NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
12
STATEMENT B.
Weeldy statement of mortality in Bombay City for January 1900.
(Prepared from the weekly summaries of Plague operations
in Bombay City.)
1
Week ending
Gfch January 1900
13th „
20th „
„
27th „
„
2
Total
Mortality.
I r 730
2,110
2,281
2,493
8
Plague Deaths
(including
cases treated
as suspicious).
575
745
843
895
4
Difference
between total
mortality and
Plague deaths.
1,155
1,365
1,438
1,598
5
Normal
Mortality.
5-23
481
520
517
6
Difference
between
column 4 and.
column 5.
632
884
918
1,081
In supplement of the above report the following table shows the
verification of deaths from the week ending 4th November 1899 to the-
week ending 26th May 1900:—
Plague
.
Suspicious
Still-born
ID Hospital
...
._
Seen by Sectional Medical Officers during last illness
Seen by Sectional Medical Officers after death ...
Certified by qualified Medical practitioners
Certified by unqualified practitioners
Deaths certified by Coroner, in Lunatic Asylum
certified by Volunteers, &c., &c.
... " .
Deaths certified by enquiry only
,
Deaths unaccounted for ...
Total Deaths ...
14,806
7,687
1,325
3,334
8,390
3,891
4,263
665
672
10,025
2,047
57,105
The average mortality for this period, taken from the figures for
the 5 years preceding the first outbreak of Plague, may be taken
at 15,500. The deaths put down to ordinary causes, including small-
pox, relapsing fever, and other epidemic diseases, number 34,612 ;
and of these nearly two-thirds were verified by methods upon which
it is impracticable to improve. As pointed out in the Commissioner's
report above, the conclusion is almost irresistible that if the large excess
mortality was really due to Plague, then it was in a form notdiagnosable
by the means ordinarily available.
The following extracts from reports received from various officers
will suffice to illustrate the difficulties they had to contend with in the
matter of diagnosis:—-
Extract from Captain Dunbar Stuart's report for the week ending
12th August 1899 ;—
This man came originally from Nana s chawl as a contact. On the 7th he was
Name.
Age and Sex.
Caste.
Residence.
Date of attack.
Date of death.
Krishna Bickoo.
Male 82 years.
Mahratta.
Grant Koad Camp.
7th August.
12th August, 4 A. M.
seen by Dr. DaGama and myself, apparent-
ly suffering from some cerebral complaint,
ratber tongue tied. He was sent to J. J.
Hospital who transferred him to Arthur
Road Hospital for observation. On the
9th August, Arthur Road Hospital tele-
pnoned t&e man naci developed rneumomc Jrlague. Me died at 4 A,M,,12tn August.
This man was a labourer, working in Kumathipura Iron Factory.
13
Extract from Lieut. Brackenbury's report for the week ending
19th February 1900 :—
In another house 2 women living in adjoining rooms fell sick~within 2 days, and
developed buboes accompanied by fever. Dr. Mathai was of opinion that the first
was Plague. The relatives asked to be allowed to call Dr. Yiegas, who said it was
not Plague. The 2nd case Dr. Viegas reported at first to me as Plague. Dr.
Mathai thought it was not. The cases were kept nnder observation and the fever in
toth cases subsided so quickly that now both are confident that they are not
cases of Plague.
Extract from Captain Lock's report for the week ending 3rd
March 1900 :—
A Medical man in whom I have implicit trust reported a man to be ill in 97,
Cawasji Patel Street, 3rd storey, stating that the man had measles, but that he was
not satisfied as to whether he might not have Plague. He promised a final decision
next morning. The man did not live until the morning and died during the night.
The doctor gave a certificate of measles. Two days after 2 children on the 2nd
floor were attacked with Plague and removed. On close enquiry the history of this
house shows that the tenants on the 1st floor had left 5 days previous to the death
on the 3rd floor, owing to numerous deaths among rats, which were found irres-
pectively all over the house. I ain convinced that the death on the 3rd floor was
Plague, and the evidence of the sudden death, 2 days illness, pain under the arm,
coupled with the description of a bubo, described as long standing by the Medical
attendant, would bear out such a belief. Yet the Medical attendant was one of the
most respected members of his profession, and I am sure acted in good faith.
