NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
Contents.
iii
CHAPTER IV.
PREVIOUS HISTORY OF PLAGUE IN INDIA.
Notices of pestilence in early Indian History — Pestilence in India in
the I4th, I5th and 16th Centuries — Outbreak in 1618 in the
District of Ahmedabad— Second outbreak in 1683-89 — Fever
epidemics in the 18th Century— First undoubted plague
epidemic in Gujarat in 1812-21 — Description of Cutch — Account
of the outbreak in Cutch in 1812— Spread to Radhanpur State
and Sind in 1816 — Outbreak in Kathiawar — Description of
Kathiawar — Account of the epidemic in Kathiawar by Drs.
Gilder and Whyte— Course of the disease in Kathiawar in 1816-19
— Ravages made by the epidemic— Extinction in 1821 — Dr. Gilder's
clinical account — Bubonic and pulmonary forms of the disease —
Dr. Whyte's report — Morvi — Vankaner — Muli — Sayla — Dr.
Whyte's discussion on the origin and spread of the disease —
The disease spread by infection and fostered by endemic
causes — Insanitary condition of Kathiawar — Remedial measures
suggested by Dr. Whyte — Segregation of the infected in the
open and destruction of contaminated clothing — Description
of the Ahmedabad District — Quarantine measures enforced
to arrest the spread of the disease — Quarantine ineffectual-
Outbreaks at Dhandhuka and Ahmedabad — High mortality —
The Pali outbreak of 1836-37 — Dr. Ranken's report — Description
of Marwar, Mewar and Merwara — Outbreak at Pali in July
1836 — Cloth printers first affected — Virulence of the epidemic—
Origin of the disease unknown — Conjecture that it was imported
from the Gujarat ports — Dr. Irvine's reasons for belief in
this theory — Flight of the inhabitants of Pali — Disease spread
by the refugees — Progress of the plague in Marwar and Mewar —
Extinction in the spring of 1838— Mortality — Contemporaneous
epidemic fever in Rohilkhand — Dr. Guthrie on the Rohilkhand
fever — Symptoms of the Pali epidemic — Bubonic and pul-
monary "forms — Description by Assistant Surgeon Maclean —
The epidemic fostered by dirty and insanitary conditions of
life — Insanitary condition of Rajputana — Land quarantine
and preventive cordons — Dr. Ranken's opinion on the subject
of land quarantine— Breach of the Merwara cordon — Dr.
Ranken's advocacy of sanitary reform — Advice with regard to
Calcutta — Measures proposed by Dr. Irvine for combating an
outbreak of plague — Encampment of the healthy outside the
scene of infection — Mahamari, the Himalayan plague — Endemic
plague centre in the Himalayas — Garhwal and Kumaun—
Outbreak of 1823 at Kedarnath — Subsequent outbreaks —
Variable intensity of the outbreaks, 1834 — 1835—1853-1854 —
Extension to places in the Bijnor and Moradabad Districts
and in the Rampore State — 1860 — 1877-78 — Later outbreaks not
severe — The disease fostered by dirty and unwholesome surround-
ings — Symptoms of Mahamari identical with those of ordinary
plague — Virulence of the disease— Flight of the inhabitants
from infected villages— Spontaneous and imported outbreaks —
Mortality among rats— Causes of spontaneous outbreaks
— Outbreak of 1897 at Okhimath— Preventive measures
adopted— Their success-— Closing the pilgrim route through
Okhimath— Danger of the spread of Mahamari
PAGES
71—94
iv
Contents.
CHAPTER V.
EXTENT AND COURSE OF THE PLAGUE IN THE BOMBAY
PRESIDENCY.
