NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
AP?. VI. ] Measures in the Bombay Presidency and Sind.
389
because of the increasing death rate. Surgeon-Captain Milne at
once, of his own motion, began examining the dead bodies, and
where any objection was made called in Lady Doctor Nash. This
thoroughness elicited the fact that the increased death-rate was largely
due to the increased population and the mortality was mainly
among- insufficiently nourished infants and very old people. Search
parties had been instituted, and their working was improved during
Surgeon-Major Baker's visit. There was an excellent spirit of co-
operation among the people, and this must be attributed to the
healthy influence of Mr, Dyaram Gidumal, the Judge, and Mr. Mohsin
Badrudin Tyabji, the Joint Judge, seconded by the City Panchayat
and the local officials.
Mr. Mules, the Deputy Commissioner of Jacobabad, had
imposed detention under observation at Jacobabad with success. This
was now asked for by the people of Shikarpur and was now sanction-
ed. Writing on the 19th February, the Collector of Shikarpur had
concurred with the Acting Commissioner that the quarantine then
imposed should be removed, and the experience of Surgeon-Captain
Milne soon showed that, without European supervision, the quarantine
would not have been successful. By the time detention was reim-
posed, the leaders of Shikarpur society were determined to make it
effectual. All through, Colonel Mayhew gave himself heart and soul
to the defence of Shikarpur, and reposed in Surgeon-Captain Milne
and Surgeon-Captain E. S. Clark, A.M.S., who was subsequently
sent to assist, the most unstinted confidence, which maintained their
authority unquestioned.
Improvement at
Karachi.
Meanwhile in Karachi improvement was perceptible. Disinfec-
tion of houses was up to date and general cleaning in full swing, and
the unaffected quarters were being taken in hand in advance
of the attack. Surgeon-Captain Arnim was now fully occupied,
having in the middle of February been placed in charge of the suburban
quarters in addition to the Sadar Bazaar. The Deputy Sanitary
Commissioner was so valuable as a general guide that it was
found impossible to give him charge of the Nasarpuri Camp, which
was looked after by Mr. Strachan.
Kiamari and
Manora.
Indeed, at this time every one's strength was being put forth in
the endeavour to limit the area infected. Major Morris, Karachi
Artillery Volunteers, Port Trust Engineer, took charge of Kiamari
and Manora. He segregated every case with extreme care, but cases at
Kiamari did not cease till the old village of huts was burnt and the people
disinfected and moved to a new site by the Plague Committee. The
Manager, North-Western Railway, Colonel Brackenbury, R.E., paid
390
Measures in the Bombay Presidency and Sind. [ APP. VI.
a visit to Karachi on the 18th February and organised the protection
of the Railway quarter, and throughout, as will appear, lent the full-
est aid of his department to the Civil officers.
Camps for subor-
dinates and
clerks.
Mr. Giles had arranged with the railway administration for spe-
cial trains to run between Karachi and the two neighbouring stations
of Landhi and Malir, where he and several of the European mer-
chants had erected camps. By this means, subordinate officials and
office clerks and coolies were safely housed out of reach of infection
and were able to come to work daily. This was a very successful
scheme, and a great boon to the mercantile firms who were being
deserted by their establishments. Major Morris was similarly active
in protecting the shipping.
Detection and
segregation
complete.
By the end of February, the Collector reported that few cases
now remained undiscovered, and hence the removal of the healthy
was at once universally carried out. To this must be attributed the
progress that was being made as shown in the decreasing mortality,
as also to the sick being rapidly brought under medical treatment.
At this time Surgeon-Captain Borradaile, A.M.S., arrived from Eng-
land. His report on the measures in Karachi and the Acting Com-
missioner's report on the rest of Sind, which that officer drafted, were
submitted to Government, and throughout Surgeon-Captain-Borradaile
lent very cordial assistance and readily volunteered for any duty.
Segregation.
In Sukkur the stringent removal of the sick had led to the sud-
den flight of some 10,000 people. In Hyderabad its most rigorous
enforcement, under the determined action of Mr. Dodgson, was fail-
ing to check the outbreak. In Karachi it was gradually being intro-
duced, and in some quarters, as Kiamari, was insisted upon from the
very first by Major Morris. Under Sardar Muhammad Yakub Khan
in the trans-Lyari quarter, where he had to contend with much fana-
ticism among the Muhammadans, isolation of the sick was only
becoming possible, but by the middle of March segregation of infected
families was the rule. Segregation camps under the magic wand of
Mr. Strachan sprang up everywhere. In these days it was necessary
to humour prejudice by having the huts near each community. It
was a long time before the fancied degradation of living in a hut
was subdued, and to the last the better classes disliked it, as was
natural.
