NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
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(3) Observation, Disinfection and Segregation of
Contacts.
7. Persons who have been in immediate contact with a plague
patient are known as " contacts " and as they are likely to develop
plague, special surveillance in their case is necessary. The clothing
and personal effects of all contacts should be disinfected and the contacts
placed under surveillance for a period not exceeding seven days under a
pass in the form in Appendix II-EI. While under surveillance, the
contacts should be allowed to pursue their ordinary avocations. Contacts
of cases of pneumonic plague should be ordinarily segregated.
(4) Evacuation.
8. By evacuation is meant the emptying of all or some of the
houses in an infected town or village, so that they may not be used as
dwelling houses until it is believed that they cau again be occupied
without risk of infection, the people thus removed being lodged in
temporary camps in the open country. To make such evacuation
thoroughly effective, the following conditions are required : (1) the
people should all be got out promptly ; (2) their effects should be
disinfected ; (3) each new case of plague should be immediately isolated ;
(4) suitable accommodation should be available ; (5) the people should
be effectually prevented from visiting or sleeping- in the infected houses
until either the houses have been disinfected or until sufficient time has
elapsed for the infection to disappear ; and (6) lastly they should not
be permitted to scatter and spread the infection in the neighbourhood.
9. Evacuation provides the most effective safeguard against the
spread of plague that has yet been discovered. Its advantages are
self-evident and it should be resorted to wherever practicable. In
villages and small towns (population not exceeding 10,000) complete
evacuation (i.e., evacuation of all the houses) will be found to be generally
possible. In large towns, the extent to which it can be carried out
will depend on the willingness of the people, the season of the year, the
situation of the town, the facilities for providing camp accommodation,
and the strength of the available staff. It will be found to be of the
greatest value at the very commencement of the outbreak, for, the
removal of the small number of people affected will not present any
great difficulties, and prompt evacuation of the infected quarter may
save the rest of the town.
.10. Evacuation is, h©wever, likely to do more harm than good in
the following cases :—
(a) During the rainy season, when it is impossible to keep the
people, after they have once been removed from their houses, from
going back to them. In such circumstances, the people who are
removed are exposed to great inconvenience and misery without any
countervailing advantages being derived from evacuation.
(b) When the infection is widely distributed among the inhabit-
ants of a large place, it is then advisable to agitate the people as little
as possible, especially when there are among them a considerable
«i
fractional doae has been taken, it is advisable to give the full dose at
once on the second occasion, after which a certificate may be given.
15. The privileges attached to inoculation are mentioned in
Rule 121. They are not admissible in oases of persons who have
recovered from plague. As a further encouragement the Government
have authorized the grant of three days' extra casual leave on full pay
to all'publio servants for the purpose of being inoculated. Students
attending Government and aided schools, who undergo inoculation, will
be marked in the registers for not more than three consecutive days as
" under inoculation," and such, an entry will be regarded as equivalent
to attendance. No subsistence allowance can be granted to inoculated
persons for the period during which they are incapacitated for work
owing to the operation.
16. The Sanitary Commissioner is in charge of all measures con-
nected with inoculation and will issue the necessary rules as to the
conduct of the operation, supply of Hafffcme's vaccine, inoculation
syringes, etc.
(6) Disinfection.
17. .Recent research seems now to demonstrate, with one important
exception, viz., pneumonic plague (a} that the number of bacilli that
actually leak out of the bodies of plague patients and rats is very small
and (¿) that having left the body of their host they do not survive the
drying action of the atmosphere for longer than 24 hours. Hence the
attempt to kill these bacilli is scarcely worth the trouble and cost
involved. But there remains an agent capable of carrying about for a
considerable number of days large numbers of virulent plague bacilli,
namely the rat-flea. This insect under normal conditions, lives in the
fur of the rat's skin and feeds on the blood of the animal. But when
the rat die« the flea leaves the dead body and goes in search of other
living rata and in the event of a failure to find another passes to the
body of man, bites him and thereby infects the individual with plague.
Consequently the great object of disinfection should be to kill the rat-
flea that has left the dead rat ; and in order to do this a preparation
that will kill fleas and not bacilli is required.
But having obtained such a solution which will kill fleas, there are
difficulties in its application. Where the houses are of the ordinary
poor class where plague is most likely to occur, the fleas may easily
escape in holes and crevices in the walls and escape the syringing of
the solution ; and in most such oases the application of the solution is
useless. In the better class of houses of masonry and plaster walls>
disinfection with the solution is more likely to be successful and should
be applied.
Bftb-fleaa however die o t starvation in a week if deprived of blood
from either rat or man ; hence a vacated house slowly disinfects itself.
An empty house moreover has no great attraction for rats especially
if it is infected.
