NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
308
Measures to prevent the
[CHAP. X.
reported on the 6th February that passengers were examined at Abu
Road, Marwar Junction, Beawar, Ajmere, Jaipur, and Bandikui.
Precautions
against Karachi.
Orders issued by
the Government
of India.
Plague having been declared epidemic in Karachi towards the end
of December, it became necessary to adopt precautions to prevent
the spread of infection from this new centre. The rest of Sind was
immediately threatened, then the Punjab, and beyond the Punjab,
Baluchistan, and the North-Western Provinces. The Government
of India telegraphed to the Government of Bombay on the 29th
December requesting that arrangements might be made for the inspec-
tion of railway passengers at Karachi and at principal stations on the
line leading from Karachi, of the same nature as the arrangements in
force to prevent the spread of plague from Bombay. On the following
day similar instructions were issued to the Governments of the Punjab
and of the North-Western Provinces and Oudh and to the Agent to
the Governor General in Baluchistan.
Arrangements in
Sind.
The Commissioner in Sind at once directed the following Civil
Surgeons to arrange for the inspection of passengers arriving from
Karachi at stations in their districts, and to isolate any person dis-
covered to be suffering from plague :—
The Civil Surgeon, Karachi (City and Cantonment Stations).
The Medical Officer, North-Western Railway, Kotri (including
Dadu, Laki, Hyderabad, and Pad Idan).
The Civil Surgeon, Sukkur (including Rohri, Ruk, and Reti).
The Civil Surgeon, Shikarpur.
The Civil Surgeon, Jacobabad.
The hospital assistants at the following stations were also
instructed to inspect passengers:—
Sehwan, Tando Adam, Mirpurkhas, Larkana, and Ghotki.
Examination of passengers at the Karachi railway station was
already in force.
Special instruc-
tions issued by
the Commis-
sioner in Sind.
A circular to district officers was issued by the Commissioner in
Sind on the 10th January, summarising the measures that had been
adopted, and stating the points with regard to which particular care
should be taken. Attention was specially called to the following
matters. When suspect cases were discovered at stations where
there were no arrangements for segregation and treatment, the suf-
ferer was to be sent on (without extra charge) to the nearest station
where such arrangements were ready. The relatives and friends
accompanying the patients were to be kept under observation.
Care was to be taken to prevent the removal of sick persons at way-
side stations with a view to avoid inspection. Instructions were given
to provide suitable accommodation, where this had not already been
CHAP. X.]
spread of infection by land.
309
done, for the segregation of the suspicious and for the treatment of
the sick. The Commissioner had only heard of accommodation being
provided at Jungshahi and Sehwan, and directed that accommodation
should also be provided at Kotri, Dadu, Larkana, Stikkur, Rohri,
Shikarpur, Jacobabad, and at Gidu Bandar or Hyderabad. Care was
to be taken to provide the persons segregated with necessaries, to
keep them as comfortable as possible, and to prevent their having
intercourse with the outside world. The Commissioner also instituted
a system of travelling European inspectors, whose duty it was
to help medical officers in detecting sick persons, and to see that
such persons were treated in accordance with the prescribed rules,
The Punjab.
Decision of
conference
adopted by Local
Government.
In the Punjab a conference was held on the 3rd January, attended
by principal administrative, railway and medical officials, to devise
measures to protect the Punjab against the spread of infection by
railway from Karachi (the rest of Sind was at this time still unin-
fected). The Government of the Punjab passed orders approving the
measures proposed by the conference, and directing that they should
be carried out. The following is an outline of the measures.