This is a report from Bycnlla :—
I beg to report that four exceptional, cases of Plague have come to my know-
ledge. All these persons were strong and sthenic between the age of 18 and 20,
There were no buboes, nor high temperature (100-101), the tongue was dry and
brown. No delirium and the patients could move about, nor were the eyes injected.
They lived in infected houses and were not inoculated. They were all new
arrivals from the Deccan, and the chief point to be noticed was that they succumbed
within 4 hours after medical examination without any signs or symptoms of having
got worse.
All these cases occurred on Haines Road.
I beg to remain,
Sir,
Your most obedient servant.
(Sd.) W. B. JAYAKAR, L, M. & S.,
Sectional Medical Officer
12*/. March 1900.
E Ward, Byculla.
No. 605 of 12th March 1900.
Forwarded with compliments. These were true plague cases, as the first caso
Chandra Bhoodhaji, male, 40 years, Maratha, who went to the Arthur Road
Hospital, was diagnosed as Plague and died the same day.
W. H. WOOLDBIDGB, CAPT.,
District Officer,
E. East Byoulla.
26
year. In Kharatalao and 2nd Nagpada from the beginning of November
to the end of the year. Kharatalao had also a slight recrudescence in
the early part of October. In Fort and Esplanade from the middle of
November to the 1st week in May.
In Bhuleshwar, Tardeo, 1st Nagpada and Parel from the middle of
November to the end of the year.
In Colaba, Mandvi, Chukla and Umarkhari from the beginning
of December to the end of the year ; Mandvi also had a recrudescence-
from the middle of August to the middle of October.
In Dhobitalao, Fanaswadi, Girgaum and Mazagaun from the mid-
dle of December to the end of April.
In Market, Kumbharwada, Khetwadi, Mahalaxmi, Sewri, Mahim,
and Worli from the middle of December to the end of the year.
Kumbharwada also had a slight recrudescence in October.
In Tarwari from the end of December to the middle of May.
In C'howpatti and Sion from the beginning of January to the end of
April.
In Walkeshwar from the end of January to the middle of May.
The effects of famine naturally reduced the standard of living of
the poorer classes of Bombay, they were enhanced by many of the
cotton mills closing or working short time. In addition Bombay
was flooded with crowds of famine refugees from Kathiawar and
elsewhere; they arrived debilitated and destitute, and wandered about
homeless begging a living. Some 8,000 of these people were turned
out of Bombay in one day and sent under the orders of Government to
Thana. They did not contribute much to the Plague mortality, as the
greater proportion of them were inoculated, but there can be no doubt
they fell a ready prey to small-pox, relapsing fever and disease of all
kinds. The number of road-side deaths in the City was very large and
chiefly occurred among these immigrants. The poorer portion of the
resident population were in like manner more liable than usual to
the attacks of all forms of disease, and District Officers ascribe the
comparatively high infant mortality of the year to. the effects of
famine.
Among other immigrants some 400 of the Khoja community were
maintained from the Jemayet Funds and accommodated at the Hassan-
abad compound belonging to H. H. The Aga Khan. The arrangement,
was not an altogether satisfactory one, as this place is at certain times
frequented by large numbers of Khojas, and there was a risk that
if any disease broke out among the refugees it might be spread all over
the City. They were, however, kept under medical supervision, most
of them were inoculated, and though there was some mortality
among them, they escaped any serious epidemic.
28
Very few rats were found in Byculla, though they were carefully watched for.
Captain Wooldridge cites one case—house No. 196 Haines Road—where a tenant
was seen throwing out 2 dead rats, and on the following day a suffering case was
found next door. This was on the 11th March, and between that date and 5th April
9 suffering cases were removed. The outbreak was stopped by evacuation and
disinfection.
Liability
to the
Disease.
The majority of District Officers hold the opinion that it is the
localities that are attacked and not any particular class of the people.
Insanitary and over-crowded areas are more liable to the disease than
others, and naturally the lower classes, who inhabit such places, are
the worst sufferers.
