NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
372
Measures in the Bombay Presidency and Sind. [ APP. VI.
Officer had paid a few visits. Since December inspections had
been ordered at—
Kotri from the 2nd
Laki
„
Dadu
„
Hyderabad
,,
Pad Edan
„
Ruk
„
January.
Jacobabad from December 26th.
Shikarpur „
„ „
22nd.
Sukkur
„
„ „
30th.
Rohr i
„ January 2nd.
Reti
The chief inspections were made by day-light at Kotri, Dadu,
Sukkur and Jacobabad ; at other places the examinations were subsi-
diary. Since the 14th January, down-trains were also being examined.
Medical subordinates in charge of dispensaries were also examining
at—
Sehwan,
Tando Adam.
Tando Alahyar.
Mirpur Khas.
Ghotki.
Larkana.
At Jungshabi, the station for Tatta, a special Hospital Assistant
had been posted from the 7th January, Isolation and segregation
sheds had been constructed by the Municipal and District authorities
and in some instances by the Railway.
Karachi to
Cutch.
On the 27th January, the Political Agent, Cutch, was informed
by telegram that the Cutchi quarter of Karachi was affected, and
Cutchis were leaving Karachi by steamer, and it was advisable to
take precautions.
Inspections by
Commissioned
Medical officers.
The weak spot in these arrangements was, however, the need
for a Commissioned Medical officer, and this Surgeon-General
Cleghorn pointed out. This want was supplied on receipt of Govern-
ment telegram dated 6th February. The Principal Medical Officer
was requested to arrange for platform inspections by commissioned
medical officers. The Principal Medical Officer immediately directed
the Civil Surgeons at Karachi, Sukkur and Hyderabad, and at
Shikarpur the Assistant Surgeon, to conduct the examination person-
ally. A second examination at Dadu by a Commissioned officer
was, however, urged, as both trains arrived by day-light and the extra
10 hours gave the fever time to develop. On the 8th the Principal
Medical Officer telegraphed for two officers. By the I5th February
Surgeon-Lieutenant A. Gwyther was posted at Dadu, where was a
bungalow and a refreshment-room and a segregation camp, and
Surgeon-Lieutenant M. R. J. Rainier was posted to Karachi City and
Cantonment stations. Detailed rules for their guidance were drawn
up and issued by the Acting Commissioner, in consultation with the
Principal Medical Officer, on the 20th February, and were approved
373
APP. VI. ] Measures in the Bombay Presidency and Sind,
by Government Resolution No. 1093-563-P., dated 27th February
1897, General Department. These two officers performed their
tedious duty most conscientiously. From the middle of February,
therefore, it became very difficult for any sick persons travelling by
rail to escape detention, and many passengers were so detained.
Further arrange-
ments in
Karachi.
Surgeon-General Cleghorn's recommendation as to the thorough
disinfection of houses had been, as already stated, anticipated to a
certain extent by Dr. Kaka, but a visit to the city on the 25th Janu-
ary of the Acting Commissioner, accompanied by the Principal
Medical Officer, the Civil Surgeon, the Deputy Sanitary Commissioner,
the Municipal authorities and the Collector of Karachi, followed by
another inspection on the 27th with the Collector, convinced all that
the disease was making rapid strides. It appeared necessary to
secure that the increase of work did not lead to delay in disinfection
and to indifferent and hurried work. Accordingly, on the 25th Jan-
uary, Police Inspector Brown was ordered by urgent telegram from
Sukkur. On the 27th Mr. P. R. Cadeil, I.C.S., was summoned by
wire from Larkana, and Mr. H. S. Lawrence, I.C.S., who happened
to be in Karachi, was detained at head quarters.
Measures
adopted.
The Collector notes (paragraph 45) that Surgeon-General Cleg-
horn recorded a favourable opinion on the plague operations in
progress at the date of his visit, and it may be convenient here to
summarise what was then being done. The measures were thus
described in a telegram to Government, dated 20th January :—
Cleansing and disinfecting streets and gullies.