Inspections were to be held at Khanpur (situated in Bhawalpur
territory, about 70 miles from the Sind frontier), Sher Shah and
Raewind. In fixing the places the conference was guided by the
following principles. The station should be one at which trains
ordinarily stop for a considerable time, it should be one at which
trains from Karachi arrive during the clay-time, and it should
not be close to a large town. Khanpur was to be the principal
inspection station and there the inspection was to be conducted by
a commissioned medical officer. At the other post special hospital
assistants were to be appointed. The following instructions were
given for the conduct of the inspections. The doctor should go round
with the ticket-collector and look at all passengers who had booked
from Karachi or Sukkur (the last place was included in order to pro-
vide against re-booking). Other passengers looking ill should also
be inspected. Suspicious cases should be removed from the train
and isolated in temporary accommodation, separate accommo-
dation being provided for the treatment of the sick. Passen-
gers alighting should be treated in the same way. Special establish-
ments should be entertained as required, and the persons segregated
should be dieted and treated gratuitously. In sanctioning the pro-
posals the Lieutenant-Governor enjoined that special caution
should be taken in the treatment of females, and that a commis-
sioned medical officer should, in all cases, see the patient as
soon as possible. Shortly after the issue of these general orders,
the Punjab Government issued subsidiary orders prescribing the
procedure to be adopted in the case of Europeans and Eurasians,
310
Measures to prevent the
[ CHAP. X.
and the precise method in which hospital sheds should be con"
structed.
The North-
Western
Provinces.
In reply to the telegram of the Government of India of the 30th
December the Government of the North-Western Provinces reported
that it had ascertained that due precautions had been taken
in the Punjab, and that arrangements had been made with the
Manager of the North-Western Railway and the Agent of the East
Indian Railway for the examination of passengers changing into
the East Indian Railway at Umballa and Ghaziabad stations. Travel-
lers from Karachi enter the North-Western Provinces at Saharanpur
(viâ Umballa) or at Ghaziabad (viâ Delhi). In addition to the other
precautions the Government of the North-Western Provinces posted
hospital assistants at both Saharanpur and Ghaziabad, and caused
suitable segregation shelter to be erected at these places. The
necessary directions for the treatment of patients were issued to the
Civil Surgeons of the Saharanpur and Meerut districts.
Baluchistan.
In Baluchistan the medical officers at Sibi, Sharigh, Bostan,
Chaman, and Quetta were instructed to examine passengers in trains'
arriving from Sind, and to provide suitable hospital accommodation?
for persons found to be suffering from plague.
Extension of the
arrangements
after the passing
of the Epidemic
Diseases Act.
The above account brings the narrative of events up to the time
the Epidemic Diseases Act was passed. Immediately after that
Act attained the force of law the railway inspection arrangements
were systematised and largely extended, until an elaborate and far-
reaching plan was evolved ensuring a thorough inspection of every
traveller from the infected districts at different points along his
routes to other portions of India. This system, as perfected in the
light of gradually increasing experience, may claim to afford the
greatest possible protection against the spread of disease along the
lines of communication, combined with the least possible interference
with intercourse and commerce.
The working of the system after the introduction of the Epidemic
Diseases Act must be described in some detail.
Clause of the
Epidemic
Diseases Act
relating to
examination of
travellers.
The following is the wording of the special clause [section 2,
sub-section 2, clause (b)] of the Epidemic Diseases Act, which deals
with the treatment of travellers :—
" In particular and without prejudice to the generality of the
foregoing provisions the Governor General in Council may take
measures and prescribe regulations for—
*
*
*
*
*
*
" (b) The inspection of persons travelling by railway or otherwise,
and the segregation in hospital, temporary accommodation, or other-
wise, of persons suspected by the inspecting officer of being infected
with any such disease."
CHAP. X. ]
spread of infection by land.
311
Instructions
issued by the
Government
of India on the
passing of the
Act. Appoint-
ment of principal
inspection sta-
tions and method
of examination
at such stations.
