NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
184
It should be understood that exemption from the passport rules does
not carry exemption from any of the other regulations framed under
the Epidemic Diseases Act.
3. Other classes of railway servants are probably less frequently on
the move and the enforcement of the rules among them is likely to
result less frequently in public inconvenience. In cases of real diffi-
culty, it may be possible to arrange under Original Mufassal Regulation
17 (i) for the inspection of the passport holder at the railway station,
or, under Additional Regulation 26, railway officers of known and
approved character and responsible position may be appointed Honorary
Assistant Plague officers, and empowered under Original Regulation
17 (i) (d) as "local authorities" at certain stations for the working of
the passport rules among railway servants.
4. Under additional Regulation 30, Collectors may exempt from the
necessity of taking out passports any person with regard to whom there
are no reasonable grounds for suspicion of infection. Such exemptions
must be made personally, not generally, and should be granted
sparingly.
5. Any concession may be withdrawn at any time without assigning
a reason.
19. The following papers relate to cases in which the
rules were relaxed under special circumstances :—
(1) G.O., No. 763-M., dated
1st April 1897.
(2) P.O., No. 932, dated
17th December 1898.
(3) P.O., No. 677, dated
11th March 1899.
(4) P.C., No. 760,
dated
17th March 1899.
P.C., No. 776, dated
19th March 1899.
P.C., No. 1108,
dated
21st April 1899.
His Highness the Graekwar of
Baroda's visit to Ootacamund.
Captain Jennings, Supervising
Medical
officer,
Railway
Medical Inspection, Bombay.
Director-General of Telegraphs.
Visit of Their Highnesses the
Maharaja and Maharani of
Mysore to Ootaeamund.
(8)—Inoculation.
The Sanitary Commissioner for Madras is entrusted with,
the making of arrangements for inoculation in the whole
Presidency including the City of Madras.
(G.O., No. 1379-P., dated 26th October 1898).
2. All commissioned Medical officers in Military or Civil
employ, Military and Civil Assistant Surgeons and such. Civil
Apothecaries as the Commissioned Medical officers under
whose orders they are serving may permit, may, at the dis-
cretion of the Sanitary Commissioner for Madras, be supplied
with M. Haffkine's anti-plague serum and all necessary
185
apparatus for inoculation against plague at Government ex-
pense. Private practitioners having qualifications not below
those permitting of entertainment in the service of Govern-
ment as Military or Civil Assistant Surgeons may, at the
discretion of the Sanitary Commissioner, be supplied with
M. Haffkine's anti-plague serum and with the necessary
apparatus for inoculation at the expense of Government,
provided they undertake the duty for the public benefit solely,
that is, that they take no fee from the subjects inoculated by
them and maintain registers and submit information required
in such forms as the Sanitary Commissioner may from time
to time direct. Only the most careful among the Civil Apo-
thecaries should be selected for inoculation work, and they
should, as far as feasible, be deputed first to work for a short
time at least in a place where inoculations are being done
under commissioned medical officers.
(G.O., No. 1463-P., dated 21st November 1898; G.O., No, 1543-P., dated 8th
December 1898; P.C., No. 1025, dated 27th December 1898).
3. The following rules founded upon those drawn up by
M. Haffkine for the guidance of inoculating officers should be
carefully observed:—
Instructions for keeping records of results of Inoculation by Haffkine's
Anti-Plague Vaccine.
As the operation does not leave any mark as vaccination does, it is
necessary to keep accurate lists of all those operated on. The following
method has been found easy to carry out in practice and has proved
effectual in checking rusults :—
1. Inoculation forms should be used—one for each person—on
which are recorded—name in full and father's name, caste, occupation
or title, sex, age, birth-place, present address, general health, date of
inoculation, dose and number of bottle. Forms may be had from the
Superintendent, Government Press, Madras, or they may be printed
locally if more convenient. All the entries, except the dose and number
of bottle, may be filled up by a clerk before the operation; the dose
and number should invariably be written by the operator himself at the
time he operates.
