NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
APPENDIX No. 3.
A Selection of Orders, Rules, Notifications and Circulars issued
by tne Bombay Plague Committee.
A ( 1). Government of Bombay Resolution, Si?h January 1898.
A ( 2). Plague Authority.
B ( 1). Duties of District Medical Officers.
B ( 2). Suggestions for information and guidance of District Medi-
cal Officers.
B ( 3). Duties of District Plague Officers.
B ( 4). Rules for Sectional Sub-Inspectors.
B ( 5). Rules for Sub-Inspectors for Disinfection,
B ( 6). Rules for Disinfection of Buildings, &c.
B ( 7). List of Stores and Chemicals required on Disinfecliug Work.
B ( 8). Rules for Segregation of Contacts.
B ( 9). Circular to House-holders re Servants' Quarters.
B (10). Circular to District Plague Officers limiting Plague Opera-
tions (after riots of 9th March 1898).
B (11). Suggested arrangements for working Native Agencies.
B (12). Instructions to District Plague Officers embodying the New
Policy.
B (13). Circulating further Government Instructions,
C ( 1). Rules for Camps.
C ( 2). Rules for Disinfection at Health Camps.
C ( 3). Regulations for the Management of Segregation Camps.
C ( 4). Notification and Rules for Private Camps in Tbana District.
C ( 5). Circular to labour employers re Health Camps.
F ( 1). Rules for Passes to Travellers leaving Bombay.
F ( 2). Resolution re Sion and Mahiin Causeways.
F ( 3). Rules for Detention of Passengers from infected areas.
F ( 4). Notice to tho Public re Surveillance Passes.
F ( 5). Notice prohibiting passage of suspicious persons to Malabar
Hill and neighbourhood.
F ( 6). Notice prohibiting passage of suspicious persons to North of
the Island.
F ( 7), Special Plague Authority for (5) and (6).
A (1).
Government of Bombay Resolution, Sth January 1898.
RESOLUTION.—In continuation of Government Notification No. 1204-702-P,
dated 5th March 1897, His Excellency the Governor in Council IB pleased to
prescribe tho following additional rules for the City and Island of Bombay under the
Epidemic Diseases Act, 1897 :—
1. The Plague Committee may appoint Special Officers, either by name or by
virtue of office, to curry out or perform, under the general directions of tho Com-
mittee, any measures or acts devised or ordered by them to be taken for the suppres-
sion or prevention of the spread of Plague. Such Special Officers may be known as
4 Plague Authorities,' and their powers and duties may be limited as directed by tho
Committee, and their appointment shall bo subject to revocation at any time by tho
Committee.
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2. In the event of any death (whatever may have been the cause thereof)
occurring in any house or any building, shed, stable or other place used as a human
dwelling (not being an hospital), it shall be incumbent on the principal adult surviving
member of the family to which the deceased belonged, or on any adult person who
was present or attended on the deceased at the time of death, to give immediate and
full information of the death and place where it occurred and of the name and caste
of the deceased to the nearest District Medical Officer or Sub-divisional Medical
Officer or Plague Authority appointed for this purpose.
3. On receipt of the said information the District Medical Officer or Sub-
divisional Medical Officer or Plague Authority aforesaid, as the case may be, shall
immediately register the death, and either himself go or send a trustworthy subordinate
to the place indicated in order to verify the information given; and thereafter may
give the informant a certificate that the death has been registered, which certificate
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shall, when duly demanded, be produced by the person or persons who shall carry or
accompany the corpse to the place of cremation or burial or to a Tower of Silence.
4. Any District Medical Officer or Sub-divisional Medical Officer or Plague
Authority aforesaid is empowered to demand production of such a certificate from the
persons carrying or accompanying a corpse as aforesaid ; and, in the event of such a
certificate being not produced, is empowered to detain, or cause to be detained, any
one of the funeral party at the place of cremation or burial or Tower of Silence until
the name and caste of the deceased and the place where the death occurred have
been clearly ascertained.
8th January 1898.
A (2).
