NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
MORTALITY OF PLAGUE.]
61
Statement compuring the total mortality for 3 normal years previous to plague, with the
total actual mortality for the 3 plague years : and shewing case-mortality percentages.
Locality.
Ahmedabad District
Ahmednagar
„ ..
Belgaum
,, ...
Bijapur
„ ..
Bombay City ...
Broach District ...
Cutch State
Dharwar District ..
Hyderadad ,, ...
Kaira ,, ...
Kanara
„ ...
Karachi
,, ...
Kathiawar State ...
Khandesh District ...
Kolaba ,, ...
Kolhapur & S. M. C.
Agency.
Nasik District ...
Palanpur State ...
Panch Mahals District
Poona
,,
Ratnagiri
„ ...
Satara
„ ...
Savantvadi State ...
Shikarpur District ...
Sholapur
,, ...
Surat
„ ...
Thana
„ ...
Totals..
Population in
1891.
921,712
888,755
1,013,261
790,339
806,144
341,490
558,415
1,051,314
918,G4G
871,589
446,453
564,880
2,752,404
1,460,851
594,872
1,562,029
843,582
283,319
313,417
1,067,800
1,105,926
1,225,989
192,948
915,497
750,689
649,989
819,580
.......
Total up to 1st
September 1899.
Cases.
191
1,897
31,656
3,002
50,457
1,676
10,888‡
39,717
851
2,429
459
11,301
2,438
1,157
-3,263
21,107
8,688
1,906
1,245
27,373
1,197
28,957
61
995
5,283
8,804
13,919
280,917
Deaths.
115
1,447
23,803
2.414
43,636
1,250
8,962‡
32,063
657
1,841
326
8,720
1,705
909
2,781
15,953
6,658
1,257
889
20,819
984
22,667
44
699
4,276
6,499
10,763
222,137
Case-mortality
percentages.
60.20
76.27
75.18
79.98
86.48
74.58
82.31
80.78
77.20
75.78
71.02
77.16
70.34
78-56
85.22
75.58
76.63
65.95
71.41
76.06
82.21
78.28
72.13
70.25
80.94
73.82
77.32
79.08
Total actual
mortality for 3
normal years pre-
vious to plague.*
93,221
96,175
83,799
63,933
80,541†
35,620
17,694
89,344
39,848
89,660
36,226
31,770
§
142,113
42,175
88,107
87,474
§
22,032
96,423
71,159
107,333
8,575**
53,937
71,598
69,705
59,607
1,678,069
Total actual
mortality for
the 3 plague
years.
79,771
86,891
120,351
71,625
159, 550†
39,505
22.558
141,109
35,198
79,195
41,217
48,068
§
162,997
55,884
115,422|
109,480
§
24,388
122,557
79,072
108,261
10,130**
64,075
103,636
69,269
* Years in which epidemics have caused an abnormal mortality have been excluded from these figures.
† Figures taken from the Municipal Commissioner's Annual Report, 1898-99.
‡ Accuracy of these figures not established.
§ Figures for Kathiawar and Palanpur are not known.
|| The figures for Kolhapur, Miraj [Junior], Jamkhandi, and Ramdurg States are for 2 years only,
** For 2 years only.
16
62
[CHAP. I., ΡT. VI.
As regards the plague mortality in Bombay City, the following quotations are made : the
first from the Municipal Commissioner, Mr. W. L. Harvey's Report for 1898-99, page 11 ;
and the second from Couchman's Report for 1896-97, page 88 :—
(1)
"Except a brief outbreak of cholera at the beginning of the monsoon of 1897, no other
epidemic of serious importance has appeared in the city during the past three years. The
line of general mortality may therefore be taken as a safe index to the rise and fall of plague.
(2)
" The figures of the actual excess of the total mortality over the average do not by them-
selves give an entirely accurate idea of the plague mortality. On 2nd March when the
Committee were appointed, the population of the city was only about 467,000 ; whereas the
figures for average mortality are based on the census population of 821,000. If account were
taken of the reduced population, the normal mortality would be found to be considerably less
than that shown in column 3 of the above statement, and the difference therefore between the
actual and the normal figures would be greater than that shown in column 4. In the absence
of any other epidemic in the city, this difference may be said to represent approximately the
plague mortality in the city. In view of the constantly changing figures of population an
accurate estimate of this difference cannot be made, but a rough calculation shows that the
deaths from plague from September 1896 down to the end of June were between 25,000 and
30,000."
