NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
CHAP, X. ]
spread of infection by land.
343
Rules issued
by the
Government of
Bombay.
Objection to the
form of the
detention rule.
Use of the word
"quarantine."
Government. It is situated on the Mahableshwar range of hills with
a general elevation of from 4,500 to 4,700 feet above the sea-level.
The regulations framed for the protection of Mahableshwar and the
neighbouring hill station of Panchgani, and a report on the arrange-
ments at Mahableshwar are reprinted in Appendix VIII. The regu-
lations were issued on the 6th April in supersession of a previous set
of rules. The Government of India took exception to a clause contained
in the rules requiring the quarantine of all persons, except those belong-
ing to certain specified classes. They stated that the detention of
persons likely to carry infection should be secured by giving a wide
discretion to the inspecting medical officer; and that though the opera-
tion of this measure and of the measures prescribed by the
Mahableshwar rules would probably give much the same results, the
proper and fair way to secure these results was by the exercise of the
discretion of the inspecting officer, and not by treating as suspicious
persons, except those belonging to certain exempted classes.
The use of the word " quarantine," the meaning of which is the
detention of all persons absolutely or fora specified period (originally
forty days), is also inadmissible in describing arrangements to secure
the observation of travellers, and the segregation of, and the
adoption of other precautionary measures towards, persons likely
to carry the seeds of infection.
Mr. Alexander's
report on the
operations.
Series of
observation
posts.
The report on the measures carried out at Mahableshwar was
written on the 8th June by Mr. Alexander, Superintendent of Police,
who was in charge of the operations. He took over charge on the
1st March and his duties terminated on the 2gth May. The station
was surrounded by a series of posts established on the different
approaches to the place. There were five main posts on the principal
roads of approach and several subsidiary posts. The posts were in
charge of a police force consisting of 4 jemadars (police sergeants),
3 naiks (subordinate police officers), and 32 constables.
Inspection and
detention of
travellers.
Observat on
camp.
Madical
surveillance of
At the protective posts travellers were either permitted to pass I
on, or were stopped for detention under medical surveillance
in an observation camp. In the camp which Mr. Alexander
considered the best equipped, the inhabitants were housed in huts
divided from one another by a considerable space. If a plague case
occurred in one of these huts, it could be burnt down. In all about'
870 persons were detained under observation in the different camps.
It was found that the public resorted to many contrivances to prevent
their detention under observation. All doubtful cases were reported to
Mr. Alexander. In all cases in which the precaution was considered
necessary persons permitted to pass into Mahableshwar without
344
Measures to prevent the
[ CHAP. X,
persons allowed
to enter the
station.
Attendance at
hospital.
previous detention were kept under medical surveillance until the
ten clays' incubation period had expired, and for this purpose they
were required to attend daily at the hospital. The preventive
posts submitted daily reports to Mr. Alexander showing who
had arrived during the day and how they had been disposed of.
From these daily reports a register was prepared in which
was recorded the name of every person entering Maha-
bleshwar, his residence, the place he came from, the date on which he
left that place, the date of his arrival, and the date up to which he had
to present himself at hospital. In this register the attendance at hos-
pital was every day marked off, and Mr. Alexander was thus able to
see at once what persons had failed to attend hospital and to take the
necessary action to secure the enforcement of the medical surveillance.
2,200 persons attended the hospital for periods varying from one
to eight days.
Cart-drivers.
Carts and
travellers passing
through the
station.
Villagers bring-
ing in the daily
food-supply.
Cart-drivers with carts were admitted straight into Mahablesh-
war, but were directed to move out as soon as they had completed
their business. As an additional precaution all cartmen moving from
the Konkan to the Satara district, and vice versá, and who did not
wish to stop at Mahableshwar, were escorted through the place
and not allowed into the bazar. Travellers who did not wish to stop
at Mahableshwar were escorted through in a like manner. Special
precautions were taken to prevent the police from interfering with
the villagers of the neighbourhood who bring daily supplies into
the station.
Only one case of
plague occurred.
