3
established locally, and that there was no evidence of any imported cases
occurring, and therefore the imposition of a more rigid quarantine was un-
called for. In his opinion a searching medical examination of passengers
departing from Bombay, and an equally rigorous scrutiny at Karachi, should be
substituted for the present rules. It was singular that, notwithstanding the
detention of between 1,500 and 1,600 persons arriving at Manora, not a
single case of plague had been detected. Government approved these sugges-
tions, and by Notification No. 592, dated 3rd February 1897, the Rules of 13th
October 1896 were amended so as to introduce compulsory individual medical
inspection, and the compulsory isolation of any sick discovered, and the segregation
of persons in immediate contact with the sick or with any one who had died,
and suspicion was made sufficient authority for action.
The Port Officer, Commander Shopland, had questioned whether much
faith could be placed on the class of Medical officers that could be procured for
a temporary job on board a steamer for Rs. 100 per mensem, and he had little
doubt that plague had been introduced through allowing vessels to land passen-
gers freely when no case of sickness was reported. The voyage from Bombay
need not take longer than 36 hours.
Up to the end of December 1896, 63 cases of plague, all local, were
reported in Karachi. 51 of these cases occurred in the Old Town. The deaths
reported were as under :—
During week ending 10th December
" " 17th "
" " 24th "
"
"
31st
"
... ... ... 1
...
...
... 9
... ... ... 21
... ... ... 28
or a total of 59. In a telegram received on 1st January 1897, Government
directed that arrangements should be made for medical inspection of passengers
at Karachi and the principal Railway stations in Sind. The Principal Medical
Officer was requested to arrange for efficient inspection, and on the same date,
the 1st, all District officers were required to adopt, in consultation with the
Medical and Railway officers, such measures as might be possible to prevent
infection spreading.
On the same date, the Collector of Karachi was asked to return from his
tour to Karachi to supervise measures necessary to prevent infected persons
leaving and the disease spreading, whether within or without Karachi, and
Mr. Giles most promptly responded and remained -at head-quarters throughout
the epidemic.
Meanwhile, the Municipality of Karachi had not been idle. It appears
that early in October 1896, the Health Officer, Dr. Kaka, called attention to
the necessity for special sanitary vigilance, and on the 16th December following
he addressed a letter to the President of the Municipally, representing that he
had already experienced opposition, and the residents of houses where cases had
occurred had flatly refused to permit disinfection of the rooms occupied by the
sick. Dr. Kaka, therefore, strongly urged the necessity for increased powers,
advocating (1) compulsory notification of sickness by the inmates of the house
and by the medical attendant, (2) compulsory seggregation of the sick in spe-
cially provided hospitals for each community, (3) compulsory disinfection and
limewashing, (4) destruction of infected articles, as clothing, bedding, &c.
Next day, a conference was held at the house of Ráo Bahádur Alumal Trikam-
das, B.A., Deputy Educational Inspector, where several of the headmen of the
Hindu sects were present, and at which the President, Engineer and Secretary,
and the Health Officer of the Municipality attended. Here Dr. Kaka's pro-
posals underwent considerable alteration. Dr. Kaka said he would not object
to allow patients to be segregated in their own houses, " but in the case of the
very poor and in the case of tenement houses where more than one family
resided," it would be absolutely necessary to remove the patients to isolation
hospitals. On the 21st and 23rd December, the Corporation passed resolutions
omitting compulsory notification of sickness by residents and limiting com-
pulsory removal to hospital to cases where, in the opinion of the Health
Officer or of any duly qualified Medical practitioner, the sick person was
without proper segregation accommodation. Where the Health Officer or any