Captain Lock notices that Plague was much more localised than
in previous years, many places that had been severely hit before hav-
ing entirely escaped infection during the year under report. He
ascribes this in part to the greater care and cleanliness of the people,
partly to the extreme thoroughness of disinfectien on the slightest sus-
picion of Plague, and partly to the wholesale inoculation of the resi-
dents of some of the worst quarters.
Lt. Dalgliesh gives as an instance of the persistency with which,
the disease sticks to certain buildings—house No. 182 II, Nowroji Hill,
North, in which 5 cases of Plague occurred, between 5th May 1899, and
12th May 1899. House was vacated, disinfected and re-occupied 10
days after, the residents having been sent to camp. The house then
remained free till 29th September 1899, when a suspicious death
occurred and four suspicious cases, from 26th January 1900 to llth
March 1900, and then two cases of Plague on 13th March 1900 and 1st
April 1900. This house remained free for four months after vacation
and disinfection, after which Plague broke out again.
Captain Cuppage mentions two large chawls in Fanaswadi—
Patras chawl and Batliwala's chawl—where attention to sanitation
seems to have conferred immunity. They were both badly infected
last year, but since then had been almost entirely renovated and recon-
structed on sound sanitary principles, free admission of light and air
being one of the chief improvements. The result was that in both
localities there was comparatively little plague, though the houses
were occupied by Goanese, crowded into clubs, and the lowest class of
Mhars. Captain Dunbar Stuart reports that in D. Ward the localities
attacked were almost invariably the same as in the previous year and in
some cases even the identical rooms,
Captain Boileau writes with regard to the reinfecton of
localities:—
Plague did not remain in any place in particular, but moved erratically all over
the district, from one place to another, and often back again to the same locality
whence it started ; but as a rule I find that once a house has been thoroughly disin-
fected, Plague does not visit it again that year, although it is almost certain to do so
during the next epidemic.
'
Volunteeis
...
«
Hospital Beturns
*
Lunatic Asylum
Prirate Practitioners ..
8. M. Oa. and Staff
...
Registration Eamosls ...
Municipal Subordinates
Police
H *
Military Authorjtieo ...
Landlords
Friends and Neighbours
Cemetery Memos,
...
Total ...
A. WARD.
21
18
7
140
7
12
27
86
22
80
...
762
3
' .
10
209
5
14
103
7
1
19
75
475
24
13
i
84
349
12
26
136
42
23
99
75
227
B. SOUTH.
25
26
79
41
48
5
2
12
124
827
...
2
8
300
]
4
1
15
336
26
26
8
49
348
6
6
13
139
163
B. NORTH.
240
78
23
162
49
4
...
12
15
583
72
9
2
369
24
...
1
...
...
2
479
31
8
2
531
73
4
1
12
15
2
062
C. WARD.
56
50
65
220
81
7
26
28
66
...
564
290
3
21
1189
350
10
32
8
15
148
066
855
509
86
1409
431
17
58
36
81
148
3030
D. WARD.
110
194
88
243
41
1
11
68
13
...
719
91
55
488
186
]
15
12
8
24
830
201
194
43
731
• 227
t
26
80
21
24
549
B. WEST.
782
100
2fe
72
29
o
2
2
6
021
i
...
...
•«.
898
...
...
...
007
791
100
28
72
927
2
2
6
928
BYCTJLLA.
110
1
r
99
182
8
30
68
498
457
336
...
...
977
5
2
...
777
567
337
5
99
1159
8
32
68
2275
WARI BUNDER.
76
48
23
101
205
...
7
1
460
58
22
1
139
263
...
...
1
2
486J
138
70
24
240
468
...
7
2
2
946
F.
&G.
197
63
30
735
264
12
4
32
10
...
347
235
127
11
889
290
17
2
6
...
46
623
432
190
41
1024
554
29
6
38
10
46
2970
CENTRAL.
622
81
14
565
91
...
2
13
19
...
407
462
23
1
1164
115
...
1
...
...
7
1773
1,084
104
15
1729
206
...
3
13
19
7
3130
GRAND TOTAL.
3175
1463
5
379
2378
997
41
77
35
22G
402
...
9178
1709
521
1
53
4455
3408
43
163
7
30
58
304
10752
488
198
43
683
440
82
4C
42
256
46(
304
1993C
30
The information supplied by volunteers, private practitioners,
friends and neighbours and landlords is of the most useful character.