Only one case of plague occurred. The sufferer was a Hindu
woman who had arrived from Poona and was undergoing the usual
detention in one of the camps. She and her relatives and attendants
were kept in the camp and all the other inhabitants, over 70 in
number, were moved to a neighbouring camp where there was
accommodation for them. Both camps were strictly segregated. The
woman died and her body was burnt outside the camp. There was
no spread of infection,
Protection of
Bombay against
re-infection.
General Gatacre gave the following account of the measures
adopted to prevent the re-infection of Bombay by persons entering
on foot :—
Places of entry
for foot
passengers.
"There are five ways by which people can eater Bombay Island
on foot:—
(1) The Bandora or Mahim Causeway.
(2) The Coorla or Sion Causeway,
CHAP. X. ] spread of infection by land.
345
(3) The Great Indian Peninsula Railway Causeway.
(4) The Bombay, Baroda and Central India Railway Cause-
way.
(5) A tract of land lying between Coorla on the mainland
and thevillage of Sion on the island of Bombay. This
is sometimes flooded, but is generally fordable.
(6) A small railway line running along a bund beside the
Tasua main water-pipe from Chimbur on the mainland
to Sion.
Closure of four
entries.
" These extend over a space of no less than five miles, and, as it
would have been impossible to hold examinations at all these points
without a very large staff, all the entrances were closed, with the
exception of 1 and 2. A police guard was posted to prevent the
public crossing by the railway causeways on foot; the ford was
watched by a military guard, who turned back all the people who
tried to go by that way and made them go by the Sion Causeway,
and the line over the water main pipe was closed by keeping the
swinging bridge always open.
System at the
open causeways.
"The inspection actually began on March 24th. The causeways
were closed from 7 P.M. to 6 A.M. by a military guard to all, except
those who had obtained a special pass. On April 21st, 8 P.M., was
fixed as the hour for closing the causeways ; and finally on June 6th,
the Sion Causeway was opened an hour earlier to suit the convenience
of the market gardeners who have to bring their produce to the
Bombay market at an early hour.
Mahim
Causeway.
" On the Mahim Causeway the inspection was at first held on the
Bombay side. Before the monsoon it was removed to the Bandora
side. The staff consisted of two medical officers, assisted by the
Mahim Sub-divisional Officer and nine police sepoys. As long as
there was a hospital on the spot, the nurses used to do the work of
examining the females. Since the hospital has been closed, Mrs.
Sanders has been engaged for that work.
Sion Causeway.
" The examination of the Sion Causeway was held at the Sion
end. The staff consisted of two medical officers and two medical
students. Since the abolition of the hospital there, a lady doctor,
Mrs. Beale, has been engaged for the examination of females.
Results.
" The number of cases detected was as under :•
Suspicious cases ...
Plague cases
...
Mahihl.
.0.
,,,
36
*** *** 13
Sion.
16
11"
44
346
Measures to prevent the
[ CHAP. X.
PROTECTION OF THE PUNJAB FRONTIER.
Protection of the
road and river
routes into the
Punjab. General
regulations.
Observation
posts at Rojhan
and the Mithan
kot ferry.
Route restric-
tions.
The Government of the Punjab issued a special set of rules to
protect the road and river routes leading from the direction of Sind.
In the first place general orders were issued to the effect that (a) any
ferry or any portion of a navigable steam, with the approaches, might
be appointed to be a place of inspection to which the railway inspec-
tion rule should apply in so far as they were applicable ; and (5)
the public or any class of persons might be prohibited by Govern-
ment notification from travelling to or from any local area, either
absolutely or otherwise than by way of a specified place or places.
These general regulations were applied to the case of the Sind frontier
by a set of special notifications which appointed the village of Rojhan
and the Mithankot ferry on the River Indus, both in the Dera Ghazi
Khan district, to be places of inspection and which prohibited travel-
lers from the direction of Sind and the Bahawalpur State from visiting
any part of the Dera Ghazi Khan district otherwise than by way of
the Rojhan observation post, the Mithankot observation post, or
some public ferry higher up the stream than the ferry of Mithankot.
The effect of the rules was to prevent any one travelling from
the direction of Sind by road or river from entering the Punjab
without being subjected to observation, and if necessary to deten-
tion. The arrangements are illustrated by the map at page 19 of
Vol. IV.
Pilgrimages in India.