As regards the plague mortality in Poona City, the following quotation is made from
Couchman's Report for 1896-97, pages 97 and 98 :—
"The steady decrease in the mortality is shown in the following table :—
Period.
March 1-10
,,10-20 *
„
21-31 *
April
1-10
„
11-20
„
21-30
May
1-10
11-20
Plague Deaths
reported.
202
241
313
218
132
66
22
16
Total
Mortality.
615
517
524
328
206
109
59
53
As regards the actual mortality which had taken place from plague, Mr. Rand points out
that the recorded figures of plague cases are little guide, as in the early period no attempt at
securing accurate returns had been made by the Municipality. He gives the following table
from which an approximate estimate can be obtained of the true plague mortality. The
population of Poona City is 118, 790 with a density of 24,242 persons to the square mile :—
Mouth.
December... ... ...
January ... ... ...
February ... ... ...
March ... ... ...
April 1st to 20th
...
...
...
Add — Reported plague deaths down
to May 20th from April 21st ...
Quinquennial
average.
261
261
225
244
178
Actual.
270
497
1,009
1,656
534
Total estimated Plague Mortality
Difference.
9
236
784
1,412
356
104
2,901 "
* Plague Committee's operations began on a small scale on March 13th, but the number of parties was increased
on March 22nd,
68
CHAPTER L
Part VII.—The Duration of Plague Epidemics.
The question of how long an epidemic of plague lasts is one of exceeding difficulty.
Leaving for the moment out of account such circumstances as the long period of dropping or
sporadic cases which may either precede or follow an epidemic, or again the total cessation of
the disease for a week or two in the very midst of an epidemic, for the great variation in the
actual duration of plague, even in places similar both as regards size, climate, and general
surroundings, no adequate reason can be assigned. And it is with extreme caution that even
the law of average itself must be applied. In the present note, therefore, the facts and figures
are stated with almost bald simplicity ; little having been attempted beyond the mere colla-
tion of the figures.
(a) Period of freedom from plague in Bombay Presidency as a whole, in Divisions
and in Agencies, since first infection in each case.
Taking Division by Division, District by District, city by city, town by town, and village
by village, the results are given categorically below.
The duration of plague in Divisions and Agencies has been so continuous that it can best
be emphasized by marking the periods of freedom. They are shown in the following table :—
Total aggre-
gate freedom.
Bombay
Presidency
as a whole.
No
single
week free
from plague
since first
infection.
Nil.
Northern
Division.
Free for
3 weeks
in Nov-
ember
1896.
3 weeks.
Central
Division.
Not
known,
"probably
3 weeks.
Probably
3 weeks.
Southern
Division.
No free-
dom
since first
infec-
tion.
Nil.
Sind.
Free for 4
weeks in Oc-
tober 1897,
and 3 in
March 1898,
and for the
months of
August and
September
1897
and
February
1898.
20 weeks.
ditch.
Free for week
ending 5th
March 1897
only.
1 week.
Kathiawar.
Free
for
weeks end-
ing
25th
March, and
23rd DC
1898 ; a n
24th March
28th April
and
2nd
June 1899 ;
for
two
weeks in
June 1897 ;
for 2 in
April 1898
and for 3
in
May
1899, and
for
the
months of
July. Aug.,
Sept., Oct.,
Nov., and
Dec. 1897.
39 weeks.
Kolhapur and
S. M. C.
Free for weeks
ending
28th May,
20th Aug.&
24th Sept.
1897 and
2nd June
1999 ; and
for 2 weeks
in April, 2
in June, 2
in July and
2 in Oct.
1897.
12 weeks.
