NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
CHAP. IV. ]
Previous history of plague in India.
73
is almost entirely cut off from the continent of India, north by the
great Ran, east by the little Ran, south by the Gulf of Cutch, and
west by the east or Kosi mouth of the Indus. Though on the
whole treeless, . barren, and rocky, the aspect of the country is
varied by ranges of hills and isolated peaks, by rugged and deeply
cut river beds, and by well tilled valleys and tracts of rich pasture
land. On the south, behind a high bank of sand that lines the
sea-coast, lies a low, fertile, and well cultivated plain from twenty
to thirty miles broad. There are no rivers in Cutch, but during
the rainy season (July to October) many streams of considerable
size flow from the central ranges of hills northwards to the Ran
and southwards to the Gulf of Cutch. For the rest of the year
the courses of these streams are marked by a succession of detached
pools. Lying along the line of the tropic of Cancer, Cutch is almost
beyond the rain-bringing influence of the south-west monsoon.
The mean average rainfall for the five years 1891-1896 recorded at
the different registration stations in the island was only 1760 inches.
Along the sea-coast, throughout the year, the climate is agreeable ;
and over the whole province, for nearly nine months, it is cool and
healthy. But in April and May burning winds and duststorms pre-
vail, and again during October and part of November the heat
becomes excessive.*
Account of
the outbreak in
Cutch.
The years 1811 and 1812 were marked by a severe famine
which extended over the greater portion of Gujarat. At the close
of the year 1812 plague broke out in Cutch with such virulence
that it is said to have destroyed half the people of the country. The
following account of the epidemic is taken from Volume V, Chapter
XII, of the Bombay Gazetteer :—
" What along with the weakened state of the people must have
strengthened, if it did not give rise to, this plague, was overcrowding
in the towns, where on account of the disorders of the few preceding
years, people from the village had sought shelter. For two years
the disease abated. Then in May 1815, the year of the heaviest
known rainfall, it broke out with deadly force in Kanthkot in east
Cutch. As in Ahmed abad, its symptoms were slight fever followed
by great weakness and weariness, and then swellings in the groin
and armpits, suppurating in some cases and in others remaining
hard lumps. Few stricken with the disease recovered. Most died
between the third and ninth day. The plague seemed in the air ;
there was nothing to show that it had been brought from outside,
or was spread by the touch. It seemed to attack most fiercely
the sluggish and vegetable eaters ; Rajputs escaped where Brahmans
* Imperial Gazetteer of India, Volume IV, pages 57-64.
10
74
Previous history of plague in India.
[CHAP. IV.
and Vanias died in numbers ; oil-makers were believed to be safe,
In Bhuj, care was taken that no one should come from the affected
districts. One man died, those with him were turned out, and the
house was smoked with brimstone and unroofed. From Kanthkot the
disease spread to other parts of Vagad (the eastern territorial
division of the State), causing much loss of life in the early months
of 1816. In May it crossed to Morvi in Kathiawar, and came back
in August to within ten miles of Bhuj."
Epidemic in the
Radhanpur State
and Sind.
After 1817 there was no re-appearance of the disease in Cutch.
At the same time that the disease spread to Morvi it raged in the
Radhanpur State (lying to the north of Kathiawar and bounded
on the west of the Ran of Cutch) and in Sind, occasioning a
severe epidemic in the capital of this latter State (Hyderabad) in
November of the year 1816.
Description of
Kathiawar.
Climate.
Kathiawar,* to which the plague spread in the spring of 1816,
is a square peninsula, standing boldly out into the Arabian Sea
between the smaller projection of Cutch and the straight line of
the Gujarat Coast. It was formed into a political agency under
the Government of Bombay in 1822, containing one hundred and
eighty-seven separate States. For administrative purposes it is divided
into four divisions : Jhalawar in the north-east, Halal in the north-west,
Sorath in the south-west, and Gohelvvar in the south-east. Lying
midway between the dry deserts of Sind and the moist wooded
Konkan, the province of Kathiawar partakes of the nature of both.