Special dangers
of pilgrimages.
Special anxiety was experienced lest the infection of plague
should be spread by means of the pilgrimages and large religious
or semi-religious assemblages which form a common incident
of Indian life. The persons taking part in these pilgrimages
and assemblages belong in many instances to classes whose habits
and method of life render them peculiarly liable to infection, the
collection of large bodies of such people in a more or less crowded
space offers conditions very favourable to the spread of epidemic
diseases, and should such disease break out amongst them they endan-
ger all parts of the country to which they return.
Orders of the
Government of
Bombay.
The Government of Bombay and other Local Governments and
Administrations issued special regulations to minimise this peril. Rule
20 of the general Bombay rules provided that the District Magistrate
might, with the previous sanction of the Commissioner, prohibit either
CHAP. X.]
spread of infection by land,
347
Prohibition of
fairs in the Thaua
and Poona
districts.
wholly, or subject to such restrictions as he might impose, the holding
of fairs, caste feasts, or other assemblages which were likely to assist
the spread of the plague. A number of orders were issued under
this Regulation, and the Government of Bombay also issued a
separate order prohibiting for a time all pilgrimages and fairs in the
Thana and Poona districts. In October 1897 a similar order
was issued prohibiting the holding of a fair at Panharpur in the
Sholapur district.
Hardwar in the
North-Western
Provinces.
Sakhi Sarwar in
the Punjab.
In another chapter the precautions taken by the Government of
India and the Government of the North-Western Provinces and Oudh
to prevent the spread of infection by visitors to the renowned place of
pilgrimage at Hardwar have been described. In the Punjab orders
issued forbidding all persons coming from the direction of Sind to visit
Sakhi Sarwar in the Dera Ghazi Khan District, where there is a shrine
which is a favourite resort of pilgrims.
The Jagannath
festival in
Bengal.
In the Puri district of Orissa in Bengal special precautions were
taken at the time of the annual Car festival of Jagannath, a sacred fes-
tival which is attended by a large concourse of pilgrims from all parts
of India. In travelling towards Puri the pilgrims from the Bombay
Presidency (who are not as a rule numerous) had to pass a series of
principal and minor inspection stations, and their condition was spe-
cially watched. At Khurda road, a principal inspection station, on
the East Coast Railway, distant about 25 miles from Puri, a special
observation camp was established and pilgrims from the Bombay
side were detained there until the necessary precautions had been
adopted, and there was no longer any danger of their spreading
infection.
The Singhast
Mela at Ujjain
in Gwalior.
A religious fair known as the Singhast Mela is held once in twelve
years at Ujjain in the Native State of Gwalior, and is usually attended
by three or four hundred thousand persons, chiefly religious mendi-
cants from all parts of India. It happened that the period of this fair fell
within the year 1897 ; it extended from the 17th April to the 16th May,
the dates being those of the full moon in the Hindu months of Chaith
and Baisakh. Arrangements were begun in the early months of
the year 1896 to provide for the great influx of people
expected at Ujjain ; but, in October 1896, when famine
threatened, the Maharaja of Gwalior issued orders prohibiting
the fair, and notices were printed by His Highness' Government
and forwarded to the Agent to the Governor General in Central
India for wide circulation. Copies were sent by the Agent in Novem-
ber 1896 to all Local Governments and Administrations and to the
authorities of all the railways in India, and a reminder was sent in
348
Measures to prevent the
[ CHAP. X.
Prohibition
against the sale
of railway tickets
to intending
pilgrims for
Ujjain.
