1651

NOTES FROM INDIA.

(FROM OUR SPECIAL CORRESPONDENT.)

The Protection of Sind.-The Camp at Reti.-The Plague in Karachi, Calcutta, and Bombay.

AFTER the first outbreak of plague in Karachi the citywas free for several months. With the object of preventinga fresh importation into Sind and also with the view to puta stop to the influx of persons coming from Bombay andother infected places, railway inspection and a detentioncamp were established at Reti, the frontier station inSind, on the borders of the Punjaub. The plague hassince been extending and ravaging many villages in thePunjaub, and recently a recrudescence or, as some preferto call it, a reimportation, has occurred in Karachi.This has been followed by a second outbreak, which

promises to far eclipse the primary epidemic of last year.The measures adopted at Reti of examining all passengershave greatly deterred passenger traffic into the Sind pro-vince. Europeans are passed but native passengers of what-ever class are detained if from an infected area, as are allnative third-class travellers for at least 24 hours fromwhatever district they may come, the people themselves andtheir kit being disinfected, while those coming from theneighbourhood of an infected area are further detained fora period of 6 days, and those coming from an infectedarea are detained for the maximum period of 10 days,Since the examining station and the camp were estab-lished on Jan. 20th only one case of plague has beendiscovered, so that the value of these measures can onlybe ascribed to preventing an influx of people. Seeing howthe disease has since developed in Karachi it is doubtfulwhether the supposed benefit is at all commensurate withthe inconvenience to traffic and the expense of an elaborateorganisation. Between 11,000 and 12,000 people have beendetained in the camp. The country around Reti is a barrenwaste and the climate is intensely hot. One of the specialplague medical officers from England is in charge with nativeassistants and a small force of the native police.

In Karachi itself the disease is rapidly developing and themortality is excessively high ; 1183 cases and 992 deaths-a death-rate of over 83 per cent. The Civil Hospital underEuropean control and two or three small native hospitalshave so far provided for the sick. English nurses areworking at the former place, but the lodging accommodationfor them immediately over the plague wards on the groundfloor is most unsatisfactory. Moreover, sufficient leisure doesnot seem to be allowed them to leave the hospital precincts,so that they must be almost constantly breathing an infectedatmosphere. In Bombay the English nurses working underthe Plague Committee had many complaints against thelodging and board accommodation made on their behalf. -The medical advisers of the Government have at length

come to recognise the probable influence of the rat -in thespread of plague and the Government have recently issuedinstructions that in the reoccupation of towns and villagesthe multiplication of rats should be watched and persistentefforts made to destroy them. The occurrence of dead anddying rats in houses shortly before the plague breaks outamong the occupants has now been repeatedly observedand that the disease in the rat is plague has been over

and over again proved by bacteriological investigation.It is only recently, and especially at Calcutta, that anysystematic attempt has been made to destroy the rat

population prior to the occurrence of plague cases. InCalcutta only a few cases of: plague have as yetoccurred and although one or two fresh cases are beingdiscovered daily it is gratifying to find that the outbreak isapparently under control. Inoculation is reported as beingat a standstill. This sudden rejection of inoculation, notonly for its own benefit but as an alternative to detentionand segregation, is peculiarly unfortunate, because in view ofa probable outbreak large numbers of the people might haveavailed themselves of the protection which it affords. InBombay the plague is dying a rapid and natural death, thetotal daily mortality having at last come down to twofigures, from 70 to 80 being the average daily number ofdeaths at this period of the year.May 12th

The Plague in Caleutta, Bombay, and Karachi.-TheMortality in the Bombay Presidency.

The irony of fate has been plainly expressed by the course

of events in Calcutta. Freed for so long from invasion ’ofthe plague, and probably by the great precautions whichhave everywhere been taken to prevent its importation,Calcutta is now suffering not so much from- plague asfrom panic. Only a few cases have been reported and thedisease does not seem to make any headway, but the alarmcaused by the anticipated carrying out of the much-talked-ofsanitary measures has been followed by strikes, disturbances,and the flight of large numbers of the people. Calcuttahas been declared an infected port, which has also added tothe trade disturbance, but the real cause of alarm is withthe house-to-house visitation, isolation-of the sick, segrega-tion of contacts, and all the other measures laid down byGovernment for combating the plague. The corporation donot appear to be quite in sympathy with these measuresand the proposed alternative of inoculation to segregation hashad quite the opposite effect to that which was intended.False reports of different kinds have produced a state ofunrest and mistrust among the natives, so that every actiontaken by the authorities is misunderstood. After the elaboratepreparations which have been made in Calcutta in the eventof an outbreak .occurring this condition of panic and

opposition must have proved very. disturbing to thoseresponsible for its sanitary administration and seems tohave disorganised all attempts at concerted efforts. - .

In Bombay the plague continues to lingerbut it is rapidlydiminishing. The number of plague case recorded fromSeptember, 1896, when the epidemic was, first discovered, orrather when cases of plague were first registered,, up toApril 22nd, 1898, is 29,062 with 26,239 deaths-a mortalityof 90’2 per cent. This is much higher than elsewhere.In Karachi the plague returns are very unsatisfactory.

