NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
CHAP. X. ]
spread of infection by land.
325
sergeant, two head constables, and nine constables attend each train.
Of these, three constables are stationed on the up-platform to see that
no person gets out on the wrong side of the train. In addition there
are a number of railway khalasis* present to open locked compart-
ments, assist passengers to alight, etc. If any one is contumacious
and declines to submit to the examination, time is not wasted arguing
with him, but he is locked in and the carriage is cut off, and put into
a siding, he being liable to the railway company for any loss or incon-
venience they may sustain on this account. On the arrival of the
train, ropes with hooks attached are fixed on to both ends of the first
carriage and are held taut by the police. Male passengers are ranged
in one or two rows nearest the ropes and facing the train. Female
passengers are ranged on the platform near the train and facing it ;
their backs are thus turned towards the men. It has, however, been
decided to examine them in future between purdahs† or kanats,† so
as to shield them altogether from the public gaze. Care is taken to
avoid wounding their feelings in any way, and the police are not
allowed to handle them at all. The police sergeant or station master
having reported that the compartments are empty, inspection of each
passenger and his ticket begins. In a large number of cases their
axillæ, femoral, inguinal regions, and paroted glands are examined,
and the temperature of all suspicious cases is taken.‡ Whilst the
inspection of carriage No. 1 is being made, carriage No. 2 is emptied
and the passengers prepared for inspection, and so on. After inspec-
tion passengers re-enter their compartments, women going first. No
one is allowed to wander up and down the platform.
Suspects
from
Bombay.
" Passengers' tickets are examined at Assansol. As a result of
that examination, the Sub-Inspector of Railway Police, Assansol, wires
in advance to the Medical Officer and the Inspector of Police at Khana
junction the number of Bombay passengers, the class in which they
are travelling, and in the case of third class passengers, the number
of their carriage. The tickets of third class Bombay passengers are
made over to the guard of the train, and they themselves are put in
the last carriage for easy disposal. Passengers from Bombay, Poona,
or other infected centres ' suspected ' by the medical officer are de-
tained, and with their baggage are handed over to a constable for
safe custody until the examination of the train is completed. If the
medical officer has any serious doubt about a case, he orders the car-
riage from which it is taken out to be cut off and immediately disin-
fected. On the departure of the train, the medical officer takes
* Porters.
† Screens.
‡ General orders were subsequently issued by the Government of India that it is
Unnecessary to examine the glands if the traveller presents no symptoms of fever.
325
Measures to prevent the
[CHAP. X.
charge of the suspect's ticket, notes down the name, age, sex, caste,
place of residence, and infected place from whence the 'suspect' has
come, and the number of the train from which he was removed. The
station master on duty hands the inspecting medical officer a slip
showing the number of passengers examined (a] 1st and 2nd, (b) all
other classes, (c) total. The inspection is then complete, and the
train is allowed to go on.
Disposal of
suspects.
" The ' suspects ' and their effects are then handed over to the
European police sergeant on duty with any special instruction the
medical officer may desire to give, and the latter arranges for their
escort to the camp.
" The camp staff consists of—
1 Military Assistant Surgeon.
3 Civil Hospital Assistants, and menial staff—cooks, bhisties,
mehters, etc.
" On arrival at the camp the ' suspects ' are made over by the
police constable to the Assistant Surgeon in charge, who tells them
off to their proper camp, locates them in a numbered hut, provides
them with bedding, i.e., straw, mat, or taktaposh* as desired, explains
the rules of the camp, and finally leaves them in charge of the hospi-
tal assistant in charge of that particular camp. The hospital assistant
examines them, takes their temperature, and is responsible that
the first signs of any illness are reported, that they are present on
various parades, and that their wants as regards water, food, etc.,
are attended to without hurting their caste prejudices. The inform-
ation regarding the ' suspects ' noted by the inspecting medical
officer is made over to the camp clerk and duly entered in the
' release diary ' of the officer in charge of the camp, and their tickets
are duly filed until their release.
The camp.
" The camp is under the immediate control of the Assistant Sur-
geon, who parades the menial servants, tells them off for duty,
inspects the latrines, trenching-ground, water-tanks, etc., daily super-
vises the morning and evening roll-call of all quarantined persons,
keeps a daily register, giving the names of all admissions, the camp
and the number of the hut in which they have been placed, the date
on which their clothes were disinfected, and how the suspects were
finally disposed of. He also brings before the medical officer in
charge each morning the persons who are to be discharged that day
for a final examination by that officer, and finally hands them over
after discharge with their baggage and tickets duly countersigned
to the Inspector of Police for escort to the railway station. He is
also in charge of all stores and equipments and their issue, and brings
* Native bedstead,
CHAP. X.]
spread of infection by land.
