38
In dealing with imported cases or early indigenous cases compulsory removal
might be advisable, but where the authorities are unable to get the bulk of the
cases, the less the sick are interfered with the better. The continual visitation of
the sick at home, frequent disinfection of the infected room, and the encouragement
of inoculation among the persons left in the houses with the sick, are the points
which should be aimed at.
Government lay down that the removal of patients to hospital should be com-
pulsory only in places and under circumstances where it can be carried out so
completely as to render it an effectual precaution, and in the case of persons who
are left without any one to look after them, or who have no home : but every
effort should be made to induce patients to go voluntarily to hospital, and to lessen
the aversion to hospitals by the means enumerated by the Commission. Govern-
ment renew their prohibition of the removal of moribund patients.
In Bombay there can be no question that the bulk of suffering cases escape
detection and the removal of the sick is not an effectual precaution. Removal of
the sick will therefore not be compulsory in Bombay, but it will be the business
of District Officers and Sectional Medical Officers to do their best to induce patients
to go voluntarily to hospital and if, as will generally be the case at any rate for
the present, they are unsuccessful, it will be their duty to arrange for the daily
visitation of the sick person at home, the frequent disinfection of the infected room,
and the encouragement of inoculation among the other inmates of the house.
Every effort should also be made to secure isolation of the sick person as far as
possible: the disinfection and removal of all superfluous kit: and where the
patient has no medical attendant, the Sectional Medical Officer should do his best
to save his life by advising and prescribing for him. Patients, who are left
without anyone to look after them or who have no home, should be removed to
hospital. The removal of moribund cases is again prohibited.
Segregation of Contacts.—Paras. 28 to 30.
The Commission are of opinion that the figures placed before them do not
justify the conclusion that contacts must be regarded from the point of view of the
protection of the rest of the community as so dangerous that they ought to be
compulsorily removed to a Segregation Camp, and though under very special
circumstances the segregation of contacts might be a measure of very great value,
it can in urban areas, where infection is widespread, be easily evaded, and has as
a matter of fact been quite ineffective for the protection of the community.
Government agree with these views and add that if a system of surveillance can
be devised which will enable a watch to be kept over the health of contacts without
exciting them to evade observation, it will be advantageous, but no such measure
will be effective in a large town unless it is carried on with the co-operation of
the inhabitants.
In Bombay, therefore, all attempt at the segregation of contacts is to be
abandoned, but when a case occurs in a house District Officers and Sectional
Medical Officers should, with the assistance of volunteers, endeavour to keep
an eye upon the health of the other inmates until the likelihood of their develop-
ing the disease has passed away, and this should be done in a kindly way, so
as to avoid frightening them.
Evacuation.—Paras. 31 to 35.
In applying the general principles here laid down to Bombay, it may be re-
marked in the first place that evacuation on a large scale as contemplated in these
paras, is regarded as out of the question in this City (para. 33).