NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
334
Measures in the Bombay Presidency and Sind. [APP. VJ.
paid constant attention to the details of the management, and has
adopted, to the best of his ability, all suggestions made to him by the
Plague Committee. I have no hesitation in saying that there is no
native gentleman in Poona who has rendered services of equal value
to Government and the public generally during the plague epidemic,
Hakim Ainudin appears to have worked conscientiously and to have
been trusted by his patients.
Hindu Plague Hospital.
24. The Hindu Plague Hospital was erected from the voluntary
contributions with the sanction of the Plague Committee. It was
situated to the west of Poona City beyond the Lakdi Pul. It consisted
of rows of chappar huts divided into compartments, each of which was
intended for the accommodation of one patient. The hospital was
managed by a committee of Brahmins, subject to the control of the
Plague Committee,
25. The hospital was opened to all Hindus except members of the
low castes. Persons admitted were usually required to pay an
admission fee of Rs. 10 and Re. 1 per diem for maintenance charges.
Of 157 patients admitted 98 were Brahmins and 59 belonged to other
castes. As in the other plague hospitals patients were allowed to be
attended by one relative who lived on the premises.
26. The hospital was under the supervisional charge of Surgeon-
Major Barry and patients were not allowed to be discharged without
his authority. Mr. V. V. Bhagwat, L. M. and S., the visiting medical
officer, directed the treatment of the patients. The chief part of the
medical work was, however, done by two medical students who resided
on the spot and took the place of hospital assistants.
27. Appendix 29 is a daily statement showing the result of
treatment at the hospital. A summary of the results of the treatment
will be found in Appendix 30. Further statistical information relating
to the plague cases admitted is given in Appendix 31.
28. The sheds provided for the patients were comfortable, and the
hospital and its surroundings were for the most part kept in a good
sanitary condition. That the hospital was appreciated by considerable
section of the Hindu population appears from the numbers that
attended it. Surgeon-Major Barry's report on the management of the
hospital is, however, generally unfavourable. The proportion of deaths
to recoveries among true plague cases was higher, not only than at the
Sassoon and General Plague Hospitals, but also than at the Muhamma-
dan Hospital, where treatment on European methods was not in vogue.
APP. VI. ] Measures in the Bombay Presidency and Sind.
335
Par si Plague Hospital.
29. The Parsi Plague Hospital is situated on the side of the old
Satara road beyond the Rifle Range. It was erected by the Parsi
community at their own expense. The hospital is a substantial struc-
ture , rectangular in shape, roofed with corrugated iron and thatched.
There are six commodious and well ventilated wards for plague patients
with a bathroom attached to each. The wards are equipped in every
essential particular. At right angles are situated the nurses' quarters,
Hospital Assistants' quarters, dispensary, observation ward, etc., all of
which are thoroughly furnished. Suitable arrangements were made for
medical attendance and nursing. The hospital was under the super-
visional charge of Surgeon-Captain Thacker, A.M.S.
30. Up to May 2oth only one patient was admitted to the hospital.
The solitary case was that of an old man who was admitted suffering
from plague on May 13th and died on May 15th.
31. The hospital is a model one and reflects the highest credit on
the Parsi community. That it has remained for the most part empty
they would doubtless consider a matter of congratulation.
X.—SEGREGATION CAMPS.
The segregation camps were designed for the reception of appar-
ently uninfected persons who had been exposed to plague infection.
Removal to them was enforced under the powers vested in the Plague
Committee by No. 6 of the rules published with Government Notifica-
tion No. 1272—765-P. of 9th March 1897. The powers of the commit-
tee under that rule were subsequently extended by Government Reso-
lution No. 1810—I264-P. of the 2nd April 1897. Segregated persons
were liable to detention for a period not exceeding ten days.
2. The object of segregating the apparently healthy inmates of plague-
infected buildings was twofold. First and principally, to prevent those
of them in whom plague was in a state of incubation from developing the
disease in private houses and becoming fresh plague centres : secondly,
to insure the non-occupation of plague-infected buildings till the
buildings had been thoroughly disinfected. Ten days was fixed as
the maximum period of detention, as that was believed to be the
longest term for which the malady commonly remained in a state of
incubation in a human being.
