NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
APPENDIX II.
PREVIOUS HISTORY OF PLAGUE IN INDIA.
The Plague Epidemic in Kathiawar.
REPORT BY DR. GILDER.
No. 1.
Dated Ahmedabad, the 25th February 1820.
From—J. GILDER, Esq., Civil Surgeon, Ahmedabad,
To—GEORGE OGILVY, Esq., Secretary to the Medical Board, Bombay.
1. I beg to acknowledge the receipt of the Board s letter, dated the
14th instant, requesting information on the alarming and fatal disease
raging in various places dependant on this Zilla and Collectorate ;
and, in reply, I have the honour of submitting for their consideration
the result of my enquiries on this subject.
2. Previous, however, to entering into detail of the history and
nature of the disease which has for such a length of time been raging
to the westward, it may not be amiss to set out with a short descrip-
tion of the soil, climate, and inhabitants of that division of the penin-
sula of Guzerat, commonly known by the name of Jháláwar, the more
immediate scene of its ravages.
3 Jháláwar, the most northern district of the peninsula, derives
its appellation from the tribe of Jhalla Rajpoots, who, in former times,
formed the chief portion of its inhabitants. It is bounded to the
east and south by Goelwar, part of Kathiawar proper, and the Run to
the north and west by Kathiawar proper, part of Hallar, that part of
the Run termed Null-khcmta, and the Company's district of Veerun-
gaum comprised within the collectorate of Ahmedabad. The prin-
cipal towns are Limree, Wudwar, Drangadra, Hulwud, and Dundoo-
ka ; the three former have a Thakore of their own. Of these however
the Thakoreship of Limree is far the most extensive and has suffered
most from the destructive ravages of the disease. The face of the
country presents in general a flat level surface denuded of vegetation,
except in the more immediate neighbourhood of towns and villages.
The soil for the greater part consists of a rich black loamy mould,
here and there intersected with portions of salt marshy tracts branch-
ing off from the Run. In the vicinity of Drangadra and Wudwar it
assumes a more gravelly appearance : the chief products are wheat,
gram, and cotton. The principal river is the Khadur, a small stream
which takes its rise in a hill called Mandwa in Káthiáwar, whence,
flowing in an easterly direction by Palliad and Ranpour, it loses itself
m the Run near Dhollera.
6o
Previous history of plague in India,
[ APP. IÎ.
4. The climate differs but little from that of Guzerat in general.
The constant exhalation however of noxious effluvia throughout the
year from the extensive tracts of salt marsh, covered with profuse
and rank vegetation within the limits of the tides which surround
the head of the Gulf of Cambay, and project for many miles within
land must doubtless exert a pernicious influence on the atmosphere
in its vicinity, and may probably confer on it the properly of retaining
within certain limits the proximate causes of a disease, whether con-
tagious or the reverse ; when once introduced, this may possibly be
thought too hypothetical an inference, but little doubt can exist that
such exhalations tend materially to corrupt the air, thereby rendering
those who inhale it more immediately predisposed to receive the
fomites of a disease lurking in their neighbourhood.
5. The principal inhabitants of this part of the country are Grassias
of the Rajpoot tribe of Jhalla, Brahmins of the Shravoe or Jain sect,
Khoombies, Kolies, and a few Bhoras,
6. As it is at all times a matter of difficulty to obtain from native
authority information whereon reliance can be placed, and as they
invariably either exaggerate or distort the subject of their communi-
cations whenever such refer to circumstances beyond their limited
comprehension, such as in the case of any prevailing disorders, etc.
To the following remarks therefore on the origin, symptoms and
progress of the disease now raging to the westward, the Board's
indulgence is solicited, no case having lately fallen under my personal
inspection.
7. In tracing the origin of the disease in question the natives
agree in referring the period of its first introduction to the Hindoo year
or Sumwut 1873 = A. D. 1817, three years subsequent to the dread-
ful famine which raged with such destructive fury over Guzerat and
Káthiáwar. It first broke out at Dhollera, where they say it was intro-
duced from Moorvee, a town in Káthiáwar proper; they are not quite
agreed as to the precise mode of introducing ; some alleging it to
have been conveyed by merchants and petty traders from Kutch,
others referring it to those people who used annually to come from
Kutch in the cotton season (February to May) with their wheels for
separating cotton from its seed. They, however, coincide in the
material point of its having been imported from the westward.
8. It is worthy of remark that although the disease was in the
town of Dhollera, three people only were attacked, all of whom died,
From Dhollera it spread over the neighbouring villages of Burrad Rojka
Peeplce, etc., and reached Dundooka ; it continued in this neighbour-
hood till the close of 1817 (diffusing its baneful influence amongst
the village's situated on the Run), being the same disease to which the
APP. II. ]
Previous history of plague in India.
