NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
CHAPTER I.
GENERAL REVIEW.
Part I.—Plague in the Presidency.
September 1896 to June 1899.
(Νότε.—The populations assigned to Districts, Towns and Villages as far as page 150 of
this volume, are those of the Census of 1891 taken from the Sanitary Commissioner' s Annual
Report for 1898; after page 150 or in cases where they cannot be found in the Sanitary
Commissioner's Report, they are taken from the Administration and Collectors' Annual Reports.)
The present series of Plague epidemics in India began in Bombay in August 1896. But
the disease was not recognised till September 23rd, when Dr. Viegas, a Private Practitioner in
Bombay, stated publicly that there was plague in the City, and made an official report to the
Municipal Commissioner accordingly. The previous prevalence of the disease in Bombay
City, however, is clearly demonstrated by the total weekly mortality for August and
September.
Week ending
18th August ... ... ... ...
25th
...
....
...
....
1st September ... ... ... ...
8th
,, ... ... ...
15th
,,
...
...
...
...
22nd „
...
...
...
...
29th
„
...
...
...
...
Total for 7 weeks ...
Actual mortality
in 1896.
650
660
029
563
580
613
671
4,375
Average mortality
for same period
during previous
five years .
559
555
508
494
459
478
492
3,545
Remarks.
Excess 830 : or about
120 per week.
Of its actual inception, as of its origin, little or nothing is known. It is not even
known in what part of the City plague first appeared. On the 29th of September the Govern-
ment of India were officially informed ; and, on the same date, Mr. Haffkine was sent from
Calcutta to Bombay to convert medical opinion into Bacteriological certainty. On the 13th
of October 1896 Bacteriological investigation confirmed the existence of Plague in Bombay
City.
FIRST PERIOD.
23rd September 1896 to 4th June 1897.
The spread of the pestilence from Bombay was at first very gradual. Thefirst District
to return indigenous plague was Satara, in the South : but, on the whole, during the first
year, the tendency of the spread was northwards. Up to the end of December 1896, Thana
and Karachi in the North, and Satara, in the South, were the only Districts to report
indigenous plague, while imported cases were returned from Ahmedabad, Broach, Cutch,
Kaira, Kathiawar, Khandesh, Mahikantha, Nasik and Surat, on the North ; and from Kanara,
Kolaba, Kolhapur, Ratnagiri, Savantwadi, and Sholapur, on the South.
The first three months of 1897 saw the infection of District after District : the tendency
of the spread being markedly northward, as Maps Nos. I and I (a) show. As regards indigenous
1
2
[CHAP. I, ΡT. Ι.
plague during this first year, Belgaum, Bijapur, Broach, Dharwar, Jath, Kaira, and Kanara—
all in the South—escaped scot-free ; while in the North, Thar and Parkar and the Upper Sind
Frontier remained untouched. The severest epidemics of this first year, which may be taken
as ending on the 4th of June 1897, occurred at Bombay, Bhiwndi, Cutch Mandvi, Damaun,
Karachi, and Poona. The following are the figures :—
1896-97.
Serial
No.
1
2
3
4
5
6
Place.
Bombay City ...
Poona (including
Cantonments
and Suburbs)
Karachi
Cutch Mandvi...
Bhiwndi ...
Damaun ...
Popula-
tion.
806,144
161,696
97,009
38,155
14,387
8,230
Duration of Epidemic.
Sep. 1896— 4th June 1897.
Sep. 1896— May 1897 ...
Dec. 1896— July 1897 ...
Apr. 1897— August 1897.
Apr. 1897— August 1897.
Feb. 1897— July 1897 ...
C.
12,425
2,629
4,178
4,359*
2,335
†
D.
10,562
1,879
3,390
3,85 3*
1,741
2,352*
Percentage
mortality on
population.
1.29
1.16
3.45
10.09
12.10
28·58
Source of
Infection.
Unknown.
Bombay.
Unknown.
Bombay or
Karachi.
Bombay.
Bulsar.
* Approximate only.
†
Not known.
But all these epidemics were destined to be eclipsed by those of the succeeding years.
