NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
APP. IV. ] Regulations under the Epidemic Diseases Act.
275
Public con-
veyances not
to carry plague
patients.
I.—Except as provided in the next following clause, no proprietor
or driver of any licensed hackney carriage or of any ekka, rath, baili
or other vehicle ordinarily employed to carry persons for hire shall
convey or permit to be conveyed in any such licensed hackney carri-
age or vehicle any person who, there is reasonable ground to believe
or suspect, is or may be infected with bubonic plague, or the corpse
of any person who, there is reasonable ground to believe or suspect,
has died from that disease.
Except under the
order of
competent
authority.
II.—A District Magistrate and any person to whom power under
this clause may be delegated by any District Magistrate, and any per-
son who has been appointed to be an Inspecting Medical Officer under
any Regulation made under the Epidemic Diseases Act, 1897, may
direct the proprietor or driver of any licensed hackney carriage or of
any ekka, rath, baili or other vehicle ordinarily employed to carry per-
sons for hire, to convey or permit to be conveyed in such licensed
hackney carriage or vehicle to any place any person who, there is
reasonable ground to believe or suspect, is or may be infected with
bubonic plague, or the corpse of any person who, there is reasonable
ground to believe or suspect, has died from that disease, and such pro-
prietor or driver shall be bound to obey every such direction.
III.—When any person who, there is reasonable ground to believe
or suspect, is or may be infected with bubonic plague, or the corpse
of any person who, there is reasonable ground to believe or suspect,
has died from that disease, has been conveyed in any licensed hackney
carriage or in any ekka, rath, baili or other vehicle ordinarily employed
to carry persons for hire, the following conséquences shall ensue,
namely.—
Public
conveyance in
which plague
patient has been
carried not to be
used again for
seven days or
until it has been
disinfected.
(i) The proprietor and driver of such licensed hackney car-
riage or vehicle shall not convey or permit to be con-
veyed in it any person otherwise than in accordance
with a direction given under clause II of these Regu-
lations for a period of seven clays from the time when
such licensed hackney carriage or vehicle was so used
or until it has been disinfected as provided in the follow-
ing sub-clause.
Disinfection.
(2) The District Magistrate or any Commissioned Medical
Officer acting subject to the general control of the Dis-
trict Magistrate or any person to whom power under
this sub-clause may be delegated by the District Magis-
trate or any Commissioned Medical Officer acting sub-
ject to the general control of the District Magistrate
may carry out or cause to be carried out any measures
that he may think fit for the disinfection of such licensed
276
Regulations under the Epidemic Diseases Act. [ APP. IV.
hackney carriage or vehicle, and may destroy or cause to
be destroyed any portion of the furniture, cushions, lin-
ing or hood or other covering thereof.
Payment of
compensation»
IV.— Compensation shall be paid to the proprietor of any vehicle
in which any person or corpse has been conveyed in pursuance of a
direction given under clause II of these Regulations in respect of the
following matters, namely,—
(() Disuse of the vehicle under sub-clause (1) of clause III of
these Regulations.
(2) Injury to or destruction of any article under sub-clause (2)
of the aforesaid clause.
Disposal of
applications,
V.—Applications for the payment of compensation under the last
foregoing clause may be made to the District Magistrate, who shall
upon receipt of any such application determine by order in writing
the amount of such compensation, if any, and such order shall be
final.
Incidence of
expenditure.
VI.—Compensation awarded under the last foregoing clause in
respect to any vehicle ordinarily employed to carry persons for hire
wholly or partly within the limits of any Municipality shall be paid by
the Municipal Committee of such Municipality.
EXECUTIVE INSTRUCTIONS.
Circular letter No. 1025, dated the 19 h June 1897.
No. 65.
Practical instruc-
tions appended
to the circular
to supersede pre-
vious instruc-
tions.
The following instructions which have been prepared in consult-
ation with Surgeon-Colonel Raye, Inspector-General of Civil Hospitals,
and Brigade-Surgeon-Lieutenant-Colonel Roe, Sanitary Commission-
er, for guidance in the event of the recrudescence of bubonic plague
and an invasion of the Punjab by the disease are intended to incor-
porate and supersede previous instructions on the same points which
have been issued by the Inspector-General of Civil Hospitals and the
Sanitary Commissioner. It is considered convenient that they should
be circulated to the Heads of all Departments as well as to the officers
on whom will devolve the duty of generally enforcing precaution-
ary measures, because Government buildings in the charge of parti-
cular departments may become infected with the disease, and Govern-
ment servants occupying such buildings may be attacked.
Reference to
clauses of the
Epidemic
Diseases
Act, authorising
the adoption of
the precaution-
ary measures.
2, In connection Math the instructions under heads A and C, I
am directed to draw attention to clauses II. III and V of the Rep-ula-
tions published with Notification No. 350, dated 8th March 1897.