6í
Board allude in the concluding part of the 3rd paragraph of their letter,
when it gradually decreased, but did not disappear altogether, for
several insulated cases were constantly occurring in the numerous
villages of the Dundooka and Limree districts; it continued lurking in
this manner till the beginning of last year, when it broke out with
renovated fury at the village of Buriad in the month of April ; this
place is situated 3 miles to the westward of Dhollera ; it raged here till
the setting in of the monsoon, and during the period of two months
40 families were literally annihilated. In the beginning of June it
spread to Rajka village, 3 coss to the west of the former, and nearly
depopulated it ; during the rains it diffused itself over a large tract of
country, carrying consternation and certain destruction wherever it
went ; it manifested equal virulence at several places (though remote
from each other) much about the same time.
9. It was towards the end of June it first appeared at Limree.
The fatal effects and dreadful ravages it made here were so awful that
the poor, terrified inhabitants, after losing from 1,500 to 2,000 of their
number, deserted the place entirely for a time, leaving a few to perform
the last melancholy rites of burning or Lurial to such of their relatives
and friends as were lingering under the disease, and who, they were
aware, had but a short time to suffer from its known rapidity and
certainty in terminating fatally, a person attacked seldom surviving the
third day after its commencement.
10. Subsequent to the dispersion of the inhabitants of Limree, the
disease abated in violence there, only to break out with increased
vigour in several other towns, and villages both to the east and west
of it, where it successively manifested itself, and some of which it en-
tirely depopulated. It should be remembered that while this work of
destruction was going on, the rains were pouring down in torrents, the
whole surface of the country between each village, which is generally
situated on a rising ground or artificial hillock, presented to the view
but one sheet of water, and by thus impeding the communication
betwixt different parts of the country, and confining the inhabitants
within the precincts of their respective habitations compelling them
as it were to inhale an atmosphere already overladen with morbid
effluvia, additional strength was given to the disease, and its victims
were, as it may readily be supposed, proportionately numerous.
11. The utmost eastern limit of its progress hitherto has been the
village of Bailóle in the Limree district on the western bank of the
Run, and about 25 coss west of this city ; it has not hitherto made its
appearance to the eastward of this salt marshy Bett. The destruc-
tive course of this dreadful scourge seems to confine itself principally
to such of the native population as subsist entirely on vegetable diet,
62
Previous history of plague in India.
[ APP. II.
Mr. Orton, in
proceeding from
Kaira to Bhore in
October 1820,
had information
of the prevalence
of this disease
at Rhadanpoor
Summer and
other towns and
villages about the
latitude of 23-40,
at different
periods while it
was prevailing
in Guzerat.
JOHN SCOTT,
S. M. B.
10-10-1836.
namely, Brahmins, Soonars, Durzees, and Khoomthees ; those using
animal food with few exceptions generally escaping. What is singular
and may tend to corroborate an idea of its being under certain circum-
stances contagious is the fact that when it once obtains a footing in a
particular tribe or profession, such as Banias, Soonars, tailors, etc.,
it seldom abates without having gone through every individual of
such tribe resident at the same place, and in general making victims
of them all.
Symptoms and effects.
12. From the native definitions of the symptoms of this disease,
one might be led to infer the existence of two distinct diseases ; this
supposition might at first seem corroborated by their having separate
names for each. The one they term Ghaut no rogue or the knotty
disease ; the other they distinguish by the appellations of Kogla no
rogue and Tao no rogue, signifying the expectorating disease and the
fever disease ; these, though equally severe in their characteristic
symptoms and similarly fatal in their effects, may only be aggravated
varieties of the same disorder, acted upon by a vitiated atmosphere
and other local causes which could only be successfully developed by
personal investigation. They describe the Ghaut no rogue to possess
the following symptoms :—great and general uneasiness of the frame,
pains in the head, lumbar region and joints on the day of the attack,
hard, knotty and highly painful swellings of the inguinal or axillary
glands (whence the name) appear in some instances ; the parotids are
affected in 4 or 5 hours, fever supervenes ; these symptoms go on
increasing in violence, attended with great thirst and delirium until
the third day of the attack, when death closes the scene ; and should the
patient survive the third day, they begin to conceive hopes of his re-
covery; suppuration of the glandular swellings occurs on the fourth or
fifth day, the other symptoms gradually diminish in force, the fever
assumes a milder aspect, and the patient regains his strength in 12 or
15 days ; such favorable terminations are however rare.