The total numbers of officially recorded cases and deaths throughout the Presidency
during this first period of Plague were :—
23rd September 1896 to 4th June 1897.
Cases, 35,434—Deaths, 28,737.
But the actual numbers were considerably larger ; concealment, flight, late detection
of the disease, all combining to prevent discovery of the real figures. An endeavour will
be made in a subsequent chapter to arrive at an estimate of the true plague mortality.
Two maps are given for each period. The first series (I, II, III, &c.) show the total plague
mortality in Districts, adding in that of the large Towns, without showing the latter separately.
The second series [I (a), II (a), &c.] shows the large Towns separately, and in this series the
plague mortality of large Towns has been deducted from that of Districts. These last obviously
give the more correct view of the actual incidence of plague.
SECOND PERIOD.
4th June 1897 to 3rd June 1898.
During the next month Plague steadily declined throughout the Presidency, until,
during the week ending 16th July 1897, it was limited to rapidly subsiding epidemics in the
Surat, Thana, Poona, and Kolaba districts, in Cutch and in Sind : the largest number of
cases returned during this week being 25 from the Karachi District, and the total number
throughout the Presidency being 132 cases and 103 deaths (including Baroda). It was
No.
II
No. II (a)
4
[CHAP. I., ΡT. Ι.
Serial
No.
1
2
3
4
5
6
7
8
9
l0
11
12
13
14
1
Place.
Bombay
Poona
(including
Cantonment
and
Suburbs).
Karachi
Sholapur ...
...
Maudvi (Cutch) ...
Sangli State ...
Κarad (Satara Dist.)
Kale (
„
)...
Supne(
,,
)...
Magod (Surat Dist),
Varunje (Satara Dist.)
Karve (
„ )...
Devi Khindi ( ,, )...
Vadkhel (
„ )...
2
Population
806,144
161,696
97,009
61,564
38,155
18,298
12,085
4,431
2,068
2,068
928
851
690
343
1897-98.
3
Duration of Epidemics.
From
June
1897
July
1897
April
1898
October 1897
April
1897
February 1898
July
1897
September 1897
September 1897
March
1897
September 1897
September 1897
September 1897
September 1897
To
May
1898
March
1898
June
1898
February 1898
August 1897
July
1898
January 1898
January 1898
November 1807
May
1897
November 1897
December 1897
November 1897
December 1897
4
Cases.
17,907
6,676
3,008
2,539
4,295
549
1,452
573
325
273
159
437
122
93
5
Deaths.
16,532
5,043
2,376
2,187
3,808
500
1,107
465
212
210
146
352
105
83
6
Percentage
of Morta-
lity on
Population.
2.01
3.12
2.41
3.50
9.98
2.73
8.38
10.49
10.25
10.12
15.73
41.36
15.21
24.19
The total numbers of cases and deaths reported throughout the Presidency for this
Second Period were—
4th June 1897 to 3rd June 1898.
Cases, 75,813—Deaths, 61,220.
THIRD PERIOD.
3rd June 1898 to 2nd June 1899.
We have already noticed that during June and July 1897, a general and almost total
subsidence of plague occurred throughout the Presidency. Some Districts were free ;
others indeed still returned plague cases, but these were but the dying embers of rapidly
subsiding epidemics. Other Districts again had so far not been attacked. But in no
case was an epidemic beginning or were the figures rising.
To a considerable extent, though in a far less degree, the same was again true in June
and July 1898. In many Districts plague had ceased altogether; in others it was
subsiding.
In the first category were Ahmednagar, Khandesh, Nasik, and ShoJapur Districts in
the Presidency proper ; the Hyderabad and Shikarpur Districts in Sind ; and Aundh, Janjira,
Palaupur, and Reva Kantha amongst the Native States. In the second category were the
Surab, Thaua, Poona, Satara, Kolaba, and Ratuagiri Districts in the Presidency proper ; the
Karachi District in Sind; and Sangli State.
No. III
Litho: B.E.S. Press.
No.III (a)
Litho: B.E.S. Press.
CHART
Shewing the Monthly
Progress of Plague
in the
Bombay
Presidency
from
Sept. 1896 to Oct.1899.
