NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
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so occupied. Nothing in this rule shall authorize the chairman
of a municipal council to enter upon, occupy or use any building
or place which is the property oí Government without the
previous permission of the Collector
Private
plague
oamps.
62. Contributions towards the cost of the construction and
maintenance of private plague hospitals and segregation camps
in places which are or may be threatened with plague will be
made by Government from provincial funds in accordance with
the following scale :—
(a) For construction, half the cost will be paid by
Government provided the charges are considered reasonable
and the buildings erected on sites approved by the Collector
or plague officer acting under his control. In any case of
doubt or dispute the Government will have the right to
estimate by means of the Public Works department the value
of the work done.
(b) For maintenance, grants not exceeding half the
actual expenses will be sanctioned by Government on the
following conditions :—
(1) the arrangements for the sanitation and supply of
food must meet with the approval of the Collector ;
(2) the amounts will be paid, month by month, in
arrears to the manager or managers approved
by the Collector.
63. Hospitals and camps to which a grant is made under
the last preceding rule will be under the general supervision
of Government officials, but these officials will have nothing to
do with the treatment of the sick except at their request, and
their duties will be confined to preserving order, preventing
theft, keeping guard, and attending to sanitation. Detailed
instructions with regard to the construction, equipment and
management of plague camps will be issued by the Sanitary
Commissioner and of plague hospitals by the Surgeon-General.
The sale-proceeds of private hospitals to which Govern-
ment have made a contribution will be equally divided
between Government and the plague committee concerned.
Grants for
erection of
sheds in
rural areas.
64. In rural areas district boards may find it cheaper to
give poor people grants not exceeding Es. 3 per household and
let them make their own arrangements rather than to build
sheds for them. Such grants should be kept at as low a figure
as possible, and should be made as a rule only to those who are
otherwise unable to furnish themselves with shelter,
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occupation of
buildings
belonging to
Government
departments.
65. It may become necessary at any moment for Collectors
or other plague authorities to occupy buildings belonging to
other departments than the Revenue department for plague
purposes. In such cases the earliest possible intimation of
such occupation should be given to the authorities in charge
of such buildings. Before occupying them, any moveable
articles in the building at all likely to retain infection should
be removed and placed under proper custody.
Conveyances
for the
carriage of
the sick and
of infected
articles.
66. The Collector, or the chairman of the municipal
council or president of the local board, as the case may be,
shall provide suitable conveyances for conveying to the plague
camps established under Rule 59 persons suffering, or suspected
to be suffering, from plague, and for the transport of any
clothing, bedding or other articles which have been exposed
to infection.
List of areas
under obser-
vation.
66-A. (I) Collectors of districts containing areas notified
under Eule 52 should submit not later than the 1st of April
and the 1st of October in every year, a statement showing
separately the taluqs and municipalities which should continue
to be regarded as being under observation during the ensuing
half-year and the areas which should be freed from observation.
Government will then publish a single consolidated notification
specifying all the areas in the Presidency which will remain
under observation during the half-year, municipalities and
taluqs of districts being shown separately.
(2) If any area not included in the half-yearly notification
is imminently threatened with plague in the course of the
half-year, proposals for placing it under observation should be
submitted to Government immediately, the municipal and non-
municipal areas comprised in it being specified separately ;
but no proposal for rescinding a notification declaring an area
to be under observation should be submitted except on the
dates specified in the previous paragraph.
Note.—For the purpose of this rule municipalities and taluqs of districts shall be
regarded as units. Proposals should, not be submitted in respect of any smaller areas.
Part III.—Measures to be adopted on the Occurrence
of a Case of Plague.
Report by
local officers
of occurrence
of plague ;
isolation of
patients and
contacte.
67. (1) On the occurrence of an actual or a suspected case
of plague in a town, village or railway station other than an
inspection station whether in a district declared to be under
observation or not, the village headman or other local officer
shall—
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(i) isolate the patient in the camp provided under
Rule 59 supra, or, if no camp has been provided,
in a hut or shed to be immediately constructed
for the purpose on a site remote from inhabited
houses, and shall invariably cause the houses
i
%i
in which the patient was found to be completely
evacuated ;
(ii) send intelligence by express to the tahsildar or
municipal chairman, and, if plague inspectors
have been appointed, to the nearest plague
inspector.
(2) The village headman or other local officer shall
segregate in a separate camp or hut all persons who have been,
or are suspected to have been, in contact with the patient if the
latter is suffering from pneumonic plague, and not otherwise.
