NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
28
* The constant provision of an
adequate supply of camp equipage
for each arm of the service there
stationed.
villages or bazaars, if these are affected by epidemic disease.* to inculcate the selection,
preparation and conservancy of cholera camps of sufficiently
easy access and, if possible, to be approached without un-
necessary travelling along public roads.
46. On the occurrence of cholera the adoption of the following Rules origi-
nally promulgated by the Cholera Commission and approved by Dr. Budd, one of the
leading authorities on this subject, is strongly recommended.
Rules for arresting Cholera among Troops in Infected Barracks.
" 1st.—The troops to be removed at once, if possible, from the infected bar-
racks, and to be encamped on high ground.
" 2nd.—All who maybe attacked after their removal, to be separated from their
healthy comrades the moment the first symptoms appear.
" 3rd.—All discharges from the sick (including those vomited) to be received,
on their issue from the body, into vessels containing a saturated solution of chloride of
zinc, or some other powerful disinfectant.
" 4th.—The latrines or other places which serve as the final receptacles of these
discharges, to be reserved exclusively for that use.
" 5th.—All latrines belonging to the Camp to be strewed, night and morning,
with a mixture of peat charcoal and chloride of lime.
" 6th.—All tainted linen, bedding, &c, to be burnt immediately after its removal
from the sick.
" 7th.—The hands of all attendants on the sick to be scrupulously cleaned (by-
means of sand and water, containing some disinfectant), whenever they have become
soiled by ' rice-water.'
" 8th.—The utmost care to be taken in providing drinking water; and, where
any doubt exists as to its quality, the water to be boiled and filtered through charcoal
before use.
" 9th.—The interior of the infected barracks to be fumigated with chlorine or
sulphurous acid.
" 10th.—Existing privies and the drains connected with them to be built over
or otherwise abolished, where necessary, after a preliminary disinfection by the free use
of chloride of lime or peat charcoal.
"11th.—Convalescents to be kept, for some time, in separation from the
healthy troops.
Troops on the march.
47. In addition to the foregoing regulations, which in most part equally
apply to the management of the sick in station hospitals and
in camps, it is necessary that measures, both of a preven-
tive and curative character, should be adopted when troops
are marching, and the points of leading importance in this respect will be found detail-
ed below in para. 54 of this Report,
29
Identity of recommenda-
tions for Station and March-
ing Cholera Camps.
48. But some of the recommendations, therein contained, are equally
applicable to the stational cholera camps which have been
established for the use of all the principal stations through-
out this Presidency. We consider it right therefore to
direct attention to them here as in case of the continuance of an epidemic in a station
cholera camp, the troops are in many respects placed in a condition strictly identical
with that pertaining during the prevalence of cholera on the march.
Rules for Cholera Camps.
49. Under these circumstances the following recommendations are in part
adapted from General Orders issued on the 7th of April
1862 by H. E. (the late) Commander-in-Chief of India, and
are submitted for approval.
(1.)—The cholera camp should be broken up into as many detachments
as the number of the Medical Officers will admit, allowing one to each party. Should
the commissioned medical staff be insufficient for this, experienced Medical Subordi-
nates might be placed in charge of small parties.
(2.)—Should cholera continue the troops should be moved daily to distances
of two or three miles, their route being directed as far as possible at right angles to
the then prevalent wind and track of the disease : care being taken also to avoid march-
ing along public roads lest the troops should, themselves, tend to diseminate the
disease through the rural population.
(3.)—Care should be taken on these marches to avoid approaching towns or
villages at a less distance than one mile. The men should not be allowed to leave the
ranks for the purpose of getting water which should be carried with them, and the
necessary precautions should be adopted for the disinfection and burying of any excreta
which may, unavoidably, have to be disposed of during the march.
(4.)—As far as possible the men should be encouraged to have recourse to
such amusements as are available in camp.
(5.)—The use of stimulants in excess of that sanctioned by Government
should be strictly prohibited.
(6.)—Intercourse with travellers, villagers or any persons whose entrance
into the camp is not distinctly permitted by the Commanding Officer should, in every
possible way, be prevented.
(7,)—The men should be made aware of the extreme importance of their, at
once, reporting illness of a character premonitory of cholera; but men under treat-
ment for such symptoms should, if admitted to camp hospital, be treated distinctly
apart from undoubted cases of the disease.
Further suggestions on
same subject.