From all these sources information comes, in by far the larger
number of cases, before the patient's death, and it is possible to carry
out all the necessary measures efficiently. Volunteers obtain their
information partly from their acquaintances and partly in the course
of house-to-house visitation; and it will be seen that they succeeded
in reporting about ¼ the cases detected during the year ; the number
reported by the other agencies above referred to being very small.
The work of volunteers was most" exceptionally good in this
respect in E Ward West, and it was good in B Ward North and the
Central District, it was also very good in Byculla, considering the very
small number of gentlemen working. In A Ward, B South and C
it was fair; but it must be mentioned that a very large proportion of the-
cases reported in B Ward South came from a single volunteer, C Ward
has been disappointing : it held a leading place for the energy and zeal
of the Committees last year, but there was a great falling off in the
proportion of cases reported by them during the year under report-
and, though every endeavour was made to induce them to bestir
themselves, practically the whole of the work was done by the com-
paratively small body who have received honourable mention at the
close of the chapter on Volunteers.
The work of volunteers as a whole in D Ward continued to be
distinctly inferior. The number of cases reported from this source in
Wari Bunder and F and G Wards was very small, but the volunteers-
dealing with these areas are comparatively few. In A Ward and
B Ward South the comparatively large number of cases reported by
friends and neighbours must be taken as an indication partly of
confidence in the District Officers 2nd partly of enlightenment among
the people. The comparatively large number of cases reported by
the landlords in D Ward is worthy of note. The assistance rendered
by private medical practitioners was most conspicuons in A Ward
and B Ward South, and after them in C and D Wards. There is
nothing surprising in this, as these are the most advanced and well-to-do
districts in Bombay. It is the duty of private practitioners to report
all Plague cases that may come within their knowledge to the Health
Officer, and the following statement shows the number of cases so
reported by various doctors :—
Name of Doctor.
Dr. E. F. Underwood
Mrs. F. Murzban, M. D.
Dr. C. H. F. Underwood
„ T. Blaney
„ N. A. DeSilva...
„ M. Bradley ...
„ V. K. Paralkar
.,
„ Dinsha Bamanji Master
No. of cases
reported
by each.
19
1
5
14
10
1
5
1
Name of Doctor.
Dr. F. N. Bisni ...
,, K. S. Engineer
„ Bhalchandra Krishna
„ G. B. Kber ...
„ R. E. Lakhdhir
„ Khaja Abdulla...
„ Nagindas M. ...
"Hakim Ram- Narayen
. .
No. of cases,
reported
by each.
4
2.
1
2
8
25
1
4
31
Name of Doctor.
Dr. Sorab Nariman
„ D. Katrak
-„ S. S. Batliwala
,, S. K. Dadachanji
,, J. I. DeQuadros
,, L. B. Dhargalker
..
Major Criimmin, Port H. O
Dr. Dadabhai N. Saher ..
„ J. K. Daji
„ Hurjibhoy J. Apoo ..
„ C. Rodrigues
„ A. A. Gair
,, Edulji Nusserwauji
„ S. B. Jatar
No. of cases
reported
by each.
11
1
5
1
3
3
2
2
2
2
3
1
1
4
Name of Doctor.
An informant signed D. E L.
Dr. Dossabhoy K. Patel
Col. G. Waters ...
Dr. Teinulji Bhikaji Nariman
,, E. J. Treasurywalla
, H. J. Dadishett
Major J. P. Barry, I.M.S.
Lt. Twigg, I.M.S....
Capt. Brogden, R.A.M.O.
Dr. H. W. B. Prescott
„ L. P. Gomes ...
,, Navazbai M. Metha
,, F. B. Seervai ...
„ J. Nicholson ...
No. of cases
reported,
by each.
6
2
2
1
1
14
2
1
1
1
11
1
1
1
But a considerable Dumber of medical practitioners habitually gave
information direct to the District Officers, and the following names, not
included in the above list, are mentioned by them: —
Dr. Viegas, Dr. Ismail Jan Mahomed, Dr. D. B. Naik, Dr. (Mrs.)
