NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
182
Measures in the City of Bombay.
[ CHAP. VII.
the 20th, 21st and 23rd three further cases occurred, and then almost
immediately the whole village became epidemic.
" Like all fishing villages, the houses here were of kutcha construc-
tion, with cadjan roofs brought down as low as possible to the
verandahs, and so effectually stopping light and ventilation ; there
was likewise a total absence of drainage.
" On the 19th of February a gang of some 300 disinfecting coolies
were sent to the village to supplement the disinfection of individual
infected houses, which was already in progress. The coolies com-
pleted their work on the 26th February. The roofs were stripped
from all the houses, and in many instances burnt, all the houses were
disinfected and limewashed, and the disease was effectually stamped
out."
General lesson
to be derived
from the
seven cases.
The lesson to be derived from these seven cases is the same as
the lesson pointed to by the facts narrated in previous chapters of
this report, and by the facts that will be narrated in subsequent
chapters. Filth, overcrowding, bad ventilation, and bad drainage
are the fostering causes of plague. Where the conditions are not
hopelessly insanitary, the vigorous prosecution of sanitary improvement
combined with the segregation of the sick may check or stop the
course of the disease. But in the worst class of cases nothing but
the evacuation of the polluted locality and its destruction or a revolu-
tion in its sanitary conditions, will stay the epidemic.
Disposal of the
city refuse.
A matter of general sanitary reform which had for a long time
engaged the attention of the Municipality and which was also care-
fully considered by the Committee was the disposal of the general
rubbish and refuse of the city. This rubbish had for a long time past
been conveyed out of the city in carts and thrown on to a place called
the flats, where the fresh deposit was daily covered by earth. The
existence of this accumulation of refuse in the immediate vicinity of
the city was held to be a danger to the health of the population at all
times, and particularly so at a time of plague epidemic. Arrange-
ments were made to remove the rubbish of the city to a more
distant place.
General
improvement
of the sanitary
condition of
Bombay,
Finally, the Government of Bombay have under their considera-
tion the general amelioration of the sanitary condition of the city,
and its protection from fresh calamity by opening out the congested
tracts, and by the substitution of reasonably well ventilated and
sanitary buildings for the overcrowded, dark, and filthy tenements
which are huddled together in the narrow lanes of Bombay.
CHAPTER VIII.
MEASURES IN THE BOMBAY PRESIDENCY
AND SIND.
Preliminary Remarks.
Division of the
subject.
The first section of the present chapter contains an account of
the general orders issued by the Government of Bombay, and discusses
a few matters connected with those orders which require special notice.
In the succeeding sections the manner in which effect was given to
the orders is illustrated by a description of the operations carried
out in some important plague centres, notably Poona, the district of
Kolaba, and the town of Cutch-Mandvi, in the Presidency proper ;
and Karachi, Hyderabad, Sukkur and Rohri in Sind.
The arrangement of subjects adopted in the last Chapter will, in
so far as is possible, be again followed.
Regulations
under the
Epidemic
Diseases Act,
General Measures.
The first set of general regulations under the Epidemic Diseases
Act was issued by the Government of Bombay on the 2oth of Feb-
ruary. A number of additions were made to the rules in the light
of later experience, and the whole series was afterwards consolidated
in a notification, dated the 29th of March. The consolidated rules
are reprinted at length in Appendix IV. Their general purport is
explained in the following paragraphs, which deal with the measures
under their several heads.
Appointment of
Plague
Authorities.
OFFICERS.
The regulations in the first place empower District Magistrates
to appoint special officers, either by name or by virtue of office,
to be Plague Authorities for the purpose of devising and carrying
out under his general directions all measures necessary to prevent
the spread of the plague.
Duties of the
District
Magistrate
and the police.
On District Magistrates the special duty is laid of doing their
utmost, both personally and through others, to make it generally
understood that the rules are absolutely necessary for the public
184 Measures in the Bombay Presidency and Sind* [ CHAP. VIII.
safety ; they are also directed to see that no needless inconvenience
is caused, that examinations are carried out with as much regard as
possible to sex and to the customs of the country, and that everything
is done to meet the wishes of the people so far as is compatible with
the public safety. On the police the special duty is laid of assisting
any duly appointed Plague Authority in the enforcement of the
regulations.
Three main
measures
adopted.
DETECTION OF CASES,
It has already been said that the prompt detection of plague
cases is of the very first importance. The measures adopted in the
Bombay Presidency and Sind to secure this end fall under three
heads : (1) the compulsory report of cases and deaths, (2) house
visitation, and (3) the examination of corpses.
Compulsory
report.
In any locality to which the rule is applied by the District Magis-
trate the regulations require householders to give immediate informa-
tion to the nearest Plague Authority of (a) any sickness due or likely
to be due to plague, and (b) any death, whatever may be the cause
of it. The Plague Authority (if he be not himself a medical officer)
is required to give notice to the nearest duly qualified medical
officer, and the medical officer is required to come to the place in-
dicated.