Vigilant house-to-house inspection.
Supervision of burial and burning grounds.
Thorough disinfection [with perchloride of mercury (1 in
1,000)] of plague-infected houses.
Destruction of infected clothing.
Infected huts burnt down.
Large camps ready, and inhabitants of infected quarters
being induced to move into them.
Air admitted into ill-ventilated rooms by breaking holes
in roof or walls.
Subordinate
Officers.
On the 28th January, the Collector applied for the loan of 20
subordinates competent to superintend a general cleaning of vacated
tenements, many of which contained property left behind by the
owners in their flight. In the Collector's opinion, it would carry
great weight with the populace if these subordinates were invested
with magisterial powers. Accordingly, on the same date, the Acting
Commissioner informed the District officers in Sind that the
374
Measures in the Bombay Presidency and Sind. [ APP. VI.
Municipality of Karachi were about to undertake this systematic clean-
ing and disinfecting of all houses in plague-infected quarters, and
requested them to despatch Revenue subordinates of standing suffi-
cient for investment with responsible powers. On the following
day, the Collector of Customs, Mr. Coghlan, was similarly addressed.
The Muncipality agreed to pay a deputation allowance of from
Rs. 15 to Rs. 30 per mensem, according to salary. These measures
were reported to Government by telegram. The customs men joined
immediately, and most of the others arrived in Karachi during the
first week of February. Among the first was Mr. Phillipowsky, of the •
Customs House, who proved of great assistance. The 20 subordi-
nates were duly obtained by the hearty co-operation of the Collectors
and Deputy Commissioners, and were invested with Magisterial
powers by Government Resolutions, dated 1st and 15th February.
Subdivision»
Mr. Cadell had been summoned in order that the work in Kara-
chi might be subdivided under responsible officers, and on the 30th
January it was arranged with the Collector that the infected portions
of the town should be divided between Messrs. Lawrence and Cadell
and Inspector Brown, with separate Sanitary establishment and
Revenue subordinates allotted to each. Thus began that subdivi-
sion of the town under Superintendents which proved the backbone
of plague management. Mr. Gloster, I.C.S., Joint Judge, joined
a few days later of his own accord, and allowed of still further sub-
division of the worst part.
On the 6th February, in a letter already quoted, the Acting
Commissioner had informed Government that a further object in
placing officers of the rank of Assistant Collector in superior charge
was that it was desirable by the free movement of officers of tact and
position among the people to endeavour to allay the panic.
Position of affairs
at the end of
January.
¡
At the end of January the situation was this. Though the
disinfection of individual rooms was being carefully done with perchlo-
ride of mercury (1 in 1,000), the best possible disinfectant, the work
had fallen into arrears. One advantage of quick disinfection was that
it usually hastened evacuation. When work was in arrears people
were not leaving their houses quick enough, and one after another of
a family fell victims. And there was no medical treatment. It was
considered of paramount importance to cleanse and disinfect the
shut-up houses, because at this stage the strain had so far broken
down the Municipal organisation that it had become impossible to
ascertain with certainty all the houses in which sickness or death had
occurred. It was therefore decided to take up the work street by
street, and do each house from basement to roof systematically. But
APP. VI, ] Measures in the Bombay Presidency and Sind.
375
Emptying
houses.
no sooner had the first Superintendents been appointed and their
gangs of masons and coolies—each gang under a revenue subordi-
nate as supervisor, with disinfectants, ladders and Hmewash—been
supplied than it was found that a hard day's work from sunrise
would barely enable them to overtake the preceding night's sickness
and mortality. And this was essential so as to use the cleansing as
a means of turning out the surviving members of the family. Dr.
Cleghorn's assurance that turning out the healthy was the right policy,
and should be continued, came at the right moment. Only, instead
of attempting to empty the first infected portion of the town in the
hope that the disease might be thereby localised, the prime object
was now to empty each house immediately it became infected ; that
is, the sick person was left in the house with one or two relatives in
attendance, and the rest must be moved. The disease, though no
longer confined to the old town and rapidly developing in the adja-
cent market and Napier Quarters, was still central, and every exertion
was to be made to secure immediate disinfection, rapid removal of
the healthy, and at least some treatment for the sick. But, to
do anything at all, it was primarily necessary to win the public con-
fidence.
