NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
LIST OF ILLUSTRATIONS.
Appendices—
A. General view of plague cases and deaths in the Northern Division
B.
C.
D.
E.
Do.
Do.
Do.
Do.
do.
do.
do.
do.
do,
do.
do.
do,
in the Central Division
in the Southern Division
in the Native States
...
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PAGE
384
384
384
384
384
Bacteriology of Plague-
Plate I. Blood of rat which had died of plague
,, II. Plague Bacilli from a 24 hours' growth on Agar-agar
„ III and IV. " Involution forms" of Plague Bacilli
„
V. Plague Bacilli in chains ...
„ VI. Haffkine's "Stalactite growth "
„ VII. "The Snowfall"
„ VIII. Growth of Plague ou Agar-agar, "Giant Colonies "
„ IX. Single Old Colony on Agar
...
...
...
...
...
...
...
,, X. Growth of B. Pestis on Agar, showing appearance of large Colonies
119
119
120
120
120
122
123
124
124
chart (S)—
Of epidemic in Kauaswadi ...
I-XXXII referred to in Major Lyons' report
Of weekly total mortality in Bombay City from September 1896 to November 1899
Showing mortality in Anklcswar Town
Do.
Do.
Do.
Do.
Do.
Do.
Do.
Do.
Do.
Do.
Do.
Do.
Do.
Do.
Do.
Do.
Do.
Do.
Do.
Do.
Do.
Do.
in Broach Town ...
in Godhra Town ...
in Bulsar Town . . .
in Su rat Town
in Surat District ...
in Bhiwndi Town
in Ahrnednagar Town
in Nasik Town ...
in Nasik District...
in Malegaon Town
in Poona City
in Poona District
in Karachi City ...
in Karachi District
in Sind
in Karad Town ...
in Tasgaon Town...
in Sholapur Town
in Sholapur District
in Ilkal Town
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....
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176,
. ..
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22
86
134
155
158
173
182
180
222
188
191
200
211
217
222
220
240
240
326
332
240
244
249
263
268
279
LIST OF ILLUSTRATIONS.
Showing mortality in Belgauin Town
Do.
Do.
Do.
Do.
Do.
Do.
Do.
Do.
Do.
Do.
Do.
Do.
in Hubli Town ...
in Satara District
in Belgaum District
in Dharwar District
in Gadag Town ...
in Panvel Town ...
in Kolaba District
in Thana District...
in Jaigad Town ...
in Bantwa Town ...
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...
in Kolhapur and S. M. Country ...
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PAGE
276
276
289
256
256
294
291
305
306
306
310
351
356
Diagram (s)—
Of triangular shelter for evacuation purposes
Oí superior shelter for evacuation purposes ...
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...
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Map (s) of Bombay Presidency illustrating extent and intensity of plague-
No. I and No. I (a) from September 1896— June 1897
No. II and No. II (a) from June 1897— June 1898
No. III and No. Ill (a) from June 1898— June 1899
...
...
No. IV and No. IV (a) from September 1896— June 1899
Explanatory of Map No. IV (a)
Plate (s)-
I. Staff of the Imperial Research Laborato]
II. Mr. W, Hafîkme in his Labora tory at F
...
...
...
...
ry, October 1899
Khushru Lodge ...
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...
between
,,
,,
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III. The Staff of the Laboratory at Khushru Lodge about July 1898...
27
28
1
2 and 3
4 and 5
8 and 9
9
.. 113
..
114
.. 114
IV. Mr. Haffkine, Capt. Milne and Assistants inoculating in the streets of
Bombay
V. Media preparation room
VI.
Do,
do.
do
VII. Steriliser, in which the 4-liltre flasks of bouillon are sterilised
VIII. The dark fermentation room ...
IX. The decanting room ..
...
X. Assistant Surgeons decanting the vacciue into small sterilised bottles ...
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114
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115
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116
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117
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118
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118
.. 118
INTRODUCTION,
[The following are the sources from which this chapter has been compiled :—
Encyc. Brit. : Qnain's Dict. of Med. : Sir A. Faulkner, M.D., A Treatise on the Plague .·
MacLean, Epidemic and Pestilential Diseases : Nathan, The Plague in India : Bombay
Gazetteer.]
The word plague is derived, through the Latin playa, from the Greek πληγή :
it signifies ' a stroke.