No. IV
No.IV (a)
9
THIRD PEKIOD,]
Explanatory of Map NO. IV (a).
TOWNTS
I. — Case incidence ; under 100 per mille.
O
Town.
(i) Sholapur
(ii) Poona
(iii) Hubli
Population.
61,564
161,696
32,194
Duration of Epidemic.
Oct. 1897— Feb. 1898
Aug. 1897— Mar. 1898
June 1898 -Dee. 1898
Cases.
Deaths.
2351
2139
10638
8064
3579
3013
Case incidence.
43
1000
66
1000
69
1000
II. — Case incidence ; between 100 and 150 per mille.
O
(i) Karachi
(u) Bantwa
(iii) Belgautn
(iv) Karad
97,009
8,641
28,342
12,085
Dec. 1896— July 1897
July 1898— Nov. 1898
Aug. 1898— Jan. 1899
July 1897— Nov. 1897
10426
8105
933
599
3260
2501
1521
1161
107
1000
108
00
115
1000
123
1000
III. — Case incidence ; over 150 per mille.
O
(i) Bhiwndi ... ... ...
(ii) Bail Hongal ... ... ...
(iii) ditch Mandvi ... ... ...
14,387
9,428
38,155
May 1898— Oct. 1898
Sept. 1898— Jan. 1899
Feb. 1897— Aug. 1897
2333
1741
1627
1311
7383
6082
162
1000
173
1000
194
1000
12
[CHAP. I, ΡT. II.
The importance of the people's co-operation in plague measures cannot be overrated,
In a Town or Village which is determined to protect itself from infection, every person in
such Town or Village becomes a plague authority to prevent the introduction of infection;
a fact to which the Panch Mahals, Broach, and other places which escaped for a long period
bear eloquent witness.
In the introduction and enforcing of any plague measure it should be remembered that
trade is liable to be affected, the occupations of the people to be seriously interrupted, their
prejudices and feelings shocked, and their comfort interfered with. It may be said that
hardly any plague measure has yet been introduced which has not had as a result one or
more of these undesirable consequences.
In weighing plague measures, therefore (the co-operation of the people themselves
being essential to their successful operation), next to their beneficial effects, the extent to
which they will hamper trade, interfere with professions and occupations; shock widespread
prejudices and still widerspread feelings, and produce general discomfort, must be
considered.
The considerations affecting the introduction of a plague-measure may be classed as
follows :—
(1) Its feasibility.
(2) Its beneficial effect and utility.
(3) Its influence on trade and on the lives, occupations and minds of the people.
(4) Its expense—costliness.
(5) The sphere of its effect.
(6) The duration of its effect.
(7) The organization required to carry it into effect, and a few other minor con-
siderations.
The value of a measure may be arrived at by an appeal to—
A.—Facts.
B.—The opinions (founded on personal experience) of those who have had a large
acquaintance with its operation.
The facts are contained in the statistics of Plague. Unfortunately, a small circumstance
will vitiate them, e. g., the natural subsidence of plague having begun before evacuation
was started, concealment of the existence of the disease until a great many cases have
occurred, false statements made by persons wishing to avoid plague restriction,
inexperience, etc., etc. These and many other similar reasons render the attitude of
the statistician towards plague figures and statements one of extreme caution; and such an
attitude makes confident deduction and reliable results almost impossible. Executive
work has, moreover, unfortunately militated against the keeping of reliable detailed records.
In such cases, however, the results have left their impressions on the minds of those
engaged in carrying out the measure; and these impressions will be noticed later.
The following is a brief sketch of the measures introduced throughout the Presidency from
September 1896 to the present time: —
Bombay City, the scene of plague's first appearance in 1896, being at once the seat of
Government, the chief commercial and trading port of India, and the Capital of the Presidency,
the following points were of the first importance :
MEASURES AND RESULTS.]
15
provision of free camps and food in times of evacuation and the many other mattere in which
the people's welfare and comfort have been considered, are the seeds of which the harvest
is not yet.