Plague Authority.
BOMBAY PLAGUE COMMITTEE OFFICE.
189
By order of the Bombay Plague Committee, in exercise of the powers vested in
them by Government Notification No. 1204—702-P of the 5th March 1897, it is
hereby notified that
Name
Address
Description
is employed by the Committee, until further orders, to carry into effect, under the
general directions of the Committee and within the district specified below, such measures
as the Committee may be authorized to take, to suppress and prevent the spread of
the Bubonic Plague in the City of Bombay, by virtue of the sections and notifications
specified on the back hereof, or other the powers enabling them in that behalf.
By order of the Bombay Plague Committee,
Chairman.
District.
Bombay Municipal Act, 1888, sections 422 to 427 (both inclusive) and section 429.
Notification of Municipal Commissioner for the City of Bombay, dntecl 6th
October 1896.
Government Notifications—
No. 228-P, dated 10th February 1897.
No. 1204-702-P, dated 5th March 1897.
No. 1638-A—1107-A. P., dated 23rd March 1897.
175
B(l).
Duties of District Medical Officers.
(B) The following duties will be assigned to the District Medical Officers, who
should, if possible, reside in their own.districts :—
(1) To superintend and exercise the sanitary supervision of the whole
district in their charge, reporting to the Plague Committee
and the Health Officer daily.
Note,—Police Commissioner to be asked to arrange this
postal service.
(2) To supervise the working of their District Hospitals and to
attend the same in routine.
(3) To supervise the work of Search-Parties in conjunction with the
Justices of the Peace.
(4) To control the disinfection of infected areas and buildings, latrines
and night-soil dep6ts.
(5) To inspect all Segregation Camps in their districts.
(6) To call the attention at once of the Officer appointed by Govern-
ment for the condemnation of insanitary buildings to any such
premises in their districts.
(7) To report on registration of burials and cremations in their districts
and to supervise the sanitary condition of cemeteries.
(8) To send daily reports to the Plague Committee and Health Officer
from 6 a.m. to 6 p.m., giving details of—
(a) What has transpired during the preceding 24 hours
in their districts.
(J) Any suggestions they have to offer.
B(2).
Suggestions for Information and Guidance of
District Medical Officers.
THE following suggestions in reference to house-to-house visitation and disinfec-
tion are drawn up for the information and guidance of District Medical Officers ; no
hard-and-fast rules can in most instances be laid down for this work, and the Com-
mittee therefore depend in a great measure on the judgment, discretion, and tact of
their District Medical Officers :—
1. It is proposed to employ, as far as possiblej the Justices of the Peace who
have volunteered their services ; each district will be divided into sub-
divisions, and sub-divisions into sections for this duty.
2. The Justices will be asked to attend at the office of their sub-divisions at
7 a.m. on each day.
3. After the muster of the staff under each Justice, they will proceed to their
sub-divisions with their staff for house-to-house visitation.
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4. It is not expected that the Justices can personally visit every house daily,
though it is hoped they will visit as many as possible, and it is presumed
that they know their sub-divisions so well that information in regard to
sick persons will be quickly obtained by them,
5. The staff allowed to each Justice will be organised according to the number
of houses in the sub-division, but the minimum staff will be one Sub-In-
spector or Muccaclum (native), one Police sepoy, and four Military sepoys.
Each Justice, on receiving intimation of, or on finding, a sick person, will
make a note of the name of the place and the number or description of
the premises, leaving a sepoy on guard to prevent the patient being
removed until an ambulance can be-obtained.
6. Each Justice, on having inspected the whole of his sub-division, will return
to the office of the sub-division to fill in and hand over a report of his
morning's work in a printed form provided for the purpose.
7. This procedure wall be followed from day to day, and any Justice prevented
from attending on any particular day is requested to send an early intima-
tion to the Sub-divisional Medical Officer, who will delegate the work
to someone else.
8. Sub-divisional Medical Officers, on receiving reports from Justices, will
immediately arrange to send ambulances to the houses in which cases
have been reported.