Plague is the most deadly of all known diseases. Obscure in its origin,
persistent in its duration, terrible in its effects, it has baffled alike the investiga-
tions of science and the observations of the most perspicacious. The attitude it
compels in those who are, and in those likely to become, its victims is one of
abject panic. It assumes varying forms, it strikes with varying force, it rises
and falls with varying rapidity.
Such is the disease which, appearing century after century, now in the most
deadly epidemic, and now in a mild sporadic, form, was the scourge of Europe
up to the very beginning of the 19th century. As well for the sake of com-
pleteness, as for that of interest and comparison, a brief sketch of what it has done
in the past, both in the West and in the East, will not be out of place here.
Previous to
A. D 1300-
PLAGUE IN EUROPE.
(A. D. 542— A. D. 1841.)
The first historical notice we have of Plague is contained m the fragment of
the Physician Rufus of Ephesus, preserved by Oribasius (circ.. B. C. 200) ; but
although mentioned later by Livy and by Orosius as destroying one million people
in Africa, it is not until the 6th century, in the reign of Justinian, that we find
Bubonic Plague in Europe.
Beginning at Palusium (Egypt) in 542 A. D., it spread over Egypt ; in 543
it reached Constantinople, where it is said to have destroyed 10.000 people in one
day ; in 546 we find it in Gaul (France) ; in 565 in Italy, " where it depopulated
the country to such an extent as to leave it an easy prey to the Lombards." Con-
stantinople was, thus, we see, the first haunt of Plague in Europe ; and it appears
to have been the starting point for most, if not all, succeeding European epidemics.
But although Plague appeared thus early in Europe, it was not until very
much later that it appeared in England.
The history of Plague from the time of the Justinian pandemic is very vague
until we reach the 14th century, when that great cycle of epidemics known as the
" Black Death," swept over Europe, inflicting enormous mortality.*
" Whether in all the postilences kuown by this name the disease was really the same may admit of doubt,
but it is clear that in some at least it was the bubonic plague"—Encyc. Brit., Art. "Plague."
" It must, however, be remembered that although numerous pestilenoes in Europe are recorded by mediæval
chroniclers, there is no sufficient evidenoe, before the 14th century, that they were bubonic plague. The undoubted
prevalence of this disease began after the black death of the fourteenth century."—-Quain's 'Dicl. of Med., Αrt
Plague."
Β
14th Century.
"The
Black Death·"
INTRODUCTION.
This frightful scourge appears to have originated in the East, and to bave
entered Europe vid Tartary and the Crimea. According to old Russian chronicles,
its origin was China, where, as is confirmed to some extent by Chinese
records, pestilence and inundations are at this time (1300-1400) said to have
destroyed the enormous number of thirteen millions. Appearing first in Sicily
and Constantinople in 1346, it invaded Greece, parts of Itaty, and Marseilles in
1347; in 1348 it attacked Spain, Northern Italy and Rome, Eastern Germany,
many parts of France, including Paris, and England, including London, whence it
spread to Scandinavia. Oxford was attacked in 1352. Scotland and Ireland, too,
though affected later, did not escape,
The death-tribute exacted by this terrific wave of pestilence was appalling.
It is estimated that three-fourths of the population of England perished* ; while
Europe · is calculated to have lost one-fourth of its inhabitants—twenty-five
millions of people. †
15th Century.
In the 15th century the pestilence re-appeared frequently in almost every part
of Europe : carrying off 80,000 in Dantzic and the neighbourhood in 1427 :
40,000 in Paris in 1466 : while Northern Italy was devastated in 1477-85, and
Brussels in 1485. In the last year of the century (1499-1500) a severe plague
in London caused lung Henry VII. to retire to Calais.
J.6th Century,
The 16th century was not more free from the scourge than the 15th ; but it
constitutes an important epoch in Plague : for, about 1550 A. D., the question of
contagion was first raised. Plague had also henceforth to be distinguished
from Typhus fever, which, during this century, made its first appearance in
Europe.
Edinburgh was attacked in 1529 : London and the north of England in 1537
and 1547 : Italy and Germany about the same time ; while in Paris about this
time plague was an every-day occurrence, familiarity with which had bred
contempt. Severe epidemics occurred at Moscow and in the neighbourhood
(1570), in which 200,000 perished; at Lyons (1570), plague mortality—50,000 ;
at Venice (1576), where 70,000 were carried off.
17th Century.
In the first half of the 17th century the pestilence was still prevalent in Europe,
though considerably less so than in the Middle Ages : in the second half a still
greater decrease took place: while in the next 25 years it was disappearing rapidly
from Western Europe.
