47
Further, the Surgeon-General and the Sanitary Commissioner gave advice
to local authorities both in correspondence and verbally in the course of their
tours. The former officer's tour in this period included Broach, Surat, Thàna,
Poona, Nàsik, Ahmednagar and Khandesh ; while the Sanitary Commissioner
visited Bombay and various districts in the Deccan.
A.
" As owing to the plague in Bombay many people are leaving and proceeding to out-
stations to live, I think all Municipalities and other places which may have cases occurring
within their limits should be informed of the mode of sanitary procedure to be adopted.
" 2. In my opinion the two great measures are isolation of those sick and the empty-
ing of the house in which a case has occurred of all human beings, keeping all the doors
and windows of the house in question open clay and night for eight days, removing the
roof or part of it if any good ventilation is to be obtained thereby. In fact removal to a
special hospital of those actually sick, removal out of the affected house of all the other
residents arid opening up to light and air the affected house are the measures to be chiefly
relied on.
" 3. Difficulties arise in the carrying out of both measures, and the fullest powers
should be given, persuasion having failed, to enforce the measures recommended. It is of
course little use to empower forcible removal to an isolation hospital if powers of detention
there are not also conferred. Again, unless reasonable proper accommodation is provided,
it is cruel to remove sick people merely to an empty hut.
" 4. Now to enter more into detail, measures have already been adopted at municipal
towns along the line o£ rail to watch for sick people and those measures have hitherto been
attended with success, and should be adopted also at all sea-port towns on the coast at
which coasting passenger steamers touch, if it has not already been done. All cases reported
from Mofassil towns have been arrivals from Bombay except in Ahmedabad in which two
cases originated in that town and they were amongst the first three reported, and in the
town of Bandra which adjoins Bombay, but the town is so near Bombay and the intercourse
between the two so great that infection was likely to occur although the Municipality did
keep a watch for imported cases.
" 5. The first thing then for a place infected or likely to be infected is to erect a mat
hut for ten people, materials being at hand for another hut. Ten feet square per patient
with plentjr of ventilation. Have ready on the spot a bhangi, a bhisti and a peon with huts
for each and tubs for disinfecting material. This will do away with the fear relative to
experience of their sick being left alone in a lonely place, and one of the attendants is at
hand to call the medical officer deputed to attend to the cases. I would,also recommend that
a compounder be also kept at the hospital who can receive the sick and see to his comfort
when first brought in.
" 6. The Municipality or place affected can only be expected to erect a hospital for the
general public, but if communities desire to build hospitals for the sick of their own caste,
they should be encouraged to do so near to the general hospital, so that supervision, cleans-
ing, and other matters may be more economically carried out.
" 7. Believing as I do that the poison of plague is soon rendered innocuous by plenty
of fresh air, I do not think these hospitals need be placed at a long distance out of the town.
Any convenient open space on which the buildings can be, when erected, 300 yards from
an inhabited dwelling, may be, I consider, with safety taken up for this purpose.
" 8. In the next place, if people are to be turned out of infected houses, they must
have some place to go to and for them also huts should be erected in which they may stay
for eight days, the medical officer coming daily to inspect them. In this case also commu-
nities may erect huts for their castefellows.
''9. After this the procedure of the authorities, municipal or otherwise, should, I
suggest, be (the watching at the station being provided for) the dividing of the town accord-
ing to size and appointing to each a medical officer to whose notice all cases of plague are
brought and upon his diagnosis and certificate all cases are to be removed. He should be
helped by an inspector or inukàdam or some one whose duty it is to look out for cases.
" 10. The authorities then should widely publish what steps they are taking, point out
that it is to prevent the people now healthy from being infected, and a?k for aid, not obstruc-
tion, and state that no one will be moved unless seen by a medical officer, and that any one
seeking to obtain money to let people off from being taken away should be handed over to
the nearest policeman as he is not an authorized person but an impostor.
"11. Also the authority should offer a fee, Rs. 2 or so, for every authentic case of
plague reported by any one not their servants paid for this particular duty. The notifier
reports to the medical man any suspicious case, and if the medical man finds it to be a true
case, he gives a brief certificate to the man reporting, who takes it to the Municipal Secretary
(say), who files it for verification and pays at the end of the'month.
" 12. When a patient is removed to a hospital, one relative or friend may be allowed
to accompany him to attend upon him, but this attendant must stay in hospital precincts, "his