The numbers ate very large for the size of the city and th6mortality is very high-76 per cent. Inoculation is beingcarried- on to a limited extent at various Centres,’ but theeffort must prove so small in its results because the numberswho will submit to the operation or who offer themselves forit are so few. The people are still leaving Karachi notwith-standing the various quarantine camps in Sind and the, incon-veniences of detention which they necessarily have to gothrough. - ’

’

,

’

The returns showing plague cases and deaths ’in theBombay Presidency from September, 1896, to April 24th,1898, give the following rates of mortality : Bombay city,90 2 per cent. ; Karachi city, 80’5 per cent. ; Thana district,80-0 per cent. ; Satara district, 78 0 per - cent. ; Poonadistrict, 75-0 per cent. ; Poona city, 74 4 per cent. ; andSurat, 744 percent. It is almost certain that the figuresfor Bombay are. vitiated by the false returns made -at thecemeteries and burning-grounds. - Large numbers of case:

were probably never reported. The returns .-from the

hospitals show a -mortality of about 80 per cent.May 18th. - - "’ - - _______

BIRMINGHAM.(FROM OUR OWN CORRESPONDENT.)

The Lunatic Asylums;THE report of the Lunatic Asylums Committee of the

town council has just been issued. The medical superinten-

dens show that there has been considerable crowding in the, wards, but that some relief had been obtained by the leaseof Sandwell Hall for male patients and the exchange of. 30,

female for 30 male patients by agreement with the Lancaster: county authorities. The admissions during the year were

250 males and 189 females, that, is 60 patients more at the: end of the year than at the commencement, there being an: increase of 87 males and a decrease of 27 females. It is: pointed out that taking the ratio of these admissions tg,

10,000 of the population they do not show any appreciableincrease in the disease itself, but merely that the excess is

.

due to increase in population. In reviewing the causes it isfound that intemperance in drink claims no less than

61 males and 47 females as its victims, showing 2kproportion to the total admissions of 24’4 per cent.: males and 24-8 per cent. females. This is an excess over.

previous years and the greatest number hitherto recorded.The .hereditary tendency was found to exist in 48 males

. and hi 13 females, while no less than 99 of the total numberadmitted had had previous attacks of insanity. The neces-sity of abstinence from alcohol in those thus predisposed

I is emphasised by this testimony. Among other caused

1652

22 males and 20 females suffered from epilepsy ; and in thecase of 16 males and 8 females some other bodily disease isattributed as a cause. Domestic troubles are assigned in15 males and 5 females, the remaining cases being 17 puer-peral and 14 congenital. The question of prevention is dealtwith from a social standpoint and other subjects of interestare discussed in a very able report.

Medical Benevolent Society.The seventy-sixth annual meeting of this society was held

on May 27th. The report stated that the invested funds nowamounted to :E12 582 2s. 2d. and that there was a balanceat the bank of £776 12s. 9d. The society has received avaluable addition to its funds in the form of a legacy of.&2000 from the late Mrs. Bromell and one of £250 from thelate Dr. Sharples. There were 17 annuitants on the books,the annual value of the grants ranging from 20 to £40, thetotal being £560. The benefit members of the societynumbered 373, 17 new members being admitted during theyear. The reports were adopted, votes of thanks were passed,and a dinner was subsequently held as usual.

Hospital Saturday Fund.The Hospital Saturday collection this year amounts to

.S16.877 3s. 2d. from 1694 contributing establishments, as

compared with £16,734 12s. 9d. from 1714 contributors atthe corresponding stage of the collection last year, anincrease of .8142 10s. 5d.

The Ticket System at Hospitals.At the Coventry and Warwickshire Hospital this question

was discussed at a special meeting on May 25th. A sub-committee had reported that they were not satisfied with theticket system as at present conducted. They consideredthat applicants for treatment, if members of sick clubs,should produce a certificate from the medical men thatthey were cases for hospital aid and that the medical officersshould have more discretionary power in dealing withthem. An amendment was carried that the report bereferred back and the sub-committee asked to see whetherthey could not suggest proposals which would be reallyeffective in preventing abuse of the hospital.June 7th.

MANCHESTER.(FROM OUR OWN CORRESPONDENT.)

