ADMINISTRATION.

PLAGUE

The volume

containing the reports of the Bombay Municipal Commissioner and the Health Officer 011 the Plague in Bombay in 1896-97 will, venture to think.be found of more than passing interest. Already in Bombay, as far as the mere date of publication is concerned, the volume we

somewhat ancient

is the

reports

with

history, but the lessons teach in the difficulties of dealing

epidemics

will remain matters of public on which the report-

interest until the obstacles

ing

officers have so vanished in

have

their

happily put an

fingers

shall

improved atmosphere of problems of sanitary

of the

public appreciation administration. The first

problem

that Mr. Snow has found

unsolvable in dealing with the is

that of

currence

tracing

the

of the first few

machinery

for

Bombay epidemic

source

and time of

cases ;

disease-and

'

the

we

existing O

death-registration

proved entirely untrustworthy and, less ; and when

oc-

consider the

in fact, usein force

system

March 1898. J

time

at the

REASON AND INSTINCT.

'

(it

is

happily

altered

now)

not to be wondered at.

103:

least wishing to detract from the reputation that this is the one medical officer worthily acquired for his skilled 1 devotion to dut}r. Enough has been said to

There was no of death-certification supervision ; the diagnosisdemonstrate that the popular fear of the hospital of the cause of death was made by the relatives was not a groundless one, and that, through neglect with the assistance of an uneducated clerk at the which might be mildl}7 styled culpable, the builddoor of the cemetery with the not unnatural ing which should have been looked to as a house result that the mortality statistics of the city of of refuge was with far too good reason avoided Bombay in the early months of the first epidemicas a charnel-house. presented phenomena in the incidence of disease We have not space to pass in review theon an urban population which, had the/ been various interesting points brought forward by expounded by any D. P. H. candidate, would tothe reporting officers; we cannot, however, rea certainty have caused him to be referred tofrain from remarking that in the Bombay of this further studj7. year with the new system of caste hospitals, the The result to the city of this lamentable defect bugbear of hospital dread appears to have been, in the registration system was briefly that it was in great measure absent. We might further point impossible to locate the first cases of the disease,out that this result would have been sooner and a measure which, had it been capable of success-better attained had the leaders o( the native ful accomplishment, would have saved the city shewn a more intelligent appreciafrom the scourge that has fallen upon it. Thatcommunity tion of their public duty at the earlier periods of this is no idle dream has been proved again and the epidemic. It was unfortunate that at the again in the history of the plague in small mofus- besrinnino- of the plague the infectious disease O sil towns and districts, and notably by the history should have resembled a pair of miserhospital of the Hubli outbreak, where the accurate locaable sheds ; but it was a situation that might tion of the earlier cases by Surgeon-Captain C. have been saved by a reasonable grasp of the H. Meyer enabled him, to use his own expressituation by those best qualified to take it; sion, to get ahead of the plague, and by timely of the kind happened, and hence we have, removal of cases and evacuation of infected nothing on the one hand, a history of riotous behaviour dwellings to entirely eradicate the scourge. the part of the mob, and on the other, a on The next few paragraphs of Mr. Snow's report picture of masterly inactivity which maybe fairly deal with the trouble experienced in keeping the held responsible for the natural irritation of the large menial staff of the Health Department at uneducated mill-hands who attacked the hospital. their work, and we can only express our sympathy In conclusion, it must be confessed that the with him in the uncommonljT difficult position two crying needs demonstrated on the first few in which he found himself. The only point pages of the Commissioner's report are : first, the which here appears to offer itself for enquiry is need of an efficient sj^stem of death-registraas to what system of discipline is in vogue tion in order to ensure early detection of an under which the men can in so short a time maintenance in an the and second, epidemic; become so out of hand. efficient condition of accommodation for, at any With regard to the hospital question there can rate, the earlier cases of the disease when it be no two opinions; at the time of which Mr. makes its appearance. Snow is now writing, the Arthur Road Hospital ?3

out, anything or infectious which to treat in any place other disease. Both the medical and menial staffs was none, were deficient in number, nursing there was,

but

as

a

Dr.

Pechy-Phipson pointed

fit

and, putting all other considerations

on

one

side,

detail of the hospital staff which be not should wanting in a plague hospital. It our now intention to pass in review the is not of the Arthur Road Hospital; that it deficiencies and was an entirely inadequate, ill-equipped, this is the

one

undermanned institution no one will be bold enough to deny, and we say this without in the

1

O