NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
90
Previous history of plague in India.
[CHAP. IV,
In describing his experiences at Jalia (south of the Ajmere dis-
trict) Dr. Irvine stated the measures on which he would rely for com-
bating an outbreak of plague—
Dr. Irvine's
opinion that the
healthy should
encamp outside
the infected
place.
Cleansing of
apparel and
houses.
" At Jalia, the healthy portion of the inhabitants were directed to
leave the town and encamp around the walls for a time, until the
plague should entirely subside, the sick alone to remain, to whom I
would attend : all filth and dirt lying in the streets or about the
houses was ordered to be collected and burnt outside the walls : the
healthy portion were ordered to wash all their wearing apparel on
leaving the town : and when the disease should be diminished, the
houses were directed to be new " liped "* with cow-dung, in the
absence of whitewash, ere re-inhabiting them. Had these instructions
been fulfilled bond fide, I have little doubt that the plague would have
been quite arrested at Jalia ; but the apathy of the natives has
occasioned them to be altogether evaded or only partially performed."
At a later date Dr. Irvine recorded the following remarks about
the possibility of combating the disease :—
Disease easily
eradicated on the
occurrence of a
few cases in a
small place, but
impossible to
arrest when it
obtains a hold on
a large town.
" From what I have myself observed of the plague, it appears that
in a small place where only a few cases occur it is very easy to be
eradicated ; but, let the malady once take a firm hold in a large
populous town, to arrest the progress of the scourge will be found in
India an impossibility. ''
Endemic plague
centre in the
Himalayas.
Mahamari—the Himalayan Plague.†
Along with the plague epidemics that have occasionally visited
India, and, in so far as the evidence goes, unconnected with them,
there has existed for a long time past an endemic plague centre on the
southern slopes of the Himalayas. The bacteriological origin of this
disease has not yet been investigated, but its clinical and epidemo-
logical history leave little doubt that it is true plague.
Garhwal and
Kumaun.
The home of the disease is in the North-Western Provinces Dis-
tricts of Kumaun and British Garhwal.
The area of the two districts is over 11,000 square miles, and
they contain a population of close on 1,000,000 persons, living at
elevations from 1,500 to over 11,000 feet above the sea-level.
* i.e., smeared.
† Surgeon-Colonel Hutchinson (formerly Sanitary Commissioner of the North-
Western Provinces and Oudh) ; Report on Mahamari (Appendix II). Mahamari, or
Indian Plague : its origin, progress and eradication ; Reports of Drs. Francis
and Pearson ; Indian Annals of Medical Science, No. II, April 1854. Mahamari ;
Dr. Stiven's Report ; Indian Annals of Medical Science, No. III, October 1854
(Appendix II).
CHAP. IV. ]
Previous history of plague in Indict.
91
The 1823
outbreak at
Kedarnath.
Subsequent
outbreaks.
Outbreaks
sometimes
virulent,
sometimes slight
1834-35-
1853-54-
Spread to the
plains.
1860.
1877-78.
Later outbreaks
not severe.
The first authentic record, relates to an outbreak which occurred
in 1823 at Kedarnath in British Garhwal. At Kedarnath there is
a famous shrine much visited by pilgrims. Local tradition asserts that
the disease originated in the person of the high priest who, having
deviated from the rules prescribed in the sacred writings for the per-
formance of the religious ceremony called " Horn," was smitten with
this new form of d sease, together with the Brahmans who assisted at
the offering. From Kedarnath the disease spread to the villages
in religious assignment to the temple, and afterwards to other par-
gannas * of Garhwal. During the first-half of the century the general
tendency of the disease was to spread from north to south. Since the
outbreak of 1823 the malady has prevailed off and on up to the present
time. There are records showing that the disease was present in some
part or other of the two districts in the years 1834, 1835, 1846, 1847,
1849, 1850, 1851, 1852, 1853, 1854, 1859, 1860, 1870, 1875, 1876 1877,
1884, 1886, 1887, 1888, 1891, 1893, 1894 and 1897. Since 1834 the out-
breaks have thus been of constant recurrence, except during the period
1860 to 1875. Some of the outbreaks spread over a number of villages
and occasioned great loss of life; others were confined to a small area.