At the same time it illustrates the transition between them by modifi-
cations of aspect ranging from the barrenness of the one to the rich-
ness of the other. Its shores, differing from the rocky coast line to
the north and south of Bombay, resemble the coasts round the head
of the Arabian Sea, and inland it shows every variety of scenery, from
the arid and sandy tracts of Okhamandal in the west and Jhalawar
in the east, covered with cactus and desert bushes, to the well watered
forests of Gir in the southern range of hills, from the desolate waste
of the Ran to the fertile and well cultivated region of the south ;
from the salt charged plains of the east and west to the rich seaboard
tracts. The climate of the peninsula is in general pleasant and healthy.
January, February, and March are marked by heavy dews and thick
fogs, which are not unhealthy. The hot weather begins in April and
lasts until the rain falls in the middle of June. The hot wind blows
in various degrees in different parts, and is hottest in the south. On
the sea-coast it is little felt. The hot weather months (April to June)
are the healthiest in the year. There is always a light, cool breeze.
The rains generally begin in force at the first change in the moon in
* See M p in Volume IV, page 1.
CHAP. IV.]
Previous history of plague in India.
75
July and are spent by about the end of August. Unlike other parts
of Gujarat, the rains are never severe and they grow lighter towards
the west. Except that slight fevers prevail in July, no disease is
specially prevalent between July and September. From the end of
September the climate undergoes a change and becomes unhealthy,
In September and October the heat of the sun is acutely felt, though
the weather is cloudy. The latter part of November and the whole
of December are in all respects like January.*
Accounts by
contemporary
Medical Officers.
Very interesting accounts have been given of the plague in
Kathiawar by two Medical Officers who visited the country during the
period of the epidemic. The first account by Dr. Gilder, Civil
Surgeon, is contained in a letter dated the 2oth February 1820 to the
Bombay Medical Board, and the second by Dr. White, Assistant Sur-
geon, is contained in a letter of the 27th March 1820 to the same
address. The two letters are reproduced in Appendix II, and the
following account is derived from them and from Volume IV, Chapter
XII of the Bombay Gazetteer :—
Commencement
of the outbreak
in Kathiawar at
Morvi.
It has been stated above that the plague was introduced in May
1816 from Cutch to Morvi, the capital of a State of the same name,
situated in the Halal division of the Kathiawar Peninsula on the
western border of the Jhalawar division.
Spread to the
Dhandhuka
subdivision of
Ahmedabad.
Dholera.
1817.
In 1817 the disease travelled to Dholera, a sea-port lying twelve
miles up a creek of the Gulf of Cambay and situated in Dhandhuka, a
subdivision of the Ahmedabad district lying to the south-east of the
Jhalawar division of Kathiawar. It was believed that the disease
was introduced into Dholera, a place of some importance in connection
with the cotton trade, from Cutch, either by merchants or by the
cotton ginners who came annually from Cutch with their wheels to
separate cotton from its seed.
In Dholera three people only were attacked, all of whom died ;
the disease spread thence over the neighbouring British villages
of Bariad, Rojka, Pipli, etc., and advanced westwards to Dhandhuka,
the head-quarters of the subdivision, and situated near the border of
Jhalawar. The epidemic continued in this neighbourhood and
amongst villages on the border of the Ran until the close of the
year 1817, when it gradually decreased without, however, altogether
disappearing. Isolated cases continued to occur in the Dhandhaka
subdivision and the neighbouring district of Limbdi in Jhalawar.
Spread to the
Jhalawar
division of
Kathiawar.
1819.
In April 1819 the epidemic broke out with renewed virulence
in the village of Bariad, a few miles north-west of Dholera. It raged
here for two months until the setting in of the monsoon, and forty
* Bombay Gazetteer, Volume VIII.
76
Previous history of plague in India.
[ CHAP. IV.
families are said to have been annihilated. In the beginning of June
the malady spread to Rojka, a village close to Dhandhuka, and nearly
depopulated the place. During the rains of 1819 the malady became
diffused over a large tract and manifested equal virulence in different
parts of the country without, however, passing the western border of
the Jhalawar division.
Limbdi.
Extinction in
1821.
Mortality.
