NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
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Measures in the City of Bombay.
[ APP. V«
removed should be got ready before measures for evacuation are
taken. It seems to the Government of India desirable that, unless
the Governor in Council sees objection to this course, the memorandum
should be made public. The Government of India would be also glad
to know whether the Government of Bombay consider it necessary to
strengthen the building regulations of the city and to take increased
power to prevent overcrowding in the chawls.
5. Dr. Cleghorn has suggested that two of the Deputy Sanitary
Commissioners serving under the Government of Bombay should be
placed at the disposal of the Health Officer free of cost to the Corpo-
ration. I am to request that this suggestion may receive the con-
sideration of His Excellency in Council.
6. In conclusion, I am to say that the Governor Gênerai in Council
has learnt with the greatest satisfaction of the untiring energy which
has been displayed by the local authorities in the thorough and sys-
tematic cleansing and disinfection of • the infected parts of the city.
The liberal measures sanctioned by the Corporation towards these
ends, and the energy displayed by the executive officers of the Cor-
poration, viz., Mr. Snow, Municipal Commissioner, Brigade-Surgeon-
Lieutenant-Colonel Weir, Executive Health Officer, and Mr. James,
Executive Engineer, and their subordinates, are appreciated by the
Governor General in Council as they are no doubt "also by the Gov-
ernment of Bombay. It is, in the opinion of the Government of India,
only by continuing and extending these efforts unremittingly, and by
supplementing them by even stronger measures such as that which is
suggested in this letter, that the spread of the disease can be suc-
cessfully and effectively arrested.
No. 4.
Note by Surgeon-Mafor-General Cleghorn^ dated loth January
189-7.
I beg to submit copy of a note signed by those medical practi-
tioners of Bombay who have had the greatest opportunities of becom-
ing practically acquainted with the present outbreak of bubonic fever,
and along with it, to prevent any future misrepresentation, a memoran-
dum of the remarks I made to those gentlemen before I submitted the
note for their approval and signature.
The proposal now submitted is quite a practicable one, more espe-
cially if the leaders of the different communities would interest them-
selves in the matter and explain to those communities the necessity
for the adoption of the recommendalions. It is feared that if compul-
sory evacuation of infected houses is carried out, more especially in
the case of Muhammadans, that there will be an outbreak ; this is the
AfP. V. ]
Measures in the City of Bombay.
287
prevailing feeling among the natives, and it was suggested to me that
if His Excellency the Governor could admit several of the chief
mullahs toa private interview, the matter could be easily arranged.
The Corporation have practically conferred full powers on Mr.
Snow, the Municipal Commissioner, and his executives, represented
by Dr. Weir, Head of the Health Department, and by Mr. James, the
Executive Engineer, have carried out their different duties vigorously
and systematically, and at the same time have exhibited great tact in
doing so.
The feeling of the native population has been decidedly against
the sanitary measures enforced until a short time ago, when it has
veered round, and the people are now willing to allow that benefit has
resulted from those measures.
It would greatly strengthen the hands of the Health Department
if His Excellency the Viceroy stated that he was pleased with the
measures taken by the Corporation and specially thanked Mr. Snow,
Brigade-Surgeon Lieutenant-Colonel Weir and Mr. James for the
exertions they have hitherto made. The whole city is now under the
inspection of the Health Department. All latrines, drains and gullies
are being flushed ; houses, as far as possible, are being cleaned, disin-
fected and white washed, and in those parts of the city not drained,
surface drains of excellent construction are being made in connection
with the house pipes. The continuance and extension of this \\ork
should be insisted upon as being of the greatest importance, and it
should be clearly understood that there is no salvation outside the
adoption of sanitary measures. The efforts of the Health Department
are to a certain extent frustrated by the difficulty they find in cleans-
ing and disinfecting inhabited houses, as this can only be effectually
carried out in the case of rooms in which cases of plague have occur-
red, or in those which have been vacated by the tenants. The pro-
posal now submitted of evacuating all houses in which a case of the
disease has appeared will enable the Health Department to apply its
measures to the house as a whole. The importance of this will be
understood from a description of the houses. The chawls or tene-
ments may run up to seven stories, and the unit of construction is a
long corridor with rooms opening on either side, in the corridor,
either at one end or in the centre, is situated a water-tap with bathincr
platform, and alongside it a latrine with two or three seats. The
whole tenement is built up of a congeries of these corridors and
rooms, and contains from 500 to 1,000 individuals. The only space
between each tenement is a gully sufficiently wide to admit a sweeper.