TO 18. Disinfection of houses should be always carried out in the
following cases :—
(i) in houses where the occupants cannot or will not vacate,
(ii) in well-built pucoa houses and bungalows,
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In these cases disinfection should be done thoroughly and at the
earliest possible moment after discovery of infection.
19. Plague authorities should manufacture locally kerosine oil
emulsion and should supply it gratis to people who wish to disinfect
their own hou«es but they need not keep up an expensive staff to do
this work.
20. Breaking holes in roofs and walls and digging up mud floors
should be discontinued.
21. The actual burning down of houses should not be resorted to
except in the case of temporary structures which are of little or no
value, or in the case of houses which are unfit for human habitation.
22. (a] The best disinfecting fluid for general use is an emulsion of
kerosine oil. The emulsion is made as follows :—
To each four cakes of sliced " Sunlight soap " add half a gallon
of water and boil until all the soap is dissolved.
Pour half a gallon of the solution still hot into an open tub tilted
to allow the fluid to be beaten up with a cocoanut spoon such as is in
general use by natives. Whilst stirring or beating up, add oil little by
little at intervals of about a minute, taking care that all trace of free
oil is absorbed into the frothy mass before fresh oil is added. After the
addition of about three gallons proceed very carefully. If properly
done, one half gallon of soap solution should emulsify a whole tin of
kerosine containing four gallons. The only error likely to be made in
the first attempt is that from inefficient stirring or too quick addition
of the oil premature over-saturation should occur, a fact which is at once
apparent to the maker. To make one brew of four gallons takes about
half an hour. It is desirable to have a couple of coolies to each tub to
take turn about stirring and pouring the oil. Each couple of coolies
should in a day turn out at the very least four brews ; in actual
practice they will probably be able to turn out much more.
Another way in which the emulsion can be made with great ease
and rapidity is to do the mixing in a country churn such aa is used for
making butter.
(¿>) The emulsion should be used in the strength of 1 part to 10
parts of water.
(c) Perohloride of mercury should no longer be used for disinfec-
tion of houses as it has little or no action on fleas.
23. Disinfection of personal effects should be carried out in the
following cases :—
(a) Native crews, third class or deck passengers and native
servants leaving infected or healthy ports for ports out of India. This
should be done on shore.
(h) Plague patients and contacts removed from infected houses,
ships or railway carriages.
(c) People vacating their houses on account of dead rats being
found in their houses.
As the disinfection of personal "belongings is very unpopular,
especially those of women, and as nothing should be done that is likely
to endanger the speedy vacating of the house when dead rats are found,
the disinfection should take the form of arranging for the owner to
0
66
place all soiled clothes in water or a solution of oyllin and water, and
of exposing the bedding and better clothes to the action of the sun for
two days.
24. Disinfection of the person should be carried out in the case of
inmates vacating a plague-infected house, but, for the reason given in
paragraph 23, the inmates should be requested to take a bath and
change their clothes.
25. There seems little danger of the spread of plague by means of
ordinary articles of merchandise, and it is therefore not necessary to
disinfect such articles. The only restriction found necessary is the
prohibition against the importation from infected localities of rags,
waste paper and soiled linen. Any such articles brought in contraven-
tion of this prohibition should be destroyed.
Grunny bags that have been in use to carry grain should be disin-
fected in a steam-steriliser before being received by railway companies
if they come from a plague-infected area. This does not apply to new
gunny bags packed in bales.
26. Any railway carriage from which a passenger who is suffering
from plague has been removed shall be detached at the nearest con-
venient station, and shall be disinfected by the railway authorities as
follows and, if that station is an inspection station, such disinfection
shall be effected to the satisfaction of the inspecting medical officer.
(i) In the case of a third class or intermediate class carriage, the
carriage should be thoroughly well swilled with a solution of kerosine
oil emulsion and allowed to dry.
(ii) In the case of a first or second class carriage, the carriage
should be kept on a siding locked and shut up for seven days. It should
then be carefully swept out and cleaned and may be taken into use
again.
(7) Bat-plague and Destruction of Rats.
27. It has been observed, and proved by experiment, that rats are
very susceptible to plague and that a large mortality among rats
ordinarily precedes an epidemic of plague among human beings. Bats
with fleas present on their bodies are the main agents in the dissemina-
tion of plague. Their destruction, and the observation of any special
sickness or mortality among tnem, is of the first importance.
28. Measures for tLe destruction of rats should be universally
adopted. These vermin should, as far as possible, be exterminated in
every locality which is likely to be exposed to infection or in which a
recrudescence is to be feared. Special precautions in regard to rats
should not be confined only to infected localities or localities immediately
threatened and the neighbourhood. Granaries being the favourite
haunts of rats, grain bags arriving from a place suspected of being
infected with plague should be carefully examined, and any rats found
should be destroyed and their bodies burnt ; the bags and the grain
should be well exposed to the sun'f or 48 hours if dead rats are discovered.