13. This form of the disease was introduced into the village of
Ballole in the end of December last by a Banian of the place who had
returned from Dewpoora whither he had been on business and where
it was raging at the time ; the night after his return he complained of
great uneasiness, pains in his loins and joints attended with fever;
these symptoms continued increasing throughout the night, and the
next morning he perceived swellings of his inguinal glands which were
exceedingly painful during the day ; he became delirious and complained
of intense thirst ; no abatement occurred on the third day, on the evening
of which he died ; every person belonging to this man's family, both
male and female, died within the space of l0 days of the same disease ;
APP. II. ]
Previous history of plague in India.
63
it spread to the other two Banian families in the village, committing
similar ravages. After remaining about 15 days from its first intro-
duction, during which period it destroyed about 30 of the inhabitants
out of a population of nearly 200, it disappeared.
14. The following case occurred in May 1817 at Dhollera while I
was there on business. It happened in alad 14 years of age. I have
stated the symptoms and treatment from the best of my recollection,
and though it terminated fatally, I am inclined to think bleeding and the
use of brisk cathartics in the early stage of the disease would go a
great way in arresting the progress of this destructive malady.
15. The disease was ushered in with considerable pain in the head
and loins, sickness at the stomach and vomitting of bilious matter, tur-
gidness of the eye, full strong and hard pulse, skin dry and intensely
hot. I immediately gave him a strong cathartic of jalap and calomel,
and took away 12 ounces of blood ; the symptoms subsided in two or
three hours after the operation of the medicine, but returned with in-
creased violence; the following morning when I repeated the medicine
and bleeding this partially relieved him ; an exacerbation of all the
symptoms took place in the evening with an enlargement of the glands
in both armpits which continued to increase throughout the night, but
without assuming any circumscribed appearance as in common bubo ;
he died at sunrise the third morning from the attack ; this boy was
living in a small hut surrounded by his relations who of course per-
formed all the requisite duties his situation required, but not one of
them was affected by the disease. Of five of other cases the first symp-
tom yielded to brisk cathartics. In the same compound where these
cases occurred, there were upwards of 200 people, including children,
all of whom came from the same district.
16. The other form of the disease, known to the natives by the
names of Kogla and Tao no rogue and which at present prevails most,
they describe as exhibiting the undermentioned symptoms. High fever
attended with burning and excruciating pains about the scrobiculis
cordis, skin intensely hot, and the patient feels as if his body within
was on fire, hiccough with deep and oppressive breathing ensue, he
also feels a pricking sensation all over his body as if it was perforated
with pins, considerable pains in the chest and joints, and about the
navel, delirium, great anxiety, and thirst follow ; at length the
patient hawks up clots of blood, the difficulty of breathing increases,
and he generally dies the second day of the attack. In both cases
native practitioners administer stimulants for the first and astringent
for the ultimate stages of the disease ; but being prejudicially aversed
to purgatives which experience teaches us are the principal and only
effectual remedies prescribable in the fevers of India, their labours
are unattended with success.
64
Previous history of plague in India.
[App. II.
17. I shall not presume upon the Board's patience further by
attempting to investigate the laws by which this malady is controlled
or account for the causes that produce it ; I shall merely state that the
name of the plague has in my humble opinion been erroneously given
to it. From the limited experience I possess of its nature, I am
inclined to think it an aggravated description of Typhus Fever, ren-
dered more terrible in its effects from local causes, and a peculiar
morbid state of the atmosphere which would probably yield to the
usual antiphlogestic regime of European practice ; but in the absence
of more correct information, it would be useless enlarging upon these
intricate points without the aid of practical experience and personal
observation on the snot.
REPORT BY DR. WHYTE.
No. 1820.
No. 2.
From—THOMAS WHYTE, Esq., Assistant Surgeon,
To—The Secretary to the Medical Board, Bombay.
I have now the pleasure to acknowledge the receipt of your letter,
dated the 19th February, directing me to institute some inquiry into
the nature of a disease, said to be contagious, now raging in the
neighbourhood of Káthiáwar and districts subordinate to the Collée-
O
torate of Ahmedabad. I was already moving, for this purpose, in
the above direction at the time of my receiving your letter and shall
first submit for your consideration a kind of journal of the principal
facts, which I collected from the places where I visited, and after-
wards with such remarks as a careful consideration of facts has
produced.
The town of Morvee is a large place, surrounded with very
high walls, situated pretty high on the bank of a fine river. Neither
in it or its neighbourhood do there appear to exist any of those
causes which are understood to produce the common Intermittent or
Remittent fevers of this country, and the character of the place has
in general been remarkable for health. The whole space within
the walls is, however, crowded with houses ; and although the popu-
lation at present is very thin, they were probably filled with inhabit-
ants before the place was visited by famine and sickness. The
disease, which is the subject of this paper, distinguished all over
this district by the general name of " Ghaut " (and which from the
exact similarity between the symptoms of that now raging at Moolee
and Sila, and those described as the common appearances in 1817
is unquestionably the same disease) prevailed for five months in this
town, three years ago. It began in the cold and lasted through the
APP. II. ]
Previous history of plague in India.