On the date that the Act was passed, the Government of India
telegraphed to the different Local Governments and Administrations
repeating its terms, and in doing this gave special directions with
regard to the inspection of railway travellers. It was stated in the
telegraphic circular that it was essential that the medical inspection
of passengers in trains coming from the direction of infected dis-
tricts should be complete, and that this could only be effected by the
removal of the passengers from the train and their inspection by a
medical officer on the platform; also that this duty should ordinarily
be performed by a commissioned medical officer. The Government
of India suggested the following series of principal inspection stations
for the different provinces, and stated that the arrangements at these
stations need not interfere with the subsidiary inspections of a less
complete character already ordered by the Local Governments and
Administrations :—
Stations
suggested by the
Government of
India.
Kalyan
Bhusawal
Palghar
Anand
Karachi
Ruk
Hubli
Itarsi
Bilaspur
In Bombay and Sind.
... On the Great Indian Peninsula Rail-
...
way.
... On the Bombay, Baroda and Central
...
India Railway.
... On the North-Western Railway.
... On the Southern Mahratta Railway.
In the Central Provinces.
... On the Great Indian Peninsula Rail-
way.
... On the Bengal-Nagpur Railway.
In the North-Western Provinces and Oudh.
Naini
Jhansi
Assansol
On the East Indian Railway.
... On the Indian Midland Railway.
In Bengal.
... On the East Indian Railway.
In the Punjab.
Raewind Maraud Kot On the North-Western Railway.
Bandikui
Perambur
Guntakal
In Rajputana.
... On the Rajputana-Malwa Railway.
In Madras,
... On the Madras Railway.
... On the Southern Mahratta Railway.
312
Measures to prevent the
[ CHAP. X.
Subsequent
alterations in and
extension of the
scheme.
Some of these stations were subsequently altered in communica-
tion with the Local Governments, who also extended the system of
both principal and subsidiary inspection stations. In the end the
long series of inspection stations shown in the list in Appendix
VIII, was established. The inspection stations are shown also
in the railway map contained in Volume IV (page 16). At the
principal inspection stations (shown in red on the map) a thorough
examination was made of through passengers or of passengers
alighting at important centres of population as the case might be,
and all suspicious persons were detained ; at the subsidiary inspec-
tion stations (shown in blue) a less thorough inspection was made,
but there were arrangements for the detection and removal of sick
persons and for the treatment of plague cases in isolation
hospitals.
Account of the
principal inspec-
tion stations on
the main lines of
communication.
Bombay to Cal-
cutta.
The following brief account explains the situation of the principal
inspection stations on the main lines of communication.
In the first place all passengers from Bombay were inspected
before departure. On the line from Bombay to Calcutta viâ, the
Great Indian Peninsula and East Indian Railways the first principal
inspection station was at Kalyan (one hour and twenty minutes from
Bombay), the second was at Manmad junction near the Hyderabad
border, the third was at Bhusawal junction near the Berar and Central
Provinces borders, the fourth was at Itarsi junction in the Central
Provinces, the fifth was at Sutna in the Central India Agency, and
the sixth and last was at Khana junction near Burdwan in Bengal
(three hours from Calcutta by the loop mail).
The inspection station was transferred to Sutna from Manikpur
junction in the North-Western Provinces at the beginning of May,
the scarcity and badness of the water-supply at Manikpur having
made it impossible to continue the inspection at that place.
Approach to
Calcutta viâ the
Great Indian
Peninsula
Railway and to
the North-
Western
Provinces viâ
the Indian
Midland
Railway.
Approach to
Calcutta viâ the
northern route.
The approach to Calcutta through the Central Provinces and Chota
Nagpur viâ the Great Indian Peninsula and Bengal-Nagpur line was
guarded by a first class inspection station at Nagpur. The approach
to the North-Western Provinces from Itarsi viâ the Indian Midland
Railway was protected by a first class inspection station at the
junction of Jhansi in the North-Western Provinces. An inspection
station was established at Katihar junction in the Purneah district
of Northern Bengal to protect the route to Calcutta from the
north viâ the Bengal and North-Western and the Eastern Bengal
Railways.
Trains travelling
northwards from
Bombay
and
Bhusawal.