Infection once brought into a granary spreads rapidly among the
healthy rats, and thence to human beings living in the neighbourhood.
Collectors, Presidents of District Boards and Chairmen of Municipal
Councils should therefore take special precautions to prevent infection
67
from this source. Arrangements should be made for the constant
inspection of granaries and grain bazaars, and care should be taken to
keep them clean and disinfected and to have the rats exterminated.
In inspecting granaries particular inquiries should be made -whether
any dead or sick rats have been observed. Eats sick with the plague
seem careless in the presence of men and run about in a dazed way
with a peculiar limping gait in the hind legs, owing to painful glands
in the groin. They frequently run round in circles or rcll over, and
are occasionally seen to drop from, the roof. The Port and Sea Customs
authorities should be instructed to see that no rats are landed with
goods imported by sea, and that rats found in ships are as far as
possible destroyed. Bandicoots, mice and other rodents are also liable
to become infected with plague and should therefore be destroyed.
29. The systematic destruction of rats whether in infected or
uninfected areas must be regarded as a measure of the first importance,
but more especially should the destruction be carried out in—
(a) infected places and the surrounding area within a radius of
ten miles ;
(ó) landing places and railway goods-sheds, where rats from
infected places are likely to be imported with goods brought by sea or
railway ; and
(c) grain godowns.
In the case of («), rewards may be necessary, but the maximum rate
should not ordinarily exceed three pies. In other cases, the Port or
Eailway authorities are expected to do all that is required without the
reward system.
30. The best methods of destroying rats are (a) by chemical poison,
and (b) trapping.
(1) Poison :—
(a) Nearly all the most efficient rat-poisons are mixtures of
phosphorus with flour flavoured and sweetened to attract the rodents.
Hence they are poisonous to man and animals and a certain amount of
care is necessary to see that children, fowls, dogs, etc., do not eat the
baits. The best preparations are the poison made by the Punjab
Government (The Punjab Eat Exterminator, price annas 12 per tin)
and Muöhicide (price Es. 3 per tin). The former can be obtained by
sending indents to the Sanitary Commissioner for Madras who will
arrange for the supply, but as a large stock is not maintained notice of
approximate requirements should be sent early. The latter can be
obtained from Messrs. Jaggat Singh, Son & Brother, Eawalpindi.
(¿>) Procedure adopted in carrying out poisoning operations.—The
following is the procedure adopted : the contents, 12 ounces, of a tin of
the poison are thoroughly mixed with 2 Ibs. of jaggery or treacle,
sufficient flour being added to make a stiff paste ; this is rolled into
large pills and is sufficient to make 1,600 baits. Although general
ignition of the poison cannot take place at high temperature, some slight
sparking of particles may occur ; to avoid this the mixing should not
be done in the sun's rays, handling should be avoided as much as
possible, hands should be kept wet with water. The pill method is
superior to spreading the paste on bread because baits can be prepared
more rapidly, the poison does not volatalise and the baits retain their
5*
69
(c) The trap should be cleaned weekly and rubbed with a little
cocoanut oil to prevent rust.
(d) All rats caught should be taken to centrally placed depots
to be counted, if possible classified and killed. In the case of rats
caught in infected localities it is desirable that such rat fleas as may be
present on the rats should be destroyed. The best method of killing
fleas on the rats caugbt prior to classification is to plunge the rat-trap
into a vessel of boiling water or solution of phenyle.
(e) The bodies of dead rats caught in au infected area should
be burnt.
(f) One cooly should be able to bait, clean, and look after 50
to 100 traps.
31. The charges incurred in the destruction of rats should be debited
to local or municipal funds according to the area within which such
charges are incurred.
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APPENDIX II-B.
GENERAL PASS.
[See Rule 83 on page 32.]
(To be issued for daily or frequent journeys by road or boat to or
from an infected area.)
No.
District.
Station of issue.
Name of person.
Father's name.
Caste.
Age.
Ordinary residence.
Journey covered by this pass.
This pass protects the person named above and the members of his
family mentioned on the reverse, but it does not authorise journey by
rail, for which a separate pass shall be obtained by each individual
requiring it, nor does is cover residence outside the village * of
It will be in force until revoked.
Signature.
Designation.
Date.
* The village specified should be that in which the holder permanently reaides with hie
family.
(Reverse of Form.)
Name.
How related to pass-holder.
Signature.
Designation.
Date.
n
APPENDIX II-O.
GENERAL PASS.
[See Eule 83 on page 32.]
