EEEATA. 

Contents, page vi, para. 322, for "Arrangement between" read "Agreement between." Page 10, para. 20, line 5, for " Dr. Gardener" read " Dr. Gardner." 

Page 55, para. 123, line 3, for " 6 and 700 " read " 600 and 700." Page 56, para. 129, lines 8 and 9, for " Shalmeu Ghat" read " Shalmee Gate," Page 72, para. 165, line 6, for " 3rd Sikh Infantry" read " 3rd Punjab Infantry." Page 83, para. 198, lino 7, for " married quarters Nos. 18" read "married quarters and Nos. 18." Page 134, para. 306, margin, line 14, for " Dr. Penney" read " Dr. Penny." 

Page 136, para. 311, line 7, for "practical," read "practicable." 





/ 

J EEPOET ON THE y CHOLEEA EPIDEMIC OF 1867, IK NORTHERN INDIA.. 

s 

ซ 

CALCUTTA : 

UAIAJUฑx.a: OFFICE OF SUP^IINTENDENT OF GOVERNMENT PRINTING. 

1868. 





CONTENTS. 

INTRODUCTION. Para. age 1 Importance of accurately recording its history as a whole 2 History of the cholera of 1861 ... ... ... ••• ฆ ฆ•• — lh ' 3 Want of information regarding previous epidemics ... 4 The outbreak at Hurdwar anticipated ... ... ... ••• ••• '" 5 Preparations made to meet it 6 Division of the Report ... ... ... ... <•• ••ฆ ••' SECTION I. THE HURDWAR FAIR OF 1867. 7 Description of Hurdwar ... ... ... ... ... ••ฆ ••ฆ 3 8 Objects of the Annual Fair ... ... ... ... •ฆฆ ••• ••• **• 9 Violence and bloodshed at former fairs ... ... ... ... ••• ••• 4 10 Causes of the unusual gathering in 1867 ... 11 General arrangements made ... ... ... ฆ•• ••• ••• ••ฆ **• 12 Sanitary arrangements ... ... ••• ฆ•• ฆ•• ••ฆ *'• 13 Supply of food and water ... ... ... •• ฆ ฆ• ฆ •• ฆ •• • 6 14 Hospitals provided ... ... ... ••• ••• ฆ•ฆ ••• **• 15 The Fair 16 Supposed number of pilgrims ... ... ... ••• ••• ••• *b> 17 Meteorological phenomena at Hurdwar ... ... ... ... •• ฆ •ฆ • 8 18 Observations at Eoorkee ... ... ... ... •ฆ• ••• ••• ib. 19 Health of the camp ... ... ... ... ... ... ... 9 20 Occurrence of first case of cholera ... ... ... ... ... ... 10 21 Eapid dispersion of the pilgrims ... ... ... ... .. ib. 22 Extent of cholera at the Fair ... ... ... ... ... ... ib. 23 Cause of the appearance of cholera at Hurdwar ... ... ... ... ... ib. 24 Did the disease arise from the want of proper sanitary conditions ? ... ... ... 11 25 The Cholera epidemic at Hurdwar in 1783 ... ... ... ... ... ib. 26 Cholera generally absent from Hurdwar fairs ... ... ... ... ... 12 27 Can filth generate cholera ? ... ... ... ... ... ... ib. 28 Filthy state of towns and villages does not produce cholera ... ... ... ... ib. 29 Apparent evidence to the contrary ... ... ... . . ... ... ib. 30 Was the cholera the result of atmospheric influences ? ... ... ... ... 13 31 Difficulty of the question ... ... ... ... ... ... ... ib. 32 The effects of the rain ... ... ... ... ... ... ... 14 33 Question of importation ... ... ... ... ... ... ... ib. 34 Cholera at other places in November and December 1866 ... ... ... ... 15 35 Cholera among the Civil population in the end of 1866 ... ... ... ... ib. 36 Cholera in the beginning of 1867 ... ... ... ... ... ... ib. 37 Cholera in the Terai early in 1867 ... ... ... ... ... ... 16 38 Cholera in Sir Jung Bahadoor's camp in January 1867 ... ... ... ... ib. 39 Possible importation from Bhurtpore ... ... ... .. ... ... ib. 40 Conclusion as to the cause of the outbreak ... . . , ... ... ... 17 41 Native opinion of the conservancy arrangements ... ... ... ... ... ib. 42 Difficulties in making arrangements ... ... ... ... ... ... 18 43 Defects in the arrangements ... ... ฆ•• ••• ฆ•• ... ... ib. 44 Possible contamination of the water ... ... ... ... ••• ฆฆ• 19 45 Objections to this theory considered ... ... ... ... ... ... ib. 46 Facts supporting the opinion ... ... ... ... ... ... .•• 20 47 Further particulars from Dr. Cutcliffe's second Report... ... ... ... ... ib. 48 Importance of the rapid dispersion of the pilgrims ... ... ... ... ... 23 



SECTION 11. THE RETURN OP THE PILGRIMS TO THEIR HOMES AND THE GENERAL DISTRIBUTION OF THE CHOLERA OF 1867. 49 Condition of the pilgrims after the fair 50 Sources from which information has been obtained ... ... ••• ' Bl Chief questions to be decided ... 62 Order in which the several parts of the country will be taken 63 In the Saharunpore District cholera believed to have been disseminated by pilgrims 54 Its apparent importation into the Cantonment of Eoorkee 65 The disease in the Deyrah District 56 The disease at Mussoorie and at Landour... 57 The epidemic in the Mozuffernugger District 68 Evidence of importation 59 The disease in the Bijnour District 60 Evidence of importation 61 Evidence of importation into the Moradabad District 62 The European Troops in Cantonments suffer slightly... ... •ฆฆ ••• ••ฆ •*• 63 A few cases among the Native Troops 64 The disease appears at Nynee Tal 65 Appearance of cholera at Almorah 66 Facts of importation into Kumaon given by the Commissioner ... 67 Spread of the disease in the Terai Pergunnahs 68 Its appearance in the Bareilly District ... 69 Only three cases among the European Troops 70 The disease in the Budaon District 71 Severe outbreak in the Shajehanpore District 72 The prisoners attacked ... •• • •• < 73 The disease in Cantonments ... 74 Part of the Regiment moves into camp ... 75 Eemaining portion moves 76 More favorable results in the Detachment first moved ... ••• ••• ••• • 77 Oude and some other parts to be considered afterwards 78 Occurrences in the Meerut District 79 Strong evidence of importation 80 Outbreak among the European Troops at Meerut 81 Extreme virulence in the Buffs 82 Pew cases among the Artillery and Hussars . 39 83 The disease in the Boolundshuhur District 84 The disease in the Allyghur District 85 The disease in the Punjab 86 The disease in the Goorgaon District 87 Cholera in the Delhi District ib. 88 Opinion as to its origin 89 Immunity of the Prisoners and Troops ... 90 Supplementary information regarding the Delhi epidemic 91 The disease in the Rohtuck District 92 It appears in the Hissar District 93 Its prevalence in the Sirsa District 94 The epidemic in the Kurnaul District 95 The importation of cholera into Kurnaul 96 Cholera in the Umballah District ... ... ••• ฆ•• ••• ••• ** 97 Civil Surgeon has no doubt it was imported 98 The Cantonment of Umballah ... ••• ••ฆ ••ฆ ฆ•• ••• *" 99 Cholera among the European Troops 100 Cholera among the Native Troops 101 Second outbreak in Cantonments 102 Umballah Jails escape ... ... ฆฆ• 103 Cholera at Kussowlie 104 Its appearance in the Hill Villages 105 Dugshaie exempt 106 The disease at Subathoo in the 90th Light Infantry ... ... ... ••• ฆ•• **• 107 The Regiment moved into camp ... ... ••• ••• ••ฆ **' 108 Re-appearance "of the disease in Subathoo ... ••• ••• ••• ••• *ฎ 

ii 



109 Tta ซ „„ • 49 iwป its re-appearance m camp ... 110 Previous unhealthy condition of the Regiment ?. ... ••• ••• •" HI Disease chiefly confined to the old Barracks ... ... ••• ••• •" 112 Outbreak at Simla ... ... ... ... ... - - 50 113 The epidemic in the Loodianah District ... ... ... ••• ••• '•• **' 114 Apparent importation into Ferozepore 115 Opinion of the Civil Surgeon ... ... ... ••ฆ ฆ•• "• tJ ' 116 The epidemic in the Perozepore Cantonments 117 The disease in the Jullundur district 118 Illustrations of apparent communication of the disease 119 Cholera amongst European Troops in Jullundur ... ... 120 Movements of the Troops ... ... ... ••• ••ฆ "' f* 121 Cholera in the Kangra District 122 Cholera in the Dhurmsala Jail ... ... ... ••• ฆ•• '" 123 A few cases among the Troops... ... ... ... ••• ••• "' 124 Particulars regarding the Hooshiarpore District ... ... ••• ••• "' • 125 The disease appears with the pilgrims at Umritsur 126 Two cases in Govindghur Fort ... ... ••• ••• "• "' 127 The epidemic in the Goordaspore District... ... ••• ••• 128 Evidence of importation into the Sealkote District ... ... ••• •ฆ• "' 129 The epidemic at Lahore ... ... ... ... ••• •ฆ• '" 130 The disease in the Cantonment of Meean Meer 131 Second outburst in 106 th Regiment and second move into camp ... 132 HoUokee Detachment ... ... ... ... ••ฆ ••• •ซ• 58 133 The Shahdrah Detachment ... 134 The families at Shalimar ... ... ... ... — ••• ••' B9 135 Cases among the Artillery ... ... ... ... ฆ•• ••• •" 136 Cholera in Lahore Fort ... ... ... ... ••• ••• ฆ•• ฎฐ 137 The disease in the Lahore Jail for women... ... ••ฆ ••• ••• ฆ•ฆ 138 Evidence of communication in the Montgomery District ... ••• •ฆฆ ••• 139 Evidence of importation into Mooltan 140 Particulars of communication at Mooltan... ..." •ฆฆ •ฆ• • ••• '" 141 Importation of cholera into Kuhroor ... ... ... ••ฆ ••• ฆ•• 142 Its late appearance in the Mozufferghur District ... ฆ•ฆ ••• "• "" 143 The district of Jhung suffers late ... ... ... ••• ••• •" 63 144 At Goojeranwalah, first cases pilgrims ... ... ฆ•• ฆ•• ฆ•• " "-145 At Goojerat the disease confined to pilgrims ... •ฆ• ••• ••• "* l ' 146 The disease not traceable to pilgrims in the Shahpore District ... ฆ• • •• ฆ •• • 147 Very few cases in the Jhelum District ... ... ... ••ฆ ฆฆ• '•• 1.48 Rawul Pindee in part suffered severely ... ... ... ••• ••• '" 149 Importation into Murree not traced ... ... ... ••• ••• "• * 150 Cholera in Hazara... ... ... ... ... •ฆ• ••• •• 66 151 The disease in the Peshawur Valley ... ... ... ••• •ฆ• ••• ' 152 Cholera at Peshawur ... ... ... ... ••• ••• "" ib ' 153 First outbreak in the Artillery ... ... ... ฆ•• ••• •ฆ' • 154 The IJorse Artillery in camp ... ... ... ... ••• ••ฆ ••• ' 155 E— l9 and 4— 22 nd Royal Artillery also suffered ... ... ••ฆ ••• ฆ•• %b %b-156 Cholera in the 42nd Highlanders ... ... ... ••• ••• — 68 157 Cholera in the 77th Regiment... ... ... ... ฆ•• ••• ••• %h ' 158 Attacks the portion left in Cantonments ... ... ... •ฆ• ฆ•• ••• DS * 159 Occurrences in camp 160 The Native Troops suffered comparatively little ... ... ฆ•• ••ฆ ••• ' 161 Origin of the outbreak at Peshawur ... ... ... ••ฆ ••• ••• **• 162 Report of the Peshawur Military Committee ... ... ฆ•ฆ ••• ••• **• 163 Statement of the Sub-Assistant Surgeon ... ... ... — ••ฆ ••• ' 1 164 Corroborated by the Civil Surgeon ... ... ... ••ฆ ••• ••• *'• 165 Native Troops suffer at Kohat ... ... ••• •ฆ• ••• •ฆ• '* 166 Cholera attacks Bunnoo in July 167 The disease in Dera-Ishmail Khan ... ... ••• ••• ••ฆ ••• ' 168 The disease in Dera-Ghazee Khan ... ... •ฆฆ >•• ••ฆ ••• *"• 169 The epidemic in Cashmere ... ... ... •ฆ• ••• ••• ••• 170 The disease in Cabul ... ... ... •ฆฆ ป• ••• ••• tb tb-171 Very little cholera in the Agra Division ... ... ... ••• ••• ••• 7^ 172 Outbreak at the Secundra Orphanage ... ... ... ••• ••• ••• *"• 

s 



Para. xAg 178 Early appearance of the disease at Bhurtpore ... ... ••• ••• "' , 174 Cholera in the Gwalior State ... ?. 175 No evidence of importation ... 176 The disease among the Natives 177 Cholera among the Europeans at Morar in May and July 178 Its re-appearance in August ... 179 Cases among the Artillery ... ... ... ~ 180 Cholera amongst Native Troops 181 Cholera in Gwalior Fortress ... 182 In the married quarters ... ... ... 188 Cholera in Jeypore 79 184 Epidemic among the Native Troops at Deolee 185 Illustrations of apparent communication of the disease 80 186 Opinion of the Medical Officer of the Deolee Irregular Force 187 Slight prevalence in Rajpootana 188 Remarkable immunity of Central Provinces 189 Cholera in the Allahabad Division ... ... ... - - " * 6'6 ' 81 190 The disease among the European Troops ... 191 Its spread in the Banda District 192 A few cases in Cawnpore Cantonment ... ... 193 Cholera in Oude ; information imperfect ... ... ... ••• ••• ' 194 Its appearance among the people generally ... ... ••ฆ ••• "• 195 The epidemic at Lucknow ... ... ... ... ••• •ฆ• '" 196 Evidence against theory of contagion ... ... ... :ฆ• ••• ••• 197 The disease at Hurdui ... ... ... ... ... - ••• ib ib-198 Its occurrence among the European Troops at Fyzabad ... ... ••• ••• *"• 199 Among Europeans at other stations in Oude ... ... ••• ••• ••' " 200 Among Native Troops in Oude ... ... ... ••• ••ฆ ••• 201 Outbreak in the Seetapore Jail ... ... ... ... ••• ••• 85 202 Slight epidemic in the Benares Division ... ... ... ••ฆ ฆ•• •" 203 The outbreak in Nepal ... ... ... ... ... ••• ฆ•• ih ih-204 Evidence as to importation ... ... .. ... ... •ฆ• — ฎ6 205 Cholera in Behar ... ... ... ... ... ... ••• ••• * J J-206 Unusual immunity of the Jails in Lower Bengal ... ... ... ••• ••• **• 207 Apparent importation into Monghyr Jail ... ... ... ••ฆ ••• ฆ•ฆ 87 208 The epidemic at Jessore ... ... ... ... ••ฆ ฆ•• ••ฆ *' 209 Pilgrims suffering from Cholera did not spread the disease at Pooree ... ••• ••• **• 210 Opinion based on these facts ... ... ... ... ••• ฆ•• ••ฆ 88 311 Evidence to the contrary ... ... ... ... ••• ••• ••• 8^ 212 Special instances quoted ... ... ... ฆ•• ...**• 213 Apparent importation into Cachar ... ... ... ... •ฆฆ ฆ•ฆ 91 214 Cholera in other parts of Lower Bengal ... ......... ... •ฆ• ••• ***. SECTION 111. THE PREVENTIVE MEASURES ADOPTED AND THE RESULTS OF THE EPIDEMIC. 215 Intelligence of the outbreak early telegraphed ... ... ... ... ... 93 216 Early instructions issued by Punjab Government ... ... ... ... ... ib. 217 The camp of Maharajah of Cashmere diverted ... ... ... ... ... 95 218 Medical arrangements ... ... ... ... ... ... ... ih. 219 Sanitary arrangements ... ... ... ... ... ... ... ib. 220 Similar arrangements in the North -Western Provinces ... ... ... ... 96 221 Opinions as to the results of these measures in the Punjab ... ... ... ... ib. 222 Opinions from the North -Western Provinces ... ... ... ... ... ib. 223 Doubts expressed as to their effect ... ... ... ... ... ... 97 224 Difficulty of the question ... ... ... ... ... ... ... ib. 225 Mortality among the civil population in the North-Western Provinces ... ... ... ib. 226 Deaths from Cholera in the Punjab ... ... ... ... ... ... 99 227 Deaths from Cholera in Oude... ... ... ... ... ... ... 100 228 Returns of cases incorrect ... ... ... ... ... m ... ib. 229 Total mortality among the people ... ... ... ... ... ... ib. 

iv 



5 

230 Measures adopted in the Jails ... ... ... ... ฆฆฆ ••• 101 231 Testimony to the value of quarantine in Jails ... ... ... ••• ••• **" 282 Comparative immunity of the Jails ... ... ... ... •ฆ• ••• *^ 233 Comparison of the Jails in 1861 and 1867 ... ... ... - •ป *• 234 Cholera in the Jails from 1859 to 1867 ... ... ••• ••• ••• 102 235 Illustrated hy a Diagram .... ... ... ... ... ••• — •'*• 236 Points illustrated hy the Diagram ... ... ... •ฆฆ ••• •<• **• 237 Satisfactory results in the Jails in 1867 ... ... ... ••• ••• "• 108 238 Cholera in the European and Native Armies in previous years ... ... ••• ••• *• 239 Results illustrated hy a Diagram ... ... •ฆ• — ••• 10 * 240 Details since 1859 ... ... ... ... ... ... ••• ib ib-241 Points illustrated by the Diagrams ... ... ••• — ... ib. 242 Special measures for the prevention of Cholera among European Troops ... ••• ••'• Iฐ*> 243 Examination of the results in each Station ... ... ... ••• ••• ** 244 Order in which the Stations will be considered ... ... — ••• ••• **' 245 Stations attacked both in 1867 and 1861 ... ... ... ••• ••• "* 106 246 Generally favorable results of 1867 in these Stations ... ... — ••• ••' tb ' 247 The case of Meerut an exception ... ... ... ••• ••• ••' 10^ 248 Sanitary measures adopted there ... ... ... ••• ••• ••• **" 249 Cause of great fatality in the Buffs unknown ... ... ฆ•• ••• ... 108 250 Stations attacked in 1867 which escaped in 1861 ... ... ••• ••• •ฆ• Ib - CNowshera and Peshawur suffered in 1862... ... ... ••< ••• ••• 109 Epidemic in the 42nd Highlanders ... ... ... ••• ••• ••• **• 253 Particulars regarding the 42nd Regiment wanting ... ... ••• ••• ••• 110 254 The 77th Regiment and Royal Artillery ... ... ... ... ฆ•• ••• **• 255 Comparison of admissions and deaths in the European Garrison, Peshawur ... ... ••• *'&• 256 No direct connection traceable between the epidemic and the pilgrims ... •ฆฆ ••• H* 257 Stations attacked in 1861 which escaped in 1867 ... ... ••• ••• ••• ib ib-258 Stations which escaped in both epidemics... ... ... ••• — ••• * la 259 European Troops in 1861 and 1867 in parts not visited by the epidemics ... ... ••• *&• 260 Cholera among Native Troops in 1861 and 1867 ... ••ฆ ••ฆ ฆ•• — lb ' 261 Native Troops attacked in 1867 at Stations which did not suffer in 1861 ... ... ••• H 3 2*52 General results of the epidemic among British Soldiers ... ... ••• ••• * bm 263 Total mortality among men, women, and children ... ... ฆ•• ••• ••• l"'l "' 264 Effects of going into camp on the spread of Cholera ... ... ... ฆ•• ••• H* 265 Cases in which the disease entirely disappeared on removal into camp ... ••ฆ ••• *"• 266 Cases in which no fresh seizures occurred after third day ... •ฆฆ -•• ••• 1*" 267 Regiments which suffered severely in spite of moving ... ••ฆ ฆฆ• ••• *"• 268 General conclusion as regards moving ... ... ••ฆ ฆ•' ••• •ฆ• ••• **• 269 After-results of moving into camp ... ... ... ••ฆ ••ฆ ••• H" 270 After-results of moving into camp in 1867 ... ••ฆ •ฆฆ ฆฆ• ••• *"• 271 Results in which portion only of the Garrison moved ... ... ••• ••• *$•• 272 Results at Peshawur ... ... ... ... >ฆฆ ••• ••• *" 273 Good results of moving Native Troops into camp ... ... .•• •ฆ• •ฆ• '" 274 Good results in checking the disease among prisoners ... ••• ฆ•• ••• **• 275 Benefit of moving illustrated at Shajehanpore .., ... ••< ••• ฆ•ฆ "'• 276 Varied opinions on the effects of moving ... ... ••• •ฆ• ฆ•• H9 277 Evidence at Shajehanpore in favor of early removal ... ... ••• ฆ•• ••ฆ 4^* 278 Further comparison of the epidemics of 1861 and 1867 ... ••• ฆฆ• •ฆฆ 12 ฐ C Comparative prevalence of Cholera in the different Arms ... ••• ••ฆ •ฆ• •'*• Comparative prevalence among Officers and men ... ... ••• >•ฆ ••ฆ 121 281 Comparative prevalence among men, women, and children ... ... ••• ••• 122 282 Comparative prevalence among children and adults ... ... ฆ•• ฆ•• ฆฆ• 123 283 Comparative prevalence at different Stations ... ... •ฆฆ ••• ฆฆ• •*• 284 Influence of age ... ... ... ฆ•• — •ฆ• ••• **• 285 Influence of habits ... ... ... ฆฆ• ••• ••• ••• I^* 286 Influence of previous state of health ... ... ... ••• ฆฆ• ••• **• 287 Number attacked in Hospital ... ... ... ฆฆ• ••ฆ ฆ•• *'*• 288 Hours of attack and admission ... ฆฆ• ... ฆ•• ฆ•• ••ฆ 125 289 Duration of disease ... ... ... ••• ••ฆ ••< ••> '*- 290 Proportion of deaths to cases ... ... .ฆ• ••• ฆฆ• ฆฆ• **• 291 Proportion of deaths to cases among Europeans and Natives compared ... ... ... 126 292 Comparative prevalence of Cholera among European and Native Soldiers ... ... ... ib. 293 Cause of comparative immunity of Native Soldiers ... ... ... •ฆ• ... 127 



SECTION IV. GENERAL CONCLUSIONS. Paba. Page 294 Conclusions to be drawn from the history of the epidemic ... ... ... ... 129 296 Arrangements regarding fairs ... ... ... ... .. ... ib. 296 Great expenditure required ... ... ... ... ... ... ib. 297 Funds how to be raised ... ... ' ... ... ... ... 130 298 Nature and amount of the rate to be levied ... ... ... ... ... ib. 299 Diminution of the number of pilgrims ... ... ... ?, ... 131 00 The effect of the dispersion of the pilgrims in spreading the Cholera ... ... ib. iOl That the pilgrims carried Cholera is indisputable ... ... ... ... ib. >02 This fact an evidence of communicability ... ... ... ib. 108 General facts of importation ... ... ... ... ... ... ?, 132 104 General evidence of importation ... ... ... ... ... ... 183 105 The first cases nearly always pilgrims ... ... ... ... ... ... ib. 106 Decided opinions of the Medical Officers ... ... ... ... ... 134 307 The evidence cannot be set aside ... ... ... ... ... ... ib. 308 If not by the pilgrims, how was the disease spread ? ... ... ... ... ... ;j. 309 Analogy of other diseases ... ... ... ... ... ... 135 310 Dr. Bryden's opinions ... ... ... ... ... ... „ jj. E Practical conclusions to be drawn ... ... ... Mt 135 A general quarantine impossible ... ... ... ... __ (งi # t Opinion of English Authorities on quarantine ... ... ... ... ib. 314 General preventive measures recommended ... ... M 1 >tj 237 315 Quarantine as regards Cantonments ... ... . ?, ... Mง _ jj 316 Quarantine to be permitted by Municipalities ... ... ... 317 General sanitation of towns and villages ... ... ... t< 13 g 318 Measures for preventing Cholera in Jails ... ... ?, __ 319 Rules drawn up by Sanitary Commission ... ... ... 320 Quarantine in Jails considered separately ... ... ... jgg 321 Sanitary Commissions Rules compared with the views of latest English Authorities ib. 322 Arrangement btween the rules and those of the English authorities ... j4,j 323 Measures to prevent Cholera among European Troops ... ... 14 2 324 Recent modifications of General Orders on the subject ... ... 325 Permanent Cholera encamping grounds proposed ... t<# 143 326 More detailed information required ... ... •••'... Ib 327 Points to be observed in moving into Camp ... ... _ 328 The terms " Sporadic" and " Choleraic Diarrhoea" ohjectionable . . . 14(4 329 Purification of buildings ... ... ... ... 330 The period of incubation ... ... ... .., #i 331 Information to be obtained in any future epidemic ... ... ... 145 332 Assistance received in preparing this Report ... ?. 

vi 



EEPORT ON THE CHOLERA EPIDEMIC OP 1867, IN NORTHERN INDIA. 

INTRODUCTION. 

It is of the utmost importance, both in a scientific and practical point of 

Importance of accurately re- view, that the history of the great epidemic of cordmg its history as a whole. cho i em which swept over Northern India during the past year should, as far as possible, be accurately recorded, and that the details which are available regarding the European troops, the Native army, the Prisoners, and the civil population, should be considered together. 

2. Of the cholera epidemic of 1861, the last of any great violence which 

History of the cholera of visited the Provinces, an admirable history 18^1. Tinซ Vปppn ฆnrpsprvpri in flip "R.pnnrf nf flip finpnial 

has been preserved in the Report of the Special 

Commission which was appointed to trace its course, investigate its causes, and suggest what practical measures should be adopted in the future to arrest the progress of any such calamity. It will be necessary to make frequent references to this report, to test how far the views which were then expressed have been verified by the experience of the late epidemic, to compare the sickness and mortality of the disease in the one year with what occurred in the other, and to examine how far the rules for the management of epidemics of cholera which were recommended by the Commission, and adopted by the Government, have had beneficial results. 

3. Of the unusual prevalence of cholera, in earlier years, no precise records 

Want of information regard- are available. All that is known is, that in certain ing previous epidemics. TOaT . s thp. /Uspjikp. Tinซ heon mnvP fTinn nvdinnrilv 

years, the disease has been more than ordinarily 

prevalent and fatal. Even of the outbreak of 1856, which in many respects resembled those of 1861 and 1867, and which was more fatal to the European troops than either of them, no general history is available. From the scanty and detached records which are to be had, it is impossible to say with any degree of accuracy which places were visited by the disease, what was the history of the epidemic, and what the losses it occasioned in each. This is very much to be regretted. It is only by a careful observation of the history and progress of this mysterious disease, by comparing the facts, and if need be correcting the opinions of one year by the details of another, that we can ever hope to ascertain with any accuracy the circumstances under which 

B 



2 

it is generated, the conditions which are favorable and even necessary for its spread, and the precautionary measures which are requisite to arrest its progress. 

4. The history of the outbreak of 1867 is in this respect remarkable 

The outbreak at Hurdwar that its occurrence was very generally feared, anticipated. tt^oi. Tn^io Viq/I f™ mnm +v> Q mA™*™ fp™ 

Upper India had, for more than the ordinary term 

of years, been free from any violent outbreak of the dreaded pestilence ; a few cases had occurred in different parts of the country in the close of 1866 and commencement of 1867 ; the fair to be held at Hurdwar in the spring was one of unusual importance, and likely to be more than ordinarily frequented by pilgrims ; the gathering of so large a number of human beings together was anticipated with unusual dread— a dread which was all the greater because sanitary authorities had drawn attention to the danger of these assemblages, and experience had shown, especially in the southern presidency, that the danger was not imaginary. 

5. As early as the 19th February 1867, the Government of the North- 

Western Provinces called the attention of the 

Preparations made to meet it. . . Commissioner of the Meerut Division to the met, that " the number of pilgrims, who are likely to assemble at the approaching Hurdwar Eair, will be very much larger than usual." The necessity for conservancy and sanitary arrangements in and near the town was insisted on, and it was remarked that it was "specially important that measures should be adopted for the daily removal and deodorization of the accumulated filth as a precaution against the outbreak of an epidemic." A special officer was accordingly appointed to superintend the medical and sanitary arrangements, and measures were adopted to place every assistance at his disposal. 

6. In any account of the epidemic cholera of 1867, the fair at Hurdwar 

must form one of the main features of the narrative, and before proceeding to detail the arrangements 

Division of the Report. 

which were adopted, and the subsequent circumstances which took place, it will be advisable to give some account of this great annual gathering which in 1867 assumed so much importance in the eyes of the people, and the history of which is so intimately associated with the subsequent spread of disease and death over the whole of Northern India. The history of the epidemic will thus be conveniently arranged in four separate sections :—: — 

I.— The Hurdwar Fair of 1867. 

II. — The dispersion of the pilgrims and the general distribution of the cholera of 1867, not only in connection with the return of the pilgrims to their homes, but also over those portions of the country in which no such connection can be traced. 

111. — The preventive measures adopted and the results of the epidemic. 

IV. — General conclusions both as regards the mode in which the disease has spread, and the practical measures which should be adopted in any future outbreak. 



SECTION I. THE HURDWAR FAIR OP 1867. 

7. Erom the writings of various officers who have visited the spot between 

Description of Hurdwar. the earS 1796 and 1867 ' the followin S Particulars 

regarding Hurdwar have been gleaned :— 

Hurdwar, or more properly " Haridwara," the gate of Vishnu, is an inconsiderable Native town in the district of Saharunpore, and distant about 40 miles due east of that station, in Lat. 29ฐ 57' N, Long. 78ฐ 14' E. according to Thornton. It is situated on the southern slope of the Siwalik Eange, at the mouth of the gorge through which the Ganges escapes from its cradle in the Himalaya to the plains of Hindustan. It is, therefore, sometimes called " Gungadwara," or the gate of the Ganges. Its elevation above the sea level is a little over 1,000 feet. In former times the river at Hurdwar was divided into three channels, but since the construction of the Ganges Canal the water has been directed into two, one of which is the main stream, and on its western bank the town is situated. What was once a shallow, fordable, sluggish stream is now, therefore, a deep, broad, and rapid river, and during the rainy season becomes a rushing torrent. The water is exceedingly cold, as it is largely derived from the melting of the snow in the mountains. The valley through which the river flows runs up in aN. E. direction, towards the foot of the main Himalayan chain, which is full 13 miles distant from Hurdwar. This valley is described as being intensely malarious, abounding in dense jungle and swamp. Even in the neighbourhood of Hurdwar itself the same condition prevails, but in a lesser degree. The surrounding country is low relatively to the bed of the river, so that the soil is very damp, and, being covered with stunted verdure, rapidly generates malaria. 

8. The sacred river here first enters the plains, and, as might be supposed, the locality is one held in peculiar sanctity by Hin- Objects of the Annual Pair. ฆ*-?,, . .-, . 

dus. From time immemorial an annual pilgrimage 

to this spot has been enjoined from all parts of Hindustan for the purposes of ablution in the sacred waters. " The bathing commences in the month of Chaitra } when the sun is in Minu or Pisces, and concludes on the day he enters Mesha or Aries, agreeably to the solar computation of the Hindus, and corresponding with the 10th April, on which day the sun has actually advanced 20ijf in that sign. Every twelfth year is celebrated with greater rejoicings, and is called the Cumbha Mela, so denoted from the planet Jupiter being then in the sign of Aquarius." " A pilgrimage at these duodecennial periods is considered the most fortunate and efficacious." Both Colonel Hardwicke and Captain Raper were fortunate enough, in 1796 and 1808 respectively, to be present at these periods, and to them we owe much of the early history of Hurdwar. The 



4 

of the meeting, but the Hindus never lose sight of their worldly interests, and a mela is a necessary consequence of their religious convocations ; numbers are led hither as much from commercial as holy motives, and independent of the merchandise brought by the merchants from the Punjab, Cabul, Cashmere, and other places, most of the pilgrims supply themselves with some articles, the produce or manufacture of the country whence they came, for which they are certain of an advantageous sale. Through this channel the principal cities in the Duaba, Delhi, and Lucknow are supplied with the productions of the western and northern countries. To facilitate these commercial transactions, which are carried on to an immense extent, agents are deputed from the most respectable bankers, who exchange money and grant bills on all parts of India to any amount. 

