NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
CHAP. VI. ]
General account, of preventive measures.
129
in the case of travellers by road and by river routes.
Measures to
prevent the
spread of
infection by
persons
travelling
by sea.
To prevent the spread of infection by persons travelling by sea,
vessels sailing from ports in the infected area, and, in the case of
vessels sailing for ports out of India, from other principal ports in
India, were inspected before departure, and any cases of plague dis-
covered on board were removed. Quarantine was also impressed
against the infected ports at other ports in India, The original rules
enforced at the ports of arrival were issued under the Quarantine
Act (1 of 1870) and were similar to those enforced against Hong-
kong in the year 1894. Revised rules were subsequently issued
under the Epidemic Diseases Act (III of 1897), based on the regula-
tions prescribed by the Venice Sanitary Convention of the 19th
March 1897. The rules for the medical inspection of vessels before
leaving port were also revised after the issue of the Convention.
Measures to
prevent
the spread
of infection by
susceptible
articles.
To prevent the spread of infection by articles likely to carry the
seeds of the disease, the importation of rags, used apparel and bed-
ding, wastepaper, and used gunny bags, from the Bombay Presi-
dency and Sind into other parts of India was prohibited, both by
land and by sea. Precautions were also taken to pevent the spread
of infection by grain and other food stuffs.
Events leading
up to the passing
of the Epidemic
Diseases Act.
The Epidemic Diseases Act.
It will be convenient at this point to notice the special Act under
which the precautionary and remedial measures were framed and
enforced. At the end of January, when the plague had, in spite of
all precautions, taken a firm hold of Bombay, when it had be-
come epidemic in Karachi and when it had begun to spread to
Poona, Ahmedabad, and other places, it became evident that the
ordinary provisions of law were not sufficient to enable the local
authorities to enforce all the measures necessary to grapple with the
emergency, and to prevent, so far as was humanly possible, the ex-
tension of the disease to other districts and provinces. Municipal
bodies were, it is true, already endowed with extraordinary powers
of dealing with disease within their own limits, but these powers were
by no means uniform, and only extended to very limited areas. For
instance, section 434 of the City of Bombay Municipal Act, 1888, pro-
vided for the imposition of such temporary regulations as might be
found necessary to prevent the outbreak or spread of disease, and
section 334 of the Calcutta Municipal Consolidation Act, 1888, em-
powered the adoption of similar measures in that City.
Under the powers conferred by section 25 of the Cantonments
Act (XIII of 1889), the provisions of sections 434 and 473 of the City
17
130
General account of preventive measures.
[ CHAP. VI.
Passing of the
Act.
of Bombay Municipal Act were, shortly after the commencement of
the outbreak, extended to the Cantonments of Poona, Kirki, Ahmed-
abad, and Deesa. In a Resolution of the Government of India in the
Public Works Department, dated the 23rd October, 1896, bubonic
fever was included in the list of infectious and contagious diseases,
given in the general railway rules of 1895, thus enabling the measures
prescribed in section 71 of the Act for dealing with persons suffering
from any such disease to be enforced in the case of plague. But
something much more general and wide-reaching was required, and
the Government of India determined, having regard to the high
mortality resulting from the plague, the persistence of the disease
in Bombay and Karachi, the apprehension that it might spread and
become epidemic in other places, the injury that was resulting to
the trade of the places affected and the country at large, that it was
necessary to take special powers by legislation. With this object a Bill
"to provide for the better prevention of the spread of dangerous
epidemic disease" was introduced in the Council of the Governor
General on the 28th January and passed into law as the *Epi-
demic Diseases Act (III of 1897) on the 4th February. In the
discussions in the Legislative Council it was recognized that the
urgency of the case made it necessary that the brief enabling Act
should receive the force of law with the least possible delay, and that
the varied circumstances and emergencies that had arisen and were
likely to arise rendered it desirable that the Act should be general in
its terms.
Provisions of the
Act.
The Act, which contains only four sections, enables the authorities
empowered under it to adopt all precautionary measures that may
be deemed necessary. The main provisions are contained in the
second section. The first sub-section of that section is based on
section 434 of the City of Bombay Municipal Act, and authorizes the
Governor General in Council to direct any measures to be taken and
any regulations to be prescribed which are deemed necessary to
prevent the outbreak or spread of dangerous epidemic disease, and
to direct in what manner the expenses incurred shall be defrayed.
The second sub-section empowers the Governor General in Council
in particular, to take measures and prescribe regulations for (a) the
inspection of ships arriving at or leaving port and the detention
of the ship or of any one on board, and (b) the inspection of travellers
by railway and otherwise, and the segregation of persons suspected
of being infected with the disease. The third sub-section empowers
the Governor General in Council to declare that all or any of the
* Appendix IV.