3. The following segregation camps have been in use under the
orders of the Plague Committee :—
The General Segregation Camp.
The Muhammadan Segregation Camp.
The Cantonment Segregation Camp.
The Parsi Segregation Camp.
336
Measures in the Bombay Presidency and Sind. [ APP. VI.
The first two camps were situated near the Shankarshett road.
The two last were situated by the side of the OldSatara road beyond
the Rifle Range.
The General Segregation Camp.
4. The construction of this camp was commenced by the Poona
City Municipality on February 1st. In the first instance eight blocks
of huts containing 32 rooms were erected. On my arrival here I
issued instructions for largely increasing the size of the camp. It was
constantly growing till finally in the month of April it contained 122
rooms. The camp consisted of substantial chappar huts with mud
floors. At the commencement blocks containing- four rooms were
constructed. Later on, however, blocks were built with only two
rooms each, the object of the change being to diminish both the loss
that would be caused in the event of an outbreak of fire in any block,
and the house space to be disinfected in the event of the occurrence
of a case of plague. The size of the majority of the rooms was 12 by
10 feet. A plan of the General Segregation Camp accompanies
(Appendix 32).
5. Fifteen cook-rooms of corrugated iron were provided for the
use of the inhabitants of the camp. There were 20 latrines, 12 for
men and 8 for women.
6. The camp was abundantly supplied with water from a neigh-
bouring draw well. A pump was fixed up at the well and an adjoin-
ing cistern was kept full of water for the use of the inmates. Bathing
and washing platforms to which water was brought from the well
by pipes were constructed within the limits of the camp. Rows of
kerosine-oil tins filled with water were placed alongside all the huts
for use in case of fire, and a municipal fire-engine was kept on the
premises.
7. The camp was lighted by standard lamps which stood in rows
between the lines of huts.
8. When I arrived at Poona so much of the camp as was then
in existence was open to any of the inmates of infected houses that
chose to come there. There was then no agency to compel people
to come to the camp, and hardly any came there of their own accord.
After my arrival and before the employment of the military on plague
duty, I endeavoured to attract the inhabitants of plague houses to the
camp by offering one free meal a day to every one in camp, and at
the same time allowing the inmates to return to the city in the day-
time to follow their ordinary avocations. Even this inducement failed
to bring any considerable number of people to the camp, and I was
forced to realise that a non-compulsory system of segregation was
impracticable in Poona.
APP. VI.] Measures in the Bombay Presidency and Sind.
337
9. From March I3th, when the plague work of the military com-
menced, the segregation of the apparently healthy inmates of infected
houses was systematically enforced. Appendix 33 is a daily state-
ment showing how the inmates of the camp were disposed of from
March I3th to May 2oth. The following is a summary of that
statement:—
Period.
March I3th — 31 st
April ist— I5th
April 1 6th — 3oth
May ist — soth
TOTAL
Number
of
persons
detained or
admitted.
960
658
968
491
3,077
Have died.
8
3
...
1
12
Have been
found free
from plaguge
and dis-
charged.
252
863
824
676
2,615
Have been
found
suffering
from
plague.
12
16
6
2
36
Have been
otherwise
disposed of.
9
59
79
III
258
Five persons were in the camp on the morning of March I3th,
and there were 161 inmates on the evening of May 20th.
10. Of the 12 deaths that took place 9 were due to plague. The
number of persons shown as found suffering from the plague is
exclusive of the plague deaths that occurred in camp before the
sufferers could be removed to hospital. The persons shown as other-
wise disposed of are chiefly persons who for some reasons have been
allowed to leave the camp before the expiry of the ten days' period
of detention.
11. The following table shows the number of days after admis-
sion to camp that the case of plague declared themselves. In this
statement cases that ended fatally in camp are included :—
I
I
I
I
I
I
I
I
I
...
...
...
...
...
...
...
...
...
Number of cases.
...
...
...
X.
...
...
