52
disinfected, either by fire or by means of a strong solution of chlorinated lime. Kat-holes should
also be carefully disinfected wherever found in an infected house.
11. A set of simple rules for the guidance of the people should be drawn up in the
various vernaculars and circulated both by printed notices and by criers. Such rules should
direct attention to the necessity for free and efficient ventilation, the prevention of over-
crowding, the· necessity of cleanliness both of the person and of the dwelling. The whole-
contents of dwelling-rooms should be \vell aired and exposed to sunlight every fortnight :
bedding and clothing should be so treated every day. Special care should be enjoined in
keeping clean all injuries or skin abrasions even of .the slightest description. They should
be washed with disinfectants obtained from the Municipality, and protected by bandages,
plaster· or otherwise. Householders and landlords should be compelled to wash and
limewash all houses and rooms which on inspection are found to be dirty. Such lime-
washing will obviously give an opportunity for exposing the contents of a room to sunlight
and air.
Persons coming in contact with the sick, especially if contaminated with
secretions, should be instructed to carefully wash all exposed skin surfaces with carbolic
lotion of 1 in 20 strength.
12. In order to increase the accuracy of the death returns, and to obtain a better
check· on the progress of the disease,'a medical officer should be stationed at each of the
places for the disposal of the dead, and should be -empowered to examine bodies in all
suspicious cases. As a general rule this examination need only be external.
13. With regard to general measures, it may be noted that overcrowding, deficient
ventilation of houses and rooms, accumulated dirt in rooms and passages, are frequently
present, and obviously require to be dealt with where necessary by compulsion. The
opening up of crowded localities for the free perflation of air is urgently needed. The
crowded and insanitary burial grounds present in the midst of thickly populated
districts should be closed on the earliest possible occasion. We also point out the need
for a steam steriliser in each district of the city.
14. The Committee is well aware that the carrying out of muoh of the above measures
will be attended with hardship and in convenience to the inhabitants, but we consider that nothing
less than the above desiderata will suffice to eradicate the disease. While every effort should
be made to prevent the regulations bearing harshly on the people, these regulations should be
firmly and unflinchingly applied in view of the enormous interests at stake. Although
interference with trade and even panic may ensue on enforcing the above measures, it should be
borne in mind that greater interference with trade and greater panic is likely to be produced by
the disease itself if allowed an untrammelled course in the succeeding months of the cold
weather.
15. While leaving the carrying out of the above rules to the Municipal authorities, the
Committee advocates the employment of Commissioned Medical Officers in each of the infected
districts to inspect and supervise the methods of combating the disease. It might be feasible to
ask the Army Medical Staff and the Royal Navy to contribute their quota of such officers if any
difficulty is found in providing them, from the Indian Medical Service. Such aid is requisite, as
it is feared that in some cases the present measures of disinfection are not efficiently carried out,
and more responsible aid is reqxured in supervising the sanitary needs of the infected areas. At
present it is feared that the medical officers employed by the Municipality' have most of their time
employed in inspecting and treating the sick. Tliese municipal officers should direct the whole
of their time to inspecting their districts, and to seeing that the above suggestions are carried out
efficiently. The Commissioned Medical Officers, if employed, should be independent of the muni-
cipality and should report to the Sanitary Commissioner with the Government of Bombay.
16. We also consider that steps should be taken for obtaining further supplies of Mr.
Yersin's antitoxin for treatment of the sick.
17. In conclusion, we wish to point out that until scientific- researches have shown us
the exact sources and modes of infection in this disease, the utility of any special mode of disin-
fection must remain a matter of theory, and the safest way of avoiding the disease must be to
run away from it. In other words, although it is probable that the suggested measures of
disinfection will be of some use, we consider that there is reason for placing more reliance on the·
evacuation of infected houses as a means of combating the disease.
We have the honour to be,
Sir,
Your most obedient Servants,
R. MANSER, M.D.,
Surgeon-Major, I. M. S., President,
Ε. Η. Η ANICI N.
L. Γ. CHILDE,
Surgeon-Captain, I. M. S.
N. F. SURVEYOR.
A minority report by Professor Haffkine is appended.