Preliminary remarks—Brief description of the Bombay Presidency—
PAGES
Extent and population—Physical aspects—Division into dis-
tricts—Agriculture—Climate—Inhabitants—Executive adminis-
tration—General remarks on the plague epidemic—Total mortal-
ity—Bombay City—Description of the City—Insanitary tene-
ments—Population—Commencement of the
outbreak—First
public announcement—M. Haffkine's investigation—Diagnosis
confirmed—Failure to discover the disease—Early suspicious
cases—High mortality in the city—On discovery, the disease
found to be widely diffused—Immediate cause of the outbreak
unknown—Possibility of importation from China—Abnor-
mal climatic conditions of 1896—Outbreak discovered in
Mandvi—Statistics and maps—Inaccuracy in reporting—
Total seizures month by month—General course of the epi-
demic—Flight of the populace—Course of the epidemic in
different wards—Manner in which the infection spread—Com-
parative intensity of the epidemic in different wards—Localities
chiefly affected—The Bombay Presidency proper—Statistics and
maps—Geographical distribution of the disease—Four main
divisons—The Konkan Coast, the chief seat of the epidemic—
Thana—Kolaba—Daman—The Deccan, the second division—
Poona City—Poona District—Satara—Gujarat,
the third
division—Palanpur State—Kathiawar—Cutch, the fourth divi-
sion—Mandvi—Course of the epidemic in the different divi-
sions—Thana—Surat—Kolaba—Baroda
State—Daman—Poona
City and District—Nasik and Ahmednagar—Palanpur—Kathia-
war—Mandvi—Sind—Infected localities—Karachi—Description
of the town—Insanitary condition of the main body of the town—
Beginning of the outbreak—Plague declared epidemic—Spread of
infection—Climax during first week in February—Total morta-
lity month by month—Decline of the epidemic—Karachi Dis-
trict—Tatta—Jang shahi—Kotri—Hyderabad District—City of
Hyderabad—Tando Alahyar—Shikarpur District—Sukkur—
Rohri—Villages in the District—End of the epidemic in Sind—
Recrudescence of plague in the Bombay Presidency proper—
General statistics—Bombay City—Konkan Coast—Surat and
Palanpur—Deccan Districts—Karnatak—Satara
District—Im-
provement in the districts during December
....
95—126
CHAPTER VI.
GENERAL ACCOUNT OF PREVENTIVE MEASURES. THE EPIDEMIC
DISEASES ACT.
Summary of measures adopted to combat the plague—General prin-
ciples—Measures adopted in plague centres—Measures to
prevent isolated cases spreading an epidemic—Measures to
prevent the spread of infection by persons travelling by land—
By persons travelling by sea—By merchandise and food-stuffs—
The Epidemic Diseases Act—Events leading up to the passing
of the Act—Its provisions—Powers conferred on Local Govern-
ments and Administrations—Enactments against plague passed
in Native States—Rules and orders issued by Local Governments
and Administrations under the Act—Orders issued by the Gov-
ernment of India under the Act
127—132
vi
Contents.
hospitals — Hospitals for individuals and families disallowed —
Multiplication of hospitals caused no spread of the disease— Con-
struction and equipment of Government and private hospitals
— Precautions against infection in hospitals— Sanitary precau-
tions in the Grant Road Hospital — Medical and nursing staff —
Difficulty of procuring nurses—Aid given by the Roman Catholic
convents — Nurses procured in India and from England — General
supervision of nurses — Their division into classes, remuneration
and duties— Useful and devoted work of the Roman Catholic
sisters— Aptitude of the English nurses — Disposal of corpses —
Sanitary condition of burial grounds— Closure of the Grant
Road Muhammadan burial-ground — Last rites performed by the
relatives — General rule for hospitals — Arrangements in the
Grant Road Hospital — Segregation of persons likely to be infect-
ed — Treatment of infected and insanitary buildings — Method
of disinfection — Evacuation — General sanitary measures— Vigor-
ous work initiated by the Municipality continued — Statistical
statement of work done — Treatment of dwellings reported to be
insanitary by the District Medical Officers of Health— The
" U. H. H."* system — Cleansing and disinfecting of entire local-
ities — Seven
instances — Kamathipura — Tarwadi— Mazagon —
Worli — Siwri — Parel — Mahim — General lesson to be derived
from the seven cases — Disposal of the city refuse — General im-
provement of the sanitation of Bombay
.....
PAGES
133—182
CHAPTER VIII.
MEASURES IN THE BOMBAY PRESIDENCY AND SIND.
Preliminary remarks—General measures—Regulations under the
Epidemic Diseases Act—Officers—Appointment of plague
authorities—Duties of the District Magistrate and the Police—
Detection of cases—Three main measures adopted—Compul-
sory report—Grant of certificate of cause of death—Action to be
taken on receipt of information—Examination of corpses—Feel-
ings of the people—Rajputana—Sind—Hardwar—Bombay City
—Poona—Officials stationed at burning and burial grounds—
Periodical mortality statements—Segregation of the sick and of
persons likely to be infected—Disposal of corpses—Funeral
processions and burial and burning of corpses—Persons touching
plague corpses —Disinfection of clothing, etc.—Disinfection of
houses and general sanitary precautions — Disuse of infected and
insanitary houses — Abatement of overcrowding—Cleansing and
disinfection — Destruction of huts— Ventilation— Evacuation of in-
fected localities—Payment of compensation—Principle enunci-
ated by the Government of India—Compensation not claimable
of right, but liberality to be shown to poor people—General rule
issued by the Government of Bombay— Appointment of Plague
Committees for large towns— Poona, Karachi, Hyderabad, and
Sukkur and Rohri—No Plague Committees in" rural areas—
Constitution of Committees—General rules for Committees—
Arrangements for the rainy season—Difficulty of carrying out
measures during the rains—Provision of weather-proof shelter in
the
districts—Suspension
of the " U. H. H." system
in the City of Bombay—Caution in destroying dwellings in
* " Unfit for human habitation."