On the 1st February, the town was visited with Mr. Tahilram,
the President, and Mr, Framroz, the Mukhtyarkar. There had been
during the preceding 24 hours the unprecedented number of 59 cases
and 51 deaths. Messrs. Lawrence, Cadell and Brown were found full
of work. Next day, the Judge, Mr. Hart Davies, though on the eve
of retirement, nobly volunteered, and thereafter till he left moved
among the people, side by side with the Acting Commissioner, with ex-
cellent effect. The people recognised that, when the Judges, Messrs.
Hart Davies and Gloster, worked with the Executive and Municipal
officers in their streets, a great effort was being made for their relief.
The 2nd of February had dawned on 50 deaths, and the 3rd broke with
51. It was the climax, as already said. Messrs. Gloster and Barker,
Abkari Inspectors, were allotted sub-divisions, and Surgeon-Captain
Arnim was asked to take charge of the Sadar Bazaar. The Sadar
Bazaar was at that time quite free, but it was the commencement of
appointing Superintendents in advance of the plague, so that the
disease might find no filth wherein to lodge and germinate. Soon
the streets all over Karachi were almost impassable for heaps
of burning rubbish and carts removing what would not burn, while
lime washing by owners or Municipal agency became nearly universal,
Surgeon-Captain Arnim was specially successful in getting the owners
and occupiers to do the work personally under repeated inspection
376
Measures in the Bombay Presidency and Sind, [ APP. VI,
Disinfecting
work.
and this example was quickly followed and so relieved the over-
strained officers. On the 4th there were 43 deaths, on the 5th 35,
but the 6th recorded 58 cases and 52 deaths, and new efforts were
called for, But it was the extreme point touched, and the disease
began to yield, and never afterwards got out of control. Mr. Crouch,
the Public Prosecutor, had unsought, quietly added himself to the
band of Superintendents, and Mr. Gumming, the Port Trust Secretary
was another valuable addition, every man working the whole day long
meeting at the Denso Hall, or other appointed spot, between 6 and
7 A. M., to get the returns of the day before and muster gangs, and
working on till dark, only returning for breakfast, By the nth Feb-
ruary, the arrear work in disinfecting houses in which plague cases
had occurred had been overtaken, and from that date the systematic
cleaning of houses in which cases had not occurred was commenced.
The scenes were heartrending. In one little close of respect-
able houses, all within a few yards, 21 plague death-marks could be
counted—6 and 7 deaths in one house. There had been a stampede
of the healthy families from the badly infected places, and many had
removed with their first sick relative to other parts of the town, but
there was no panic in the sense that anything was noticeable in the
streets. Only when houses were entered was the state of affairs dis-
closed, and then it was good to see the devotion, ignorant though it
was, with which the survivors would lay out their dead and attend the
funeral. The Acting Commissioner endeavoured, for the sake of
example to the people and the preservation of the workers, to insist
on disinfection, by spraying in the manner appointed by Doctors Kaka
and Arnim, preceding the advance into the houses. But there was
as noble and devoted a band of officers and men as could be srathered
D
together whom nothing would restrain.
As an example of the intense anxiety of these days, after a long
morning with Messrs. Hart Davies and Cadell, in the evening it was
reported to the Acting Commissioner that Mr. Cadell was down with
fever. The Civil Surgeon was sent for, and took the temperature.
It was normal—not plague ; but the shock to the Acting Commissioner
when he saw the officer he had summoned suddenly, as it were
struck down, he will not easily forget. At that time, the immunity of
Europeans was not realised, and the Acting Commissioner had served
under his well-known father, Colonel Cadell, and the son followed the
father in disregard of danger.
Disposal of
bodies.
