74
ened by reliable non-commissioned officers and men belonging to British regiments serving in the
Bombay Presidenny. This clement would largely stiffen the professional and native one engaged
in these operations. Of the devoted services of the soldiers in Hongkong we have had experience.
and we are confident that they would work with equal zeal and trustworthiness in India. In all
duties in India the European element is most essential ; it is found to be so in the army, and it
will be at least equally so in this plague work, and i£ the disease is to be effectually grappled
with, their employment becomes an absolute necessity. From our knowledge of the plague and
the means by which it is spread, we can guarantee that these duties will be carried out with
almost complete immunity to the men employed ; far from suffering in health, the men employed
on this work in Hongkong gave fewer admissions into hospital from ordinary affections.
"The history of plague at all periods tends to show that it is a slow-spreading disease ; but,
if at once vigorously attacked, it can be stopped. To effect this, the isolation of the sick and
segregation of the probably infected is of the first importance, without which it is hopeless to
control its spread. For the efficient carrying out of this system careful house-to-house visitation
is necessary, the sick should be at once removed to hospital, and those immediately in contact
with the sick in the same room removed to a segregation camp. Unless this action be taken, in
spite of any disinfection and cleansing that may take place, the patient and his family will
still remain as great a danger as before and will certainly lead to further infection of the house
and its inhabitants. Already infected people have arrived and formed new foci of infection in
parts of the city which at great trouble and expense had previously been cleared and disinfected.
This may carry on the epidemic indefinitely, thus showing the hopelessness of dealing with this
disease without efficient isolation and segregation.
"This presumes the necessity of having suitable hospitals and segregating buildings in
proximity to the affected districts, and in view of these measures being adopted, it is desirable
that means should be taken at once for erecting hospitals, and also segregation huts for the
reception of the infected. These buildings should be in the vicinity of the infected districts, and
we understand from Mr. James, Executive Engineer under the Municipality, that there would
be no difficulty in erecting such structures on suitable sites. The objections that are put for-
ward against this segregation are mere prejudices, and should not be entertained for one moment ;
and whatever weight the objections may have had at the commencement of the epidemic, we
cannot too forcibly impress on those in authority that they are now face to face with a state of
affairs in which all such prejudices must be set aside. The difficulty of isolating and segre-
gating a large number of people of different castes can be readily overcome by proper adminis-
tration.
"We have made it our duty to get information on this subject from those best qualified to
judge, and the almost unanimous opinion is that this question of segregation could be easily
arranged.
"We venture to point out that the epidemic of 1894 in Hongkong was practically got under
in about eleven weeks' time after these measures were put in force, and, although determined
opposition was experienced in the early stages, the inhabitants gradually gave in to the inevit-
able. Those who have knowledge of both Indians and Chinese know that the prejudices of the
latter are quite as strong as those of the former. If further evidence is wanting of the absolute
necessity of such measures, we would add that in Hongkong in 1895, where a large staff educated
in plague work was ready at hand, the immediate removal of sick and isolation of all probably
infected persons prevented small outbreaks from assuming large proportions, whilst disregard of
segregation of infected and other practical matters led to the 1896 epidemic in that colony.
"It is needless to say that such a huge task as the administration of the details of this epide-
mic requires the most thorough organization, and we feel bound to say that, in spite of the real
hard work which has been done, there is an absence of any proper chain of responsibility. The
disease is now scattered over the Bombay Presidency, and we would urge that this want of orga-
nization should be remedied at once, as the chaos caused by such a want will certainly increase.
We suggest that a small Central Working Commitee be formed, presided over, if possible, by
an official having high executive authority, the members of such Committee being composed
of representatives of departments having special bearing on this work, and all orders should
emanate from this authority. Sub-Committees under the Central committee would, of course,
be formed in the various districts, who should report direct to the Central authority. As the
Central Committee should be composed of men who have had experience of the disease in the
city of Bombay, they would be competent to issue instructions which, if energetically carried
out, will have beneficial results.
"A matter requiring immediate attention is the inspection of incoming passengers to the city.
This is necessary as a protective measure, and will also deter a considerable number from re-
entering the town until the situation improves. As noted in a previous paragraph, instances
have been brought under our notice where diseased persons have re-infected districts.
"Prompt suppressive measures should be taken, as the longer the disease persists the more
likely is it to become endemic, remaining as a constant source of danger, and likely at any time to
light up into epidemic dimensions. Signs are not wanting which lead us to think that the