9. In former times, when this portion of country was under the sway of 

__. , . J ,_ J the Mahrattas, these duodecennial gatherings were Violence and bloodshed at ฐ ฐ former fairs. marked by much violence and bloodshed, owins: 

marked by much violence and bloodshed, owing 

to the contentions of the several sects of fakirs, who congregated in vast numbers and fought for the ruling power. The gosains, being the more powerful sect, gained and held the ascendancy through many succeeding ages, and levied a poll-tax and other imposts on the pilgrims independently of their Mahratta rulers. Since Hurdwar, however, became British territory, this arbitrary system has been abolished, " and all castes and descriptions of people have free ingress and egress without impost or molestation." In the year 1760 the superiority was contested by the hairagis, the next most powerful sect to the gosains, and after a long and bloody battle, victory declared itself on the side of the latter. It is stated that about 18,000 of the bairagis fell on that occasion, and that for many years afterwards the sect were debarred altogether from the privilege of attending the mela. Subsequently, in 1796, owing to an outrage by the gosains on an old Sikh priest, Oodasee, who came to the fair, with the avowed object of bathing, Rajah Sahib Singh, the Sikh Chief, with 10,000 horsemen, attacked the offending parties, and having slaughtered a great number, drove the remainder into the river, where many were drowned, and the survivors, having gained the other side, sought safety in flight to the hills. This is the last occasion on record of such scenes of bloodshed. Now, though the concourse of pilgrims is doubtless vastly in excess of what it was in former times, the Cumbha Mela is marked throughout by harmony and order — arms are forbidden in the fair, and a large force of Military and Police are in attendance, so that tranquillity is readily maintained. Accidents are still, however, not uncommon, especially on the Purbi or last day of the fair, when vast crowds collect at the bathing ghat, and some of the pilgrims are frequently either crushed or are carried away by the stream. The bathing ghat is termed hari-ka-paira or the feet of Vishnu, and to it vast multitudes throng on the great bathing day, as priority of ablution is believed to exercise an additional influence in purgation from sin. The last great loss of life occurred in 1 819, when it is stated that upwards of 400 pilgrims were either crushed to death or drowned in the river. This led to the construction by the British Government of an ample stone ghat leading down to the river by a flight of sixty steps. Here men and women, old and young, may be seen bathing indiscriminately together and 



5 

Pssisted; but the aged and pious are generally supported between two hmins, who receive certain fees for the service rendered. The ceremony sists in simple immersion, but widows undergo the operation of tonsure rwards, the hair being strewn on the ground, under the superstitious belief that a good or evil omen is portended by the animal which first treads on it. The elephant is regarded in this particular as the king of beasts, wealth and happiness being supposed to follow his royal foot-prints. 

10. Several causes conspired to make the fair of 1867 one of unusual 

Causes of the unusual ga- numerical magnitude. In addition to its being a thering in 1867. Cwmhha Mela, a belief had gained ground in all parts of the Peninsula that the sacred character of the Ganges was being interfered with, and that ere the time of another gathering could arrive, it would be entirely destroyed. This idea seems to have originated, suggests Mr. Robertson, the Magistrate of Saharunpore, on the completion of the Ganges Canal, which was expected to rob the sacred stream year by year of an increasing quantity of water, and so eventually to dry up its bed altogether ; but, as has been before stated, the effect has been rather the reverse, for the river at Hurdwar is now comparatively broad and deep, and its permanency established more surely than ever. Mr. Robertson suggests another view of the case which, it may be hoped, is nearer the truth. "It declares in fact that the Brahmins admit that advancing intelligence is undermining both their influence and that of the Ganges, and that they are prepared to meet this change in public opinion as a circumstance long foretold." Whatever may have been the causes at work, there is no doubt that the desire to make the pilgrimage to the sacred river was more than ordinarily widespread, and the extension of railway communication afforded facilities for the journey which in no former Cumbha Mela had ever existed. 

11. To provide for the safety and proper management of so vast a crowd of people as was expected, more than ordinary prepara- General arrangements made. * , , , , _ ? . . „ tions had been made. Considerable sums ot money had been expended on terraces, in extension of the sacred ghat, in filling up holes in the river opposite to it, in reducing the depth of channel, and in constructing ten bridges to facilitate the passage of the bathers. The arrangements, in the language of the Magistrate of Saharunpore, " were subordinate to the principle that the crowd was invariably to move in one direction, so that no opposing bodies of men could under any condition meet each other ; that no carts, elephants, or horses were allowed to enter the town of Hurdwar during the great bathing day ; that the people, wherever encamped, were forced to submit to the sanitary rules enforced by the police, and that the processions of the different sects of fakirs, instead of traversing the town of Hurdwar, should proceed to the bathing place by the island of Roree, whence, after crossing one of the bridges and bathing, they recrossed at a lower bridge to Roree and rejoined their elephants." In carrying out these plans, and in every thing calculated to add to the convenience and comfort of the multitude, the officials, civil, engineer and police officers, all vied with one another, and with such success that with one slight exception no accident occurred. 



6 

12. Nor were the sanitary arrangements prepared with less activity. 

Dr. Cutcliffe, to whose charge they had been speci- Sanitary arrangements. ? " x . 

ally entrusted, had been early on the ground, and 

lad set himself to his task with great zeal. The conservancy system was based on the principle that dry earth as a deodorizer should, as far as practicable, )e everywhere adopted, and that all filth should be either buried in trenches or burnt in furnaces specially erected for the purpose. Latrines were provided n convenient situations ; measures being at the same time taken to prevent any ;rench for the reception of sewage being dug on ground which could form any )art of a water-course. The latrines generally consisted only of screened xenches, two being dug at a time with a space of two feet between ; the earth vhich was thrown up in digging the one being stored for future use on the edge of the other. In some situations, where the soil consisted of sand and boulders, the trench system could not be worked, and from these the sewage having been first mixed with earth was carried by donkeys or mules to the furnaces to be burned. It will be necessary to recur to these arrangements in Cscussing the sickness which afterwards occurred. As regards the general saniry management of the encampment the ground was cleaned and cleared, streets were marked out so as to guard against overcrowding and secure ventilation, orders were issued to ensure the proper disposal of the dead and prevent their being thrown into the river, and precautions were taken to prevent, as far as possible, the introduction of any infectious diseases. 

13. Attention was directed towards maintaining the purity of the river, 

and for this purpose patrols of police were posted Supply of food and water. _L *- ฆ F_ x upwards from Hurdwar to Eikhikes, where it emerges from the mountains. River water was mainly drunk by the devotees, but some of the hospitals were supplied with well water, previously filtered. Mahomedans, as a rule, drank well water. Supplies, we are told, were abundant and good, as the Magistrate of Saharunpore had, for some time previous, made special arrangements to have large quantities of the best grain concentrated at Hurdwar pending the arrival of the pilgrims. The food exposed for sale, moreover, was subjected to frequent and careful examination, and any found to be unwholesome was at once seized and destroyed. Despite these precautions, however, Mr. llobertson states that, as many of the poorer pilgrims brought food all ready cooked from their homes, much that was unwholesome found its way into the fair. These poorer pilgrims do not, or Perhaps cannot, purchase their food at the fairs, and are dependent solely on their home supplies, so that all efforts in the direction of a good Commissariat are thrown away upon them. This is consequently the class in which disease most generally originates. 

14. To provide for the wants of the sick hospitals were constructed in 

various parts of the encampment, and were so placed as not to intercept the prevailing winds. 

Hospitals provided. 

Six hospitals and two dispensaries were thus organised, and were taken charge of by the Civil Surgeons of Dehra, Bijnour, and Saharunpore ; the latter officer, Dr. Cutcliffe, performing also the duties of Sanitary Officer, as already mentioned. Besides these, two hospitals for infectious and contagious diseases 



7 

were established, the one situated between Myapoor and Jowalapoor, the other n the Dehra section of the encampment. They were isolated from all other buildings, and were guarded by a cordon of police. All the hospitals were uniformly constructed of thatch and matting work, supported on strong poles and logs, and in no case were they intended to accommodate more than 30 >atients in each. When two or more such buildings were required together, they vere so disposed as to allow free ventilation on all sides. Arrangements were also made to provide additional accommodation, in the event of its being equired by excess of sickness amongst the pilgrims. Each patient had upwards of 65 superficial feet of space, and no more than two rows of beds were allowed between opposite walls. Accommodation was screened off for emales to the extent required. For the conduct of the subordinate duties of lese hospitals the adjacent districts had been indented upon for Native doctors nd compounders, and a staff of vaccinators was also furnished by the Kumaon nd Meerut divisions. Doolies were distributed here and there for the coneyance of the sick to the hospitals, and every precaution was taken that such s were employed in the transport of contagious cases should not again be sued for general use. 

15. About the middle of March many faltirs and shop-keepers, anxious 

to secure good positions, began to arrive. Pilgrims also from distant parts arrived early, performed 

The fair. 

! ablutions, and again departed, dreading, most probably, the crowding and oil which invariably attend the after stages of the fair. A constant succes:>f arrivals and departures was thus kept up until about the end of March, . the multitudes showed less and less disposition to disperse as the great ng day approached. During the first week of April and on subsequent up to the 12th, dense masses of pilgrims poured in from all quarters, and npedin every direction for miles on both sides of the river. The arrange-3 on the last day, the Purbi, which were planned by Mr. Robertson, and i are fully detailed in his report, were admirably carried out, and were corny successful in preventing accident, though it appears that they did nofc ly meet the approval of the more wealthy pilgrims and of the excited '. Slight concessions were granted on both sides, however, and all passed :11. Noon of the 12th April was the auspicious hour and day for ablution, svhich the stream of pilgrims flowed steadily from Hurdwar. 

16. As to the numbers actually present at this great gathering, opinions 

kupposed number of pil- are divided. It was doubtless the most numerously ms> n,f,f,fiTiflfirl fnir nn rponvrl nwino 1 nfii-linns nln'rvflv in flip 

attended fair on record, owing perhaps chiefly to the 

lief that had got abroad as to its being the last. Dr. Cutcliffe adopted awa calculating the numbers, which no doubt gives a pretty truthful approxi tion. He selected three portions of the encampment, a thinly populatec loderately populated, and a densely populated portion. Accurately mea ing the area of each of these, he took a census on the night of the 9t ril. Taking the result, the sum of the three, as his basis of calculation L computing the total area of the encampment to be 22 square miles, h ad that the number actually present would amount to 2,855,966. Thi V be taken as rather below than above the truth, as in 1796 Ilardwick 



8 

estimated the number at 2,500,000. Eaper also, at the Cumbha Mela of 1808, estimated that 2,000,000 would be rather under than over the mark. In those days there were means of arriving at the truth which we do not now possess. Eor instance, Hardwicke, in his "Narrative of a journey to Sirinuggur," speaking of the numbers as 2,500,000, states, "this estimation may appear enormous, and it, therefore, becomes necessary to give some account of the grounds on which it was formed. Small sums are paid by all at the different watering places, and the collectors at each of these, in rendering their accounts to the mohunta, who regulate the police, are* obliged to form as exact a register as a place of so much bustle will admit of. Prom the principal of these offices the number of the multitude is found out probably within a few thousands. The gosains, on whose information the calculation was formed, had access to these records, and the result, as delivered above, was thought more likely to be under than over the mark." Dr. Cutcliffe's census may therefore be regarded as nearly correct, and as fairly representing the number actually on the ground on the night of the 9th April. If we include those, however, who, for some weeks previous to the 12th April, paid hurried visits to the fair, the total number will more correctly be represented by 3,000,000. 

17. The meteorological phenomena which occurred during the fair are a 

matter of very great importance. Erom Dr. Cut- 

ar T Hu?dwi? gical phenomena cliffe's abstract, it would appear that the daily 

mean temperature during the week ending on the 

14th April was 76ฐ. The weather for some time previous was unsettled, but towards the end of March some rain fell, and it continued fair to the 11th April. It would appear that there are great extremes of heat and cold in the early spring months at Hurdwar. During the day the heat is very powerful, partly owing to the configuration of the ground causing great radiation. The lower strata of air are thereby much overheated. At night the cold air from the snow-capped mountains rushes down the gorge through which the river flows. This wind is ' locally known as the Dadoo,' and often blows with great force. Its direction is N. E., and it blows from 9p.m.to 10 a. m., an upward current from the plains supplying its place during the day. Storms are very frequent in this locality. The 11th of April was a sultry cloudy day, and in the afternoon a storm, accompanied by heavy rain, thunder and lightning, came up from the west. The effect of this, of course, was a sudden and marked decrease of temperature, which was simultaneously noted by Dr. Murray Thomson at Eoorkee. It rained heavily all night and drenched the whole encampment, so that most of the pilgrims were without dry clothing, and remained in tins state all the following day. Rain continued to fall during the 12th, the great bathing day, and the pilgrims, in addition to the drenching which they experienced, drank freely of the river water, which had been polluted and rendered muddy by the heavy rain and the bathing operations of the vast multitude. 

18. Annexed is an abstract of the meteorological observations made at 

Roorkee during the month of April 1867, by Dr. Observations at Eoorkee. -. r m , ? -,ซ-, i.-it> Murray Thomson, the Meteorological .Reporter of the North Western Provinces. These observations may be considered appli- 



Abstract of Meteorological Observations made at Boorhee during April 4ง6y t by Dr. Murray Thomson, Meteorological Reporter, North- Western Provinces. BAROMETER. THERMOMETER. , Station. HYDROMETER. — — RAlir - WIND< * With Latitude and Longi- 4a. m. 10 a. m. 4p. m. 10 p. m. Exposed. In Shade. งL tude and Height above ฆ " , . — — — Six Jj sea level in feet. 71 J J I 4 J A ฃ 4 Dht AHD WW ซW g ™ C T^ ' a I I i \\ W^ i ll '-J* -il tl -, I I II II II I 1 li.Tl 1 il 1| j | s | 18th 15th 18th 15th 12th 7th I 16th 3rd 19th 12th 6th 2nd 3rd 12th 6th 13th 12th 0303 0 3 5 21410 a. m. Roorkee 29ฐ52' 77ฐ57' 880 28-945 28-859 28-771 29-058 28-945 28-848 28-910 28849 28-713 28-977 28-884 28-791 863 65- 91 65- 50- 47' -373 '338 -314 -224 135 123- 878 66- 57- 50- 102-fi' 95-i 73-7 74-4 66-j 59"7 29- 80- 78- 86- 12- -52 -52 1-5 1 3, 0 0 0 610 82 4 p.m. 599 j ฆ 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 10 4 10 4 10 4 10 4 10 4 10 4 10 4 10 4 10 4 10 4 10 4 10 4 10 4 10 4 10 4 10 4 10 4 10 4 10 4 10 4 10 4 10 4 10 4 10 4 10 4 10 4 10 4 10 4 10 4 10 4 10 4 L 29-1 29>1 tl MeanHeigU ... 2,9 ,\ \ ... t ... 1 .... /,, .../.. t ... i ... fc A ... A ... , A ป/ ? - V" / "ป Mean Hei g h, | 28-6 286 28-5 28 5 _J J |_ __ __„ __ __ | 85 J\ / \ / M | 84 \ / <S 83 \ / 83 *.\ / • / I \ • N ' si fn m „„ * •-* \ \ * I 80 Mean Temperature. H Mean Temperature 80 . ... \ 1 / * 1 1 " / .79 ni / \ / / 71 If " 70 I '" / y 66 

Office Supdt. Govt. Printing.— No. 4616 S. G. R.— 3-7-65— 900. 



9 

cable to Hurdwar, the distance between the two stations being only 17 miles. At Roorkee the month of April was marked by small barometric pressure, the maximum (29058) being attained on the 18th, and the minimum (28713) on the 7th; the monthly mean of four daily observations being 28*884. The humidity of the atmosphere, as indicated by the great difference between the wet and dry bulbs, was very small. The average of the 4p. m. observations shows a difference of no less than 26ฐ; The temperature was not on the whole high during the month, but was marked by great alternation point to be principally noted, however, is the great and sudde epression of temperature which followed the storm on the evenin f the 11th April. This sudden depression succeeding the close an( ultry condition of the atmosphere, as observed by Dr. Cutcliffe, mus lave exercised a very deleterious effect on the mass of shivering devotee lain fell on twelve days during the month ; but except on the night of the lit le quantity appears to have been inappreciable. The winds in April wer ariable, though those having a westerly direction prevailed. The wind wa ue W. in 15 out of 60 observations, and in 19 more it had a north-west o outh-west direction. Sixteen observations are noticed as calm. Summa sing these results, the month of April would seem to have been cha acterised by excessive dryness of the atmosphere, low barometric pressure, grea nd sudden alternations of temperature, westerly breezes and absence of ozone nd that these conditions existed prior to, and concurrently with, the fair. 

19. The health of the camp, considering the enormous multitude 

present, appears, up to the 12th April, to have been excellent. The medical returns of in-door 

Health of the camp. 

and out door patients treated, during the whole period of the fair, a the general hospitals, show the total number to have been only 1,367, 823 being out-door and 514 in-door patients. If the lowest estimate of th number of pilgrims at 2,500,000 be taken, it results that only about 1 in 2,000 were sick during the fortnight of their stay at the fair. Thi seems almost incredible, but the statements of the several medical officer agree as to the remarkable immunity of the encampment from disease It may be said that many cases of sickness might have occurred withou their having been brought to the notice of the medical officers, but the police were ever on the alert against cases of serious illness, and their attention to this important matter is the subject of very favorable commen by most of the officers present during the fair. As may be inferred from the meteorological and topographical peculiarities of Hurdwar already noted ordinary intermittent fever or ague was the most common disorder amongst the pilgrims, about 17 per cent, of the total treated being from this cause. Intermittent and remittent forms of fever caused 6 deaths out of the very small total of 16 fatal cases which occurred. But bowel affections are those which have a special importance. Taken collectively they show a total sick roll of only 308, or 21*9 per cent, of the whole (diarrhoea 101, dysentery 79, colic 64, dyspepsia 61), a marvellously small number when we consider the many conditions that were present predisposing to such affections. Towards the close of March a few cases (4) of severe diarrhoea were sent to hospital, 



10 

where they speedily recovered. Only 4 deaths from diarrhoea and dysentery occurred during the period under review. There is a long list of other diseases given in the return, but they do not call for special remark. A few cases of small-pox occurred and were speedily isolated, so that the disease did not gain a footing amongst the pilgrims. Of accidental deaths there were 5, of which 2 were caused by lightning. 

20. It is of great importance to fix the precise date on which the first 

occurrence of the first case case ฐf cholera occurred at the fair. On this point of cholera. Tkซ n,-.ฑซi;fl฿a ™ nft *f D ซ Tปi. "RiV.lmWla,™ cfofซ c in 

Dr. Cutcliffe reports — " Dr. Richardson states in 

his report that no case of cholera or of small-pox occurred in the Deyrah section up to the 14th , and Dr. Gardener's returns show a similar absence of either of these diseases up to the same date. Dr. Kendall, in medical charge of a detachment of the 14th Bengal Cavalry stationed below Kunkhul states that a case of sporadic cholera occurred in a grass-cutter of his regiment on the night of the 9th April. Under treatment this man speedily recovered, and no other case occurred in the Regiment at Hurdwar. Of all the hospitals and dispensaries at Hurdwar the medical returns show an absence of the disease up to the 13th April. On that day 8 cases of cholera were sent to hospital. Up to the 15th there were 19 admissions from this disease." 

21. So far then as was ascertained only one case of cholera occurred 

Bapid dispersion of the P U- at the fair before the 13th. By that time the gnms. vncli nf •nilo > i*ima frrYm TTnvrlwm* wns nf. its 

rush of pilgrims from Hurdwar was at its 

height. From noon on the 12th, which was the auspicious hour for bathing, the vast multitude had begun to depart. The rapidity with which the crowd dispersed is reported to have been inconceivable, and the fact has an important bearing in relation to succeeding events. Dr. Richardson reports that on the afternoon of the 13th, there were not 300 people remaining in the Dehra section. By the same time the Bijnour section was empty ; and on the morning of the 15th the entire ground, so lately covered by the encampments, was a bare plain again. 

22. The rapid dispersion of the pilgrims had much to say to the fact 

that cholera, although it had broken out in the Extent of cholera at the fair. 

camp, found very few victims there. The disease 

does not appear to have declared itself as an epidemic until the great object of the pilgrims had been accomplished and the vast multitude was already moving off to their homes. It is not, therefore, to be wondered at that only 19 cases of cholera were actually seen and treated at Hurdwar. 

23. Having now briefly narrated the main facts connected with the 

cause of the appearance of sanitary history of the Hurdwar Pair of 1867, the Cholera at Hurdwar. yaw imnAw^aTif nrmsfirm nvio^c Tn wlint ra.nsft IS 

very important question arises — To what cause is 

the appearance of cholera among the pilgrims to be attributed ? Was it generated within the camp by filth or any defect in the sanitary arrangements ? "Was it produced solely by atmospheric phenomena and the other local circumstances under which the vast multitude were placed ? Or was it the result of some specific germ of disease which was imported from without and germinated 



11 

because it found the conditions necessary for its spread ? These are questions of very great difficulty, — questions which involve the whole origin and development of the disease, — questions to reply to which with accuracy precise data are unfortunately wanting ; but although they involve many intricate points, although they may not admit of altogether satisfactory replies, they must not be avoided. It is of the utmost importance that the facts, so far as they have been reliably ascertained, should be carefully examined, and that an unbiased endeavour should be made to learn' whether our knowledge of the origin and spread of cholera has been in any degree advanced, or whether these questions, so largely connected with the welfare of the human species, remain as mysterious as ever. 

24 The three questions which have thus to be discussed appear to em- 

_. _ .. brace the only three modes in which the disease Did the disease arise from 11, r. the want of proper sanitary could have appeared, and each must therefore be conditions? , , .._..- , ? -x^.-. 

separately examined. In the first place then, — Did 

the disease arise from the filthy condition of the camp or from any defect in the sanitary arrangements ? To this question there is not much difficulty in replying. The testimony of all concerned is to the effect that the encampment was singularly clean, that the arrangements for disposal of all filth were actively and successfully carried out. As far as the senses could testify, there was nothing which could offend either sight or smell. In this respect the fair of 1867 presented a marked contrast to any previous gathering which had ever been held at Hurdwar. In former years it was hardly possible to move in any direction on account of the filth which lay about in every quarter, and yet while cholera appeared in 1867, the fairs of previous years had often and indeed generally been free of any outbreak of the disease. 

25. Vague traditions exist to the effect that cholera broke out in the fairs 

of 1819 and 1829, but no particulars are known. 

HSdwMฃ?7B3? idemi ฐ at The epidemic of 1783 is thus referred to in Dr. 

Jameson's report on the cholera of 1817. "Hurd- 

war," he writes, "is held very sacred by the Hindoos, and every year, at the full moon in April, an immense concourse of people assembles near it for the purpose of ablution in the holy stream. It so happened that the year 1783 was one of the twelfth years deemed peculiarly propitious, and that the body of pilgrims then collected was unusually great, amounting, it is believed, to between one and two millions. It is the custom of the pilgrims to repair to the bed of the river, where they pass the night with little, if any shelter ; many persons being crowded together under the cover of a single blanket thrown out as an awning. The temperature is very variable, the days being hot, and the nights cold with heavy dews and sudden chilly blasts from the clefts in the mountains. On the 'present occasion these causes were sufficient to generate the cholera which broke out soon after the commencement of the ceremonies and raged with such fury that in less than eight days it is said to have cut off above 20,000 victims ; but so confined was its influence that it did not reach the village of Jowalapore, only seven miles distant, and ceased immediately on the concourse breaking up on the last day of the festival." 



12 

26. The sanitary and medical histories of previous Hurdwar melas are un- 

Choiera generally absent fortunately very incomplete. Kegarding the earlier from Hurdwar fairs. xraara thprp is nn roliniilA information hnf. if. i a ™f. 

years there is no reliable information, but it is not 

necessary to go very far back in order to collect evidence sufficient to decide the point in question. In the year 1857, an outbreak of considerable severity occurred at the fair, but with this exception the disease appears to have been unknown between the years 1854 and 1868. Of fourteen fairs accordingly, ;hirteen passed off without any epidemic, while the fifteenth and only one in which any attention was paid to sanitary measures was attended with the commencement of the most wide-spread and fatal outburst over Upper India of which there is any record. It may therefore be stated with perfect confidence that the appearance of cholera at the Hurdwar Eair of 1867, was not generated by any insanitary conditions. 

27. It may not be out of place to consider whether filth alone is suffi- 

ฆ cient to engender the disease. On this point the Can filth generate cholera ? ... . .. n . . , ... . ..„ , ? evidence is chiefly negative, but it is still valuable. Successive fairs have been held at Hurdwar, where the whole space occupied by the pilgrims was as unclean as it well could be, and yet no case of the disease occurred. It may be said that the number of persons present was not so large as in 1867, and that therefore their filthy habits were of less importance ; but although the last fair was of extraordinary size, the ordinary assemblage every year is immense, and if want of sanitary arrangements can by itself produce cholera, the collection of many hundreds of thousands of human t sings left entirely to follow their usual filthy habits ought certainly to have duced the disease. The same may be said of the numerous other though laller assemblages which annually take place over Northern India, and in rich the outburst of cholera has been very rare and altogether exceptional. 

28. There are towns and villages, moreover, scattered over the whole 

_?.. . . . length and breadth of the Upper Provinces, which, Filthy state of towns and. ฐ xr villages does not produce if filth is the parent of cholera, ought never to be cholera. „ L , 

free from the disease, and which yet, within the 

lemory of the oldest resident, have enjoyed a remarkable immunity from its vages broken only at long intervals of many years. The conclusion to which [ the facts, which we possess in relation to the connection between cholera and th, point is, that while a filthy state of things, as a general rule, singularly rors the spread of the disease, it hper se altogether incapable of producing it. 

29. The fact that the sanitary measures which have been adopted at 

Apparent evidence to the Conjeveram and other places of pilgrimage both in contrary. TVTnrl-pna rmrl in f.Vio crvnf.Tiovn nnrl nAnfrril -nnvfcj r\f 

Madras and in the southern and central parts of 

Ehave been attended with marked success, and that assemblages whicl passed off without a serious epidemic have in consequence become atively free of the disease, although apparently opposed to the view jus ited. is not so in reality. In these parts of the country, a new elemen be taken into consideration ;in them the disease is endemic ; from them jcific cause, whatever that may be, which engenders cholera, is never and if it be true, as is now generally believed by the highest authorities, 



13 

that the dejecta of those suffering from the disease contain the poison by which it is propagated, a filthy condition of any place occupied by large masses of human beings must in these parts be almost synonymous with the presence of the poison under circumstances which are most favorable to its rapid and extensive development. 

30. But if the disease was not generated by filth, was its appearance due to any peculiar atmospheric phenomena, aided by Was the cholera the result >^ • > j -. f., ? . of atmospheric influences P tH6 circumstances under which the pilgrims were 

placed? The condition of the atmosphere, as 

detailed in a preceding paragraph, was certainly remarkable and well worthy of notice, but there is perhaps no subject on which precise information in India is so much required as meteorology. There is nothing to show that the variations in barometric pressure or temperature or the fall of rain were very different from what may have occurred in a series of preceding years. There are no corresponding observations made in any other outbreak of the disease with which they can be compared, and the mere occurrence of atmospheric phenomena, however singularly contemporaneous with the commencement of the epidemic, far from warrant any deductions being drawn from the coincidence. 

> 

31. Even in England, where meteorological observations have been 

taken on a scale and with a care which have 

Difficulty of the question. yet been unknown in India so far as our knowledge yet goes, nothing appears more hopeless than to establish any connection between epidemic cholera and known states of the atmosphere. The results which Mr. Glaisher has obtained serve only to add to the difficulties of the question. Of the several epidemics of the disease which have visited London, the main feature in connection with this important point, is the very remarkable contrast which they exhibit. Writing of the epidemic of 1866, Mr. Radcliffe, whose account of it will be found appended to the ninth report of the medical officer of the Privy Council, observes : — " The visitations of 1832, 1848, and 1854 were coincident with great atmospheric pressure, high temperature (except in 1832), small diurnal range (owing mostly to high night temperature), deficiency of rain, very little wind (and comparative stagnation of atmosphere and prevalent mist), a deficiency of electricity (indicated by the few electrical disturbances), and in 1854, the presence of a remarkable blue mist which prevailed night and day. During the three months of principal prevalence of the recent outbreak in the metropolis (July, August, and September), the atmospheric pressure was remarkably low ; from the 26th July to the end of the quarter the barometer, reading at the height of 160 feet, never reached the point of 30 inches, a most rare occurrence, Mr. Glaisher writes. The temperature of the air was low night and day, except in September, when the nights were warm. The daily range of temperature was small, ' chiefly owing to the low day temperature, particularly in August, and to a somewhat less degree in September, but the range in September was still further lessened by the high temperature of its nights.' There was an abundance of rain, and the air was in almost constant motion, 



14 

frequently blowing a much heavier gale than is usual at this season of the year. ' Nearly all these circumstances,' observes Mr. Glaisher, ' are directly opposite to those mentioned above as being present at the previous visitations of cholera, and have probably aided in checking its wider extension.' " Mr. Eadcliffe, in opposition to Mr. Glaisher, maintains that certain excessive variations of temperature attended the early sudden and large development of the outbreak, but he remarks " that temperature and meteorological changes played a very subsidiaiy part in the great development of the epidemic in the east districts." The late Dr. Baly, in like manner, repudiated the constant connection between certain atmospheric phenomena and cholera, though he admitted that the temperature, as a rule, " does in some way or other exert an influence over the degree of prevalence of cholera, and generally determines the periods of its greater or less intensity." He believed, however, that it is neither necessary nor constant in its operation. 

32. In regard to the meteorological phenomena which occurred at Hurdwar, 

the two facts of the greatest importance appear to be, — first, the heavy rain of the 11th and 12th ; and, 

The effects of the rain. 

secondly, the rapid and marked diminution in temperature. In the Upper Provinces epidemics of cholera most frequently occur in the rainy months, and there can be no question that the pilgrims, many of whom were scantily clad, when wet and cold were more susceptible to any causes of disease than they otherwise would have been. It is worthy of notice that in the only particulars which have been given regarding the great fair of 1855, it is specially stated that "there were alternations in weather," and yet no epidemic occurred. 

33. In discussing the probability of the disease having been imported 

- . into Hurdwar during the fair, it will be necessary to Question of importation. . ฐ . ' 

review shortly the various facts with reference to 

the appearance of the disease in the Upper Provinces during the latter part o 1866, and the three months of 1867 which preceded the gathering. Th chief fact regarding the former period is that an epidemic of the diseas broke out at Agra during the Durbar held by His Excellency the Viceroy and that it became advisable to break up the camp earlier than had bee intended in order to prevent the spread of the pestilence. In connectio with this epidemic there are some facts of more than ordinary interes For some months previously the disease had been threatening to becom epidemic in some of the Native States of Rajpootana. The camp of the Agen of the Governor General, in marching up from Aboo in the middle of Septem ber, had to take a circuitous route through the Jodhpoor territory in order to avoid the affected localities. It arrived at Halena, a village in the Bhurtpore district, on the 27th of October, and halted the following day, Sunday, continuing the march on the 29th towards Agra. Two cases, the first which occurred, proved fatal on the morning of the 29th. These were carried on from the encampment at Halena. The camp then marched in two divisions towards Agra vid Futtehpoor Sikri. At the village of Buronda, 10 miles from Agra, where it arrived on the 2nd November, the main portion of the camp was halted, the 



15 

Agent, Colonel Eden, taking only his personal staff and office establishment to cantonments on the morning of the 3rd November. Agra was at this time quite free from cholera, but about noon of the 4th November the disease appeared in the Agent's camp, and a few hours afterwards reappeared in a virulent form in the main encampment at Buronda. Twenty-one cases and seven deaths occurred in little more than twenty-four hours after this outburst at Buronda. The disease subsequently gained a footing amongst the European and Native troops during the Viceroy's Durbar, and also in the city of Agra. Among the European troops there were 1 2 cases and 7 deaths. Among the Native population generally, between the 4th and 26th November, 114 were ascertained to have occurred, and of these 64 proved fatal. 

34. The disease continued to follow some of the regiments on the march to their various destinations. Notably the 36th Native vember and December S iB6 6?" Infantry, en-route to Meerut, suffered after leav- 

ing Agra, 7 cases and 5 deaths having occurred 

between Ghazeeabad and Meerut. Dr. Bryden's Tables show that among Native troops in camp and on the march in the Agra and Meerut districts during the months of November and December 1866, 28 cases of cholera occurred in all, of which 19 were fatal. In December 1866 there were 2 fatal cases in the 2nd Battalion Eifle Brigade at Meerut ; also one in the Royal Artillery at Delhi, and one in the Sappers and Miners at Roorkee, both of which recovered. In the jail population of the Upper Provinces no case occurred in these months. 

35. As regards the general population, no reliable data are to be had 

beyond a few isolated facts. Of these one has already 

pSatSnVSTlnJofTsee! 0 " feeen notecl regarding Agra; another of great 

importance is, that on the 4th and 23rd December 

2 fatal cases of cholera occurred at Roorkee, a station in the immediate vicinity of Hurdwar. In the opening paragraph of his report on the epidemic of cholera, which proved so severe and fatal among European troops at Meerut, the Deputy Inspector General of Hospitals Her Majesty's British Forces remarks that at the Goormooktesur Pair, held 28 miles from Meerut, in the end of 1866, cases of cholera were said to have occurred, but to what extent is not known. The mortuary returns of the Punjab show that cholera prevailed to a considerable extent in the Delhi district during the month of December. Fifty-eight fatal cases are noted as having occurred there, and the tslief was current that the disease had been imported by the troops and people turning from the Agra Durbar. 

36. The statistics of 1866 show that during the three first months of the Cholera in the begining of y ear not a sin S le case occurred among the troops 

1867- 

whether European or Native, nor was there any 

among the prisoners in the Upper Provinces, with the single exception of the central jail at Allahabad, where, between the 22nd March and 4th April, 27 cases occurred and 4 deaths. There is no traceable connection between this epidemic and the outburst of the disease at Hurdwar. 