...
...
...
...
...
...
...
...
*..
...
...
• •«
• • .
...
...
...
...
...
...
...
...
Day of segregation on which
they occurred.
Ist day.
2nd „
3rd „
4th „
5th „
6th „
7th „
10th „
11th „
338
Measures in the Bombay Presidency and Sind. [APP. VL
As regards the case that occurred after the tenth day, it may be
explained that the patient's ill-health prevented his discharge when
his ten days of detention had elapsed.
12. The General Segregation Camp was in charge of Surgeon-
Captain Beveridge who visited it and inspected all the inmates daily,
besides closely supervising the sanitary arrangements. His principal
subordinates were the Superintendent, the native officer in com-
mand of the infantry guard ; and the hospital assistant. Besides a
native infantry guard a sufficient staff of clerks, water-carriers, cooks.,
bhangis, sweepers, lamplighters, and coolies was maintained.
13. A copy of the rules in force is attached (Appendix 34).
Though the rules contemplated the grant of allowances for rations
to members of the labouring classes only, as a general rule, it was
found to be a matter of much practical difficulty to determine who
should and who should not receive them, and in practice they were
allowed to nearly all the inmates of the camp. There were three
banias' shops within the encampment, which was visited daily by
milk and vegetable sellers. Some members of the Hindu community,
with the permission of the Plague Committee, opened an eating-house
in the encampment, where such persons as desired it could obtain
food ready cooked on payment.
14. Surgeon-Captain Beveridge is of opinion that apart from
plague the general health of the inmates of the camp was good, and
that segregated persons as a rule improved in condition during the
period of their detention.
The Muhammadan Segregation Camp,
15. This camp was built and equipped at the expense of the
Muhammadan community and was under the same management as the
Muhammadan Plague Hospital, from which it was only a short distance
away. It consisted of rows of chappar huts, which would comfortably
accommodate one hundred persons. Sufficient latrines and cook-rooms
were provided. The camp was under the supervision at first of
Surgeon-Captain Beveridge and subsequently of Surgeon-Lieutenant
Kiddle.
16. Appendix 35 is a daily statement showing how the persons
admitted to the Muhammadan Segregation Camp were disposed of.
Admissions took place from March I5th to April l6th and the camp
was finally closed on April 22nd. The total number of inmates
admitted was 302, of whom 255 were found free from plague and dis-
charged, 2 were found to be suffering from plague, and 45 were
otherwise disposed of. No deaths took place at this camp.
App. VI.] Measures in the Bombay Presidency and Sind.
339
17. Two inhabitants of the camp, both women, were attacked with
plague. One was admitted to the camp on March 20th and was
. attacked on March 22nd ; the other was admitted on April 6th and
was attacked on April gth.
18. As at the General Segregation Camp the period of detention
was ten days, Inmates Were inspected daily by the supervising medi-
cal officer. Some of the inmates were provided with food by the
Muhammadan committee of management, while others were kept sup-
plied with food by their relations and friends.
The Cantonment Segregation Camp.
19. The Cantonment Segregation Camp consisted of three rows of
8o-lb. tents, eight tents in each row, and could comfortably accom-
modate from 100 to 120 persons. Behind these were situated bath-
rooms, store-houses, etc., built of corrugated iron. Latrines of corru-
gated iron were also provided. As at the other camps the native
infantry guard was accommodated in tents.
20. Appendix 36 is a daily statement showing how the persons
admitted to the Cantonment Segregation Camp were disposed of. In-
mates were first admitted on February 24th. Between that date and
May 29th the admissions numbered 659. Of these 601 were found
free from plague and were discharged, 6 were found to be suffering
from plague, 26 were otherwise disposed of, and 26 remained in camp
on May 20th. No deaths occurred at this camp.
21. The following statement shows the dates of admission and
attack in the case of six persons who were found to be suffering from
plague :—•
Case number.
Î
2
3
4
5
6
Date of admission to camp.
gth March
2nd April
5th April
4th April
6th April
1 3th May
.
•
Date of attack.
9th March.
3rd April.
5th April.