Clause II empowers the District Magistrate to order the disinfection
or destruction of any article which is or has been in the possession of
any person, who, he sees reason to believe or suspect, is or may be
APP. IV. ] Regulations under the Epidemic Diseases Act.
277
infected with bubonic plague, or is or has been suffering from that
disease, or which is or has been in the possession of any person whom
he considers to have been in dangerous proximity to any such person.
Clause III empowers the District Magistrate to order the disinfection
or destruction of any building or part of any building in which any
person is or has been who, he sees reason to believe or suspect, is or
may be infected with bubonic plague, or is or has been suffering from
that disease. Clause V allows the District Magistrate by order in
writing to delegate these powers to any person exercising 1st Class
Magisterial powers or to any Commissioned Medical Officer. Clause
IV, regarding payment of compensation, has been modified by Notifica-
tion No. 634, dated 8th April 1897, and the District Magistrate now
has a discretionary authority to award or withold compensation for
injury done by action under clauses II and III.
A.—Instructions regarding the treatment of buildings and sheds
which have been occupied by persons infected with Plague.
1. Fire is the most effective means of destroying the bacillus of
plague. All grass huts and buildings of small value which have been
occupied by a plague patient should therefore be burned down wherever
this can be done without excessive danger to surrounding property.
2. Buildings which it is for any reason not considered desirable to
burn down should be dealt with as follows :—
I.—Having removed all furniture, the walls, floors and the inner
side of the roof or ceiling should be sprayed or hosed
with water containing a powerful disinfectant. The
furniture should be similarly treated (though articles of
little value may with advantage be burned).
II.—The best disinfectant for this purpose is a solution of
perchloride of mercury otherwise known as corrosive
sublimate (i part to 1,000 parts of water or I ounce
to 6 gallons, a quantity which when sprayed carefully
will disinfect from 2,000 to 3,000 square feet of surface).
It is understood that large quantities of this can be
obtained from Messrs. Waldie & Co., Calcutta, Messrs.
Smith, and Stanistreet, or Messrs. Peake, Allen & Co.,
Lucknow, as well as from other nearer sources.
III.—Failing perchloride of mercury, biniodide of mercury (i
per 5,000 solution) or carbolic acid (20 per 100 solution)
may be used in lieu.
IV.—It is a wise precaution to colour the solution of perchloride
of mercury with aniline blue to prevent the possibility of
poisoning. Persons engaged in the work should be
278
Regulations under the Epidemic Diseases Act. [ App. IV.
occasionally examined to see that no signs of mercurial
poisoning are present.
V.—The spraying or hosing may be done by means of a wooden
gardener's syringe with a rose over the end. Wooden
buckets should be employed for holding the solution, as
mercury acts upon metals. Failing wooden buckets,
earthen gumlahs or glazed earthenware may be used and
should be destroyed after use. Amop may be used to
spread the disinfectant if a syringe is not procurable.
VI.—One of the objects of the spraying or hosing is to lay dust,
which is a dangerous vehicle of disease. All crevices or
places where dust lodges should therefore be thoroughly
soaked with the disinfecting solution. For the same
reason every effort should be made not to raise dust
in a plague-infected dwelling.
VIL—If in any case disinfectants are not immediately avail-
able, another method of treating interiors is to light
small fires all over the ground, spreading out the red
cinders so as to thoroughly scorch the entire floor and
raise the temperature of the room or hut to the highest
point possible above 140° Fahrenheit, as at this tempera-
ture the germ is said to die.
VIII.—When the rooms have had their preliminary treatment
by fire or by spraying with disinfectants, the floor, if
kacha, should be dug up to the depth of 3 or 4 inches
and the loose earth mixed with fresh lime which will act
upon it as a disinfectant. This earth should then be
carried away, if possible, in a covered vessel, and buried
at a distance from all human habitations. The walls
of the room or rooms should then be whitewashed and
the building left uninhabited for a period of twelve days.
IX.—It will always assist the process of disinfection to leave a
building or room open to sun and air by removing the
doors, windows and even the roof, and this is recom-
mended as a supplementary method when feasible.
X.—Persons with scratches, cuts or sores on their persons,
especially on the hands, feet or face, seem to be espe-
cially liable to become infected and therefore ought not
to be employed on plague cleansings.
3. It will be observed that no mention has been made in the
foregoing of aerial disinfection, e.g., by burning sulphur. This is
APP. IV. ] Regulations under the Epidemic Diseases Act.
279
because there is good reason to distrust the efficacy of such processes.
The direct propagation of the disease by means of the atmosphere is
limited and a room must be hermetically closed to allow of fumiga-
tion. It is best therefore not to attempt aerial disinfection.
4. All rags and dead animals found in the building should be
burned. Dead animals, such as rats, should be soaked in kerosine
oil previous to burning.