Convalescent
home.
Early in March, the need for a convalescent home, to get the
recovering patients out of the depressing influence of the mortality
of a plague hospital and to relieve crowding, became pressing, and
Surgeon-Lieutenant-Colonel Henderson, to whose solicitude and organ-
isation the hospital owed much, suggested that the newly built and
ÀPP. VI. ] Measures in the Bombay Presidency and Sind,
391
unoccupied Lady Dufferin Hospital should be utilised as the convales-
cent ward. It was just opposite the plague hospital, and in every
way suitable, and upstairs had accommodation for European and other
patients who could not be treated in the plague hospital. The Com-
mittee agreed, and the happy faces of the convalescents testified to
the wisdom of the change.
Evacuation of
Trans-Lyari
Quarter.
The 19th of March, the crowning day to the Sardar's work across
the Lyari, saw the voluntary removal by the Muhammadan communi-
ties of all their sick, and So patients were during the day safely
deposited in the isolation sheds, and all came under medical treatment.
Mr. Giles, who had devoted himself to this quarter, was justly proud
of the great achievement. Some 40 malcontent families withdrew to
some distance, and from that date there was no reluctance but eager-
ness to isolate every case throughout the villages of the large Trans-
Lyari tract.
Example of the
result of segre-
gation.
The Jail is a striking example of segregation. It is situated in
the heart of the town, and for some time plague circled it. Surgeon-
Lieutenant-Colonel Henderson had taken every careful precau-
tions. No new comers were admitted till stripped and bathed, and
reclad in fresh clothing and kept for some days apart by them-
selves. Notwithstanding, one prisoner caught plague. He had
been five months in jail. He was removed to the plague hospital
and recovered. It is supposed a warder may have introduced the
germs. No other case occurred. Nor did any case occur in the
Hyderabad Jail, where, also, Dr. Jackson was minutely careful
over every detail.
With plague broken out at Plyderabad and Sukkur, and threat-
ening at Shikarpur, and villages in different quarters occasioning
anxiety, the dearth of officers made itself felt. Some of the staff
given to Karachi must be withdrawn and their places supplied, and
more medical officers must be obtained. As the disease approached
cantomments, it seemed desirable also to reconsider the position
in Karachi itself. Just about this time, the Bombay Plague Com-
mittee was formed, Something of a similar character for Karachi
seemed to offer exactly what was required. On the loth March
a memorandum was drawn up, pointing out that, though plague in
Karachi had been held in check, it had not been stopped and was
constantly reappearing in a new quarter. It was clear that the
best results had been obtained by separation between the sick,
the possibly infected and the healthy, and to the perfecting of this
separation, to efficient guarding of the camps, to house-to-house
searching the full strength of the administration should now be
392
Measures in the Bombay Presidency and Sind, [ APP. VI.
directed, and the memorandum closed by suggesting the assistance
of the Brigadier-General. A large meeting of plague officers
assembled on the 12th, at which the Principal Medical Officer was
present. The opinion was strongly in favour of working on exist-
ing lines. The plague was decidedly not gaining ground, the
arrangements for dealing with it were gradually being made more
stringent, and beyond pushing the removal of the sick to hospital, no
change was required.
Private hospitals
beginning to fill.
It should be mentioned that at this time the private hospitals
were beginning to fill, and that Seth Vishindas, a wealthy and
philanthropic citizen, quite fearless of plague, was constructing
what developed into the best private hospital in Karachi, where
he generously received Hindus and Muhammadans alike, having
separate wards for each, and supplying medical and other attendance,
food and medicine at his own expense. The removal of the sick
difficulty, which had been such a mountain in the way of effective
remedies, had thus quietly disappeared, and, as the Collector remarks,
a few days later the sick were being removed to hospital as a matter,
of course.
Appointment of
the Karachi
Plague Commit-
tee.