In the outbreak of 1834-35, the ascertained total of deaths was 633, and
in 1851-52, 567 deaths were reported to have occurred in seventy-seven
villages. In 1853-54 the epidemic spread to the plains and attacked
places in the Bijnor and Moradabad districts and in the Rampore
State. An article in the Indian Annals of Medical Science, April 1854,
on the subject Dr. Stiven's report on the appearance of the disease
in the plains is reproduced in Appendix II. He gives some account
of the epidemic at Thakurdwara in the north of the Moradabad
district, and the manner in which the disease was there introduced by
a refugee from a neighbouring infected place. Maliamari was at the
same time prevalent at Afzalgarh in the Bijnor district, and at
Kasipur in the Tarai in the extreme south of Kumaun. It is stated
that about 8,000 persons lost their lives. The period from 1850 to
1854 appears to have been the worst on record. The considerable
mortality and the tendency which the disease showed to spread to the
plains occasioned much anxiety. The Government of the North-West-
ern Provinces sent officers to study the disease and to find means to
stop its ravages. In 1860 nearly 1,000 deaths occurred. In 1877-78
the epidemic which extended over eight pargannas caused 550 deaths.
None of the later outbreaks appear to have been widespread or to
have attacked large numbers of persons.
The disease
fostered by
It must at first sight occasion surprise that constant outbreaks
of plague should occur in villages scattered over the mountain side,
* A revenue division.
92
Previous history of plague în India. [ CHAP. IV.
dirty and
unwholesome
surroundings.
open to the pure air of the hills, and supplied with water from the
mountain streams. Here, as elsewhere, the explanation lies in dirty
and insanitary conditions of life. In another place a description has-
been given of a typical Garhwal village, with its iil-ventilated houses
of which the ground floor is crowded with cattle, and its accumula-
tions of filth and refuse. The following passage occurs in a report
written by Dr. Rennie, who investigated the disease locally in 1850 :—
"The filth is everywhere—in their villages, their houses and their
persons. It destroys the otherwise pure quality of the air, and main-
tains ever round the inhabitants that contaminated atmosphere so
favourable to the condensation of infectious emanations. Their dwell-
ings are generally low and ill-ventilated, except through their bad con-
struction ; and the advantage, to the natives in other parts of India, of
living in the open air is lost to the villagers oí Garhwal, from the neces-
sity of their crowding together for mutual warmth, and shelter against
the inclemency of the weather. The food of the majority is bad and
insufficient." It is stated in Dr. Stiven's report that the infection of
mahamari spread from the house in which the first cases occurred
over Thakurdwara, "curiously enough, however, choosing the most
populous, crowded, ill-fed and filthiest parts of the Kasba for its
development." In the more healthy quarters of the town, it is stated
that only one case occurred, which ended in recovery.
Symptoms,
The symptoms and characteristics of mahamari are identical
with those of ordinary plague. The usual symptoms are shivering,
quickly followed by intense fever, ending in delirium, insensibility
and death on the third or fourth day ; also the characteristic enlarge-
ment of lymphatic glands, except in some of the severest cases, where
death ensues during the first three days from extreme virulence
and shock of the great nerve centres.
Virulence of the
disorder.
The disorder is extremely fatal and only a small proportion
of the persons attacked recover. Instances are given in which all
or nearly all the members of a family living together have been
attacked and died, In Dr. Rennie's reports of 1850 it is stated that
" the mortality from mahamari is very great, not so much in actual
numbers as relatively to the small amount of the population. The
recent mortality has been estimated by the civil authorities to be
probably twenty-five per cent. on the total population. Recent en-
quiries show it to have been even greater; but the statistical details
are most defective. In certain places the destruction has been very
great, of which an example has been given, of fourteen deaths out of
sixteen people in one place. In the village of Sarkote in 1846-47, if
the reports of the inhabitants are to be trusted, out of a population of
sixty-five in all, forty-three died, two only recovered, and twenty
CHAP. IV. ]
Previous history of plague in India.
93
Flight of the
inhabitants from
infected
villages.
escaped without infection." The villagers are terrified at the disease,
and it is now their common practice to flee from a village in which
it has broken out and to camp on the hill-sides. Experience has
shown them that to leave the plague-infected locality is their best
chance of escape.