16 

37. The occurrence of the disease in the Terai Pergunnahs, which skirt 

Cholera in the Terai early in *he 00^ ฐf the Nepal and Kemaon Hymalaya and 1867. !• „-.+ x> j- 4. i n TT,, OT J m . o ซ i a a fan^ nf mroaf. 

lie not far distant from Hurdwar, is a fact of great 

importance. The opinion of the Superintendent of the district is verydecided. He writes—" It appears almost certain that this attack of cholera originated with the pilgrims visiting the Hurdwar Pair. They took it with them to Hurdwar, it having heen prevalent all along the horders of Nepal during the cold season, and from Hurdwar they brought it back, and on their return, it spread on all sides." Although opinions may differ as to the correctness of this view of the case, it is of great importance to observe that numerous cases occurred in pilgrims proceeding westward to Hurdwar, prior to the general outbreak there. Cases are specially noted as having occurred at Bazpoor, on the road to, and 50 miles distant from, Hurdwar, on the sth of April. There were 19 deaths in that town from cholera between the sth and 12th April inclusive. 

38. It is also worthy of notice that the disease which is thus believed to 

Cholera in Sir Jung Baha- nave ss P rea( l westward towards Hurdwar is also door's camp in January 1867." SU p pose d to have spread to the east. Sir Jung Bahadoor marched up the Nepal Frontier early in January, with a camp, of about 5,000 men. During his long march of 200 miles from Singowlie there was not the slightest appearance of sickness. On arrival at Barumdeo on the left bank of the Gogra where it escapes from the hills, Sir Jung Bahadoor was informed of the prevalence of cholera on the other side of the river, to the west of Barumdeo, and he was advised to prevent, as far as possible, communication with the affected districts. This seems to have been impracticable, however, his mission being the marriage of his son to the daughter of the Eajah of Kashipore. Tree intercommunication was established, and in the course of a few days cholera broke out in his camp. Mr. E. Read, Conservator of Forests in Oudh, who furnished this information, further remarks that the disease appears to have been travelling due east* and that it had caused considerable anxiety at Ramnuggur, Kaladoongee, and Huldwanee for some time previously. There is no record of cholera to the east of Barumdeo prior to the first week in January. Sir Jung Bahadoor, finding that the disease had fairly gained a footing amongst his men, returned by forced marches, almost in the same track by which he had come, but the disease did not abate, and in the course of less than a fortnight it is stated that about 650 of his followers died. 

39. Assuming for the present that cholera is capable of being imported 

Possible importation from among a healthy community by persons suffering Unurtpore. frปrvm fho /liecmeo fTieปvซ la nnfliino' imrvtปnl"ปnlYlA in 

from the disease, there is nothing improbable in 

the statement that pilgrims from the Terai, who suffered from the disease on their march to the neighbouring fair, may have brought the germs of the outbreak with them. There is also another source from which the importation may have taken place. The Agency Surgeon at Bhurtpore reports that cholera assumed an epidemic form in that district on the 6th April. He states also, that it hung about in the neighbourhood of Bhurtpore all the cold weather, and that " the 



17 

district was never wholly rid of the disease from last season" (September, October and November 1866) . Cases of what seemed choleraic diarrhoea were very common in December, January and Eebruary. "In February a case of cholera is returned from Pahari, and two cases occurred at Ochea in March. It will be remembered that the Maharajah of Bhurtpore visited Hurdwar with a large retinue, and that he left his territory just about the time when cholera began to extend. The disease also appears to have prevailed epidemically at Bindrabun near Muttra during March, but I can find no positive information as to its extent." 

40. Looking at all the facts which have been stated, to what cause is the 

outburst of cholera at Hurdwar in 1867 to be pro- 

of C th n e C Jutbreak! t0 ** ฐ ause perly ascribed ? It has been shown that filth, or the 

want of proper conservancy arrangements exists, and 

has existed for ages in many cities of the Upper Provinces, and yet that cholera has been a rare visitor; that in thirteen out of fourteen fairs in which sanitation was altogether neglected, cholera was unknown. That atmospheric phenomena produced the disease, is a theory which may hereafter be proved to be correct, but as yet it rests on no basis of fact. In the present state of the question such an assertion is simply equivalent to stating that the Origin of the disease is inexplicable. But if these two opinions be set aside as untenable, there remains but one other. If the disease was not generated at the fair, it must have been brought from elsewhere. This idea is quite consistent with the facts ; it is quite consistent with the analogy of other diseases, such as small-pox, regarding the propagation of which we have more precise information. Considering that the pilgrims flocked in by hundreds and thousands from all parts of India, it is not difficult to understand the danger lest disease should be imported, and when it is known that cholera had been prevalent in a neighbouring district, the danger was indefinitely increased. Even had it been impossible to discover the probable source of importation the argument would not have become invalid, but there is the direct testimony of the Superintendent of the Terai that pilgrims going to Hurdwar from his district had the disease among them, and that several died on the way. The general question of importation, and the difficulties which beset this, as well as any other theories which have been advanced to account for the spread of cholera, will be more conveniently considered when the whole facts of this epidemic have been recorded. In the mean time it is sufficient to state that the disease, as it broke out at Hurdwar, appears to have been introduced by pilgrims from some infected district. 

41. The universal testimony of all the officials, who were present, bears 

witness to the extreme cleanliness of the camp and 

seSfancy aJrang^mlnS?. C ฐ n " to the care and success with which the conservancy 

arrangements were carried out. The opinion of the 

Natives themselves, with regard to them, is thus given by Mr. Robertson, the Magistrate of Saharunpore. " The Native hakeems," he says, " attribute the appearance of cholera to the smoke from the furnaces used for burning the filth from the latrines on boulders. The mass of the people, however, attribute the outbreak to the circumstance that we buried the filth from the latrines in 



18 

;renches close to their tents. They assert that this answered admirably while he weather continued dry, but that the extremely heavy fall of rain on the night ' the 11th saturated these trenches, raising a miasma that affected the whole eople." It is not to be wondered at, that an ignorant and terror-stricken multiude should have seized on the chief new feature of the arrangements as the cause : all their troubles. Other fairs, they argued, in which no attempt had been made o interfere with their ordinary habits, had, as a rule, come and gone without ny serious sickness. Now when a new system had been in force how disastrous ere the results. A religious element also largely entered into their feelings. n former years they had trusted to Kallee, and she had preserved them in health. /"hat were all these so-called sanitary improvements, but evidence of distrust, nd was it strange that the goddess should resent them, and visit the offending >eople with her grave displeasure ? 

42. The encampment at Hurdwar consisted of a long strip, nine miles long 

ป_._ ,„ ? by a mean of three in breadth, and thus covered an Difficulties in making arrange- "* ents. area of twenty-seven sauare miles. Deducting "one- 

area of twenty-seven square miles. Deducting "one- 

ourth or one-fifth for ground which was not occupied, we may assume" says )r. Cutcliffe, " that the remainder, or say twenty- two square miles, represent the mount of ground actually encamped on." To superintend the cleanliness of o large an area, occupied by a population not much smaller than of London, as no light task. To remove the filth without the camp was believed to be mpossible. Even assuming that the number of pilgrims present at any one ime exceeded two millions, it would have been simply impossible, remarks Mr. Williams, the Commissioner of Meerut, to have arranged for the removal f above 446 tons of dry matter daily, which he estimates would have been the mount to have been carried away on a moderate computation. 

43. Admitting all the difficulties which had to be encountered in carrying _ . out an efficient conservancy system over so large Defects in the arrangements. , . , .. ? . ,;„ 

an area and for so vast a population, it must still 

)e remarked that the objections which were urged by the Natives against le arrangements in force were not altogether without some grounds ; while iere is no reason whatever to suppose that they originated the disease, it s not improbable that they may have favoured its spread. The system f disposing of sewage by burning it in furnaces is open to question. Great leat will doubtless destroy the cholera germ or any other organic element, >ut it appears very doubtful whether in a smouldering fire the poison lay not be given off with the smoke during the first few minutes of leating when the temperature to which it is exposed cannot exceed that of a tropical sun. In disposing of excreta, especially under circumstances in vhich there is reason to fear that cholera may become epidemic, it is of the utmost importance that the means employed should without doubt be effectual. There is no evidence to show that the exhalations of these furnaces had any ffect in disseminating the disease among the people of the fair, but it is not be less advisable that in future arrangements this mode of treating the ewage should not be resorted to. All excreta should be so disposed of that neither the air nor the water supply can be contaminated. So far as is yet 





19 

Era there may be a risk of contaminating the air by the use of furnaces, her enquiry may demonstrate that this is a mere imaginary danger, but i this has been demonstrated to be the case, the possible danger should not be left out of sight. 

44. But if it is possible that the furnaces may have caused contamination 

of the air, it is still more possible that the water 

thewS 6 contamination of may have been contaminated by the latrines. It 

was only "in certain few and exceptional cases 

it was absolutely necessary to provide latrines on sand and boulders where the trench system could not be worked" ; the excreta consumed in the furnaces was therefore comparatively small in amount. " Nearly all the latrines," says Dr. Cutcliffe, " were situated on an earth soil, or on such an admixture of earth and sand, as admitted the digging of transverse trenches, one foot broad and four feet deep." The annexed sketch map will explain the position of Hurdwar, of the bathing ghat, and of the different sections of the encampment. In the island of Roree the arrangement of latrines, blocks, and roads, which was adopted in all of them, is shown. It will be observed that the latrines were numerous, and were dotted over the whole ground occupied by the people. The soil is very porous, consisting of river sand, pebbles and boulders. The trenches were carefully covered over with several inches of rammed earth, but they had no roofs, and were completely exposed to the weather. In such a soil with the rain of the 11th and 12th the whole ground must have been more or less impregnated with sewage, and the water of the Ganges must have become contaminated with the accumulated excreta of an immense multitude. If any cases of cholera had previously existed, and the water supply, which it must be remembered was drawn almost exclusively from the river, thereby infected, the rapid spread of the disease might be explained. 

45. To such an argument it may be replied that with the exception of 

Objections to this theory the grass-cutter on the 9th no other person had been 

considered. 

attacked till the 13tb, but although this has been 

described as a " sporadic case," it cannot be considered as having no connection with the wide-spread epidemic which is known to have existed only four days afterwards, and with all the vigilance of the police it cannot be stated as a fact that no other cases occurred during the intermediate days. In so vast a multitude cases may easily have escaped detection, and the aversion of the people to be taken to hospital would induce them all, and especially the better classes, to conceal the disease. Again it may be argued that the Ganges is a large and rapid stream, and that even granting the possibility of the excreta of a few cases of cholera having found their way into it, the quantity must have been altogether insufficient to have infected the water drunk by the devotees. It yet remains to be discovered how small a quantity of cholera contagkmi is sufficient to propagate the disease. A proportion altogether inappreciable to the most delicate chemical test is believed to be enough, and in the late epidemic of cholera in England the discharges of two patients are supposed to have contaminated the river Lea and so to have spread the epidemic over east London. Whatever opinions may be entertained regarding the possibility or 

i 



20 

even the probability of the water of the Ganges having been infected from the latrines, and having thereby spread the disease, there can be no question that at all fairs sewage should be so disposed of as to render any such pollution as far as can be impossible. 

46. It is of the utmost importance to discover in what manner an 

Pacts supporting the opi- immense multitude previously healthy suddenly nion. V>Fปnn,mfi infftptprl with ohnlfirn,. for f.lifi whnip hisfnvv 

became infected with cholera, for the whole history 

of the epidemic leads to the belief that, although very few were actually attacked at Hurdwar, the poison had been imbibed before they left the fair. There are to all appearance but two modes in which such a wide-spread infection could have taken place — either through the air or through the drinking-water. There is no evidence to show that there were any causes at work calculated to pollute the air with cholera contagium ; but assuming that this contagium was really present among the people, there are several strong grounds for supposing that the circumstances were not unfavorable for its dissemination by means of the drinking-water. It has already been stated that the soil in which the trench latrines were placed was of such a nature as to favor filtration of their contents into the river, and that the heavy rain of the 11th and 12th must have passed through them. There are two other facts which support the idea that the people may have been and probably were infected by means of the water. In the first place such filtration carrying with it any impurities, and in all likelihood cholera contagium, must have been very active on the great bathing day — rain, it will be remembered, fell heavily throughout the 11th, and continued up till noon of the 12th, when the bathing ghit was crowded with devotees, and, secondly, there is the fact, that to drink the water of the holy river is no less a part of the pilgrim's object than to bathe his person in its stream. 

47. Some additional and very interesting particulars have been furnished 

Further particulars from by Dr. Cutcliffe in a further report, copy of which Dr. cutciiffe's second report. has been rece i vec i s i nce the earlier portion of this narrative was sent to press, and they serve in a great measure to support the opinion w hich has been already expressed. "We have," he says, " proof sufficient to lead to the belief that the exciting cause — the contagium of cholera — was actually in the crowd. Is it possible to find the mode of the propagation of this exciting cause (contagium) in anything connected with the bathing ? Allow me to explain what occurred at the bathing-ghat. The bathing-place of the pilgrims was a space 650 feet long by about 30 feet wide, shut off from the rest of the bed of the River Ganges by rails, which prevented the people from getting any further out into the river than the limits of the space which was thus enclosed. Into this long, narrow enclosure, the pilgrims from all parts of the encampment crowded, as closely as possible, from early morn till sunset. The water within this space was, during the whole time, thick and dirty, partly from the ashes of the dead, brought by surviving relatives to be deposited in the waters of their river god, and partly from the washing of the clothes and bodies of the bathers, who were all decently, though lightly, clad. Now, pilgrims at the bathing-ghat, after entering the waters, dip themselves under water three or more times, and then drink of the holy water whilst 



21 

saying their prayers. The drinking of the water is never omitted, and when two or more members of a family bathe together, each from his own hand gives to the other water to drink. This reciprocal offering of water takes place between friends as well as relatives, and the drinking is accompanied by exchange of vows of love and fidelity, or of friendship. These vows are held to be sacred in the extreme. Old feuds are thus made up, and love or goodfellowship is established between the drinkers. The quantity of water drunk by the bathers varies, but it is never less than about as much as can be taken up by the palms of the two hands, held together so as to form a cup, and usually several cups-ful are drunk. 

" This custom it was to which, in my Hurdwar Report, I alluded, when I wrote of the ' much- polluted water at the bathing-ghat,' and again when I mentioned that 'to drink the sacred waters of the Ganges was as much an object of the pilgrims as to bathe in its stream.' Before leaving the water, the bathers usually wring out their clothes, so as to dry them as much as possible. 

" Now, let us suppose that in any pen-like enclosure bathers were densely crowded together, and that amongst those bathers there were some who had very recently come from districts infected with cholera — some who had brought with them, indeed, the contagium, whatever that may be, of cholera. Let us suppose that the bathers dipped and moved about in the water, and wrung out their clothes in the water and drank of that water, would it be unreasonable to think that persons in drinking such water would probably imbibe the cholera poison washed from off the clothes or bodies of those who had recently come from infected places, or who even might themselves be infected ? Is it an extravagant or a far-fetched idea that persons drinking of such water would very likely be directly poisoned ? I think that, apart from the feeling of disgust at the dirt of the water, no one acquainted with the disease would like to experiment on himself by drinking the water from a pen in which bathers, amongst whom were some who had recently come from a locality infected with cholera, were crowded. For my own part, I should feel more than a suspicion that in drinking such water my life would be endangered by the poison of cholera. 

" But at the bathing-ghat at Hurdwar there actually was a pen full of bathers who had been subjected to the predisposing causes of disease, and who had amongst them people fresh from a place infected with cholera, if not themselves actually at the time infected. These bathers in this pen all drank of water which was foul, and which must have been contaminated by whatever was washed from the bodies or the clothes of their fellow-pilgrims. I see no difficulty in supposing that, in drinking this ' much-polluted' water, the bathers imbibed the contagium of cholera, or imbibed that which developed the disease within them. It appears to me that it is possible that the sudden outbreak of cholera in different parts of the encampment the day following the great bathing-day, may have been due to the fact of the people having been congregated together into one spot, where some were directly poisoned by the imbibition of 



22 

the exciting cause or contagium of a disease to the attack or development of which other causes had predisposed them to succumb. 

11 But it may be asked why this poisoning did not take place before the great bathing-day ? If the people were poisoned at the bathing-ghat, lam unable to say on what day the poisoning actually occurred. "We do not know precisely how long a time is required for the development of the cholera disease after infection : we do not know the period of incubation, as it is called, of the disease. It is probable that the majority of medical men would expect the symptoms of cholera to develop themselves rapidly — not more than twelve or twenty-four hours, perhaps, after the imbibition of a large dose of cholera poison. On the whole, we may say that if the outbreak of cholera on the 13th was due to the poisoning of the people at the ghat, most men would think that the day in which that poisoning occurred was the 12th April. 

11 Now, it is well known that, as a rule, those people who reside near to Hurdwar do not come to Hurdwar to bathe until the last, or nearly the last, day of the fair, and that on this last day every one who possibly can get to the ghat goes there and bathes. Major Watson and other officers who have been present at many Hurdwar fairs have explained this to me. From Bazpore, the cholera-infected place, pilgrims would get to Hurdwar in two or three days, and would probably come into the fair only in time for the great bathing-day. It is quite possible that the people who brought with them the cholera contagium did not bathe until the 12th, and that the delay in the outbreak of the disease may be so explained. It is certain, however, that the number of bathers on the 12th far exceeded that of any other day, and that, therefore, the chances of poisoning, from the presence of infected persons, or from persons who conveyed with them the contagium of cholera, were greatest on that day. It must be remembered, too, that the causes which would so strongly predispose to the breaking out of disease were not acting with full force until the 12th. As the predisposing causes of disease had reached their greatest intensity on the 12th, and as the chances of the presence of a possible exciting cause were greater on the 12th than on any other day, the probabilities are, if my hypothesis is true, that it was on that day that the infection of the pilgrims occurred. 

" If the poisoning occurred at the ghat on or about the 12th, we can easily understand the breaking out of the disease almost simultaneously in all parts of the encampment. There is in the subsequent history of the epidemic, and in its dissemination by the infected pilgrims, nothing that appears to me to be incompatible with the hypothesis which I have now put forth as a possible explanation of the cause of the outbreak of the disease. The hypothesis which I have now advanced is one which I have, from the date of last year's fair, believed to be the most probable explanation that can be conceived of the cause of the outbreak of the epidemic of cholera. Believing that this explanation might eventually be found to be true, and convinced that there can be no safety if the importation of cholera into a fair be not prevented, I urged in my Hurdwar Report that 'Natives should be prohibited from setting out for these fairs from any place in which cholera or small-pox is known to be epMemic/ and that, by constant supervision of the advancing crowds, 'no 



23 

individual affected with small-pox or cholera should be allowed to proceed forward. He should be detained in hospital until cured, and be then sent back to his home.' 

" In conclusion, I beg respectfully to urge that the correct determination of the causes of the outbreak of cholera at the Hurdwar Fair of 1867 is a matter of very grave importance ; for, should a wrong judgment on the causes of the origin of the epidemic be pronounced, attention in instituting future preventive measures will be misdirected ; and whereas time and labour may be devoted to latrines and to the general cleanliness of the encampments, it is possible that cholera unperceived may creep into the crowd, and, in spite of the best police conservancy arrangements possible, there develope itself with all its fury through a medium which, till too late, may be unsuspected, or if suspected, be unavoidable, on account of its being inseparable from, and an indispensable part of, the whole religious ceremony which pilgrims are bound to observe at the sacred bathing-ghat." 

48. As has been already shown, the disease did not appear in an epidemic 

Importance of the rapid form tiU the day after that on which the religious dispersion of the pilgrims. ceremonies had ended. By the evening of the 15th, writes Dr. Cutcliffe, " the pilgrims had all departed ; and it was when they had left Hurdwar, and were beyond all sanitary control, that the disease began to spread amongst them. At former fairs, as I have previously shown, when cholera broke out, it destroyed the pilgrims in great numbers at Hurdwar itself, and since the laws which the disease observes in relation to crowds are known to be everywhere alike, we may be sure that it would, this year, have produced a terrible havoc in so vast and dense a multitude as were present at the Cumb, had it not been for the very complete arrangements that opposed both its outbreak and its diffusion." Very great obscurity, as has been already stated, hangs over the sanitary history of previous fairs, but all the evidence goes to show that for the nine years preceding 1867, cholera had been altogether unknown at the annual gathering, or had existed to so small an extent as to attract no attention, and yet during all these years there had been no sanitary arrangemsnts whatever, and the whole camp had been most offensive. Excepting the fair of 1783, in which the epidemic was so severe, there is no evidence beyond vague tradition to show that the disease had ever been very destructive among the pilgrims so long as they remained at Hurdwar. Referring to Dr. Cutcliffe's remark above quoted, Mr. Robertson observes that "it is amongst Natives notoriously admitted that when cholera breaks out amongst the people, it does so chiefly on their return home from the fair and not to a large extent in the fair itself." The same peculiarity has been remarked in reference to most fairs in India. The longer a large mass of people are crowded together the more risk of the specific cause of cholera appearing, and returning pilgrims exposed to privation and fatigue are in circumstances most favorable for the specific cause to act. There can be no doubt, however, that once the disease appeared at the fair, the sooner the assembled multitude dispersed the greater their chance of escape. Any sanitary control that could possibly have been exercised over three millions or over 





even one million of persons would have been utterly powerless to prevent its spread, and from all that is known of cholera in India, there is good reason to believe that had the pilgrims continued at Hurdwar for even a few days longer, the mortality amongst them would have been infinitely greater than it unhappily was. 



SECTION 11. THE RETURN OF THE PILGRIMS TO THEIR HOMES, AND THE GENERAL DISTRIBUTION OF THE CHOLERA OF 1867. 

49. Terror-stricken the vast crowd dispersed, many of them ill-clad and 

Condition of the pilgrims m - fed > sufferin g fro^ the effects of privation, all 

after the fair. 

anxious to return as quickly as possible and leave 

the dreaded foe behind. Their very eagerness to escape, the fatigue which attended long and harassing marches, made them fall but the more easy victims to the disease. The roads in every direction were crowded with the unfortunate devotees, but the main routes adopted were three — one south-east through Rohilcund and Oude ; a second south-west through the Seharunpore, Mozuffernuggur and Meerut districts; and a third north-west through Seharunpore to the Punjab. 

50. It will be necessary now to follow these streams, to examine th c 

sources from which in- reports which have been received from the various formation has been obtained. districts of Upper India, to ascertain as far as possible what are the facts, and to learn the opinions of the medical officers by whom they were observed. In the end of April, when there was no longer any doubt that a very wide-spread and formidable outbreak of cholera had appeared, a circular letter, dated 29th April 1867, was addressed by the Sanitary Commissioner to the civil surgeons throughout Upper India, requesting them to furnish information on the following points :—: — 

Ist. — To what extent has the disease appeared in your district ? (The 

precise dates of its commencement and disappearance should here be given as nearly as possible.) 

2nd. — Was it confined to the pilgrims, or did it also attack others ? 

3rd. — In the latter case, what facts are there to prove beyond all doubt 

that the disease was due to importation by the pilgrims ? 

4<th. — What facts are there to show the period of incubation observed 

in the disease ? 

sth. — What measures were adopted to prevent the importation? 

6th. — "What success has attended those measures ? 

The information received in reply to these queries has also been supplemented in many cases by answers to the following questions contained in the Sanitary Commissioner's annual circular :— 

Has there been any cholera during 1867 ? 

& 



26 

If so, state — 

Ist. — Time and place of its origin, and also of its termination. 2nd. — Direction of its spread. 

3rd. — Extent of sickness and mortality it occasioned. 4ith. — Its causes. 

"What measures were adopted to meet the epidemic ? What success attended these measures ? 

Are there any observations connected with the direction and force of the 

wind during the cholera epidemic which are trustworthy ? If so, what 

are they ? 

Have any facts come to your notice during the epidemic, tending to prove that the disease is propagated by contagion, or the reverse ? 

The local Governments were also requested to aid in every way in their power, and every assistance has been rendered. As regards the army both European and Native, through the kindness of the heads of the British and Indian Medical Departments, many reports have been made available, while the annual records of the jails supply details of the disease among the prisoners. Both of these contain many valuable particulars, and the data they supply are necessarily much more accurate and precise than can be obtained regarding the general population. The information derived from all these sources is of very great value, and forms a mass of evidence such as never has been collected with reference to any previous epidemic in India. 

51. As regards the extent of the disease in the various districts, the data 

Chief questions to be de- cannot be altogether relied on, for as yet the morcided. t.iifivv sfniisfins n.rp far from nprfprf,. Tlifi rmin+s rvf 

tuary statistics are far from perfect. The points of 

chief importance are referred to in the second and third questions, and the replies which have been received to them will be given at length. Even at the risk of being prolix it is of the utmost importance that on a matter of so great moment the evidence of the witnesses should be recorded in their own words. The answers to questions Nos. 4, 5 and 6 are necessarily less precise, and an attempt will be made succinctly to summarize the information collected on these heads. It would extend this history to an undue length if the details of the disease in each military cantonment were given in the words of the original reports, but an endeavor will be made to state the facts as accurately as possible. 

52. The mass of information derived from all these sources will now be 

considered. The facts gleaned from each district Order in which the several ฐ parts of the country will be and from, each military cantonment it may contain lakeu. in i_ _ii /-i • .iifNi •ฆ 

will be recorded. Commencing with Seharunpore it 

will be convenient to relate what occurred in the districts lying immediately to the south-west and south, and then accompany the pilgrims through Rohilcund. To advance onwards into Oudh would be the natural geographical course, but for reasons to be stated hereafter, it will be better to consider the epidemic of cholera which covered that province in a succeeding portion of the report. 



27 

The events in the Meerut and Allyghur districts will next be noted, and then commencing the Punjab, with its most southern portion, Goorgaon, the disease will be traced as it successively appeared in its various parts upwards to Peshawur. Next will come the Agra division, and an account of the disease in Hajpootana and Central India. The epidemic in Oude will be described, and then in succession will be noted the facts which have been ascertained regarding the history of cholera in the Benares division, in Behar, the Central Provinces, and Lower Bengal during the year 1867. 

53. The district of Seharunpore, in which Hurdwar is situated, first demands attention. Excluding the " sporadic" attack In the Seharunpore district , , _ . f cholera believed to have been of the 9th, the first known case of cholera occurred disseminated by pilgrims. at on 19th of June. Between these two dates 1,323 deaths are reported to have occurred among the people. The disease was chiefly confined to pilgrims. " Excepting those who had been at Hurdwar," observes Dr. Cutcliffe, " very few people have any where in the Seharunpore district suffered from cholera." As regards importation his evidence is very strong. "It was on the 1 7th April, i. c., four days after the arrival of the pilgrims at Seharunpore, that cholera first attacked in the town any individual who had not been to Hurdwar. In no single instance has there been reported to me a case of cholera in any town or village out of the line of march of the pilgrims. The cholera cases which first occurred in the towns and villages were confined, so far as I can discover, to those who had been present at Hurdwar, and in these places the pilgrims and the disease appeared for the most part simultaneously." 

No cases occurred in the jail, which contains about 180 prisoners. 

54 Within the Seharunpore district, and only 1 1\ miles from Hurdwar, is 

Its apparent importation in- the cantonment of Eoorkee. It was occupied by a to the cantonment of Roorkee. w } n g o f Her Majesty's 79th Regiment, and by a body of Sappers and Miners. It is besides the head quarters of the Thomason Engineering College, of the Ganges Canal, and of large Government workshops. The first case occurred here on the 13th, the same day as the disease appeared at Hurdwar. The epidemic soon spread in the town, but was never very severe. In all there were 145 cases and 76 deaths up to the 27th May. when it is said to have disappeared. 

The Europeans entirely escaped, but there were two cases among the Native Sappers. As regards the source of the disease, writes Dr. J. P. Walker :—": — " My opinion is that cholera was imported into Roorkee by pilgrims returning from Hurdwar, where some hours previously it had appeared amongst the two or three millions assembled for the Koom Mela. The first case at Roorkee occurred late on the afternoon of the 13th April 1867, in the person of a pilgrim from Hurdwar. Up to the 19th all the affected, with one exception, were returning pilgrims. The exceptional case was the cook of the cholera hospital who was attacked on the 18th or 19th. The second non-pilgrim attacked was a thatcher 



28 

of the town, and the third, on the morning of the 22nd, was the compounder of the Ganges Canal Hospital, who was regularly on night duty at the cholera hospital." 

55. The district of Deyrah Doon lies along the north-east side of that of 

_ .. .. _ , Seharunpore, and one portion of it is close to The disease in the Deyrah n district. Hurdwar. The first case here is reported to have 

Hurdwar. The first case here is reported to have 

appeared on the 16th April. The person attacked was a traveller and most probably a pilgrim, but this point is doubtful, no special report having been received from the officer who was civil surgeon of Deyrah at the time ; the data are therefore imperfect. Between the 16th and 29th April it is said that no fresh cases occurred ; on the latter date there were two, and two more on the day following. With the exception of the first case, all those attacked appear to have been residents of the district. In the Deyrah jail among some 40 prisoners there were 12 cases and 2 deaths from cholera during the months of April and May. From the small proportion which proved fatal the disease appears to have been of a mild type. The civil surgeon returns them under the head of " choleraic diarrhoea." Of the Body Guard none of the men suffered, but sof the camp followers were attacked and 3 died. The medical officer, Dr. Banister, writing of the epidemic in the district, says " cholera was imported by pilgrims returning to their homes." 

56. At the hill station of Mussoorie, which looks down on Deyrah from 

The disease at Mussoorie an elevation of about 7,000 feet, and is only 30 and LandOUr. . Tniloa funm i+ +V>a rlieoaaa flrsf. fl/nflPflrprl nrt 

miles distant from it, the disease first appeared on 

the 27th April in the wife of an officer who had just arrived from the plains. O the 30th two cases occurred among natives, one of whom had arrived from Deyrah two days previously. At Mussoorie the disease was but slight, anc disappeared on the 22nd May, by which date there had been 12 cases and 1 deaths. Landour, which is a convalesent dep6t for European invalids, anc which joins the civil sanitarium of Mussoorie, escaped entirely during April, bu among the native residents at this place there were 4 deaths from choler during May. 

57. The district of Mozuffernugger lies immediately to the south of 

The epidemic in the Seharunpore. From Hurdwar to the civil station Mozuffernugger district. o f Mozuffernuo-per thn distant is abonf, 50 miles. 

of Mozuffernugger the distance is about 50 miles. 

The particulars furnished by Dr. Kirton are very interesting: "On the 15t April the pilgrims began to return into the district in numbers from Hurdwa by the Roorkee road, and it soon became evident that cholera to a great exten existed amongst them. The first authentic case of cholera was seen by m on the morning of April 15th ; the patient, a woman, was brought to th dispensary in a state of collapse, and died two hours after admission. The pilgrims reported that many deaths had occurred from cholera on the road They were, they said, in great alarm on account of the pestilence, and expressec much anxiety to hurry on so that the journey might the sooner be ended As the stream of traffic increased in density, it was seen that not only cholera existed amongst the people, but that small-pox, diarrhoea, and fever also prevailed Altogether on April 15th 3 cases of cholera were admitted to the dispensary 



29 

and 96 cases of sickness, including cholera, diarrhoea, fever, &c, were treated on the road. On April 16th the stream of traffic, on the main line of road, became very dense, and continued ' so all through the following day. Although by far the greater number of pilgrims were travelling on foot, yet every conceivable form of vehicle appeared to have been called into use. Besides bullocks, which were used chiefly in dragging the carriages, camels and horses were to be seen in numbers, while elephants and mules were also used. The women travelled mostly in covered hackeries, crowded generally in parties of ten or twelve, with children, in each conveyance. It was in these that the worst cases occurred. ****** 

****** 

On April 28th the wife of the native doctor in charge of the dispensary was seized with the disease, and died after a few hours' illness. This woman had not visited Hurdwar." 

The total number of persons attacked was 1146, of whom 737 died. The prisoners did not suffer. 

58. Dr. Kirton's opinion on the question of importation is very decided. 

"The disease," he says, "was not confined to Evidence of importation. ... . . ? . , . mi 

pilgrims only, but attacked other persons also. The 

number of pilgrims and other persons in the district attacked by the disease may be shown as follows :—ln: — In the district — pilgrims 483, other persons 603, deaths 724. Dispensary cases, pilgrims 57, other persons 3, deaths 13, Total — pilgrims 540, other persons 606, deaths 737. The disease was due to importation by the pilgrims. No cholera existed in the district previous to the Hurdwar Fair, and it appeared in the district immediately on the return of the pilgrims after the close of the fair." 

59. The district of Bijnour lies to the south-east of Seharunpore and 

' The disease in the Bijnour is separated from it only by the Ganges. Here in district. +u o immprlinffi vi^init-.v of Hnrdwar the disease broke 

the immediate vicinity of Hurdwar the disease broke 

out suddenly on the 13th April, the same day as that on which it appeared at the fair. On that date there were 23 cases and 22 deaths. During the first week the number attacked was 871, and of these 426 died. It then gradually declined and disappeared altogether in the middle of June. By that time there had been 2,201 cases and 1,065 deaths. The Jail altogether escaped. 