On the 2Oth March His Excellency the Governor of Bombay,
Lord Sandhurst, G.C.I.E., arrived, and after inspecting all that
had been done, appointed a Plague Committee for Karachi, consist-
ing of Brigadier-General T. A. Cooke, Commanding Sind District,
as President, with the Collector, the Deputy Sanitary Commissioner
and Mr. Strachan, of the Municipality, as members, though the last
named was added a day or two later. This measure was like the
relief of a beleaguered garrison. Not only did His Excellency's
approval encourage everyone, but the General immediately threw him-
Military aid.
self heart and soul into the work, brought to bear the whole strength
of the military, with unlimited officers and men and habits of rigid
discipline on the existing material, and soon had the population
under thorough control. In their first sittings, the Committee had the
advantage of the counsel of Surgeon-Major Reade, one of the Joint
Presidency Plague Commissioners. He suggested the bathing and
disinfecting sheds for arrivals at each camp, the disinfection of all
bundles and baggag-e brought to the camp, and similar arrange-
ments on leaving. These suggestions were most carefully elaborated
Disinfection of
the person and of
clcthing.
by the Plague Committee. Disinfection of the person and personal
clothing had previous to this been in the background, the getting
of sick and healthy out of the infected houses, and the disinfecting
and cleaning of those houses absorbing all the time of the workers.
Now immediate transference to hospital and camp was working
APP. VI.] Measures in the Bombay Presidency and Sind.
393
smoothly, and it was possible to perfect that control of the camps to
which Surgeon-General Cleghorn had invited attention. This thorough
and painstaking disinfection of the clothing and bathing of the
persons in tubs with a mixture of Jaye's fluid in the water soon
extended upcountry with marked effect.
Military search
parties.
On the 25th March the first military search party went out. It
was very carefully organised and admirably managed, the civil officers
accompanied by medical men taking charge of each party. The
General had carefully instructed the men, and from that day forward
there was no need for the slightest apprehension, either that the
soldiers would not deal tenderly, or that the people would not wel-
come them. Not a complaint was ever preferred.
Soldiers and
labourers sent to
Sukkur.
Mr. Dodgson responded to the invitation to meet His Excellency,
and returned to Hyderabad versed in all that was being done and
proposed to be done in Karachi. Surgeon-Major Baker, now on
special duty, on the 28th March presented a report of the state of
affairs in Sukkur, which showed, as he expressed it, that the local
organisation was not abreast of the disease. The Plague Committee
being now well established at Karachi, it was possible to spare an
officer, and Mr. Cadell was despatched that evening to Sukkur to the
assistance of the Collector. Surgeon-Lieutenant A. F, W. King,
I.M.S., had already taken charge of the two plague hospitals at
Sukkur. Mr. Lucas, I.C.S., was also placed under the orders of
the Collector of Shikarpur, and with Surgeon-Major Baker started
for Sukkur on the 29th. Surgeon-Major Baker had reported that
the chief difficulty in getting anything done at Sukkur was the gen-
eral panic and flight. Accordingly, 200 to 300 trained Karachi coolies
and masons, under supervisors, were sent up by train by the ready
aid of Mr. Giles and his indefatigable Mukhtyarkar, Khan Bahadur
Framroz, together with a supply of perchloride of mercury. The delay
in sending Mr. Lucas to Sukkur had af.ter all not been lost time. Mr.
Lucas had spent some time in Karachi, had seen the soldiers at work,
and the disinfection machinery well started, and was thoroughly
competent to introduce the system cut and dry. He received carte
blanche powers, and the Collector placed the plague administration in
Mr. Lucas' hands. At the same time, on the advice of Surgeon-Major
Baker, it was arranged with General Cooke to despatch 30 British
soldiers of the Duke of Edinburgh's (Wiltshire) Regiment, under a
specially selected officer, from Hyderabad to Sukkur. General Cooke
arranged everything with the utmost celerity, and some long-aban-
doned barracks were immediately put in such order as was possible,
and furniture and commissariat were provided by rail. Lieutenant
A. E. Beadon went in command.
b 50
394
Measures in the Bombay Presidency and Sind. [ APP. Vï.
Similarity in the
outbreaks at
Hyderabad and
Sukkur.
The following table will exhibit a somewhat striking similarity
in the outbreaks at Hyderabad and Sukkur :—•
Week ending
26th February 1897
5th March
„
32th „
„
19th „
26th „
,
2nd April
„
9th ,,
„
16th „
„
23rd „
„
30th „
7th May
14th „
„
2ist „
„
28th „
„
4th June
„
TOTAL
,.