xii
Contents.
of observation posts on roads, and to secure the co-
operation of the villagers—Arrangements made to protect
Mahableshwar : an instance of the working of the general rules
—Measures adopted to prevent the re-infection of Bombay
City by foot-passengers—Protection of the Punjab Frontier—
Pilgrimages in India—Orders prohibiting certain fairs issued
by the Government of Bombay—Hardwar—The Jagannath
festival in Bengal—The Singhast Mela at Ujjain in Gwalior—
Precautions to prevent the spread of plague across the frontier
—Summary of the Punjab precautions—Protection of Afghanis-
tan—Protection of Baluchistan—Inspection posts in Kashmir—
Success of the measures for the protection of the frontier-
Precautionary measures in countries beyond the border—
Kandahar—Persia—Mesopotamia—Russian
Turkistan and
China
PAGES
2921—352
CHAPTER XL
MEASURES TO PREVENT THE SPREAD OF INFECTION BY SEA.
Original quarantine measures—Previous history of sea quarantine
in India—A and B quarantine rules of 1879—History of quaran-
tine from 1881 to 1893—Quarantine against Hong-kong and
Canton, 1894—Quarantine against Bombay, 1896—Rules for
Aden, Karachi, Calcutta, Madras, and Rangoon—Quarantine
against Karachi—Modification of the rules at Karachi—
Epidemic Diseases Act, section 2, (2), (a)—Extension of quaran-
tine to minor ports—Inspection of the inward sea traffic at
Bombay—Regulations of the I2th April 1897—Establishment—
Steamer traffic—Native craft—Treatment of the suspicious—
Results of the inspection—Rules for minor ports in Bombay—
Precautions against arrivals from Cutch—Quarantine at Aden—
Modification of the Ader, rules—Revised rules issued by the
Government of Madras—Original measures for the inspection of
outward bound vessels—Rules for Bombay and Karachi—Details
regarding the inspection at
Bombay—Results—Staff—
Difficulties—Place of examination—Examination of crew—Suc-
cess of the measures—Risk of the spread of infection by ocean
traffic said to be small—Inspection of vessels at the ports of
Calcutta and Madras—Bengal rules—Madras rules—Tuticorin
and Ceylon—The Venice Sanitary Convention of 1897—General
scope and arrangement—Indian delegates—Regulations pre-
scribed by the Convention based on previous Conventions—Im-
portant points of difference—Preventive measures to be adopted
outside Europe—Notification—Inspection of vessels sailing from
infected ports—Pilgrim traffic—The Red Sea and the Suez
Canal—The Persian Gulf—Measures to be adopted by
European Governments—Measures to be adopted in Europe
at ports of arrival—Three-fold classification of ships—Infected
vessels—Suspected vessels—Healthy vessels—Regulations for
inspection of inward-bound vessels based on the Venice Con-
vention—Instructions of the Government of India—Revision of
the Quarantine Rules of the Local Governments—Period of obser-
vation—Infected and healthy vessels—Bombay Presidency—
Rules for the inspection of vessels arriving at the port of
Bombay from infected ports—Rules for Aden—Three-fold
xi v
Contents.
transport of merchandise—Precautionary measures with regard to
food-stuffs—Fear that plague infection might be brought from
Sind into the Punjab in grain or other food-stuffs—Prohibition
of the export not considered necessary—Careful precautions
prescribed and carried out—Precautionary measures in the City
of Bombay .
.
.
.
.
.
.
.
.
.
PAGES
389—394
CHAPTER XIII.
•STAFF.
Preliminary remarks—Medical Staff—Tabular statement—Strain on
the Medical Services—Private Practitioners—Staff at the time of
the recrudescence—Excellent work of the Medical Staff—Orders
granting special remuneration to different classes of medical
officers—Commissioned Medical Officers of the Indian Medical
Service and Army Medical Staff—Commissioned Medical
Officers sent from England—Uncovenanted Medical Officers-
Applicants for employment in the Uncovenanted Medical
Service—Civil and Military Assistant Surgeons-—Retired
Military Assistant Surgeons—Civil and Military Hospital
Assistants—Military Staff—Work done by the Staff—Tabular
statement—Sanitary and Guard duty—Remuneration—Com-
pensation for wear and tear of clothing—Grant of conveyance
allowances—Pensions for the widows and children of deceased
police officers
395—404
CHAPTER XIV.