Two noteworthy epidemics, nevertheless, were recorded during this century.
The first—one of the most terrible and destructive of all recorded European
epidemics—raged at Naples in 1656: where it destroyed 300,000 people in
5 months. Genoa also lost 60,000 in this epidemic.
* " In England a great, part of the country remained untilled, and the deficiency of labourers was such as to
'' cause a sudden rise of wages, which, in spite of attempts to check it by legislation, is believed to have effected
" the final emancipation of the labouring class. On the other hand, a great transfer of property to the Church
" took place—with what results is well known."—Encyc. Brit., Art. "Plague."
† Heckcr's estimate.
INTRODUCTION.
i
The second was the great Plague of London ; in which, out of an estimated
population of 500,000 (two-thirds of whom are supposed to have fled panic-
stricken), 68,000 perished within the year.*
From 1666 England was free from Plague. A few sporadic cases indeed
occurred up to 1679, and a column filled up with " 0" is found in the bills of
mortality up till 1703; when it finally disappeared. For its disappearance from
England now (1679), as for its disappearance from the Continent of Europe later,
no reason can be assigned.
18th Century.
In the 18th century Plague was more or less confined to Eastern Europe,
although in 1720-1722 a severe outbreak occurred in Provence; Marseilles and
Toulon being attacked. In this outbreak, out of a total population of 250,000, 87,500
are said to have perished. The Provence epidemic is noteworthy because of the
panic it caused in England : where in consequence quarantine was enforced for the
first time. In 1717 Plague re-appeared at Constantinople: 1719 in Transylvania,
Hungary and Poland: 1743 in Sicily: 1738-1744 in Hungary, Moravia and
Austria: 1755 in European Turkey: 1770 in Moldavia (during the Russo-
Turkish War), Poland, Kieff, and Moscow, at which latter place it developed into
one of the most destructive epidemics of modern times. Over 50,000 persons—
nearly one half of the population—perished. From 1770 the disease, while
re-appearing in the haunts of the terrible early epidemics, was more limited both
in range and duration. In 1799 and 1800 a new epidemic in Syria and Egypt
affected both the French and the English Armies which were operating there.
19th Century.
Throughout the 18th century the tide of Plague had steadily ebbed away from
the West ; in the 19th century this ebb was still more marked. In 1802 Plague
appeared at Constantinople and Armenia: in 1806 at Astrakhan (Russia): in 1808
at Smyrna. In 1812 a more general epidemic affected these places and also Egypt.
From 1813-1815 it appeared in Bucharest, Malta, Corfu, Dalmatia and Egypt : in
1815 at Noja on the East Coast of Italy—so far its last appearance in that coun-
try— and produced a panic throughout Europe. In 1824 it attacked Tutchkoff in
Bessarabia, but the town was strictly isolated by a military Cordon, and the disease
did not spread. In 1828 it appeared in Cronstadt, and is believed to have been
again confined by similar action. In 1828-9, during the campaign of the Russian
Army against Turkey, a more serious outbreak occurred : for Plague appeared in
Odessa, the Crimea, Moldavia, Wallachia, and Bessarabia ; but it spread no further ;
its limitation being again attributed to the Russian and Austrian military Cordons.
In 1831 Constantinople and Roumelia suffered from Plague ; in 1837 Roumelia
and Odessa ; and, with an isolated outbreak in Dalmatia in 1840, and one in
Constantinople in 1841, the Plague-History of the European Continent comes to a
close.
* " This number is likely to be rather too low than too high ; since, of the 6,432 deaths from spotted fever,
" many were probably really from plague, though not declared so to avoid painfttl restrictions."—Encyc. Brit., Art,
"Plaguo."
Xii
INTRODUCTION.
With such a previous record, the recent appearance of Plague in Portugal and
Spain cannot be regarded without anxiety.
At the present time there are believed to be three endemic haunts of plague.
The first in Mesopotamia, ; the second in Gahrwal and Kumaon at the foot
of the Himalayas in the North-West Provinces : the third in Yunnan in China.
Dr. Koch mentions another endemic centre, which is situated in Africa
(near lake Nyassa), and is supported in this view by Dr. Proust,
Before
1800 A- D.
PLAGUE IN INDIA.
(Up to September 1896.)
We cannot in the case of ludia trace the history of Plague century by century.
