NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
24
CPart II—Rule 66.
Conveyances
for the
carriage of
the sick and
of infected
articles.
66. The Collector, or the chairman of the municipal
council or president of the local board, as the case may be,
shall provide suitable conveyances for conveying to the
plague camps established under Rule 59 persons suffering, or
suspected to be suffering, from the plague, and for the
transport of any clothing, bedding or other articles which
have been exposed to infection.
Part III.—Measures to be adopted on the Occurrence
of a case of Plague.
Eeport by
local officers
of occurrence
of plague and
isolation of
patient and
contacts.
67, On the occurrence of a suspected or actual case of
plague in a village or town whether in a district declared to
be under observation or not, it shall be the duty of the
village headman or other local officer—
(1) To isolate the patient and all who have been or are
suspected to have been in contact with him in the camp
provided' under Rule 59 supra. If no camp has been provided
under Rule 59 it shall be the duty of the village headman or
other local officer to cause a hut or shed to be immediately
constructed on a site remote from inhabited houses and to
isolate the patient and contacts therein.
(2) To send intelligence by express to the tahsildar
or the municipal chairman and, if plague inspectors have
been appointed, to the nearest plague inspector.
Eeport by
plague
inspector and
tahsildar or
municipal
chairman.
68. Upon receiving information of the occurrence of a
case of plague, the tahsildar, the municipal chairman or plague
inspector shall inform all superior officers up to the Collector
by the quickest possible means, and shall go at once to the
infected locality. The tahsildar or the municipal chairman
shall arrange to be accompanied or followed by the nearest
medical officer with a supply of medicines and disinfectants
and by a sufficient staff of constables and peons.
Action to bo
taken by
plague
inspector and
tahsildar or
municipal
chairman.
69. On arrival at the intected place, the plague inspector
(or medical officer if there is no plague inspector) shall
supervise the isolation of the patient and the disinfection of
his residence, clothing and excreta, and the clothing, and at
his discretion, the person of all who have been in contact with
the patient and shall continue such supervision until relieved
under the orders of a plague officer and sent back to other
duty. Houses immediately adjoining that in which the case
of plague has occurred shall also usually be disinfected.
70. The tahsildar or the municipal chairman shall, if the
plague patient and contacts have already been completely
isolated, arrange for the efficient maintenance of such isolation,
for the provision of medical attendance on the patient and. for
thorough disinfection as above. If the patient or his contacts
25
Part Ill-Rule 71.]
has not been isolated, the tahsildar or municipal chairman
shall at once provide for the isolation of the patient and
contacts, and if necessary, shall provide the accommodation
referred to in Rule 59 supra.
Action to be
taken by
plag ne officer.
71. On receiving information of a case of plague, the
duties of a plague officer (see Eule 103) shall be as follows :—
(1) He shall send telegraphic information to the
Collector and the district medical and sanitary officer.
(2) He shall then go to the scene of outbreak, and shall
enforce the measures mentioned above.
(3) He shall see that the hospital, the suspect camp
and the health camp are properly organized and guarded.
(4) He shall see that the patrols and guards round the
infected area completely isolate it, or such part of it as he
deems fit, so as to prevent the return of the inhabitants
without his written permission.
(5) He may also, when authorized by the Collector,
direct the evacuation of the village or town or any part of it,
and the removal of the inhabitants to a health camp, provided
sufficient shelter is available, and their detention there for a
period not exceeding ten days from the date of the occurrence
of the last case of plague among them.
(6) On the evacuation of houses, he shall cause them
to be surrounded by a cordon with the object of preventing
the return of the inhabitants without his written permission,
and to be thoroughly disinfected.
(7) He may also cause the village to be disinfected.
Note.—For further information as to the steps to be taken in plague
outbreaks, the importance of early discovery of plague cases, and the segre-
gation of contacts, see notes (1), (2) and (3) in Appendix I.
Report by
Collector and
the action to
be taken by a
him.
72- (1) The Collector, on receiving information, shall tele-
graph to Government, the Surgeon-General and the Sanitary
Commissioner, and shall despatch the ambulance staff with
its equipment to the village under the district medical and
sanitary officer, or his assistant.
(2) He may notify by tom-tom (the notification to be
as soon as possible published in the District Gazette) that any
town or village, or part of a town or village, or group of
villages, is infected, and thereupon the regulations contained
in Part II shall come into force in the district if they have
not been brought into force by Government already.
(3) He may order the evacuation and disinfection of
infected houses and houses in their neighbourhood, or of
n
26
[Part IV—Rule 73.
infected villages and towns, and may prohibit their re-
occupation without permission.