It is not necessary in the case of Districts to give a tabular statement. Appendices
A, B, C, etc., show clearly the duration of plague in them ; and a reference to these appendices
shows at a glance that the periods of freedom in Districts are both more frequent and more
lengthy than those in Divisions. Thana and Kolaba are exceptions ; but their case is easy to
explain.
Close proximity to Bombay City, constant and intense intercourse with it
maintained by every possible means, fairly account for their almost uninterrupted infection,
64
[CHAP. T., ΡT. VII.
Taking now the largest cities in the Presidency, the results are as follows :—
(b) Duration of plague and intervals of freedom in large cities.
Total aggregate
freedom.
Bombay City.
819,00
Constantly
infected since
September
1896. Longest
period of cessa-
tion, two days.
Nil.
Poona City.
161,390
Continuously affect-
ed except for
one
week in
June 1897 ; one
in April 1898 ; 2
in May 1898; 3
in June 1898 ;
3 in July 1898;
2 in Nov. 1898 ;
one in January
in February 1899.
-
14 weeks.
Surat City.
109,229
Free for one week in Decem-
ber 1896 ; 2 weeks in May
1897 ; 3 in July, 1 in Aug.
1897 ; 3 weeks in May
1898, two in July, two in
August, 3 in September,
3 in November and 4 in
December, 1898 ; one week
in January 1899, 3 in
February, 1 in March, 2 in
April, 2 in May, 1 in June
1899, and for the months
of June 1897 and June
Oct. 1898.
46 weeks.
Karachi City.
98,195
Free for 3 weeks in
March 1898; one
in December 1898;
and for
the
months of Aug-
ust, September,
October, Novem-
ber and Decem-
ber 1897, and
January and Feb-
ruary 1898.
35 weeks.
It will be seen that the Bombay Presidency, as a whole, and Bombay City alone since first
infection, have never been free from plague. The first follows as a natural consequence of the
second. But the explanation of the second is not easy, although several plausible reasons
might be adduced. This City is, as it were, the heart and brain of the Presidency. Radiation,
whether of people or goods, is from, and aggregation is to, it: in it, therefore, some of
the germs of a disease so widespread as plague-germs—scattered broadcast over the Presidency—
might at any and every time be reasonably, expected to be found (either present or imported),
A difficulty now arises in the further subdivision of places. There is ,no town in the Presi-
dency with a population between 62,000 (Sholapur) and 100,000 (Karachi). On the other hand
there is a large number of towns with populations varying from 60,000 to 20,000 : and these
have been massed together in the next category. It is in the case of these towns both useless
and unprofitable to dwell on their periods of freedom ; the duration and number of their
epidemics are therefore alone considered below :—
(c) Duration of plague in towns with a population of between 60,000 and 20,000.
Town.
Sholapur * ...
Hyderabad ...
Hubli †
Broach
Mandvi
Ahmednagar *
Dharwar
Sukkur
Belgauua
Miraj
...
Nasik
...
Gadag
Palanpur
Approximate durations of
Population.
62,329
58,048
52,194
40,137
38,155
36,031
32,533
29,302
28,342
26,060
25,748
24,406
23,821
21,092
1st Epidemic.
22 weeks.
13 „
30 „
16 ,
20
,
15 ,
15 ,
10 ,
13 „
13 ,
16
,
14 ,,
15 ,
10
,
2nd Epidemic.
...
...
...
25 weeks.
··· ...
...
24 weeks.
...
...
18 weeks.
...
13 weeks.
3rd Epidemic.
18 weeks.
...
* ··
* * ·
··«
* · ·
» * »
...
...
* Epidemic shortened by
evacuation.
†
Phenomenal.
‡ No measures : epidemia exceedingly severe.
DURATION OF PLAGUE EPIDEMICS.
65
The average duration of plague in towns between 20,000 and 60,000 appears to be
therefore between 15 and 18 weeks—or about 4 months. The effect of evacuation, the
phenomenal outbreak at Hubli, and want of measures in Mandvi, etc., combine to render
the figures less definite than they would otherwise be.
Places with a population of under 20,000 still remain to be dealt with. The variations
in the duration of plague in these places, even when situated in the same District, and
administered by the same officers, render it necessary again to resort to subdivision.
