NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
APP. IV. ] Regulations under the Epidemic Diseases Act.
221
the corpse, when not interred with the corpse, shall be destroyed. In
cases where cremation is the custom, the body shall be completely
burned at the usual burning ghat or other isolated locality in accord-
ance with custom, the cloths brought in contact with the body being
either burnt according to custom or disinfected.
53. Ambulances.—The Magistrate of the district or the Canton-
ment authority, or in Calcutta the Chairman of the Corporation, shall
provide suitable conveyances, painted in a conspicuous manner, for
the free carriage of persons suffering, or suspected to be suffering,
from the plague, and it shall be lawful to drive or carry such convey-
ances through any public or private thoroughfare.
54. Disinfection of public conveyances.—Any conveyance, public
or private, that has been used by a person infected with, or suspected
of being infected with, plague shall be thoroughly disinfected and
exposed to air and sunlight for not less than twenty-four hours before
being again used, and all articles of furniture belonging to it, which
in the opinion of the Health Officer cannot be properly disinfected,
shall be destroyed by fire.
Part IV.—Rules of General Application.
55. Compensation.—The Magistrate of the district or Canton-
ment authority, or in Calcutta the Chairman of the Corporation, may
in his discretion, pay compensation to any person who has sustained,
substantial loss or damage by reason of anything done under these
regulations ; provided, however, that no person shall be entitled as of
right to claim any compensation whatsoever.
In deciding claims to
compensation, the Magistrate or the Cantonment authority, or in
Calcutta the Chairman, shall consult the Committee appointed under
rule 32, but shall not be bound to follow their advice.
56. Control.—All powers conferred upon the Health Officer or
on a plague authority by these rules shall be exercised subject to the
general control of the Magistrate of the district, or in Calcutta of the
Chairman of the Corporation.
57. Expenses.—Subject to the provisions of Rules 33 and 34 all
expenses incurred in carrying out these rules shall, in the first ins-
tance, be paid from the Municipal or District Fund or from loans
made under the Local Authorities (Emergency) Loans Act, 1897 ; but
the Magistrate of the district or the Cantonment authority, or in
Calcutta the Chairman of the Corporation, may recover from any
person any amount which such person would under similar circums-
tances be liable to pay to the Commissioners under the Bengal Muni-
cipal Act, 1884, or the Cantonment Act or 1 Rules, or the Calcutta
Municipal Consolidation Act, 1888, as the case may be,
222
Regulations under the Epidemic Diseases Act. [ APP. IV.
Jurisdiction of the Military Authorities at Calcutta.
Rules for dealing with cases of actual or suspected plague
occurring within the jurisdiction of the military
authorities at Calcutta.
No. 43.
No. I399-D., dated Fort William, the 22nd March 1897.
From—MAJOR-GENERAL P. J. MAITIAND, Secretary to the Government
of India, Military Department,
To—The Quarter Master General in India.
I am desired to acknowledge the receipt of your letter No. 314-
B.— Camp, dated 19th March 1897, submitting, for approval, draft
rules for dealing with cases of actual or suspected plague occurring
within the jurisdiction of the military authorities at Calcutta. It is
stated that the rules were framed by the Principal Military, Medical
and Civil authorities at a Conference held at Calcutta on the 18th
March last.
2. In reply I am to say that the Government of India approve the
rules which will be communicated to the Government of Bengal.
Proceedings of a Conference held at Calcutta on the 18th March
1897.
Present :
Surgeon-Major-General Gore, Principal Medical Officer, Her Ma-
jesty's Forces in India.
Major-General Badcock, Quarter Master General in India.
Honourable H. Risley, Financial Secretary, Bengal Government.
Surgeon-Colonel Franklin, Officiating Inspector-General, Civil
Hospitals, Bengal.
H. C. Williams, Esq., Chairman of the Corporation of Calcutta.
Dr. Simpson, Health Officer, Calcutta.
Major-General Badcock read the orders of His Excellency the
Commander-in-Chief, referring to the Conference the question of the
arrangements to be made to deal with future actual or suspected
cases of plague occurring in Calcutta under the jurisdiction of the
military authorities.
The following rules were framed :—
I.--If, on examination of a sick person, the examining military
medical officer suspects that such person is suffering
from, or infected with, plague, he shall at once send
intimation to a civil medical officer designated for this
purpose by the Inspector-General; Civil Hospitals, Ben-
gal.
APP. IV. ] Regulations under the Epidemic Diseases Act,
223
II.—The Civil Medical Officer shall thereupon proceed to exam-
ine the patient in consultation with the Military Medi-
cal Officer.