2. Certificates granted under the terms of G.O., No. 837, Public,
dated 17th August 1898, may also be filled up beforehand, but the
thumb-mark must be impressed immediately after injection in front of
the operator. To save time this operation should be done by a peon
and the certificates can then all be signed together after the close of the
operations.
3. At the close of each day's operations, all the sheets should be
sent to one central office where they may be arranged and indexed.
They should be arranged alphabetically and then numbered serially,
the first number for any day running on from the last of the previous
one. The object of numbering is to make sure that none of the papers
go astray at any time. The names should then be entered in the index
24
187
and taking some rest. General symptoms subside after 24 to 36 hours ;
the pain at the seat of inoculation lasts for 3 or 4 days, disappearing
gradually ; a painless induration remains there for some time longer.
It is desirable to produce a rise of temperature of at least 102° F. If
the reaction is less marked, the operation may be repeated 3 or 4 days
later, with the same or an increased dose, according to the result of the
first inoculation. There is no harm in leaving a longer interval
between the two inoculations, or in dividing the doses in several parts
to be given at an interval of a few days ; but it is preferable to inject
a full dose on the first occasion, unless some medical reason exists
indicating caution as being necessary. In case the supply of prophy-
lactic is accompanied by a direction of doubling or trebling the
standard doses, this should be attended to ; please, therefore, note the
instructions on the label of each bottle.
7. No changes in diet or occupation are necessary, beyond, if
possible, taking some rest.
8. The prophylactic material is harmless, and can be thrown about
without danger ; but it is liable to get infected. A. bottle, once opened,
is therefore not to be corked again, but used up at once, or the rest of the
contents thrown away. While a bottle is open, it should be guarded
from insects flying or walking into it, or dust falling in, by being leaned
against the syringe box in a slanting position. The empty bottles, the
boxes and, if possible, also the cotton in which they were packed, are to
be returned to the Laboratory, Parel, Bombay.
9. In sealed-up bottles, and when kept in dark and sufficiently cool
places, the prophylactic is likely to retain its power indefinitely.
10. It is requested that a detailed account of all operations done, and
of any observations made, be communicated at the earliest convenience to
the Sanitary Commissioner, Madras,—the inoculation forms being filled
up at the time of inoculation, and the occurrence of plague in families of
the inoculated being noted, in the observation sheets at the close of the
outbreak. These latter sheets will be supplied to any Medical officer
desirous of compiling statistics at the close of any outbreak.
11. Indents for serum should be made on the Sanitary Commissioner
in the annexed form :—
DATE
PLACE
Indent on the Sanitary Commissioner, Madras, for Haffkine's Anti-Plague
Vaccine required for the use
of
To be sent by
rail/post
to
Addressed
to
By whom
required
Number of doses asked
for
Number of doses
supplied
Sent by
rail/post
on
addressed as above.
On receipt of the vaccine the receipt below to be signed and returned
to the Deputy Sanitary Commissioner, Park Town, Madras.
188
Received from the Sanitary Commissioner, Madras,
doses of Haffkine's anti-plague vaccine.
Date
District Medical and Sanitary Officer,
District,
(G.O., No. 1345-P., dated 21st October 1898 ; Sanitary Commissioner's
Circular No. 2585-S, dated 4th November 1898).
4. The plague prophylactic and syringes are supplied from
the Plague Research Laboratory, Parel, Bombay, upon an
indent forwarded by the Sanitary Commissioner. Forms of
inoculation certificates and observation sheets will be printed
at the Government Press, Madras, and supplied by the Sani-
tary Commissioner to officers applying for them. Care should
be taken that the inoculation certificate forms do not fall into
the hands of unscrupulous persons. The forms should be
issued from the Press in books of one hundred each, and each
officer supplied with them should be required to keep an
account.
(G.O., No. 998-P., dated 3rd September 1898 ; G.O., No. 1463-P., dated
21st November 1898; G.O., No. 1236-P., dated 12th August 1899).