With the increased mortality, it was feared there might be care-
less buying, and with increased stringency that bodies might be sur-
reptitiously removed. From the beginning of January, one or two
APP. VI. ] Measures in the Bombay Presidency and Sind.
377
police had been posted but from the 3rd February the District
Superintendent of Police was requested to take the burial and burn-
ing grounds under his personal supervision, and thereafter the police
returns became a very useful addition to the daily municipal record,
allaying any suspicion lest deaths might be escaping record.
Muhammadan
medical officers.
In the letter to Government, dated 6th January, it was stated that
the presence of a thoroughly competent Muhammadan medical offi-
cer would greatly strengthen the Health Officer. The Principal
Medical Officer had been able to supply one of the 'best in Sind,
Sheikh Abdul Rahman. This Hospital Assistant came from Mirpur
Khas and soon commanded respect. Government were good enough
to procure an Assistant Surgeon Subhan Ali from the North-Western
Provinces, and the Municipality obtained Mr, Fazul Ahmad, a private
practitioner, from Amritsar. All these were at work by the first
•week in February in the trans-Lyari quarter.
Plague in the
trans-Lyari
quarter.
The trans-Lyari quarter is separated from the town of
Karachi by the broad, sandy bed of the Lyari. On the flats beyond
are clustered 2o settlements of poor Muhammadans of different
tribes, fisher people Sidis, Mekranis, Pathans, Baluchis, Brahuis, etc.
each in their separate village. Twelve of the settlements are mostly
only reed and mud-plastered huts. The remaining eight are of
inferior houses of a permanent type. The sites of the huts are held
on leases from the Municipality, terminable at one month's notice.
Among these people, numbering at the census over 22,000, but
estimated now at over 30,000 or one quarter of the present estimated
popluation of Karachi (124,000), plague did not show itself till the
10th January, when two cases occurred, and up to the end of January
cases were few and isolated. But, with the beginning of February
cases multiplied rapidly, and on the 6th February there were 22
cases and 17 deaths. With the first indication of coming trouble
resort was at once made to the contemplated employment of Muham-
Appointment of
Muhammadan
officers.
madan agency. Sardar Khan Bahadur Muhammad Yakub, Deputy
Collector of the Nara Valley, who had done distinguished service in
the suppression of the dacoities in the Thar and Parkar District
a year ago, was sent for and placed in charge of the quarter, as
though it were a sub-division. To assist him, Mr. Giles recommended
Khan Saheb Rasul Baksh, a very happy selection, who was brought
from his Mukhtyarkarate of Kambar in the Larkana sub-division.
A few Muhammadan supervisors were added. The Sardar at
once set to work to get hold of the tribal headmen and to provide
segregation huts, with Mr. Strachan's ready aid for each tribe.
Loan for
Karachi.
On the 3rd February, also a telegram was despatched to Govern-
ment, asking for a loan of a lakh of rupees for the Karachi Municipality
b 48 .
378
Measures in the Bombay Presidency and Sind. [ APP. VI.
A ppointment of
two Commis-
sioned medical
officers.
and for the deputation of two gazetted medical officers, The
Assistant Collectors and other officers working in the town were
becoming pretty well known, and it was hoped that access to the sick
might now be obtained if a medical officer moved about in their
company. In writing to Government on the same day February 3rd,
Difficulties in the
way of segregat-
ing sick.
it was stated that the compulsory removal of the sick would probably
be the most effectual of all remedies, and was the one advocated by
the medical officers ; but it was hopeless to work counter to the
popular feeling, and the Muhammadans were so far particularly
obstinate, A rule had been promulgated by the Municipality that an
infected house was to be compulsorily vacated by the surviving
inmates. These, it was found, cling to their house till as many as
6 or 7 deaths practically annihilate the family.
Work by Drs.
Niblock and
Cornwall,
Government responded immediately, and Surgeon-Lieutenants
Niblock and Cornwall reported themselves on the 12th February.