It is sufficient in cases of bubonic plague to observe contacts
for a period of seven days, and to disinfect their clothing and
effects.
Report by
plague
inspector and
tahsildar or
municipal
chairman.
68. Upon receiving information of the occurrence of an
actual or a suspected case of plague, the tahsildar, the municipal
chairman or plague inspector, as the case may be, shall inform
all superior officers up to the Collector by the quickest possible
means, and shall go at once to the infected locality. The
tahsildar or the municipal chairman shall arrange to be
accompanied or followed by the nearest medical officer with a
supply of medicines and disinfectants and by a sufficient staff -
of constables and peons.
Action to be
taken by
plague
inspector an d
tahsildar or
municipal
chairman. ,
69. On arrival at the infected place, the plague inspector
(or medical officer if there is no plague inspector) shall
supervise the isolation of the patient and the disinfection of
his residence, clothing, sputa and excreta, and the clothing,
and at his discretion, the persons of all who have been in
contact with the patient and shall continue such supervision
until relieved under the orders of a plague officer and sent
back to other duty. Houses immediately adjoining that in
which the case of plague has occurred shall also usually be
disinfected.
70. (1) The tahsildar or municipal chairman shall, if the
plague patient has already been completely isolated, arrange
for the efficient maintenance of such isolation, for the provision
of medical attendance on the patient, for the complete evacua-
tion of the house and for the thorough carrying out of the
measures of disinfection specified in the last preceding rule.
If the patient has not been isolated, the tahsildar or municipal
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chairman shall at once provide for his isolation, and shall, if
necessary, provide the accommodation referred to in Rule
09 supra.
(2) The tahsildar or municipal chairman shall, in like
manner, provide for the efficient maintenance of the segregation
of contacts, if they have been segregated, or for the efficient
carrying out of the seven days' observation, if they have been
placed under observation.
Action to be
taken by
plague officer.
71. On receiving information of a case of plague, the
duties of a plague officer (see Rule 103) shall be as follows :—•
(1) He shall send telegraphic information to the
Collector and the district medical and sanitary officer.
(2) He shall,then go to the scene of outbreak, and shall
enforce the measures mentioned above.
(3) He shall see that the hospital, the suspect camp and
the health camp are properly organized and guarded.
(4) He shall see that the patrols and guards round the
infected area completely isolate it, or such part of it as he
deems fit, so as to prevent the return of the inhabitants without
his written permission.
(5) He may also, when authorized by the Collector,
direct the evacuation of the village or town or any part of it,
and the removal of the inhabitants to a health camp, provided
sufficient shelter is available, and their detention there for a
period not exceeding seven days from the date of the occurrence
of the last case of plague among them.
(6) On the evacuation of houses, he shall cause them to
be surrounded by a cordon with the object of preventing the
return of the inhabitants without his written permission until
he considers that the infection has disappeared.
Note.—For further information as to the steps to be taken in plague outbreaks, the
importance of early discovery of plague cases, and the segregation of contacts, see notes
(1), (2) and (3) in Appendix I.
Report by
Collector and
the action to
be taken by
him.
72. (1) The Collector, on receiving information, shall
telegraph to Government and the Sanitary Commissioner, and
shall despatch the ambulance staff with its equipment to the
village under the district medical and sanitary officer, or his
assistant.
(2) The Collector may notify by tom-tom (the notification
to be as soon as possible published in the District Gazette) that
any town or village, or part of a town or village, or group of
villages, is infected, and thereupon the regulations contained
in Part II shall come into force in the district if they have not
been brought into force by Government already.
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(3) The Collector may order the evacuation and disinfec-
tion of infected houses and houses in their neighbourhood, or
of infected villages and towns, and may prohibit their reoceu-
pation without permission, provided that such arrangements as he
thinks fit shall be made before evacuation, for the accommoda-
tion, in a health camp or elsewhere, of those who may be
unable to provide shelter for themselves.
Note.—Por further remarks regarding evacuation, see note (4) of Appendix 1.
(4) The Collector may require the evicted people to
reside in any place which he may appoint, under such restric-
tions as he may deem necessary.
(5) The Collector may requisition the services of any
public servant or, for work connected with a railway, of any
railway employé.
(6) The Collector shall, if possible, go to the village and
direct operations.