60. The Civil Surgeon, Dr. Gardner, states that the disease " was at first 

certainly confined to pilgrims and persons returning 

Evidence of importation. from Hur( j war; but at a later stage, in several places, persons who had not been to Hurdwar at all were affected/ A special case of supposed communication of the disease is thus narrated :— " At the village of Bisahat 2 men who had returned from Hurdwar Fair died of cholera on 30th of April, and their clothes were not burned according to orders given, but washed in a pond which was inside the village and the water of which was used for domestic purposes. On the Ist and 2nd May, in the same village, 16 attacks occurred, giving about one day only for period of incubation." 



30 

61. The station of Moradabad is 86 miles distant from Hurdwar. The first .. . case occurred here on the 15th April, and up to the Evidence of importation in- # , ? ?, to the Moradabad district. middle of May, when it disappeared, there had been, 1,247 attacks, but only 178 deaths. The Civil Surgeon Dr. Collison remarks :: — ฆ " Cholera first made its appearance in the Moradabad district in consequence of the return of pilgrims from Hurdwar on the 15th of April, and the last case occurred at Kasheepore on the 12th of May. The disease was not altogether confined to the pilgrims, but it was almost limited to the line of road taken by them through the district. Some of the non-pilgrims attacked were living in the same house with pilgrims who had just returned from Hurdwar, and there was no cholera in the district until the pilgrims returned from Hurdwar." The statement of the district officer is equally positive :—": — " Under no circumstances could more satisfactory proof have been obtained of the communicability of the disease. Previous to the arrival of the pilgrims not one case had occurred ; simultaneously with their arrival it attacked residents of the towns with whom they came in contact, and assumed for a time an epidemic form ; nor was this confined to one stream of pilgrims; — wherever they went the result was the same." 

62. Out of a strength of nearly 300 European soldiers quartered at 

The European troops in Moradabad no cases occurred till the month of July, cantonments suffer slightly. |n that month there were four, and in August three ; five of the seven died. While the Native troops were suffering, the Europeans were free from the disease. 

63. Among the Native soldiers, whose average strength was 382, the 

A few cases among the Na- disease was not severe > but {t appeared much tive troops. earlier. The particulars of the outbreak are thus related by Dr. Cavendish Johnson, the surgeon of the 29th Regiment Native Infantry: — "The first case was admitted on the 16th April, the patient a sepoy, who had returned with the pilgrims from Hurdwar that day. On the 17th a similar case occurred under similar conditions except that the period of death was delayed till the 19th. Both these men were young soldiers of short service (Sikhs) and both returned from Hurdwar the same day. The disease did not show itself again until the 24th." Another case (a drummer on the 25th, a fourth on the 29th. On the latter date an old woman living i the drummers' lines was seized. "On the 30th a dhobee and a Sikhnee, wife o a Sikh sepoy, were attacked. The dhobee made a good recovery. The soldier wife lingered till the 3rd May when she died. Another Sikhnee living in th same enclosure and suckling a child was seized. She recovered a very sever and lasting collapse. Both mother and child are now quite well and the latte is still at the breast." Only five cases and five deaths are entered in the table o Native troops, but this does not include camp followers, of whom the numbe seized is not noted. Remarking on the different manner in which the sam circumstances affect different individuals, Dr. Johnson observes that the sepoy who had been to Hurdwar and were attacked, were two out of 250 who hac obtained leave to be present at the fair ; that all had been exposed to lik privations, had rejoined at the same time, ate much the same kind of food, ye of the 24-8 not one man had any symptoms resembling those of cholera. 



31 

64. In the hill country of Kemaon and about 60 miles from Moradabad 

The disease appears at lies the station of Nynee Tal, which has for some NyneeTal. years been the head quarters of the Government of the North- Western Provinces during the hot months, and attached to which is a convalescent depot for European soldiers. In the outbreak which was confined entirely to the Native community at this place, twenty-two cases altogether occurred between the 22nd of April and the 11th of June 1867. " The first case," Dr. Hilson reports, " showed itself in a female pilgrim from Hurdwar, who came up to Nynee Tal from Huldwanee on the 18th or 19th of April, suffering from cholera and choleraic diarrhoea, and who went to reside with some relatives in the compound of Pear Tree situated on the margin of the Lake and tenanted by the establishment of Messrs. Drew and Co. She was brought to the dispensary on the 22nd in a state of collapse and died on the following day. From her own statement and from enquiries made at the time I ascertained that this woman was undoubtedly a pilgrim from Hurdwar, and there is also no doubt that she was the first person in whom the disease appeared at Nynee Tal. On the 22nd four other cases occurred among the servants of Colonel Barwell, living in the compound of 'New House,' on the margin of the Lake and immediately adjoining that of Messrs. Drew and Co. These were not pilgrims and had been for some time resident in the station, but they were in frequent communication with and attendant on the preceding case. On the 23rd and 24th four fresh cases occurred in the same locality and then the disease ceased for a time. All these cases from the 22nd to the 24th inclusive occurred in two compounds adjoining each other, and were all apparently caused by contagion from the pilgrim. The disease never re-appeared in that part of the station. 

11 On the 7th of May a native living on the compound of ' Strawberry Hall' in the Ayah Puttah Hill was attacked. Eour or five days previously he had come up from Kal&doonghy at the foot of the hills where the disease was raging, but he declared that he never came in contact with, or indeed ever saw, any cholera patient while there. On the Bth a rnehter and a cooley living in the large bazaar were seized by the disease. The former arrived in the station on the 30th of April, having come from Sewarah, a village in the plains, about forty miles from Kaladoonghy on the Hurdwar road. The latter came from Jewley, an infected locality, two or three days before he was attacked. It is difficult to say whether these three cases were sporadic, or whether they resulted from contagion, communicated by pilgrims or others suffering from the disease in the plains, but in all the others which occurred in various parts of the station between the 10th of May and 11th of June, the cholera was entirely of a sporadic nature, and showed no tendency whatsoever to spread by contagion. On some occasions a Jampanee would be attacked while living with three or fou r others in a small outhouse 8 feet by 10 feet, and would not be removed until collapse had fairly set in, yet none of his comrades, although sleeping alongside of him, would show anysymptoms of the disease." 

65. Almorah is a sanitarium and military cantonment about 40 miles 

Appearance of cholera at further in the interior of the Kemaon Hills than Almorah. NTvnao Tal TTora fl-io rliannaa annoovo/1 rm +liฃป O^fl-i 

Nynee Tal. Here the disease appeared on the 25th 

April. "It was chiefly confined to the pilgrims," says Dr. Govan. On the 



32 

subject of importation he remarks that two facts are known ; "first, that no cholera had been prevalent till the pilgrims arrived ; second, that their arrival was the signal for several cases in the surrounding villages." From the 25th April to the sth July, 166 cases were registered, of which 126 died. In the native regiment and jail, there were altogether but two cases, one in July and the other in August. 

66. The particulars furnished by Colonel. H. Eamsay, the Commissioner of 

Kumaon, are of special interest. "It is impossible Pacts of importation into , ฆ * x . r Kemaon given by the Com- to give any correct information regarding these missioner. ? . _ „ _" ? . , . xx , , ? 

pilgrims from their leaving Hurdwar to the time of 

their reaching home, because they concealed, as far as possible, the fact of their having had the cholera among them, and passed on as rapidly as possible, leaving their sick to die, and their dead to be buried, if any died during the march : those who died during the halt were buried or thrown away in the jungles. We have correct data as yet only regarding those pilgrims who went from the villages at the foot of the hills. The Hurdwar Fair was over on the 12th April, and pilgrims from the villages near Kaladoonghy and Huldwanee reached their houses on the 1 9th idem. Some died the day they arrived ; others communicated the disease to their friends, without suffering themselves. This has been clearly proved in several instances. In one case, a woman, on her return to a village about three miles from Huldwanee, went to her brother's house ; he was taken ill almost immediately after ; he died. His son, mother, and two wives died within a few days, while the woman who brought the disease escaped altogether. "Within a few days the cholera spread, and, exclusive of those who were buried or burned by passing pilgrims, not less than 500 died in Kota Chukhata. Of these, 307 died in the villages between Kaladoonghy and the Sookhee River (about 1 5 miles). While the cholera was carrying off 40 or 50 a day, travellers appeared to pass with impunity. Very few from these Bhaber villages went to Hurdwar, and of the 307 who died, about 30 only were pilgrims. 

" The pilgrims carried the disease to the hills ; it broke out in the villages as soon as the pilgrims returned, and has continued spreading ever since. In those pergunnahs from which none went to Hurdwar, there is no cholera yet, except in a few villages, and in the latter it has been proved that it was brought from other villages where cholera was bad. In the pergunnahs of Dhyanirow, Kalee — Kumaon, and Chougurkha, from which many went to Hurdwar, cholera has been going on since the 20th or 22nd April ; and in other pergunnahs which sent no pilgrims there is no cholera. This is conclusive evidence that the disease was imported from Hurdwar. At the foot of the hills, the disease broke out on the 19th April, the very day the pilgrims returned." So convinced were the people as to the danger of importation that " pilgrims in Kemaon, instead of meeting with respect, received unlimited abuse from all classes on their return from Hurdwar." 

67. The Terai Pergunnahs lie immediately below the Kemaon Hills. It 

Spread of the disease in the has already been recorded that cholera appeared Terai Pergunnahs. h erfi Wflv i niiq t n fao. fair and t.W. in all ™-nhahilit.v 

here previous to the fair, and that in all probability 

the pilgrims attacked in this district on their way to Hurdwar may have been 



33 

the means by which the disease was introduced among the large assemblage. The disease was " rapidly disappearing," writes the Superintendent, " when the return of the pilgrims caused it to break out afresh on all sides. The villages which suffered most were those close to the direct line of road to Hurdwar, and it was in villages so situated that the disease first appeared. Many villages removed some distance from this line of road had not a single case of cholera, while others were decimated, and in one case the village has entirely broken up." 

"The visitation continued for about 40 days; 1,113 persons were attacked, and of these 596 died." 

68. In the Bareilly district, which immediately adjoins the Terai, cholera Its appearance in the first appeared on the 18th April. The statements Bareilly district. o f authorities are very plain and emphatic. The Commissioner Mr. Inglis writes :—": — " The disease appeared first among the pilo-rims returning from the Hurdwar Fair, but afterwards attacked others who had not been there. That the disease was communicated by the pilgrims is shown by the fact that it was almost entirely confined to the lines of road along which they travelled, and to places to which people who had been to the fair returned." Dr. J. C. Corbyn says, " the disease was propagated in the direction the pilgrims went." The Magistrate Mr. E. Colvin states : — " It is clear that the cholera did not reach this district before the pilgrims ; it appeared simultaneously with them, and then spread from them to the other inhabitants." In a subsequent report his opinion is, if possible, even more decidedly expressed. " There cannot be the slightest doubt," he says, " that the disease was imported by the pilgrims, for previous to their return there did not occur a single case of cholera. It was only on their return to their homes that the disease appeared at those places." Between the 18th April and 27th May when the cholera ceased there were 552 cases. Of these only 63 are said to have been fatal. 

69. The prisoners and Native troops at Bareilly escaped altogether. 

Among the European soldiers one man was seized 

o **" in May, a second in July, and a third in August, 

and of these two died. Dr. Innes, the Deputy 

Inspector General of Hospitals, writes that " the visitation was confined to the married quarters. The families from these were placed in tents, pitched 100 yards in rear or to the south-east of these barracks. Two men, three women and a child had previously died from cholera. They remained under canvas from the 17th August until the 6th September, having once taken up fresh ground in order to facilitate the proper conservancy of the camp. There were no cases under canvas." The comparative immunity from cholera which the cantonment of Bareilly has hitherto enjoyed is very remarkable. 

70. Budaon is another of the districts of Kohilcund and immediately joins 

Bareilly. The stream of pilgrims which passed 

d .T t he c disease in the Budaon through it was not large. Dr. Walsh records "that 

the disease first appeared in this district at Bissowlee 

on the 18th April ; two cases were reported and two deaths. On the same day one case occurred at Islamnuggur. Its first appearance at the sudder station 



34 

was on the 21st April when two were attacked, of whom one died; the disease confined itself solely to the pilgrims up to the 4th May. There was not a single resident attacked before the 4th May." Dr. Walsh expresses his opinion that " there can be no doubt that the disease was due to importation by the pilgrims." Up to the 11th May there had been 151 cases and only 14 deaths reported. 

71. The Shajehanpore district, which lies south east of Bareilly, suffered 

longer and more severely from cholera than any of" 

Sh 6 lhan o^district. 111 the the other districts of Rohilcund. From April to 

September nearly 3,000 persons had died of the 

disease, or about one half of those attacked. Even by the middle of October the pestilence had not ceased. The first case occurred on the 24th April. It was that of pilgrims returning from Hurdwar. Dr. Harris's opinion as regards the origin of the disease is very decided. " The fact of the importation by the pilgrims, " he writes," is self-evident, as the disease was unknown in the district until the 24th of April last, when the first case occurred among some of the pilgrims at a place called Bantra, in this district." 

72. The Shajehanpore Jail was one of the few in the North- Western Prov 

inces which suffered from the scourge. In all there 

c prisoners aac . were 22 cases, of which 6 ended fatally. The first was in May ; the three next in July, and the remaining 18 in August. "As quickly as possible, a large number of the prisoners were moved to a large native building, and among them no cases occurred, while the disease was lessened in the jail." 

73. The Native soldiers, numbering about 200 men, suffered very slightly ; 

only five of them were attacked ; but the head quarters 

The disease in cantonments. r. t-i h* • , , n/ ,,i n • . x i i t? of Her Majesty s 36th Regiment, the only European troops in the cantonment of Shajehanpore at the time, suffered severely- Suddenly on the Bth of May a woman belonging to the regiment was attacked. She was at once carefully isolated, and the remaining families vacated their quarters that evening and went into camp on a dry site near cantonments. Their barracks were then thoroughly cleaned out and fumigated, and no more cases having occurred either in camp or cantonments, they returned to quarters in ten days. For more than two months subsequently, the troops preserved complete immunity from cholera, though, as reported by Dr. Ball, the Surgeon in charge, the mortality amongst natives in the city continued very high. 

74. Towards the end of July a second case occurred. The same measures 

Part of the Regiment moves of prevention were at once taken, and the company into camp. affeotpA itiovpH onf, into na,mn near the*, sfaf.inn On 

affected moved out into camp near the station. On 

the 9th August, however, on the occurrence of a, third case the day before, it was deemed prudent to detach head quarters and three companies. They accordingly marched that evening to an encampment five miles to the south west, the neighbourhood of which was reported to be free from cholera. The weather had been very unsettled for some time, and it was with some difficulty a proper site for a camp could be found, as a great portion of the country was inundated. There was heavy rain again with thunder and lightning on the 13th August, 



35 

but the health of the detachment did not suffer. A single case of cholera occurred on the 11th which terminated fatally in six hours. The three following days passed without any symptom of disease, but on the 15th a fresh case occurred. A week elapsed, when on the 22nd August a Sergeant of the Regiment, who had been acting on Provost duty, was attacked. Ground was changed on the afternoon of the 27th consequent on the occurrence of a fresh case two days before. There were no cases for six days after this change of camp, but on the 2nd September another case, the last in the detachment, occurred. On the llth September the disease having disappeared, camp was broken up, and the troops returned to cantonments. 

75. The party left behind at Shajehanpore during the absence of the head 

quarters' detachment consisted of two companies, the married families, and the sick in hospital. One of the companies had been moved into camp near the station, as already stated, about the end of July, on the occurrence of the second case of cholera. A scarcity of tents prevented the removal of the entire wing, and it was not till the 14th August that sufficient tentage was procured to enable the remaining company, married families, and sick to vacate their quarters. One of the regular cholera camps at Peina, 2| miles north of the station, was occupied forthwith, but meantime three cases of cholera had occurred, all of which eventually proved fatal. It was not considered desirable to take these cases into camp with the party, so they were left behind in hospital. Immediately on arrival in camp another fatal case occurred, and on the following morning " a broken down old soldier, who had been a long time in hospital, died with symptoms of collapse." It had been arranged that the party should cross over the river Kanout to ground well adapted for a cholera camp, but the design was frustrated by the breaking down of the bridge of boats. On the evening of the 16 th August, therefore, the party marched to a new camp 3^ miles north of the old one. During this march a woman was seized with cholera and died on the 17th, and at the same time the hospital orderly, who had been in constant attendance on the cholera cases, was attacked. He survived till the 26th August. There were no fresh cases on the 17th, but on the 18th August there were eight admissions. On the 19th, the party again changed ground a short distance to the south-east of the previous camp. During the day two men, one woman, and two children were seized with cholera. The state of the weather was such as to render further movement impossible till the 25th August. Meantime four fresh cases of cholera occurred in camp, and the detachment marched to a new camp near Kudhouth. Heavy rain again set in, and a neighbouring tank having overflowed its banks, a portion of the camp was nearly inundated. A very virulent case of cholera occurred on the 28th August, and on the morning of the 29th " the detachment marched to its final encamping ground near Newathepore." Here they had one case, the last on the 30th August. There was great improvement subsequently in the general health of the party. Ophthalmia, which had been long prevalent amongst the women and children, gradually disappeared, and the men 



36 

recovered their wonted vigour. The detachment returned to quarters on the 13th September. 

76. The most noticeable feature in this outbreak at Shajehanpore is 

I More favorable results in tne comparative immunity from cholera of the c detachment first moved. head quar t e rs party of the 36th Kegiment. The Len of the three companies, which accompanied head quarters to camp, were similarly exposed with those of the other companies and married families, and yet the disease was much less prevalent and fatal amongst them. As remarked by Dr. Ball, the sanitary conditions were the same in toth, and the other circumstances were almost Identical. He says — " I fail ) discover any local causes in the encampments selected or in the general hygienic arrangements to account for so remarkable a difference, nor, a priori, is it probable that foci of disease should have been repeatedly pitched upon, notwithstanding every care and anxiety in one case, and avoided in the other." There was one important difference, he states, in the conditions to which the parties were subjected. " One marched out of the infected locality on the first appearance of the disease, the other, from unavoidable causes, was detained in it nearly a week." An unusual number of sick attendants were attacked with cholera during the progress of the epidemic. There were six Europeans employed on this duty, and of these three suffered from the disease. This is a large proportion, but, as Dr. Ball remarks, the arduous nature of the duties, the continuous fatigue and loss of adequate rest would involve special liability to any prevalent disease, setting aside altogether the idea of contagion. 

77. As has already been stated, the natural course from a geographical 

Oude and some other parts P oint of view would be to advance from Rohilcund to be considered afterwards. to Qude and detail the facts of the epidemic in each district and cantonment of that province. It will be more convenient, however, first to trace the disease in those parts of the country in which its appearance was coincident with, or followed immediately after, the arrival of the pilgrims, and on the confines of Oude, which lie more than 200 miles in a direct line from Hurdwar, the evidence on this point becomes indistinct. Oude and other parts of the country, therefore, to which similar remarks apply, will be discussed in a subsequent part of this report, and the districts which lie to the south-west of Hurdwar will now be considered. 

78. The populous district of Meerut with its large military cantonment 

occurrences in the Meerut lies immediately to the south of the district of district. TVlnznfffirrme'e'ur. the ooourrenofis in yxrhioh TinvA 

Mozuffernuggur, the occurrences in which have 

been already detailed. The following interesting extracts taken from Dr. Moir' ireful report of the epidemic give a resume* of the extent to which the people in eerut suffered, and also that officer's opinion on the question of importation :—: — [t may be stated that cholera was in the first instance almost altogethe nfined to the towns and villages on the roads by which the pilgrims returned >m Hurdwar, and was consequently most severe in the western portion of th strict, as by far the greatest number of the pilgrims passed through it. A as is known there was not a single case of cholera in the district befor 



37 

he return of the pilgrims from Hurdwar. They began to reach Meerut in straggling bodies on the 14th April, and on the 16th the most advanced portions of tie great mass came up and continued to flow fast in one undiminished stream or five days, after which it began to decrease. The first case of cholera in the ity of Meerut reported by the police was on the 14th April, when a resident s said to have been attacked, but not till the morning of the 16th did any case ome under my own observation. It was fatal ; the victim was a pilgrim re;urning to Agra — a sepoy belonging to the Native Regiment at present stationed lere. Within the next 12 days cholera was reported from 30 out of the 33 >olice stations in the district. The towns and villages near the roads along diich the pilgrims chiefly travelled were most severely attacked, and in most nstances in the order in which they were reached. Prom these numerous entres, the disease soon spread to the neighbouring villages, and before the end I April 736 cases were reported by the police, attended with 162 deaths ; the ;otal number of persons treated in hospitals throughout the district in April as 339, of whom 87 died. Of the treated cases 205 were residents, and 134 >ilgrims, and the respective deaths were 53 and 34. The police reported ;he number of persons attacked in May (all residents) as 2,903, and the deaths as 916; in June the respective numbers were 795 and 332, and up to 22nd July 158 and 37, which gives the total number of cases in the district as 4,592, and the deaths 1,447 according to the police reports, from the commencement of the outbreak up to July 22nd." Even then the disease was still lingering in the district and continued to be reported from six police stations, though the numbers were few. 

L 79. " That the disease was imported by the pilgrims," writes Dr. Moir, . . „ ซ seems to me to be proved beyond all reasonable mg evidence of impor- %., ฆ, -, • ,!• tation. doubt. As before stated there was no cholera m this district, in April last, before the pilgrims entered it on their return from Hurdwar. It is well known that cholera broke out among them at Hurdwar, and that it accompanied them on their journey through the districts of Seharunpore and Mozuffernuggur, and also through this district, where the severity of the disease bore a direct proportion to the number of pilgrims, being most severe where the pilgrims were most numerous, and vice versa. Wherever the pilgrims went, cholera appeared, and in almost every instance direct communication between infected persons and the places attacked could be traced. 

" Of the 30 police stations above referred to, cholera manifested itself at 10 among pilgrims and residents on the same day, at 16 other stations it appeared among the residents three days on an average after the arrival there of pilgrims suffering from cholera. At one station the residents escaped for 12 days, and at three other places no residents were attacked at all." 

80. Both the Native troops and the Jail preserved perfect immunity 

outbreak among the Eu- throughout. The European troops also escaped ropean Troops at Meerut. during the time the disease was at its height among the general population. Suddenly, on the 15th August, the first case of cholera occurred, "without its advent being ushered in by any preliminary cases of bowel complaint." By this time the district was well nigh clear of the malady altogether 



38 

so that it is difficult to account for this sudden outbreak. Dr. Gordon, the Deputy Inspector General of Her Majesty's British Forces at Meerut, remarks that " the epidemic seemed to have travelled from Moradabad, about 80 miles to the east of Meerut, as the 36th Regiment there had suffered a few weeks before, and there was a strong and persistent easterly wind blowing at the time." The Native population of Meerut and its vicinity was scarcely touched by this second epidemic ; nor were the Native followers of the European regiments, only two of whom died. The disease appeared first in the Royal Artillery, two of whom were struck down on the 15th August. 

81. The Ist Battalion of the Buffs had a case on the 17th, and from that 

Extreme virulence in the date to the 2nd September one or two cases occurred SUIIS. /I'illir O.li ri] am +11011 Tvnvo^. rmf: TirifTi rproaf cs/vrr/nn+ir 

daily. Cholera then burst out with great severity, 

and continued its ravages undiminished till the 14th, when it began to subside, and disappeared entirely on the 25th September. It spared neither age, sex nor temperament, but attacked all indiscriminately. The regiment was speedily placed under canvas, only a few men^ and their families being left to occupy the unaffected barracks ; but as the disease also showed itself in them (five fatal cases having occurred), they too were ordered into a separate camp on the Ist September. A short lull was now apparent, but on the 2nd cholera again became virulent, and on the 4th the regiment removed to a new encampment along the Bijnour Road. The married camp of the Buffs, consisting of women and children, sick in hospital, and about 150 nfen, moved out of cantonments, as already stated, on the Ist September, and encamped about a quarter of a mile distant from the rest of the regiment. On the 6th, cases continuing, they moved again, but with no good effect, for the disease became even more virulent up to the 13th September. On the 10th they changed encampment a third time, and three days afterwards the disease subsided, but as the rains had ceased and the weather was now becoming warm, a further remove was made into a tope of trees, where they remained till their final return into cantonments on the Ist of October. In the head quarters' camp improvement began to show itself on the 9th September, but not till the camp had shifted ground three times. On the 15th the men again removed in sub-divisions for shelter under topes, from which date the disease rapidly declined. They were brought back to cantonments by detachments, the third and last returning on the 9th of October. During the interval from the 15th August to the 25th September the Buffs lost one officer, 105 men, 12 women, and 20 children, in all 138, inclusive of three cases of choleraic diarrhoea. The total number of cases of cholera treated was 155, and of these only 22 survived, which gives the appalling mortality of 85*7 per cent., perhaps the highest death rate from the disease that has ever yet been reached. The regiment was more than decimated. 

82. As already stated, cholera appeared first in the Royal Artillery on the 

Pew cases among the Artii- 15th August, when there were two cases, from lery and Hussars. different though contiguous barracks. On the 20th August, three batteries were moved into camp on the Allygurh Road, and on the 22nd were followed by the heavy battery. It was not found necessary to 



39 

change ground, as only two cases of cholera occurred in camp on the 6th and 22nd September. On the 24th these batteries returned to cantonments, but that in which the last case occurred changed ground and did not return till the 3rd October. The D-A. Royal Horse Artillery did not leave cantonments at all, neither did the sick in hospital, nor the women and children. There were five cases in all amongst the men of the Royal Artillery, all of which were fatal. Five children also fell victims. The 19th Hussars remained free of the scourge up to the Bth September, when a man under treatment in hospital for contusion was seized and died, and on the 20th September a woman was also carried off. It was not considered necessary to move the regiment from barracks, no further symptom of cholera having appeared. 

83. South of Meerut is Boolundshuhur. No report has been received 

The disease in the Boolund- & om tlie Civil Surgeon, but the replies of the Mashuhur district. r,;.^^ am ซซป*, ซi™ซ n^ ~™™^ ซ ni,ซiซ-n ป 1,ซ 

gistrate are very clear and concise. " Cholera," he 

says, "first made its appearance in this district on the 19th April. The first place attacked was Galaoti, the first point where the returning pilgrims entered this district. It was of a fatal type ; seven died out of ten attacked there on the 19th ; every one attacked on the 22nd, 23rd, 24th, 25th and 27th died ; all were pilgrims. Thus out of 16 pilgrims attacked, 13 died. After the 29th of May no one died at Galaoti, though nine cases have since been reported as attacked. This proves that the pilgrims returning from Hurdwar through this district were largely infected with cholera of a fatal type The proof that they communicated cholera or choleraic disease to numbers of persons is, that after the appearance of cholera among the pilgrims, cholera among the residents of this district made its appearance. But there seems ground for believing that the cholera so conveyed was less deadly, for — firstly, out of hundreds reported to have been attacked, few cases of deaths in comparison occurred ; and secondly, despite the number of places in which reported cholera subsequently occurred, the pestilence instead of spreading has daily subsided." 

84. Still following a southerly direction the next station is Allyghur, and 

The disease in the Aiiyghur the main road which traverses Meerut, Boolunddistrict. d-mlm-p n.nrl n+lipr rlisf.vipfs flip nnnnvwnnf'K in wliipli 

shuhur and other districts, the occurrences in which 

have already been described, passes through it. Dr. Kilkelly thus describes what occurred : — " The first case of cholera that is known to have occurred in this district occurred on the 20th April. A cart man who had come from a village about 10 miles distant, was attacked by cholera in the Coel market place and died after a few hours' illness. He had not been to Hurdwar, nor had any of his relations or neighbours been there, and no cases of cholera had previously occurred in the village from which he came. On the 23rd and 24th two more cases of cholera occurred in Coel ; neither of the parties attacked had been to Hurdwar, nor had they associated with persons coming from Hurdwar or from any other infected locality. On the same dates reports were received of the appearance of cholera at Somna, a Police station 14 miles distant from Allyghur on the Delhi Road. Two cases occurred there on the 23rd, one case occurred on the 26th, one case on the 27th, one on the 28th, and one case on the 30th. 



40 

All the persons who suffered at Somna had been to Hurdwar or had travelled with pilgrims who were returning from Hurdwar and who afterwards had cholera. It thus appears," he continues, " that from the 20th to the 30th April 20 persons had cholera in the Allyghur district, and that 7 of them had either been to the Hurdwar Pair, or had travelled with returning pilgrims. In the 15 remaining cases of cholera, the sufferers stated that they had not been exposed to any infection, but it is a remarkable fact that all the localities at which cholera appeared, lie either on, or close to, frequented lines of communication. Cholera cannot be directly traced into the villages of Jawan and Akrabad, but as both the villages lie within a mile of the Ganges Canal, it is more than probable that communication was held between the villages and some of the bands of pilgrims that halted at the different ghats on the banks of the canal." 

Dr. Kilkelly thus sums up :—": — " Prom the facts stated it appears to me clear that the disease was introduced into many places and extensively propagated through the medium of pilgrims, but it also appears to me to be equally clear that in many other places the disease originated, as it does in ordinary cholera seasons, without any assignable cause." The records show that in this district during April there were 22 cases and 14 deaths, in May 538 cases and 139 deaths, and in June 71 cases and 29 deaths, making a total of 631 cases and 182 deaths. Among 450 sepoys there was but one case and that occurred in April. The only prisoner who suffered was not attacked till December. 

85. Reserving the history of the epidemic in the other districts of the Agra division to be detailed hereafter, in connec- The disease in the Punjab. ฐ ... ? ?..,,. „ , , . _ , 

tion with the distribution of cholera in Oude, 

and other parts of the country in which no connection between the Hurdwar pilgrims and the appearance of the disease is traceable, the extension of the epidemic throughout the Punjab will now be considered. The evidence regarding its progress in this province is remarkably full and replete with interesting facts. Although other districts, such as Kurnaul and Umballa, lie nearer to Hurdwar, it will be the most convenient arrangement to commence with the most southern portion and to travel regularly upwards from this point to the north and north-west. 

86. The most southern district of the Punjab is Goorgaon. The Civil 

The disease in the Goorgaon Surgeon, Dr. Birch, states that " the pilgrims began district. to enter this district in lnrfffl mimbftrs on thn 91 ef. 

to enter this district in large numbers on the 21st 

April and on that day the commencement of the epidemic dates." This statement, however, is qualified by the addition that between the Ist March and 21st April there had been three doubtful cases. "When the pilgrims first arrived they suffered much more than others, but after a time the disproportion ceased. The following individual examples which appear to support the theory of contagion are thus given :—": — " The first case that occurred in the village of Bussyee (which afterwards suffered very severely) was that of a girl, a nonpilgrira, but she lived in the house of a Bunnea who had recently returned from 



41 

Hurdwar. The village of Dhoolkote is inhabited by Mahomedans, and is situated between two Hindoo villages (about one mile from each) both of which at the time of my visit (May 13th) were suffering severely, whilst Dhoolkote was quite free from the disease, but in addition to its being a Mahomedan village it had the advantage of being some little distance removed from any large road." 

87. There is some discrepancy as to the date of the first case appearing 

Cholera in the Delhi dis- in the Delhi district. In the general summary of triCt. -fllO fvrปlrJaTYlirป in +110 Pn-rn'oVl TrrVii/Vh lino liaan niuinniMul 

the epidemic in the Punjab, which has been prepared 

by Drs. Smith and Dallas, it is said to have occurred on the 17th April- The Civil Surgeon, Dr. Taylor, reports ; — " some cases had been seen at Delhi on the 19th and on the 15th, but they were all pilgrims." About that time the disease became epidemic and lasted with severity till the 20th June. The total number of cases in the Delhi district was 2,590, and the deaths 1,436. 

88. The opinions of the medical and district officers as to the origin 

Opinion as to its origin. ฐ f the e P idemic are very emphatically stated. 

Dr. Adam Taylor writes — " I have not the remotest 

doubt that the disease was imported solely by pilgrims, and my reasons for this belief are the following.— The disease was not known until the pilgrims had returned ; not a case had occurred either in the city or district since the commencement of the year. It had certainly appeared in November 1866* after the Agra durbar, but if it had been dormant during the cold weather it would have appeared earlier than the 19th April. The first cases were among Hindoos ; this was especially marked in the city, where of 11 deaths registered from cholera in April only one was of a Mahomedan. The cholera chose as its seat the country through which the pilgrims passed. A map of the district has been prepared by the Deputy Commissioner's orders in which the affected villages are marked. These are all along the lines of the march of pilgrim B returning by the gMts, and a triangular space, which had the river Jumna for its base and these lines for its two sides, escaped almost completely. The police and railway officials whose duties carried them among the masses of returning pilgrims suffered much more in proportion than the rest of the community," In this opinion the Deputy Commissioner fully concurs. He considers the introduction of the disease into the Delhi district by the returning pilgrims as established " beyond the slightest shadow of a doubt." He states " that there was no cholera before the return of the pilgrims, that large masses of returning pilgrims, while moving towards their homes, were found to have cholera among them, that cholera commenced to show itself in towns and villages directly after the return of the pilgrims, and chiefly along those routes where the largest bodies of pilgrims passed." 