Grant of
certificate of
cause of death.
On receipt of information of any death, the Plague Authority
must register the death and give the informant a certificate. Until
such a certificate has been received, the body may not be removed
for the purpose of performing the last rites. If a body is removed
in contravention to this order, the funeral procession may be stopped
and interrogated, and some member of the party may be detained
until all necessary information is given. Medical practitioners are
also required to give notice of any plague cases or cases of fever with
glandular swellings which come to their notice.
Every officer of the Government, however subordinate his position,
is required to give notice at the nearest police station or Government
office of every suspicious case of illness and every death likely to be
due to plague which comes to his notice.
Action to be
taken on receipt
of information.
Immediately on receipt of information of a death or suspicious
case of illness, the Plague Authority must visit the dwelling, and take
all measures necessary to ascertain if it contains any plague case,
suspected plague case, or infected person. Entry may, if necessary,
be made by force^ and any person found in the dwelling may be
detained for examination. Details regarding the working of the
visitation rule will be given in the second part of this Chapter.
Plague Authorities are also empowered generally to have the cause
CHAP. VIII. ] Measures in the Bombay Presidency and Sind. 185
of death enquired into in all cases and, unless satisfied, to treat the
case as a plague case.
Examination of
corpses.
Feelings of the
people.
Rajputana,
The examination of corpses with a view to discover plague cases
is a matter that on more than one occasion engaged the attention of
the Government of India. They feared that the general enforce-
ment of this measure might prove peculiarly repugnant to the feelings
of the native community. In the month of June, Surgeon-Major Reade
(one of the officers with Chinese experience) paid a visit to Rajpu-
tana. He feared that plague might exist in Rajputana and recom-
mended to the Administrative Medical Officer of the State that a
system of corpse inspection of a thorough character should be insti-
tuted in the towns of Ajmere, Jaipur, and Udaipur. When this
matter was brought to the notice of the Government of India they
considered it necessary to inform the Agent to the Governor
General in Rajputana that in their opinion this suggestion would
be so strongly resented that the introduction or the measure would
not be justifiable, except under circumstances of much greater
danger than then existed. The Agent to the Governor General
replied that the proposal had not been adopted on account of the
discontent it would have caused,
Sind.
The examination of corpses in Sind came under special notice in i
connection with an order of the Commissioner to continue the
process after the decline of the disease with a view to the immediate
detection of any recrudescence. On enquiry it was ascertained from
the Commissioner that the measure had been introduced with
satisfactory results in the town of Shikarpur, and had then been gene-
rally adopted. The Commissioner, Mr. Wingate, made the following
remarks on the subject :—
" When I sent Surgeon-Captain Milne to Shikarpur in March,
there was every reason to apprehend that plague was about to break
out there as it had broken out in neighbouring Sukkur. The result
would have been disastrous, both because of the size of the town and
because Shikarpuris have business relations everywhere, and the
town was crammed with refugees from Karachi and Hyderabad.
Deaths from imported plague were increasing. The death-rate from
all causes was considerably in excess of the average. From the 19th
March, of his own accord, Surgeon-Captain Milne examined every
dead body himself. The first satisfactory result was that the
examination proved that there was no plague in the town. This
gave the town confidence. Next, any imported case was immediately
discovered. Whether it was due to the examination of bodies or
to the excellent arrangements for detaining new-comers under
observation, or whether the protection of the town was due to other
34
186 Measures in the Bombay Presidency and Sind. [ CHAP. VIII,
means used or the immunity it enjoyed was independent of all means,
I am unable to discriminate, but the fact is that the imported cases
ceased. People with sick relatives did not attempt smuggled
entry.
"I visited Shikarpur early in April and the examination of every
dead body impressed me. I met the townspeople, and though I
endeavoured to meet some of their wishes, not a word do I recollect
being said about the examination of dead bodies. On the. contrary,
the people were free from further inquisition and the measure
was, I think, liked. The measure was so effectual that it recommended
itself and soon became general in most towns, and, so far I as know,
without complaint. I have had numerous petitions relating to segre-
gation, never one about examination of dead bodies. "
Mr. Wingate subsequently ascertained that the examination would
be repugnant to the feelings of the people as soon as the fear of plague
was removed, and the measure was abandoned when the epidemic
died out.
Hardwar.
During the outbreak at Hardwar the examination of corpses
was one of the measures which the Government of the North-West-
ern Provinces and Oudh carried out with the concurrence of the
inhabitants, but it must be remembered that the measure was
adopted at a time of great local alarm.
Bombay City.