In the next category, therefore, towns of from 20,000 to 7,000 are alone included. But
the number of such towns is so large that it is necessary to treat them aggregately by Districts.
(d)
Duration of plague in towns with a population of between 20,000 and 7,000.
District.
Thana District
...
...
Surat
,,
...
...
Satara
,,
... ...
Kathiawar Agency ... ...
Other Districts
Total ...
Number of
places (20,000—
7,000) affected.
9
4
3
3
15
34
Total aggregate
duration of
plague
(in weeks).
1131
51
40
44
167
433
Average
duration
(in weeks).
14
12¾
13
14
11
12
In places with a population of under 7,000 the duration of an epidemic appears to be
limited to a few weeks. The results in the case of these latter obtained by the same method as
statement (d) are given in the following statement :—
(e) Duration of plague in towns and villages with a population of 7,000 and under.
District.
Bijapur District ...
...
Thana
,,
Dharwar ,,
Surat
,,
Cutch State
Belgaum District ...
Kolaba
,,
Ahmednagar,,
...
Kaira
„
Broach
„
...
Other Districts
Total ...
Number of
places (7,000
and under)
affected.
51
42
40
39
32
28
26
23
22
16
25
344
Total aggregate
duration of
plague (in
weeks).
293
859
299
316
316
240
203
147
79
51
165
2,468
Average
(in weeks).
5 5/1
82/4 8/2
71/4 9/0
86/8 4/3
9 7/8
8 4/7
7 2/3 1/6
6 9/2 3
3 1/2 3/2
3 8/1 2
6 3/5
7 1/8 5/6
A comparison of all these statements appears to show that the duration of plague is to
some extent dependent on the area and population of the place affected.
In order to obtain information on the general question of the continuance of plague
in a place, the following Circular was issued by the Plague Commissioner on the 15th of
August 1898 —
17
66
[CHAP. I., ΡT. VII.
Circular.
" When plague ceases for several months in a town, or village, or house, is the germ dead
or is it merely dormant ? This is a point on which it is important to collect evidence. And
the Plague Commissioner will be glad to have any that there may he already, or that may in
future come to notice. And he requests that a look-out may be kept for facts bearing on the
point. To what extent is it found that in the present, or past, spreads of plague the disease
keeps re-appearing in the same villages and in the same houses, as though the result not of
new imported infection, but of the re-awakening of a germ that has never quitted the room.
(Sd.) A. CUMINE,
Acting Plague Commissioner."
Replies to this Circular were received from Ahmednagar, Kathiawar, Khandesh, Satara,
Sholapur and other places; but they were all inconclusive.
82
[CHAP. IL
care treated by M. Yersin's antitoxiaseruiu. From these 27 cases he excluded 4 (2 of which
died and 2 recovered), viz., one suffering from meningitis and an osseous tumour pressing on
the medulla (case 4), one treated prophylactically (case 11) and two which were not plague
cases (cases 24 and 27). Of the remaining 28 plague cases, 14 or 60.88 per cent. died.
[A reference to an antitoxic serum prepared by Mr. Haffkine, but distinct from his well-
known prophylatic, occurs in Dr. Lyons' report at this point, but as the results are not given
it is omitted.—J. K. C.]
The prophylactic measures which demand attention on the occurrence of a case of plague
in a family are the removal, when practicable, of the unaffected members from the house, to
allow of its being thoroughly cleaned, and of the patient to a hospital where he can receive
proper care and attention, unless suitable provision can be made for his treatment at home.
All those who have been living with him should undergo inoculation against plague, as this
is found to diminish the risk of infection by 70 to 80 per cent., and to increase the prospect
of recovery in those attacked after inoculation by 60 to 70 per cent. (vide report on inocula-
tion). The patient's sputa and excreta and all discharges from buboes and sores should be
received in vessels containing suitable disinfectants, and on the termination of the illness
everything which was used by him, or had been rendered liable to contamination, should be
thoroughly cleansed and disinfected, or, if practicable, burnt (vide Mr. Hankm's Report).