Towards the end of June the disease appeared in the town of
Limbdi and made such ravages that the terrified inhabitants after losing
fifteen hundred to two thousands of their number deserted the place,
leaving their sick and a few persons to perform the rites for the dead.
After this emigration the disease abated in Limbdi, but only to
break out with increased virulence in other towns and villages of the
neighbourhood, some of which are said to have been totally depopu-
lated. The misery of the situation was aggravated by the fact that the
rains were pouring down in torrents, flooding the country and forcing
the inhabitants to crowd together in the infected villages, which rose
like islands from a sheet of water. In 1821 the epidemic died away.
Except for the 1816 outbreak in Morvi, the malady does not appear to
have been diffused in Kathiawar beyond the limits of the Jhalawar
division. Of the total mortality no estimate was made, but it must
have amounted to a large proportion of the inhabitants of the stricken
region. Dr. Gilder and Dr. Whyte agree that the disease was ex-
tremely fatal and that few recovered.
Classes most
affected.
It is said that persons of the Brahmin, Merchant, Goldsmith, Tailor
and Kanbi* castes suffered most, and that the flesh-eating classes
largely escaped. Dr. Gilder remarked that when once in any place
the malady obtained hold over the members of any particular caste
or trade it seldom abated without having made victims of them all.
Symptoms.
Dr. Gilder gives a detailed clinical account of the disease, derived
from native sources, in which he draws a marked distinction
between the bubonic and pulmonary types, and gives a descrip-
tion of each, which tallies exactly with the description given in earlier
and later epidemics. The natives had different names for the two
forms of the disease ;. the bubonic form they termed Ghant no rogue or
"the knotty disease ; " the pulmonary form they distinguished by the
appelations Kogla no rogue and Tao no rogue, signifying, respec-
tively, "the expectorating disease" and "the fever disease."
Pulmonary
variety, the first
to occur.
Dr. Whyte also notices the existence of the two forms,
and states that in all cases the pulmonary form first broke out,
and that the ordinary bubonic plague made its appearance afterwards.
He gives the following description of a case of the pulmonary disorder
which came under his observation : " In this man the heat of the body
* The principal cultivating caste.
CHAP. IV.]
Previous history of plague in India.
77
Mild bubonic
form.
was not much increased nor the pulse greatly accellerated ; his bowels
were not disordered nor did his tongue indicate much febrile irritation.
He was able to walk about and converse, answering questions dis-
tinctly. No person would have thought him in danger, but there existed,
in the patient's mind, a degree of alarm and anxiety altogether dispro-
portionate to the apparent symptoms. He had only been attacked
that morning. All his consideration seemed absorbed with a pain in
his chest. He answered to my questions whether he had not other
pain, as in his head, his back or limbs, that these were slightly painful ;
but he immediately recurred to his chest, dwelling upon that with a
look of most painful distress ; and if not questioned about other symp-
toms, it seemed as if he would not have mentioned them. He had
besides a very slight cough,—so slight that it might easily have escaped
unnoticed,—and this was accompanied with a discharge of blood from
the mouth. The following day he was delirious, had a burning skin,
with a very quick pulse. I searched for but found no buboes. He
died in the course of the succeeding night, i.e., in less than forty-eight
hours from the first attack. The characteristic symptoms of this variety
are, slight cough, pain of the chest, and haemorrhage from the mouth,
attended with fever, but no buboes." Dr. Whyte also gives a descrip-
tion of the mild form of bubonic plague unaccompanied by fever.
" I saw,"* he states, " a great number who had buboes, without any
fever, and was told that upwards of one hundred and twenty had
suffered in this way. These people walked about without either
alarm or inconvenience, for none had died, and not many of the
buboes suppurated. "
Dr. Whyte's
report.
Morvi.