In conclusion, a general review of the Plague History of this Presidency during the last
three years tends to show that although the Presidency has suffered heavily, and that, although
the pestilence has spread, neither the general incidence of the disease, nor the actual plague
mortality—except in certain very small places in the rains, when no measures could be effec-
tually enforced — will bear comparison with the terrible results—the appalling mortality—
accredited to the pestilence in the past. And it may fairly be urged that to the various mea-
sures so promptly and thoroughly enforced, and to the loyal efforts made in their introduction,
and the careful watch kept over their strict observance, by a large and devoted body of plague
workers scattered over the entire Presidency—men and women—European and Native-
Official and Non-Official—this moderated virulence—this lessened mortality—in other words,
this success in the fight with plague is due.
18
[CHAP. I, ΡT. III.
(1) Its feasibility—
Theoretically speaking, there is no limit to its feasibility, as it is merely the transference
of a population from one locality or site to another. But, in practice, many circumstances
combine to limit it. Amongst the chief of these are want of space, danger of spread, interfer-
ence with trade, occupations, etc., etc. Looking at what has actually been accomplished, we
find that Jawalapur (10,000), Abmednagar (37,000), Sholapur (62,000), were all completely
evacuated; and a population of 100,000 may perhaps be considered a rough limit of the
feasibility of the complete evacuation of a town.
There are, however, but few such towns, and this consideration therefore does not affect the
large bulk of towns and villages in the Presidency, which vary in population from 300 to 30,000.
In these, almost without exception, evacuation may be said to be quite feasible.
The statistics of Plague show that complete evacuation—
(i.) Checks a crescent epidemic.
(ii.) Lessens plague mortality,
(iii.) Shortens the duration of an epidemic.
(iv.) Tends to arrest the disease in toto in villages if carried out at once.
Taking first—
A.—Facts.
(i.) Evacuation checks a crescent epidemic.
Instances of this in large towns are Sholapur, Nasik, Jalgaon, Malegaon, and Godhra ;
whilst amongst villages the number is very large.
The following table shows the progress of the disease before, during, and after evacuation
at Jalgaon, Malegaon, Nasik, Sholapur and Godhra : —
Week ending
1897.
October
1st
8th ...
15th
„
22nd
29th
November 5th
12th
19th
...
26th ...
December 3rd ...
10th ...
17th
...
24th ...
,,
31st
..
1898.
January
7th ...
14th ...
21st
..
28th ...
February 4th ...
11th
..
18th
..
,,
25th ....
March
4th ..
11th
..
18th
...
„
25th
April
1st
JALGAon
(POPULATION,
14,67272).
Oases.
...
...
$ 20
* 7
‡ 32
17
10
14
11
14
8
2
1
1
...
1
...
...
Deaths.
...
...
15
4
30
10
8
17
7
12
8
1
2
1
...
1
...
...
MALEGAON
(POPULATION,
15,633).
Cases.
9
7
4
21
19
24
26
* 63
† 78
†150
†l29
‡ 27
12
10
11
2
4
1
Deaths.
6
5
.3
16
13
17
18
48
62
41
27
20
13
9
9
4
3
....
...
...
NASIK
(POPULATION,
24,406).
Cases.
3
11
11
12
*3
‡ 68
†31
† 33
I 26
† 40
†43
†44
$ 49
32
18
7
5
5
4
4
3
6
8
3
1
Deaths.
3
9
11
10
...
35
36
26
23
30
34
34
45
32
12
9
3
5
3
4
1
5
3
2
1
SHOLAPUR.
(POPULATION,
61,564).
Casos.
19
26
50
116
146
143
221
363
*502
† 501
†300
† 134
‡ 53
26
9
7
5
1
9
2
6
2
1
...
Deaths.
13
8
45
90
117
118
182
297
377
436
246
149
36
27
9
11
8
2
8
4
4
2
...
...
GODHRA ***
(POPULATION,
14,691).
Cases.
...
...
...
...
...
...
...
*3
†10
† 27
†18
†28
† 41
†45
†59
†107
‡106
125
137
28
13
...
2
...
Deaths.
...
...
...
...
...
...
...
...
2
5
22
10
19
26
29
50
64
79
108
78
22
11
3
1
1899( Godhra
only.) 1898.
* Evacuation begun.
†
Evacuation rapidly proceeding.
‡
Evacuation complete.