50. The following points must be invariably attended to :—The treatment
of all cases of cholera in (temporary) wards or tents, used
for this purpose only ; the destruction of all hospital cloth-
ing used by cholera patients; the professional inspection of all families twice in the
twenty hours ; the fumigation of all family quarters, whether infected with disease or
not; the careful examination of all articles of food,
30
Removal of Troops to
Cholera Camps.
51. Regarding the removal of Troops from Cantonments we recommend
that the particular body of men attacked by the disease,
should be at once sent into camp, and that the other troops
should be similarly dealt with should the disease show a tendency to spread; that
carriage used for the sick, should not, under any circumstances, be subsequently used
for the transport of clothing, provisions, or persons in health, until it has been
thoroughly purified.
Cots in Camp for all
Troops.
No European sick order-
lies.
Funeral parties to be
discontinued.
52. We also consider it of importance that, when the weather is wet, all
troops European or Native, whether sick or well, should be
provided with, cots ; that in camps, separate hospital accom-
modation should be provided for ordinary and epidemic sick;
that European soldiers should not be employed as sick
orderlies during the existence of epidemic disease; that
funeral parties and firing at funerals should be discontinued;
and that dead bodies should be removed, either being borne by native coolies or in
carriage other than that usually employed for this purpose.
III.
CHOLERA AMONG- EUROPEAN TROOPS ON THE MARCH.
53. So judicious has been the attention which has been directed to this
Railway travelling by
important subject, that we have little to add to the follow-
Military Troops.
ing
recommendations promulgated by H. E. the Command-
er-in-Chief of Madras, under date the 22nd January 1866. The only point which
appears to us to have been overlooked, are the special considerations which arc neces-
sary with regard to the transfer of troops by railway. "With reference to this subject
we would recommend attention to the following points.
Rules recommended for
adoption.
(1.)—That no body of Europeans should travel for
more than twelve hours continuously by rail.
(2.)—That strict orders should be issued for the provision of their customary
meals to be in waiting at the station next adjacent to the place where they will proba-
bly be, at the usual hour appointed for such meals.
(3.)—That if possible, where large bodies of men are to be thus moved, they
should go in special trains, running at as high a rate of speed as is consistent with the
Railway arrangements and the convenience of the public,
(4.)—That these trains should stop not less than once in 4 hours for a period
of half an hour.
(5.)—That at such halting stations an ample provision of good drinking
water should be provided; but that no articles of food of any description should be
offered for sale at any station, and that the men should not be allowed to leave the
carriages during the halt and wander beyond the strict limits of the railway platform
or enclosure.
(G.)—That, when halting for meals, the men should be rigidly restricted
from access to adjacent native bazaars or towns.
(7.)—That separate and suitable accommodation should be provided for any
sick, the nature of whose cases may not necessitate there being left behind.
31
(8.)—That independent of such accommodation one or more empty vans
(without seats) should form a portion of the train. To these might be transferred any
emergent cases or cases of epidemic sickness and a suitable number of straw paillasses
might bo kept ready in these vans.
(9.)—That a competent Medical Officer should accompany each large party
of men, and that he should be provided with suitable medicines and medical appliances
all ready prepared for the treatment of emergent cases of sickness or accident.
(10,)—That, invariably, Commissioned Medical Officers in charge should be
accompanied by a suitable subordinate medical establishment, and that these should be
accommodated in a separate carriage or compartment to be rendered conspicuous by a
suitable placard.
(11.)—That on the occasion of the periodical baitings of the train, the
Medical Officer in charge should distinctly enquire as to the state of health of the
men in each separate compartment or carriage.
(12.)—Lastly, that if possible, the special trains should run between the
hours of 6 A. M. and 6 P. M.
General Order regarding
the marching of Troops.
54. The following is the order above referred to
in para 47.
Cholera on the March.
1. " Prior to the march of Troops, it should bo
ascertained whether Cholera prevails on the road.
2. " Particular attention must, at all times, be given to the selection of en-
camping grounds, for which, whenever practicable, elevated and dry situations should be
chosen, sufficiently removed from the village or town, and from the influence of swamps
or pools of stagnant water. The banks of rivers are to be avoided. Officers are strictly
enjoined never, tinder any circumstances, to encamp upon ground, however inviting it
may appear, where Cholera has shown itself in a preceding Corps or Detachment.