9. Before removal, cases should be visited by the Sub-divisional Medical
Officers or one of their qualified assistants, or, in the case of females, by
a Lady Doctor, who will arrange for their removal.
10. The bullock carriage at each sub-division should be utilized to convoy the
family of each patient to the segregation quarters at the hospital in which
the patient has been placed.
11. In the removal of sick persons, the Sub-divisional Medical Officer should,
in ihe absence of the District Medical Officer of Health, personally super-
vise the procedure and submit a detailed report to the District Medical
Officer of Health.
12. All commissariat and other arrangements for those people removed will
be made by the District Medical Officer of Health or such official as he
may appoint in each sub-division.
13. As soon as the sick shall have been removed, Sub-divisional Medical
Officers will make immediate arrangements for the thorough disinfection
of the infected-places as follows :—
(a) All rags, bedding, cloths, etc., belonging to persons affected,
as well as all kutchrn in infected places, shall be carefully removed
and immediately burned,
(£) The infected place shall then be washed down thoroughly
with a solution of Perchloride of Mercury in the proportion of 4 oz. to
30 gals, of clean water in a wooden tub or bucket, a mop being used
for all parts within reach, and a wooden hand-pump for parts beyond
reach. In the use of Perchloride of Mercury, it must be remembered
that it is a virulent poison. In dissolving it, a little common suit should
be used.
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(c) For the general treatment of the building, the measures of
the Health Department will proceed as usual.
(d) Immediately on the drying up of the disinfected place, lime-
washing with quicklime laid on hot should proceed.
(e) Sub-divisional Medical Officers will see that this work is
thoroughly done, as the checking of the spread of the disease depends
upon it.
(/)
Re-occupation of places so treated should not be permitted
without the sanction of the District Medical Officer.
(</) Disinfect the moree, nani, privies, and traps, scraping such
places as are likely to retain filth.
(A) Open out the roofs so as to admit light and air thoroughly.
B(3).
Duties of District Plague Officers.
To carry the increased burthen of work falling on the District Medical Officers,
Civil or Military Officers were in most districts appointed to take executive charge,
and the following instructions were issued to them :—
To
THE DISTRICT PLAGUE OFFICER.
The District Plague Officer is the Chief Local Plague Officer in his district
and is invested with the general control of all Plague operations in his district, ward,
or division, of the City of Bombay.
His duties fall under the following heads :—
(a) To distribute his charge into suitable major and minor inspection units.
On the correct division of a district the success of Plague measures
mainly depends. As a rule the scheme of local sub-divisions should
be worked out either in communication with, or with the approval
of, the Committee.
(6) To arrange and enforce regular daily and special house-to-house visitations.
These house-to-house visitations are of four classes :—
(1) Justices' visits.
(2) Visits by local officers.
(3) Occasional district visitations where more than one party com-
bine to search considerable area.
(4) Special general visitations in which a large area is cordoned by
police or troops, and many parties unite in searching a whole
district.
The discovery of cases greatly depends on the zealous inspections
by Justices and local officers, together with the occasional exa-
mination of large blocks or areas.
(c) To employ and organize a body of informers paid by the month, or better,
by results, for the discovery of concealed or other cases of Plague.
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The successful Plague management of any badly infected section of
Bombay depends to a very great extent on the exertions of an active
staff of informers.
(d) To discover all local deaths.
Deaths are discovered —
(i) By local Plague and Health Staff,
(ii) By cemetery returns.
An efficient local staff should before the close of each day know every
death that has occurred in its charge. For certain reasons this
knowledge has to be supplemented by information from cemetery
returns. Till lately the efficiency of cemetery returns has been
marred by the vagueness or the inaccuracy of the corpse addresses.
To remove this defect a notification has recently been issued. It is
hoped that before long this notification will secure the clear and
true address from which every funeral party starts. The noti-
fication does not require the entry of the cause of death. It follows
that in each case the ascertaining of the cause of death,
whether Plague or not Plague, rests with the local staff. This
important detail must, as far as possible, in each case, be ascertained
from the family or neighbours of the deceased. Every doubtful
case should be treated as a case of Plague, and disinfection of the
room and segregation of the family of the deceased should be enforced.