(7) The Collector may also, on the evacuation of houses,
make such arrangements as he thinks fit for the custody, free
of charge, of money and valuable property of small bulk
belonging to persons who are bonâ-fide residents of houses that
may be evacuated, and who mav desire so to deposit such
property, provided that articles so deposited are securely packed
and sealed, and on the clear understanding that the Govern-
ment will not be responsible for any loss or damage to the
property so deposited.
Every person depositing property in the manner aforesaid
shall be granted a certificate in the following form :—
Certificate for property deposited in safe custody.
Certified that a sealed package said to contain (nature of property)
and said to be of the value of
has been received for
deposit from (person)
residing in (town or village,
street and No.
of the house, etc.)
on the sole responsibility
of the depositor ; the Government not being responsible in the event of
any damage or loss occurring to the property in deposit.
Date
Signature and designation of the officer
issuing the certificate.
Signature and designation of the
depositor.
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Part IV.—Rules applicable to Areas declared
to be infected.
Preventive
ranges.
73. If observation ranges have already been established
under Rule 56 supra in the neighbourhood of an infected area,
they shall be reduced in extent so as to enable the inspectors
to visit every village within their respective ranges in seven
days. The distance from the extreme limits of any such range
to any point on the periphery of the infected area shall not
exceed twenty miles. If an observation staff has not been
already appointed, the Collector shall at once organize one so
as to meet this requirement. Ranges so formed round infected
areas shall be termed preventive ranges to distinguish them
from the observation ranges mentioned in Rule 56 supra,
These ranges shall be placed in the charge of plague inspectors,
whose duty shall be to visit frequently every inhabited part of
their ranges, to check the working of the passport system, and
to maintain a watch over the health of the inhabitants with the
object of quickly discovering cases of plague and preventing
the spread of the disease.
Inoculation.
74. The Collector shall arrange for a sufficient supply of
Haffkine's vaccine in order to bring inoculation within the reach
of the inhabitants of plague-infected and plague-threatened
localities and shall afford them every facility for being
inoculated.
Note.—l'or further information regarding inoculation, see note (5) in Appendix I.
Certificates
of canses of
death.
75. (1) When he has a sufficient medical staff at his
disposal to secure immediate inspection, so that there may be
no chance of funerals being delayed, the Collector may, with
the previous sanction of Government, order in respect of any
particular area that a certificate of a medical officer showing
the cause of every death shall be obtained within two hour»
after such death. It must be understood that medical exami-
nation of a corpse is entirely optional on the part of the
relations, and that no one will be compelled to allow the inspec-
tion of the corpse of a deceased relative. The examination of
the corpses of women by men shall never be required. The
orders of the Government shall be obtained before this rule
is acted upon in any area, and in applying for sanction, the
Collector shall report fully on the following points :—
(i) What classes of officers will be authorized to issue
certificates under the rule,
(ii) Whether any fee will be required for the grant of
this certificate.
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(iii) Whether there is such a number of Government
medical officers, male and female, at the station
as will be sufficient to carry out inspection
promptly so as not to cause any delay in burials.
(iv) "Whether there has been any increase in the rate
of mortality.
(v) Whether there is any reason to believe that deaths
are concealed or that causes of death are not
correctly reported.
(2) If, after the issue of an order under clause (1) of this
rule, a burial or cremation takes place without such a certifi-
cate having been obtained, the death may be presumed to have
been due to plague, and the rules regarding the segregation of
the contacts and the disinfection of the" house may be applied.
House
search.
76. With the previous sanction of Government, the
Collector may organize search parties to visit houses for the
purpose of detecting cases of plague, when there is reason to
believe that the residents are attempting to conceal them.
Special enquiries shall also be made as to any sickness or
mortality among rats, and houses in which sick or dead rats
have been found shall be disinfected.
77. The system of house-visitation and house-search will
ordinarily be permitted only when plague exists in small and
well-defined areas } such for instance as an isolated quarter or
ward of a town, or a single village in a neighbourhood which
is otherwise completely free from infection. When this mode
of discovering plague is adopted, care should be taken that a
sufficient number of European officers are employed to render
the powers of search effective and at the same time prevent
the subordinate establishments from abusing their authority.
Failing officers of the civil establishments, young officers of
the Staff Corps should be deputed for this duty. Respectable
inhabitants who volunteer for the service should be employed
to assist in searching for concealed cases of plague. As far as
possible, houses should be allowed to be entered only by persons
of caste or of the same religion as the occupants, and women
should be utilized in examining women and in searching any
room or place exclusively occupied by them.