3. " Officers Commanding Corps or Detachments in movement, are to con-
sult with the Officer in medical charge, regarding the healthiness of the site upon which
they propose encamping, and in such cases, Officers are to be guided by medical opinion
unless they shall see weighty reasons for setting it aside, which are at once to be re-
ported to the Quarter Master General for the information of the Commander-in-Chief.
4. " In the event of the Troops, or followers being attacked by sickness, it is
directed that the greatest attention be paid to the selection of encamping ground;
that it be high, dry and clean ; and this, it is considered, may generally be found at
some slight sacrifice of convenience, with respect to water and supplies, which, however,
in the case supposed, must be looked upon as of minor importance.
5. " Officers whose Camps may be attacked by Cholera, arc strictly enjoined
to avoid encamping near towns or villages; and to allow no further communication
with the inhabitants than may be absolutely necessary for the supply of provisions; and
this under such restrictions, as may confine it to the healthiest part of the Camp.
6. " The same rules are to be followed when passing through a district, or
through a town or village, in which the disease may exist.
34
manner, and forwarded to the Quarter-Master General to be disposed of, as arc all other
contingent expenses on a march.
34. "The requisition for the coolies should be made by the Commanding
Officer at the same time that he furnishes the Civil authorities with the Indent for
supplies.
35. " In the event of difficulty being found in supplying coolies, a working
party from the Regiment must be told off to dig the trenches and fill them with earth
but not to remove the excreta.
36. Regimental intrenching tools are to be used.
Families on the March.
37.
" The following arrangements are ordered with
reference to the movement of the families of Troops, Euro-
pean and Native,
38. " Officers Commanding Regiments, are allowed the discretion of send-
ing the families in advance of the men in the afternoon, or of suffering them to follow
the Regiment; but the former course is to be preferred when it can be adopted without
inconvenience.
39. " If the road is good and the obstruction of rivers, &c., does not occur,
the families may generally arrive soon after the Regiment on the ground. When it is
otherwise, it is better that the families should precede the men. But in either case
the Regimental Artificers and a strong working party from the Regiment, under a Non-
Commissioned Officer, should accompany the carts to assist them in case of need.
40. " The Quarter Master of the Regiment will mark out, on the new ground,
a site for the families to leeward of the ground chosen for the Camp of the men and at
some distance from it. Crowding of the bandies should be prohibited, and the bullocks
should be removed to the rear. No carts ought to be allowed to leave the camp during
the night, as they create disturbance and obstruct the road for the Regiment in the
morning.
41. " The Officer Commanding will take particular care that unripe fruit
and other sources of disease, are not sold in the Camp nor brought to it. Frequent in-
spection of the bazaars should be ordered.
42. " In order to maintain men and families in health, they should be en-
couraged to eat heartily, and to bring to speedy notice any attacks of diarrhoea or any
premonitory symptoms of Cholera, however slight."
IV. CHOLERA AMONG NATIVE TROOPS ON THE MARCH
Honorable Mr. Ellis' Report
on marching of Native Troops.
55. " The question of the measures to be adopted on the march of Native In-
fantry Regiments was very fully gone into by the late Sani-
tary Commissioner the Honorable Mr. Ellis. As his report on
the subject has already been submitted to Government and
has received general sanction in their order in the Military Department No 2074 dated
3rd June 1865 para. 7 we need do little more than note the general results which were
arrived at by Mr. Ellis as regards cholera.
35
Details regarding the pre-
valence of Cholera.
56. "An analysis of the returns of the Native
Infantry Regiments on the march for a period of 24 years
is appended below.
TABLE A.
RETURN shewing the number of Regiments attacked on the line of march after every two hundred miles
of road passed over, from 1820 to 1824 inclusive.
Distance of each
march.
Under 200 Miles.
From 200 to 400 do
s, 400 to GOO do
,,
600 to 800 do
„
S00 to 1052 do
Total....
o
"p
S
o
CJ
144
222
83
27
6
432
Infant! j
5
o
CS
<J
14
58
27
16
4
119
TS
U
C
«
130
164
56
11
2
363
r.
O
it
o a>
o|
'43 t*
PH "
9-722
26-126
32 .530
59-250
66-666
24-088
Cavalry.
eS
s
o
l_
<u
ir,
2S
12
16
2
74
S
o
<J
1
4
4
4
2
15
£
PH
<s
W
15
24
8
12
0
59^>
'S p,
at
P3 "
6-250
14-285
33-333
25-000
100-000
20-270
.a
o
5
3
2
6
3
]
0
12
Artillery.