March 1897. On the 10th April 1897 Colonel Barr, the Agent,
reported that notwithstanding these precautions about fifteen
thousand religious mendicants had arrived from all parts of India,
and that it was not possible to prevent them from going to
Ujjain, notwithstanding the anxiety felt lest an epidemic, possibly
of plague, should break out amongst the pilgrims. He therefore
arranged in consultation with the local authorities and with the
consent of His Highness that the pilgrims should bathe on the 17th
April in the Sipra at Ujjain under strict rules with regard to encamp-
ment outside the city and sanitary arrangements, and under a
promise to leave Ujjain on the following day. The spiritual heads
of the different sects agreed to these arrangements and bound
themselves to enforce obedience on their followers. Colonel Barr at
the same time urged that, in view of the prevalence of plague in
some of the districts whence the pilgrims had come, it was most
important to prevent a further assemblage during the period interven-
ing between the first and second bathing days. With this view
the Government of India fully agreed, and on the 12th April a tele-
gram was sent to all Local Governments and Administrations repeating
Colonel Barr's observations, and stating that everything possible
should be done to meet His Highness Maharaja Sindhia's desire
to restrict the assemblage. The Government of India also issued,
and gave wide circulation to, a notification under the Epidemic
Diseases Act prohibiting, until the 1st May, the sale of tickets to travel
by railway to Ujjain to all persons intending to visit the Singhast
Mela. On the 23rd April, Colonel Barr reported that the
pilgrims who were permitted to bathe at Ujjain had dispersed with-
out any outbreak of disease occurring amongst them. About
twenty-two thousand devotees were present at the bathing, and the
arrangements for sanitation and control were carried out without
difficulty.
Orders issued
during the
second period of
the plague.
During the second period of the plague epidemic the Govern-
ment of India issued several Notifications under the Epidemic
Diseases Act prohibiting the sale within the Bombay Presidency
of tickets to travel by railway to the scene of different fairs
held in various parts of India, to pilgrims and other persons in-
tending, or believed to be intending, to go on pilgrimage to those
fairs. A number of similar orders were issued in the Bombay
Presidency.
The Frontier.
Adoption of pre-
cautions to pre-
vent plague
The Government of India recognised that it was incumbent
upon them to cause every precaution to be taken to prevent plague
CHAP. X.]
spread of infection by land.
349
spreading over
the frontier. The
precautions
adopted in the
Punjab, Balu-
chistan, and the
North-Western
Provinces afford
the surest
safeguard.
infection from crossing the frontier, and thence invading Baluchistan,
Afghanistan, Persia, or Russia. The careful and successful precau-
tions adopted to prevent the spread of plague from the Bombay
Presidency and Sind into the North-Western Provinces, the Punjab,
and Baluchistan afforded the surest protection to the trans-frontier
countries, and in elaborating these precautions this matter was
constantly borne in mind. The most direct line of invasion was
from Sind via the Punjab or Baluchistan. The means adopted to
prevent the spread of plague to these parts of the country have
been described in this and previous chapters, but it will not be out of
place to repeat here the summary of the Punjab measures given by
the Government of that province in discussing the protection of the
Central Asian countries.
Summary of the
Punjab precau-
tions.
" The province is protected by a system of inspection at railway
stations, ferries, and road posts, of the general character of which the
Government of India are already aware. In addition to the inspection
of travellers alighting from the trains at a large number of stations
which include all district head-quarters and all cantonments on or
near the line of railway and all termini for hill stations, there are
special inspections, at which all passengers are examined at certain
points which have been so selected as to enable the work to be done
by daylight. Passengers from Sind are all inspected at Khanpur or
at some neighbouring station, the actual place of inspection being
varied from time to time to provide against the practice of evading
inspection by marching across country. All intermediate and third
class passengers are now detained for 24 hours at Khanpur, in order
to undergo the disinfection of their clothes and personal effects, and
an Assistant Commissioner has been placed on special duty there
to superintend the arrangements. A second line of defence against
the danger from Sincl is provided by inspection of all passen-
gers either at Sher Shah or at Raewind, all passengers for the
Sind-Sagar line being inspected at the former place. Passengers from
the Bombay direction by the Bombay, Baroda and Central India line
undergo inspection either at Bhatinda or at Ferozepore according to
the train by which they arrive, while those travelling by the East
Indian Railway, after undergoing inspection at Ghaziabad in the
North-Western Provinces, are again inspected either at the junction
of Wazirabad or at Jhelum, according to the train by which they
arrive.
" Passengers up the Indus from Sind are stopped at the ferry of
Mithankot and there examined. Entry into the Dera Ghazi Khan
350
Measures to prevent the
[ CHAP. X.
district from Sind or from the Native State of Bahawalpur, which
lies on the opposite side of the Indus, is prohibited otherwise than by
way of Mithankot or Rojhan,—a road inspection post situated at the
extreme south of the district,
"A record is kept by the police of all arrivals from the infected
provinces, and particular attention is paid to deaths occurring among
such persons with a view to immediate detection of cases of plague.