Manchester Medical Staff Corps.WHITSUNTIDE is a great holiday time in Lancashire and

the people-gentle and simple-pour out of Manchester andthe other large towns in crowds, while numbers more fromthe surrounding districts come into Manchester in search ofamusement. It is a great week for Volunteers campingout and on the coast of North Wales and Lancashiretheir white tents may be looked for every Whitsun week.Sometimes they have good weather and enjoy their experi-ence of life under canvas, but this year the rain hasinterfered much with their comfort. The two Manchestercompanies of the Volunteer Medical Staff Corps went intocamp at Lytham under the command of Surgeon-CaptainCoates. There were also present Surgeon-Captain Fair-clough, Surgeon-Captain Mann, Surgeon-Lieutenant andAdjutant Phillips, Surgeon-Lieutenant Smith, Surgeon-Lieutenant Pritchard, and the acting chaplain, the Rev.Canon Kelly. The number of men under canvas was about130. Instruction was given in bearer-company drill, theestablishment of field-dressing stations, ambulance andwaggon drill, &c. The corps were inspected on June 3rdby Surgeon-Colonel Scott, C.B., the principal medical officerof the north-western district. He Eaid that he was struck

with the smart and soldier-like bearing of the men andhe commended the rapidity with which the work was doneand the excellent manner in which the stretcher exer-cises were performed. He thought "the whole of thecamp, and especially the work of the bearers, reflectedvery considerable credit upon Surgeon-Captain Coates andthe officers under his command." There is one matter inwhich an improvement in the treatment of the Volunteersmight and ought to be made. A large proportion of thetents used by the Cheshire and Lancashire VolunteerBrigade were old and worn and they "acted like sieveswhen the rain came, and time after time deluged their occu-pants as they lay in bed." They were unhesitatingly con-demned by an officer of the Ordnance Department as " unflt

for further service." As is well known, when a tent isthoroughly wet if it is touched on the inside by a man’s heador anything else the water, instead of running down out-side, drips on to the unfortunates within, much to theirdiscomfort. The first four days of this year’s camping outwere excessively wet and when eight men were inside oneof the bell-tents its shape rendered it almost certain to betouched by a head or two, as one of the sufferers feelinglypointed out. Notwithstanding this there seems to have beenvery little sickness.

Poor Cieildren at the Seaside.

Among the most commendable of the efforts for benefitingthe slum children of Manchester is that of sending them inrelays through the season for a week’s sojourn in summercamps by the sea. There are two small camps at St. Anne’s-on-the-Sea, to which forty children will be sent weekly tillthe end of September. Tents have given place to corrugatediron buildings, and an excellent feature of the scheme is thatmilitary discipline is maintained-a most valuable lesson.There is another camp for little slum girls, where some240, from six to twelve years of age, will have a

fortnight’s holiday during June, July and August. Abouttwo miles from St. Anne’s-on-the-Sea 488 boys and 44officers of the Manchester battalion of the Boys’ Brigadehave been under canvas, and at Birkdale, Southport, thecommittee of the Strangeways Refuges, Manchester, havetheir annual camp. Since the latter was started, aboutfifteen years ago, from 12, 000 to 14,000 poor lads from thecrowded districts-the back streets and alleys of Manchesterand Salford and other places-have had the benefit of aweek’s holiday at the seaside. It is difficult for those in adifferent condition of life to realise what this must mean tochildren who have known nothing but crowded streetswith all the sordid and depressing surroundings of slumlife in town. In addition to the physical benefit, themental effect of the marvellous revelation of the exis-tence of a brighter world than that hitherto knownwill be difficult to calculate, but altogether good. Ifthere are any previous ideas of cleanliness they are ex-tended and some notion of method and orderly arrangementis obtained from the rules and regulations which are carriedout with military precision. The health of the boys while incamp has been very good. On arrival their own coat, vest,and cap are exchanged for a scarlet tunic and a round foragecap bearing the name of the institution and the lad’s ownclothing is fumigated. At the opening of the camp this yearSir George A. Pilkington, M.R.C.S., and other gentlemenaddressed the boys. There are more of these agencies forgiving poor town children a country holiday, but thoughmuch is done the numbers are so great that if all are tobenefit these agencies may be extended almost indefinitely

Manchester Corporation Dwellings.It may be remembered that after the demolition of some

notoriously insanitary property the Manchester corporationbuilt large blocks of dwellings in Oldham.road and Pollard-street, which were ready for occupation in the summer of1894. There was a strong prejudice at first among thelabouring class and others against these " barracks " as theywere often called, but in a couple of years it died away andnow applications for tenements are so numerous that aselection can be made of the most suitable as to character.Payments are made weekly, the total number in O:dham-roadbeing 284 and in Pollard-street 135. The rents are paidregularly and from April 1st to May 14th last there was notin either block of dwellings a single penny of arrears.

An Unfortunate Case.An inquest was held on May 27th by Mr. Smelt, the

city coroner, on the body of Thomas Smith, a carter, ofNelson, who died in the Manchester Infirmary on theprevious day "from delirium consequent on his injuries."’He was kicked by a horse about 9 A.M. on May 13th andsustained "a compound fracture of the right knee-cap," wastaken to a medical man, who, after having attended tem-porarily to the leg, sent him on an ambulance to theVictoria Hospital, Burnley. To make a long story short hewas received at the hospital, but ae there was-or hadbeen shortly before-a case of scarlet fever there itwas thought safer for him to be removed to the work-house infirmary. This was not done at once, and afterhaving passed a night in the infected hospital they wouldnot have him at the infirmary, so he was sent home and gotthere between 8 and 9 o’clock on Saturday night, the 14th.