327
to the notice of the medical officer persons who are destitute and
have to be fed at Government expense. He keeps a daily report
book for the information of the medical officer in charge. The medi-
cal officer in charge being on inspection duty every other night and
part of each day has to rely greatly on the Assistant Surgeon in look-
ing after the camp. He, however, personally each morning, having
given orders the previous evening, examines all suspects paraded for
discharge, and, after satisfying himself as to their health, counter-
signs their railway tickets which have been filed in the office at the
time of admission. Subsequently he inspects the camp in company
with the Assistant Surgeon and hospital assistant, and sees all
quarantined persons, listens to complaints, etc., etc. At the time
of his parade all suspects are summoned by a gong and stand in front
of their huts. To facilitate these orders being carried out by persons
unaccustomed to discipline, the bunniah's* shop is closed during this
parade and opened again immediately after it."
Separate hours were fixed for the occupants of the contact and sus-
pect camps to obtain their supplies at the shop which was erected
between the two camps. With a view to keeping the camps as dry
as possible, suspects were not supplied with bathing-water, but were
permitted to bathe in the large tank at two separate bathing-places,
constables being stationed at each place to prevent any water being
carried away for cooking or drinking purposes.
Police force.
The police force on duty consisted of—
1 European Inspector of the Bengal Police,
2 Sergeants of the Railway Police,
2 Constables of the Railway Police,
11 Head constables of the Bengal Police,
72 Constables of the Bengal Police.
Of these, 2 sergeants, 4 head constables, and 18 constables were
employed on platform duty in two batches, 3 head constables and
24 constables were employed on sanitary duty in camp, and the re-
mainder on miscellaneous duty.
General rules for
observation
camps in Bengal.
Dr. Dyson also prepared a set of general rules to be observed by
medical officers in charge of observation camps with prescribed
arrangements similar to those in force at Khana (Appendix VIII).
Total Staff.
The total medical staff employed on inspection duty in Bengal 1
consisted of 4 commissioned officers and 2 military assistant surgeons,
5 civil hospital assistants and 4 lady doctors.
* Retail vendor.
328
Measures to prevent the
[ CHAP. X.
Rules issued by
other Local
Governments.
Rules for the inspection of railway traffic were also issued by the
Government of Madras, the Chief Commissioner of the Central Provin-
ces, the Residents in Hyderabad and Mysore, and the Agents to the
Governor General in Rajputana, Central India, and Baluchistan. These
rules do not require examination in detail. The regulations prescribed
by the Government of Madras require, amongst other matters, that
any person who has been in an infected locality within the previous
ten days, and is unable to satisfy the inspecting officer that he is
proceeding to a fixed place of residence, shall be detained for ten
days in segregation.
Hospital accom-
modation and
medical staff.
In Madras hospital accommodation was provided at the inspection
stations of Guntakal, Podanur, Arkonam, Kondapali, and Tuticorin.
The medical staff detailed for plague duty consisted of 3 com-
missioned medical officers, 3 assistant surgeons, 2 civil apothe-
caries, and 15 hospital assistants. Midwives were employed as
female inspectors at five principal inspection stations. In the Central
Provinces special temporary plague hospitals were maintained at
Nagpur and Itarsi, and hospital accommodation for plague patients
at Jubbulpur and Bilaspur. The plague medical staff consisted of
2 commissioned medical officers, 4 assistant surgeons, 4 hospital
assistants, and 1 female hospital assistant at both Nagpur and
Itarsi. In the Central India Agency hospital accommodation was
provided at Sutna, Indore, Rutlam and Ujjain. In addition to the
medical staff transferred from Manikpur to Sutna the plague staff com-
prised 2 commissioned officers, 2 medical officers of the State, and 5
hospital assistants. Nurses were posted at Sutna and Rutlam. In
Rajputana temporary plague hospitals were established at twelve
places. At Ajmere and Bandikui there were European medical officers
and female assistants, and there were native subordinates at other
places. In Mysore hospital arrangements were made in the city and
at the inspection stations, and female hospital assistants were em-
ployed at Bangalore, Harihar, and Yesvantpur. In the Hyderabad
State temporary plague hospitals with doctors in attendance were
established at the various inspection stations ; and female doctors were
posted to Wadi and Gulburga. The arrangements in Baluchistan
have already been described.
Prevention of
the evasion
of inspection.
Sind.