It has been made legally incumbent upon certain persons, including
village officials, house-holders, and serai-keepers, to report at once all
arrivals from infected provinces and all suspicious cases of disease.
The District Magistrate and any 1st class Magistrate or Commission-
ed Medical Officer, to whom he may delegate the power, has legal
authority to remove a plague patient to hospital, and to destroy
or disinfect any building which he has occupied. Many minor
matters have also been provided for by regulations issued under the
Epidemic Diseases Act, 1897, and it is believed that such machinery
as can be provided exists for the discovery and stamping out of the
disease as soon as it shows itself."
Protection of
Afghanistan.
With regard to Afghanistan the Lieutenant-Governor of the
Punjab (Sir William Macworth Young) considered that so long as the
Punjab remained free from plague, the protection of Afghanistan was
as efficiently secured by the measures adopted on the east and south
frontiers of the province as by any special arrangements on the
north and west frontiers. The Lieutenant-Governor suggested that,
if the Punjab or any part of it became infected, it might be necessary
to establish an inspection cordon for the special protection of Afghan-
istan, but he considered that it would be best to await the development
of events before deciding precisely the line of defence that should be
adopted. In this view the Government of India concurred and for-
tunately the measures adopted were successful in protecting both the
Punjab * and the countries lying beyond it.
Protection of
Baluchistan.
For the protection of Baluchistan, in addition to the railway traffic
inspection and the quarantine arrangements that have already been
described, all roads leading across the border of the Shikarpur district
in the north of Sind were carefully watched on both sides of the
boundary, and the tribal levies of Las Bela prevented travellers from
* The outbreak of plague confined to a few villages of the Jullunder and
Hoshiarpur Districts) the inmates of which were segregated in camps, which occurred
during the second period of the plague did not make it necessary to reconsider this
decision.
CHAP. X.]
spread of infection by land.
351
Inspection posts
in Kashmir.
Karachi from crossing into Baluchistan. In Kashmir plague inspection
posts were established at Jammu, the terminus of the railway, and at
Ranbirsinghpura, Tawi, and Kohala. A letter was received by the
Government of India from His Highness the Amir of Afghanistan
expressing satisfaction with the completeness of the precautionary
arrangements.
Success of the
measures for the
protection of the
frontier.
Two cases of plague were detected and stopped at the principal
Baluchistan inspection station, but so far as is known no other
case, indigenous or infected, occurred in either Baluchistan or
Afghanistan. From time to time rumours were heard of the exis-
tence of disease resembling plague in some part or other of Afghan-
istan, but these rumours in all cases turned out to be without
foundation.
Precautionary
measures in
countries beyond
the border.
Before leaving this portion of the subject the precautionary
measures adopted in some of the countries lying beyond the border
must be noticed.
Kandahar.
For the further protection of Kandahar it is stated that all persons
coming from the direction of Baluchistan were detained for a certain
number of days at some distance from the city before being
allowed to enter it, and that a list was kept of the names, etc., of all
persons coming to the city.
Persia.
The Persian Government issued a set of quarantine regulations
for the control of traffic coming from Baluchistan and Afghanistan.
The regulation directed that all roads from Afghanistan to Persia,
with the exception of the two main routes, the one from Herat
to Meshed and the other from Kandahar to Birjand and Yezd
should be absolutely closed, and that a quarantine of fifteen days
should be enforced at the frontier on these two roads. The regulations
further provided for the establishment of lazarettos provided with a
medical staff and sanitary arrangements. Early in July, when- the
fear of the spread of infection had abated, the period of quarantine was
reduced to three days.
Mesopotamia.
Ill Mesopotamia fifteen days' quarantine was imposed against all
travellers from India. This portion of Turkish Arabia is peculiarly
sacred to the Shiah sect of Muhammadans, who are in the habit of visit-
ing the country on pilgrimage and of sending corpses there for burial.
By order of the Turkish Government the entry of Shiah pilgrims and
corpses from India and Baluchistan was, as a temporary measure,
absolutely prohibited.