III.—If the two consulting officers agree, the case is one of plague
or of suspected plague, they shall record their opinion to
this effect and shall send a copy to the Health Officer of
Calcutta, with a statement of the case.
IV.—The military authorities shall then arrange in communica-
tion with the Civil Police, for sending the case, in a mili-
tary ambulance, accompanied by a medical subordinate to
the isolation hospital at Maniktolla. The medical officer
in charge of the hospital shall countersign the duplicate
sick report.
V.—If the two consulting medical officers fail to agree in their di-
agnosis of the case, the Principal of the Medical College
shall be called in and the decision of the majority shall be
final.
VI.—On the termination of the case, the Health Officer shall re»
port to the military authorities, Fort William.
VII.—Nothing in these rules shall be held at present to apply to
British troops, but any case of plague or suspected case
of plague that may occur amongst such troops shall be
notified at once to the inspector-General, Civil Hospitals,
Bengal, and Health Officer, Calcutta.
Regulations issued by the Government of the
North-Western Provinces and Oudh.
GENERAL REGULATIONS.
No. 44.
Resolution N o . , 5 7 / X V 1 - 4 0 4 - B . dated the I2th February 1897.
READ—
Act No. III of 1897, an Act to provide for the better prevention
of the spread of Dangerous Epidemic Disease.
Notification No. 302, dated 4th February 1897, of the Governor-
General of India in Council, directing that the powers con-
ferred by the said Act may be exercised by the Government
of the North-Western Provinces and Oudh, with respect to
the territories administered by it.
Letter No. 38/XV1-404-B dated 29th January 1897 (Sanitation De-
partment), from the Secretary to Government, North-West-
ern Provinces and Oudh, to the Inspector-General,of Civil
224
Regulations under the Epidemic Diseases Act. [ APP. IV.
Hospitals"conveying instructions with reference to the de-
tection of cases of bubonic plague.
Observations at
railway stations.
The measures
hitherto adopted.
OBSERVATIONS.—The adoption of measures to prevent the in-
troduction into these Provinces of the bubonic plague now prevalent
, in Bombay has occupied the attention of this Government. Hither-
to the measures adopted have consisted in the appointment of sub-
ordinate medical officers to the principal railway stations on the fron-
tier and at railway junctions to observe the condition of passengers
arriving from Bombay, and in the independent action by District
Officers in keeping under observation persons known to have re-
turned to their homes in these Provinces from the Bombay Presi-
dency. The observation, however, at railway stations cannot lead
to the detection of cases in which the prominent symptoms of plague
are not apparent, much less to the detection of cases in which the
disease is in the state of incubation and has not disclosed itself ; and
the independent action of District Officers needs to be extended and
regulated.
Importance of
ascertaining the
health of
immigrants
from the Bombaj
Presidency and
of adopting
sanitary
precautions.
2. It appears that there is considerable intercourse between cer-
tain districts of these Provinces and Bombay. For instance, many
weavers are known to have sought employment in the Bombay direc-
tion. With the large exodus taking place from Bombay at present,
there is reason to believe that these and other persons are returning
to their homes in these Provinces ; a system of general observation
is therefore necessary, and towns and villages the inhabitants of
which are known to be directly connected with Bombay require above
all to be carefully watched. It has become a matter of urgent neces-
sity to establish a system of ascertaining the health of these immi-
grants and of immigrants who have already returned to their homes
from Bombay, and of taking all sanitary precautions to prevent the
spread of the disease should it break out—precautions which recent
legislation has placed it in the power of the Government to adopt.
Agency in rural
villages.
3. Rural villages.—The agency at the disposal of the Govern-
ment in the interior of a district for ascertaining the required informa-
tion is at present four-fold. First, there is the Police, Second,
the Revenue Staff [patwari, kanungo, etc.]. Third, the officers at
present engaged in Famine Relief in certain districts. Fourth, the
Hospital Assistants at the Branch Dispensaries. Each organization
must now be turned to the best account for the object above stated;
and detailed rules defining clearly the duties of each class of officer,
issued by the Government under Act No. III of 1897, are appended
to this Resolution [Annexure A, Part I].
Registers to be
maintained in
4. In every district lists will be made out of villages known to be
directly connected, by trade relations or otherwise, with those parts
225
APP. IV, ] Regulations under the Epidemic Diseases Act.
villages having
intercourse with
the Bombay
Presidency.