89. Among the prisoners there was not a single case of cholera through- 

out the year. In the Native Regiment there was 

andt^Ssf ฐ f the prisoners but one which occurred in the month of June, and 

of the European soldiers also only one was attacked, This was in the month of April. 



42 

90. Dr. Penny, during whose absence Dr. Adam Taylor was officiating 

as Civil Surgeon of Delhi, mentions some further 

re|S?dS? e the ry DShi ri ??idS facts of interest. He states that in his opinion mic. fh A nTinlp.ra wTiinh nrmpnrpfl in thp, fiitv in the end 

the cholera which appeared in the city in the end 

of 1866 was not traceable, as was supposed, to the Agra Durbar, but had been mported by pilgrims returning from the Goormooktesur Pair in the neighbourhood of Meerut. "In 1865," he says, " cholera was brought into Delhi by pilgrims returning from the same fair." News of the outbreak at Hurdwar reached Delhi by telegraph on the morning of the 14th April, and at the ame time the child of a Eurasian, who had arrived by train from Allahabad he previous day, died of cholera. The case is mentioned of a man who left Hurdwar on the 9th April well, and arriving at Delhi on the 14th of that month, was immediately seized with cholera. 

91. The Rohtuck district lies immediately to the north-west of Delhi and 

somewhat nearer to Hurdwar. For three years this 

tThe disease in the Eohtuck district had been free from the disease, when on the istnct. . . .. ?-, /. 

13th April a supposed case occurred in the village of 

Vludeena in the person of a pilgrim returning from Hurdwar. An undoubted case was seen among the pilgrims on the morning of the 20th. Dr. Dickson expresss his belief that this was the date on which cholera was imported into the district. On the morning of the 25th the first residents are believed to have een attacked. The Deputy Commissioner states — " I have not the shadow of doubt that cholera was introduced by the pilgrims. In proof of this I may mention that Gohana, the first pergunnah they passed through, was the first ergunnah attacked, and Jhugger, the last they passed through, was the last ttacked. Further in every tehseel the pilgrims were the first victims." 

92. In the Hissar district the first case of cholera is believed to have 

Ilt appears in the Hissar dis- occurred on the 20th April. It was then rife ict. nTYinno 1 fhp rpfnrniTiP 1 -mlo-rims. Thfi m฿flifial officer. 

among the returning pilgrims. The medical officer, 

|[r. Minas, expresses his opinion that " through them it was imported and unmunicated to the other residents." The Deputy Commissioner also states at there was not a single case of cholera in the district until the arrival the pilgrims. At the commencement it was distinctly traced along their ute, first appearing among the pilgrims, then seizing the residents, then reading gradually to the neighbouring villages, and " eventually flitting about )m place to place miles apart suddenly and capriciously." 

93. In the Sirsa district, which lies to the west of Hissar, the disease 

its prevalence in the Sirsa appeared on the 22nd April, with the return of the district. rnlornrnsi fvmn TTnvrlwflr. Tf. rปp.nsprl n.Vinnf, fhp pnrl 

pilgrims from Hurdwar. It ceased about the end 

I July, having attacked 1,323 persons, of whom 612 died. The medical officer *. Nulty, is of opinion that as the pilgrims distributed themselves over th trict and dropped numbers at their several homes, they disseminated the dir ease. The Deputy Commissioner is " convinced that there was no choler ong the population of the district till the pilgrims introduced the disease. 5 ฆhey were for the most part it struck me," he says " diseased and unhealthy in >earance ; many parties were composed chiefly of aged and emaciated women 



43 

and sickly children, and old and tottering men who seemed quite exhausted from fatigue." 

94. The district of Kurnaul lies immediately to the west of Seharunpore. 

+v, v^ The history of the epidemic in this part of the The epidemic in the Kur- * f ฆ * 

naul district. 

country has been carefully recorded by Dr. Newton. 

The first reliable case of cholera occurred on the 16th April ; previous to that the district had been quite healthy, but on the date in question the disease was reported to have been brought into the village of Chajpore by the pilgrims returning from Hurdwar. This village is on the direct line of route from the fair. On the 18th another case occurred five miles from Kurnaul, and from these points it spread to almost every village in the district ; at first confined to the pilgrims, but soon attacking others also. Up to the Bth May, 1,442 cases and 794 deaths had been reported. Of these 743 were pilgrims, and 699 among those who had not been to the fair. Up to the 19th June, 1,755 persons had been attacked, and 982 died. 

95. The occurrences attending the appearance of the disease in the city 

The importation of cholera of Kurnaul are particularly circumstantial, and in 

into Kurnaul. 

Dr. Newton's opinion prove beyond all doubt its 

importation by the pilgrims. " All or almost all the pilgrims (some 500 or 600)," he says, "reached the city on the 18th Aprilin abody, fourof theirpartyhavingbeen attacked, and two died at Roorkee. One of their party fell sick and died of cholera on the noon of the 15th, the day they left Hurdwar — a sweetmeat-maker whose house is near to Ham Ruttan and Maneer Khan's. Three of their number, viz., the daughter of Earn Ruttan, a Moonshee in the office of Deputy Commissioner, Maneer Khan, a durzie, and thirdly, Ram Lall, all fell sick at a place named Gungoah, in the Saharunpore district, after eating their dinner at night (12 midnight) on the 17th or two days after the first case. They became frightened, and although having only just finished the day's march, off they started for Kurnaul ; on reaching the Jumna at the Begi Ghat, they became worse, vomiting and purging commenced. This made them hurry on all the more for Kurnaul, but one of their party, viz., Ram Lall, succumbed at a village named Baboo Keiree, about five miles from Kurnaul ; the other two reached the city about 8 o'clock on the morning of the 18th with the rest of the pilgrims ; they immediately came under dispensary treatment, and eventually recovered. In the mean ttiem c the returned pilgrims all settled in their own different streets. The next case in the city, that of Kungeh, did not occur until the 21st or three whole days after the return of the pilgrims into the city. Kungeh did not go to Hurdwar, but his relatives did ; he shared the half of a house with another who returned with the pilgrims ; they were constantly together ; the pilgrim remained well, but Kungeh was attacked with cholera and died. Again, from the village of Phoosghur seven or eight people went to the fair and left Hurdwar on the 14th. They took the same route as the Kurnaul pilgrims, excepting instead of halting at Gungoah, they went close to the village of Lucknoutee, and there one of their women was taken ill and died ; they arrived mt Phoosghur on the 17th, when all of them remaining well until the 22nd, the woman's husband took ill and died." 



44 

96. The district of Umballa joins that of Kurnaul, and also forms the 

Cholera in the TTmballa north-west boundary of the district of Seharunpore. district. rrW^ „„„„„ ซ,„,, -^^t^A ซ<-, l, ni n'>in. nnn-nmaA in +>IA rปit,V 

Two cases are noted as having occurred in the city 

on the 13th April, — one a pilgrim, the other a man who had not been to Hurdwar. Until the 18th no new case is recorded. In that month in the district 1,651 cases are entered and 996 deaths. In May there were 2,032 cases and 1,044 deaths. In June 335 deaths, and in July 152. Of the casualties in April 671 or more than two-thirds were pilgrims. 

97. The Civil Surgeon, Dr. Bateson, who was indefatigable in carrying 

Civil surgeon has no doubt out arrangements for the comfort of the pilgrims, it was imported. „ „ฆ, „„„„• +/%v , j- „ .i/L rt mnnanv - aa wln'A Vmrl hpp.Ti 

and superintending the measures which had been 

resolved on for preventing the spread of the disease, has no doubt that it was imported. " I am positive," he says, " that cholera was introduced into the Umballa district by the pilgrims. We had been perfectly free of the disease until they arrived, and in almost every affected village that I visited I was able to trace the outbreak to the return of residents who had been to Hurdwar, and who were attacked with it after their return." In one remarkable instance it would appear to have been brought by a healthy person. The circumstances are thus graphically described : — " Within a mile of the Umballa Civil Cutcherry is a small village of some 170 to 200 inhabitants, all Jdt peasants. The name of the village is Singhawara. In this place Singhawara, forty years ago, there were seven deaths in one night from cholera ; the inhabitants there and then deserted it, and the disease stopped. Eleven years ago in the rainy season, cholera attacked the villagers and kept among them for three days, but the most deaths were within the first few hours after the outbreak. They deserted their village, but this time it did not quite stop, a case occurred at intervals of hours for three days, when it ceased. Eor a year up to Sunday, the 30th July 1867, there had not been a death in the village and the last death not of cholera. On Saturday night, the 29 th, every body was as well as usual to all appearances ; the village daily routine had been attended to as usual ; then came the 30th, a black Sunday to these Singhawara peasants. I now quote from my MS S., taken at the village itself. 30th June— Chotoo, a boy act 7, taken ill 6a. m., died 4p. m., cholera. Then, in a house which is just opposite across the way, Kanoo (2), a girl 10 years old, was playing about at 1 o'clock, and in evening dead, cholera. A little further on from this house or hut> Hurree (3), act 25, taken ill morning, dead evening. Dhuleepa (4), act 10, taken ill noon, dead 4p. m. Rooldoo (5), act 30, taken ill noon 30th, died 3a. m. July Ist. Nundoo (6), boy, act 9, taken ill evening, died sunrise July Ist. Uttroo (7), act 4, ill in night, died 10 a. m. July Ist. Nurayana (8), ill at Bp. m. 30th, died forenoon July Ist. Kurma (9th case), wife of Huroo, taken ill in night, very bad— better July 2nd. Koroo (10), child, taken ill 30th— better. , I saw Kurma and Koroo. On Ist July, the villagers fled, deserted their village, and scattered themselves over the neighbouring fields, where I found them. This small community experienced 10 cases and 8 deaths in the time I have stated. On the evening of the 30th, the lumberdar of thi% village ran off with his family to another not far off (Toorkhra). His son, 



45 

act 11, was seized with cholera, Ist July and died that night. I saw him dead. Toorkhra village kept free. Since July Ist there has been but one fresh case, a child, and he is doing well. On the 3rd of July, a heavy storm of rain came on ; all the people of Singhawara went back into their village, and although this step was a cause just at the time of some anxiety to me, yet no more cholera showed itself. Thus, here at Singhawara was a blaze, a burst out of the disease. One person from this village went to Hurdwar and he died there ; the villagers heard of his death from a returning pilgrim commissioned by the dying man to deliver the message at Singhawara. I am assured that he did not stop. 'He passed through and told us.' This village is off the line of traffic. No marriage procession had come to or gone from it for a long time. *As after the first rain eleven years ago we had this burst-out ; and now, we have had another blaze out after the first rain,' the old men of the village told me. The immediate neighbouring villages kept untainted." 

98. The cantonment of Umballa is situated immediately on the Grand _, . „__ . „ Trunk Road, by which the great mass of pilgrims The cantonment of Umballa. J & r ฐ 

returning northwards travelled. Measures were 

adopted to divert the stream, but before the arrangement could be carried into effect many had already passed. On the 19th April the first case occurred in cantonments. The subject was a prostitute belonging to the 94th Regiment bazaar, which is within a hundred yards of the Grand Trunk Road. She died after 5| hours' illness. On the 20th another death from cholera occurred, and a third on the 21st. 

99. The above facts are taken from the very interesting and able report 

Cholera among the European of Dr - Munro, the Deputy Inspector General of tr0 ฐP s - TTm. TVToinchr'a •Rfif.i'c'h "KWnoa n.t TTrwluilla fvnm 

Her Majesty's British Forces at Umballa, from 

which also the following particulars are extracted. "On the 22nd," he writes, 11 two Europeans were seized with cholera, — one a man of the 11th Regiment on his way down country from Sunawur, — this man had crossed the line of pilgrims ; the other belonged to the 94th Regiment, and had been in company with the first man during the whole day before that on which he was taken ill." Both of them died. On the morning of the 23rd, 20 cases of cholera were reported to have occurred in the 94th bazaar during the previous night. The place was accordingly vacated and the inhabitants sent into camp ; the same evening an officer of the 94th and the wife of a soldier were seized, and as two of the medical officers also showed suspicious symptoms, the regiment moved that night into camp about three miles from cantonments. No more cases occurred till the 26th, when a patient in hospital was seized. The regiment then changed ground. From that date to the 7th May there were 13 cases in camp, and one in quarters amongst the women. The regiment was then broken up into three divisions, and separately encamped some miles apart. The women and children likewise were removed from cantonments to a rest-house along the Grand Trunk Road about 12 miles off. These measures proved very beneficial. No more cholera occurred in the more distant camps, but the head quarters camp suffered a good deal from bowel complaints, and had to change ground in consequence. The other detachments also changed ground 



46 

as a precautionary measure, and on the 19th May they all returned to quarters without having suffered in the least from exposure, though one fatal case occurred after return to cantonments. The heat was very great. As the villages all round cantonments were tainted, and as the ordinary cholera encampments to the north of the station had previously been occupied by pilgrims, much difficulty was experienced in securing suitable ground. That to the south had to be taken up though very unsuited for the purpose. The bazaar likewise suffered a good deal in camp. Prom the 23rd April, the date of being turned out, to the Bth May, there were 36 cases and 21 deaths. The camp was shifted further off, and as the disease soon disappeared, the people were permitted to return to cantonments. The Royal Horse Artillery, occupying the barracks on the extreme right of the European lines, furthest removed from the Grand Trunk Road, had but one fatal case amongst them on the 2nd May. Otherwise the health of the Artillery was good throughout. The 21st Hussars had hitherto escaped, but on the 4th May two fatal cases occurred in the bazaar of the regiment, and another case two days subsequently. A woman of the regiment was the first European seized. She died on the 9th May after an illness of 11 hours. On the 13th, 16th and 19th there were three more cases, only one of which proved fatal. These were the only cases at that time in the 21st Hussars. The bazaar continued to suffer a good deal till the end of the month, and then the disease disappeared for a time. 

100. The Native Regiments preserved complete immunity from the 

Cholera among the Native disease during the whole of the month of May. troops. Prpvirms frป fliA rmfhrAnV in +.hp 31 sf Na.tiVfi Tnffllltrv. 

Previous to the outbreak in the 31st Native Infantry, 

the medical officer states that there was a great increase of diarrhoea and colic, which he attributes to bad quality of water. " The water supply by aqueducts having failed, the men were driven to drink from wells with little water in them, and after two or three mussucks being drawn, the remainder was quite thick with mud." He noticed the same liability to bowel complaints on a former occasion when the water supply was scanty. The first case occurred on the evening of the 3rd June, and from that date to the 10th there were in all seven cases (including one tent lascar) and three deaths. The affected companies were at once moved into camp, and the disease appears to have been timely checked, The lines of the 31st Regiment Native Infantry adjoin the Grand Trunk Road and are immediately opposite to the European Infantry Barracks. The 11th Bengal Cavalry, whose lines are on the extreme right of the station, escaped cholera entirely, but there were one or two cases in the Regimental Bazaar at a subsequent period. 

101. Cholera ceased as an epidemic in the district towards the end of July ; 

Second outbreak in canton- tne station had been free from it for some weeks, mCIItS. Tn-lii-vM ซMirl/1/->vilxT nVinn<- +l-ปiei +imo aa-rra-n r\r> airpVif ndccic 

when suddenly about this time seven or eight cases 

occurred in one day amongst the commissariat cattle servants located behind the Sudder Bazaar. They were immediately turned out and isolated in tents for 10 days, when they were allowed to return, no further cases having occurred. Prom the date of this second outbreak, however, scarcely a day passed without one or more cases in the Sudder Bazaar, the Regimental Bazaars being exempt. About the middle of August, some villages close 



47 

to cantonments suddenly became affected, and towards the close of the month the cases in the Sudder Bazaar became more numerous. On the 13th September, the disease again appeared in the Regimental Bazaars and at the same time attacked Europeans. Dr. David Scott, medical store-keeper, who had been ailing for some time previously, was seized on that date ; there were no more cases till the 22nd September, when two soldiers of the 2 1st Hussars were attacked. These three were the last and only cases amongst the European Garrison of Umballa during the second outbreak of cholera. The Regimental Bazaars were not entirely exempt from the disease till the end of September. 

102. The Umballa Jails, with a population of 487 prisoners, remained 

The Umballa Jails escape. throughout, although they are in close 

proximity to the city ; strict quarantine was enforced. 

103. Large numbers went from all the hill sanitaria and neighbouring 

Native States to Hurdwar, and returned vid Kalka to their homes. Cholera broke out in this village 

Cholera at Kussowlio. 

about the 18th April, immediately on the arrival of the pilgrims, amongst whom it is reported the disease was then very prevalent. The dead and dying men were left on the roads leading up to the foot of the hills, and in Kalka itself, as well as along the roads to Kussowlie and Dhurmpore, many died uncared for, and were disposed of by the police ; a few of the sick who had the necessary means were carried on litters to their homes in the hills. Many passed through Kussowlie, where several cases of cholera immediately afterwards occurred in the Sudder and Regimental bazaars. In May there were but four cases and two deaths in Kussowlie, and in June only one case. Early in July it became more prevalent, though it could scarcely be termed epidemic. On the 11th July a soldier of the dep6t was attacked by cholera and died, and simultaneously there were several cases in the bazaar and throughout the station. The soldier, however, was the only European victim. After the 15th July, no more cases occurred. 

104. Tew of the villages in the neighbouring valleys regarding which 

its appearance in the hill we have an J information escaped the visitation, villages. but there were none in which it committed great ravages. The village of Gurkul, midway between the Lawrence Military Asylum and Kussowlie, afforded the first case in this immediate neighbourhood. It occurred on the 25th April. The man was a pilgrim and had just returned from Hurdwar. On the 26th April Dr. Chesnaye reports the first case of cholera in the Lawrence Military Asylum Sunawur, in the person of a native tailor belonging to the boy's school. He had not been to Hurdwar, but several servants of the institution who had gone thither returned to Sunawur on the 24th and 25th April. This case proved fatal on the 27th April. A few more of the institution servants who lived in the adjacent villages were carried off, but that of the 26th April was the solitary case which occurred on the estate itself at that period. Eour months afterwards, on the 30th August, the steward of the asylum was attacked, and four days subsequently a little boy, a ward of the institution, who at the time was under treatment in hospital, was seized. Both of these cases were fatal. Great fears were entertained lest the disease should gain a footing at Sunawur, but happily these were the last and only cases. 



48 

105. The military station of Dugshaie, distant about two miles from 

Sunawur, and garrisoned by the 104 th Regiment (805 strong), was entirely exempt from cholera 

Dugshaio exempt. 

throughout the year. Two fatal cases were returned by the police on the 17th May, but as there is no mention of them in any report, they probably occurred not in the station but in some village in the neighbourhood. Previous to the 23rd April several pilgrims suffering from cholera were carried along the old road towards Simla. They did not pass through Kussowlie but round it. At Kukkurhutty they were seen and tended by two European women. 

106. A woman of the 90th Light Infantry at Subathoo, who, it is 

The disease at subathoo in stated, had been with pilgrims the day before on the 00th Light infantry. road below the station, was seized with cholera and died on the 23rd April. The hospital ayah who attended her was the next victim in the station. Diarrhoea then became prevalent in the regiment, and on the 27th a fatal case of cholera occurred in a soldier. After an interval of one week, during which there was no cholera, two children were seized, one of whom died. A month elapsed before the next case occurred, when on the 3rd June three men of the regiment were admitted to hospital, and simultaneously diarrhoea again became prevalent. During the second and third weeks of June, there were two more cases, and one of choleraic diarrhoea, but towards the end of the month all signs of disease disappeared, and the regiment regained its normal health. This did not long continue, however, for in July diarrhoea assumed an alarming prevalence, though not till the 28th of the month did any case of true cholera appear. On that date a patient in hospital was carried off after a few hours' illness. He had been under treatment for diarrhoea since the 4th July. Numerous cases were reported amongst natives in the bazaar on the same day. From the 28th July to the sth August, nine cases of cholera (including men, women, children, and natives) occurred in Subathoo, besides a large number of cases of choleraic diarrhoea. There was then a lull for 36 hours, when 13 fresh cases occurred amongst the troops and bazaar population. 

107. The Deputy Inspector General of Hospitals British Troops, TJmballa 

The regiment moved into Circle,had meantime arrived in the station,and seeing camp. , +,hat thfi malady had t,akfin a, firm hrVM. ho rpinnm- 

that the malady had taken a firm hold, he recom- 

mended the immediate removal of the regiment into camp. It was accordingly divided into five different parties, four of which were enacmped in different direc tions at various distances from each other, so that by the 14th August the statio was nearly denuded of troops. The married families and sick in hospita constituting the fifth party, alone remained, and were segregated in the vacatec barracks, chapel, and school-rooms ; cases of cholera and choleraic diarrhoea onl were treated in hospital. The first party, consisting of two companies, move( to Solon Ridge early on the morning of the 9th. Another party of 48 me had moved into camp on the heights above Subathoo on the 9th. The thir( party moved to Barrologhee, six miles from Subathoo on the Loodianah Roa( on the 12th and 13th. The head quarters, consisting of three companies, moved to a ridge of hills four miles east of Subathoo, on the old Solon road, on the 13th and 14th. Dr. Munro believes that the moving into camp of this 



49 

regiment was followed by good results. The companies encamped at Solon had no return of the disease after moving out, and those encamped on the Loodianah Eoad had but one case. The Dhobie Ghaut or fourth party carried one case with them into camp, and two days afterwards, viz., on the 16th August, another case occurred which ended fatally the following day. Ground was at once changed, and the disease disappeared for a time. The party encamped on the heights above Subathoo had two cases amongst them on the 19th. On the 20th they changed ground along the Dhurmpore Road, and thereafter there was no recurrence of cholera. The married families and sick in hospital, who, as already stated, were left behind in the station, remained perfectly free from cholera after changing barracks. 

108. During the absence of the 90th Light Infantry from the station of Reappearance of the disease Subathoo, the bazaar, which is a very large one, was 

in Subathoo. 

thoroughly cleansed and fumigated, and afterwards 

well aired and white-washed. The people, likewise, were turned out into camp to admit of this being more perfectly accomplished. Despite these precautions, on the 25th August, three cases of cholera occurred in the barracks ; one of these a woman just arrived from Simla. 

109. After an interval of nearly 15 days, the disease suddenly reappeared 

amongst the Dhobie Ghaut party on the 29th Its reappearance in camp. ฐ • 7 ? 

August. Three cases occurred on that date, all 

of which proved fatal. Dr. Munro remarks that, " ten days' exemption is supposed to be sufficient time to keep a regiment or party in quarantine, after which time they may safely return to quarters, but here is an instance in which there was complete exemption for 13 days, when cases of as virulent a character occurred as any previously under treatment." This party again changed ground to a distant isolated spot near Solon, on the Subathoo side, after which there was no recurrence of cholera. These wero the last cases in the regiment. Communication between camps was restricted for a considerable time, but on the 10th September free communication was permitted. The issue of beer was discontinued for some weeks, and an extra dram of rum given instead. 

110. It appears that the 90th Light Infantry were not a healthy body of 

men on their arrival at Subathoo. While serving 

tion^Ftheregitti^t! 17 condi " in the Peshawur valley, they suffered much from 

the obstinate fever of that locality, and on the 

march down country, cases of a typhoid character were numerous, betokening a generally enfeebled state of the corps. Dr. Munro was particularly struck with their anoemic appearance, and directed the daily issue of quinine to the whole regiment. The men seemed to improve so much in general health during their stay in camp, that it was deemed advisable they should remain out till the beginning of the cold weather. They did not, therefore, return to Subathoo till the middle of October, and some companies came later. The barracks had, meantime, been well cleansed and purified, and, so far as practicable, improved. 

111. The mortality in the 90th Light Infantry, as shown in the report of Disease chiefly confined to the Deputy Inspector General, from the 23rd April 

the old barracks. 

to the 13th September — a period of upwards of 



50 

four months— was 28 out of a total of 62 cases. It is a fact worthy of notice that the disease was chiefly confined to the old barracks, which are badly constructed and badly ventilated. Thirty of the cases occurred in these buildings, four in the old guard-room, four in the camp immediately above the old barracks, and four of those who were seized in camp had occupied these buildings within 24 hours of their being attacked. In the old barracks fourteen of the women and children who suffered resided, and only two in the new barracks ; only eight cases of cholera were admitted from the new barracks, and several of choleraic diarrhoea. 

112. Cholera broke out in Simla on the 20th April, or about the period 

when the influx of visitors from the plains was greatest. The disease is said to have been entirely 

Outbreak at Simla. 

unknown in the sanitarium for at least ten years, and the Civil Surgeon, Dr. Tuson, states as his conviction that the present outbreak was due solely to importation from the plains by pilgrims and others who had come in contact with them on the road. He cites one instance in support of this opinion. A ady with all her servants travelling up to the hills came in contact on the 17th April with a party of pilgrims returning from Hurdwar, amongst whom there were several cases of cholera. Immediately on her arrival at Simla on the 24th April, one of her servants was taken ill with the disease, and others were affected subsequently. There had been only one or two cases in the sanitarium prior to that date. The disease at no time assumed an alarming prevalence in Simla, but as the cases, though comparatively few, were scattered over a considerable period of time, a constant uneasiness, amounting almost to alarm, existed throughout the settlement from the 20th April till about ;he middle of September, when the disease entirely disappeared. The total number of cases among European residents was sixteen, out of which six proved 'atal. It is a curious fact that they were nearly all children. Between the 21st April and 3rd September there were in all 83 admissions and 47 deaths among the native population. 

113. The Loodianah district stretches in a westerly direction from the 

The epidemic in the Loodia- upper part of Umballa. Here the first case ocnah district. miinwl rm flio IQfV Ay\™l ซ ATrif n naoo nf Am'ripTniP. 

curred on the 18th April. " Not a case of epidemic 

Asiatic cholera," writes Dr. Johnston,- the Civil Surgeon, " can be traced in the istrict prior to the advent of the pilgrims. Coincident with their arrival holera appeared, first a feeble spark scattered here and there, but pari passu, ugmenting with the returning crowd. There can be no doubt that cholera ollowed in their wake." The following instances of importation are then ecorded. " Two Gunga Bashees attacked with cholera after 48 hours' quaranine, and a day's residence at home, infected two males and one female residing n the same mohulla. They were removed to, and died in, the cholera camp. Vo bunniahs detailed to provision the encamping ground of Loodianah an d ฃhunnah respectively were attacked and died. An old woman returned from Hurdwar on the 23rd April to Tuckerwall, her native village. On the 24th seven ases were reported. On the 25th I galloped there, and found her still alive. he had been ailing for four days, and circumvented the guard; not a villager 



51 

was affected but those who had been attending on, or residing in her house. She lived until the 28th, while the infected seven died to a man on the 25th. A sepoy on permanent guard over the Loodianah Hospital was seized and died in eleven hours; he was a hale and hearty man." 

114. To the west of Loodianah is Ferozepore, and here the first case of 

Apparent importation into cholera was reported on the 22nd April. The Deputy Perozepore. nnTYimissirmAr MaW P TWWwall cfa+oa ซH,af o+ fiซ D + 

Commissioner, Major P.Maxwell, states "that at first 

the disease was almost entirely confined to pilgrims, and the cases even among them were not numerous, though usually fatal. Shortly after their passage, however, it made its appearance among the villages in the neighbourhood, anil chiefly on the line of the Loodianah Road, a circumstance which leaves little room to doubt that it was derived from the pilgrims. The mortality in these villages has been serious, and I regret to say it is not even now (22nd May) sensibly abating. Shortly after its appearance in the village several cases occurred in the compound of the kutcherry which is situated within cantonments. It there first attacked two police constables of a treasure escort which had just arrived from Loodianah, and shortly afterwards it seized several of the suitors and litigants who were attending in the kutcherry. These cases were very virulent, and nearly all, I believe, terminated fatally. From the kutcherry compound the disease gave unmistakeable symptoms of spreading in the cantonment by the appearance of some cases in adjoining compounds." 

115. There is some discrepancy as to the date of the first case, but this is immaterial, as in both instances the sufferer appears Opinion of the Civil Surgeon. . , _. mi. /v -i a to have imported the disease. The Civil Surgeon Dr. Williams reports that the first case of cholera in the city of Ferozepore occurred on the 24th April " in the person of an inhabitant named Gunga Doss who had not been to Hurdwar, but had returned from Julluudur vid Loodianah on the evening of the 23rd in a dak carriage in company with four pilgrims. Next morning at 6 o'clock he was seized with cholera." Dr. Williams is of opinion that the case of Gunga Doss is a fact capable, as far as possible, of proving beyond all doubt that the disease was due to importation by the pilgrims. " The first case in cantonments," he adds, "on the 24th April was that of a pilgrim woman who had returned from Hurdwar. The first reported fatal case in Ghull, where the disease is still prevalent (26th May), was a returned pilgrim." 

116. Cholera prevailed in the villages surrounding the Perozepore can- 

The epidemic in the Feroze- tonment for about two months before it broke pore cantonment. ou ฃ j n European garrison of that station. Dr. Jephson states that " strict quarantine appears to have kept it off for a long time." The 15th Native Infantry was the first corps affected, and a few cases appeared amongst them in the early part of June. The infected company was promptly moved into camp, and cholera thereupon disappeared. The l-sth Fusiliers are reported to have suffered from heat apoplexy for some time prior to the appearance of cholera ; otherwise the general health of the regiment was good. The weather had been for some days, oppressively warm, the evenings and nights especially being close and stifling. On the 27th June the first 



52 

cases, two in number, occurred, both proving speedily fatal. The following day there was another case. The affected barrack was evacuated in the evening, and all the men moved into camp. The women and children from Nos. 30 and 31, in the former of which a second case had occurred, were transferred on the 29th June to the old mess-house of the 15th Native Infantry. There were two more cases on the afternoon of the 3rd of July, and the entire regiment marched into camp on the following day, the head quarters wing to Khai, and the left wing to Vellour. A detachment was also encamped on the race-course, and there was besides a company on duty in the fort. There was but one case in camp two days after moving out. The women and children were moved into camp at " Honeymoon Lodge" on the morning of the sth July. Three cases occurred there on the 6th July, two of which recovered, and these were the last amongst the detachments outside cantonments. A child of the Sergeant Major died subsequently in an officer's house in the station. The whole regiment returned to quarters about the end of July, having had in all 16 cases, 12 of which ended fatally. Dr. Tippitts, the Surgeon of the Fusiliers, remarks on the two epidemics that " in none of the cases of cholera was there premonitory diarrhoea to any extent. All the men who were attacked died, and they were all well conducted healthy temperate men. Of the seven women attacked, four were pregnant, and they all died ;" none of the patients in hospital caught the disease. 

117. Of the history of the epidemic in the Jullundur district a very excel- 

lent account has been given by the Civil Surgeon 

dS<ft! sease in the Jullundur Dr. Verchere. " The first case of cholera," he says, 

" which occurred in the neighbourhood of canton- 

ments, was that of Heera, a fakeer (beggar) returning from Hurdwar in an ekha (a native one-horse vehicle). He had been ill nearly three days when he arrived at the Khajoorla Chowkey (police station). He was first attacked one march east of Loodianah. At Loodianah he obtained some medicine and continued his journey ; he arrived at the Khajoorla station at 6a. m., 19th April, in a state of deep collapse." On the 19th and 20th, before quarantine was established, 100 pilgrims are supposed to have entered the city. Only six cases occurred there, and all were, " with one exception, traced to direct communication with the pilgrims or with travellers coming from infected spots." The measures to which these successful results are attributed will hereafter be noted. 

118. Dr. Verchere expresses his opinion that a careful enquiry into all 

the details of the appearance of the disease at Jul- 

commuScfaSon of the disease! lundur " will convince most enquirers that cholera 

is communicable by carts, wagons, &c, which 

have travelled along an infected road or halted at infected halting grounds." Several instances are cited in which the persons attacked appeared to have been infected by visiting the quarantine camp. The following narrative is of interest, as the Civil Surgeon believes that " little doubt can be entertained that cholera was communicated in this case by the cart. Only one case occurred in cantonment, viz., Gainda bheestie. He was taken ill on the Bth May at about sp. m., and died at 6a. m. next day. He never received any 



53 

medicine, and never was seen by either medical officer or bazaar hakeem ; but from the appearance of the body, which I saw a few minutes after death, and from the symptoms which the man is said to have had during his illness, viz., watery vomiting and purging, the vomit and the stools being alike, the corpse-like coldness of the skin, the insatiable thirst, the sunken eyes and husky voice, there can be no doubt of Gainda having died of cholera. This was therefore one of those singular cases of cholera occurring in the middle of a crowded neighbourhood perfectly healthy, without any relation to the infected pilgrims, the patient not having gone out of cantonments for months, knowing no pilgrims or pilgrims' friends, and neither his master or any of his master's servants being pilgrims or having been in any way connected with pilgrims. Patient investigation, however, proved that the case was after all but one of communication of the disease. On examining carefully all the houses around the bheestie's dwelling, and questioning the inhabitants thereof, I could elicit nothing until I came to a godown belonging to Ram Rusood, contractor, holding commissariat contracts for potatoes and other articles. Some of the potatoes were told me to be 'the new potatoes' by one of the godown servants, and after a great deal of prevaricating it was admitted that these potatoes had been brought in on a cart the day before. I happened to know a good deal about these potatoes ; five carts had arrived at the Dokoha Serai on the sth May, and three more at the Beyn Bridge on the 6th.* I had seen the three carts at the Beer Chowkey, where they had been detained two days by a mistake, and ordered them to go to the serai. On the morning of the 7th, I had seen some of the carts at the serai, and noticed how dirty they were, my attention being called to them by the swarm of flies which formed quite a cloud over some of the carts. By questioning the drivers it came out that, as the three last carts were being taken from the beyn to the serai, a bunniah met them near the cavalry picket and then produced a rawanah from the Executive Commissariat Officer, requesting that the carts be not detained. I subsequently obtained the rawanah from the duffadar in command of the picket, and it was, I believe, merely the usual rawanah given to government servants travelling for government purposes. The duffadar, however, allowed one of the carts to proceed at once to cantonments, without going to the Dokoha Serai, but taking a kutcha road or track which leads from the picket direct to cantonments. The drivers were kept back, but the clothing, sacking, boosa-bags, blankets, &c, were not removed. The cart left the picket at 4 p. m., and must have arrived in the bazaar at about 6 p. m., probably too late to unload that day, and was, either loaded or unloaded, left in the lane in front of the godowns until the Bth of May. Now this lane is so narrow that the cart nearly completely blocked up the way, and at the same time the door into the bheestie's house." 