Note.—For further remarks regarding Evacuation, see note (4) in
Appendix I.
(4) He may require the evicted people to reside in any
place which he may appoint, under such restrictions as he may
deem necessary, provided proper shelter is available.
(5) He may requisition the services of any public
servant or, for work connected with a railway, of any railway
employé.
(6) He shall, if possible, go to the village and direct
operations.
Part IV.—Rules applicable to Areas declared to be infected,
Preventive
circles.
73. If an observation staff has already been appointed
in the neighbourhood of an infected area, the Collector shall
modify the observation circles so as to contract them to five
miles diameter, within a radius of twenty miles or less distance
around the infected area. If an observation staff has not
been already appointed, he shall at once organize one so as
to meet this requirement. Circles so formed round infected
areas shall be termed preventive circles to distinguish them
from the observation circles mentioned in Rule 56 supra.
These circles shall be placed in the charge of plague inspectors,
whose duty shall be to frequently visit every inhabited part
of their circles, check the working of the passport system, and
maintain a watch over the health of the inhabitants with the
object of quickly discovering cases of plague and preventing
the spread of the disease.
Inocnlafcion;
74. The Collector shall arrange with the Sanitary Com-
missioner for a sufficient supply of Haffkine's vaccine in order
to bring inoculation within the reach of the inhabitants of
plague-infected and plague-threatened localities and shall
afford them every facility for being inoculated.
Note.—For further information regarding- Inoculation, see note (5) in
Appendix I.
Certficates
of causes of
death.
75. (1) When he has. a sufficient medical staff at his
disposal to secure immediate inspection, so that there may be
no chance of funerals being delayed, the Collector may, with
the previous sanction of Government, order in respect of any
particular area that a certificate of a medical officer showing
the cause of every death shall be obtained within two hours
27 .
Part IV-Rule 76.j
after such death. It must be understood that medical
examination of a corpse is entirely optional on the part of the
relations, and that no one will be compelled to allow the
inspection of the corpse of a deceased relative. The examina-
tion of the corpses of women by men should never be required.
The orders of the Government should be obtained before
this rule is acted upon in any area, and in applying for
sanction, the Collector should report fully on the following
points : —
i. What classes of officers will be authorized to
issue certificates under the rule.
ii. Whether any fee will be required for the grant
of this certificate.
iii. Whether there is such a number of Government
medical officers, male and female, at the station as will be
sufficient to carry out inspection promptly so as not to cause
any delay in burials.
iv. Whether there has been any increase in the rate
of mortality.
v. Whether there is any reason to believe that
deaths are concealed or that causes of death are not correctly
reported.
(2) If after the issue of an order under clause (1) of
this rule, a burial or cremation takes place without such a
certificate having been obtained, the death may be presumed
to have been due to plague, and the rules regarding the segre-
gation of the contacts and the disinfection of the house may
be applied.
House search.
76. With the previous sanction of Government, the
Collector may organize search parties to visit houses for the
purpose of detecting cases of plague, when there is reason to
believe that the residents are attempting to conceal them.
Special enquiries shall also be made as to any sickness or
mortality among rats, and houses in which sick or dead rats
have been found shall be disinfected.
77, The system of house-visitation and house-search will
ordinarily be permitted only when plague exists in small and
well defined areas, such for instance as an isolated quarter or
ward of a town, or a single village in a neighbourhood which
is otherwise completely free from infection. When this mode
of discovering plague is adopted, care should be taken that a
sufficient number of European officers are employed to render
the powers of search effective and at the same time prevent
28
[Part IV—Rule 78.
the subordinate establishments from abusing their authority.
Failing officers of the civil establishments, young officers of
the Staff Corps should be deputed for this duty. Respectable
inhabitants who volunteer for the service should be employed
to assist in searching for concealed cases of plague. As far
as possible, houses should be allowed to be entered only by
persons of caste or of the same religion as the occupants, and
women should be utilized in examining women and in searching
any room or place exclusively occupied by them.
Removal of
plague
patients to
hospital.
78. Plague patients who are left without any one to look
after them or who have no home should in all cases be removed
to hospital, and in dealing with imported cases or with an
outbreak in a small place upon which it is possible to concen-
trate a sufficiently strong establishment, the first measure to
adopt is the compulsory removal of the sick to hospital. In
dealing with early indigenous cases the same policy may be
advisable. But if plague continues a point may soon be
reached when it will cease to be possible to obtain information
as to all cases. When this point is reached, the continuance
of attempts to remove the sick to hospital may result in the
sick being carried from house to house for purposes of con-
cealment, and at this stage the less the sick are interfered
with the better. All that can then be done is to endeavour
to palliate the evils that result from leaving people in their
houses by arranging for continual visitation of the sick at
home, the frequent disinfection of the infected room, and the
encouragement of inoculation among persons left in the houses
with the sick.