Where circumstances favoured such a course, passengers sometimes
endeavoured to evade inspection, and various measures were adopted
by the Local Governments to prevent their efforts from succeeding. It
has already been noticed that the Commissioner in Sind caused booking
to be closed at the stations in the immediate neighbourhood of
Rohri in order to prevent passengers desiring to avoid inspection
CHAP. X. ]
spread of infection by land.
329
Baluchistan.
Shikarpur.
Khanpur.
Madras.
Bengal.
starting their journey at a neighbouring station, and that the Agent
to the Governor General in Baluchistan was obliged to prevent
travellers alighting at the desert stations near the Punjab border
in order to evade observation at Sharigh or Sibi. Similarly, booking to
the stations immediately on either side of Shikarpur was prohibited
in order to prevent evasion of the Shikarpur inspection, and book-
ing to Tando-Thoro, a small station, distant two miles from Hy-
derabad in Sind, was prohibited in order to prevent evasion of inspec-
tion at this latter place. To prevent evasion of inspection at the
important station of Khanpur, the Government of the Punjab insti-
tuted a system of moveable inspections. Attention was drawn to the
fact that some passengers evaded the inspection at Khanpur by
alighting at other stations and walking across country to rejoin the
railway at some place beyond. Arrangements were therefore made
under which the inspecting medical officer varied the place of
inspection from day to day. Ten stations, situated above or
below Khanpur, were appointed inspection stations ; and in the event of
cases being discovered in the course of the inspection at any of these
places, the suspects were to be sent for treatment and observation either
to Khanpur or to Sher Shah. The rules issued by the Government of
Madras provide that, if a passenger from an infected district appears
to be attempting to evade inspection by alighting at a station short
of that for which his ticket is taken, he shall be obliged to continue
his journey as far as the next inspection station. The Bengal Regu-
lations of November 1897 contain the following rule :—
" In the event of a traveller from an infected area alighting at an
intermediate station with the object of obtaining a fresh ticket, so as
to conceal the fact that he comes from an infected area, the railway
police will take down his name and the number of the fresh ticket
issued, and will send information down the line, so that he may, on
alighting, be placed under observation."
Lighting of
stations, and
travellers by
goods trains.
Minor matters on which orders were issued by the Government of
India were the proper lighting of inspection stations, and the notifi-
cation to the inspecting officers of the carrying of passengers by
goods trains.
Results.
The result of the carefully devised scheme of inspection which ;
has now been described proved the efficacy of the arrangements.
Leaving aside the outbreaks at Khandraoni and Hardwar and the cases
that infected these places, only 67 cases of plague escaped across the
Bombay and Sind frontier during the first period of the epidemic, of
these 57 were detected at inspection stations along the railway routes.
Thus, so far as is known, only 10 cases of plague were introduced
42
330
Measures to prevent the
[CHAP. X.
from the Bombay Presidency and Sind into the rest of India and
passed undetected through the line of inspection station.* These to
cases occurred in the following localities in the North-Western
Provinces and the Punjab :—
North- Western Provinces,
Bareilly
Rai Bareilly
Unao
Luck now
Cawnpore ... ... ... ...
Punjab.
Rawalpindi district
Sialkot
I
I
1
2
1
2
2
No case, detected on the railway or undetected, is known to have
passed into Bengal viâ the North-Western Provinces, the Central
Provinces, or Madras. Having in view the rigorous system of
observing the suspicious enforced at the Khana inspection station,
it is unlikely that a single case of plague has arrived as far as that
station along the main route from Bombay.
Surveillance of Travellers.
Orders issued by
the Government
of India.
Registration
of names,
addresses, etc.,
of passengers for
communication
to local
authorities.
Functions of the
railway staff,
After consulting the Local Governments and Administrations
principally concerned, the Government of India issued a resolution in
the Public Works Department, dated the 6th March, prescribing
measures to facilitate the surveillance of travellers arriving by railway
from infected districts by action in co-operation with railway
administrations. It was stated in this resolution that the Government
of India desired that all passengers from stations within the limits of
the infected area should, on arrival at stations outside these limits, and
at which no staff had been posted for the inspection of travellers, be
required by the railway staff to furnish to the police, or other agency
designated by the Local Government, their names and addresses,
and such other particulars as might be required for the maintenance of
a check on their proceedings and movements. Railway administra-
tions were informed that the Government of India looked to them to give
* During the recrudescence a few more cases of plague have been carried beyond
the borders of the Bombay Presidency. Three of these cases occurred in the Madras
Presidency—one of them at Madras itself. Almost all were detected at the inspection
stations. In October 1897 a small outbreak of plague was reported from a village in the
Jullunder District of the Punjab and has since spread to some neighbouring villages. It
is not known whence the infection was derived. Some villages in the Sirohi State of
Rajputana, on the borders of the Palanpur State, and some villages in the Naldrug
District of the Hyderabad State, on the borders of the Sholapur District of the Bombay
Presidency, have also become infected, In the latter case the infection was probably
carried by road.
