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I would further suggest that it is deducible from the above main conclusions
that disinfection is likely to prolong the period quiescence of the disease by reason of the
large destruction of plague bacilli that must have taken place in the past six months. That
the epidemic of next year, if combated by chemical disinfection alone (including sterilization
of clothes, &c.) on these lines, starting at a later date is likely to last over a shorter period
in its upward progress to maximum point, claiming a smaller number of victims and reaching
at its acmé a lower level; and that its fall to normal is more than probable to be
hastened. To still further limit its duration and its magnitude the following measures should
be adopted.
i. A proper system of death registration and of notification of plague (among other
infectious diseases) as carried out at Home.
ii. Measures such as putting the more notoriously overcrowded houses under an Act
approximating in its provisions and objects to the Lodging House Act of England having
for its object the prevention of overcrowding and the apportioning a reasonable amount of
cubic space (suitable to this country) to those residing in or lodging in large chawls. This
would involve diminution in the expense and improvement in the methods of human transit
in and out of the Island of Bombay as well as a building programme.
iii. Improvements m the sanitary condition of insanitary houses and the adoption of
a rule that all ground floors should be 'pucca'; structural changes for the admission
of air and light to houses that are bad in this respect.
iv. The adoption and encouragement of voluntary evacuation in the case of certain
houses, involving as it does the adequate provision (over a certain period) for the housing
in comfort of those displaced from their homes.
v. The encouragement of inoculation, though this measure in a city like Bombay must
always take a place secondary to disinfection for the reason that few avail themselves
of it, and that it does not strike at the root of the trouble.
vi. A most determined crusade against rats. This is a measure I lay a very large
amount of stress on, and I will discuss the matter at greater length later on in this report.
vii. The starting of hospitals for the clinical study of plague as well as for the
treatment of the same. The hospitals should be under the immediate supervision of
European Medical officers who could in this way throw a large amount of light on the
disease, a thing which up to now seems to have been only carried out with a moderate
amount of success for the reason apparently that few men with the necessary knowledge or
ability have been in charge of such hospitals,
I now proceed to discuss the proposed crusade against rats at length.
The intimate connection between the rat and plague admits of no doubt and
that the rat plays a most important part in the dissemination of the disease is a
fact borne out by too many observations to be for a moment doubted, in fact in
the Island of Bombay, we have a wide and general distribution of the disease or
the reverse in proportion to the number of rats affected. Since it is an impossibility to
disinfect the holes and burrows and runs of these rodents, it behoves us to ask
the question is there any other way of obtaining in a measure the same results.
And the answer is yes, by a great diminution in the number of rats in the island
of Bombay. Rats flourish in badly made drains and wherever filth and garbage ac-
cumulate and their multiplication is due to human neglect—if there were no waste
products for them to devour they would not be present in such formidable numbers. So
that by directing our attention to those causes such as the accumulation of garbage, &c., to
the faulty character of drains, &c., we will do an amount of good commensurate with the
diminution in the number of rats therefrom. But this is not enough. It will be necessary
to take measures for the actual destruction of rats. This brings us to the consideration of
how to deal with them in this connection ; and our mode of dealing with them will depend on
(a) Whether the rats are primarily affected and act as carriers of infection.
to man or ;
(b) Whether man is primarily affected and acts as a vehicle of infection to rats.