288
Measures in the City of Bombay.
[App. V.
In most of the corridors and. rooms, either from the absence of open-
ings or from the obstruction of the existing ones, there is absolutely
no light admitted, and consequently no ventilation. The Health
Officer informed me that he estimated that 70 per cent, of the popu-
lation live in such houses. The corridors, before being taken in hand
by the Health Department, were the repositories of filth of all kinds,
and it is surprising that the mortality under such conditions has been
so small. It shows, I think, that the disease, in the common accepta-
tion of the terms, is only slightly contagious or infectious, and that its
incidence is chiefly due to local conditions.
The importance of removal from the infected locality thus becomes
apparent. Dr. Weir, the Health Officer, is now gradually trying to
induce the inhabitants to vacate infected houses, and if generally
carried out, he will require more assistance than at present. Under
any circumstances, I do not consider that he has a sufficient number
of officers for the supervision of operations, and I would recommend
that the Government of Bombay should place at his disposal, free of
cost to the Corporation, two of the Deputy Sanitary Commissioners
serving under the Government of Bombay.
At the same time it should be suggested that the Sanitary- Com-
missioner and one Deputy Sanitary Commissioner should proceed to
Karachi and take over the arrangements connected with that city.
The Health Officer is a native, and is, I am afraid, wanting in the
necessary force of character and initiative.
The Government of Bombay should, I think, legislate in the direc-
tion of conferring powers on the Municipal Committee to regulate
the building and construction of houses and to place a limit on the
number of people inhabiting each room and house. Many of the
former are now simply unfit for human habitation, and the sanitary
arrangements connected with them are of the most crude and primi-
tive description.
No. 5.
Memorandum on- the Plague in Bombay by Medical Practitioners ,
of Bombay.
We, the undersigned Medical Officers and Members of the
Special Research Committee, are of opinion that the bubonic plague
now prevailing in the City is, under certain conditions, only silghtly
contagious or infectious, and the. facts observed in connection with
individual cases and thpse associated with the general progress of
the djsease, warrant us in concluding that its incidence.is greatly
due to local conditions.
APP. V, ]
Measures m the City of Bombay.
289
We are emphatically of opinion that the only practical method
of dealing with the outbreak and of arresting the progress of the
disease is by the removal of the inmates from those houses in which
a case of the disease occurs.
We quite appreciate the practical difficulties attending the
adoption of this proposal, but in such an emergency as the present,
these difficulties can and must be overcome. The Municipal
Corporation will no doubt provide suitable huts, free of rent, for
the accommodation of the different classes, and we understand that
Mill Companies and other employers of labour are prepared to erect
huts for their different employés. The experience gained in the
mêlas at Allahabad and Hardwar will be available, as to the con-
struction and arrangement of the huts.
There will thus be no difficulty experienced in providing suffi-
cient and suitable accommodation for the evicted, and it requires
only the concurrence and sympathy of the leaders of the different
sections of the native community to render the scheme a success.
If houses in healthy localities are available for occupation, there is
no reason why they should not be utilized.