Trains travelling northwards from Bombay viâ the Bombay-Baroda
Railway were first inspected at Palghar (about three hours from
CHAP. X. ]
spread of infection by land.
313
Rutlam and
Ujjain.
Ajmere.
Bandikui.
Bombay by fast passenger train) and then at Ahmedabad in the
north of the presidency. Trains travelling northwards from
Bhusawal junction through Central India and Rajputana by the
Rajputana-Malwa Railway were inspected at Rutlam junction in
the Central Indian Agency. The Rutlam inspection station
also served for the examination of passengers travelling east-
wards by the Bombay, Baroda and Central India Railway, a second
principal inspection station at Ujjain protected both this route and an
alternative route to the North-Western Provinces through Central
India. The lines (Rajputana-Malwa Railway) running northwards
from Ahmedabad and Rutlam converge at Ajmere in Rajputana, and
here there was another principal inspection station. Beyond Ajmere
there was a further inspection station for the protection of Northern
and Western India at Bandikui, midway between Jaipur and the
Punjab and North-Western Provinces borders.
Bombay to
Madras.
Hotgi.
The line from Bombay to Madras via the Great Indian Peninsula
and Madras Railways passes through the inspection station of
Kalyan and then through Poona, which was the scene of a severe
outbreak of plague. There was an inspection station at this place.
The next principal inspection station was at Hotgi junction on
the Hyderabad border. This station served for the protection of
Hyderabad as well as for the protection of the route to Madras.
Hyderabad was further protected by the inspection station at Wadi.
There was another principal inspection station at Guntakal
junction in the north-west of the Madras Presidency, another at
Arkonam (an hour and fifty minutes from Madras), and lastly one at
Perambur, a suburb of Madras City.
The south of the
Deccan.
Bangalore.
Kondapalli and
Bezvada.
To protect the route to the south of the Deccan via the Southern '
Mahratta Railway, an inspection station was established at Rajevadi
(an hour and three-quarters from Poona by the mail), and another at
Londa* junction near Goa on the main line from Castle Rock to
Bezvada. At Bangalore also there was a principal inspection post ]
for the protection of the civil and military station as well as for
the inspection of through passengers. To protect the north of the
Madras Presidency and Bengal from persons travelling from or
through the south of the Bombay Presidency, there was a principal
inspection station at Kondapalli, thirty-seven minutes from Bezvada
on the Nizam's State Railway. At the instance of the Government
of Bengal this station was moved to Bezvada junction during the
time of the pilgrimage to Jagannath, with a view to form a midway
inspection station for pilgrims travelling to Puri by the circuitous
* During the recrudescence this station was transferred further north to Kurlchi.
40
314
Measures to prevent the
[ CHAP. X.
Approach
to
Calcutta viâ the
East Coast
Railway.
southern route. At other times goods only were examined at the
Bezvada station by the civil apothecary superintended by the Civil
Surgeon. As a further protection for Bengal against persons travel-
ling by the new East Coast Railway, a principal inspection station was
established at Khurda Road in the Puri district of Orissa. This station
was of particular importance during the time of the pilgrimage to
Jagannath.
Sind.
In Sind there were principal inspection stations at Karachi,
Hyderabad, Rohri, Sukkur, and Shikarpur, Persons entering the
train at Hyderabad, Rohri, and Sukkur (in all of which places plague
was at some time epidemic) were carefully inspected as well as
persons passing through the stations from the direction of Karachi.
The arrangements at Sukkur and Rohri have, already been noticed in
connection with the discussion on the stoppage of third class railway
traffic.
Khanpur on the
North-Western
Railway.
Sher Shah.
Series of inspec-
tion stations
across the
Punjab.
Lines
entering the
North-Western
Provinces.
Simla.
Outside Sind the first principal inspection station for the
protection of the Punjab was at Khanpur in the Bahawalpur State. A
second station at the junction of Sher Shah (near Multan) protected
the route to both the north-east and the north-west of the Punjab.