Nurses and attendants who are in close and constant attendance on. plague patients,
should undergo inoculation. All wounds and abrasions on the hands, etc., should be pro-
tected from the risk of infection, and the hands should be thoroughly washed and disinfected
after dressing sores or otherwise becoming soiled. Their natural immunity should be
increased as much as possible by regular meals, sufficient exercise and rest, to ensure their
keeping in good health.
[The cases of Kondabai and Noronha (illustrating the course of plague m the inoculated),
and that of Kallian Vishram (a case of marked general inco-ordination and paresis after
plague), as well as Tables VII and IX and the General Appendix containing the Committee's
recommendations have been omitted here.—J. K. C.]
TABLE I.
A Table showing the admission among Europeans and Eurasians into St. George's Hospital
Bombay, at different periods of life, and giving the results.
Europeans ...
Eurasians ...
...
Total ...
R
U
R D
R
U
Percentage of deaths to admis-
sions ...
1 Year
and
under
1
0
0
0
1
0
}·
Tears
2 to 5.
0
1
0
0
0
1
100
Years
6 to 10.
6
3
4
2
10
5
33 . 3
Years
11 to 20.
4
0
13
12
17
12
41 . 38
Years
21
to 30.
6
3
10
6
16
9
36
Years 31
to 40.
6
2
3
2
9
4
30 . 76
Years
41 to
50.
0
1
3
2
3
3
50
Years
51 to
70.
0
1
2
2
2
3
60
Total.
23
11
35
26
58
37
38 . 95
Percent-
age of
deaths to
attacks.
32 . 35
42 . 62
R= Recovered. D= Died.
MEDICAL ASPECTS OF PLAGUE.]
88
TABLE II.
A Table showing the admissions among Native Christians, Jews, Parsis, Mohamedans, Brah-
mins and other Hindus into the Arthur Road and Parel Hospitals, and giving the
results : for the Arthur Road Hospital the admissions at the different ages aré shown.
Native Christians
Jews
Parsis ...
Mahomedans
Brahmins ...
Other Hindus
Tota
Percentage of deaths to
admissions ...
...
...
R
D
R
D
R
D
R
i D
R
D
R
D
R
D
1 Year
and
under.
0
0
u
0
0
0
0
0
0
0
5
0
o
0
0
Years
2 to 5.
1
2
υ
0
υ
0
0
0
0
0
2
6
3
8
72
. 73
Years
6 to 10
4
3
1
1
0
0
0
4
0
0
19
I 32
21
40
62
. 5
Years
11 to
20.
19
23
υ
2
2
1
16
21
2
0
66
139
105
186
63
. 92
Years
21 to
30.
14
30
υ
0
0
1
19
24
2
3
106
246
HL
304
68 . 31
Years
31 to
40.
7
16
i
U
I
0
1
1
y
25
1
3
42
150
60
195
76
. 47
Years
41 to
50.
9
24
1
0
υ
2
7
24
0
0
17
112
34
162
82
. 65
Years
51 to
70
0
1
υ
0
u
0
0
0
0
0
1
G
1
7
87
. 5
Total.
54
09
2
3
3
5
51
98
5
6
258
691
373
902
70
. 74
Treated
in Parel
Hospi-
tal.
22
45
1
3
2
4
8
8
3
9
72
127
108
1196
64
. 17
Total.
76
144
a
6
5
9
59
106
8
15
330
818
481
1,098
69
. 54
Percent-
age of
deaths to
attacks.
65
.
45
66·57
64
. 29
64
. 24
65
. 21
71
. 25
69
.
54
TABLE III.
A table showing the comparative case mortality per cent. among (a) Europeans
and Eurasians, and (b) Natives, in youth, adult life and old age.
Europeans and Eurasians
Natives ... ... ...
Years 1 to 21.
( 28
or 39 . 137 per cent.
1 18
177
or 02
. 34
( ea3
Years 21 to 40.
25
or 34 . 21
13
255
or 69 . 75
588
Years 41 to 70.
5
or 54 . 55
G
49
or 81 . 51
21G
TABLE IV.
A Statement showing the number of deaths from Plague in Bomban according to age
and sex from August to December 1896.*
Months.