REGULATIONS AGAINST ARRIVALS FROM INDIA ENFORCED IN OTHER
COUNTRIES.
General remarks—Summary of regulations—Alarm in Europe—Venice
Sanitary Conference—Regulations modified in accordance with the
Venice Convention—Regulations respecting vessels and pas-
sengers—Passage of the Suez Canal—Plague Regulations of
1894 put into force by the Egyptian Sanitary Board—Treatment
of healthy, suspected and infected ships—Passage of the Canal
by the infected ship Dilwara—Regulations of the Venice Con-
vention—Three-fold classification of ships—Healthy ships pass the
Canal in quarantine—Treatment of healthy and infected ships—
The United Kingdom—Local Government Board Rules of Novem-
ber 1896—Healthy and infected ships—Examination of persons
on board—Removal of the sick—Addresses of other persons
restrictions—General rules of January 1897—Later orders—pas-
sengers eventually allowed to land at Marseilles—Italy—Onerous
restrictions—Later regulations based on the Venice Convention—
Arrangements to facilitate the precautionary measures—Belgium
—Royal decree of 1895 enforced—Treatment of healthy vessels at
Doël—Regulations based on the Venice Convention—British
dependencies in the Mediterranean—Malta—Severe restrictive
measures—Partial relaxation—Gibraltar—Cyprus—Other Euro-
pean countries—Holland, Spain, Portugal, Russia, Roumania,
Turkey—Temporary closure of the Dardanelles to Indian ships
—Persian Gulf—Imposition in Turkish Arabia and in Persia of
the quarantine regulations of the Ottoman Empire—Muscat—
Contents.
XV
Regulations for the Persian Gulf in the Paris Convention, 1894,
and in the Venice Convention, 1897—Ceylon—Fifteen days'
quarantine—Regulations modified in accordance with Venice
Convention—Other Asiatic ports—Goa, Netherlands India, and
Siam—Egypt—Plague regulations of 1894 and regulations based
on the Venice Convention of 1897—Treatment of infected, sus-
pected, and healthy ships—Other African ports—Algiers,
Morocco, Madagascar and Natal—America and Australia—
United States—Brazil—Peru—Australian Colonies—Regulations
regarding merchandise—Venice Convention—Susceptible articles
of Indian trade—Hides and skins, raw wool, raw silk—Statistics
of the trade in hides and skins—Countries concerned in the
trade—Restrictive measures enforced in Germany, France, and
Italy—Protest of the Calcutta merchants—Relaxation of the
restrictions—Statistics of the trade in raw wool—Discussion
regarding the importation of raw wool into the United Kingdom
—Regulations issued in France—Silk trade chiefly centred in
Bengal—No restrictions imposed—General regulations issued
by Foreign Governments—Statistics of export trade to Europe—
Restrictions in European countries—France—Italy—Belgium-
Germany'—Austria- Hungary—Other
European
countries—
Indian tea at Batoum—Export trade to Asiatic countries—
Ceylon—Persia—Muscat—Netherlands—India—China—Export
trade to Africa—Egypt—Réunion
PAGES
405—426
CHAPTER XV.
THE PILGRIMAGE TO MECCA.
The suspension of the pilgrimage from India—Alarm in Europe
lest the plague should be spread by pilgrims—Closure of the
ports of Bombay and Karachi to the pilgrim traffic—Endea-
vour to dissuade persons from making the pilgrimage—
Calcutta and Madras open to the pilgrim traffic—Asiatic
Russian pilgrims—Protests against the embarkation of pilgrims
from Madras—Precautionary instructions issued by the Govern-
ment of India—Detention of pilgrims in an observation camp
in the Bombay Presidency—Further protests from Madras
and Bengal—Prohibition of the pilgrimage in the case of
persons who had been in the Bombay Presidency or Sind—
Muhammadan traditional law on the subject of plague and
pilgrimages—Precautions to be taken in the case of intending
pilgrims from places outside the Bombay Presidency and Sind—
Dissuasion—Detention in observation camps away from the ports
—Removal from camp to place of embarkation—Complete suspen-
sion of the pilgrimage—The prohibitory notification—Making
public the causes which led to the suspension—Return of intending
pilgrims to their homes—Detention of the pilgrims in observation
camp at Nasik in the Bombay Presidency—Arrangements for
return home after undergoing observation—Despatch of the
pilgrims to the Nasik camp—Arrangements at the camp—
Despatch of the pilgrims from the camp to their homes—Pecu-
niary concessions made to returning pilgrims—Central Asian
pilgrims—The return of the pilgrims from Jeddah—Arrangements
xvi
Contents.