§ The Collector estimates that some 20 deaths from plague at least must have occurred up to this date.
** A day's difference in the dates owing to difference of year,
19
EVACUATION.]
In each of the above cases the Collector unhesitatingly attributes the sudden subsidence
of the epidemic to the direct action of evacuation ; an action directly proportionate to the
promptness and rapidity with which it is carried out.
As regards—
(ii.) Evacuation lessens plague mortality.
The following statements show thé percentage of plague deaths on population in evacuated
and non-evacuated towns : —
Towns.
Surat ..
...
Sholápur* ...
Broach
Ahmednagar ...
Satara
Násik
Gadag
Málegaon
Godhra*
Jalgaon
Ilkal
Aahta ..
Ankleßhwar ..
Population.
108,631
61,564
40,137
36,031
25,748
24,406
23,821
15,633
14,691
14,672
11,216
11,412
10.692
Cases.
2,621
2 ; 639
622
326
720
461
395
395
761
118
284
135
322
Deaths.
1,834
2,187
514
272
612
369
254
314
538
108
238
112
238
(a) Evacuated Towns.
DunATTox OF EPIDEMIC.
From
1st August
1897 ...
1st October 1897 ...
1st December 1898 ...
20th November 1978 ...
1st December 1897 ..,
1st October 1897 ...
18th November 1898.
1st November 1897..
1st December 1898..
1st December 1897 ..
15th September 1898
1st February 1899 ..
15th July 1898 ...
To
1st May 1898
1st February 1898 ...
1st April 1899
1st April 1898
1st April 1898
1st April 1898
24th February 1898 ..
1st April 189S
1st March 1899
1st February 1898 ...
18th November 1898
19th May 1898
1st October 1898 ..
Average ...
1-67
3.5
1.03
75
2.00
1.51
1.06
1.63
3.66
73
2.00
98
2.22
1.75
REMAEKS.
* Sholnpur and Goclhra were not evacuated until the mortality had been very severe.
(b) Non-evacuated Towns.
Towns.
Hubli
Dharwár ...
Belgaum
...
Bulsar
Bhiwndi ...
Karad ...
Bassein ...
Tasgaon ...
Bail Hongal...
Bantwa ...
Population.
52,194
32,583
28,342
14,714
14,387
12,085
11,291
11,251
9,428
8,641
Cases.
3,486
1,179
3,213
943
546
1,789
1,518
497
356
345
535
1,627
932
Deaths.
2,957
374
2,413
739
452
1,289
1,154
377
283
30.
453
1,01
59
DURATION· of
From
lst June 1898 ...
1st August 1898
...
1st July 1898 ...
1st February 1897 ...
1st January 1897 ...
15th April 1898 ...
1st July 1897...
1st February 1897 ...
10th December 1897...
1st November 1898...
13th September 1897..
26th August 1898 ...
1st August 1898 ...
EPIDEMIC .
To
1st December 1898...
1st January 1899 ..
1st January 1899 ...
1st June 1897
1s t May 1897
7th October 1898 ...
1st December 1697...
1st June 1897
1st August 1896
...
1st April 99
1st January 1898 ..
15th December 1898..
1st November 1898..
Average . .
Percentage of deaths
of population.
5-62
2.9
8.51
5.10
3.14
8.95
9.54
3.33
2.50
2.69
4.02
13·78
7.84
5-95
REMARKS
20
[CHAP. I., ΡT. III.
On a population of 10,000, therefore, the mortality, according to: these averages, would
be——
Evacuated town of 10,000
= 175
Non-evacuated
„
...
= 595
or on a population of a million, a difference of some 40,000 lives.
As regards—
(iii.) Evacuation shortens the duration of an epidemic.
Taking District by District, the average actual duration of epidemics in evacuated and
non-evacuated towns and villages is given below.*
They are classified as follows: —
(a) Evacuated towns.
(b) Non-evacuated towns.
(c) Evacuated villages.
(d) Non-evacuated villages.
In cases (b) and (d) are included also partially-evacuated towns and villages, so that the
figures for them obtain whatever benefit this measure may have bestowed. Bombay, Karachi,
Poona and Surat, also, on account of their size, have been omitted from the following
calculations.