Enquiries in such
villages and
procedure on
occurrence of
suspected cases.
of India in which bubonic plague is prevalent. To such villages the
rules relating to the reporting of deaths when cholera is epidemic
will be applied, that is to say, daily reports will be required. At the
same time, a register will be prepared in each police station, from
reports furnished by village policemen, of all persons who have re-
turned from any part of the Bombay Presidency since the beginning
of January, or who may return in future so long as these regulations
are in force. On receiving information of the death of any person
whose name is recorded on the register or who resided in any vil-
lage from which daily reports are submitted, or on finding that an
unusually large number of deaths are returned from any village in his
circle, the officer in charge of the police station will inquire into the
symptoms which are alleged to have preceded death. If there is
reason to believe that these answer the description of the symptoms
of bubonic plague given in the instructions issued for his guidance,
the officer in charge of the police station will go to the village con-
cerned, and pending the arrivarl of a superior officer will, in a case of
ascertained plague, take certain precautionary measures with a view
to the prevention of the spread of the disease in the village. The
Tahsildars, who will also receive information through the patwaris,
will supervise the action taken by the police, and give such assistance
as may be required by the circumstances of the case.
Evacuation and
disinfection of
infected
localities.
5. From the inquiries made in Karachi and Calcutta, it appears,
that the best practical means of checking the increase of the plague
has been found to be the abandonment and thorough disinfection of
infected houses and localities, and the removal of the inhabitants to
camps constructed in the open, and the Lieutenant-Governor and Chief
Commissioner wishes this principle to be kept prominently in view. It
will be the duty of the district authorities to take steps to secure the
temporary abandonment of infected houses, and if such a course be
necessary, of infected villages or portions of villages. The inhabi-
tants should camp in the open or under trees at a suitable distance
from the infected spot, and will not be allowed to return until the
place has been thoroughly ventilated, disinfected and pronounced fit
for occupation by the medical officer.
Sanitary
measures in
municipalities
and small towns.
Evacuation of
infected quarters.
6. Municipalities and small ¿owns.—The rules applying to vil- í
lages will be applied, mutatis mutandis, to municipalities, canton-
ments and towns administered under Act XX of 1856. Here also the
chief remedy to be adopted is temporary evacuation of infected houses
or mahallas, and the occupation of temporary settlements well beyond
the limits of the town, until return is permitted. The Lieutenant-
Governor and Chief Commissioner desires to impress upon Municipal
b 29
226
Regulations under the Epidemic Diseases Act. [ APP. IV.
Boards the urgent necessity of scrutinizing the death returns, of check-
ing, so far as possible, the recorded causes of death, and of supervising
most carefully the sanitary arrangements, a duty which has already
been urged upon them in G. O. No.2626/X1-255-B, dated loth October 1896. It
is especially necessary that the latrine arrangements of all private
masonry houses in towns should be at once examined, and put in a
thoroughly satisfactory condition. For the Benares Municipality an
Assistant Surgeon has already been appointed as Special Health
Officer, and similar appointments will be made in the large towns of
Agra, Allahabad, Cawnpore, Fyzabad, Lucknow, and Meerut : the
services of commissioned medical officers will, if possible, be obtained
for the purpose. The Government looks to the Civil Surgeon or to
the Special Health Officer of the Municipality, when such an appoint-
ment has been made, to detect and immediately report to the Magis-
trate of the District any suspicious case that may occur. For collect-
ing information, the agency of the municipal police, chaukidars and
the conservancy staff should be fully utilized, and where necessary
strengthened.
Report of cases.
7. The rules in force in municipalities for reporting and dealing
with cases of infectious disease apply only to cholera or small-pox,
and are not sufficiently comprehensive in their nature : rules have
accordingly been made under Act No. III of 1897 (Annexure A,
Part II), providing for the reporting in municipalities, and also in
cantonments, of suspicious cases of illness indicating the presence
of bubonic plague, the segregating of patients, and the due disposal
of the corpses of persons who have died of the disease. These rules
will be publicly notified in all places where they have effect ; and
the attention of all Magistrates is drawn to the fact that a breach of
the rules is punishable under section 188 of the Penal Code. The
military authorities will be asked to co-operate in giving effect to the
regulations within the limits of cantonments.
Plague on' relief
works.
8. Relief works.—The occurrence of any case of plague on
relief works will be immediately dealt with by segregation under the
orders of the officers in charge of the works. Immediate notice of
such case will be sent to the nearest Medical Officer, the District
Engineer and to the Magistrate of the District. The associates of
any person seized with plague symptoms will be segregated and
placed in a gang by themselves. Special attention shall be paid to
the food grain sold and water supplied on any work where a case of
plague occurs.