To ascertain daily all deaths in his charge and to satisfy himself whether
Plague is the cause of death, is the fundamental duty of a District
Plague Officer.
((?) To secure that all rooms where Plague cases occur are disinfected and that
all members of the infected family are segregated as Contacts.
District Plague Officers should give special attention to the question of
Contacts, that is, of members of the family or others who have lived
in the room with a Plague case. The necessity of isolating
Contacts is undoubted. The practical difficulties in the way of
enforcing the necessary isolation are serious. The concessions
found advisable in Bombay are shown in the Contact Rules.
Since the passing of these rules experience shows that unless
worked with energy and strictness, only a small proportion of Contacts
are isolated. A considerable and probably the most seriously infected
class of Contacts go with patients to hospital. All hospitals have ac-
commodation for one or two relations of each inmate. Even mak-
ing allowance for this safeguard the number of Contacts in Govern-
ment Camps (about 400) and in Community Houses (about 100) falls
short of the total which should be isolated. The question of securing
the isolation of a greater number of Contacts without causing public
dissatisfaction is one of the most difficult with which the District
Plague Officer has to deal.
To remove to Contact Camps or Houses all Contacts whether discovered
after or before the death of the Plague case.
The remarks under (i) apply to this head. But difficult cases occur. As
a rule the correct procedure is to despatch all members of the family
found in the sick room to a Contact camp or house at the same time
as the patient is sent to hospital.
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(g) To disinfect infected houses.
The District Plague Officer is responsible for all disinfection whether of
vacated rooms or of vacated houses. A room is vacated when a case
of Plague occurs in it; a house is vacated in which Plague cases have
occurred both during the last and the present epidemic. A special
assistant is allotted to each District Plague Officer to carry out dis-
infection.
(A) To vacate infected houses.
The choice of such houses or blocks of dwellings as require to be
vacated should be made by the Committee in consultation with the
District Plague Officer. As a rule no house should be vacated ex-
cept houses in which a large or a repeated number of Plague attacks
have occurred. The actual work of vacating the houses is entrusted
to a special officer, Captain Betham. The duties of the vacating
officer are—
(i) To see the house is vacated and closed and marked with the
letter V.
(ii) To hand all unclaimed property to the Police or other
authority.
(iii) To see that the inmates with their belongings are taken to
the Segregation Camp. The time during which the
persons evicted are kept in the Health Camp should
not be less than 10 days. The District Plague
Officer is responsible that all Evicts are brought back
to their houses at the end of the 10 days or other
appointed period of segregation. The District Plague
Officer is further responsible that every vacated house,
after disinfection, and with such alterations as make
it fit for human use, is ready to receive its former
tenants. As a rule no shop should be vacated. The
premises should be disinfected, and comunication with
the rest of the building be carefully cut off. Similarly,
llie workshops of home craftsmen—handloom-weavers,
blacksmiths, coppersmiths, and others—should not be
closed. In such cases the bread-winners should be
encouraged to live with their family in a camp at
night, and to return to their workshop during the
day.
(?) To condemn vacated houses incapable of improvement.
The condemning of vacated houses will be settled by the Committee in
consultation with the District Plague Officer.
No house should be condemned until an attempt has been made to make
the house or certain portions of the house fit for human use. With
this object alterations should be attempted to secure sufficient hori-
zontal and vertical ventilation.
As a rule vertical ventilation
can be best secured by cutting a four feet square opening through
each floor, and horizontal ventilation by driving openings through
each partition and o?er every door.
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In large lodgings or chawls it may not always be necessary or advisable
to Vacate more than the gromnd floor or the floor in which Plague
cases have occurred.
In the case of certain houses condemnation may be avoided provided the
landlord agrees either to keep certain insanitary portions per-
manently closed, or to remove the defect by which the entrance of
air and light is prevented. In most lodging houses or chawls the
offending portion is the basement; in a few the most unwholesome
quarters are the attics. Again, in certain buildings the removal of
wooden partitions secures for a reduced number of rooms a sufficient
supply of light and air.