Spontaneous
and imported
outbreaks.
Mortality among
rats.
Spontaneous
outbreaks how
caused.
Dr. Hutchinson classes the outbreaks into two kinds : spontaneous
outbreaks and outbreaks caused by the importation of the disease,
The outbreaks are frequently associated with, and sometimes pre-
ceded by, a great mortality among rats. All the civil and medical offi-
cers who have observed the disease lay the strongest stress on this
marked characteristic. It is said that no other animals have been
attacked. An instance is recorded in which the inhabitants of a vil-
lage promptly left it on the occurrence of a great mortality among the
rats, and thus probably saved themselves from an attack of the pesti-
lence. Dr. Hutchinson ascribes the ever-recurring recrudescence of
the plague in this portion of the Himalayas to the germination of a
specific poison, and its spread by fomites and other means through
neglect to destroy articles, etc., likely to convey and retain infection
for long periods, and to the imperfect burial of the dead in epidemic
and at other times. Modern research on the general subject of
plague points to mild sporadic cases, and the preservation of the
bacilli in contaminated articles kept under conditions favourable to
the vitality of the microbe, as the probable means whereby the infec-
tion is preserved between successive epidemics.
Assistant Surgeons Francis and Pearson, who made a local investi-
gation of the disease in 1852, drew the following " practical deduc-
tions " from their observations :—
" First.—Mahamari and plague are identical.
Secondly.—The disease is of local origin ; capable of transmis-
sion from person to person, and from place to place.
Thirdly.—That it is gradually extending itself; and that no
sufficient grounds exist for the supposition that it will
never be developed in surrounding countries.
Fourthly.—That the local circumstances, upon which mahamari
depends, should be done away with, and sanitary measures
introduced ; in which case, it is probable that the disease
will be gradually eradicated, or, at any rate, modified in
severity.
Fifthly.—That it is likely the disease, if dealt with early, will
be found to be curable ; and that the people themselves
may use the remedy furnished by authority."
Outbreak of 1897
at Okhimath.
The last outbreak, which occurred in the spring of the present
year, occasioned particular notice and anxiety as it was contem-
poraneous with the worst period of the Bombay plague.
The
94
Previous history of plague in India.
[ CHAP. IV.
locality was a small village near Okhimath on the main road of
pilgrimage from Hardwar to Kedarnath, and some 20 miles distant
from the latter place, which was the scene of the 1823 outbreak.
Preventive
measures
adopted.
Their success.
Closing the
pilgrim route.
At the commencement of the attack some of the inhabitants, follow-
ing the usual practice in such cases, left the village, which was very
small, remote and inaccessible, and thus escaped infection. Only
four or five families remained, most of the members of which died of
the disease. There were 17 deaths in all. As soon as information
was received by the authorities, the villagers who had not already left
were removed and segregated, the houses were burnt and orders were
issued that the site, which was water-logged and insanitary, should
not be re-occupied. The neighbouring villages were thoroughly
cleaned. These careful precautions were successful, and the infection
did not spread. The direct pilgrim route through Okhimath was kept
closed during the time that the danger of infection was apprehended.
Danger of the
spread of
mahamari.
Future outbreaks of the disease will require to be met by careful
precautions, and the general insanitary condition of the villages is
deserving of attention. On one occasion, at any rate, the plague is
known to have spread from the hills to the plains and to have occa-
sioned considerable loss of life. The experience of the past year, as
well as the experience of former outbreaks, shows that the conditions
of a large part of India are not unfavourable to the spread of
plague, if it once assumes an epidemic form. Hardwar, the great
pilgrim centre, is not far from, and is in communication with, the area
where the pestilence lurks, and has been attacked by plague dur-
ing the present epidemic. Lastly, Dr. Hutchinson points out
that the disease might prove disastrously fatal if it spread to the
overcrowded communities of the hill sanitaria which exist in the
immediate neighbourhood.
CHAPTFR V.
EXTENT AND COURSE OF THE PLAGUE IN
THE BOMBAY PRESIDENCY.
Preliminary Remarks.