CHAP. VI. ]
General account of preventive measures.
131
powers conferred by the Act may also be exercised by any Local
Government with respect to the territories administered by it, Sec-
tion 3 makes disobedience to any regulation or order made under the
Act an offence punishable under section 188 of the Indian Penal Code.
Conferring of
powers on Local
Governments and
Administrations
under the Act.
The intention of the Government of India in passing the Act was
that regulations for dealing with the epidemic should, subject to
the general control of the Governor-General in Council, generally be
made by the Local Governments, who, with their greater local know-
ledge and experience and with their greater facilities for gauging local
opinion and enlisting local sympathy, were in the best position to devise
regulations to meet the particular circumstances which had arisen and
might arise in the territories under their administration. Accordingly,
on the day that the Act received the force of law the Maritime Gov-
ernments of Bombay, Madras, Bengal, and Burma were empowered* to
exercise all the powers conferred by the Act. The Governments of
the North-Western Provinces and Oudh, the Punjab and the Central
Provinces, whose territories stood in danger of the spread of infection
by land, were given powers under the first, or general, sub-section of
section 2, and also under the clause of sub-section 2 au thorizing the
examination and detention of travellers. In Assam, Coorg, and Baluch-
istan, where the danger was more remote, powers were conferred on
the Chief Commissioner under this latter sub-section only. At the same
time a notification issued applying the Act to all territories in India
which are under the administration of the Governor General in Council,
but are not part of British India including the Baluchistan Agency
and railway lands ; and in a second notification the administrations of
these territories were given powers under the clause authorizing the
examination and detention of travellers. Other notifications confer-
ring powers on Local Governments and Administrations were issued
from time to time as occasion arose. On the 12th February powers
under the general sub-sections were conferred on the Resident at
Hyderabad for the Civil and Military Station of Bangalore. On the
16th February the Chief Commissioner of Ajmere-Merwara was granted
powers under the railway inspection clause, and on the 6th March
under the general sub-section. On the 1st March powers under the
general sub-sections were conferred on the Agent to the Governor
General in Baluchistan. On the 3rd April powers under the same
sub-section were conferred on the Resident at Hyderabad for the
Hyderabad Residency Bazaars, the Cantonment of Secunderabad, the
stations of the Hyderabad Contingent, and the Hyderabad Assigned
Districts. On the 15th of April powers under the same sub-sections
were conferred on the Agent to the Governor General in Central India
for the Cantonments of Mhow, Neemuch, and Nowgong.
* Home Department Notification No. 302 (Sanitary), dated the 4th February 1897,
Appendix IV.
132
General account of preventive measures.
[ CHAP. VI.
The series of notifications conferring powers on Local Govern-
ments and Administrations are given in Appendix IV.
Enactments
against plague
passed in Native
States.
On the 11th February the Mysore Government passed a Regula-
tion (II of 1897) in the same terms as the Epidemic Diseases Act,
and subsequently issued rules and orders under it. The Maharajah
of Travancore and the Rajah of Cochin also issued Regulations based
on the Act. These Regulations are set forth in Appendix IV. The
Baroda Darbar issued a series of well-devised rules for checking the
epidemic in Baroda territory.
Rules and orders
issued by Local
Governments
and Administra-
tions under the
Act.
Both the Government of Bombay and other Local Governments
and Administrations issued a number of rules and orders under the
powers conferred on them under the Epidemic Diseases Act, for the
purpose of regulating the operations against plague. These regu-
lations are examined and discussed in the portions of this report
which deal with the matters to which they refer. As the regulations
on different matters are in many instances gathered together in one
resolution or notification, the general orders issued by the principal
Local Governments, dealing mainly with the means taken to suppress
outbreaks, to prevent the occurrence of isolated cases resulting in epi-
demics, and to prevent the spread of infection by persons travelling by
land, are grouped together in the Appendix IV. The rules and orders
issued by the Governments of Bombay, Madras, Bengal, the North-
Western Provinces and Oudh, and the Punjab are given at length.
Similar rules and orders were issued by a number of other Administra-
tions, both within and without British India. These follow the lines
of the rules and orders issued by the principal Local Governments,
and it is net necessary to reproduce them. The orders issued for the
regulation of sea traffic and to meet special circumstances are given
in the appendices to the appropriate chapters. In order that each
Local Government and Administration might have the advantage of
the experience of other Provinces, the Government of India directed
each Government to send a copy of all the rules it issued under the
Epidemic Diseases Act to every other Government in India.
Orders issue by
the Government
of India under
the Act,
The Government of India found it necessary to take action them-
selves under the Epidemic Diseases Act in only four classes of cases.