Up to 1800 a reliable historical document is a rara avis. We can only record the
instances where mention is made of Plague under such terms as 'Waba,' ' Ta' un,'
etc., and conjecture bow far the statements are accurate, and to what extent the
pestilence referred to is identical with that which is amongst us now. But even
such references as these are rare. The folio wing brief summary of what is known
on the subject is taken from Nathan's Plague in, India :
" Only two direct references have, however, been traced which may point to
the existence of Plague in the west of India in the fourteenth and fifteenth cen-
turies. The first is from Ibn Batuta, who notices that Muhammad Tughlak's army
in Ma'bar (1325-1351) mostly perished of pestilence, and that at the end of the
century (1399), after Timur left, the districts through which he had passed were
visited by pestilence. The second relates to the year .1443, when pestilence
caused such loss of life in the army of Sultan Ahmad I. that, leaving many of the
dead unburied, he retired to Gujarat. Ferishta calls this disease ta'un, and
speaks of it as very unusual in India. The famine of 1590 to 1594 was followed
by a pestilence that, besides hamlets and villages, depopulated whole cities. It
must remain a matter of conjecture whether these outbreaks of virulent pestilence
were epidemics of true Plague.
" Twice in the seventeenth century the district of Almiedabad in the Bombay
Presidency was visited by severe epidemics of pestilence which were probably out-
breaks of Plague. The Bombay Gazetteer gives the following description of the
first of these epidemics, which appears to have been very widespread :·—
"' The disease that raged in Ahmedabad in 1618 began in the Punjab in 1611.
It is called the plague, Waba or Waba-o-ta'un, and the works of the Hindus are
said to have no mention of such a disease. It was thought to be connected with
the comet of 1612. From the Punjab it spread through Lahore, through the Doab
to Delhi, and north to Kashmir. No place in Hindustan was free fro m its ravages.
Lulling at times, it continued to lay waste the country for eight years. About
the same time in Kandahar the land was overrun by mice, and mice and plague
seem to have had some close connexion, A Mouse would rush out of its hole as if
INTRODUCTION.
Xiii
mad, and striking itself against the doors and walls of the house, would die. Then
the plague was in the house. If the people at once fled they might be saved; if
they stayed, the whole village was swept away.'
" With reference to the second outbreak which occurred during the period
1683 to 1689, the Gazetteer makes the following remarks : ' For several years
before 1689 the plague, Tá'un and Wabá, was again in Ahmedabad, and lasted for
seven or eight years. The visible marks were swellings as big as a grape or banana
behind the ears, under the arms, and in the groin, and redness round the pupils
of the eyes.' Hirsch repeats the following quotation made by Macpherson
('Annals of Cholera,' London, 1872) from an Indian chronicle which appa-
rently refers to this epidemic : Ά fever had prevailed for some years both in the
Deccan and in Gujarat. It consisted of a slight swelling under the ears, or in the
armpit or groin, attended with inflamed eyes and severe fever. It generally
proved fatal in a few hours.' Hirsch remarks that this description is suggestive
of plague.
" It is stated in the Ahmedabad Gazetteer that during the eighteenth century,
though none of the symptoms of the disease are described, there would seem to
have been several outbreaks of a most deadly form of fever. In 1718, a year of
famine, great numbers died of sickness ; in 1770, another famine year, 'on account
of the unwholesomenesa of the atmosphere, thousands of people died of fever in
two or three days, so that no one could be found to bury them.' Fearful disease
is said to have accompanied the 1790 famine. "
The
Gujarat Epide-
mic, 1812-1821.
From the year 1800, however, the sources of information are reliable, and we
have authentic records of at least two great epidemics. The first of these was the
Gujarat epidemic of 1812-1821.
Breaking out first in Cutch in 1812, and spreading thence over Kathiawar,
Ahmedabad, and Southern Sind, it devastated Western India for a period of ten
years. The years 1811 and 1812 were remarkable for a severe famine which
affected the larger portion of Gujarat. It was at the close of this famine that the
Plague appeared in Cutch.
Cutch is said to have lost half its population during this epidemic. Two
Medical Officers, Drs. Gilder and White, visited the country at the time, and
wrote accounts of the disease : and the pneumonic form of plague was now dis-
covered for the first time by Dr. White, who gives the following interesting
description of its symptoms :—·
The first notice
of pneumonic
plague.