65
hot months, without undergoing any change from the change of
weather. It is in general stated to have carried off fifteen hundred
people, which account, I should think, is exaggerated about two-
thirds above the actual number. It must remain a subject of
conjecture, however : for the different statements vary so much as to
set all accuracy at defiance. The same doubt exists regarding the
proportion between the deaths and recoveries; some declaring that
one in ten recovered, others that not one in fifty did so, and a barber
surgeon of the town informed me that two thousand recovered and
two thousand five hundred died; he said he never meddled with the
patients, till after the fifth day, when it is probable the principal
part or whole of the danger was at an end. His practice consisted
entirely of hot stimulating applications to the bubos ; he gave no
internal remedies, I saw and examined four of the recovered men,
which number, although so small, seemed to be procured with diffi-
culty, and may serve to show how few actually survived. In the
houses of the three first no other person had been affected ; in two
there was no more than one bubo ; the third had three, and of the
whole only one suppurated. The fourth was a Mussulman who took
care of cows and sold milk and ghee ; his house, from his descrip-
tion, was very close and ill aired ; out of nine composing his family,
seven had been attacked by the same disease ; he was first taken ill,
two were seized two days after, and the rest successively at about an
equal distance of time. Three died and four recovered. They all
had first a severe fever which deprived them of their reason ; on the
second day in all who recovered the consequent debility was very
great, and convalescence extremely slow. None of these four men
entertained "the smallest suspicion of contagion; one said he
could not tell how he caught the disease, unless it was from his
wife, to whom he had been married about six months before, and
who then had a little itch up her thigh. He seemed to puzzle him-
self very much however in accounting for his illness, being not at all
sure that his wife had been the cause of it ; and the other three could
assign no reason whatever. Indeed, no one in the towns considered
the disease as contagious, and the Thakoor or chief brother seemed
to have proved very satisfactorily in his own person that it was not
so. He with a laudable kindness and anxiety for the welfare of his
people had been in the habit of frequently visiting the sick, comfort-
ing them, enquiring into the nature of their complaints, handling and
touching them, and all with complete impunity, from which, I think,
we may safely infer that casual intercourse is unattended with much
danger; it is probable, likewise, that the disease is not readily com-
municated by the touch, and possible that confinement to the same
¿9
66
Previous history of plague in India.
[App. II.
apartment is in general necessary for its production. The only part
of the town which did not suffer was the Thakoor's palace. It is a
very large, well aired place, elevated above the other parts of the
town in a slight degree, and contains about one hundred people,
all of whom enjoy a perfect immunity. On the opposite side of the
river, less than a quarter of a mile distant, on a very high and exposed
situation, is a small village called Moorba, not one of whose inhabit-
ants were attacked, although a daily and hourly communication was
maintained during the whole period of the above five months. The
people say that the river set bounds to the disease. On the same
side of the river with Morvee the disease was communicated to a
village two coss off, called Moolee ; but the situation of this village is
low, close and ill aired, being surrounded with jungle. It is more
probably therefore that Moorba, and its exemption to its high and
airy site, and that Moolee suffered from the opposite causes.
Wuccaneer is a large walled town, seated at the foot of a moun-
tain of considerable height and on the bank of a very fine river,
distant about eighteen miles from the Morvee. While this disease
raged at the latter place, it likewise paid Wuccaneer a visit, and the
people say that it came from Morvee. Here it lasted no longer
than fifteen days, and was almost solely confined to one class of
people, viz., the Borahs, whose occupation is the manufacture of cotton
cloths. I am told that the greater part of the cotton was imported
from the surrounding country and part of it from Morvee. The
number of deaths was estimated at 60 among the Borahs ; and no
more than four or five of all the other inhabitants suffered. These
numbers too are probably correct ; for the testimony of different
people was nearly the same ; and it is obvious that where the disease
was so nearly confined to one set of people, it would be no difficult
task to arrive at precision ; every one who was attacked is said to have
died. The Borahs became so much alarmed at a visitation so dread-
fully severe and at the same time so partial, in which every one of
them seemed to have been doomed to destruction, that they all left
the town, and went to live upon the mountain in the neighbourhood,
leaving only those that were sick in their houses, and one attendant
upon each of them. The whole of these very soon died. Whenever
they heard of a death, the friends of the deceased came down and
performed the last offices as speedily as possible, returning again to
their abode on the mountain ; some of those who attended these
funerals were taken ill, but not many could have suffered in this
manner, for at the end of fifteen days, after their removal to the
mountain, the disease had entirely disappeared from amongst them.
\Vhen this was the case, they all came down and reoccupied their