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"Up to this time the Medical Officers on plague duty had little more than their own personal opinion to
support their advocacy of inoculation. This opinion was based partly upon the evidence recorded in a few
official reports and in contributions to the medical journals, and partly upon their own somewhat limited experience.
Owing, however, to the exacting nature of the duties of the Plague Medical Officers, they had been unable to
spare sufficient time for thorough enquiry into the subject.
Theory as to means by which infection is kept alive.
Perhaps by very mild undetected cases.
If these could be prevented, plague might be stamped out.
"The manner in which the infection of plague persists in the interval between the end of one epidemic
and the beginning of another has not been definitely
ascertained. One theory, however, is that, during the
apparent absence of the disease, cases occur, which,
though so mild as to escape detection, are nevertheless
capable of communicating infection, and that when
climatic conditions are favourable the disease will resume
its ordinary virulence. The idea was, therefore, suggested that if such mild cases of plague could be prevented,
infection would die out and the disease thus be finally got rid of.
I noculation should prevent these mild cases.
"It was reasonable to suppose, moreover, that, as inoculation afforded considerable prolection against
plague when its virulence was at its height, it would be all
the more effective during the period that infection was
only capable of causing mild attacks of the disease.
Therefore universal inoculation after an epidemic might stamp
out plague.
"It followed therefore that if during the seasonal subsidence of plague the entire community, among
whom an epidemic had occurred, were inoculated, there
was a fair and reasonable hope that unless some new
source of infection were imported, no fresh outbreak would
occur.
Possibility of such a scheme discussed.
Were people likely to accept it?
Could the scheme be carried out?
"The question that then presented itself was—Was such a scheme feasible ? Was it reasonable to expect
that even for the hope—and it was only a hope—of finally
ridding themselves of plague the inhabitants of an exter-
sive and densely-populated area would universally accept
inoculation, and in the event of the people being willing,
would it be possible with the staff and in the time available to inoculate them all ?
"The character of the people and their attitude towards inoculation has already been briefly referred to,
These will be more fully described later.
Inducement to people considered sufficient.
"It was felt that the prospect, which was held out by universal inoculation, of finally stamping out plague
from amongst a community, who year after year had
suffered from the troubles and inconveniences brought
upon them by a succession of epidemics, afforded sufficient inducement to the great majority of the people for
accepting a measure, of the efficacy of which they had been assured and which only involved a slight and
temporary inconvenience.
Extent of the work.
"The extent of the work involved had then to be
considered.
Consi 'erations as to area and population involved.
Previous experience.
"The epidemic of 1897-98 had affected chiefly the central portion of the Nawashahr Tahsfl with some
adjoining villages of the Phillour Tahsíl Outbreaks
had also occurred in the central and northern portions of
the Garhshankar Tahsíl and in two villages near the
eastern extremity. Infection was thus spread over an area measuring about 20 miles both in length and
breadth.
"The succeeding epidemic was chiefly limited to the south-eastern portion of the Nawashahr Tahsíl, but
four villages were also attacked in the Garhshankar Tahsíl, one of which was near its western border, while the
other three were in the eastern portion of the tahsíl.
"The present epidemic was still more extensive, and affected villages situated throughout almost the entire
length of both tahsíls. In none of the epidemics, however, had the disease shown much tendency to spread
across the sandy part of the Phillour Tahsíl, and it had never invaded villages in the hills on the north-eastern
boundary of the Garhshankar Tahsíl.
"Although past experience made it seem possible that another epidemic would in due course follow the
present one it was impossible to conjecture where the disease would first make its appearance.
"The last case of the epidemic of 1897-98 had occurred at Dosanjh Kalán just beyond the western border
of the Nawashahr Tahsíl; while it was at Kariám, nearly 18 miles away, in the eastern part of the tahsíl that
the first outbreak of the succeeding epidemic took place. This second epidemic came to an end at Karnána
near the centre of the Nawashahr Tahsíl, while the first case of the present epidemic occurred at Sáhiba, a village
in the eastern portion of the Garhshankar Tahsíl, about 15 miles distant.
Extensive operations necessary.
The task defined.
"It will be seen from the above considerations that, in order to afford any fair prospect of success in
preventing another epidemic, it was necessary that inocu-
lation should be carried on throughout a very extensive
area before the beginning of the cold weather. It was necessary, in fact, to attempt to inoculate the entire
population of the Nawashahr Tahsíl, amounting to over 200,000 people, of the greater part of the Garhshankar
Tahsíl, another 130,000, and of a few villages on the Nawashahr border of the Phillour Tahsíl, with a population
numbering about 8,800. This infected area was about 500 square miles in extent, and its population amounted
to 345,220. Of this number some 31,000 had been inocu-
lated by the latter part of May ; the task that remained
therefore was to inoculate over 300,000 persons by the end of September.
Visit of the Commissioner to Banga.
" On May 26th Alex. Anderson, Esquire, the Commissioner of Jullundur, visited Banga and addressed a meeting
of Zaildárs, Lambardárs and other local notables on the sub-
ject of inoculation. He pointed out that although the
Government had done all in its power during the last three years to stamp out the plague from among the people, it had