In many ground floor or one-storeyed tenements, even if uninfected, it is
advisable or even necessary to strip the roof of a portion of its tiles.
(j) To pay close attention to all rumours and complaints regarding sick or dead
rats. To satisfy himself of the correctness of the information. To have
the dead rats burned and to secure that every effort is made to stop the
progress of rats by flushing drains and closing openings with cement.
(k) On such subjects as the flushing of drains and the removal of nuisances
the District Plague Officer should communicate direct with the Health
Officer to the Municipality.
(l) A Plague District is well administered—
( i ) When all deaths are accounted for.
( ii) When the bulk of Plague deaths occur in hospital.
(iii) When the number of attacks, that is, of cases discovered before
death, falls little short of the total of probable Plague deaths.
B(4).
Rules for Sectional Sub-Inspectors.
1. Each Sub-Inspector is to be present at the Section Head Office for muster
not later than 6-4=5 a. m. Their morning work goes on till 10 a. m.
2. The afternoon hours of work are from 2 till 5.
3. Before and after the hours of work, morning and afternoon, they must
present themselves at the Section Office or they will be marked ''absent" and be
dealt with accordingly.
4. Each Sub-Inspector will have charge of a group of houses assigned him by
the Medical Officer, which must be visited thrice a week. He is held responsible for
finding out Plague cases occurring in that group and for notifying them to the
Medical Officer for examination and removal.
5. He is required to keep a note book for recording the names and addresses
of persons removed to hospital and of buildings in which a death has occurred.
6. He must in Plague cases communicate at once with the Sub-Inspector in
charge of Disinfection, in order to have that work promptly proceeded with.
181
7. He must submit to the Medical Officer, when the day's work is over, a list of
the houses he has visited, the number of cases, real or suspected, he has discovered,
and state whether notice has been duly given to the Disinfecting Officer.
8. The Sectional Sub-Inspectors must clearly understand that the principal
duties of the entire staff resolve themselves into two :—
Firstly, the discovery of Plague cases and deaths.
Secondly, the disinfection of Plague premises.
9. They are not to interfere in any way with halalcores or the sanitary staff
of the Municipality. They should bring nuisances to the notice of the Medical
Officer and leave it to him to take action.
10. The Sub-Inspector must understand that any Plague case or death report-
ed late or from outside sources, and not through his instrumentality, reflects on his
efficiency. If he keeps actively in touch with his section, he ought to know what
happens in it.
B(6).
Rules for Sub-Inspectors for Disinfection.
1. It is the duty of the Sub-Inspecter in charge of Disinfection to secure the
thorough disinfection of all rooms where a Plague case has occurred. The disinfection
by Perchloride of Mercury must be complete within 6 hours of removal of a case by
day. The period may extend to 12 hours if the cases are removed at night.
2. The value of a Sub-Inspector will depend not only on the thoroughness of
his work, but also on the promptitude with which it is executed.
3. The disinfecting procedure is as laid down in Plague Committee's Circular,
dated 1st January 1898. Bach Sub-Inspector must have a copy with him and is
responsible for instructing his staff in the details of his work.
4. He is expected to work cordially with the Sectional Sub-Inspectors, each
member of the staff loyally co-operating with the other for the discovery of cases
and speedy disinfection of rooms.
5. He will keep a note book for recording day by day—
(a) the rooms or houses he has disinfected ;
(&) those remaining to be disinfected.
6. He is responsible for painting the Plague mark and date on every place he
disinfects.
B(6).
Rules for Disinfection of Buildings, &c.
1. Immediately a patient has been removed, the following disinfecting
measures should be put in operation.
2. All rags, bedding, clothing of the patient, and kutchra generally should be
carefully lifted, removed, and burned outside the building. In placing the arti-
cles outside they should be carefully laid down (not thrown down) so as not to raise
dust.