79. Except as mentioned in the last preceding rule the
removal of patients to hospital should not be compulsory.
Every effort should, however, be made to induce patients to
go voluntarily to hospital and to lessen the aversion to hospital
by the following means—(1) by encouraging the establish-
ment of private and caste hospitals ; (2) by locating hospitals
near to infected quarters; (3) by limiting the size of hospitals
so that patients may receive more individual attention ; (4) by
arranging for the provision of an adequate number of medical
attendants and nurses and of ample and comfortable accom-
modation for patients and their immediate relatives or
friends ; (5) by permitting at least two relatives or friends to
be in attendance on each patient so that the patient may never
be left alone ; (6) by allowing the patients to have their own
food and medicines and to receive visits from their relations,
friends and religious instructors ; (7) by taking care that all
29
Part IV—Bule 80.]
arrangements for observance of caste customs and for the
comfort and convenience of patients and their attendants
are completed before inviting admission to hospitals.
80. Moribund patients should never be removed to hospital
except at the express wish of the friends or relations of the
patients. The risk of leaving in his house a patient whose
case is so serious that the medical officer thinks he has not a
fair chance of recovery is not great after the existence of the
case has become known. The pneumonic variety of plague
being the most contagious, persons suffering from this type of
the disease should not be removed to the general wards of
plague hospitals, but should bo isolated in separate wards of
the greatest possible air space. It is further advisable that
such cases should not be treated in private houses, unless in
the opinion of the medical officer, the room occupied by the
patient is suited for his complete isolation, and proper control
over the number of attendants and enforcement of disinfection
can be had.
sanitary
restriction«
with
regard Lo
faneral
processions
and burials.
81. (I) The Collector of the district may make
rule
(a) prescribing the route which shall bo taken by
a funeral procession from tho place of death
to the grave-yard, burning ground or other
place for final disposal of tho corpse, and the
places, if any, at which such procession may
halt on its way for funeral prayers, ceremonies
or other purposes ;
(b) for enforcing burial in certain places or at a
certain depth, ordinarily not less than six feet. ;
(c) requiring that the bathing of persons attend-
ing the funeral shall be conducted at a place
prescribed by him.
(2) He may also prohibit the burial or burning of
corpses of persons reasonably supposed to have died of the
plague in or upon ground other than ground specially assigned
by him for such purpose.
(3) When a person dies of plague elsewhere than
within the limits of a hospital, no one shall touch the corpse
except those who undertake the necessary duties of preparing
it for the funeral. • The dead may be dressed for the grave
by their own relations or in whatever manner maybe customary
among the class to which they belong, but such persons shall
disinfect themselves according to the orders which may be
issued by the Collector in this behalf.
30
[Page IV—Rule 32,
Persons
leaving
au infected
place should
obtain pass-
ports.
82. The Collector may direct that every persson wishing
to leave an infected or notified town, village or area with
a view to reside in another town, village or area, whether
infected or not infected, shall, before doing so, apply to and
obtain from such officer as may be appointed in this behalt;
passports in the form shown in Appendix II—A ; provided
that no passport shall be issued to any person suffering or
suspected to be suffering from plague, or to persons who have
so lately suffered from plague as to be in an infectious state
or who are likely from recent contact with plague cases to be
infected or to be in an infectious state ; and the said officer
may always require, before granting a passport, that all
clothes and other articles which are proposed to be taken
away shall be disinfected in such manner as he or superior
authority may direct.
Other kinds
of passports.
83, In lieu of the passport prescribed under the last pre-
ceding rule, the Collector may issue or permit to bo issued
other kinds of passports, namely —
(1) A general pass in the form shown in Appendix 11-B
covering frequent or daily journeys by road or boat, but not,
journeys by rail nor residence outside the affected area.
(2) A general pass in theformsho wn in Appendix II—C
covering frequent or daily journeys by rail but not residence
outside the affected area.
(3) A general pass in the form shown in Appendix
II—D covering visits to a periodical market.
General
passes.
84. General passes in Forms B and C may be given to
agriculturists and others having occasion to make daily or
frequent journeys from an infected area, and may be given
for an indefinite period, but they will not cover residence
outside of the infected area. In the case of agriculturists, if
the officer granting the pass is satisfied that it is necessary for
the whole family to go and work in the fields, a single pass
may be given for the family, but in the case of railway journeys
a separate pass in Form C must be issued to each individual.