119. While cholera was raging in towns and villages of the Jullundur Cholera amongst European district the Euro P ean garrison in cantonments 

troops in jullundur. was quite exempt from the disease. After it had well nigh exhausted itself in the district, it made its appearance in Her 

* These carts came from Kuruaul, and had therefore travelled along the Grand Trunk Koad at the time it was thronged by the pilgrims. 



54 

Majesty's 82nd Regiment. On the 3rd September, the first case is recorded as having occurred in the medical subordinates' quarters of the Regimental Hospital, and in the afternoon of the same day, in the hospital itself and in No. 12 married quarters. On the following day these buildings were vacated and the patients and families encamped outside cantonments. On the sth a woman from No. 12 barrack and a man from No. 6 barrack were seized ; the company occupying the latter were at once sent to join the infected camp, and the rest of the regiment with the families from No. 19 barrack were moved into a separate camp. No cases of cholera occurred in this party either previous or subsequent to leaving cantonments. It was considered prudent to change ground twice however, owing to the insanitary nature of the neighbourhood. Thes^Tmoves were made at right angles to each other. 

120. Owing to scarcity of tent accommodation in the head quarters 

party, two companies returned to cantonments on 

Movements of the troops. I^ h g eptemberj and were locate d in the barracks furthest from those in which cholera had occurred. No evil consequences followed this movement ; indeed Dr. Munro, the Deputy Inspector General, reports that it was attended with benefit, in so far as it afforded 11 space and comfort." The infected camp had no cases of cholera from the evening of the sth till the morning of the 12th September. They changed ground to the south-west on the 9th, and again on the 11th, as a precautionary measure. On the 12th three cases occurred, and a movement was at once made in a north-west direction. Here six more cases occurred, and on the 15th September the party moved again, and were kept moving short distances every second day in the same direction till the 2nd October, " when having been nineteen days without fresh cases the whole returned to quarters." The families of No. 11 barrack, which had gone into camp with the head quarters party, returned with the two companies already noticed to cantonments on the 12th September. On the 14th and 15th idem, two cases of cholera occurred among them. No tents were available, so they were put into an empty barrack, but another case having occurred on the 17th, and tents having in the mean time arrived from Perozepore, the party went into camp about three miles southwest of the cantonments. A case of choleraic diarrhoea is reported to have occurred on the 20th September, and this was the last of the kind amongst the European garrison. Dr. Munro remarks that the disease " was confined throughout chiefly to those persons occupying buildings in which it first appeared." The hospital compound furnished the first case, and Dr. Munro observes that '• in the neighbourhood of the hospital is a large tank on one side ; on the other, close to the building, one of the large surface drains of the station, and report says, I know not how truly, that the hospital stands where an old tank formerly was, which had been filled up with earth taken from a Mahomedan burial ground, close to where formerly stood a village in which cholera frequently occurred." 

121. Kangra, the hill district which adjoins Jullundur, has furnished no special report ; but from the general account of the Cholera in the Kangra district. •-, . . .ฆ. -n ?, ? ? ?, ? epidemic m the Punjab it appears that the disease spread over the district and attacked both the civil station and jail of Dhurm, 



55 

gala. The Deputy Commissioner Major Paske states that " cholera had not been heard of until the returning pilgrims began to appear, and for some days all the cases reported were confined to the pilgrims. I think too it will be found," he adds, Hat least such is the result of my own observation, that returning pilgrims have passed through, or have remained in every locality where the disease has appeared." 

122. Among the prisoners, 14 cases of cholera occurred, and of these seven 

were fatal. On the night of the 6th May, the first 

ja?f Olera "* th ฐ Dhurmsala seizure took place, and a second on the morning of 

the 7th. On the 28th June the last case occurred. 

Before any of the prisoners had been attacked, on the sth one of the police guard had been taken ill with cholera, and although every precaution was at once adopted, Dr. Warburton expresses his opinion that the outbreak " appears in some way, either directly or indirectly, to owe its introduction to the police." 

123. Among the European troops, numbering about 100, there was one 

admission and one death from cholera in July. Out 

A few cases among the troops. Qf & fi m there were three cases in May, all of which proved fatal. 

124. In the district of Hooshiarpore, which lies to the north-east of 

Jullundur, Mr. Barnes, the medical officer, states — 

Hoos r hSo r redSrTct? nS the " the first case of cholera that occurred was re- 

ported on the 19th April. This was one of the 

pilgrims returning from Hurdwar, who had just entered the district. It cannot be doubted," he adds, " that the disease was imported by the pilgrims, as it made its appearance along the route taken by them, whereas at the Thannah of Tanda, through which pilgrims did not pass, not a single case occurred." Considering the large body of pilgrims that passed through the district by two parallel routes, the disease did not prevail to any great extent. 

125. In the Umritsur district there was no appearance of the disease 

prior to the pilgrims reaching it. " The first case 

the pilgrims B atuSsL. With of cholera in the city," writes Dr. Henderson, the 

Civil Surgeon, "was reported to me at 11 A. m. 

April 22nd. lat once went to the serai and found the patient in collapse. He had just arrived after a march of 30 miles and was at once attacked with cholera." 

126. The European troops in the Fort of Govindghur were exempt from 

cholera for a long time after its first appearance in 

p Two cases in Govindghur q{ Umritsurj from which it is separated 

a distance of only a few hundred yards. Every 

precaution was taken to prevent communication between the inhabitants and troops. On the 4th August, however, a woman, the only woman in the Eort, the wife of a private in the detachment 38th Toot, was attacked and died. Nearly one month elapsed before another case occurred, when on the 2nd September a man of the detachment was seized. This case proved fatal on the 4th September, and was the last. 



56 

127. In the Goordaspore district " the first cases," writes Dr. Oldham 

" occurred on the 25th April among pilgrims return- 

The epidemic in the Goor- jj n ™ f rom Hurdwar, of whom great numbers passed daspore district. ฐ > & r 

along the roads leading towards Bassowlie and 

neighbouring ferries on the Ravee. At first all those attacked were pilgrims, then some of the kahars employed in carrying doolies containing people returning from Hurdwar, some of whom are reported to have had cholera and to have been hurried on by their friends to avoid detention. The disease gradually spread to the villages along the roads, and then cases occurred in those more remote, as people belonging to them returned from Hurdwar. Many of the cases afterwards occurring could be traced to contact with pilgrims. The whole history of the epidemic in this district," he adds, " shows the disease to be propagated by contagion ; it appeared with the pilgrims and was at first confined to them, spreading first to the villages along their lines of route, and finally to others more remote, appearing in no place in which there had not been some communication with pilgrims, direct or indirect, and in several cases people who had not left their villages were attacked, after attending upon relatives who arrived sick from Hurdwar." 

128. The first case of the disease in the Sealkote district is reported to 

Evidenceof importations have occurred on the 20th April; "soon after the Sealkote district. +i, ft arP i V al of the T>iWims from Hnrrtwar " Ma™ 

the arrival of the pilgrims from Hurdwar." Many 

interesting particulars regarding the epidemic have been supplied by the Sub- Assistant Surgeon, Bhoobun Mohun Mitter. "At Seeranwallee, a town nearly 22 miles south of Sealkote, a pilgrim by stealth returned home while he was suffering from this disease, and died within a short time after his arrival ; the son and daughter of the hakeem who treated him got the disease on the 7th May 1867, three days after the return of the above pilgrim, and died within 24 hours. At Bhodewalla (a village nearly 21 miles from Sealkote) the disease was brought by a man who came to this village on the 21st June 1867 from Dalowalee (a village in the Goojranwalla district) where the disease was prevailing with great virulence. He was seized with purging and other symptoms of cholera on the 25th June 1867, and died within 48 hours. Fifty-six persons became affected, of whom 27 died, and the rest recovered, the disease continuing till 28th July 1867. The disease appeared in more than 40 villages, and the cause of outbreak in each of these localities was reported to be direct or indirect communication with the pilgrims." 

129. In the Lahore district the first case occurred on the 24th April. 

With regard to its origin the Deputy Commissioner 

The epidemic at Lahore. thug writeg ._ซ There ig in my opinion no positive proof, though strong presumptive evidence, of the disease having been introduced by the pilgrims. The earliest cases certainly occurred among the pilgrims, and the disease did not appear at all until the stream of pilgrims began to pass through the district." The very first case that occurred was in the city of Lahore ; the patient was a child, son of " Chooley," resident near the Shalmen Ghat, who had returned with his family from Hurdwar on the 21st April. In the village of Lahari Hetoo, nine miles west of Kussow, where on the 30th and 



57 

21st May fourteen cases occurred, of which six were fatal, it was ascertained that one pilgrim had visited the village, but he was in good health, and the virulence of the outbreak was probably owing to the filthy state of the village. The opinion of the Civil Surgeon, Dr. Smith, is given in the general conclusions of the Punjab Cholera Report, and is to the effect — " That cholera is conveyed in the first instance by human agency alone." 

130. The cantonment of Mean Meer is five miles from the city of 

Lahore. Dr. Jephson, Deputy Inspector General 

The disease in the canton- -o •.!.• i. -n xi. n- 1 l l i.\. i. ฑ\~ ment of Mean Meer. British I forces, Lahore Circle, states that the epi- 

demic first appeared in the 106 th Regiment on the 

night of the 26th May, when a man, presenting suspicious symptoms, was brought into hospital under observation. True cholera speedily became developed, and the case proved fatal on the morning of the 27th May. On this date a second case was brought in from a different barrack, and later in the day a third case from another barrack. The companies to which these cases belonged were despatched by rail that evening to the district barracks at Hullokee, on the Mooltan Line of Railway, distant 12 miles. On the morning of the 28th a fourth case occurred, so it was resolved to move four more companies into these barracks and into those of Ammursiddoo, about 4^ miles down the line from Mean Meer. On arrival at the latter place a fifth case occurred. The remaining four companies of the 106 th Regiment, together with convalescents and sick which were able to be moved, were sent out to camp at Burkee, about 10 miles south of cantonments. The married families and sick in hospital remained with the regimental head quarters at Meean Meer. From the 28th May till the Bth June there was no recurrence of cholera either in cantonments or camp. On the latter date it reappeared in the Burkee Detachment, and two other cases following on the 9th June, the detachment changed ground. On the 10th there were three more cases, and the detachment was split into two parties, — one being sent to Hullokee, the other to Ammursidoo District Barracks. These were then both empty, as the companies which first occupied them had in the meantime returned to cantonments. On the 11th and 13th June there occurred two other cases, which were the last at this period of the epidemic. The Burkee Detachment returned to cantonments on the 20th June, having been absent about three weeks, during which time eight cases of cholera occurred, six of which were fatal. Assistant Surgeon Ffolliot reports that the worst features of the first outbreak of cholera were the rapidity with which it commenced, the fatality of the first three cases though they came from different barracks, and the absence of premonitory warnings. 

131. A week after the return of the last detachment to quarters, viz., on 

the 28th June, a man of the 106 th was admitted with 

afฃฃฃnt ฐ?ndi!coEd move suspicious premonitory symptoms, which were soon into camp. declared to be those of true cholera. On the 30th June there was another case, and on the Ist July three more, all of which proved fatal. The regiment was at once ordered out of cantonments in four detachments. The first party, strength 180, left by rail for Hullokee temporary barracks. On the evening of the Ist July, the second party, strength 203, marched for Ammursiddoo temporary barracks. On the morning of the 2nd July, the third and the largest party, strength 2G7, marched at the same time 



58 

for Shahdrah, on the other side of the river Ravee ; and the fourth, consisting of the married families, went on the evening of the 2nd July into tents at the Shalimar Gardens. The hospital, in which one case had also occurred, was thinned as much as possible, those who were able to be discharged joining their several companies. 

132. The Hullokee Detachment had two cases of cholera the day after 

their arrival ; one of these ended fatally. The remainder continued healthy, and as these barracks 

Hullokee Detachment. 

were required for the Shahdrah Detachment, they returned to their own quarters in cantonments on the 27th July. Cholera had not yet left the station, but Dr. Jephson explains the early return of this detachment, by the unhealthy state of the Shahdrah Companies which required a change, and there were no other barracks available but those at Hullokee. No bad results followed these arrangements, and the health of the returned companies continued unimpaired. The Ammursiddoo Detachment were less fortunate, as on the first day of their arrival two men were attacked with cholera. On the 3rd there was another case, and also one amongst the camp-followers. A short march was made that evening at right angles to the prevailing wind and to the east of the Ferozepore Road. The camp was pitched on land which had recently been under cultivation. One case occurred that night, and another the following morning, but both men had been suffering previously from diarrhoea. Heavy rain fell on the night of the Bth July, and swamped the encampment. It was found impossible to move the detachment owing to the saturated state of the tents and the nature of the ground which was impassable for carts or camels. On the 9th and 10th July there was again rain; two cases of cholera occurred and diarrhoea became very prevalent. The weather then cleared, and on the evening of the 11th July, the detachment took up a position at Attarie, about one and a half mile to the east. Here cholera also followed them. On the 12th and 13th, there were two cases in the detachment and one amongst the camp-followers. Ground was again changed still further east, but on the following day, the 14th, three soldiers were attacked, as were also several followers, with cholera and diarrhoea. On the 15th and 16th, two more cases occurred. It was then deemed advisable "to give the party an entire change of country," as the whole locality was considered to be unhealthy, and there were no good encampments available. The next move on the 16th was towards the north-east, when the party again encamped at Ammursiddoo. There they had another case, and on the 17th they marched in the same direction to Bhukowal, the distance each day being four to five miles. There were several cases of sunstroke during the two days' march, but the general health of the detachment greatly improved. On the 20th July they moved to Neaz Beg temporary barrack, " which could not be used before this time in consequence of cholera in the villages surrounding it." The health of the detachment continuing good and cholera having disappeared, they returned to cantonments on the 27th and 28th July. 

133. The Shahdrah Detachment were likewise unfortunate. The morn_„e. . e . , ._ . . ing of the 2nd July was very hot, and there were The Shahdrah Detachment. 

two cases of sunstroke after the march to Shah- 

drah, The troops, with the exception of 48 men, were sheltered in the corridors 



59 

and passages of Jehangir's tomb. There was a case of cholera on the 4th, and four cases on the sth July. More tents were at once pitched, and the men segregated as much as possible. On the Bth, 10th and 13th, one case occurred each day, but from the latter date to the 22nd, there were no admissions. On that day, there were four cases, and on the following day, the 23rd, three. On the 24th, the detachment marched to camp at Dilkoosh Bagh, which had previously been prepared for their reception. There five fresh cases of cholera occurred, and there were also several cases of sunstroke and fever. On the 26th, they changed ground again to the encamping ground at Lahore, five miles distant, and on the evening of the 27th, cholera still continuing, it was decided to divide the detachment. The larger party proceeded by rail to Hullokee Barracks, and the smaller party likewise by rail to Ammumddoo Barracks. The Hullokee party suffered much from sunstroke, and on the 30th July, two cases of cholera occurred. They remained a month at their temporary quarters, and having finally shaken off the disease, they returned to Mean Meer on the 30th August. The Ammursiddoo party had no cases after the 22nd July, and were brought back to cantonments on the 13th August. 

134. The remaining detachment of the 106 th, consisting of married men, _, women and children, were, as already stated, The families at Shalimar. ? _? ? „ , 

sent into camp at the Shalimar Gardens on the 

evening of the 2nd July. One man, two women, and one child were seized with cholera on the 2nd, 3rd and 4th respectively. A march was at once made to Tulseepore, four miles to the east of the Shalimar Gardens. Here they had three cases, and fever and ophthalmia became very prevalent. The whole party were sent by rail to Umritsur on the 25th July, and were there located in the Infantry barracks ; ophthalmia increased both amongst young and old, and there were also two slight cases of cholera shortly after their arrival. The detachment returned to cantonments in small parties about the end of August, having entirely shaken off both diseases. The last case of cholera in the 106 th Regiment took place in hospital at Mean Meer on the sth August. The man was a patient at the time of his seizure and made a good recovery. 

135. The Artillery at Mean Meer had hitherto preserved complete immu- 

nity from cholera, but on the 4th August, a patient Cases among the Artillery. , ; ฐ , in hospital was attacked. He was at once removed to the station cholera hospital. Three days subsequently two more cases occurred in hospital, which were likewise at once removed. These .three men belonged to the B-A Battery, and occupied the same wing of the hospital. The remaining patients were turned out and transferred to one of the Artillery barracks in the centre of the lines. On the 11th August two cases occurred in the E. 19th in a barrack on the extreme right of the lines in close proximity to the hospital. Both men slept in the same wing on opposite sides, and one had been employed in rubbing the other previous to his removal to hospital. The barrack was at once vacated, and the remaining inmates transferred to an iron-frame barrack on the extreme left of the Artillery lines. Here two cases of cholera occurred, one on the 12th, the other on the 13th August. The whole Battery, therefore, moved to Ammursiddoo on the morning of the 14th August. 



60 

There they remained till the 2nd September, when they returned to cantonments, no fresh cases having occurred in the interval. The Artillery Bazaar, though at no great distance from the hospital in which the first seizures took place, was exempt from cholera throughout the year. 

136. The troops garrisoning the fort of Lahore were singularly free from 

-. , ._ . ? cholera during its prevalence in the adjacent city Cholera m Lahore Port. 5 r •> 

and cantonment. There were in all three cases 

at long intervals. The first case, in the person of a child belonging to the Artillery, proved fatal on the Bth July. The other cases, a gunner of 6-22 Battery and a private of the Detachment 38th Eoot, occurred on the Ist and 30th August respectively ; they both ended fatally. The health of the garrison otherwise continued good throughout. 

137. Although the large central prison at Lahore with nearly 2,000 in- 

The disease in the Lahore mates altogether escaped the disease, the women in Jail for women. +i, Q fQTVIof QTVlo l Q i o ;i i,"f^u a™ซ 1 Kft iซ nnml^r- snflWprl 

the female jail, little over 150 in number, suffered 

considerably. Of twelve cases, nine were fatal. Regarding this outbreak the Superintendent Dr. Gray writes — " My impression is that it was introduced through the medium of some of the establishment, probably one of the female warders'. There is a bazaar within a few hundred yards of the penitentiary in which a number of cases occurred. On enquiry I found that one of the female warders was in the way of going there for the purpose of purchasing her food. Neither she, however, nor any of the establishment suffered from cholera for many days after its first appearance among the female prisoners. This supposition, however, may be entirely erroneous. The disease might have been introduced by means of the wool, cotton or other raw material used in the manufactory, or the provisions brought for the prisoners may have been the vehicle. The first case appeared on the 10th July. Prom the 11th to the 20th five others were attacked. On the 21st the prisoners were moved into camp, and during their absence every ward and cell was thoroughly cleansed and disinfected." 

138. On the 25th April at the Montgomery station a pilgrim was found 

Evidence of communication dead and another suffering from cholera, in one of in the Montgomery District. the carr i a g es o f the Railway train passing down from Lahore to Mooltan. Several facts are cited "as proofs that the disease was due to importation by the pilgrims." The circumstances which attended the epidemic in the village of Khooj Kullam are particularly worthy of notice. " A pilgrim, who died there, had, with four companions, been to Hurdwar ; they reached Khooj Kullam at 10 a. m. of the 28th April. Deceased, who had been quite well up to that time, took ill at mid-day, was attacked with vomiting, purging and cramps at 8 p.m.; his friends put him on a charpoy (bedstead), and had him carried to his house at Deopalpore, 19 miles off, where he died at 10 a. m. the following day, three hours after reaching his house. Cholera broke out in Khooj Kullam on the 30th April, the third day of the deceased's arrival and attack of that disease." It appears that he was taken ill at the village well, and the spread of the cholera is attributed to the fact that his clothes were washed in an adjacent pond, and other parties who afterwards visited the well and the pond for water caught the infection. In this village 



61 

fifty-three persons were attacked, of whom twenty-seven died. These facts are testified to by the Deputy Commissioner Mr. Blyth and Dr. Kingsmill. 

139. Mooltan had for many years previous preserved a remarkable 

Evidence of importation immunity from cholera. The last epidemic of the into Mooltan. rHsfifl,Rfi whip.h Vinrl hrnk-fin rvnf, np.nmvrArl fmon+Tr.lln.ao 

disease which had broken out occurred twenty- three 

years back. It was reported to have been very severe and to have carried off vast numbers of people. In 1867 the disease was very limited in its spread, there having been in all only twenty-five cases, and these all in the city. But although fortunately so limited in extent, some very interesting particulars have been furnished with regard to it by the Civil Surgeon Dr. De฿enzy. "The first case," he writes, " occurred in a pilgrim in a railway carriage on the 26th April. The first four cases occurred among pilgrims while en-route from Lahore. The fifth case occurred in a pilgrim in the city on the 6th May. The victim was the wife of a rich Bunya (Wullee Earn) and there was a great Julsa at his house on the occasion. I am informed that 100 men and 150 women were present. On the evening of the 10th May a case of cholera occurred in a boy who lived close by the deceased's house ; and there was a rapid succession of cases all through the night till twelve had occurred. A very large proportion of those attacked had attended the Julsa, and of the remainder all were near neighbours. There was no cholera before the arrival of the pilgrims. The circumstances stated admit of no other conclusion than that pilgrims brought the cholera." 

140. In reply to the annual sanitary questions Dr. De฿enzy furnishes 

Particulars of communica- the following additional particulars :—" Up to this tion at Mooltan. firnfi (iha 3rd Mnv^ +,Tia naaaa wnrA nnnfinorl fซ 

time (the 3rd May) the cases were confined to 

pilgrims. On the sth May the wife of a dhobee, a resident in the city, and who had not been out of it, was attacked and died. I failed to trace any connexion between her illness and the pilgrims. Failure to discover connexion does not exclude connexion. No other cases occurred till the evening of the 10th May, when about 4 o'clock p. M. cases began to occur in the Ghogera Mohulla within a few yards of Wullee Ram's house. By 9 o'clock next morning twelve cases had occurred in the city, of which eleven proved fatal. Of the twelve cases, nine occurred in the Ghogera Mohulla all within a narrow compass, and at least four of the nine had been at Wullee Ram's house after his wife's death. One of the twelve cases of that day occurred in a female pilgrim in a different part of the city. The remaining two were residents of Mooltan, between whom and the pilgrims I failed to discover any connexion. The Ghogera Mohulla, like other parts of the city, is very closely built upon. The houses are packed together as close as they can be. The streets were narrow and tortuous and very filthy. They were unpaved and undrained, and happened at the time to be very sloppy from a fall of six-tenths of an inch of rain that had fallen on the Bth May. The soil of the streets was saturated with organic matter from the excremental accumulations of ages, and presented a black color and emitted a foul smell when stirred up. Eor some years back the solid excreta have been removed from the city by hand, but the liquid excreta still accumulate in the soil. The houses were badly ventilated and generally 



62 

overcrowded, and the mohulla was closed at one extremity forming a cul de sac, an arrangement which rendered free perflation of the city impossible. The people were so accustomed to use foul water, that they have learned to test whether it is dangerously impure or not by dipping a rupee into the wells. If the sulphuretted hydrogen in the water tarnishes the silver much, the well is pronounced dangerous and the water abstained from. Such was the sanitary condition of the Ghogera Mohulla, and it was an average specimen of the city generally, when cholera appeared in an epidemic form on the evening of the 10th May, and such or worse it had remained for the twenty -four preceding years, during which cholera was unheard of. It was impossible to trace the course of the disease after the 11th, as the people concealed it through fear of their sick relatives and friends being removed from the city to the cholera hospital." 

141. Dr. De฿enzy's report is replete with interesting details. One other 

importation of cholera into extract must suffice. " The history of the importa- Kuhroor. firm nf p.linipiva. into TTnlirnnr is vpw nlfiar. This 

tion of cholera into Kuhroor is very clear. This 

city is a particularly filthy place and labours under great disadvantages as regards ventilation and perflation, arising from its faulty position at the base of a high mound. It is fifty miles from Mooltan, and the road to it lies through a very thinly populated district. The villages along the road are ten or twelve miles apart and consist of a few huts only. Dunyapore, a town of three or four thousand inhabitants, is nearly equi-distant from the two cities. There is a small amount of traffic between Mooltan and Dunyapore, but very little between the latter and Kuhroor. Cholera had not been known in Kuhroor for twentyfour years. The first case occurred in a Mr. G., a Canal Engineer, who had left Mooltan on the 3rd July, and was attacked at Dunyapore on the 4th. There was no cholera there at that time, nor was there any subsequently. Mr. G. was carried into Kuhroor in a dying state, and expired in a few hours after his arrival. The next case was a boy named Teloka. He was seized with cholera on the road from Mooltan at Mustee Khan. He was conveyed on his arrival at Kuhroor on the 9th July— to the dispensary. He was waited on there by his father Lokoo, recovered, and was discharged on the 16th July. His father was the third case. He was attacked on the 15th July and died on the 17th. The fourth case was a man named Shukoora, a massalchee who had formerly been in the service of Mr. G., the first case. He was attacked with cholera on the 15th, and died the same day. I failed to discover positive proof that Shukoora had been near Mr. G. in his last illness, but as Mr. G. was the only European in the station at the time, and his sudden death caused considerable sensation among the Natives, it is very improbable that Shukoora, who lived in the next compound not a hundred yards off, should not have visited the house of his old master." 

142. In the district of Mozufferghur, which is situated on the western side 

of Mooltan, cholera did not appear till late in the 

MozlferVTSTict. ta ** y ear - The first oase occurred on the 13th of July, 

There is no record of the number of persons 

attacked, but the deaths from the disease were 1,147. The civil medical officer believes, that it was " originally imported by pilgrims returning from 



63 

the Hurdwar Fair to the districts of Mooltan and Jhung, and reached Mozufferghur after the lapse of nearly a month by the extension of the epidemic from those districts." The particular grounds on which this opinion has been formed are not stated, but Mr. Harrison has no doubt that the disease was propagated by contagion. 

143. In Jhung also the epidemic was comparatively late in appearing. 

The district, it is said, had been free from cholera for 

iaS hedlStriCt ฐ f JhUnSBUfferS five-and-twenty years. The returning pilgrims 

appeared in the beginning of May. Mr. Mitnish, 

the Medical Officer, states — " On the Ist June four or five cases of cholera were reported at Rehannah. It was discovered that pilgrims from Hurdwar had stayed at this place and drank of the water. A few days after cholera broke out at Chowwullee, another village about 15 miles from Eehannah (the inhabitants had fled to this place)." The disease lasted in this place about a month. " On the 16th June six or seven cases of cholera were reported at Jok Mynhum about 15 miles from Rehannah. The dresser was despatched with instructions and medicines to this place. He was there about 10 days when he was himself seized with cholera." " I believe," adds Mr. Mitnish," that cholera happened in this district probably from certain Hurdwar pilgrims passing through the village of Rehannah and drinking from the well there." 

144. The district of Goojeranwallah also, which lies to the north-east of 

At Goojeranwallah first cases Jhung, suffered very slightly. The first case pilgrims. nnm -, v -ป a A nl o vVIo™ ซollซ^ TTnvinMi<vrcrana>l and WflK 

occurred at a place called Kunguewallah and was 

followed shortly after by five fatal cases near Wuzeerabad. These were all pilgrims. Goojeranwallah itself entirely escaped, and Wuzeerabad had only one case, and that in a pilgrim. Mr. R. C. Bose, the Sub- Assistant Surgeon, states that " the disease became spread in different parts of the district in various directions along the lines of commerce. The causes of the epidemic may be briefly mentioned to be the importation of the disease by returning pilgrims from Hurdwar, innumerable sanitary defects which then existed and still exist in this district, and a meteorological condition of the atmosphere favorable for the development and spread of the disease." 

145. In the district of Goojerat, which lies farther to the north, the disease 

At Goojerat the disease con- a PP ears to have been "entirely confined to the fined to pilgrims. Hurdwar pilgrims." "Only one case of genuine cholera," says the Deputy Commissioner, " occurred on the 28th April, the subject being a youth of 15 or 16 years of age, a resident of the district, who had gone to Hurdwar;" he recovered as well as a few others who showed signs of choleraic diarrhoea and were put under treatment. "Writing on the 30th May 1868, the district officer observes—" The cholera did not spread among the residents of the Goojerat district. It was entirely confined to the pilgrims, and no cases occurred subsequent to their passing." 

146. In the Shahpore district 621 persons are reported to have died of 

The disease not traceable to cholera in 1867. The disease commenced in the SSfScT in the Shahl)Ore m onth of June and continued till October. It appeared first at a small village (Dhull), situated on the high road from Jhelum 



64 

to Dera Ismail Khan, and from thence it spread chiefly following the bend of the river. The disease is " supposed to have| followed the pilgrims," but no evidence on this point appears to be available. One instance of apparent communication of the disease is given by the Civil Surgeon, Dr. Massey. "At a town called Saheewal the inhabitants were free from the disease until three or four persons entered the place from an infected village ; some of these men were attacked with cholera a short time after their arrival at Saheewal, and consentaneously the disease broke out in the town amongst the previously healthy inhabitants. The men belonged to a small village named Lukkishah, about four miles from Saheewal, and they left their houses through fear of the disease." The Deputy Commissioner gives the 30th June as the date on which the first case occurred in the district, and expresses his opinion that "it was imported from Pind Dadun Khan in the Jhelum district." 

147. On the 30th April the first case of cholera occurred in the Jhelum Very few cases in the Jhelum district in the person of a boatman employed at district. thfi hridio'e-of-hnfl.f.s nvpr w"hi<Vh fliA -mlrwiwie -noocaA 

the bridge-of-boats over which the pilgrims passed. 

Two returned pilgrims were also attacked, and a muleman whose mule had been hired by pilgrims coming back from Hurdwar. This district suffered comparatively little. Only 103 deaths are reported to have occurred from cholera. The Civil Surgeon Dr. Cary states that the disease "was brought in by Hurdwar pilgrims." 

148. The particulars of the origin and spread of the disease in the Rawul Hawaii Pindee in part suffer- Pindee district are very clearly and succinctly 

Ed severely. 

stated in the following extract of a report by the 

Civil Surgeon, Dr. Lyons :— " The epidemic of cholera began in the month o May, and there are fair grounds for attributing it to importation. The Hurdwa pilgrims began to enter the district about the close of April. The first intelli gence of the occurrence of cholera in the district was received in the second wee of May, when the disease broke out in an epidemic form at the large village o Sokow, near Goojur Khan, and within sight of the Grand Trunk Road. Th native doctor, who was sent there from the sudder station to render medical ak states positively that the first two fatal cases were Gungabashees, and that i was the belief of the villagers that the disease was imported by the pilgrim The next outbreak occurred on the 20th May amongst the large body o coolies employed in the construction of the bridge on the Sohan, about five mile from Rawul Pindee. Here also the origin of the disease was apparently dv to a recently returned pilgrim, a bunniah, who kept a shop on the further ban of the river. The first cases occurred in the immediate neighbourhood of hi shop, and by far the greater proportion of the seizures and the worst case occurred on that bank of the river. Here, likewise, the people attributed th outbreak to the only returned pilgrim on the spot. Another view of the mean by which the disease was introduced amongst the Sohan coolies was suggested b the police ofiicers. A spot about a mile- beyond the bridge had been selected for the purpose of stopping the pilgrims until they were inspected by the Civi Surgeon, their bodies and clothes washed, and their baggage exposed to th sun and air, before they were allowed to enter the large city of Rawul Pindee. 