5, Inoculation certificates, which do not absolutely satisfy
the requirements prescribed in original Mufassal Regulations
31 and 32, pages 39 and 40, and City Regulations 21 and 21-A,
pages 18 and 19, should not ordinarily be recognized. Each
certificate should bear the thumb-mark of the person inocu-
lated. But where from any cause the thumb-mark has been
omitted, the officer responsible shall satisfy himself as to the
genuineness of the certificate by such other indications as are
available, especially relying upon the trustworthiness of the
bearer. All District Medical and Sanitary officers, Civil Sur-
geons, Treasury officers, and most Police Station-house officers
have been supplied with the finger-print apparatus ; one is also
issued with each set of inoculation apparatus by the Sanitary
Commissioner. The inoculation certificate should be issued
immediately after one full dose has been given, but the
recipient should be recommended to return for a second
inoculation after ten days. The full dose should always be
given at one time, unless for medical reasons it is considered
advisable to divide it. If it is necessary to do this, a certifi-
cate should not be given until the equivalent of two full doses
has been given. If, however, no undue re-action ensues after
the first fractional dose has been taken, it is advisable to
give the full dose at once on the second occasion, after which
a certificate may be given.
(G.O., No. 1181-P., dated 26th September 1898; P.C., No. 778, dated 23rd Nov-
ember 1898; P.C., No. 547, dated 28bh February 1899 ; and G.O., No. 876-P.,
dated 12th June 1899.)
189
6. Submission to inoculation is entirely voluntary. No
compulsion of whatever kind should be employed, and before
starting inoculation at any place, the inoculating officer
should consult the District Magistrate, who is responsible
if any disturbance takes place. Collectors are desired to
take such measures as they consider best suited for the pur-
pose to bring home to the people that no one will be inocu-
lated against his will, and to impress upon village heads the
necessity for making villagers understand the difference
between anti-plague inoculation and vaccination. The atten-
tion of all officers is drawn to the following remarks of
M. Haffkine :—
" While it is fairly safe to trust a careful subordinate in
charge of a local dispensary with performing inoculation in
a place where a spontaneous demand to that effect has arisen,
or where the Medical subordinate has had himself the inspira-
tion of talking on the subject to the local residents, and
unconsciously creating a demand, it is desirable that where
such a demand does not yet exist, the subordinates should
not be commissioned to preach or popularise the idea, excep-
tion of course being made for particularly able and authori-
tative men, enjoying confidence and influence among the
inhabitants. The reason of this evidently being that an
awkward attempt at persuasion is liable to create opposition,
resistance, and, occasionally, unfounded apprehension. Until
inoculation becomes better known in the country, it is
desirable to request the local Magistrate and Civil Surgeons
to try to introduce inoculation, at first, into places under their
immediate control and after having personally ascertained
that the leaders of the community have been won to the
idea."
(G.O., No. 999-P., dated 3rd September 1898 ; G.O., No. 1463-P., dated 21st Novem-
ber 1898; G.O., No. 1513-P., dated 6th December 1898; G.O., No. 1532-P.,
dated 7th December 1898; P.C.'s Pro., No. 937, dated 18th December 1898;
and P.C.'s Pro., No. 1025, dated 27th December 1898.)
7. The privileges* attached to inoculation are mentioned
in original Mufassal Regulation 31 and City Regulation 21.
As a further encouragement the Government has authorized
the grant of three days' extra casual leave on full pay to
all public servants for the purpose of being inoculated.
Students attending Government and aided schools, who
undergo inoculation, will be marked in the registers for not
more than three consecutive days as " under inoculation," and
such an entry will be regarded as equivalent to attendance.
* Note.—These are not admissible in the case of persons who have recovered from
plague. (P.C., No. 594, dated 2nd March 1899.)
190
No subsistence allowance can be granted to inoculated persons
for the period during which they are incapacitated for work
owing to the operation.
(G.O., No. 1532-F., dated 7th December 1898 ; G.O., No. 742-P., dated 17th May 1899.)