For (a) and (b) the results are as follows :—
(a)
Number of epidemics in evacuated towns
Total aggregate duration of epidemics ...
...
...
Average duration
(b)
Number of epidemics in towns not evacuated
Total aggregate duration of epidemics ...
...
...
Average duration
...
...
...
,,,
...
...
= 12
= 184 weeks.
= 15 weeks.
= 13
= 266 weeks.
=206/13weeks.
Evacuation, therefore, would appear to shorten the duration of epidemics in touns
by one-quarter.
For (c) and (d), taking District by District, the results are as follows :—
1 . Belgaum.
{ Villages evacuated
{ Aggregate duration
(c)
Average duration
= 15
= 90 weeks.
= 6 weeks.
Villages not evacuated = 13
Aggregate duration
=150
weeks.
(d)
Average duration =11
7/
13 weeks.
2. Cutch.
(
Villages evacuated
Aggregate duration
Average duration
= 8
= 54 weeks.
= 6¾ weeks.
(Villages not evacuated = 24
Aggregate duration
=262 weeks.
Average duration = 1011/12 weeks.
8. Dhárwár.
Villages evacuated
(c) Aggregate duration
Average duration
= 22
= 96 weeks
= 4 4/11 weeks.
Villages not evacuated = 18
(d) Aggregate duration
=203 weeks.
Average duration =115/18 weeks.
*Epidenics of under four weeks have been neglected. Only towrs and villages in which evacuation was
begun within a mel th after the first case, and for which the figures are reliable, have been taken.
21
EVACUATION.]
(c)
Villages evacuated
Aggregate duration
Average duration
(c).
"Villages evacuated
Aggregate duration
Average duration
(c) \ /
Villages evacuated
Aggregate duration
Average duration...
(c) (
Villages evacuated
Aggregate duration
Average duration
4. Káthiawár.
= 3
= 16 weeks.
= 51/3 weeks.
{Villages not evacuated
{Aggregate duration
(d) Average duration
= 3
= 35 weeks.
= 112/3 weeks.
5. Ratnágiri.
o
= 19 weeks.
= 61/3 weeks.
{ Villages not evacuated
{Aggregate duration
(d)
Average duration
= 1
= 9 weeks.
= 9 weeks.
6. Surat·
= 23
= 133 weeks.
— 51/2 8/3 weeks.
{
Villages not evacuated
{Aggregate duration
Average duration
= 16
=183 weeks.
= 117/16weeks.
7.
Thána.
= 20
= 123 weeks.
= 6 3/20 weeks.
{Villages not evacuated
{Aggregate duration
(d)
Average duration
= 22
= 236 weeks.
=10 8/11 weeks.
The general result, as shown by these 8 Districts, is as follows : —
Evacuated Villages.
(c)
Total aggregate duration
Number of villages
Average duration
per village = a
= 531 weeks.
= 94
bout 5 1/2 weeks.
Non-evacuated Villages.
{ Total aggregate duration
{Number of villages ...
(d) { Average duration
{per village
=
=1,078 weeks.
= 97
about 11 weeks.
Or, in other words, in villages with a population of from 100 to 7,000, evacuation shortens the
duration of an epidemic by one-half.
The following interesting table of the effect of evacuation on the duration of epidemic
in the villages of Palánpur State is given by Lt. Rainier, I. M, S. :—
Palánpur Town
Total villages, ex-
cluding Palánpur.
Villages not imme-
diately evacuated.
Villages immediately
evacuated
Population.
21,092
57,934
3'6,301
2,1633
Cases.
674
953
616
337
Deaths.
413
656
454
202
Mortality
per cent.
of cases.
61.2
66.8
73.7
59.9
Case inci-
dence per
mille.
31.9
15.5
1.60
15.0
Average
duration
(first to last
case in days).
15.3
31.3
46.6
14.1
Slumber of
Villages.
1
53
22
31
As regards—
(iv.) Evacuation tends to arrest the disease in toto in villages when carried out at once.
The following instances, where 120 case was reported subsequent to the completion of
evacuation, may be quoted. There are others, but the details are not to hand :—
6