The steps leading up to removal would be the report to the
Health Officer of a case by a duly qualified Medical Officer. The
Health Officer would then notify the occurrence to the Municipal
authorities, and would at the same time submit his recommendations
for the removal of the inmates in the particular home and, if he
considered it necessary of those also in the immediate neigh-
bourhood. The Municipal authorities would then take the necessary
action and indicate the huts available. Carts, if necessary, should
be provided free of cost for the removal of the goods and chattels
of the inmates,
The person attacked would either be removed to hospital or
remain in the house with his or her relatives until recovery or death
took place. The house would then be completely vacated and taken
possession of by the Health Officer for purposes of cleaning and
disinfection, and he should be invested with full powers, in consult-
ation with the Executive Engineer, for removing all partitions,
erections or portions of house walls which impede or obstruct
ventilation. After an interval to be determined by the Health
Officer, the house would be re-occupied.
There can be no question as to the necessity for the adoption of
the measure we now advocate, and we trust that, in the interests
not only of Bombay, but also in those of the whole of India, it will
be at once accepted and acted upon, more especially as the untiring
*> 37
2QO
Measures in the City of Bombay.
[ APP V.
energy displayed in the thorough and systematic cleaning and
disinfection of the affected parts of the city has as yet failed to
arrest the progress of the disease.
K. N. Bahadur] i.
James Arnott.
Temulji Bhicaji Nariman.
Ismail Jan Mahomed.
Bhalchandra Krishna.
E. H. Hankin.
L. F. Childe.
Accacio G. Viegas.
N. F. Surveyor.
Thomas Blaney.
Henry Cook, M. D. }
Su rgn . - Maj. -Geni.
James Cleghorn,
Director General,
Indian Medical Service.
T. S. Weir.
Sydney Smith.
I am of the opinion that, as there are facts showing that the
. plague is spread by people coming from infected localities, the
measures compelling the inhabitants to leave those localities ought
to be accompanied by others calculated to control their further
movements.
W. M. Haffkine.
No. 6.
Telegram No. 388, dated Calcutta, the gth February 1897.
From—The Secretary to the Government of India, Home Department,
To—The Secretary to the Government of Bombay, General Department.
My letter No. 45 of I'gth January last regarding measures suggested
by Dr. Cleghorn for suppression of plague in Bombay. Daily
returns unfortunately show that the disease shows no signs of abating,
and returns of deaths are now worse than ever. In view of gravity of
situation, Government of India are constrained to press on Government
Bombay the need for vigorous and immediate action and will be criad
to learn what measures have been taken in pursuance of suggestions
made by Government of India. They will be obliged if a reply can
be sent to this telegram urgently.
No. 7.
Telegram No. 227-?., dated Bombay, the loth February 1897.
From—The Secretary to the Government of Bombay, General Depart-
ment,
To—The Secretary to the Government of India, Home Department.
Your telegram 388 of yesterday. Of the suggestions in your letter
45 evacuation of all infected houses and removal of people to tempo-
rary dwellings deemed impracticable if on large scale and carried
out by force. All that is practicable being done by persuasion.
Vigorous action being taken under section 426 of Municipal Act for
APP. V. ]
Measures in the City of Bombay.
291
demolition of insanitary huts. Some already destroyed ; more about
to be. Further measures of the most drastic kind will be taken
under regulations drafted under Act III, 1897, and submitted to law
officer before publication. Those regulations will provide for evacu-
ation of infected houses, entry into deserted houses, for cleaning, etc.,
prohibition of further use of evacuated and deserted houses, summary
reduction in overcrowding and closing of houses unfit for habitation.
At present house-to-house visitation conducted vigorously in order
to ascertain cases of plague, mark houses needing cleansing, etc.,
and such as are unfit for habitation. Paragraph 4 of your letter 45.
Memorandum not published, because ascertained several signatories
did not intend compulsory segregation of healthy, and publication
would publicly misrepresent their real views regarding building
regulations. Government do not doubt they need strengthening
and are making provision to strengthen them, both temporarily by
regulations under Epidemic Diseases Act, and hereafter permanently
by amending Bombay Act III of 1888. Paragraph 5. One Deputy
Sanitary Commissioner in Bombay, one in Thana District, one in
Karachi, only two left for ordinary and famine work and to aid in
repressing extension of plague to mofussil. Four doctors who were
through plague in Hong-kong are coming out ; two extra commission-
ed medical officers are already assisting Health Officer, another assist-
ing at European hospital, another assisting Port Health Officer ;
others will be employed as they arrive.