8. The following note, copies of which in English and
vernacular languages may be obtained from the Government
Press, Madras, may be supplied to each inoculated person
after he has been operated upon :—
" Persons desirous of being inoculated—
(1) May take on oil-bath a day or two before ;
(2) if subject to constipation, it is as well to take a dose of a
purgative or a laxative a few days beforehand;
(3) after inoculation, the diet should be, simple and light; milk,
conjee, sago, coffee, soda water, &c., might be taken freely with advan-
tage ;
(4) people sometimes suffer from faintness and giddiness after
operation ; this need cause no anxiety. The best remedy is to lie flat
on the ground, and to loosen all articles liable to constrict the throat or
chest. Soda water or strong coffee mixed with a little milk might be
taken;
(5) if the arm inoculated gives much pain, bran or any other
dry fomentation may be used and the arm should be supported by
sling ;
(6) inoculated persons should avoid exposing themselves until
the fever entirely subsides ; pain in the arm may continue for some
days, but this need not prevent the ordinary work ;
(7) for three or four days, even ordinary bath should be avoided ;
or if it is absolutely necessary, a sponge-bath should be taken in a closed
room so that the person may not catch a chill; cold baths should be
avoided ;
(8) oil-bath should not be taken for eight or ten days after
inoculation;
(9) no treatment is necessary for the fever which will subside by
itself in two or three days. Head-ache, if present, may be treated by
external application of menthol or ice or cold lotions, such as vinegar
and water. Should, however, the fever rise high, the inoculated person
would do well to seek the advice of a competent medical officer or send
intimation to the nearest dispensary and not trust to quacks ;
(10) sickness and nausea, when present, are best treated by a little
iced soda water or soda water and milk mixed ;
(11) sexual abstinence should be observed at least for two or three
weeks;
(12) females will find it convenient to be inoculated a week or ten
days before menses; they may be operated on one week after the
period;
(13) persons with a weak heart or lungs and persons subject to
hysterics, heart disease or nervous disability should get themselves
carefully examined by a medical officer before they subject themselves
to inoculation."
9. The Sanitary Commissioner should submit to G-overn-
ment a weekly return showing the progress of inoculation in
191
the whole Presidency. He should also forward direct to the
Financial Department by the 5th of the first month of each
quarter an estimate of all charges relating to inoculation.
(P.C.'s Ref. on 0, No. 97, dated 4th January 1899; G.O., No. 864, Finl., dated
31st July 1899).
9—Fairs, Festivals and Pilgrimages.
The views of the Government of India with regard to the
imposition of special checks on large gatherings during times
of plague are contained in para. 12 of their Resolution printed
on pages 83—92.
2. Any proposals which Collectors may desire to make in
the matter should be forwarded through the Sanitary Com-
missioner (and the Plague Commissioner) so as to reach
Government a month and-a-half previous to the holding of the
fairs and festivals. Proposals submitted at later dates do not
allow proper measures being taken to enforce them. In view
to avoid delay in their submission, Collectors should prepare
in their office every month a list of all the fairs and festivals
to take place in the ensuing three months, and should send
by the 15th of each month their recommendations relating to
religious and other gatherings to be held in the next month
but one.
(G.O., No. 279-P., dated 25th March 1898; No. 645-P., dated 1st May 1899; P.C.,
No. 462, dated 22nd February 1899.)
3. The Collector's reports should be invariably accom-
panied by draft notifications under the Epidemic Diseases
Act and by a statement in the following form :—
Name
of
festival
or
fair.
1
Place
where
held.
2
Distance
to
nearest
railway
station.
3
Date of
commence-
ment and
termination
of festival
or fair.
4
Average
attendance
during the
past three
years.
5
From what districts in
the Madras Presidency
and from what places
outside the Presidency,
pilgrimage should be
prohibited, and the
number of people
expected from each of
such districts or places.
6
(G.O., No. 279-P., dated 25th March 1898; P.C., No. 843, dated 3rd December 1898;
No. 462, dated 22nd February 1899).