6th April.
7th April.
17th May.
It will be seen that no one was attacked later than four days after
admission to camp. Persons found suffering from plague were des-
patched to the General Plague Hospital.
22. The usual period of detention at the Cantonment Segregation
Camp was from seven to ten days, but in some instances inmates were
discharged after shorter term.
340
Measures -in ¿he Bombay Presidency and Sind. [ APP. VI.
23. Water was brought to within 200 yards of the camp by means
of pipes and was conveyed into the camp by bhistis. The supply was
of a sound, potable character, and was ample in quantity.
24. All the inmates of the camp were supplied with rations. The
daily ration consisted of 2 lbs. of rice or flour, 3 ozs. dal, 2 ozs. ghi, 2
ozs. jagri, 1/8th oz. salt, chillies and tamarind, besides fresh vegetable.
For Goanese and Eurasians, mutton, bread and vegetables were sup-
plied.
25. On arrival in camp each person had a good bath, and was pro-
vided with fresh clothes and bedding. All clothes and similar articles
brought to the camp were thoroughly disinfected by steeping for 30
minutes in carbolic solution or corrosive sublimate solution and placed
in the sun to dry for five or six hours.
26. The inmates of the camp were regularly inspected by the
medical officer. New admissions were kept separate from the other
inhabitants of the camp for the first three days of the detention.
27. When a case of plague occurred the tent which the patient had
inhabited was struck and placed in the sun for three days. The ground
was well soaked with carbolic solution and chloride of lime in solution
was sprinkled about.
28. The latrines were kept under close supervision and were
attended to twice daily, the evacuations being disinfected before
removal.
29. Surgeon-Captain Thacker reports that the inmates of the camp
declared themselves much pleased with the treatment they received
and expresses an opinion that they improved in health and general
appearance during their sojourn there.
30. The camp was under the management of Surgeon-Captain
Thacker and was well administered in every particular.
Tli e Par si Segregation Camp.
31. The Parsi Segregation Camp, which was situated alongside
the camp last described, consisted of four large tents capable of accom-
modating from 40 to 50 people. It was provided with bath-rooms, a
cook-house, a store-house and latrines. All were thoroughly suitable for
their respective purposes. The camp was under the same management
as the Parsi Plague Hospital which was situated on the opposite side
of the road and was under the supervision of Surgeon-Captain
Thacker.
32. Appendix 37 shows how the inmates of the camp were dis-
posed of, Between March 27th, when the first admission took place,
APP. VI. ] Measures in the Bombay Presidency and Sind.
341
and May 20th, 20 persons were admitted, of whom 18 were found
free from plague and discharged, and two remained in camp on May
20th. There were no deaths or plague attacks. The period of deten-
tion was ten days.
XI.—PLAGUE AND MORTALITY STATISTICS.
Poona City.
The population of Poona City, according to the census of 1891, is
118,790. The area of the city is 4.9 square miles and 24,242 persons
per square mile represents the density of population. For statistical
purposes the population, according to the census of 1891, is throughout
this report taken to be the population of Poona.
2. As a matter of fact, however, the population of Poona has fluc-
tuated considerably between September 1896 and May 1897. Owing
to the establishment of the plague in Bombay people from that city
began to flock into Poona so far back as September 1896, and con-
tinued to do so till February 1897. On the other hand, an exodus from
Poona set in towards the end of January when the plague had taken
root in the city. It continued throughout February and the early days
of March. In the second week of March, when it was known in the
city that the military were to be employed to suppress the plague,
large numbers of people left Poona. From the middle of March to
the middle of April the exodus continued on a diminished scale. To-
wards the end of April the tide turned, and during the first-half of
May there was a considerable influx of population. When the mili-
tary operation s ceased on May 19th the population of Poona was prob-
ably about what it was when they commenced on March 30th.
3. Estimates of the population at various stages of the epidemic are
necessarily a matter of guesswork, a very large proportion of the
egress having been by road, statistics of which are not available, i
believe, however, that the maximum population was attained in the
middle of January when there were probably not less than 150,000
people in the city. In the middle of April, when the population had
reached its lowest point, the number of inhabitants probably did not
exceed 80,000.