No. 8.
Telegram No. 459, dated Calcutta, the i2th February 1897.
From—The Secretary to the Government of India, Home Department,
To—The Secretary to the Government of Bombay, General Department.
Your telegram 227, dated I2th. Government of India have learnt
with regret view of Bombay Government on evacuation of all infected
houses and removal of people to temporary dwellings. Situation
is so grave and importance of vigorous action so manifest that they
would desire Bombay Government to reconsider decision that evacu-
ation of houses and removal to temporary dwellings on a large scale is
impracticable. Experience now shows that outbreak will not be got
under unless strongest measures are taken, and every day's postpone-
ment renders success less easy. The other measures which Bombay
Government are taking will be of much use, but are not calculated to
take the place of removal from infected houses to healthy locality.
This course appears to Government of India to be only course left
which gives prospect of getting plague under subjection. Bengal
Government have published following rule for compulsory evacuation
2Q2
Measures in the City of Bombay.
[ APP. V.
infected premises under Epidemic Diseases Act :—Begins. When a
case of plague occurs in any premises, the Chairman may, after giving
reasonable notice, summarily cause such premises to be vacated and
thoroughly cleansed and disinfected in such manner as may appear to
him necessary, and may cause all articles which, in the opinion of the
Health Officer, cannot be properly disinfected, to be destroyed. He
may also in consultation with the Engineer of the Corporation,
cause to be removed all partitions, erections or portions of house-walls
which impede or obstruct ventilation. The premises shall not be re-
occupied without the written permission of the Chairman. The
Chairman shall provide the inmates thereof, when necessary, with
temporary accommodation.— Ends. In order to carry out scheme
first necessity is provision of sufficient temporary accommodation in
healthy locality, and Government of India would be glad to learn what
steps have been taken to provide this accommodation. It appears to
them that experience at Karachi tends\ to show that if well regulated
temporary accommodation is provided and executive and municipal
authorities endeavour strenuously to carry out scheme on large scale,
population will not be very difficult of persuasion.
No. 9.
Telegram No. 292-?., dated Bombay, the ißth February 1897.
From—The Secretary to the Government of Bombay, General Depart-
ment,
To—The Secretary to the Government of India, Home Department.
Your telegram 459, i2th. Please see paragraph 9 of my letter
263-?. and Notification 228-?., loth, in Government Gazette Extra-
ordinary of same date, page 200-B.
No. 10.
No. 263-?., dated Bombay, the nth February 1897.
From—J. DEC. ATKINS, E*q., I.C.S., Secretary to the Government of
Bombay, General Department,
To—The Secretary to the Government of India, Home Department.
I am directed to acknowledge the receipt of your letter No. 45,
dated jgth ultimo, forwarding a memorandum signed by certain
medical practitioners in the City of Bombay and offering certain
suggestions for the consideration of the Government of Bombay. I
am to say that the suggestions have been carefully considered by
His Excellency the Governor in Council, who directs me to make
the following observations in reply to your letter.
2. In the first place I am to say that His Excellency the Gover-
nor in Council has some hesitation in complying with the request
that the memorandum should be made public, as it has been ascer-
tained that many of the medical practitioners who signed it did so
APP. V.]
Measures in the City of Bombay.
293
on the distinct understanding that the" removal of the inmates from
those houses in which cases of plague occur was not to be effected
by any measures of compulsion.