Dr. Whyte's report is divided into two parts. In the first part E
he gives a description of the matters that came under his obser-
vation in the different places he visited, and in the second part
he states his general conclusions. Morvi, in the Halal division, and
Wuccaner (Vankaner), Sura (Sara), Moolee (Muli), and Sily (Sayla)
in the Jhalawar division were the principal places visited. It was
three years since the outbreak at Morvi (1816) when Dr. Whyte
made his tour. He stated that the situation and surroundings of Morvi
were healthy and not such as predispose to ordinary malarial fevers,
but that the whole space within the walls of the town was crowded
with houses. The disease prevailed for five months in Morvi, begin-
ning in the cold and lasting through the hot months without undergoing
any modification on the occurrence of the change of weather. The ac-
counts given of the mortality varied greatly. Dr. Whyte considered five
hundred deaths to be a probable estimate. He with difficulty procured
* At Muli, in the Jhalawar division.
78
Previous history of plague in India.
[CHAP. IV.
Local belief that
the disease was
nut contagious.
Beneficial
influence of a
healthy situation
and abode.
Vankaner.
The Bohoras, or
cotton weavers.
Suppression of
the disease by
removal to the
open.
Muli.
four recovered patients for examination, and instances this fact to show
how few of those who were attacked recovered. The inhabitants of
the town did not believe the disease to be contagious. The Thakur
or Chief's brother had been in the habit of visiting and looking after
the sick, frequently handling and touching them, and did this with
complete immunity. Dr. Whyte inferred that casual intercourse
with the sick is unattended with much danger, that it is probable
that the disease is not readily communicated by the touch, and that,
it is possible that confinement in the same apartment is in general
necessary for its production. The Thakur's palace, containing about
one hundred people, escaped completely. It was a large well aired
place elevated above the other parts of the town. Equal immunity was
enjoyed by a small village situated on the opposite side of the river
less than a quarter of a mile away on a very high and exposed situa-
tion, although there was daily and hourly communication between
the village and the infected town. Vankaner is a large walled
town, seated at the foot of a hill and on the banks of a fine river,
distant about eighteen miles from Morvi. It is believed that the
disease was imported from this latter place. The outbreak lasted
only fifteen days and was almost solely confined to the Bohoras—a
sect of Muhammadans whose occupation was the manufacture of cotton
cloth. The number of deaths was estimated at sixty among this
community, while not more than four or five among the rest of the
inhabitants caught the infection. The Bohoras became so alarmed
that they all left the town and went to live upon the mountains in the
neighbourhood, leaving only the sick and their attendants. It is
said that the whole of these very soon died. Whenever they heard
of a death, the friends of the deceased came down and performed
the last offices as speedily as possible, returning again to their abode
on the mountains. Some of those who attended the funerals fell ill, but
at the end of fifteen days after the Bohoras removed to the moun-
tains, the disease had entirely disappeared from amongst them.
When this was the case they all came down and re-occupied their
houses, and they declared that no person was afterwards attacked by
the disease. Dr. Whyte remarks " chat this is a curious and singular
fact, affording a rare instance of a measure dictated by fear, and
carried into effect without reason or reflection, being attended with
complete success." " In fact," he says, " it corresponds very nearly
with what has been recommended to be done by one of our best
writers, Dr. Adams, on such an occasion, and is a very good practi-
cal illustration of the measures, which with so much care, delibera-
tion, and strict induction from the facts before him, he laid down
and thought likely to be successful." Muli is described as a large and
CHAP. IV.]
Previous history of plague in India,
79
Bad ventilation.
Sayla.
populous town, the inhabitants of which are mostly Rajputs. It
was surrounded by an old ruinous wall full of breaches, which
were all carefully stuffed with thorns, and every house had a
wall of the same material much higher than a man's head. " No
better means could possibly have been adopted," says Dr. Whyte,
" completely to exclude ventilation, if this had been the sole object
of the inhabitants. " At the time of Dr. Whyte's visit, the disease
was still prevailing and had already caused about eighty deaths.
It was at this place that Dr. Whyte recorded his clinical observations
on the pulmonary and mild bubonic forms of the plague which are
quoted above. Sayla is a large walled town in the neighbourhood of
an extensive tank, which supplied it with excellent water. The
disease had prevailed for about two and a half months at the time Dr.
Whyte paid his visit. At first it had been very severe and general,
but latterly it had become more partial in its attacks. Here also the
Bohoras were the first and severest sufferers ; one hundred and twenty
deaths were said to have occurred, of which sixty were amongst the
Bohoras. In some houses the loss had been very heavy, amounting
to five, eight, or nine of the household.