OJ
At
ci
<S
0
4
1
1
0
6
c
CS
o
2
2
2
0
0
G
o
-»=
„ a
"3 o
c; &
o
•2S
66-666
33-333
lOO-OOO
•<
50-000
Sappers and Miners.
o
i-
ci
s
C4-J
o
$-1
<a
g
14
18
0
1
0
u
o
*o
"0
3
1
0
0
4
1
a
14
If)
1
1
0
30
o
l ft°ô
g
« 3
16-066
100-000
...
11-764
S
Si
a
o
0}
S
176
?.74
99
45
8
602
Total
••3
<Û
4
O
C3
<
15
93
S3
?1
G
144
S,
c-
o
161
205
fifi
24
9
458
o
tn Î
s
.2 S
f§ S
8-522
33-944
33-333
46-666
75-000
23 920
57. By the following table, it will be seen that the attacks progressively
increase with the duration of the march, till about the end of the 3rd month; when these
reach as high as 61 per cent, in the Infantry, after which period the proportion of attacks
would appear to diminish, though amongst the Cavalry and Artillery it increases.
TABLE B.
RbTUUN shewing the proportion of attacks according to the number of days occupied in the completion of
«ach march, from 1820 to 184-4 inclusive.
Number of days on
tlie march.
Under 20 days.
From 20 to 40 do.
,, 40 to 60 do-
„
GOto 80 do.
„ 80 to 100 do.
„ 100 to 120 do.
,, 120 and upwards
Total
Infantry.
o
'o
a
a
o
3
1
10R
ns 95
61
13
10
17
482
o
<
9
34
31
?5
5
7
119
o
W
99
144
6-1
30
5
5
10
3G3
o
ti
& "
8-333
19-101
32-631
40-9S3
61-538
50-000
41-176
24-GSS
Cavalry.
w
o
cz
3
&
13
99
17
12
0
3
ô
£
O
<
s 4
4
0
1
7415
I
Pi
o
w
12
19
13
8
5
*)
0
59
o
to H
|Ŝ
| s
.si
7-092
13-036
23 529
33-333
33-333
100-000
20-270
Artillery.
o
1!
g
O
o
s
3
0
7
0
0
1
1
12
M
o
X
0
3
0
0
1
1
6
1
2
0
4
0
0
0
0
«
o
-»J
-^ S
ci .
+3 3
a P<
33'333
o-ooo
42-857
...
100-000
100-000
50-000
Sappers aud Miners.
m
43
3
g
o
5
13
19
• 1
1
0
0
0
34
S
<
1
0
2
1
1
0
0
0
4
<L>
13
17
0
0
0
0
0
30
o
1!
o
c u*
p
10-526
100-000
10C-000
11-764
Total.
a)
«
s
Ô
>
s
3
137
219
120
74
18
34
20
602
11
89
89
30
8
7
10
144
1
o
H
126
ISO
81
44
10
7
10
458
o
of 1
S i
S-029
17-762
20-232
40-540
44-440
50-1)00
50-000
23-02-0
•58. It is clearly shown in the following table that large bodies of men are,
when marching, more liable to attack than small detachments, and that the death rate
is in proportion higher.
36
TABLE C.
Return shelving Ratio of Deaths to strength per thousand
from Cholera in bodies of men varying in strength from
under 300 to 1,500 while marching.
100 to 300 Men
300 to 500 do
500 to 700 do
700 to 900 do
900 to 1100 do
1100 to 1534 do
Average of Total
24.2424
29.5742
24.3939
35.9500
36.8574
48.7322
35.5242
Return shewing the Number of marches mude and attacks
of Cholera in bodies of men varying in strength from
under 300 to 1,500—from 1820 to 1844.
100 to 300 Men ...
300 to 500 do ...
500 to 700 do ...
700 to 900 do ...
900 to 1100 do ...
1100 to 1534 do ...
Total...
Number of Marches.
53
75
98
239
108
29
602
Attacked.
10
15
21
54
35
9
144
Escaped.
43
60
77
185
73
20
458
Ratio of
attacks to
marches
per cent.
18.867
20.000
21.428
22.594
32.407
31.034
23.920
Analysis of the foregoing
Returns.
Strength of the Troops.