The east portion of the Punjab and thence the North-Western
Provinces, Kashmir, and the trans-frontier countries were further
, protected by a line of five principal inspection stations stretching right
across the Punjab, north and south, from Kashmir to Rajputana.
The names of these inspection stations were Jhelum, Wazirabad, Rae-
wind, Ferozepore, and Bhatinda. The two lines of entry into the
North-Western Provinces from the direction of the Punjab were
further guarded by principal inspection stations at Saharanpur and
Ghaziabad. These North-Western Provinces and south-east Punjab
inspection stations served as an ultimate line of defence against the
Bombay Presidency proper as well as against Sind. For the further
protection of Simla a principal inspection station was established at
the Kalka terminus and a minor inspection station on the cart-road.
Baluchistan.
Sibi and Sharigh.
Mushkaf-Bolan
line.
The last line of railway that remains to be considered is the
branch of the North-Western Railway leading north-westwards from
Sukkur through Baluchistan. For the protection of Baluchistan and
the trans-frontier countries a first class inspection station was, it has
already been stated, established at Sibi junction. In the middle of
May the station was removed from Sibi to Sharigh on the northern or
Sind-Pishin branch of the railway on account of the heat and bad
water-supply at Sibi. This left the southern or Mushkaf-Bolan branch
of the railway unprotected by a first class inspection station. This
portion of the route was accordingly closed, except to first and second
class passengers who were examined en route. It was explained
CHAP. X. ]
spread of infection by land.
315
that there is hardly any traffic on the Mushkaf-Bolan Railway, and that
this course therefore occasioned no inconvenience.
New inspection
stations opened
during the
second outbreak.
During the period of the second outbreak, Khana, the Bengal
inspection station, was abandoned in favour of the more convenient
arrangement of three inspection stations on the borders of the prov-
ince. The three stations were established at Mairwa on the Bengal
and North-Western Railway, Chausa* on the East Indian Railway, and
Chakardharpur on the Bengal-Nagpur Railway. To meet the danger
arising from the spread of plague in the Deccan the following new
principal inspection stations were opened :—
Madras
...
...
...
Central Provinces
...
Hyderabad ...
...
Hospet.
Burhanpur.
Lingampalli, Gulburga
and Malkapur.
In the Bombay Presidency a principal inspection and disinfection
station was also opened at Anand, south of Ahmedabad.
Arrangements
within the Bom-
bay Presidency.
Although for the purpose of devising precautions to protect the
rest of India it was necessary, when plague had become epidemic in
nearly every district in the Bombay Presidency and Sind, to treat the
whole of the province as infected, all places in the Presidency were by
no means equally infected. Whilst some towns and villages were the
scene of virulent epidemic, many others escaped altogether or suffered
only slight loss. To protect the uninfected against the infected
localities, inspections were made of railway travellers at the time of
starting from infected places, during the journey, and on arrival at
other places in the Presidency, similar to the inspections instituted for
the protection of other provinces.
Inspection of up-
trains in and
near Bombay.
Specially careful arrangements were made when the epidemic
declined in the city of Bombay, and passengers from infected
districts began to flock into the capital. A set of rules to meet
this emergency were issued by the Government of Bombay on
the 15th April, which were slightly modified on the 28th May. Up-
trains to Bombay via the Great Indian Peninsula and Bombay,
Baroda and Central India Railways pass through the principal
inspection stations of Kalyan and Palghar, respectively. On the Great
Indian Peninsula Railway persons travelling by up through trains
were medically inspected at Kalyan, and the train was not again
inspected, but no passengers were allowed to enter at any station
between Kalyan and Kurla, except at Thana where they were inspected
before being permitted to entrain. All local trains were emptied and
their passengers medically inspected at Sion. On the Bombay,
Baroda and Central India Railway up-trains starting from stations
* For plan of this camp, see Volume IV, page 17-A.