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from the Chief Accountant, They are printed in triplicate, but the triplicate is
not wanted, and should be torn off leaving only foil and counterfoil.
On each foil and counterfoil should be written the letter of the Ward of the
city, and the name of the section in which the beat lies.
The District Officer should inform me 2 days before he intends to issue these
books in order that I may ask the Police Commissioner to recall the ticket books
now in the hands of Police Constables, who will then cease to give tickets to
funeral parties.
District Officers should also report how the beats are arranged, and what meet-
ing-places are fixed.
This system of ramosis reduced the number of deaths that could
not be traced to a very small proportion of the total mortality ; the
Sectional Medical Officers had to make personal enquiries regarding the
cause of every death, and had every week to submit returns, showing the
method of their verification of the deaths they put down to causes other
than Plague or suspicious. If the death had occurred in hospital there
was comparatively little doubt about the correctness of the diagnosis ; and
so too if the Sectional Medical Officer had seen the patient during his
last illness, or examined the body after death. Medical certificates from
qualified practitioners were ordinarily accepted, and sometimes from
unqualified practitioners of good repute. There were a few other satis-
factory sources of information ; e.g., deaths certified by the Coroner, and
deaths in the Lunatic or Leper Asylum, &c. The balance of deaths put
down to ordinary causes which were verified only by enquiry from
friends and neighbours, it was the constant object of the Deputy Commis-
sioner to reduce to the lowest possible figure. If there were many the
Sectional Medical Officer was warned to be stricter in his enquiries, and
to be more careful about accepting the statements of other residents in
the house, and was persistently impressed with the necessity of treating
as suspicious all deaths about which there could be the least possible
doubt, and thereby securing an least the advantages of disinfection.
The results of this continual pressure are given in the section referring
to the mortality of the city at page 12 of this report.
Removal of
Patients to
Hospital.
Removal of patients to hospital is thoroughly unpopular and is no
doubt the principal reason why Plague is concealed. A considerable
number, however, do go voluntarily. When a suffering case is found
the people now, as a rule, accept the necessity of removal though
generally with reluctance.
The statement of work done shows that of 9,127 suffering cases
found 8,144 were removed to hospital and 983 left at home. Of those
left at home a few were Health Department biggaries who were looked
after by their own departmen; the number isolated by District Officers,
in the exercise of their discretion, was 159, and the whole of the rest
were moribund cases.
Isolation was only permitted in airy well-ventilated rooms, the rest
of the house was, so far as possible, kept empty, the number of attendants
was limited, medical attendance was insisted upon, visitors prohibited,
sanitary precautions enjoined, and disinfectants provided. The District