3. It is understood to be the opinion of the Government of India
that such evacuation of houses should be enforced even in the face
of ill-will and opposition. His Excellency the Governor in Council
ventures to think, however, that neither the preliminaries necessary
to carry out such a measure nor the probable consequences of doing
so have been fully realized by Dr. Cleghorn or the Government
of India. His Excellency is advised that, to give full effect to such
a proposal, at the lowest computation, 30,000 persons belonging to
different races, castes and creeds would need to be provided with
temporary dwellings There is no site within the limits of the
Bombay Municipality which would accommodate a tenth of this
number. Great difficulty has attended all attempts at the segrega-
tion of healthy inmates of infected houses hitherto made, and very
limited success has been achieved. From the beginning of the out-
break of this disease it has been found that the native inhabitants
of the city are very reluctant to leave their houses or to allow any
member of their family afflicted with the disease to be taken away.
Indeed their dread of the disease itself appears to be hardly so power-
ful as their horror of being removed from their houses. Ignorance and
superstition prevent them from discerning either that removal to a
hospital is good for the sick or removal to uninfected dwellings good
for the healthy, and they are far more easily moved by fear of the
Municipal and Police authorities than by any realization of the benefits
that will accrue from a sensible course of action. It is estimated that
not less than 300,000 persons have already fled from Bombay, moved
so to do not only by fear of the plague but quite as much, if not more,
by an unfounded and unreasonable fear of what might happen to them
at the hands of the Police and Municipal authorities were they to
remain.
4. The gentlemen who signed the memorandum have expressed
themselves to the effect " that there will be no difficulty in providing
sufficient and suitable accommodation for people removed from in-
fected houses, 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." In so doing they have failed
to measure the force of the influences I have already described ; they
have forgotten that nearly all the chief leaders of the various commu-
nities have left Bombay ; and they have failed to realize that there is
not the space within the city for a large health camp,
5. An alternative scheme is to construct large health camps out-
side the city. This would take some months to accomplish, for both
2Q4
Measures in the City of Bombay.
[ APP. V.
materials and labourers are scarce ; the latter so scarce that it is with
great difficulty that a sufficient number can be obtained for the cleans-
ing and disinfecting operations that have been and are still being
carried on in the city. Indeed it seems unlikely that any large
camps could be constructed until so short a time before the setting
in of the monsoon (when they would become unsuitable for habitation)
as to make their construction of little practical use.
6. Again this Government are advised that nothing short of com-
pulsion would induce the people to leave their houses, and even if
driven out of them, they probably could not be induced to resort to
the health camps. They would, it is believed, leave Bombay altoge-
ther and would present to the popular view the spectacle of a people
driven by force from their homes. This, it is feared, could lead to
but one result—a state of panic so intense that sweepers, scavengers
and labourers alike would desert Bombay. This would be a disaster
far greater than any that has yet befallen the city ; for trade would
be paralyzed, shops closed, the docks and mills deserted and the
Municipality left unable, not only to carry out any special measures
of cleansing and disinfecting, but to conduct the ordinary sanitary
necessities and conveniences of every-day life.
7. But great as would be the evil to Bombay, this is not the only
unhappy result that would attend such a feeling of panic. The
exodus has already necessitated precautionary measures against
arrivals from Bombay in every part of this presidency ; it has led to
the plague becoming endemic in Poona and in parts of the Thana
District ; it has resulted in overcrowding by refugees from Bombay
of many cities and towns, and it has made demands on the number
of qualified medical practitioners available to Government that can
with difficulty be met. Every addition to the number of refugees
adds to the possibility of spreading the disease and to the difficulty of
dealing: with it should it break out.
CD
3. I am to assure the Government of India that every precaution
is taken short of measures that would, it is feared, lead to the panic
and the evils I have described. The liberality of the Corporation and
the energy displayed by Mr. Snow, Municipal Commissioner, Brigade-
Surgeon-Lieutenant-Colonel Weir, Executive Health Officer, and Mr.
James, Executive Engineer, and their subordinates are, as is surmised
in paragraph 6 of your letter under reply, appreciated by this Govern-
ment no less than by His Excellency the Governor General in Coun-
cil, and it is a very great satisfaction to the former to find these
efforts are so cordially acknowledged. But it is not only their
energy that deserves notice ; it is the conviction of this Government
as will be gathered from what I have written, that they have shown