NOTE.—It has to be remembered that corrosive sublimate forms an inert com-
pound with albumen, ami to obviate this the solution should be acidulated. The Local
Government Board of the United Kingdom therefore recommends that the soluton be
made as follows :—
"Dissolve half an ounce of corrosive sublimate, one fluid ounce of hydrochloric acid
and five grains of commercial aniline blue in three gallons of water. For convenient
use, however, asaturated solution of the above quantities of l in 10 should be prepared
and kept in bottles, so that each bottle when mixed with a bucketful of water—three
gallons—will yield a solution of the required standard."
The rule adopted at Bombay, which is simpler, but possibly less effective, is to add
to the corrosive sublimate and water a handful of common salt and a few grains of
aniline blue.
For a carbolic acid solution, enough soft soap should be added to ensure the
thorough'admixture of the acid with the water.
B,—Instructions regarding treatment of the excreta of Plague pa-
tients and of the drains in the neighbourhoods of Plague-infected
buildings,
1. The excreta of plague patients should be mixed at once in a
solution of perchloride of mercury otherwise known as corrosive subli-
mate (1 to 1,000 parts of water). Where feasible a portion of this
solution should be placed in the pan before use, and a small quantity
of it should be left in the pan after each cleaning.
2. The best method of disposing of excreta is by incineration
and where quantities are small, this may be feasible if a sufficient
quantity of saw dust is added.
3. But ordinarily the most easily practicable method of disposing
of the excreta is to bury them with at least two feet of earth above
them, at distance from habitations. Every precaution should be
taken while removing them.
4. All drains in the locality of the plague-infected dwelling
should be thoroughly washed down with a liquid disinfectant. The
best disinfectant for the purpose is corrosive sublimate (1 to 1,000
parts of water) ; or failing this, carbolic acid (1 to 10 parts of water),
or phenyle.
5. Latrines should daily be treated in the same way, and after
the application of the liquid disinfectant it is advantageous also to
sprinkle Macdougal's powder over every part.
280
Regulations under the Epidemic Diseases Act. [ APP. IV.
C.—Instructions regarding the clothes and bedding of Plague
patients, of persons who have been in attendance or in close
proximity to them, and of persons who have carried or disposed
of Plague corpses.
1. The clothes and bedding of plague patients should be burned.
2. The clothes of persons who have been in proximity to plague
patients or plague corpses should be thoroughly boiled. Bedding
which has been in close proximity to plague patients should be
similarly treated. But razáis of quilted cotton, which cannot be
boiled, should be burned.
D.—Instructions regarding disposal of Plague corpses.
1. Violation of religious and caste customs should be avoided;
and quicklime should not be uted with bodies which are buried if
objections are raised to this by any person interested, as it is not
certain that it is efficacious.
2. Bodies which would in ordinary course be buried should be
buried at least six feet deep.
3. Bodies which would in ordinary course be burned should be
reduced as completely as possible to ashes.
B.—Precautions to be taken by nurses and attendants upon Plague
patients.
1. In addition to the ordinary precautions taken in nursing an in-
fectious case nurses and attendants should be warned that the poison
is usually taken in through an abrasion, often most minute. The hands
should constantly be cleansed in some antiseptic. Abrasions about the
mouth and lips should be attended to. Male attendants should wear
beards to prevent the risk of abrasion from shaving,
2. Before stooping over a patient to apply dressings or for other
purposes the bedding should be thrown down for a few minutes to
allow of the effluvia from the patient's body becoming diluted with the
surrounding air.
APPENDIX V.
MEASURES IN THE CITY OF BOMBAY.
PAPER
Nos.
I — 2.
3—12.
13-1
CONTENTS.
Appointment of a Plague Research Committee.
Evacuation of infected localities in the City of
Bombay
.
.
.
.
.
.
4Establi,shment of a plague hospital at Govern-
ment House, Parel, Bombay
PAGES.
283—284
284 — 296
296—298
b 36
APPENDIX V.
MEASURES IN THE CITY OF BOMBAY.
Appointment of a Plague Research Committee.
No. 1.
Resolution of the Government of Bombay, No, 4533, dated the
13th October 1896,
His Excellency the Governor in Council is pleased to appoint
Surgeon-Major R. Manser, M.D., Surgeon-Captain L. F. Childe,
M.B., and Dr. Nasarvanji Fakirji Surveyor, M.A., B.S.C., M.D.
(Bom.), to serve with Dr. W. M. Haffkine and Mr. E. H. Hankin on
a Scientific Committee to enquire into the nature and history of the
disease, stated to be bubonic plague, of which a number of cases
have occurred in Bombay City. Dr. Manser is appointed President
of the Committee.
No. 2. Circular Memorandum of the Surgeon-General with the Government
. of Bombay, dated the 10th October 1896.