In the month of August when the reported plague cases in the
City of Bombay showed some tendency to increase, and a rapid rise of
the total mortality of the city created a fear that the disease had again
broken out and that cases were escaping detection, it was considered
whether an examination of all dead bodies in the city should be en-
forced. The Government of Bombay decided against this course. In
the first place there was a strong consensus of medical opinion that
the inspection of corpses would not have any appreciable effect towards
the more accurate registration of the cause of death, for the
diseases to which the great majority of deaths were due were known
to be devoid of bubonic symptoms. In the second place, the objections
to corpse inspection in Bombay were so great that the Government
hesitated to adopt it in the absence of certain and great advantage.
Poona.
The following remarks in the late Mr. Rand's report on Poona
are of interest :—
" In suburban and cantonment limits, where the death-rate never
reached the height it did in the city, arrangements for the medical
examination of corpses of persons who died in places other than
hospital were made at an early stage of the operations. This had
the effect of keeping down the number of houses which had to be
disinfected and their inmates segregated, since when the
CHAP. VIII.] Measures in the Bombay. Presidency and Sind. 187
examination showed that death was not due to plague, disinfection
and segregation were inapplicable.
" In the city, owing to the calls upon the time of the medical officers
employed, a system of medical examination of corpses was not intro-
duced till May 19th, when the work of the search parties stopped, and
since that date it has been performed by Surgeon-Captain Beveridge,
and has had the effect of saving the public from much inconvenience.
" By this system of inspection of dead bodies by a medical man
combined with efficient death registration arrangements, it is improb-
able that any considerable number of deaths from plague can
escape the notice of the authorities, and the enforcement of disinfec-
tion and segregation in all doubtful cases which it renders possible
should go far ta prevent a recrudescence of the epidemic."
Officials stationed
at burial and
burning grounds,
In Poona and at other places officials were posted at burial and
burning grounds to record the burials and cremations. If the funeral
party failed to produce a certificate of the cause of death, inquiry was
made to ascertain where the death had occurred, and, if necessary, the
precautionary measures were enforced.
Periodical
mortality
statements,
A useful measure enforced by the Government of Bombay
was the submission of periodical mortality statements for all the
principal places in the Presidency. A scrutiny of these statements
showed whether there was an unusual mortality pointing to the
existence of a hitherto undiscovered outbreak of plague.
General rule.
SEGREGATION OF THE SICK.
The rule for the segregation of the sick empowers every medical
officer who has been appointed a Plague Authority to examine all
suspicious cases and all cases brought to his notice, and to detain and
segregate persons suffering or suspected to be suffering from plague
in any place appointed for the purpose. The District Magistrate or
any officer appointed by him is empowered to take possession of any
vacant ground or building for segregation shelter, compensation being
afterwards paid.
The District Magistrate is also empowered to prohibit the removal
of plague patients from houses or sheds, except in accordance with
regulations framed by himself.
General rule.
SEGREGATION OF PERSONS LIKELY TO BE INFECTED.
By an amendment of the original rules published on the 30th of
August, Plague Authorities are empowered to detain, in an appointed
place of observation, and for a period not exceeding ten days, any
188 Measures m the Bombay Presidency and Sind. [CHAP. VIII.
person found within the limit of their jurisdiction whom they consider
likely to be infected.
Funeral
processions and
burial and
burning of
corpses.
DISPOSAL OF CORPSES.
The two following rules are prescribed to regulate the disposal of
corpses :—
" The District Magistrate is empowered to make regulations, when
he deems it necessary, for prescribing the route which shall be taken
by a funeral procession from the place of death to the graveyard,
burning ground or other place for final disposal of the corpse and the
places (if any) at which such procession may halt, on its way, for
funeral prayers, ceremonies or other purposes, for enforcing burial
in certain places or at a certain depth and for: requiring that quicklime
be placed with the corpse ; and may prohibit the burial or burning of
corpses of persons reasonably supposed to have died of the plague in
or upon ground other than that specially assigned by him for such
purposes."
Persons touching
plague corpses.
" When a person dies of the plague elsewhere than within the
limits of a hospital, no one shall touch the corpse, except those who
undertake the necessary duties of preparing it for the funeral. Such
persons shall disinfect themselves according to the orders of the
Plague Authority or person authorized by the Plague Authority."
General rule.
DISINFECTION OF CLOTHING, ETC.
The Plague Authority may require people to adopt such measures
as he thinks necessary for the disinfection of their persons,
clothes, and other property. He may also in cases of necessity order
any such property to be destroyed. The amendment of the 30th
August specially empowers the Plague Authority to take measures
for the disinfection of the clothing, etc., of persons likely to have
been infected.
Disuse of
infected and
insanitary
houses.
DISINFECTION OF HOUSES AND GENERAL SANITARY
PRECAUTIONS.
Any Plague Authority appointed for the purpose may prohibit
until further orders the use as a dwelling house of any building which
is or has been occupied by a sufferer from plague, or which is in his
opinion in such an insanitary condition as to be unfit for human
habitation. If necessary, the inmates may be forcibly removed from
such a building.