Removal of
plague
patients to
hospital.
78. Plague patients who are left without anv one to look
after them or who have no home should in all cases be removed
to hospital, and in dealing with imported cases or with an out-
break in a small place upon which it is possible to concentrate
a sufficiently strong establishment, the first measure to adopt is
the compulsory removal of the sick to hospital. In dealing
30
with early indigenous cases the same policy may be advisable.
But if plague continues a point may soon be reached when it
will cease to be possible to obtain information as to all cases.
When this point is reached, the continuance of attempts to
remove the sick to hospital may result in the sick being carried
from house to house for purposes of concealment, and at this
stage the less the sick are interfered with the better. All that
can then be done is to endeavour to palliate the evils that result
from leaving people in their houses by arranging for continual
visitation of the sick at home, the frequent disinfection of the
infected room, and the encouragement of inoculation among
persons left in the houses with the sick.
79, Except as mentioned in the last preceding rule the
removal of patients to hospital shall not be compulsory. Every
effort shall, however, be made to induce patients to go
voluntarily to hospital and to lessen the aversion to hospital
by the following means—(1) by encouraging the establishment
of private and caste hospitals ; (2) by locating hospitals near to
infected quarters ; (3) by limiting the size of hospitals so that
patients may receive more individual attention ; (4) by arrang-
ing for the provision of an adequate number of medical
attendants and nurses and of ample and comfortable accom-
modation for patients and their immediate relatives or friends ;
(5) by permitting at least two relatives or friends to be in
attendance on each patient so that the patient may never be
left alone ; (6) by allowing the patients to have their own
food and medicines and to receive visits from their relations,
friends and religious instructors ; (7) by taking care that all
arrangements for observance of caste customs and for the
comfort and convenience of patients and their attendants are
completed before inviting removal to hospitals.
79-A. For each plague hospital or camp in a town or other
large centre of population, the Collector shall appoint a com-
mittee of non-official visitors. The committee shall consist of
as many members as may be fixed by the Collector, shall be as
representative in character as possible, and shall work subject
to such rules as may be laid down by the Collector. The
functions of the committee shall be confined to the making of
useful suggestions in connection with the administration of
the hospital or camp and shall not include any power to
interfere with or issue orders to any of the officials on duty at
the premises.
80. Moribund patients should never be removed to hospital
except at the express wish of the friends or relations of the
31
patients. The risk of leaving in his house a patient whose
case is so serious that the medical officer thinks he has not a
fair chance of recovery is not great after the existence of the
case has become known. The pneumonic variety of plague
being contagious, persons suffering from this type of the disease
should not be removed to the general wards of plague hospitals,
but should be isolated in separate wards of the greatest possible
air space. It is farther advisable that such cases should not
be treated in private houses, unless, in the opinion of the
medical officer, the room occupied by the patient is suited for
his complete isolation, and proper control over the number of
attendants and enforcement of disinfection can be had.
81. (1) The Collector of the district may make rules—
Sanitary
restrictions
with
regard to
funeral
processions
and burials.
(a) prescribing the route which shall be taken by a
funeral procession from the place of death to
the graveyard, burning ground or other place
for final disposal of the corpse, and the places,
if any, at which such procession may halt on its
way for funeral prayers, ceremonies or other
purposes ;
(b) for enforcing burial in certain places or at a
certain depth, ordinarily not less than six feet ;
(c) requiring that the bathing of persons attending
the funeral shall be conducted at a place
prescribed by him.
(2) He may also prohibit the burial or burning of
corpses of persons reasonably supposed to have died of the
plague in or upon ground other than ground specially assigned
by him for such purpose.
(3) When a person dies of plague elsewhere than
within the limits of a hospital, no one shall touch the corpse
except those who undertake the necessary duties of preparing
it for the funeral. The dead may be dressed for the grave by
their own relations or in whatever manner may be customary
among the class to which they belong, but such persons shall
disinfect themselves according to the orders which may be
issued by the Collector in this behalf.
Persons
leaving
an infected
place should
obtain pass-
ports.
82, The Collector may direct that every person wishing
to leave whether by road or rail an infected or notified town,
village or area with the view of residing in another town,
village or area, whether infected or not infected, shall, before
doing so, apply to and obtain from such officer as may be
appointed in this behalf passports in the form shown in
Appendix II-A ; provided that no passport shall be issued