It will not be necessary to give a very long or detailed descrip-
tion of the course and extent of the epidemic in the Bombay
Presidency.
Statistics,
charts, and maps.
The statements in Appendix III and the maps and charts in Volume
IV furnish as clear a picture of the epidemic as any verbal description
could convey. The statements, charts, and maps include the period
from the first outbreak until the end of August; they thus carry the
account through the entire period of the first portion of the epidemic
and through the beginning of the recrudescence which has since
attained to such great proportions. The account given in this
chapter will deal mainly with the first period of the epidemic, but a
few remarks will also be made about the recrudescence.
Description of
the Presidency.
A brief description will first be given of the Bombay Presidency,
its physical aspects, climate, political divisions and form of adminis-
tration. To those who are not familiar with the subject the account
will make clearer the description of the epidemic and of the measures
taken to combat it which is given in the present and following chapters.
Sources from
which the
account is
derived.
Brief description of the Bombay Presidency.
The following account of the Bombay Presidency is derived
from Volume III of the Imperial Gazetteer of India, with the excep-
tion of the description of the climate which has been prepared by
Mr. W. L. Dallas of the Meteorological Department of the Govern-
ment of India.
Extent and
population.
Extent and population.—Bombay, the Western Presidency of
British India, is divided into four revenue divisions and twenty-four
British districts. It also includes numerous Native States under
96
Extent and course of the plague
[ CHAP. V.
The Capital.
the protection of the Government of India. The territory thus
composed extends from 13° 53' to 28° 45' north latitude and from
66° 40' to 76° 30' east longitude. The British districts, including
Sind, contain a total area of 125,064 square miles, and a total popula-
tion (according to the census 6f 1891) of 18,857,044 souls ; the Native
States under the Bombay Government, excluding Baroda, cover an
additional area estimated at 69,045 square miles, with a population of
8,05,298 souls ; grand total area, 194, 109 square miles ; grand total
population, 26,916,342 souls. The State of Baroda, with an area
of 8,226 square miles, and a population of 2,415,396 souls, although
in direct subordination to the Supreme Government of India, is
intricately interlaced with the Bombay British districts, and may,
from a geographical point of view, be regarded as forming part of the
Bombay Presidency. The Portuguese possessions of Goa, Daman,
and Diu, with an aggregate area of about 3,806 square kilometres,
and population (1881) of 475,172 souls, are also included within its
geographical limits. The capital of the Presidency, the residence of
the Governor, and the head-quarters of all the administrative depart-
ments, is Bombay City, situated on an island of the same name on
the shore of the Arabian Sea, in 18° 55' 5" north latitude, and
72° 53' 55" east longitude.
Physical aspects.
Physical aspects.—The Presidency of Bombay presents on the
map the appearance of an irregular strip of land, stretching along
the eastern shore of the Arabian Sea, and extending up the lower
portion of the Indus Valley. The continuous coast-line is only
broken towards the north by the Gulfs of Cambay and Cutch, between
which lies the projecting peninsula of Kathiawar. The sea board is
generally rockbound and difficult of access, although it contains many
little estuaries forming fair-weather ports for vessels engaged in
the coasting trade.
North of the
Narbada.
Physically, as well as historically, the Bombay Presidency may be
roughly divided into two distinct portions, the Narbada (Nerbudda)
forming the boundary line. To the north of that river lie the Province
of Gujarat, with the peninsulas of Kathiawar and Cutch, and the
Province of Sind, to the south the Maratha country, part of the
Deccan, the Karnatak, and the Konkan. The former of these tracts
is for the most part a low plain of alluvial origin. In Southern
Gujarat the valleys of the Tapti and Narbada form sheets of unbroken
cultivation. But in Northern Gujarat the soil becomes sandy and
the rainfall deficient ; cultivation is largely dependent upon either arti-
ficial irrigation or the natural humidity caused by the neighbourhood
of the ocean. In Sind (beyond the delta on the east), the surface is a
CHAP. V. ]
in the Bombay Presidency*
97
wide expanse of desert, interrupted only by low cliffs or undulating
sand heaps. The geological formation is distinct from that of the
rest of the Indian Peninsula, consisting of limestone rocks, continuous
with those found in Persia and Arabia,
South of the
Narbada.