65 

It was surmised that the waters of the Sohan river had become tainted with cholera poison from the pilgrims bathing in it, and that the coolies at the Sohan bridge had contracted the disease from using the river water. This view of the cause of the outbreak, though plausible, is weakened by the fact that the inhabitants of two or three small villages, about half or quarter of a mile lower down, who likewise use the river water, were not attacked. But whether this view be incorrect or not, it does not affect the main and important fact that the primary cause of the disease was importation of the poison by the Hurdwar pilgrims. The disease subsequently spread gradually through most parts of the district. On the 25th May it occurred in the sudder bazaar of the cantonments ; on the 26th in the city of Hawul Pindee ; on the 7th June in the cantonments ; on the 9th June in Hussun Abdal (where it was very severe) ; on the 11th June at Futteh Jung ; on the 7th June at Huzrah ; on the 28th June in the neighbourhood of Attock. A few cases occurred in the Kahoota Tehseel, where it was introduced by the Sohan coolies who had dispersed in that direction. It has since spread all over the district, but it has not been very severe in more than a few places. It was remarked that in most of the villages seized, the disease at the onset attacked a large number simultaneously, on the average about twenty to forty, of whom about half or two-thirds died. The epidemic then almost immediately subsided, or was prolonged only by the occurrence of a few desultory cases, of whom a greater proportion survived. It would then depart to some neighbouring village not always the nearest or most immediate." 

149. The sanitarium of Murree, which is situated in the hills not far 

importation into Murree from Hawul Pindee, suffered to a considerable not traced. +v.r> ™,ซo,w,™ ~p +i,~ Ai~^m*> „„„ 

extent, and the presence of the disease which was 

spread over many weeks caused much anxiety among the residents, who, as usual in hill stations, consisted chiefly of officers and their families who had gone up for the season to escape the heat of the plains. The history of this epidemic is very imperfect. It appears that the first case occurred on the 10th June. " This person had not come from Hurdwar. He had been living at Murree for some time previous to the attack. He was a Cabullee, strong, stout, and very robust. He had been living in a serai in the bazar for several weeks and been employed in making roads. The duration of the disease was very short, as he died within eight hours after the commencement of the attack. A number of Cabullees were living in the same serai, and many of them were quickly brought to the dispensary. At this time, up to the 20th June, cholera was confined to the people living in this serai, but the disease quickly spread among the natives. Many natives (servants belonging to the visitors) were attacked in the various compounds, and there was a great reluctance on the part of these people to be taken to the cholera hospital, so that very many of the cases were treated in their own houses." It is not known with any accuracy how many of the native residents of the settlement were attacked. Forty-six were treated in the cholera hospital, of whom twentyfour died. Twelve Europeans were seized and of them nine died. The type of cholera is reported to have been " most malignant and the average duration of the disease very short." Dr. Williams, who was in Civil Medical charge, states 11 1 can see no reason for supposing the disease to have been imported " 



66 

150. In the Hazara district cholera was epidemic in the months of 

May, June, July, and August ; during that time 1,000 deaths were reported from the disease. The 

Cholera in Hazara. 

Civil Surgeon, Dr. Parrell, is of opinion that "it was first introduced by atmospheric influence, but its subsequent propagation was more or less effected by contagion. The first stricken by the disease were two policemen on duty at the Hurreepore Thanna, who were both taken ill with choleraic symptoms within a few hours of each other on the 17th May and both died. I believe these men had been on duty at the thannah for some days previous to their attack, and beyond the fact that the thannah might be a halting place for pilgrims and others returning to their homes, I am not aware of any contagious influences to which these men could have been exposed. Ido not know the number of pilgrims who may have visited Hurdwar from this district, or the chief routes by which they returned. I believe, however, that the great majority had returned before the above-mentioned deaths occurred. At this period the rest of the district was free from cholera as far as could be ascertained." In the station of Abbottabad there were twenty-seven cases and five deaths among the Native soldiers. 

151. The information regarding the appearance and spread of the disease 

The disease in the Pesha- in the Peshawur Valley is someWhat meagre, and wur Valley. ... . „ ? „„ , , vnma ii. a i uortQlloou 0rtQ1100 ffco 

this is all the more to be regretted, because the 

outbreak, which occurred among the European troops in cantonments, was very severe. Dr. Bellew, who is now Civil Surgeon, states that the first case appeared in the city of Peshawur on the 11th of May, and that between this time and the 20th June, 1,020 of its inhabitants were carried off by the disease. He says it was " supposed to have been imported by the Hurdwar pilgrims." The opinion of the Civil Surgeon, quoted by Drs. Dallas and Smith, is to this effect — " I have little doubt but that the disease was due to importation ; no cases had occurred for some years, and not until after these Hurdwar pilgrims had arrived ; and although the time of incubation was limited, I think there can be little doubt on the matter. I hear that the mortality among these pilgrims on their way up was severe." 

152. The cantonment of Peshawur had been free from cholera for nearly 

five years when the epidemic now under consideration broke out. In the month of May 1867, the 

Cholera at Peshawur. 

European garrison of the station consisted of two Batteries Royal Horse Artillery, two Batteries Foot Artillery, the 42nd Royal Highlanders, and the 77th Regiment. 

153. On the 20th of May, the first case occurred in cantonments in a 

First outbreak in the Artillery. Gunner of the E Batter y R brigade Royal Horse 

Artillery. He was seized at 4a. m., and almost 

simultaneously a child belonging to the Artillery was also seized ; a very few hours elapsed, and two more cases occurred in the F. Battery P. Brigade Royal Horse Artillery. These four cases were in separate barracks on the right flank of the Artillery lines, distant about one mile from the city of Peshawur. The two Batteries affected were moved into camp at " Barra" the following morning, 21st May, and every effort was nrade to prevent intercommunication between camps 



67 

and villages. The two Batteries in cantonments were unaffected till the 24th May, when one case occurred in the 4th Battery 22nd Brigade. On the 25th May, the E. Battery 19th Brigade had a case likewise, and that same evening the remaining Artillery force went into camp at Buddu Bar. 

154. The two Batteries of Horse Artillery were encamped side by side at TheHorseArtiileryincamp. Barra ' The E. F. Battery, in which the first case 

occurred, had no admissions for two days after 

moving out, but on the 23rd, 25th, and 26th May there were four cases, two of which occurred on the latter date. A long interval then ensued of perfect immunity from cholera. Ground was changed as a precautionary measure on the 29th May, and again on the 7th and 12th June, on which latter date the camp was pitched at "Aza Khail." Here the batteries remained for three days, during which an outbreak of the same character occurred which necessitated a further change of encampment. Almost each succeeding day there were one or more cases, but on the 14th June ten cases were admitted, and the Batteries thereupon returned to the old camp near Fort Mackeson. Cholera still continuing, they changed ground three times, and returned to cantonments on the 26th June, having been five days without a fresh seizure. On the 28th, however, one case occurred, and again on the 30th two cases, which terminated the epidemic in the E — F. Battery. The number of cases in this Battery, between the 20th May and 30th June, was twenty-six, and the deaths fourteen. The F — F. Battery Koyal Horse Artillery accompanied the other throughout, but suffered much less severely. From the 20th to the 29th May inclusive there was one case almost daily. There was then a long intermission lasting till the 15th June, when cholera reappeared, cases occurring at intervals of a day or two up to the 22nd of the month. Both Batteries returned, as has been stated, on the 26th June. On the 28th a case, the last recorded, occurred in the troop quarters in cantonments. Altogether in the F — F. Battery Royal Horse Artillery, there were sixteen cases and eleven deaths. 

155. The first camp of the Foot Artillery was formed at Buddu Bar on the 

E— l9 and 4-22 nd Royal Ar- 25th May. Here there were three cases on the same tillery also suffered. , , „ .„ ,n, n nnaaa _? QM , -ป„- . ,, a 

day, and again two cases on the 30th May in the 

E—l9E — 19 Battery. On the 31st May the camp was moved to fresh ground in the vicinity, but on the day following and on the 3rd June, three cases occurred in the same Battery, and on the 4th June one in the 4-22 nd Battery, this last being the only case in the Battery since the 24th May. This necessitated further change of ground to Muttunnee on the sth, when another case was admitted from E. — 19 Battery, and again one on the 6th from 4-22 nd Battery. After an interval of two days, there were two fresh admissions from the latter, and it was then decided to make a retrograde movement to Buddu Bar, near the Kohat road. This was carried out on the 9th June, but was attended with disastrous results, which Dr. Summers suggests were occasioned "by the vicinity of the infected Kohat road." On the 10th, 11th, and 12th June thirteen cases of cholera were admitted into hospital, all of which belonged to the E—l9E — 19 Battery. The site of the camp was accordingly again changed on the 13th June, and on the 14th the two batteries were separated, the E—l9E — 19 proceeding to Chumkunnie and the 4ป22nd remaining at Buddu Bar. On the 14th, 15th, and 19th June there was 



68 

a case each day in the E—l9E — 19 Battery, but none subsequently, and the Battery returned to cantonments on the 27th June ; the Buddu Bar encampment remaining free from disease after the 14th June. There were in all six seizures and five deaths in the 4th Battery 22nd Brigade Royal Artillery, and twenty-nine seizures and sixteen deaths in the E— Battery 19th Brigade Royal Artillery. 

156. About 6-30 on the morning of the 20th May the first seizure took 

Cholera in the 42nd High- place in the 42nd Highlanders. The man had been landers. _.. , ? ... , ฆ?_•_ ? . , , * _ _ , _ 

on barrack picquet during the night, and was asleep 

in No. 8 Barrack at the time of his seizure. That same evening there were seven more admissions, all of which proved fatal. The total absence of premonitory symptoms was remarked in each case. Five companies of the Regiment marched to Chumkunnie on the 21st May. Seven cases were admitted on that day, and on the 22nd twelve cases. Of these latter six were from camp and six from barracks. Three more companies were sent out to join the camp on the 23rd May, and on that date there were thirty-seven admissions. Ground was changed the following day, and the remaining two companies, with the hospital, joined from Peshawur. On this day, the 24th May, there were twenty-five new admissions. The camp stood fast on the 25th, and there sixteen fresh cases occurred. A short move was made on the 26th and eight cases were admitted, followed by six on the 27th ; ground was again changed, on the 29th May, and there were four fresh cases. Improvement not being manifest, it was resolved to divide the Eegiment into wings, and then march' for Cherat. On the 31st May the right wing accordingly moved to Oomur Payan, seven miles off in a south-east direction, thence via Jalouzie and Shahkote to Cherat, followed by the left wing a few marches in rear. A few more cases occurred during the progress of the Regiment towards Cherat, but they were of less frequency, and by the time the entire Regiment was located at the sanitarium, all traces of the epidemic had ceased. This was about the 18th of June. During this trying period of epidemic prevalence of cholera, extending over not more than twenty days, the admissions amongst the men, women, and children of the 42nd Highlanders amounted to one hundred and thirty-four, and of these seventy-four died. 

157. The first case recorded in the 77th Regiment was that of a patient 

Cholera in the 77th Regi- in hosp ital > wll ฐ was attacked by cholera on the meat. 91st.Mn.v nf, 11 A.M. On f.hpi fivpnino" nf Hiซ sqtyip 

21st May at 11 a. m. On the evening of the same 

day, a second case was admitted from the barrack workshops. The next case occurred in a Private of the same Regiment on duty in the fort, which is close to the city. He was admitted at 3p.m. on the 22nd May.. The following day there were three cases from different parts of the barracks, and it was then arranged that the four companies to which the patients belonged should go into camp at ' Harree-Sing-ka Boorj," which is about four miles distant along theMichnee road. Chis they did the same evening. On the 24th and 25th there were two cases each day, and on the 26th May twelve men were admitted into hospital with choleraic diarrhoea, four of which eventually passed into true cholera ; ground was changed on the 27th in a southerly direction towards the Barra river. There vere no fresh admissions that day, but on the four following days occasional cases of cholera and choleraic diarrhoea occurred, which necessitated a further •ojnoval of the camp. This was carried out on the 2nd June, the companies 



69 

encamping closer to the Barra river on an elevated ridge of ground. Here they remained till the 11th June, having during the interval experienced a fresh outburst of cholera. On that date the camp was moved four miles to the left to the banks of the Barra river. "The Detachment," Dr. Hensman states, "now Etinued free from disease for eight days, when a solitary case was admitted." s was the last amongst the companies first infected. 

158. Cholera was not long in asserting itself in the head quarters 

Attacks the portion left in detachment and sick left behind in cantonments. A cantonments. man o f j\ Company was seized on the 24th May, and on the 26th the hospital inmates were attacked. Nearly the whole of the ordinary sick were then transferred to No. 4 Barrack Bungalow, which had been unoccupied during repairs, only a few sick females and cholera patients being left in the regular hospital. Another case occurred there on the 30th May, and on the 31st May a man of K. Company, living in a different barrack-room, was admitted with cholera ; an intermission followed this last case, but again, on the 3rd June, two patients in the remaining hospital ward, the wife of one of those men from the married quarters and a man from the barracks, were all attacked. 

159. All the ordinary sick, male and female, were at once sent into camp a 

mile and a half from cantonments, where, on the 12th. June, those who had been transferred to the barrack 

Occurrences in camp. 

hospital also joined them. A case occurred in the camp hospital on the morning of the 4th June, and again on the sth June. The camp was accordingly shifted on the 6th June to a spot two miles out on the Michnee road, where two days afterwards two companies from head quarters joined it. The tents of this detachment were pitched some distance in rear of the camp hospital on the opposite side of a stream. That evening a fatai case occurred in the detachment, and on the 9th a patient in hospital was carried off. The following day a march of four miles was made towards a new encampment, four miles from Peshawur on the Barra road, close to the river, and here the remaining sick from the barrack hospital in cantonments joined the party on the 12th June. Between the 11th and 16th June, during which time the camp was stationary, there were fourteen fresh admissions. On the latter date a further move was made across the Barra river to ground covered with loose stones and very scanty vegetation. From the 17th to 21st June there was no recurrence of cholera, but on the 22nd one case from the detachment was admitted, and there were also several cases amongst Native followers. That evening a violent thunderstorm occurred and cholera thereafter disappeared. The camp returned to cantonments on the 28th June. The head quarters of the Regiment, with the remaining companies, went into camp on the Kohat road on the 10th of June. No sick were carried with them, but on the 12th one of the bandsmen was attacked with cholera. There were no more cases till the 17th June, but on that day there were four admissions, the Adjutant who died being one. On the 19th another case occurred, and on the morning of the 20th ground was changed to a distance on the Barra road three miles from Peshawur. There two more cases occurred on the 23rd and 24th, but Ihose were the last in the Regiment. The total admissions from cholera in the 7HL. Regiment amounted to 78, and the deaths to 54. 



70 

160. The Native portion of the garrison suffered comparatively little. 

The Native troops suffered Out of a strength of 4,395 only 63 in all were comparatively little. o+fanlrprl onH nf tfipsn fl* diprl. 

attacked, and of these 27 died. 

161. Considerable obscurity hangs over the origin of this virulent out- 

Origin of the outbreak at break - The late Dr ' Macintire, Deputy Inspector Peshawur: d-^-naval nf TTnsnif.nl a of FTor Mnipsfv's Tnrlinn Ser- 

General of Hospitals of Her Majesty's Indian Ser- 

vice, ascribed the appearance of the disease entirely to local causes, and stated his belief that when the epidemic commenced among the European troops there had not been a single other case of cholera within one hundred and twenty miles of Peshawur. There had, however, been a case in the city on the 11th of May, and the pilgrims returning to Jellalabad had passed through the neighbourhood on the 3 9th, or the day immediately preceding that on which the troops were seized. It is also a noteworthy fact that the 42nd Highlanders, among whom the disease became so rife, had been volunteering into other Regiments not long previously, and " the volunteers after receiving their bounty were constantly in the habit of passing their time in the city of Peshawur at this very period." The percentage of those men who were attacked was much greater than that of those who had not volunteered, as is shown in the annexed statement ; but whether the difference in this respect is to be ascribed to the fact that the volunteers were more in the city, or that they had been rendered more liable 

to attack by intemperate habits or to both causes having been at work, cannot be ascertained. Ratio peb cent, op Strength. Regiment. Description. Strength. No. No. attacked - died - Attacked. Died. 42nd Highlanders. Non-Volunteers ... 523 84 46 16-08 B'Bo Volunteers ... 151 35 21 2317 121 9 Total ... 674 119 67 17-65 100 Although, therefore, there is no direct evidence to show that the cholera was introduced by the pilgrims, the history of its upward advance the events which occurred in the other districts through which they passed, and the fact that they had arrived in Peshawur before the disease appeared, all tend to render 

it extremely probable that it was imported into the city and afterwards into the Military station. 

162. It has been stated that there was a case of cholera in the city of 

Report of the Peshawur Mili- Peshawur on the 11th May, but it is right to add tary Committee. +i,_f f i,_ + Wll fi, n e i^; a c+o+ QQ ™ Q vi+ Vioo KQK QO r, ooll^l 

that the truth of this statement has been called 

in question. At the request of the Government of the Punjab a Military Committee assembled at Peshawur to enquire into the origin of the outbreak and in their report, which is dated the 18th September, they reply to the various questions which had been proposed. They state that the " cholera broke out in the city of Peshawur on the 23rd May, one Sirdar Sing, Hindoo was the first attacked, and succumbed to the disease." This was followec by the seizure of three other persons. None of these people, it is stated, had 



71 

been among Hurdwar pilgrims. M Previous to the outbreak in the cantonment no case was reported as having occurred between Attock and Peshawur in the daily reports of the police, who had strict orders from the Deputy Commissioner to be on the watch." The first man attacked in cantonments at 4a. m. of the 20th May had not visited the city or bazar, so as to come in contact with pilgrims. Within a few hours two other artillerymen and a child were attacked ; " all these cases were in separate buildings on the right flank of the Royal Artillery lines, and extended gradually to the left." It appears that " about the 25th or 26th April, the first pilgrims began to return ; these were of the better classes, travelling by dak ; during May the general influx to the city commenced, arrivals occurring daily. Prom the city of Peshawur 548 men, women, and. children went to Hurdwar ; of these 524 returned, 24 having died of cholera or other diseases on the road, but the nature of these diseasesป and the locality of the last case, cannot be ascertained. Of the 524 who returned only seven afterwards died of cholera, but there are no memorandums to show the dates of each death. From the cantonment 22 persons only in all went to Hurdwar. These all returned, having had no sickness amongst them on the road and not having come in immediate contact with it. Neither have they or any of their families since been attacked, nor did the disease show itself among those living close round about them." Prom all the facts and the absence of any trace of the disease above Lahore, " the Committee consider that the outbreak of cholera in Peshawur cannot be ascribed to the return of the Hurdwar pilgrims." 

163. In opposition to the facts recorded by the Military Committee the 

Sub -Assistant Surgeon, Cheytun Shah, whose exer- 

aSI2SSฃ.ฐ f the ' Sub - Assist - tions during the epidemic are honorably mentioned 

the Commissioner, reports — " On a close enquiry 

the earliest noticed case appears to have been of one Shunkur Doss in the Undur Shahar Mahalla on the 11th May, i. c., about a fortnight after the arrival of the first Hurdwar pilgrims, and four days after the arrival of his father-in-law, also a Hurdwar pilgrim, with whom he lived in the same house. The symptoms of the case, as stated by the hakeem who attended him, appear to have been those of genuine cholera. This case recovered. There were admitted into the dispensary on the 13th and 14th of May three cases of dyspepsia, and one of them showed symptoms of collapse. This man also recovered, and the case passed as doubtful. On the 20th, however, cholera made its appearance in the cantonment, and on the 21st it spread in an epidemic form in the city." 

164. The Civil Surgeon, Dr. J. J. Clarke, thus corroborates the statement 

of Cheytun Shah — " I have looked over all the cvi- 

Su?gS bb ฐ rated by the CiVil dence in the Magistrate's Office, and by the aid of 

Cheytun Shah, through the Kotwal, I have learnt 

all that can be relied on about the outbreak of cholera in the city, &c. 

11 1 st. — The case of Shunkur Doss, who was seized on the 11th of May and who recovered, lived with his father-in-law, a pilgrim from Hurdwar, who returned to Shunkur Doss's house four days previous to his attack. The pilgrim 



72 

himself in no way suffered either on the road or at home. So far as I can learn from the hakeem himself who treated the case, I should say it was, if not a case of pure cholera, one at all events with choleraic symptoms, as cramps, vomiting and purging, &c. The hakeem himself, I may mention, was a pilgrim, and returned from Hurdwar with Shunkur Doss's father-in-law. 

11 2nd. — Utter Sing, a man of about 20, was seized and died on the 14th May in the city, and his body was burnt on the 15th. His death is recorded in the Brahmanical records. Utter Sing's father is a druggist, and states that his son's death was caused by cholera ; that he had bad cramps, vomiting, purging, &c, and that previous to the attack he was quite well. 

11 3 rd. — Sirdar Sing, the man recorded by the Military Committee as the first victim, was seized and died on the 23rd May. This man, Sirdar Sing, was a Hindoo fukeer, and lived outside the city at the Tueksallee City Gate, through which gate the pilgrims mostly entered the city, it being the gateway where the choongee is gathered, and possibly the greater number of them held converse with him as they passed by." 

165. In the Kohat district " one man was seized," writes the Deputy Commissioner, "on the 22nd May with cholera at the Native Troops suffer at Kohat. o1 ? -^ , ? , ? 

Shadipore Perry, and died the same evening. No 

other cases have occurred, and most of the pilgrims who went from this district have returned." No report of later date has been received regarding the civil population. Mr. Tandy, the Medical Officer of the 3rd Sikh Infantry, appears not to have been aware of the case on the 22nd May. In narrating the history of the epidemic, in which his Regiment and the other Native troops at Kohat suffered, he states — " Its first appearance among the. civil population was on the 26th July in the village situated close to the station hospital on its eastern side, whence it spread among the villages in the Kohat valley, and thence travelled north-west to the Hingoo valley. It persisted at its greatest intensity from the 13th August to the 12th September and then suddenly ceased. It reached its maximum and disappeared in cantonments and the district simultaneously." Among the troops the disease first appeared in a detachment of the 3rd Sikh Infantry, which had been on out-post duty, and marched into Kohat on the 9th July ; on the 10th two cases were brought into the station hospital ; on the 12th two cases occurred among the residents. "No case," writes Mr. Tandy, " had occurred in the district prior to the outbreak in the detachment 3rd Sikhs on the 9th July. No direct communication could be traced between *the detachment 3rd Sikhs and the two which occurred in cantonments on the 12th July, and the two which appeared on the 21st." Up to the 12th September there were in all 121 cases and 69 deaths, including camp followers. 

166. As regards the origin of the disease in the Bunnoo district the Civil _ . ซ, t, •t i Surgeon remarks, "no certain intelligence can be Cholera attacks Bunnoo in July. , UD 

obtained, but the disease is believed to have been 

introduced from the Rawul Pindee district, by means of the salt traders, to Maree, Kalabagh, and Meanwallee. The cholera appeared in the latter phee as early as the 26th May, and gradually spread and continued till July. On 31st 



73 

July three sepoys in quarantine camp at Nowrung, sixteen miles from Bunnoo, were seized with the disease. They were Dograhs returning from their homes in the Kangra district, where cholera was prevalent when they started to rejoin. On the 19th September a Kahar, who had visited No wrung, was attacked \vith cholera, and on the 20th September the first case amongst residents of the city occurred, and the last case on 11th of October. The date of first case in surrounding villages is not exactly known ; but when the city people fled in the beginning of October the villages suffered. About the 20th September the epidemic appeared to subside in the near villages, but there have been slight outbreaks since in remote places ; and lately, about 19th November, it showed at Tajom, a village 39 miles from Bunnoo, and continued till 22nd of same month. The duration of the disease has been five months and four days." 

167. In the district of Dera Ismail Khan the first case of the disease is 

The disease in Dera Ismail reported to have occurred on the sth August and Khan. j.-l_ i nc ,i. _„ a^ oaiv, ~v a™^™!^™ n^i-^,*™ *-i*™~ 

the last on the 24th of September. Between these 

dates it is stated that 246 persons were attacked, of whom 83 died. It was confined to Kotsultan and the surrounding villages. No British Officer was in medical charge at the time, and there is no evidence to show that the disease had been introduced by pilgrims. It is reported that they had all returned long before the first case occurred. Among the Native troops occupying the cantonment there were no cases. 

168. In the military station of Dera Ghazee Khan two cases occurred 

The disease in Dera Ghazee in Jul y and one in September. Throughout the Khan. /liufi>iซ.f ft?i'7 /Iqq+Tiq -fwvi-n +TlO /Heoneo woro iปA i nrปT r f*ปrl 

district 857 deaths from the disease were reported 

between the Ist June and the 15th of August ; of these 517 occurred in July. Cholera had been unknown in the Dera Ghazee Khan district for many years, and the cause of last year's epidemic has not been ascertained. " There was no evidence," writes the Civil Surgeon, Dr. George Thomson, " to show that it was imported." 

169. The city of Sirinuggur and the valley of Cashmere generally were 

visited by the disease. Major Cracroft, who was on 

The epidemic in Cashmere. u{t wag hlO vght by some soldiers who had been with His Highness the Maharajah to the Hurdwar fair. The first case occurred among the troops about the Bth June, and the epidemic lasted until the 15th September." It is estimated that 12,485 persons were attacked, of whom 6,295 or about one-half died. Dr. Lackersteen also expresses his opinion that " the seeds of the late epidemic were no doubt sown by the troops returning from Hurdwar." At one time as many as 200 deaths were daily occurring. 

170. In Cabul the sufferings of the people were great. The following 

particulars regarding the disease in that country have been kindly supplied by Mr. Wynne, 

The disease in Cabul. 

Under Secretary to the Government of India in the Foreign Department. The first notice of the prevalence of cholera in those parts is found in a report of the 19th July. It is there stated that Jelalodeen, an intriguing Sirdar, who 



74 

was at Bajour in the Kaffiristan Hills, intending to pounce on Jelalabad, was deterred from doing so "by reports of cholera." The further information is thus communicated — 

" 26th July 1867.— F0r the last four days owing to the increase of cholera, there has been no durbar, the bazars are closed, and from 100 to 150 people die daily in the town of Cabul, vomiting and purging carry off those attacked in the course of three or four hours, and no medicines avail. The disease has spread to the country round, and, except on very urgent business, no one leaves his home. 

" 29th July.— Many of the Cabul soldiers have left for their homes on account of the cholera, without leave ; about half the Army remains at Cabul. 

11 3 rd August. — A great deal of cholera reported in the city. 

" 12th August. — The ruler of Cabul has ordered the traders of the bazars, who had closed their shops in consequence of the cholera, to open them again under pain of a fine of Es. 25. There is an improvement in the health of the city since the 11th. 

"14ith August. — About 8,000 people have succumbed to cholera, and the disease is now abating. 

19th August. — Cabul is becoming more free from cholera since rain has len ; the villages in the vicinity continue to suffer severely. 

" 22nd August. — Cholera continues. 

I" 24<th August. — Cabul continues to suffer from cholera ; it fluctuates, ecreasing for a day or two, and then becoming worse. 

" Bth September. — Cholera in Cabul and vicinity is now on the decline." 

171. Throughout Agra, Etawah, Muttra and Furruckabad, which are 

very little cholera in the districts of the Agra division, the disease was Agra Division. fnvt,nnn/talv sliVhf;. Thprpi was no pvidfvnp.fi in nnv 

fortunately slight. There was no evidence in any 

!ise to show that it had been communicated by pilgrims. The outbreak a gra in December 1866 has been already recorded, and most of the reporter 3m this part of the country state that cases had occurred now and the iring the months of March and April. Among the prisoners and troop the station of Agra, numbering altogether about 3,500 persons, only two case cholera occurred throughout the year, and these were among Native soldiers the districts of Etah and Mynpooree, the mortality from the disease is sai( have been considerable. 

172. At the Secundra orphanage, 5| miles from Agra, an outbreak of cholera 

Outbreak at the Secundra suddenly occurred on the 30th May, and continued orphanage. tfii +.liซ Rfli nf .Tutia Out nf a fnfcal cfw>™fl, *c akr 

till the 6th of June. Out of a total strength of 456 

itive Christians, forty-six were attacked and thirteen died. The first twenty ht cases were solely from amongst the big girls who had been exposed to the a. " Possibly," observes the Civil Surgeon, " had I kept the small girls sepa-3, they might have remained as free from the disease as the boys did — not one • was attacked." "On the evening of the 29th May," writes Dr. Playfair, le girls had been out for their usual constitutional walk. When returning, 



75 

and within the compound of the orphanage, a sudden shower of rain fell ; the 

younger girls being close to their dwelling, at once escaped, but the elder girls, laving to go about a hundred yards further, got more or less wet. Next morning, about half past four o'clock, one of the elder girls was found ying moribund in the court attached to the sleeping verandah, with all the appearances of cholera morbus. She died in an hour and a half ; and from that iime the disease spread with great rapidity." 

173. It is worthy of special notice that, while the Agra district almost 

I Early appearance of the dia- entirely escaped the epidemic, the State of Bhurtpore, ase at Bhurtpore. whioh lies incrmfidiathlv r,o t,Vm wfist. suffered con- 

which lies immediately to the west, suffered con- 

siderably. As has been already noted, cases occurred in Bhurtpore at the close of 1866. On the 6th of April 1867, Dr. Harvey states that a fresh outbreak commenced. The disease spread throughout the whole State with rapidity, and by the beginning of May was prevalent in every pergunnah. It was fortunately of a mild type. In the city of Bhurtpore, where it was most severe, the total number of deaths is estimated at 255. The fresh appearance of cholera in April could not be traced to returning pilgrims, nor is it probable that they were the cause of it. Pew or no pilgrims had returned from Hurdwar by the 6th of April, and among the 1,000 or 1,200 followers who accompanied the Maharajah to Hurdwar, no case appears to have occurred after their return to their homes. 

174. No reliable information of the ravages of cholera in the State of „ . ... _ .. _. . Gwalior is available, but it would appear that the Cholera m the Gwalior State. l r 

epidemic of the past year was a mild one. Cases 

now and again appear at all times and seasons in this part of the country, so much so, that the inhabitants of the cities and villages are said to look upon the disease as a more or less constant visitor. 

175. The report of Dr. Morice, the Residency and Staff Surgeon, deals only 

with cholera as it occurred in the cantonment of No evidence of importation. 

Morar and its neighbourhood amongst the Native 

inhabitants. Dr. Menzies, Superintending Staff Surgeon Major British Troops, deals mainly in his report with the rise and progress of cholera amongst the Europeans. The cantonment of Morar has suffered periodically, but at long intervals, from epidemics of this disease. It appears, however, to have culminated in severity in the years 1860-61-62, in all of which it committed considerable ravages. Since the latter year the station has been almost, if not entirely free from cholera. The origin of the present outbreak seems to be undetermined. Dr. Menzies remarks on this subject that "we have direct lidence of a connecting link, although a weak one, between Gwalior and the urdwar fair in the fact that though His Royal Highness Scindia did not go, c of his Sirdars did go with a few followers ; his return was rapid on account the sickness. None of his people suffered." Again — " lam not disposed to drop the link of connection, however slight, between the Hurdwar fair and this year's outbreak of cholera in the Gwalior district ; there is no doubt that some persons, and they may have been infected, came from there as well as from the Agra Durbar and Butaisser fair." Speaking of this latter fair Dr. Morice states — " There was not much sickness there this year, and I have never heard of any violent epidemic occurring there. There has been on an average about 



76 

one death per month, since the fair took place, amongst camp followers and 

coolies in the Sudder Bazar from cholera." It would, therefore, appear that no direct evidence of importation from Hurdwar can be brought forward in the case of the Gwalior State. The pilgrims were not numerous, and most of them must have returned to their homes long before the disease began to assume an epidemic form in the city of Gwalior and cantonments of Morar. 

176. The Gwalior Durbar furnishes a return which shows that the first The disease among the death P rior to the epidemic invasion took place on Nati ves. the 22nd of May in the Lushkur five miles distant from cantonments. Up to the 31st of May only five deaths were reported, the city of Gwalior being still free. Towards the end of the month cholera appeared in a village called Koomarpore, to the south-west of the station of Morar on the opposite side of the Morar River. This village is reported to have been "in a filthy state with drains running close by the wells used for drinking water, and surrounded by heaps of stable litter and rubbish." The cantonment latrine pits which "were most offensive" were close to the village. Vigorous conservancy measures were adopted, and the village put into a proper sanitary state. Quarantine was established and the sick were removed to a temporary hospital a few hundred yards distant. No fresh cases occurred for some time after the cleansing of this village. The Sudder Bazar, which is close to "Koomarpoor," did not long remain free. There were several cases in it a few days after its appearance at Koomarpoor. The disease soon after appeared in the village of Pudumpoor at the extreme end of cantonments, distant about 2|- miles from the Sudder Bazar. The condition of this village is likewise reported as very unsatisfactory. " The latrines had been washed away by the rains, and the soil was exposed to the action of heat and moisture." Details of the subsequent progress of cholera in these villages and in the Lushkur and Native city of Gwalior, are very imperfect ; but it would appear from the returns furnished that the disease continued to hang about in the former till the middle of September. During this period of four months, 113 cases and 59 deaths are returned amongst the native inhabitants of the two villages and cantonment bazars. After its first invasion in May it progressively increased to about the end of June. In July there were but three cases, and again in August there was an increase. There were no cases after the 15th September. The first death, as already stated, occurred in the Lushkur on the 22nd May, and the last death on the 22nd August. During these three months there were only 41 deaths in this populous locality, 35 of which were Hindoos. This fact may appear significant of importation from Hurdwar, but it must be remembered that Hindoos largely preponderate in the population of the Lushkur, In the Native city of Gwalior, the first death recorded occurred on the 7th of June, and the last on the 13th September. There were in all 60 deaths, namely, Hindoos 32, Mussulmans 21, and Christians 7. Nearly one-half of these occurred in the month of August. 