(ïo be issued for daily or frequent journeys by rail to or from au
infected area.)
No.
District.
Station of issue.
Name of person.
Father's name.
Caste.
Age.
Ordinary residence.
Journey covered by this pasa.
Signature,
Designation.
Date.
APPENDIX 1I-D.
GENERAL PASS,
[See Rule 83 on page 32.]
(To be issued to persons who leave an infected or notified place to
attend markets in the adjoining iion-infected area.)
1. Inspection station through which the holder will pass.
2. Eailway station where the holder will alight.
3. Name of person.
4. Father's name.
5. Caste.
6. Age.
7. Sex.
8. From what infected or notified place.
9. To what market
. .
, .
f District.
4 Taluk.
[Village.
("District.
. { Taluk.
1 Village.
This pass allows the holder to remain in the village of
for 24 hours at a time without a passport. On the expiry of the period
he must either have left the village or have provided himself with a
passport. He must show this pass to the officer in charge of the
inspection station through which he will have to pass when proceeding
to the village where the market is held and to the passport-issuing
officer at the railway station where he alights as also to the local
authority of the village at or near which the market is held and obtain
their initials on the reverse. He will likewise show this pass on his
return to the officers mentioned above and obtain their initials. There
is, however, no necessity to present it at the railway inspection station
if there be no medical inspection on his return journey from the village.
Solder's signature
Date
Signature of issuing officer.
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APPENDIX II-E.
SPECIAL PASS.
[See Kule 85 on pag* 33.]
(To be issued to persons leaving an inhabited infected area to reside
in its neighbourhood.)
No.
District.
Station of issue.
Number of office of issue.*
Name of person.
Father's name.
Caste.
Occupation.
Age.
Ordinary residence.
The above-named person (and his family consisting of
males
and
females as per reverse) ~ permitted to reside temporarily at
(name of site or number of ßeld] on his producing this pass, with the
accompanying certificate t duly filled in by the officer responsible for
disinfection.
Date
Signature and designation.
* To be entered when there ÍB inore than one office of issue in a town,
f If the family leaves a healthy area of the town or a house that has not been infected,
this part of the certificate may he dispensed with at the discretion of the issuing officer.
(Reverse of Form.}
Name.
How related to pass-holder.
Signature.
Designation.
Date.
Disinfection Certificate.
I hereby certify that haying satisfied myself that arrangements for
residence at the site named- by the above-described person (and his
family) were complete, I immediately before-^4^-departure ca,refully
disinfected all clothing and property removed by ^—D
ate
Signature of officer in charge of
disinfection.
u
APPENDIX II-Ei.
Pass for Plague Contacts.
[See Rule 86-A on page 33.]
Take notice that you
being a plague contact
are required to submit yourself daily for examination at *
between the hours of
and
by the
passport examining officer until he is satisfied that by reason of dis-
infection of all infective matter in your residence, property and clothing,
and complete recovery and discharge of any person who has suffered
from plague with whom you may have last been in contact, a period of
seven days' freedom from imminent danger of contact with infective
matter has elapsed.
Date
Range Inspector,
* Here insert either a public office, or in special cases the person's residence.
Register No.
I acknowledge receipt of contact pass No.
, and am aware
that disregard of its conditions will subject me to prosecution under
Bule 100 of the Madras Plague Regulations in force outside the Presi-
dency town.
Date
.
Signature of contact or guardian of contact.
APPENDIX II-! 1 .
fSee Rule 121 on naecs 44 and 45.1
jt*. _
[COUNTEKFOIL.~J
No.
Name
Father's name
Street
Village
Town
fakiqf
District
Date
Initials of operator
is Plague Inoculation ? fifr
Certificate.
M No.
*™ "-
\f CERTIFIED that
, son of
§
., , .
Street
, resident of
, ==_
M
ViUage
W
Town
, District
£1
' Taluq
w
5 has been inoculated by me, and
W that his thumb-mark was at the time impressed
i before me.
. Space for left thuinb-mark.
I
Signature and~\
designation* ]
¡I
Dated
§ Note.— Unless suffering from, or suspected to be suffer-
ing from, plague, the holder of the certificate is exempted
tfrom segregation, from detention when travelling, and from
seven days' observation under the passport rules. It does
/\ not, however, exempt him from liability to evacuate an
M infected house, except in the case where all the occupants
v'J of the house have been inoculated, or to have his clothes
§and person disinfected when travelling. The certificate is
valid for a period of nine months.
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APPENDIX II-GL
Register of Permanent ¿Passes issued to Persons attending
Markets.
[See Rule 84 on pages 32 and 33.]
Name of person.
Pass nmnber.
Date of
Arrival.
Return.
; llemarkfl.