4. The first registered case of plague in Poona City, an imported
one, occurred on 19th December 1896. Having regard to the numbers
of plague patients found at Poona railway station during the previous
2 1/2 months, it is probable that cases occurred earlier, but if they did,
they were not reported to the municipality.
5. A statement of the daily plague attacks, plague deaths, and total
mortality from December 1st, 1896, will be found in Appendix 38. The
342
Measures in the Bombay Presidency and Sind. [ APP. VI.
monthly mortality of the city during the period of the epidemic is
contrasted with the mortality in previous years in Appendix 39.
Appendix 40 shows how the various castes and races have been
affected by the epidemic. The following statement, which is an
abstract of Appendix 38, gives statistics of plague attacks, plague
deaths and total mortality for the 1st to 10th, 11th to 20th and 21st to
the last clay of each month :—
Period.
December 1st —10oth
December 11th — 20th ...
December 21st — 31st
January 1st —10th
January 11th — 20th
...
January 21st— 31st ...
February 1st— 10th
February 11th — 20th
February 21 — 28th
...
March 1st— 10st
March 11th — 20th
March 21st— 31st
April 1st —10th
•
April 11th— 20th
April 21st — 30th
May 1st— 10th
May 11th— 20th
TOTAL
PLAGUE ATTACKS.
Impor.
ted.
...
1
1
7
3
8
5
,.,
2
I
...
...
...
I
2
...
X
32
Local.
...
...
2
5
18
60
64
51
81
245
399
453
337
165
88
29
20
2,017
Total.
...
I
3
12
21
68
69
51
83
246
399
453
337
1 66
90
29
21
2,049
Plague
deaths.
...
...
4
IO
20
65
66
42
64
202
241
313
218
132
66
22
16
I,48l
Total
mor-
tality.
59
72
139
9°1
66
241
256
329
424
615
517
524
328
206
109
59
S3
4,187
\nnual death-
rate per mille
represented
on census
population
by total
mortality.
18
22
38
27
51
67
78
I 01
163
189
159
146
1OO
63
33
18
16
...
6. From Appendix 39 it will be seen that the registered mortality
was abnormally low in October and November 1896. It was slightly
above the average in December, and largely so in January, February,
March and April. In May it was again below the average.
APP. VI. ] Measures m the Bombay Presidency and Sind.
343
7. There is little reason to doubt that owing to the exceptional
dryness of the weather consequent on the early stoppage of the mon-
soon of 1896, the general health of Poona from October 1896 to May
1897 was, apart from the plague, exceptionally good. This fact being
accepted, it will be evident from a perusal of Appendices 38 and 39
that the number of reported plague deaths does not wholly account for
the largeness of the total mortality in the month of January, February,
March, and a portion of April. The fact is that a large proportion of
the plague deaths that have occurred in private houses have been
falsely reported as due to other causes and registered accordingly by
the municipal authorities.
8. The total number of plague deaths registered up to May 20th
has been 1,481. A more correct idea can, however, be obtained of the
number of plague deaths by deducting the average mortality from the
actual mortality for each month and treating the balance as due to
plague. The number of plague deaths reported after 2oth April may
be accepted as approximately correct. The following statement shows .
the plague mortality of Poona City as arrived at by this method :——
Month.
I
December
,.,
January
...
...
February
...
...
March
.,,
...
April ist to 2oth ...
Average mor-
tality of preced-
ing five years.
2
261
261
225
244
178
Actual mortality
in plague
year.
3
270
497
1,009
1,656
534
Add — Reported plague deaths from April 21st to May 20th ...
Total estimated plague mortality
,,.
Difference bet-
ween columns
2 and 3.
4
9
236
784
1,412
3S6
104
2,901
9. The estimate of the total plague mortality thus arrived at is
probably too low rather than too high. In the first place it has to be
remembered that the general health, apart from plague, was good
throughout the epidemic. Another cause that operated to keep down
mortality during the period the military search parties were employed