HYDERABAD.
Local.
Cases.
I
3
5
42
40
33
117
119
73
49
37
13
8
i
2
...
544
Deaths.
2
4
29
27
25
58
104
68
40
32
12
8
2
2
...
4Ï3
SUKKUR.
Local.
Cases.
4
6
14
28
97
105
in
87
42
37
13
6
4
i
I
Add I2lh Feb. 1
537
Deaths.
3
8
9
19
76
56
75
59
50
16
8
5
5
2
3
Add 7th July E
39
The period of intensity in each case was 8 to 9 weeks, and the
beginning and ending of the epidemic almost synchronised.
Hyderabad.
The Acting Commissioner left Karachi on the 1st April and
first visited Hyderabad. He paid two other visits to Hyderabad
but it will be convenient here to finish the history of the Hyderabad
APP. VI. ] Measures in the Bombay Presidency and Sind.
395
Situation,
climate and
population.
outbreak. Hyderabad, like Karachi, consists in part of a closely
packed old town, with narrow lanes and blind alleys. Its situation
upon a hill and its dry climate would, it was hoped, be unfavourable
to the epidemic, and considering that Hyderabad had a population
of nearly 55,000 in 1891 and was now packed with Karachi fugitives,
and probably contained not less than 65,000 people, the expectation
was not disappointed. The first local cases had been removed to
hospital. The inmates of the infected houses were all carefully segre-
gated in a camp outside the town. The inmates of houses surround-
Evacuation.
ing the infected house for a considerable area were removed. The
value of this last measure was proved by the great quantity of dead rats
afterwards discovered in the shops and houses opened for cleaning.
Had the inmates been sleeping in these rat-infected rooms, the
mortality would in all probability have been severe, whereas as
inmates of the camps they altogether escaped. For four weeks
Mr. Dodgson, assisted by the Military officers and his Civil staff,
by the Sessions Judge, Mr. Knight, I.C.S., and by a strong body
of volunteers, among whom was Mr. Hesketh, Principal of the Sind
College, fought the plague and kept the weekly mortality almost
level. Mr. Dayaram Gidumal, the Judge of Shikarpur, in Hyderabad,
Hospitals.
also lent valued assistance. He established a private hospital on
the Native Library premises, and entrusted it to the superin-
tendence of the Revd. A. Canney, of the Church Missionary Society,
and Miss Pigott, Zenana Mission. By his request also Surgeon-
Lieutenant-Colonel Henderson took a general medical supervision.
A Committee of leading Native gentlemen supplied all that was
needed, and the percentage of cured, 41.71, testifies to the devotion
of the staff. This was about the percentage reached by the Karachi
and Sukkur Government hospitals. This private hospital was
opened on the 19th March, and on the 24th idem the Government
High School buildings were opened as a General Plague Hos-
pital under Surgeon Lieutenant-Colonel Henderson, assisted by
nurses obtained from Calcutta. Both hospitals were closed on June
15th.
Spread of the
disease.
Still the disease spread. Persons feeling the dreaded symptoms
would hope to escape by fleeing to another portion of the town, till
they got over the dread of hospitals and sought asylum there, Rats
also tried to leave infected houses, but were in large numbers exter-
minated by the pestilence. Clothes and bedding, spite of all precau-
tions, would be smuggled away. As one woman said when ques-
tioned as to the clothes of a child that had died, " Oh no, they were
not in the house. They had been given to the poor." Or a banya, whose
little shop, where a death had occurred, was being emptied, watching
396
Measures in the Bombay Presidency and Sind. [ APP. VI.
articles being listed and then burnt in the street, when it came to
the bag oí grain protested. The Superintendent explained how it
had come in close contact with infection. " Welll," said the banya,
"don't burn grain; at least, give it to the poor." Close supervision
had also to be kept over the disinfecting coolies to prevent the appro-
priation of infected articles ordered to be burnt by the Superin-
tendents. These remarks exhibit how little the idea of contagion
has penetrated the native mind.