192
4. As Stationmasters and booking clerks are not likely
to find out in the case of small fairs and festivals whether the
purchasers of railway tickets are going as pilgrims or not,
the prohibition of the issue of tickets in such cases does not
work satisfactorily and need not be recommended. As, how-
ever, pilgrims to large fairs and festivals can perhaps be
recognized, and it is of considerable importance to reduce
the number of visitors to these festivals, the issue of tickets
in their case may continue to be prohibited. It is left to the
discretion of Collectors to decide which of the fairs and festi-
vals are small and which large. In the case of unimportant
local festivals, a careful working of the passport rules should
suffice. Notice of the prohibition of the issue of railway
tickets should be given to the Railway authorities at least a
week previous to the date of commencement of the prohibition.
(G.O., No. 645-P., dated 1st May 1899 ; No. 651-P., dated 2nd May 1899.)
5. Where pilgrimage to a fair or festival has been prohi-
bited by Government, the Collector should, as far as the
means at his disposal permit, watch all the roads round the
village or town and prevent pilgrims from entering the place.
Persons who are suspected to have come from infected parts
should be watched for ten clays, and, if not suffering from
fever or any suspicious complaint at the end of that period,
should be allowed to proceed on their journey. It must be
distinctly understood that the prohibition is not in any way
intended to interfere with the performance of the usual
religious ceremonies at the temple, and that its only object is
to prevent the assemblage of persons who might import or
spread the plague.
(G.O., No. 208-P., dated 15th March 1898; No. 823-P., dated 31st May 1899.)
6. As regards pilgrimage to the Hedjaz, the Government
of India issues orders either prohibiting it altogether or
allowing it under certain conditions from uninfected parts
only. In the latter case, the intending pilgrims are collected
at convenient observation camps, they are not allowed to
purchase passage tickets to the Hedjaz except at those
observation camps, and after they have been detained for
the prescribed period and certified to be free from infection,
they are sent in special trains or carriages to the selected
ports for embarkation. Pilgrims returning from the Hedjaz
in healthy vessels are, after disinfection of their clothing and
baggage, sent at once to their destination without being
allowed to mix with the population of the port of landing.
Those returning in a plague-infected vessel are subjected to
ten days' observation in a camp before being sent to their
193
homes. The authorities of the port of landing are required to
send nominal rolls of the pilgrims to the local Governments and
Administrations concerned, and to give previous intimation of
their departure, in order that they may be watched for a few
days after arrival at their destination.
(G.O., No. 148-M., dated 18th January 1898; No. 851-P., dated 3rd June 1899.)
(10)—Rats.
There is a general belief, supported by medical opinion,
that rats are peculiarly susceptible to the infection of the
bubonic plague and are active agents in its dissemination.
Granaries are the favourite haunts of rats, and grain bags
arriving from any place suspected to be affected by the plague
should be very carefully examined, and any rats found with
them at once destroyed and their bodies consumed by fire.
Infection once brought into a granary spreads rapidly among
the healthy rats, and thence in time to human beings living in
the neighbourhood. The attention of all Collectors, Presidents
of District Boards, Chairmen of Municipal Councils, and the
President, Municipal Commission, Madras, is therefore drawn
to the necessity of taking special precautions to prevent the
danger of infection from this source. Arrangements should
be made for the constant inspection of granaries and grain
baazars and care taken to keep them clean and disinfected
and to have the rats destroyed. In inspecting these gra-
naries particular inquiries should be made whether any dead
or sick rats have been observed. Rats sick with the plague
seem careless in the presence of men and run about in a dazed
way with a peculiar limping gait in the hind legs owing to
painful glands in the groin. The Port and Sea Customs
authorities should be instructed to see that no rats are landed
with goods imported by sea into this Presidency, and that
rats found in ships are destroyed forthwith.
(G.O., No. 274-M., dated 23rd February 1897 ; No. 459-P., dated 10th May 1898.)
2. The Traffic Manager, South Indian Railway, has issued
the following circular to his subordinates :—" Stationmasters
and their staff should carefully inspect consignments of grain
from plague-infected areas to see that any rats that may
arrive concealed in the grain are destroyed; should also
destroy bandicoots, rats and mice where grain is deposited
on railway premises in case they may have eaten of the grain
and so become infected, This vermin should be tracked and
25