"In this man the heat of the body was not much increased nor the pulse
" greatly accelerated ; his bowels were not disordered, nor did his tongue
" indicate much febrile irritation. He was able to walk about and converse,
" answering questions distinctly. No person would have thought him in
" danger, but there existed in the patient's mind a degree of alarm and
" anxiety altogether disproportionate to the apparent symptoms. He had
c
Xiv
INTRODUCTION.
" only been attacked that morning. All his consideration seemed absorbed
" with a pain in his chest. He answered to my questions whether he had
" not other pain, as in his head, his back or limbs, that these were slightly
" painful; but he immediately recurred to his chest, dwelling upon that with a
" look of most painful distress ; and if not questioned about other symptoms,
" it seemed as if he would not have mentioned them. He had besides a very
" slight cough—so light that it might easily have escaped unnoticed—and
" this was accompanied with a discharge of blood from the mouth. The
" following day he was delirious, had a burning skin, with a very quick pulse,
" I searched for, but found no buboes. He died in the course of the succeed-
" ing night, i.e., in less than forty-eight hours from the first attack. The
" characteristic symptoms of this variety are, slight cough, pain of the chest,
'' and haemorrhage from the mouth, attended with fever, but no buboes."
Mild Bubonic
Plague.
Dr. White also observed a " mild bubonic type," which he describes as
follows : —
" I saw," he states, " a great number who had buboes without any fever,
"and was told that upwards of one hundred and twenty had suffered in this
" way. These people walked about without either alarm or inconvenience, for
"none had died, and not many of the buboes suppurated."
Quain also records a similar form * :—
" In 1677 an outbreak occurred at Resht, the capital of the province of
" Ghilan, Persia, and in the surrounding district. Ghilan lies at the south-west
" angle of the Caspian Sea. The same year cases of a fatal bubonic febrile
" malady occurred in the District of Baku on the Caspian shore of Trans-
" Caucasia : and an outbreak of a non-fatal bubonic affection took place in
" Astrakhan and its vicinage, since recognised as a form of plague.'
It is interesting to note that the same form occurred, in Cutch last year,
and is thus described by the Political Agent, Major Hyde Cates †:—
" During the last three months of the year under report (i.e., March, April,
"and May 1899), several cases have occurred in which there has bubo a bubo (gene-
" rally in one of the arm-pits), bub without fever. The person attacked has suffered
''from headache for a day or two, but has not otherwise been inconvenienced.'
The Pali
Epidemic
1836-1838.
The second epidemic was the Pali outbreak of 1836-38 ; although a disease
suspiciously akin to plague was discovered by Col. Skinner at Hansi (Punjab)
in 1828-29.
The Pali outbreak occurred in the District of Merwara, between the State of
Jodhpore on the north; and the State of Udaipur on the south. Breaking out in
July 1836 at Pali, a large town in Marwar, where it destroyed some 4,000 people,
* Quain's Dict. of Med., Art. "Plague."
† Cutch Political Agent's Report No. 339 of 24th July 1899.
INTRODUCTION.
XV
it spread to Sujat (population, 6,000) and Jodhpur (capital of Marwar); affecting
all the intervening towns and villages. From June to March 1837, it attacked
the villages of Dewair, Deoghar, Lucanithana, Bednore, Jalia and Ranghar
(Ajmere). In April 1837 it spread in the direction of Neemuch Cantonment, two
villages in Merwar being attacked. Towards the end of 1837 it again appeared in
Pali and did not die out until the Spring of 1838. The total mortality of this
epidemic is not known with any certainty ; but it is estimated that 100,000
Marwaris perished. Apart from these great epidemics which have occasionally
visited India, and apparently unconnected with them, there is an epidemic centre
of plague at Grharwal and Kumaun at the foot of the Himalayas. These two Dis-
tricts, situated in the North-West Provinces, with an area of over 11,000 square
miles, contain a population of nearly 1,000,000 persons. The disease is here
called mahamari ; but Assistant Surgeons Francis and Pearson, who investigated
the disease locally in 1852, arrived at the following conclusions :—
(1 ) Mahamari and Plague are identical.
(2) Mahamari is of local origin : capable of transmission from person to
person and place to place.
(3) That it is gradually extending itself, and that there seems no reason
why it should not be developed in the surrounding country.
À little more detail as regards former epidemics in Districts in this
Presidency is given in the chapters devoted to the recent outbreaks of Plague in
such Districts ; but for full details, " Nathan's Plague in India," 1896-97, Vol. I.,
should be consulted.
No.
I
Litho: B.E.S. Press.
No. I (a)