Dr. Whyte's
discussion on the
origin and
spread of the
disease.
Spread by
infection and
fostered by
endemic causes.
Dr. Whyte's report contains a long discussion on the origin of the
disease and the way in which it spread. The opinions at which he
arrived were very similar to those which are held at the present time.
He believed that the disease spread from place to place by contagion
(in the broad sense of the term), and especially by fomites, but that
while it spread with facility in a close and insanitary situation, the
reverse was the case in an open space and where sanitary conditions
prevailed.
Insanitary
condition of
Kathiawar.
He describes in detail the endemic causes which fostered the growth
of the disease in Kathiawar. The inhabitants were to the last degree
uncleanly in their persons and habits, political causes had checked
industry and agriculture and engendered idleness and want, and these
evils had been aggravated by severe famine. It was also the habit of
the people to live in crowded, dirty and ill-ventilated walled towns, and
in the houses men and cattle (which were usually diseased), were
herded together in the most unwholesome manner. The long duration
and virulence of the outbreak can, under these circumstances, occasion
no surprise.
Remedial
measures
suggested by
Dr. Whyte.
In the remedial measures which he suggested, Dr. Whyte was also
in agreement with the opinions that now prevail. " It is cheering to
reflect," he remarks, " that we have arrived at the knowledge of a
plan, by which, if its rules are rigidly attended to, we have it in our
power speedily to check the progress of this scourge, in any place
80
Previous history of plague in India.
[CHAP. IV.
Segregation of
the infected
in the open, and
destruction of
contaminated
clothing.
where it may be introduced. * * * * These (rules), I need hardly add,
are such as would secure cleanliness, and a complete separation of
every family where the disease had appeared ; they ought to be com-
pelled instantly to depart from the town and live in the open plain, under
a temporary encampment, which (if the subject were thought of suffi-
cient importance) might be erected at the public expense for the lower
orders. It would be well if the clothes of the diseased were to be
burned at the public expense likewise. Experience has proved
that, if not crowded, in such a situation the disease would not spread,
and there can be no doubt the beneficial consequences would soon be
a subject of joy and congratulation to every one who had a hand in
promoting so benevolent a purpose." Dr. Whyte had little hope
that these measures would be adopted in Kathiawar.
Outbreak in the
Dhandhuka
subdivision.
Description of
the Ahmedabad
District.
The outbreak in the Dhandhuka subdivision of the Ahmedabad
District which spread from the sea-port of Dholera in 1817 has
already been noticed. Dhandhuka forms the southern portion of
the main body of the Ahmedabad District. The town of Ahmedabad
is situated in the north-east corner of the main portion of the
district and is some seventy miles distant from Dhandhuka. It is
a flourishing town encircled by a belt of park-like country several
miles in depth, and it is situated in the fertile plain of sandy soil
which extends through the Daskroi and Dholka subdivisions which
form the central portion of the district. The Dhandhuka subdivision
lies in a fertile but treeless plain which changes towards the east to
bleak, salty flats intersected by marshes.
Quarantine
measures.
Quarantine
ineffectual at
Dhandhuka.
Pestilence at
Ahmedabad.
To stop the spread of the disease in the Ahmedabad District,
the Collector ordered all heads of villages to allow no one to come
from infected villages ; if any one harboured people from a diseased
village he and his family were to be turned out. Later on (January
1820) it was found necessary to keep people from going to infected vil-
lages to attend their relations' funerals, and village officers were ordered
to turn any one out who had visited an infected village. But these harsh
and stringent measures were powerless to check the spread of the
disease. Notwithstanding the quarantine which was imposed at Dhan-
dhuka, the infection found an entry and nearly depopulated the place.
And at Ahmedabad itself ''a contagion raged with a fury that can
scarcely be believed." Of the symptoms of this sickness no details are
recorded, but there can be little doubt that it was the same plague
that was ravaging the neighbouring parts of the country. It is said
that " every house sickened, whole families were carried off, and many
a funeral party coming back to the house of mourning found that,
in their absence, another member of the family had sickened and died.
So thinned were some castes that their women had to help to carry