The orders issued by the Government of India referred to the prohibi-
tion of the pilgrimage to Mecca, to the prohibition of emigration from
India, to the temporary prohibition of the booking of railway fares to
certain localities with a view to prevent the assemblage of large reli-
gious gatherings, and to the prohibition of the importation of certain
articles likely to carry the seeds of infection from the Bombay Presi-
dency to other parts of India. These matters are discussed in later
chapters of this report.
CHAPTER VIL
MEASURES IN THE CITY OF BOMBAY.
In this chapter the measures devised and adopted in the early
period of the epidemic will first be noticed and a description will then
be given of the system of remedial and preventive operations carried
out by the Special Plague Committee, of which General Gatacre was
the President.
Measures during the early period of the Epidemic.
Beginning of the
epidemic.
General course
of the epidemic.
Dr. Viegas, a private medical practitioner of Bombay, di?covered
cases he believed to be plague about the 26th September; the Govern-
ment of India at once deputed M. Haffkine, the bacteriologist, to
Bombay to investigate the disease, which was officially affirmed to be
plague on the 20th September, and this statement was shortly after-
wards confirmed by M. Haffkine, It will be remembered that the
disease was mild during the month of October, diminished some-
what in the first half of November, and from December to the end of
February spread and increased with the utmost virulence, From the
beginning of March the strength of the epidemic gradually declined,
until in July only isolated cases occurred.
Conduct of
operations by the
municipal
authorities.
Until the appointment of General Gatacre's Committee on the 9th
of March, the remedial and preventive measures were carried out by the
municipal authorities of the city, within the scope of whose functions
the care of the public health lies. The following brief account of the
constitution of the municipal government of the city, and of the speci-
al sections of the municipal law dealing with the suppression of infec-
tious and epidemic disease, will make it easier to follow the conduct
of the operations.
The constitution
of the municipal
government.
The law relating to the municipal government of the City of
Bombay is contained in the " City of Bombay Municipal Act—
Bombay Act No. III of 1888," as amended in some portions by later
Acts of the Bombay Government. The municipal authorities charged
with carrying out the provisions of the Act are
(1) a Corporation,
(2) a Standing Committee, and
(3) a Municipal Commissioner.
134
Measures in the City of Bombay.
[ CHAP. VII.
The Municipal Corporation consists of seventy-two councillors, of
whom thirty-six are elected at ward elections, sixteen are elected by
the Justices of the Peace for the City of Bombay, two are elected by Fel-
lows of the University of Bombay, two are elected by the Bombay
Chamber of Commerce, and sixteen are appointed by the Local Govern-
ment. The general municipal government of the city is vested in this
corporation. The standing committee consists of twelve councillors,
eight appointed by the corporation and four by the Government.
This committee transacts the general business of the corporation)
and their special functions are indicated in numerous sections of
the Act. The Municipal Commissioner for the City of Bombay is
an officer appointed by the Government. In him rests the entire exe-
cutive power for the purpose of carrying out the provisions of the
Municipal Act. He also controls the municipal staff; he is vested with
certain special powers by the Act ; and in cases of great emer-
gency he is empowered to take what action he considers necessary
on his own authority. During the period of the plague epidemic. Mr.
Snow was the Municipal Commissioner, Surgeon-Lieutenant-Colonel
Weir was the Executive Health Officer, and Mr. Murzban was the Ex-
ecutive Engineer.
Regulations of
the Municipal
Act against
dangerous
disease.
The general regulations for the prevention of the spread of dan-
gerous disease are contained in sections 421 to 433 of the Muni-
cipal Act. The following are the main provisions of these sections.
Medical practitioners are bound to give information of any cases
of dangerous disease that may come to their cognizance. The Com-
missioner may inspect any place in which dangerous disease is said
to exist, and may take such measure as he may think fit to prevent
its spread. He may prohibit the use for drinking purposes of water
likely to cause dangerous disease. He may order the removal of
patients to hospital. He may cause buildings to be disinfected
and huts and sheds to be destroyed. He may direct the disinfection
or destruction of clothing, bedding, or other infected articles. He
may provide and maintain conveyances for the carriage of the sick.
All persons are also prohibited from trafficking, etc., in contaminated
articles, and from letting any infected building or part of a building
until it has been properly disinfected. The drivers of public con-
veyances are prohibited from carrying infected persons, and the latter
are prohibited from using such conveyances.
Section 434 of
the Municipal
Act.
In addition to these measures for ordinary occasions section 434
of the Act empowers the Commissioner, with the sanction of the Local
Government, in the event of the city being visited or threatened
with an outbreak of dangerous disease, to take such special mea-
sures and prescribe such temporary regulations as he may deem
CHAP. VII. ]
Measures in the City of Bombay.
135
necessary. It will be remembered that the first or general sub-section
of section 2 of the Epidemic Diseases Act was based on this section
of the City of Bombay Municipal Act.
First measures.
Activity of the
Municipal Health
Department.
