a large irregular bubo of a livid gangre-
nous appearance, occupying the whole cluster of glands at the upper
APP. II. ]
Previous history of plague in India.
71
part of the thigh, and discharging a thin ichor ; does not know how
he caught the disease, had been insensible for some time, but says
the bubo and fever came on together. He lies in an open veranda
fronting the street, Both this and the former patient are very weak.
Judging from the hardness and quantity of dirt accumulated on this
boy's skin, he cannot have washed his body for years.
Fourth case, a Dair woman, with a large bubo in one armpit, the
top of which is covered with a white slough. The bubo has a gan-
grenous appearance ; but she says she has not had any fever. No
other person has had this disease in the Dairwar, which is a large and
populous place, close to but outside the walls of the town. There
were not many of these wretched outcasts in the towns named above,
and they had not, I believe, a separate place assigned them, as in the
present instance ; but lived within the walls.
A Banyan's wife had just died in the town on the ninth day of
her illness; she had a bubo on one side of the neck, the inflammation
and swelling from which had extended over to the other side appear-
ing to occupy the whole throat. Her brother had died a little before
her in the same house on the third day. There were no fresh cases
at present in the town, and they thought it was leaving them. On
its first visitation, that form noticed above as distinguished by fever,
slight cough, pain of the chest and hemorrhage had been" the most
common ; it had disappeared for some time. This variety seems to
have appeared first at every place which has yet been visited. I may
remark that the famous plague of Athens is said to have been ushered
in by an Epidemic Catarrh, or Pleurisy, which yielded to no remedy
and which gradually gave way to a fever accompanied by the true
pestilential tokens, In the town of Sila only seven or eight are said
to have had " tunda ghaut," or bubos without fever.
Before proceeding farther, it seems necessary to take notice of
some peculiarities of the people in this province, which in my opinion
exert a powerful influence over the progress, at least, of this disease.
They are the only people, whom I have seen in India, who might pro-
perly be termed filthy. Ablution, which from being sanctioned and
enjoined by divine authority, in every other place, is practised with
all the diligence and scrupulosity of their other religious ceremonies
in Káthiáwar, from what cause I know not, is almost wholly neglected.
The evil consequences of this neglect are much increased by the
enormous quantity of clothes which it is the fashion for all ranks to
wear ; and in most ranks these clothes are but seldom changed ; in
some of the inferior it seems almost as if they were allowed to rot
upon the persons of their owners, without once being washed or ever
removed from their first_being put on, till they can no longer serve
72
Previous history of plague in India.
[ APP. II
the purpose of covering their nakedness ; another common practice
in most parts of India, friction of the body with oil, which might in
some measure have counteracted the evil consequences of the other
neglect, is unfortunately here also in equal disuse. This very grate-
ful and salutary practice which by encouraging and at the same time
modifying the process of perspiration has so powerful an effect in
regulating the temperature of the body, as well as in preserving the
balance of the circulation, and by preventing cuticular absorption
must prevent the admission of contagion into the system, in that
direction, has upon very good authority and extensive experience
been supposed a complete preventive, as well as a powerful agent in
the cure of plague. If this disease is plague, some of the facts, above
related, are sadly at variance with this opinion. I hope, however, I
may not be accused of giving way, too far, to prepossession on the
present subject, if I declare that my opinion of the efficacy of this
practice, has not been much shaken by them. The facts were not
witnessed by, but reported to me, and I had dwelt so much upon the
necessity of ablution and oily friction in my conversation with the
inhabitants, that I shall not be much surprised if, when I enquired
regarding the oil manufactures, they had invented these circum-
stances to excuse to themselves and me, their own apathy and neg-
lect of the precaution, which I had pointed out. If this disease is
communicated by the touch, there can be no more powerful antidote
than oily friction; where infection is received with the breath, it will
be efficacious only in so far as it invigorates the general system,
thereby enabling it to resist its influence.
In addition to the above causes, which are permanent, it is like-
wise certain that, for some time past, the great body of the people
have laboured under all the depressing disadvantages of precarious
existence. It is not for me to investigate the political causes that
may have been agents in reducing the country to its present state.
It is probable that they were in a great measure unavoidable and
impossible to be foreseen or even prevented, at least effectually. The
country has in a short space of time undergone a most complete revo-
lution ; the tide of public authority has on a sudden diverted into a
totally new and totally different channel. The hundreds of little
lords that once enjoyed perfect and indépendant authority in their
own little districts, have, by this revolution, been deprived of every-
thing but the name of independence, It is not therefore to be
wondered at if those districts should for a time feel the want of the
fostering influence which once protected them and to which they
were attached by every tie. The severe famine, which visited this
province, gave an influence to the above causes which otherwise they
ÁPP. II.]