The Acting Commissioner told them that two duties of the utmost
importance lay before them. They were to induce people to come to
hospital, and they were by their acts to give the lie to the stories in
circulation that the aim of Government was to stamp out plague by
poisoning the sick. Right nobly they discharged the trust. Next
morning, the Acting Commissioner missed Surgeon-Lieutenant
Niblock from his side. The young doctor had discovered a house full
of sick, and was already at work arranging the helpless. Presently,
he was to be seen with an attendant carrying a small box, rigged up
as a little potable medicine chest going his rounds, welcomed by
nearly all, and the effect of the treatment was electric. Dr. Corn-
wall was doing the same splendid service across the Lyari.
Without hospitals, without appliances, asking for no help, and ignorant
of the language, these young doctors in a few days had won free
entrance everywhere. First the sympathy and fearlessness of the
officers, moving among the people with gentle firmness, and then
the healing treatment and the all-day long devotion and skill of
these two young medical officers convinced the poor there was
nothing to dread.
Plague hospital
in Karachi.
With doctors in the city and doctors at the Railway stations
patients began to be taken to the Civil Hospital. Mr. Giles visited
the hospital and finding plague patients in the same compound with
the ordinary civil sick, he arranged with the assistance of Mr. E. Giles,
the Educational Inspector, for making the Government High School,
next door to the Civil Hospital, available for ordinary patients, while
the Civil Hospital became the Plague Hospital. Throughout the
plague and wherever it broke out, the schools were the only large
APP. VI. ] Measures in the Bombay Presidency and Sind.
379
Schools as
hospitals.
suitable airy buildings available. Many a head of a department might
have hesitated. To Mr. E. Giles the most hearty thanks of the prov-
ince are due for placing freely at disposal colleges and schools, thus
enabling the best possible accommodation to be given to the sick in
the approaching heat of Sind, and saving Government and the Muni-
cipalities a heavy expense. Government approved the arrangement
by wire, and Surgeon-Lieutenant-Colonel Henderson, with Surgeon-
Lieutenant Niblock's assistance, soon had a fully equipped plague
hospital, of which subsequently Surgeon-Lieutenant Niblock took
charge.
Relief fund'.
The pleaders and other native gentlemen had been desirous to
give a farewell entertainment to Mr. Hart-Davies. Mr. Hart-Davies
begged that, in consideration of the suffering around, the money might
be devoted to some public object. A meeting was called at Govern-
ment House, and it was decided to raise a relief fund, so that those
working among the people might be placed in funds. Mr. Motiram
Advaui, Barrister-at-Law, kindly undertook the task of collecting.
The ladies of the station gave a successful concert in the Frere Hall,
and eventually Mr. Advani produced the substantial assistance of
some twenty thousand rupees, for which he deserves the gratitude
of many. Each Superintendent was at once supplied with a perma-
nent advance. Furniture was placed in the plague hospital, and
stimulants and food and comforts were liberally supplied, and soup
kitchens opened across the Lyari. One thing was yet lacking, and that
was nurses. The good work done by the Convent Sisters in the
Famine Hospital in Bangalore was recollected. Sister Heriberta,
of the Karachi Convent, with the approval of the Revd. H. Jürgens,
responded without hesitation, and in a few days the Sisters were
heartily welcomed by Dr. Henderson, who had made, with Mr.
Nurses.
Advani's help, every arrangement for their comfort. The Sisters
occupied the upstairs or European wards of the hospital and lived
there for several months, nursing the 60 to 100 sick below by day and
by night, and entered on the dangerous duty with happy self-sacrifice.
They were soon beloved. Later on, they were joined by several
nurses paid from the Charitable Fund and were assisted by the two
Misses Carey of the Zenana Mission. The agreement was that there
was to be no mention of religion. The light that shone from the
healing of the sick under such loving ministration could not, however,
be hid.
Another act also impressed the native community. Special
prayers were offered in church from Sunday, the 14th February, and
on the 19th February a special intercessory service was held by the
Revd. F. Sandberg in Trinity Church, which was largely attended.