59. These tables were prepared by Dr. Lorimer in 1842, and from them it
will be- seen, that the ratio of attacks to inarches was sensi-
bly higher in proportion to the strength of the bodies of the
troops marching, and that the death-rate from cholera fol-
lowed a similar progression.
Detachments.
Thus in the case of detachments, 18 per cent. only of marches were attended
by cholera, while, when bodies of 1,000 men and upwards
marched, the proportion of marches attended by cholera was
31 per cent.
Numbers in Camp.
60. The death rate from cholera would also appear to be influenced in the
same degree by the numbers congregated. In detachments
of from 100 to 300 attacked by cholera, the death rate was
24 per mille, while in bodies of 1,000 and upwards it was
48 per mille.
Duration of Marches.
61. It will also be observed from these tables that the duration of marches
seems to exercise a considerable influence on the liability of
troops to attacks of cholera, for from Tables B. and C. it will
be seen that the attacks progressively increase up to a certain
point, with the duration of the march, either in distance or time, short marches being
comparatively exempt from attack.
Same subject.
62. Thus out of 108 marches, which lasted less than 20 days, only 9 were
attended by cholera. Of 10 marches, which lasted from 100 to
120 days, 5 were attended by cholera. As regards distance,
out of 144 marches under 200 miles, 130 escaped cholera.
Out of 222 marches, extending from 200 to 400 miles, only 164 were free
from cholera.
Out of 27 marches from 600 to 800 miles, only 11 escaped, while out of 6
marches, from 800 to 1,052 miles, only 2 escaped.
Peculiarity of Madras N. I.
Regts. as contrasted with
those of Bengal.
63. We think we cannot too prominently bring these facts to notice. The
Madras Regiments are always accompanied by the sepoys'
families and by crowds of followers, and their greater sub-
jection to cholera than native soldiers in other Presidencies
may, in a great measure, be attributed to the greater agglomeration of numbers.
37
64. These facts should have considerable weight in determining in time of
Practical conclusions.
peace the frequency of reliefs and the duration of marches.
Arrangements already
sanctioned.
65. It will be seen from our remarks in para. 54, that the sending of the
families both of European and Native Regiments in advance
of the men in the afternoon has received the conditional
sanction of H. E. the late Commander-in-Chief ; while the necessity of preventing
the crowding of their bandies, the propriety of the removal of bullocks to the rear and
the ensurement of quiet in the camp during the night, have already received official
sanction.
Movement of N. I. Regts.
by wings and by Railways
and Steamer recommended.
66. It remains therefore only for us to bring prominently to the notice of
Government the extreme desirability, if not necessity, of
enforcing Mr. Ellis' recommendation that Native Infantry
Regiments should, as a rule, be marched by wings and that,
as far as possible, advantage should be taken of railways, steamers, &c. ; so as to lessen
the probability of the Regiment contracting or disseminating the disease on the line of
march.
Cholera Camps on the
march of N.I. Regts.
67. Regarding the measures which should be adopted when cholera
actually breaks out on the line of march, the rules already
set forth by H. E. the Commander-in-Chief are equally
applicable to European and Native troops, and we have in para, 50, with reference to
the outbreak of cholera in cantonments and the subsequent management of the cholera
camps, sufficiently indicated the further points to which attention should be directed.
V.
DURING, OR SUBSEQUENT TO, AGGLOMERATIONS OF PEOPLE AT PILGRIMAGES
AND FAIRS.
This subject already dis-
posed of.
68. This subject has, as noted in para. 24, been already sufficiently discussed ;
but we quote from the Sanitary Commissioner's draft Report
on this subject, the following sketch of the arrangements
which should be made at fairs and festivals for the prevention of epidemic disease.
These are now about to be submitted to Government by him. His proposals meet our
entire approval.
SKETCH RULES FOR THE ARRANGEMENTS TO BE MADE IN THE MANAGEMENT AND CONSERVANCY
OF FAIRS AND FESTIVALS.
I.—Accommodation.
" Make suitable provision for the probable number of persons who may not
be able to find accommodation in adjacent towns and villages ; as follows :—
i.—Select level and lay out suitable encamping ground ; bearing in mind
the principal requirements of elevation, proximity to place of concourse,
sufficiency of a pure water supply, dry, clean and untainted soil and
direction of prevailing winds.
ii.—Lay out the ground in divisions, or sections, separated by streets not
less than 40 feet wide, and where space permits with subsidiary streets
20 feet wide.