Arrangements
for detection of
9. Railway stations.—The arrangements for detecting and dealing
with cases, or suspected cases, of bubonic plague at railway stations in
227
APP, IV. ] Regulations under the Epidemic Diseases Act.
cases at railway,
stations.
these Provinces have been recently revised : the rules on the subject
are now re-issued as regulations under the new Act (Annexure A,
Part III). It is not practicable to post a medical officer on duty at
every railway station in the Provinces. The most that can be done
is (I) to provide Medical Officers for special duty at stations on the
border of the Provinces, or at important junctions with a view to the
careful examination of passengers and the detection of suspicious
cases, and (2) to direct subordinates of the Medical or Sanitation De-
partment to be in attendance at the larger stations in the interior and
at less important junctions to assist the station masters in watching
for cases of plague. As regards the former measure, at Manikpur,
Jhansi, Saharanpur, and Ghaziabad, the duties of inspection and of
carrying out the prescribed measures on detection of a case of
bubonic plague devolve on commissioned Medical Officers, officers
of the rank of Civil Surgeon, or Military Assistant Surgeons, assisted
by female medical practitioners or female medical subordinates who
will be stationed at those places for the purpose. At these four
places, which command the approaches to the Provinces from Bombay
and Karachi (the Government of India having made arrangements for
examination at Bandikui), trains from infected quarters will be
stopped, and the passengers required to alight for the purpose of exa-
mination by the Medical Officer. Hospital Assistants have been
appointed by the Government at the stations of Agra, Allahabad,
Benares, Cawnpore, Lucknow, Moghal Sarai, and Muttra, whose sole
duty is to watch the trains, and to take precautionary measures, pend-
ing the receipt of orders from the Civil Surgeon. The Sanitary
Commissioner will now be requested to issue instructions to all Dis-
trict Superintendents of Vaccination to depute competent officers to
the stations, 32 in number, falling under the second class above men-
tioned, to assist the railway authorities. In the case of Rampur, the
authorities of the State will be asked to co-operate, and will, the
Lieutenant-Governor has no doubt, render every assistance possible
to the Sanitary Commissioner in making the necessary arrangements.
Inspecting
officers for
railway circles.
Io. In order to supervise the arrangements generally and to
assist the Civil Surgeons in the work of the control, the railway
system of the Provinces has been divided into three circles, and an
Inspecting Officer has been appointed by the Government to each
circle, whose duty will be to travel up and down the line, to visit the
observation sheds, temporary hospitals and segregation huts, and to
check the work of the Hospital Assistants and other subordinates.
Procedure on the
detection of
II. On detection of a case at a railway station, the rules provide
that the person believed to be infected with bubonic plague shall be
228
Regulations under the Epidemic Diseases Act. [ APP. IV.
cases at railway
stations.
placed under observation in a shed in the neighbourhood of the rail-
way station, until under the orders of a superior Medical Officer, he
is either discharged or removed for treatment to the temporary
hospital as suffering from the disease. Temporary hospitals have been,
or will now be, established at suitable places in the vicinity of, but at
a proper distance from, all railway stations in the Provinces where
officers of the medical or vaccination department have been posted,
43 in number : they are (with the exception of Manikpur, Jhansi,
Saharanpur, and Ghaziabad where special officers have charge) under
the direct management of the Civil Surgeon within whose district
they are situated. It is understood that the railway authorities have
provided observation sheds at all such places ; but if in any case this
has not been done, the necessary action should be immediately taken
in the matter by the Inspector-General of Civil Hospitals; in addition
to observation sheds and temporary hospitals, places of segregation
should be provided for use by persons accompanying a patient treat-
ed in a temporary hospital who are detained by order of a Medical
Officer.
The Inspector-General of Civil Hospitals should specify to each
Civil Surgeon (where this has not already been done) the extent of
the accommodation required in view of the above orders, the estab-
lishment to be maintained should occasion arise, and the furniture,
etc., to be provided. The Lieutenant-Governor and Chief Commis-
sioner leaves it to the Inspector-General to issue orders, in consulta-
tion with the Sanitary Commissioner, on other matters of detail, such
as the method of disinfecting houses and personal property, etc., and
the provision of ambulances or dhooiis.
Respective
duties of
Government
officers and
rai Iway
authorities.
12. It is essential for the due apportionment of responsibility
that the relative duties of the Government officials on the one hand and
of the railway authorities on the other should be clearly defined.
Except in the case of Allahabad, all Civil Surgeons or Medical Offi-
cers of the railway passing through their districts and as such have,
it is understood, taken certain precautionary measures in communi-
cation with the railway authorities. The precautions taken vary on
different lines in extent and in their character : except in the case
of the East Indian Railway, the Government has no detailed inform-
ation on the subject before it. It is reported that, on the East Indi-
an Railway, measures have been adopted—
(1) For the inspection of trains by medical subordinates.
(2) For the removal of a passenger from the train in a sus-
pected case, for his isolation in hospital and for dis-
infection of bedding, burning of clothes, etc., when he
leaves.