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necessary amount of annoyance to the other inhabitants of the building. By repeated
disinfections, it causes waste of solution, unnecessary hard work on the staff, and
disheartens the District Officer. In my opinion the isolation of a case should be left
entirely to the discretion of the District Officer who is an officer and a gentleman.
To lay down a regulation indiscriminately and say it must be carried out, with-
out limitation, is a measure of the worst kind and so isolation has proved to
Bombay. The conditions of the people are generally such that isolation becomes a
farce. Take for instance a chawl like 389, Duncan Road, a large barrack, some 60
feet by 30 feet without any partition walls, latrines, at one end, and wash house at
the other. Some 20 families live in this chawl ; no privacy whatever. They live
like a pack of hounds in a kennel, though not half so clean. A case of plague
takes place in the centre. You induce the friends to send the patient to hospital.
They refuse. How are you going to isolate the patient ? You cannot turn the
people into the street ; you cannot put them into another room, as there is no room
to put them in ; you cannot send them to camp, as they refuse to go. What are
you to do ? All you can do is to place the patient as far from those surrounding
him as possible and disinfect the house, knowing full well that as soon as your
back is turned they will go back and crowd around him : Dr. Fazl Ahmed has had
the best success with isolated patients, but his patients have been well-to-do people,
having their own medical attendants who carry out instructions, and see that
orders are obeyed. Under such circumstances isolation is a benefit, otherwise a
curse. I will quote a few instances in which isolation has been one of the means
of spreading plague throughout my district although every endeavour to carry out
the orders of Government on the subject were complied with.
The following particulars of plague cases in which the isolation of the patients
was effected will show that isolation is inefficacious, and that it is practically im-
possible to prevent the relatives of the patients from coming in close contact with
the patients, and thus obviating the danger of infection :—
A case of plague which was of the bubonic type occurred in a Dhobi family
consisting of five members, on the 6th of January 1901, at No. 6, Packmodia,
Street ground floor, which house has presented a clean bill of health from the
first outbreak of plague in Bombay. It was not known how the deceased caught
the infection, but it was believed that he might have caught the plague from the
infected clothing which he had to wash, as he was a washerman. This Dhobi died,
and it was the death-memo which brought the case to notice. On the 7th of the
January two other persons, who were in close attendance on the deceased, con-
tracted symptoms of plague. I disinfected a room in another house, No. 24,
Packmodia Street, and isolated them in it. In the meantime, No. 6, Packmodia
Street was disinfected. The relations about two hours after brought the patients
back to the original house without my knowledge. One of them died on the same
day, while the other survived till the 12th. The fourth and fifth, who, as a matter
of necessity, were in attendance on the deceased, got virulent attacks of plague,
and died on the 14th and loth January respectively. Thus by isolation the whole
family was destroyed.
A patient was isolated in house No. 252, Ghellabhai Street, as he did not wish
to be sent to hospital. He was one of the leaders of Ghellabhai Street Mahomedan
faction. He was attended by his nephew who resided at house No. 244, Ghella-
bhai Street. While in attendance he also became attacked. He was brought home
to 244, Ghellabhai Street where he died. During his illness the inmates in spite of
remonstrances from me used to go and visit him as soon as our backs were
turned. This started the epidemic and 24 cases occurred within a month, and was
only stopped by the house being disinfected from top to bottom.