Bombay, south of the Narbada, consists of a level coast strip,
rising into an upland country. Mountains furrowed by deep valleys
intercept the rain-clouds of the monsoon, and blossom with tropical
vegetation. The geological formation is composed of nearly horizontal
strata of basalt and similar rocks, which break into steep terraces
and hogbacked ridges, and have produced by their decompo-
sition the famous ' black cotton soil,' unsurpassed for its fertility.
The Deccan, the Karnatak, and the Konkan are each marked by
special features of their own. The Deccan, including Khandesh dis-
trict, is an elevated plateau behind the Western Ghats. It is drained
by several large rivers, along whose banks are tracts of great fertility ;
but for the rest, the air is dry and the rainfall uncertain. The
Karnatak, or country south of the Krishna (Kistna) river, is a plain of
lower elevation, and contains wide expanses of black soil under con-
tinuous cultivation. The Konkan is the name of the narrow strip of
land lying between the base of the Ghats and the sea, As a whole,
it is a rugged and difficult country, intersected by numerous creeks,
and abounding in isolated peaks and detached ranges of hills. The
cultivation consists only of a few rich plots of riceland and groves
of cocoanut. The rainfall is excessive.
Districts.
The districts of the Presidency are classified as follows with refer-
ence to the natural divisions above described :—
Sind districts.—Karachi (Kurrachee), Hyderabad, Shikarpur,
Thar and Parkar, and Upper Sind Frontier, forming the
Sind division.
Gujarat districts.— Ahmedabad, Kaira,
Panch-Mahals,
Broach, and Surat.
Konkan districts.—Thana, Bombay city and island, Kolaba,
Ratnagiri, and Kanara.
Deccan districts.—Khandesh, Nasik, Ahmednagar, Peona,
Sholapur, and Satara.
Western Karnatak or South Maratha districts.—Belgium,
Dharwar, and Kaladgi.
Agriculture.
Agriculture.—The wide extent and the varied configuration of
the Bombay Presidency permit great variations in agriculture. The
two most important food-crops are bájrá or great millet (Sorghum
vulgare) and joárí or spiked millet (Holcus spicatus), which are
especially cultivated in the Deccan. Rice is chiefly grown in the
13
98
Extent and course of the plague
[ CHAP. V,
lowlands of the Konkan. Wheat is extensively cultivated in parts
of Gujarat and in Sind, and barley is grown in the same localities to a
smaller extent. The aboriginal tribes mainly support themselves on
inferior cereals, such as náchaní (Eleusine corocana) and kodrct
(Paspalum scroliculatum), which they plant in patches of culti-
vation amid the primeval jungle that clothes the hillsides. Pulses
and oil-seeds are cultivated to a considerable extent, and among fibres
cotton holds by far the chief place. Cotton, oil-seeds and wheat are
the chief staples available for exportation.
Climate.
Climate.—The climate of Bombay differs so greatly in different
parts of the Presidency that it is essential, in order to obtain a correct
idea of the climatological conditions, to split it up into a number
of areas or divisions, in each of which the climate and weather may be
considered as approximately homogeneous, The divisions adopted are
as follows :—
(1) Sind,
(2) Gujarat,
(3) the West Coast, and
(4) Khanclesh and the Deccan.
Even within these areas or divisions there arc considerable diversities
of climate, but, on the whole, the climatic conditions over each division
are approximately similar.
Sind.
The great Sind plain is the driest and hottest part of the Bombay
Presidency. The aridity, which more or less characterises the whole
division, reaches its highest expression in Upper Sind, and, as will be
seen from the following table, the relative humidity, as shown by the
records of Jacobabad,* is very low throughout the year :—
Humidity
Rainfall
%
46
In.
0'2
February.
%
39
ln.
0'2
%
41
In.
0 3
%
38
In.
0'2
May.
%
36
In.
0 I
June.
%
42
In.
0 1
%
53
In.
1 4
%
5S
In.
1 4
%
55
In.
0 3
%
46
In.
...
November.
%
45
In.
0 1
%
45
In.
O'1
The driest month is May, after which the dampness of the sum-
mer monsoon begins to influence the climate and the humidity rises
* Upper Sind Frontier District.