Abatement of
overcrowding.
The Plague Authority may also require the abatement of over-
crowding in any dwelling so overcrowded as to endanger health, and
CHAP. VIII. ] Measures in the Bombay Presidency and Sind. 189
after the expiry of due notice may cause such number of the inmates
as he thinks proper to be, if necessary, forcibly removed.
Cleansing and
disinfection.
Destruction of
huts.
In the case of any dwelling treated under the above rules, or in the
case of any dirty or insanitary building the Plague Authority may clean
and disinfect the place, and may disinfect or destroy any clothing or
other property found in it, Forcible entry is permitted if necessary.
The operation may be performed in case of necessity immediately
and without previous notice, or the Plague Authority may require the
householder to carry out the necessary measures, intervening himself
only if the householder fails to comply with the order. The Plague
Authority is further empowered, with the consent of any First Class
Magistrate having jurisdiction in the locality, to remove or burn any
huts or erections in which a case of plague has occurred, or which are
likely, from their insanitary surroundings or conditions, to give rise to
or facilitate the spread of the disease.
Ventilation.
District Magistrates or Plague Authorities are also empowered to
break holes in the walls or roofs of houses, or to remove roofs
altogether, for the purpose of admitting air and light.
General rule.
EVACUATION OF INFECTED LOCALITIES.
" A District Magistrate is empowered to direct the evacuation of
houses in the neighbourhood of an infected house, or of a block of
houses, or a particular locality and to prohibit re-occupation of such
houses or locality without permission. Notice for such period as the
District Magistrate thinks suitable should be given, and temporary
accommodation should be provided. "
The subject of the evacuation of infected localities will be con-
sidered in some detail in the account of plague administration in Sind.
PAYMENT OF COMPENSATION.
Principle
enunciated by
the Government
of India.
In a Resolution of the 23rd March the Government of India laid ]
down the principle which should govern the payment of compensation
for property destroyed, in order to prevent the spread of plague, in
the following terms :—
"The Government of India are of opinion that the principle upon
which the payment of compensation should be regulated is that laid
down in the Calcutta and Bombay Acts and followed in the plague
regulations of the Governments of Bengal and Bombay. Persons should
not be considered entitled to compensation because it becomes neces-
sary to destroy property in their possession which is dangerous to the
public health, and the prescribed authorities should always retain the
190 Measures in the Bombay Presidency and Sind. [CHAP. VIII.
Compensation
not claimable of
right but
liberality to be
shown to poor
people.
discretion to award or refuse compensation according to the circum-
stances of the case. At the same time, it is of importance that the
disinclination of the poorer classes to disclose cases of plague should
by all reasonable means be reduced, and the Government of India
consider that, in the case of the destruction of bedding, clothing and
similar articles, the authorities may be reasonably liberal in admitting
payment of compensation, when the loss would fall upon people in
very poor circumstances, to whom it would be a great hardship to
bear it. "
General rules
issued by the
Government of
Bombay.
The following is the general rule issued by the Government of
Bombay to regulate the payment of compensation :—
" Before the destruction of property of special value under Rule
12 or 13, the value of it shall be assessed by a Panch* of three persons,
including the President, who shall be an officer appointed by the
District Magistrate by name or by virtue of office and by general
or special order. The President shall appoint the two other members.
Subject to the sanction of the District Magistrate or of any officer
specially empowered by him in this behalf, not being lower in grade
than a First Class Magistrate, the award of the Panch shall be final
and conclusive. A Plague Authority is empowered to decide whether
an article which it is proposed to destroy is of sufficient value for a
Panch to be called to assess its value. If he decides it is not of
sufficient value, he may destroy it on the spot, and may in his
discretion pay compensation to the owner : provided, however, that
no "person shall be entitled as of right to claim any compensation
whatsoever. It is the desire of Government that Plague Authorities
should show liberality and promptness in the exercise of their power
to award compensation, and that, for example, a very poor man
should be promptly compensated for the loss of clothes which, though
of no special market value, may be of considerable value to him. "
Plague
Committees for
large towns.
APPOINTMENT OF PLAGUE COMMITTEES.
Whilst in most places the conduct of the operations was entrusted
to the control of the District Magistrate—the executive head of the
district administration—in some large towns which were the scene
of severe outbreaks the example of the City of Bombay was followed
in the appointment of Special Plague Committees to carry out, under
the orders of the Government, measures to suppress the plague.
Poona, Karachi,
Hyderabad, and
Sukkur and
Rohri.
Recourse was had to this procedure more frequently in Sind
where the disease had a tendency to locate itself mainly in large
towns, than in the Presidency proper where the epidemic spread in
a more general manner over the country. Poona was the only place
* Committee of Arbitration.