to prevent their spreading infection on return—Despatch from
Bombay by special trains without being permitted to mix with
the infected population—Outbreak of plague at Jeddah—Jeddah
treated as an infected port under the Venice Convention, and
special precautions taken to prevent the spread of infection by
returning pilgrims—Arrangements at Bombay—End of the
epidemic at Jeddah and discontinuance of the precautions
PAGES
427—434
CHAPTER XVI.
CONCLUSION.
Lessons to be derived from the recent experience of plague—Condi-
tions which foster and which destroy the infection—Measures
best adapted to suppress plague epidemics—Evacuation, segrega-
tion and disinfection—Special difficulties in India—Prevention
of the spread of infection by land, by sea, and by merchandise
and food-stuffs
435—437
CHAPTER I.
INTRODUCTORY.
Period covered
by the report.
At the time that the preparation of this narrative was begun
it was hoped that the epidemic of plague which had almost died
out in the Bombay Presidency would soon completely disappear.
Unfortunately this hope was not realized. With the rainy season a
recrudescence of the disease began, which spread and increased with
alarming rapidity. The present account deals mainly with the first
period of the epidemic, which lasted, roughly, from August 1896 to
July 1897, and although some observations have been recorded on
the progress of the recrudescence and the further measures adopted
on its occurrence, the subsequent history of the plague will have to
be examined in another report and at a later date.
Main object,
The main object of the report is to furnish an account of the
epidemic, of the conclusions arrived at with regard to the nature of
the disease and of the measures best calculated to check and to stay
it, and of the operations that have been carried, out in the Bombay
Presidency and elsewhere with this view. It appeared to the Gov-
ernment of India that a narrative of the measures adopted at different
places and under different conditions, and of the results following on
the measures, would serve as a useful guide for future occasions,
should such a guide unfortunately be needed. As a main object
of the report is to serve as a work of reference, the account of the
remedial and preventive measures has been given in considerable
detail.
Causes and char-
acteristics of
plague.
Chapter II of the report deals with the causes and characteristics
of plague with special reference to the observations recorded by the
most qualified observers during the present epidemic. Particular
attention is paid to those portions of the subject which throw light on
the manner in which the disease is spread and the direction in which
the efforts to combat it are most likely to be successful.
History of
plague.
Chapters III to V deal with the history of plague. In Chapter III a
brief account is given of the general history and geographical distribu-
tion of the disease. The previous history of plague in India is
2
Introductory.
[ CHAP. 1.
described in greater detail in Chapter IV, and Chapter V contains a
short history of the course and extent of the present epidemic.
Remedial and
preventive
measures.
Measures adopt-
ed in plague
centres.
Measures to
prevent the
spread of infec-
tion.
The next portion of the report deals with the remedial and preven-
tive measures. Chapter VI gives a general account of the measures.
Chapters VII to IX deal with the measures adopted in the plague centres
themselves, separate chapters being devoted to the City of Bombay, to
the remainder of the Bombay Presidency and Sind, and to places
outside the Bombay Presidency. Chapters X to XII describe the
measures that were adopted to prevent the spread of plague by land,
by sea, and by articles likely to carry the germs of the disease.
Staff,
Regulations
enforced in
foreign coun-
tries.
The pilgrimage
to Mecca.
In Chapter XIII some details are given regarding the medical and
military staff employed on duty connected with the plague, and of the
remuneration that was granted to them, Chapter XIV contains an
account of the regulations enforced in foreign countries against persons
and merchandise arriving from India. Chapter XV deals with the
pilgrimage to Mecca from the point of view of the danger apprehended
of the introduction of plague into the Hedjaz and thence into Europe.
Lessons to be
derived from the
recent experience
of plague.
In the sixteenth and last chapter a brief summary is given of
the conclusions with regard to the best means of combating plague
which are to be derived from the experience of the present and former
epidemics.
Appendices to
the report.
Attached to the report are a set of appendices consisting mainly of
copies of the orders issued by the Government of India and the Local
Governments and Administrations, of a selection of papers from the
official correspondence on the subject of the plague, and of reports
submitted by officers in charge of the operations at important plague
centres. The appendices are arranged under heads corresponding
to the chapters.