CHAP. X. ]
spread of infection by land.
331
all the assistance in their power to facilitate the arrangements made
by the Local Governments ; but it was recognised that the time of
the station staff was ordinarily too fully occupied with railway duties
to admit of their undertaking any specific responsibilities beyond stop-
ping the passengers, and thus giving an opportunity for making the
necessary enquiries. It was, however, suggested that at smaller
stations the railway staff might, in the absence of any special agency,
record the names and addresses of passengers coming from the
infected area, and forward the names and addresses, and any particulars
of importance (such as attempts to evade inspections by re-booking), to
the next inspection station, or to any authority designated by the
Local Government. It was also suggested to the Local Governments
that they should arrange to procure the necessary particulars at stations
where an inspection staff was employed. A list of the railway stations
within infected limits was circulated to Local Governments and
Administrations and revised from time to time as the area of infec-
tion widened.
Rules made
by Local
Governments,
Central
Provinces.
Some of the Local Governments and Administrations made
additions to their railway inspection rules with a view to utilize the
arrangements made for co-operation with the railway administrations.
The most complete rules on the subject were issued in the Central
Provinces. In a notification, dated the 18th March, the Chief Commis-
sioner directed that all travellers arriving by rail from stations
within the infected area should be kept under surveillance
until the ten days' period of incubation had expired. Lists of the
infected stations were supplied to the railway officials. The
railway police at all stations were directed to take down the
names and addresses of passengers alighting from stations entered in
the list, with particulars of the places whither they were bound and the
length of time they meant to stay there. To enable these particulars
to be recorded, a railway police officer accompanied the inspecting
medical officer at places where individual medical inspection was
made. At other stations the railway staff were directed to assist
the police officer to take down the particulars, either in the course
of collecting the tickets, or by checking the exit of passengers, or
otherwise as might be found convenient. The railway police officer
was directed to communicate the particulars to the Civil Surgeon
of the district and to the District Superintendent of Police. The latter
sent information to the officer in charge of the police station within
whose jurisdiction the destination of the traveller was situated. The
officer in charge of the police station was directed to satisfy himself
by enquiry of the state of the traveller's health for a period of ten
days after his arrival, and in the case of the traveller falling ill to take
332
Measures to prevent the
[ CHAP. X.
action in accordance with the general plague regulations of the
province.
Rules issued by
the Government
of Bombay.
The rule issued by the Government of Bombay was to the follow-
ing effect :—
" Railway station masters shall require all passengers coming from
infected stations to give names and addresses, business which has
brought them to the station and intentions regarding future move-
ments.
* * * * A station master shall forward a copy of his
list containing the above information every day to the nearest mam-
latdar* who shall forthwith instruct the headman of the town or
village or the secretary of the municipality to watch such person and
send a report if he is ill or departs within ten days."
Arrangements in
the Sholapur
district.
The following description given by the Collector of Sholapur of
the arrangements enforced at the railway stations in his district is
an instance of the manner in which the rules were worked in the
Bombay Presidency:—
" A kar kun† is posted (at the railway station) who takes the
names and destinations of all passengers alighting from Dhond and
stations beyond, a dakhila (pass), containing his name and place
from where he has come, is then given to the passenger with orders
to present it to the patil‡ of the village to which he is going immedi-
ately on arrival. At the same time the karkun despatches by post a
post-card to the patil containing the same information. The patil is
ordered to keep such arrivals under special observation for eight
days. At the end of each week the patil submits to the mamlatdar
a statement showing the results of such observation, which is com-
pared with the statement received from the station clerk,"
Arrangements
in the North-
Western
Provinces.
The Government of the North-Western Provinces caused parti-
culars to be recorded only at the stations where a medical inspection
staff was posted. It was said by that Government that the plan was
not found to work well and that it would not therefore be extended.
Bengal.
The Government of Bengal issued orders that at Chapra (Ben-
gal and North-Western Railway), Chakardharpur (Bengal-Nagpur
Railway), and Dinapore (East Indian Railway), the stations where
tickets are checked, the railway police should take down the names,
addresses, and destination of any person holding a ticket from anyone
of the infected stations, and should report these particulars to the Dis-
trict Superintendent of Police of the districts for which the passengers
were bound. These arrangements were largely extended in the regu-
lation issued by the Government of Bengal in November 1897. Two
* Executive officer of the Government.
† Clerical officer.
‡ Village headman.