Further increase
of the plague at
Hyderabad,
With the week ending the 9th April, plague broke through the
barriers. Cases trebled and mortality doubled. The over-strain
proved too much for Mr. Dodgson's health, and most reluctantly he
had to take furlough. Mr. Gloster was sent up from Karachi, and
Mr. Steele, the Deputy Commissioner of Thar and Parkar, who was
to succeed Mr. Dodgson, spent a few days in Karachi, learning the
Plague Com-
mittee.
plan of campaign. Mr. Dodgson's last act was to recommend a
Plague Committee, and this was constituted by Government on the
9th April, with the Collector as Chairman, and Surgeon-Lieuten-
ant-Colonel Henderson, Major Price, Commanding the Station,
Surgeon-Captain Cater Jones, A.M.S., and Mr. Hiranand Khemsing,
President of the Municipality, as members. The Committee did
admirable work, and, as in Karachi, it minimised correspondence
and promoted united, well considered effort. The camps were
Camps.
brought under the control of European soldiers and non-com-
missioned officers. These camps had been carefully
laid out
and very systematically worked by Surgeon-Captain Cater Jones,
who devoted himself to the efficiency of their management and the
comfort of the inmates. Tickets showed the occupants of each hut,
with full particulars, so as to avoid constant reference by the inspect-
ing officer to the registers which were kept in the camp of office.
The observation shed for any sickness, disinfectants, provision
arrangements, were all well ordered. With the increase in attacks
O
'
the population recommenced flight from Hyderabad, but, with the
minute precautions taken to watch every outlet, the sick scarcely
Good effect of
the exodus of
the healthy
population.
End of the
epidemic at
Hyderabad.
attempted to get away, and, as Mr. Steele writes, the exodus of the
healthy here as everywhere contributed to that abatement of the
epidemic which began from the middle of April and rapidly continued
till plague disappeared. The last case occurred on the 2nd June,
the very day that the last case occurred in Sukkur.
Returning
population.
With the abatement, the tactics of the Committee were reversed.
This was ever the case with plague. Scarcely were dispositions
made than modification was called for to meet some new develop-
ment. A returning instead of a departing population had to be dealt
APP. VI. ] Measures in the Bombay Presidency and Sind. 397
with. Till the house had been certified fit for re-occupation by the
Superintendent of the quarter, no family could be allowed to enter,
and morning by morning inspections were made to see that there
was no unauthorised dweller and no sickness among the permitted
residents. Nor would the Superintendent allow entry till the family
was certified to be disinfected. Some 23,000 persons passed through
the disinfecting depots, where the arrangements for women and
children were very complete. To all this minute care and to the
great heat prevailing must be attributed the fact that plague did
not anywhere re-appear, and the Committee were able with fair
rapidity to reduce the establishments. The personal fatigue to all
the officers in supervising their quarters was very great, but fatigue
and heat and unpleasant surroundings were cheerfully borne.
Villages round
Hyderabad.
Meanwhile the villages were being overhauled lest plague were
anywhere smouldering. Mr. J. C. Pringle, I.C.S., a young officer,
who had distinguished himself in the city, was placed on this duty.
He was very careful in his investigations, but so good was the net
round Hyderabad that, as already said, few sick found their way out,
while the healthy were not kept in, with the result that the Hyderabad
District, excluding Hyderabad itself and Tando Alahayar, where 18
cases occurred, escaped with only 37 plague cases among a popula-
tion of between eight and nine hundred thousand people.
Hospitals at
Sukkur.
Two visits were paid to Shikarpur and three to Sukkur during
April and May. The work was being done well, and there was little to
do but be thankful that so fine a body of officers had been provided,
animated with the one mind to clear plague from the province arid
suspicion from the people. At Sukkur, as elsewhere, the sick were
accommodated in some of the best buildings in the town, the schools
having been placed freely at disposal by the Educational Inspector,
and the best comforts and nourishment that could be procured were
Nursing.
provided, while the nursing was that of the motherly Sisters of the
Lady Aitchison Hospital, Lahore, generously spared and eager for the
service assisted by the Zenana Mission ladies. While the sick were
thus accommodated, usually in the centre of the towns, instead of
being banished to some dreaded lazaretto, it was remarkable that the
Plague Hospital attendants and guards, and even the relatives of the
sick, enjoyed almost complete immunity. One of these nurses. Miss
Home, in Karachi, besides Sister Isabel at Rohri, took the disease,
but she also recovered. Under proper management, the disease
seemed paralysed and innocuous.
Immunity of
Europeans.
Not a single European worker took the disease, and the only
instance of a pure European taking plague was a little daughter of