Previous history of plague in India.
73
would never have acquired ; the one thus aiding the other, they both
gained an increase of force ; indeed pestilence and famine have so
constantly gone together, and are so linked even in our speech that a
sentence seems incomplete where one is pronounced without the
other. The consequence of all has been general distress, general
despondence, and general inactivity ; every town swarms with idlers,
than which no more fertile source of disease exists. It may be truly
said to set up ; its effects are so powerful that they may be traced
even in individual instances ; but where indolence and inactivity affect
a whole community, the consequences force themselves upon our
notice. In Kathiawar industry is unknown in many places (in many
it is beginning to revive) and seems particularly so in the districts
where this disease has raged. Cultivation is almost neglected, and
the inhabitants depend, principally, upon the milk and ghee furnished
by their cattle for the means of subsistence. Partly from the cause
and partly from the strictness of their religious tenets, which rigidly
forbid the death of any animal, every family has accumulated a large
stock of cattle, and these amounting to hundreds or thousands, accord-
ing to the size of a town, are invariably driven within the walls at
sunset and are penned for the night in the same house which contains
the rest of the family. Thus no limits are set to the number of cattle
accumulated in every family, excepting by death in consequence of
disease or old age. Still all animals are doomed to die, and notwith-
standing the humanity of religious tenets, this is a forfeit which must
be paid in one way or other. In proportion, therefore, as we diminish
the number of deaths by artificial or violent methods, Ave should natur-
ally expect an increase to the number by natural causes, or, in other
words, that disease and sickness would be multiplied. Accordingly
we find this to be the case. The cattle of Kathiawar afford the clearest
proof of it. Few seem altogether free from disease, and many are
seen, in the most wretched condition, crippled with swelled legs, and
diseased skins, crawling about.
Such a degree of obscurity, hangs over the origin of most fevers as
can seldom be removed by years of the best directed enquiry. After
so many years of observation and experience, during the whole
of which the eyes of an enlightened public have been diligently direct-
ed to the subject, it is still a matter of doubtful discussion what are
the causes which produce the annual fever of North America. The
same remark is applicable to the yellow fever of the West Indies
some still attributing it to contagion, others entirely to local causes.
We are completely in the dark likewise as to the origin of almost all
the specific contagions ; of one, we cannot be in doubt; I mean the
Cow-pox ; and many are of opinion, from their great similarity in many
b 10
74
Previous history of plague in India.
[ APP, II.
points, that small-pox originally took its rise from the same source.
It may perhaps facilitate our enquiry into the cause of the present
disease if, before we proceed further, we can distinctly point out what
at least are not agents in its production. We may then at once, and
altogether, exclude from our consideration all putrifying animal and
vegetable substances, all effluvia from jungles and marshes. Every one
of the towns which have suffered from the disease in question that
I have visited are in a remarkable degree exempted from everything
that could produce these. Their situation was either on the rocky
bank of a running stream or on a dry sandy soil. Leaving all these
causes therefore out of sight, we may now observe that another of
fever, at once the most common and the most destructive, has been
clearly and indisputably ascertained, I mean the cause of infections of
typhus fever. We now know that wherever a number of human beings
are crowded and confined within a narrow space, where the atmos-
phere which they breathe cannot frequently be renewed ; but on the
contrary the effluvia from their bodies remain undiluted, and are
allowed to accumulate ; we know that when these effluvia have attained
a sufficient degree of concentration, the atmosphere which is loaded
with them will excite in the bodies of those who live within its influ-
ence a fever of the most malignant nature. This fever from the
places which have in general been most favourable for its production
has been called u gaol " or " hospital " or " ship " fever. Now I appre-
hend that it will be difficult to find a situation more likely to give rise
to such a fever than many of the above walled and crowded towns
will furnish. If, however, we include in our consideration the manner
in which man and cattle are crowded in the same narrow unventilated
spaces, that many of these cattle are labouring under diseases, regard-
ing the nature of which we are ignorant (an epidemic or contagious
disease has since the famine run through the whole of them) and that
every predisposition is furnished in general by the listlessness and
despondence impending over all the people, it will not appear improb-
able that disease should arise under such peculiar circumstances.
Indeed it is what Í think we might naturally look for and expect.
From an atmosphere thus deteriorated, partly by the accumulation of
human and partly by that of diseased brutal effluvia, we would expect
a disease"sui generis," or at least resembling infectious fever,
modified by the peculiarity of its causes, in fact specifically different.
If, then, the causes which produce this disease are local and existing
in the places where it has made its appearance, I think it probable
that they may have taken their rise in the above unnatural association
and seclusion of man and cattle, in close situations, within walled
towns. I offer this however only as conjecture ; and you will receive