In accordance with the orders of Government the following
gentlemen are 'appointed members of a Scientific Committee for the
purpose of investigating the bubonic plague now existing in
Bombay :—
Surgeon-Major Manser (President),
Surgeon-Captain Childe.
Professor Haffkine.
„
Hankin.
Dr. Surveyor.
The points for investigation will embrace everything on which
reliable information may be obtainable as to the mode of origin and
nature of disease, its communicability from one human being to
another by infection, contagion, inoculation or otherwise ; whether
communicable from man to animals or animals to man ; whether
there is any connection between the disease and grain used as food ;
whether the grain is sound or otherwise ; its period of incubation
284
Measiires in the City of Bombay.
[App. V.
(a) by direct inoculation or (b) when received by ordinary exposure
to infection or contagion from a person suffering from the disease
or articles of clothing, bedding, etc., used by the sick; the period
during which patients apparently recovered may retain the power
of infecting the healthy, etc. The suggestion of any special
preventive or curative measures, which may be deduced as the result
of these enquiries, and any other matters of practical or professional
interest which may occur to any of the Committee. The Committee
will meet at such times and places as may be appointed by the
President for interchange of opinion, recording of work accom-
plished, division of labour and such other purposes as may be deemed
expedient.
Evacuation of infected localities in the City of
Bombay.
No. 3.
No. 45, dated Calcutta, the igth January 1897.
From—J. P. HEWETT, Esq., C.I.E., Secretary to the Government of
India, Home Department,
To—The Secretary to the Government of Bombay, General Department.
Home Depart-
ment tele-
gram No. I,
dated 2nd
January 1897.
Bombay
Government
telegram, dated
4th January 1897»
I am directed to forward, for the information of His Excellency
the Governor in Council, a copy of a memorandum signed by some of
the principal European and Native Medical Practitioners of the City
of Bombay and Members of the Special Research Committee regard-
ing the bubonic plague in that city and measures for arresting its
progress. This memorandum has been presented to the Government
of India by Surgeon-Major-General Cleghorn, Sanitary Commissioner
with the Government of India, on return from his visit to Bombay
which formed the subject of the telegraphic correspondence with the
Government of Bombay cited in the margin. Dr. Cleghorn shares in
full the views recorded in the memorandum.
2. His Excellency in Council will observe that the view is expressed
that the bubonic plague now prevailing in the City of Bombay is under
certain conditions only slightly contagious or infectious ; that its
incidence is largely due to local causes, and that the only effective
way of dealing with the outbreak and of arresting the progress of the
disease is to insist on the evacuation of houses in which cases of
plague have occurred. The gentlemen who. have signed the memo-
randum consider that there will be no difficulty in providing sufficient
and suitable accommodation for people removed from infected houses,
APP. V. ]
Measures in the City of Bombay.
285
and that it only requires the concurrence and sympathy of the leaders
of the different sections of the community to render the plan proposed
by them a success.
3. The Government of India regard this influential medical opinion
that the plague is not at present either generally epidemic or conta-
gious as of very great importance. The history of previous outbreaks
of the disease shows, however, that it has a strong tendency to epi-
demicity. There has already been very grave loss of life in the
population of the city, and the consequences to the trade of Bombay,
already very serious, promise to be disastrous unless the plague can
be speedily reduced. Should it assume a more severe epidemic form,
the whole of India may be affected. The Government of India are,
therefore, of opinion that there should be no hesitation in taking the
strongest measures to prevent its spreading, even though they may
be once distasteful to the people affected. The particular measures
advocated in the memorandum, namely, the removal of all persons
from infected houses and the thorough disinfection of those houses,
appear to the Government of India to be well calculated to check the
progress of the disease, and the vigorous action that has been taken
to clean and disinfect the infected parts of the city having failed to
arrest its progress, it appears to the Government of India to be neces-
sary that they should be adopted. Dr. Cleghorn has also reported to
the Government of India that the nature of the buildings in which a
larce proportion of the inhabitants of Bombay dwell, make it specially
important to remove all persons from infected houses and to allow
the officers of the Health Department to thoroughly cleanse and dis-
infect such houses. He points out that in the large and ill-lighted
and ill-ventilated houses or chawls occupied by so many as 500 to
i ooo individuals means of disinfection and cleansing can only be
effectually carried out by the complete evacuation of the tenement in
which a case of plague has occurred,
4. I am to say that the Governor General in Council commends
the suo-o-estions contained in the memorandum to the earnest attention
of the Government of Bombay, and trusts that the Governor in
Council may find it possible to act upon them. Should the Govern-
ment of Bombay concur in thinking that the removal of all persons
from infected houses is the best practical method for checking the
progress of the plague, the Governor General in Council will be glad-
to learn in due course the measures which are adopted to bring the
plan into general effect.
It will no doubt commend itself to the Government of Bombay that
convenient temporary accommodation suitable to the families to be