While the nature of the disease was still under discussion the
Government of Bombay directed their principal sanitary and medical
adviser, the late Surgeon-Major-General Cooke, to furnish full in-
formation regarding the facts that had been ascertained with regard
to the epidemic and to suggest, in consultation with the Municipal
Commissioner, further measures with a view to obtain correct
information as to the daily progress of the disease, and to prevent its
spread. In a letter, dated the 29th September, Surgeon-Major-General
Cooke reported to the Local Government that the disease was no
doubt plague, that it was of a mild type, and that it had probably ex-
isted in the city for over a month. He assured the Government that
the Health Department of the Municipality was acting with the utmost
activity in the infected area, and that a large establishment of inspec-
tors and labourers was at work under the superintendence of Surgeon-
Lieutenant-Colonel Weir.
In the district examined by Dr. Cooke sea-water was pumped all
night through the sewers by a powerful centrifugal pump. Fires
of tar and sulphur were lighted at the foot of the staircases leading
to houses and in the corridors of houses. Limewashing and cleans-
O
ing of walls and lanes were in active progress, fire-engines being
employed in the work. In addition to these measures, Dr. Cooke
suggested the following further precautions : an increase in the
sanitary and medical staff of the Municipality ; arrangements to
detect the disease should it occur in suburban municipalities ; the
segregation of the sick in hospital; the disinfection or destruction
of the bedding of patients, and of all other bedding found in the
house or rooms occupied by the patient ; and more complete
arrangements for carting away filth from sewers.
Committee
appointed by the
Local Govern-
ment.
Before the end of September the Local Government appointed
a committee, of which Mr. Snow was the Chairman, and the
members of which were chiefly medical officers of the Government
and private medical practitioners, to consider remedial and sanitary
measures. Dr. Cooke attended the meetings of the committee.
At the first meeting, which took place at the end of the month, the
suggestions made by Dr. Cooke were discussed and Surgeon-Major
Manser insisted on the necessity for the complete disinfection
of every house in which cases were known to have occurred. He
suggested that the inhabitants of such houses should be removed
to empty houses or tents on the Port Trust Estate. Mr, Snow pointed
out that under the Municipal Act the Municipal Commissioner
136
Measures in the City of Bombay.
[ CHAP. VII.
Powers conferred
on the Municipal
Commissioner
under section
434 of the
Municipal Act.
would need to apply to the Government for special powers to carry
out certain of the suggestions, and a resolution was adopted by the
meeting that the Municipal Commissioner should be requested to
apply for such powers. On the 2nd of October the Local Govern-
ment conferred powers on the Commissioner under section 434 of
the Municipal Act to take whatever measures were found necessary
to prevent the epidemic from spreading. The corporation voted a
large grant for the purpose, and a large additional medical staff was
employed to carry out the extensive sanitary measures, the adoption
of which was advised.
Proclamation of
the Municipal
Commissioners.
Alarm and
excitement of
the population.
On the 6th of October the Municipal Commissioner issued a
proclamation under section 434 of the Municipal Act making pro-
vision for the removal to hospital of all plague patients and the dis-
infection and evacuation of infected houses. The assistance of the
police was to be employed where necessary. The populare evinced
the greatest alarm and excitement at the suggestion for the compul-
sory removal of the sick to hospital, and the increase in the epidemic,
coupled with the operations in progress, produced widespread alarm.
People fled from the city in large numbers. On the 10th of October
a number of mill-hands assembled outside the Arthur Road Hospital
and threatened its demolition as well as voilence to the employés.
On the afternoon of the 29th October a gang of nearly one thousand
armed mill-hands attacked the same hospital, and were dispersed by
the police. The incident was a grave indication of the general feel-
ing. The large Municipal conservancy staff became affected by the
general feeling of unrest and it was feared that a strike might occur
among them. Mr. Snow stated that such a strike would have had the
most appaling results. " Bombay would, in a few days, have become
uninhabitable and left to reek in a mass of sewage, sweepings and
pollution, with no one at hand to conduct the daily routine of sanita-
tion, much less to adopt a single preventive measure against plague."
Modification
of the orders.
Explanatory
proclamation.
On the 16th of October, the Commissioner issued a memorandum
to the Health Officer stating that as only a few cases of bubonic fever
had been reported within the past few days, and as influential peti-
tions and representations had been made against the removal of
patients to the Arthur Road Hospital, patients should not be removed
if they were living in houses where they could be properly attended
and isolated in a reasonable degree. Also that every possible
consideration should be shown to the caste and prejudices of persons
whose houses the Health Department officials had to enter. To allay
the alarm and the opposition excited by the fear of compulsory segre-
gation of the sick, a further proclamation was issued by the Commis-
sioner on the 3Oth of the month, in which it was stated that the