August ...
...
September
October ...
November
December...
Total...
Males
Females
Males
Females
Males
Females
!" Males
1 Females
Males
Females
Γ Males
L Females
Percentage
...
...
...
• · »
...
1 Year
and
under.
• · ·
...
1
1
1
2
3
2
22
Years
2 to 10.
...
4
1
11
15
15
23
56
49
86
78
8 . 47
Years
11 to
20.
...
15
3
58
23
51
25
208
109
.. , .
332
160
25 . 41
Years
21 to
30.
...
13
6
81
23
64
22
291
95
454
146
30 . 99
Years
31 10
40.
...
14
2
36
10
32
8
183
50
265
70
17 . 30
Years
41 to
50.
• ··
5
3
23
12
18
8
91
45
137
68
10
.
59
Years
51 to
60.
...
4
1
10
5
7
2
42
14
63
22
4 . 39
Years
fil and
over.
...
3
...
4
1
5
2
18
17
30
20
2 . 58
Total.
...
...
63
16
224
89
193
80
890
381
1,370
566
...
* Details up to 31st May have not yet been received from the Health Department.
84
[CHAP. II·
TABLE V.
Admissions into the Arthur Road Hospital according to Occupation.
Occupation.
Domestic Servants *
Mill-hands
Coolies ...
...
...
Syces
Beggars
Sepoys (including Native Soldiers and Police)
Dhobies, Labourers (each)
Dirzies
Gowlies, Metal-workers, Peons (each) ...
Cart-drivers
Malíes
School children, Carpenters (each)
Barbers ..
Shopkeepers
Clerks and Butchers (each)
Printers
Masons ...
...
Shoemakers, Painters, Sweepers (each)
Ward-boys and Lascars (each) ..
...
...
...
...
...
...
...
Priests, Sailors, Firemen, Wool-cleaners, Bakers, Carpenters, Com-
Numbers of
each class.
266
147
110
49
41
21
19
18
15
13
12
11
10
9
8
7
6
5
4
3
...
Total.
266
147
110
49
41
21
38
18
45
13
12
22
10
9
16
7
6
15
8
24
398
1,275
*Iucluding personal servants, cooks, hamals and masalchics.
TABLE VI.
A Statement showing the number of deaths from Plague in Bombay City according to
Occupation from September to December 1896.*
No.
I
1
2
3
4
5
0
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
Occupation.t
Municipal and Local Bodies (including Police)
Devotees, Bhikshuks, ‡ Fakirs, e
Indoor servants
Dhobies (Washermen)
Servants not otherwise describee
General Merchants ...
Rankers
Commercial Agents, Brokers, etc
Commercial Clerks, etc.
Drivers of public vehicles ...
Cart-owners and drivers
Seamen (not Government) ...
L ...
...
...
Messengers, Porters, etc. (not Government)
Jockey Grooms
..
Fishermen, etc.
Printers by steam, compositors
Figure casters (Otarva)
Engine-makers (Fitters, etc.)
Carpenters, Joiners, Sawyers
Masons and Bricklayers
Cotton Dyers
...
...
Spinners, Weavers and Factory workers
Cotton goods sellers, drapers
Tailors
...
..
...
...
...
...
...
..
...
..
..
..
..
..
Number of deaths in
Sept.
...
2
5
6
1
...
...
...
« ·.
...
1
1
Oct.
2
3
8
6
1
9
11
1
3
.,.
3
4
2
...
...
2
3
1
...
1
1
6
Nov.
2
4
5
2
6
1
2
2
8
...
4
...
1
4
...
...
...
...
4
1
...
...
...
4
Dec.
19
11
26
17
27
4
9
7
36
5
15
5
6
10
5
8
5
9
18
12
5
16
3
11
Total,
21
17
36
19
46
11
12
¿4
56
6
22
0
1,0
18
7
S
5
11
25
14
5
l7
5
22
* The details up to 31st May 1897 have not yet been received from the Health Department.
† Occupations have been excluded in which less than 6 deaths occurred during the 4 mouths.
‡ Religious beggars.—W. B. B.