Nadirshaw, Dr. Rozario, Dr. Narielwala, Dr. Erachshah Hakim, Vaid
Erapa, Dr. F. X, Fereira, Dr. P. J. deSouza, Dr. Purshotam Earichand,
Dr. S. S. Misir, Dr. B. D. Kapadia, Dr. Popat Parbhuram, Dr. Ranina,
Dr. Moses and others.
In some 7 cases during the course of the year serious occasion
arose to suspect medical practitioners of deliberately neglecting their
legal obligation of reporting Plague cases. Two of these cases were
taken into Court and convictions obtained; in another case the doctor
concerned apologised and promised amendment, in the other 4 cases
there was insufficient evidence to warrant legal proceedings. Only
two of the 7 above referred to were qualified men. Information
derived from hospitals is in a way satisfactory; it may be observed
that as many as 10 per cent, of the total number of Plague cases detect-
ed were voluntary removals to hospital. The disadvantages attached
to this form of information are first that the patients or their friends
and relatives give as often as not most vague and unsatisfactory
addresses, and secondly that even when the house, where the patient
fell sick is found, the contacts have frequently removed themselves
elsewhere, taking all their belongings with them undisinfected, and
probably causing danger to other people. The proportion of voluntary
removals in B Ward South was noticeably high. Information supplied
by the Lunatic Asylum and by the Military, refers entirely to A Ward,
where the asylum is situated and the troops are quartered. The
detection of Plague amongst the troops and their followers was entrusted
to the Military, and the work was most efficiently performed.
It will be seen that the sectional medical officers and staff,
together with the registration ramosis, discovered more than half the
Plague cases by their own efforts, but less than a third of the cases they
found were detected before the death of the patient. In D Ward, Wari
Bandar, and F and G Wards this work weighed heavily upon the staff,
principally owing to the lack of energy in the volunteers of D Ward and
S2
their scanty numbers in the other two districts. In Wan Bandar and F
and G Wards the staff were more successful than elsewhere in detecting
cases at their earlier stages, while in C Ward and E Ward West they
were distinctly unsuccessful in this respect.
The number of cases reported by the Police and subordinates
of the Health and other Municipal departments was very trifling, the
comparatively high number of cases reported by the Police in A Ward
was probably due to roadside cases among destitute people who slept
on the open maidans of that district. A very satisfactory feature of the
table is the small number of cases detected through the means of reports
from the cemeteries. This method of obtaining information is both
inaccurate and tardy, and only came into operation when every other
agency had missed the case.
Reference was made in last year's report to the institution of an
uniformed corps of ramosis to improve the registration of deaths.
The cemetery returns showed formerly that the administration was
entirely unable to trace something like 20 per cent, of the deaths that
occurred : and in these cases it was impossible not only to take any
sanitary action, but even to make enquiries as to whether any action
was necessary. The registration ramosis are assigned beats through-
out the City, and it is their business to see that no dead body is
removed from their beats without a pass. A duplicate of the pass is
made over by the ramosi to the sectional Medical Officer, and the
original is handed by the funeral party to the clerk at the cemetery.
At the three principal cemeteries arrangements were further made that
if a dead body was brought for disposal without a pass, a messenger
should be sent back with the party to verify the address.
The system succeeded almost beyond expectation, the people have
fallen into it readily, the ramosis have missed but a small proportion of
funerals and those principally still-born infants, and very young
children, who are carried in the arms to the cemeteries without much
ceremony. The majority of deaths missed by the ramosis have been
verified by the cemetery messengers, and from the beginning of
November to the end of May the proportion of deaths, in which the
district staff failed to find the address, was reduced to 3'58 per cent.
In addition to being very much more accurate, the information, was
very much more prompt, and, speaking generally, when the list of
deaths for the day was received from the Health Department in the
various districts, nearly all the deaths in the list had already been
enquired into, in consequence of information received from the registra-
tion ramosis. The registration ramosis in some parts of the City also
gave valuable information as to plague and other sickness, and they
were of the greatest use to the district staff in carrying out the various
measures adopted.
The following Circular initiated the system of registration ramosis:—
It is intended to abolish the present system of collecting information of deaths
systematically through the police.