General passes should be given freely, and in the case of agri-
culturists working in the fields need not be revoked even
should a case of plague occur in the family of the pass-holder.
In the case,of persons who regularly visit weekly markets
in adjoining non-infected areas and return to the infected
or notified place within a period not exceeding 24 hours, a
permanent pass in the form given in Appendix II—D should be
issued. Intimation of the grant of such passes should be
31
Part IV—Rule 85.]
duly communicated to the officers concerned in the non-
infected area, and a register should be maintained in the form
shown in Appendix II—G of all permanent passes issued.
Special
passes.
85. Instead of the passport or passes referred to in the
last three rules a special pass in the form shown in Appendix
II—E may be issued permitting persons to leave inhabited
areas of an infected or notified town or village and reside on
fresh sites approved by an officer authorized in this behalf.
Such passes may be granted for households, provided that the
name and description of each person covered by the pass is
entered therein. The officer issuing the pass may always re-
quire, before the pass is given, that all clothes and other articles
to be taken away shall be disinfected in such manner as he or
superior authority may direct. Persons holding these passes
shall not be allowed to return to the inhabited area except
under such restrictions as the said officer may from time to
time require or until the pass shall have been cancelled by him
and until all clothing and articles to be taken back with them
shall have been disinfected.
Establish-
ment of pass-
port-issuing:
offices.
86. At convenient spots within, or in the proximity of,
the inhabited area of an infected or notified town or village,
the Collector shall establish one or more offices for the issue
of passports and passes and shall notify by tom-tom the
locality of such office or offices at such intervals as he shall
consider sufficient to inform the inhabitants of their purpose
and position.
Duties of
passport-
issuing-
officers.
87. Passport-issuing officers are required, not merely to
issue passports to those who apply for them, but also to trace
out persons who have evaded or infringed the passport rules.
Evasion of
rules.
88. Any person evading or infringing these rules should
be prosecuted, unless the Collector sees reason to the contrary,
and any such person, whether prosecuted or not, should be
placed under the passport system as soon as the evasion is
discovered.
Exemption
from rules
requiring
passports
and passes.
89. The Collector shall have power also to exempt from
the necessity of taking out passports or passes the following
classes of persons :—
(1) Railway, Postal or other Public servants of such
grades as may, from time to time, be determined by Govern-
ment. Reference on this subject may be made to the Plague
Commissioner's proceedings No. 16, dated 5th January 1S99,
which are printed in Appendix II—H.
32
[Part IV—Rule 90.
(2) Any person with regard to whom there are no
reasonable grounds for suspicion of infection.
Observation
camp to
protect a
town or
large village
threatened
with plague.
90. When there is a town or large village in the vicinity
of an infected area, the Collector may establish a camp of
observation at such town or village and may order detention
and disinfection in such camp of all suspected persons coming
from the infected area without passports or passes. He may
appoint special places where markets may be held and may
prescribe limits beyond which it shall not be lawful for
persons bringing articles for sale from or to an infected area
to pass.
Use of pnblic
conveyances
by plague
patients
prohibited.
91. No owner, driver or person in charge of a public
conveyance shall carry any person suffering from the plague ;
nor shall any person suffering from the disease enter or bo
taken in a public conveyance.
Infected
houses not
to be let until
disinfected.
92. No person shall let, or show for the purpose of letting,
a building or part of a building in which he knows, or has
reason to know, that a person has suffered or is suffering
from the plague, without having such building or part thereof,
and every article therein likely to retain infection, disinfected
to the satisfaction of the medical officer appointed by the
Collector in this behalf.
Destruction
of infected
hnts or sheds.
93. If the Collector of the district or an officer generally
or specially authorized by him in writing in this behalf is of
opinion that the destruction of any hut or shed is necessary
to prevent the spread of the plague, the Collector or such
officer as aforesaid may summarily take measures for the
destruction of such hut or shed and the materials of which it
is constructed.
Disuse of
buildings
unfit for
human
habitation.
94. If it appears to the Collector or an officer appointed
by him in this behalf that, in view of the prevalence of the
plague within his jurisdiction, any building within such juris-
diction, intended or used as a dwelling, is in so insanitary
a condition as to be unfit for human habitation, he may
summarily cause the same to be vacated, and may prohibit, by
a written order, the further use of such building as a dwelling.
After such prohibition no owner or occupier of such building
shall use or suffer the sanie to be used for human habitation
until the said officer gives written permission in this behalf.
Abatement of
overcrowd-
ing.
95. When any building or place is, in the opinion of the
Collector or an officer generally or specially authorized by
him in writing in this behalf, so overcrowded as to make the
inmates or occupiers specially liable to an attack of plague,