177. Dr. Menzies remarks that " the first sharp chord of alarm at Morar 

... . ... _ was struck at the end of May. On the 31st the Cholera among the Euro- . J peans at Morar in May and 103 rd Royal Bombay Fusiliers suddenly lost one 

man, and in the first fortnight of June, the 11th 

and 12th, two boys, sons of one of the Privates, also died." Strenuous efforts 



77 

had been made to check the disease in the bazars and villages when it first 

appeared. These were attended apparently with success, and hopes were entertained that cholera had been eradicated, the more especially as no further cases occurred amongst the Europeans. On the 10th July, however, a patient in the hospital of the 103 rd was attacked. He died the following day. On the 13th and 15th there were two cases in the barracks, one of which proved fatal in eleven hours. Preparations had meantime been made for the Regiment to go into camp. They accordingly marched that evening (the 15th July) to Girgoon, distant three and a half miles from cantonments in a north-easterly direction. Dr. Menzies states that this change was attended with the best results. Only one case of choleraic diarrhoea occurred, the general health improved much, and the Regiment returned to quarters on the 25th July, having only been absent ten days. 

178. Fears were entertained that, as the epidemic season had not yet passed, cholera might re-appear in cantonments. Its reappearance m August. *_ , ,ฐ Xi The strictest sanitary measures were therefore enforced in all the barracks and bazars. As anticipated, it did reappear, in the early days of August, amongst the bazars and village inhabitants. On the 12th August a fatal case occurred in the C. F. Royal Horse Artillery ; a patient in the 103 rd hospital was seized with choleraic diarrhoea on the 14th August ; on the 17th idem, a Private of the same Regiment was attacked with cholera; and on the 20th another patient showed symptoms of choleraic diarrhoea. The camp was reformed at Girgoon, with a view to accommodating two companies of the 103 rd should the disease spread, but it was not required. " A patient in hospital was attacked on the 23rd with slighter symptoms, and on the 24th a delicate child of the Band Master died of choleraic diarrhoea." These were the last cases of the kind in the 103 rd Regiment. 

179. As already remarked the Artillery remained free from the disease up 

to the 12th August, when the C. Battery F. Brigade, lost a case. On the 23rd of that month, simultaneously with the last case in the 103 rd Regiment, a case occurred amongst the men of E-ll Battery Royal Artillery. The C. F. Royal Horse Artillery had two fatal cases again on the 29th August, one in barracks, the other in hospital. The sick were at once moved out to camp two hundred yards distant from the hospital, and a camp was likewise prepared for the Battery about three miles E. S. E. of the station. The next fatal case in the person of an ophthalmic patient of the same Battery, who had been left behind in one of the small hospital wards, occurred on the 4th September. On the Bth, and again on the 11th September, there was a case respectively of choleraic diarrhoea and cholera, the latter proving fatal in a few hours. Dr. Menzies in summing up says — " Prom the 31st May then, until the 12th September, the 103 rd Regiment had five cases and three deaths, the Royal Artillery Division six cases and six deaths, and five of them were in one Battery, the O. F. Koyal Horse Artillery ; they were spread over such a lengthened period, and all appeared so distinct from each other, and so purely sporadic, that it was not considered necessary to move them into a camp of health, but every preparation was made i'or that purpose." 



78 

180. The Native troops in the Morar cantonment, though strong in point of 

cholera amongst Native numbers, there being two Regiments of Infantry and troops. r\-no "RomrvioTif nf rin.vfl.lvv txtp.vp. wnnri prfnllv VlAfl.Hhv 

one Regiment of Cavalry, were wonderfully healthy 

during the prevalence of cholera in the villages and bazars. Two cases only occurred, one in the 22nd Native Infantry, the other in the 33rd Native Infantry. These regiments are widely separated from each other, the 22nd on the extreme right, and the 33rd on the extreme left of the station. There were no cases of cholera in the 16th Bengal Cavalry. 

181. A detachment of the 103 rd Regiment, consisting of 6 officers, ซr_ , - ซ v -m 217 men, 39 women and 73 children, composed the Cholera in Gwalior Portress. 

garrison of Gwalior on the 19th July 1867. Up 

to that date, cholera had not made its appearance, although the position of the fortress between the thickly peopled Native city and the Luskhur, in both of which cholera was prevalent, rendered it most probable that exemption would not long continue. Free communication was maintained, rendering it all the more likely that disease would soon reach the garrison. Accordingly, on the 19th July, a patient in hospital, under treatment for syphilis, presented well marked symptoms, which, however, ended in recovery. Until the 14th of August, the detachment remained free from the disease, but on that date a Sergeant, who had just returned from leave to Morar, was attacked and died in a few hours. 

182. Owing to the unsafe state of the barracks, the whole detachment, with 

_ ? the exception of the two married families, were In the married quarters. L 

moved into tents a few days before the occurrence 

of this last case. This would appear to have been a fortunate step. The married families quartered in No. 3 Barrack were next attacked. On the 16th August two children died, the one of cholera, the other of choleraic diarrhoea. On the 17th a woman was seized who died on the 22nd, and on the 19th a girl who recovered. On the 23rd there were two more cases amongst the occupants of the same Barrack No. 3, which rendered it necessary that the building should be at once vacated. This was done with the effect of checking the further inroads of disease in the occupants of the barrack. During the following five days, with the exception of the 27th August, there was a case each day. Of these five cases three occurred in hospital, one in camp, and one in the staff quarters. Again, on the 6th September, an overseer of the Public Works Department, living in the fort, was attacked and died. A soldier living in the Officers' Square showed slight symptoms on the 11th September, after which cholera entirely disappeared. The married families in whom the disease was most virulent were sent out to quarantine camp on the 28th August. Having finally shaken off all traces of cholera, they returned to cantonments on the 7th September. 

183. The Native State of Jeypore, which lies to the south-west of Bhurt- 

pore, also suffered from cholera. The Medical Officer of the Political Agency reports that it 

Cholera in Jeypore. 

appeared on the 15th April, and continued with more or less severity up to the 20th of October. Throughout the State 739 deaths are reported to have taken 



79 

place from the disease, of which 428 occurred in the capital. Dr. Burr expresses his opinion that the disease was "communicated by pilgrims from Hurdwar." In answer to an enquiry on the apparent impossibility of any one who had been at the fair having returned by the 15th April, he states that there is no mistake, and that the first case of cholera actually occurred in one of the pilgrims from Hurdwar on the day in question. 

184. The cantonment of Deolee is situated at a point where the Jeypore, 

Epidemic among the Native Boonde e, Oodeypore and Ajmere territories meet, troops at Deolee. an( l i s a hont, 95 milps distant, frnm thfi oanital of 

and is about 95 miles distant from the capital of 

the first of these States. Of the epidemic of cholera which occurred at this station, an excellent account has been furnished by Surgeon Major J. D. Crawford, of the 2nd Bengal Cavalry. The prevalence of cholera in Bhurtpore and Jeypore in May had come to his knowledge ; " early in June it was known to be in a village four miles distant, and on the 20th of that month the first case occurred in Deolee itself." Dr. Crawford says — " I have not been able to connect the outbreak of the disease here with the arrival of pilgrims from Hurdwar, and I believe they must have all reached this part of the country about a month before cholera made its appearance." "In this way, however," he believes, " the disease was conveyed in this direction rapidly as far as the Jeypore territory. The stream of pilgrims then becoming very small, the disease died out from amongst them and afterwards progressed by slower and more gradual steps from village to village until it reached Deolee." Dr. Crawford traces three distinct waves of the epidemic, each of which invaded a fresh section of the inhabitants ; the third wave, which invaded the station on the 20th of July, having been cut short by moving the troops into camp on the 22nd. Between the 20th June and the 31st July there were in all 41 cases and 12 deaths among the Cavalry, in the Deolee Irregular Force 46 cases and 10 deaths, in the Sudder Bazar 22 cases and 6 deaths, in the Civil Lines 33 cases and 13 deaths, or a grand total of 142 cases and 41 deaths. 

185. Several instances of apparent communication of the disease are 

Illustrations of apparent S iven by Dr. Cnroford :-" Of the 41 admissions communication of the disease, i^ hj s Regiment 12 were either members of the same families or lived in the same hut with some of the others :—: — 

A saees s wife died in lines on momma- of Bth July ... 1T . ? ? , . tt , i ?, i -?.,, r , & J }- Lived in the same nut. Her step-son admitted 10th July ... ... ... j A saees's wife admitted and died Bth July ... ... ") Her child admitted Bth July ... ... ... J- Ditto. A second girl admitted 11th July ... ... J A saees's child admitted Bth July ... ...") -ry,i Another child admitted Bth July ' ... ... J 

A sowar was admitted on the night of the 17th July. His wife's mother admittec 24th July. His wife's great-grand-mother was admitted on the 25th July The wife and grand-mother escaped. These people lived in three separai huts, but there was constant intercourse between them, and the husbanc of the woman who was first taken ill had been in attendance on his son in-law. Again, a sowar was admitted and died on the 11th July. Anothe who lived in the same hut was admitted and died on the 17th ; he hac attended on his comrade in hospital. A child was admitted and died on th 



80 

Bth July. A woman living next door was admitted, and died on the 11th ; she had assisted in attending on the child before it was taken to hospital. Two of the hospital servants also suffered from the disease, and so did the Native doctor. 

186. In the hospital establishment of the Deolee Irregulars, on the other 

hand, not a single case occurred. The theory of 

OfflSe^fthe'DeSiee^rrfgu- 1 contagion is not supported by any facts noted in lar Force. ฑ1, Q Q ™Vlawn',ป an fay aa 4* of+ar.lro/1 +>ปJa fnvno TllP 

the epidemic so far as it attacked this force. The 

opinion of the medical officer on the subject is thus stated : — " There can, I think," writes Dr. DeFabeck, "be no doubt that this epidemic owes its origin to the transmission of the disease from Hurdwar by the pilgrims returning from that place after the great festival held there early in the year ; but while this conviction forces itself strongly upon us, I must admit that the small amount of evidence which I have been able to collect from persons who either themselves visited or have since been in communication with others who visited Hurdwar, is very inconclusive." 

187. Prom Eajpootana the only report received is from the Civil Surgeon 

of Ajmere. In that part of the country the disease 

tan l^ prevalence in Ra JPฐฐ- continued from the 9th July to the 30th Septem- 

ber, but during all that time only 247 persons were 

attacked, of whom 65 died. Three of the Europeans in the fort also suffered from the disease which proved rapidly fatal in the case of two of them. Dr. Murray states :—"I: — "I could not in any instance connect the appearance of the malady with the advent of pilgrims returning from Hurdwar." In Marwar there was no epidemic. 

188. The Central Provinces enjoyed a remarkable immunity from cholera 

during 1867. Neither in the jails nor among the 

th?c?ntrli b proiS?^ nity ฐ f troo P s ' either European or Native, did a single case 

occur. The Civil Surgeons of Hushungabad, Bai- 

tool, Nursingpore, Raepore, Mundla, Nimar, Seonee, Dumoh and Nagpore all report that the year was singularly free from epidemics, and that cholera in particular was almost entirely unknown. 

189. The occurrence of a smart outbreak among the prisoners in the 

Cholera in the Allahabad di- Allahabad Central Jail in the months of March and VISIOD. A taut 1 TiQcj filvoorliriiDon rvionfirvnorl in +Viq ookltt t-ปov>+ /->-P 

April has already been mentioned in the early part of 

this report. The following particulars regarding the appearance and progress of the disease in the division up to the 22nd June are thus given by the Commissioner :—": — " In the district of Allahabad, the first cases reported were on the 24th April, three cases occurring at Lutchageer, a village on the left bank of the Ganges, at which river steamers during the hot months terminate their voyage. Altogether seven other cases occurred in the Hundeea and Mah Pergunnahs, but the disease was sporadic, and did not attract notice up to the 30th April, when it broke out with considerable violence in Ghoorpore, a village on the Allahabad and Eewah road, in Pergunnah Arail, about eight miles west of the Central Prison, and from this date the cholera proceeded steadily west along the south, or right bank of the Jumna. From 30th April to 7th May, 27 cases occurred 



81 

in Ghoorpore, which ended in death in 19 cases. From the 3rd to 16th Mayit spread over the Bara pergunnahs of Allahabad, and the adjoining pergunnahs of Chiboo and Tirohan, in the Banda district. Prom the 19th it decreased south of the Jumna, but crossed this river at Kote, a large village in the Ekdilla Pergunnah, and thence westward along the left or north bank of the Jumna, as far as the Ghazeepore Pergunnah, but up to the last returns has not gone further in this direction. Prom 28th May it again increased in the Chiboo, Tirohan, and Dursenda Pergunnahs of Banda, where it has been since raging in violent and epidemic form. Excepting in the two pergunnahs of Futtehpore mentioned above, the epidemic has been confined to the Bundelkund soils south of the Jumna. The Doab, including the military stations of Allahabad and Cawnpore, have been almost free of the disease, and I take the epidemic line to have commenced in Hundeea, on the extreme east of the Allahabad district, and to have travelled thence west and south, crossing the Ganges at Lutchageer, and thence proceeding through Arail, Bara, and Khyragurh, all south of the Jumna, in the Allahabad district, into the Banda district, and partly in a branch line into the Futtehpore district." "Not one single case," he adds, "can be traced to pilgrims returning from Hurdwar." 

190. A month later, when it was reported that "as far as one can foresee, 

The disease among the cholera need not be apprehended in the station of European troops. Alla.lia.hnri. fov it, has nnssfirl n.wnv in the. west 

Allahabad, for it has passed away to the west 

of it," the disease broke out among the European troops. It appeared suddenly on the 28th July. The troops were healthy, and the sanitary state of the cantonment good. The first person attacked was an officer of the 107 th in the " Chatham Lines," who was suffering from dysenteric diarrhoea, and who sank rapidly. A woman of the 107 th in an adjoining barrack was attacked next day, as was also a man of the same corps. The wing of the 107 th occupying the " Chatham Lines" was accordingly marched into camp on the 30th, and remained free from the disease till the Bth August, when it broke out again. On the 12th the camp was shifted to Madowri ; no further cases occurred, and the wing returned to the Chatham Lines on the 20th. The wing of the 107 th in the Clydesdale Lines was attacked with cholera on the Ist August, from which date to the 6th, five cases were admitted, of which two proved fatal. The wing, including head quarters, was accordingly moved into camp at Mhowke Serai, four miles off, but though the site of the camp had been carefully chosen and promised well, the disease continued to prevail ; seven men and a child were attacked between the Bth and the 12th, and on the latter day the camp was shifted to another spot. Five fresh cases occurred here on the 13th ; the disease then ceased until the 26th, when, as the detachment was about to return to barracks, two fresh cases (a married man whose child had already died of cholera, and a bandsman who had been encamped close to the married people) occurred. The detachment, with the exception of the married people, was moved that day into barracks. One case was admitted on the day of the return to barracks, and this was the last that occurred. The married people were moved to a fresh camp six miles off; they remained healthy, and returned to cantonments on the 29th August. One case occurred on the 7th August in 



82 

the detachment of the 107 th in the Port. It did well. The Artillery remained free from cholera up to the 6th August. Between the 6th and 9th, three men and two children were attacked. The entire Artillery division was then moved into camp four miles out of the station, whence they returned to cantonments on the 30th August, having been quite healthy in the interval. Nearly one-half of those attacked with cholera in both corps had been men of intemperate habits. The weather during the outbreak was seasonable. The heat was never excessive ; there were fresh easterly breezes, and the rainfall was moderate. The health of both corps had been excellent up to the time of the outbreak, and the arrangements for marching out to camp, and from one camp to another, were very efficient, and such as to save all unnecessary fatigue to the men. 

191. From the Banda district of the Allahabad division, a special 

Its spread in the Bandara re P ort has been received from the Civil Surgeon. district. T\r> T?/inowp •tifvif.oc f.linf flio rlicpo.sia nnnaovorl of 

Dr. Ringer writes that the disease appeared at 

Kirwee on the 12th May, and that it cannot be attributed to any perceptible cause. It afterwards broke out in three different places widely removed from each other, and no pilgrims having any traces of the disease are said to have passed through at the time ; other facts weighing against the contagious theory of spread are also given. Two villages, for instance, have suffered severely, while an intervening one has escaped. In some small villages again, removed from any road or line of communication, individual cases have occurred, and yet no epidemic broke out. 

192. Futtehpore almost entirely escaped ; but in the Cawnpore district 

A few cases in Cawnpore the disease was more severe > i' Bl6 deaths havin g cantonment. \ )een attributed to it. In the cantonment also a few cases occurred, one among the Native soldiers in June, three amongst the Europeans in May, and two in July. 

193. From Oude the information received is generally scanty and 

wanting in details. An interesting summary of 

tiS'imptrfect 0^ 61 informa " all the facts which could be collected regarding the 

appearance of the disease in the province, both" as 

respects the ordinary population and the troops, has been given by Dr. Innes, the Deputy Inspector General of Hospitals Her Majesty's British Service. Without detailing what occurred in each district, the progress of the epidemic may be described, first, as regards the people generally, and secondly, as regards the military cantonments. 

194. The prevalence of cholera along the Terai land, at the foot of the 

Kemaon Hills, and the spread of the disease to Sir 

people generally 6 among the Jung Bahadoor's camp, have already been detailed. 

Whether the return of his stricken followers had 

any thing to do with the importation of the disease into Oude does not appear, but it is stated that, " during the months of February and March, cholera was very prevalent all along the Himalayan Terai, skirting the northern part of Oude and also of Goruckpore." As early as the 27th of March the disease appeared in the Central Jail at Lucknow, and nearly at the same time in the 



83 

Lunatic Asylum. On the 29th there were two more cases among the prisoners, but the disease did not spread among them to any extent. Out of a strength of 1765, there were eleven cases and only one death. The jails of Oude were generally exempt, and none suffered Severely except that at Seetapore. How far the disease prevailed in the various populous towns and villages of Oude, there is little evidence available. The Civil Surgeons of Baraitch, Fyzabad and Seetapore, all report that it was epidemic in these parts of the country in April. In Roy Bareilly it was not so severe. Both in Oonao and Pertabghur, it is said to have broken out in May and again in September. The Civil Surgeon of Oonao remarks that "it was observed in many places widely separated at or about the same date." 

195. In the city and district of Lucknow the disease was for a time 

_ . very rife. Two cases are noted as having occurred The epidemic at Lucknow. __ . . ? 

in March, 3 in April, 15 in May. In August 

the number had reached 1,396. The disease then declined, and in December there were only 29. The total number of persons supposed to have died in the city and district taken together was 2,364. No connection could be traced between the epidemic and the return of pilgrims ; the first noted case, indeed, both in the city and jail, took place before the fair had been held. 

196. Two facts are noted by the health officer of the <;ity of Lucknow 

as pointing to " some general influence acting as 

Evidence against theory of • ฆ> i ฆ, • ฆ-, ฆ%• contagion. a cause on organisms placed under similar condi- 

tions." The first is that, " among the number of 

deaths, there was pretty nearly an equal number of males and females above 10 years of age, and pretty nearly an equal number of boys and girls of 10 years old and under." The second is that "it does not appear that in those parts of the town which are in the immediate vicinity of filth depdts the inhabitants have suffered more than those of other parts. In those which immediately surround the two largest and worst there were no deaths reported in June." 

197. The epidemic in the Hurdui district occurred at the town of Sun- 

deela in the months of July and August. It is attributed to defective drainage and to the fact 

The disease at Hurdui. 

that three of the tanks had overflowed and carried a quantity of putrid animal and vegetable matters over a part of the town. No clue to any introduction of the disease could be found. 

198. The first case of cholera among the European troops in Oude was 

its occurrence among the at Fyzabad on the 28th April. Three men, three European troops at Fyzabad. WO men, and three children were its victims. The medical officer expresses " his opinion that it was brought to the married quarters by the punkah coolies. The whole of the punkah-pulling establishment supplied to the regiment came from the moveable column, except those for the married quarters Nos. 18, 19 and 20 barracks. The moveable column, be it here observed, is a fixed establishment maintained by the commissariat for various duties within cantonments. During the hot season they are employed in pulling punkahs and watering tatties. The Natives 



84 

forming this column lived within cantonment limits, and so, up to date of commencing punkahs, within a circle altogether free from cholera. The usual time for commencing punkahs is 15th April, but it so happened this year that a succession of dust and tliunder-storms, with occasional rain, commencing on the 12th, lowered the temperature, so that artificial means were altogether unnecessary until the 24th. The punkah-pulling establishment, however, had been collected on the 15th, but the coolies finding they were not called upon to work stole away and dispersed to their homes in the neighbourhood. When required again on the 24th they had to be hunted up from their villages, and as by this time cholera had become general, and especially so in the Gondah district, on the other or north side of the Gogra, there can scarcely be a doubt that some of them came from infected villages. Punkah-pulling was commenced on the 24th April at the married quarters ; on the 27th the first case of cholera, or more correctly, choleraic diarrhoea, occurred. Similarly in 1865, when the disease attacked the Regiment, punkah-pulling commenced on the 15th, and cholera appeared on the 18th, or three days after the exact time. I have, on two other occasions, witnessed the disease occur after undoubted communication with the infected. That this year the disease did not attack 18, 19 and 20 barracks, which were supplied with coolies from the same source as those sent to the married quarters, does not, I conceive, militate against the above conclusions. The poison required a nidus for its germination, and that it should have found this in the low, crowded, indifferently ventilated and filthy (this last almost of necessity, in this instance, because of the children) married quarters, and not in the lofty, clean, well ventilated men's barracks with ample cubic and superficial space, need excite no wonder. Nor is the opinion materially opposed by the fact of a married couple (Private Joseph Manelly and Sarah Manelly) occupying the end room of No. 1 barrack, and with coolies supplied from the moveable column, being attacked. These people occupied one small room with two children, and they were notoriously filthy. They both, and they only recovered, which is perhaps the best evidence that, with them the poison, from whatever source derived, was not so virulent as in the married quarters. The wife was first seized at 3 a. m., the attack commencing without any premonitory symptoms. She was brought to hospital at 6a. m., removed into a tent, and attended by her husband, who was seized at 3 p. m. the same day." 

199. At Seetapore there were eight cases among the Europeans, four of 

Among Europeans at other tuem in August, and four in the month following. Stations in Oude. Af T\nnVrmw fhป rli'oaooo AWI nr>+ o™™,^ +„ „ • 

At Lucknow the disease did not amount to an epi- 

demic, only eleven having been attacked out of the large garrison of 2,535 soldiers. In regard -to only one of them was there any evidence whatever of the communicability of the disease, and that was in the case of an Assistant Apothecary who had been unremitting in his attendance on a sick soldier. He had for some time previous been suffering from chronic diarrhoea. 

200. In only two of the stations in Oude were the Native soldiers 

Among Native troops in attacked, and in neither of them did they suffer Oud.6. + A aryTr ซAnoi^o™lilo OV * OT + Tv> T,,~% XI 

to any considerable extent. In Lucknow there 

were five cases, two in June and three in July ; at Seetapore three, two of 



85 

which, occurred in August and one in September. Of these eight cases, seven were fatal. 

201. The Jail at Seetapore was the only one in Oude which suffered to any 

Outbreak in the Seetapore g reat extent, and the epidemic here was more severe Jail* than in any of the in.ils of TTrmpr Tnrlin Thft 

than in any of the jails of Upper India. The 

particulars of its occurrence are thus noted by the Civil Surgeon Dr. Ellis — " The first case of cholera that occurred among the prisoners was on the 15th of August. Between that date and the Ist September 53 cases occurred. Of these 13 were fatal. The first case was from the temporary jail, that is, the man slept there at night, but he worked at blanket-weaving during the day in one of the new barracks. Fourteen other cases were from the temporary jail. The remainder from the different barracks, not one of which escaped. A cholera hospital was established in the temporary jail, and the men who had previously been confined there were moved out into camp about two miles from the jail. With these were sent some from each of the barracks, viz., those who were weak and sickly, in all about 200 men, and on the disease appearing in camp, the patient was removed to the cholera hospital. Pour such cases occurred and the camp changed. The barracks were cleaned and disinfected, 

and every precaution taken to keep the diseased apart from the other prisoners." 

!) 

202. In the large central prison at Benares not a single case occurred 

Slight epidemic in the throughout the year. The European troops sta- Benares Division. tinnprl t.Viprp wptp n.lsn olfno-pfTiPV PYPtrmf. AmonD* 

tioned there were also altogether exempt. Among 

the Native soldiers only three cases occurred in March and one in May. The first case in the city of Benares occurred on the 23rd March in one of the dirtiest, worst-drained, and most thickly-populated parts. "As far as could be ascertained," the Civil Surgeon Dr. Cockburn reports, " not a single case has occurred among the pilgrims passing through from Hurdwar. Those attacked have been residents of the place or pilgrims from Bengal, of whom there was a considerable influx during the early part of April." In the district of Bustee the disease was more widely spread. The Collector remarks — " Cholera was most severe in the northern part of the district, and this I ascribe to Jung Bahadoor's camp having been attacked by cholera on its return from the plains a few months back, when some of the camp-followers spread the disease to the villages on the Nepal frontier, and from thence it spread into this district. " 

203. No particular history has been received regarding the extent of the 

disease in the other portions of the Benares division, 

The outbreak in Nepal. ? ,ฆ• ? .• . ซ ซ <• -? ? but as the district of Goruckpore lies contiguous to the State of Nepal, the very interesting particulars which have been received from Dr. D. Wright, the Residency Surgeon at Katmandoo, may now conveniently be considered.. From the 19th April to the middle of May a few scattered cases, it appqfirs, occurred at Katmandoo, but no alarm was created. Towards the end of May and beginning of June the disease raged at Goorka, a town about 60 miles to the west of the Nepal valley. Cases then began to occur daily in Katmandoo, and by the 18th June the disease was 



86 

fairly established and continued till the end of September. It is difficult to form a correct estimate of the mortality, but not less than 2,500 deaths are supposed to have taken place. When Sir Jung Bahadoor was in the Terai in the cold season, cholera, as has been already mentioned, broke out in his camp, but before the return of the expedition, the disease had entirely disappeared from his camp, and no cases occurred in the valley at that time. 

204. But although the epidemic does not appear to have been introduced 

at that season, the opinion of the Eesidency Sur- Evidence as to importation. ? . , , z ., ซ, ... . nmT geon on the subject of its after importation is very decided. " I think," he says, " that there can be no doubt that in Nepal, as well as throughout Hindoostan, the cholera was this year introduced by the pilgrims returning from Hurdwar, whose numbers, as will be shown hereafter, must have been upwards of 1,000. At any rate it made its appearance to the westward shortly after the Hurdwar fair in the end of April, and it had reached Goorka in May, whence it was not long in finding its way into the valley of Nepal. The rulers of the country are well aware that the disease is introduced into the country by pilgrims and travellers, and that it is fostered by filth." The following opinion" of the Minister to the Resident is remarkable, as it embraces the views regarding the spread of the disease which are now entertained by the highest sanitary authorities : — " Cholera is a plague sent by God. It spreads by intercourse with pilgrims, traders, &c. It is a catching disease. It does not spread much in clean places, but it spreads much in unclean places." 

205. In the two divisions of Allahabad and Benares no connection can be 

traced between the return of the Hurdwar pilgrims and any increased prevalence of cholera among the 

Cholera in Behar. 

people. In Behar and Lower Bengal, such a connection, therefore, could hardly be looked for. Of the extent of the disease in these provinces, all that can be ascertained is contained in the statistics of the jails and military cantonments they contain. Behar lies on the verge of the endemic area of cholera, if not actually within its limits. In the Patna, Deega, Arrah, and Mozufferpore Jails, cholera prevailed to a considerable extent during 1867. In the first two mentioned prisons the epidemic was severe. The Superintendent, Dr. Jackson, reports that he is " satisfied that the outbreak originated in the jail," and that " there was no direct proof of contagion throughout the outbreak, not a single mehter was attacked, and none of the hospital attendants." 

206. In a few of the jails of Lower Bengal cholera was somewhat 

Unusual immunity of the se vere, but, as a whole, their chief sanitary feature Jails in Lower Bengal. is t.hfi unusual I'mmnnttv from thfl disease which 

is the unusual immunity from the disease which 

they enjoyed. In this group the lowest admission-rate from the disease during the previous eight years had been in 1865, when it was 238 per 1,000. In 1867 the ratio was only 17 9. It is not a little remarkable that both 1861 and 1867, which are distinguished by a comparatively low ratio of mortality from cholera in the Bengal jails, have been market^ by the two most severe and widely spread epidemics of the disease over Northern India of which there is any particular record. In 1860 and 1866, the years immediately preceding these epidemics, the prisoners in Bengal suffered much more than usual. 



87 

207. In the Monghyr district cholera became prevalent in April. 

The history of its appearance in the jail is thus 

Mtnfhy? I jan? iPOrtation int ฐ recorded h7h 7 Dr - Cameron—" The epidemic in the 

jail seemed to have arisen from the admission of 

a prisoner from a part of the district where cholera was prevalent. There was no cholera in the neighbourhood of the station, the prisoner was attacked on the day of his admission, and within a few days the disease appeared in an epidemic form in the jail. It did not spread beyond the walls." This narrative is of particular interest in connexion with the question of establishing a system of quarantine in the Bengal jails. 

208. At Jessore, in March and April, the epidemic was very carefully 

observed by the Civil Surgeon Dr. McLeod, and The epidemic at Jessore. , 

has been fully reported. Out of about 200 persons 

attacked, 60 perished. The meteorological observations show that " the period of appearance and gradual spread of cholera was marked by low barometer, high thermometer, low dew point, small humidity, great evaporation, strong wind and rapid drying up." There was no reason to suppose that the cholera was imported or owed its rise to any other than strictly local causes. " Certain conditions of an insanitary kind prevailing among the Natives, no doubt greatly assist its development among them, principally (a) The close crowded harries in which they live ; these generally consist of a square of houses nearly joining, surrounded by a thick hedge and in most cases buried in jungle, (b) The large quantity of underwood surrounding the houses, (c) The shallow filthy holes and tanks which dry up in the hot weather, and which must emit in that process the most noxious putrefactive emanations, (d) The abominable system of latrines, which consist of a couple of bricks on each side of a hole into which the foeces are deposited, sometimes open and sometimes enclosed by a piece of matting ; these latrines are never disinfected, seldom or never cleansed, and are generally situated between the houses and the enclosing hedge, (c) The bad unfiltered water which is drunk and used for cooking food." Throughout the district there were two epidemics, one in March and April, the other in November and December, the mortality from which must have been considerable. Regarding the origin of the disease, Dr. McLeod observes :—": — " The circumstances of the general outbreak of the disease throughout the district and of particular invasion of villages, go against the theory of contagion. In the former case, the disease sprung up in numerous independent centres simultaneously or nearly so, and in the latter case several members of a family or several houses in a village were attacked, while other members or houses escaped without any precautions whatever being adopted against the spread of the disease. It is difficult to see how in such a case the majority of the population should not succumb to the disease if it is contagious. Besides there was good reason to believe that its severity was materially checked by a heavy fall of rain in April, an event which if it were contagious could hardly happen." 

209. At Pooree the epidemic is specially worthy of notice, because, 

although the disease was brought by pilgrims, it 

ch^ie?a in did nof e spi-ead fr tS does not appear to have spread from them to the disease at Pooree. ,' T ,i in Ku n ซ+ r , rm^ Tv/ro™c,^ซ+^ WQ^™.f a . ซTl^ /lie- 

inhabitants. The Magistrate reports : — " The dis- 



88 

ease never assumed serious proportions. It was brought here by pilgrims from the Gurjat Hill Tracts, who performed their journey to Pooree during an unhealthy season, and who are notorious for their filthy habits, their dirt, their extreme poverty, and utter carelessness about their health. Cholera appeared among them and confined itself almost exclusively to them. Although there were thousands of them in the town, the deaths hardly ever exceeded twenty in a day, and this only for a few days. A very few of the towns-people had the disease, but the number was most trifling. The disease never in this town assumed a serious appearance, and disappeared almost altogether with the pilgrims who brought it. It has now, and some days past, ceased altogether." Pooree is held in peculiar veneration by the Hindoos as the seat of the temple of Juggernauth, and is visited by crowds of pilgrims from all parts of India. The festivals, which are numerous, are thus detailed by the Sub- Assistant Surgeon Uddy Chund Dutt : — 

" Ist. — The Snan and Ruthjuttras for the bathing and car festivals, in June and July, 

" Ind. — The Dolejattra or the swinging festival, in February and March. 

ซ 2,rd. — The Punchock and Kartikam'asee pilgrims., in October and November. 

ซ ktk. — The Mukkursunkrant, about the middle of January. 

" hth. — The Sewrattree Mela at Lokenauth Ghaut, in February. 

ซ 6^, — The Chundunjattra or festival in the Norender Tank, in April. 

" Of all these the Ruth and Dolejattras are most important. The outbreak in the past year occurred in the months of October and November, and was one of the most severe on record. It is important to observe that there was no cholera previous to the arrival of the pilgrims, and that ' the epidemic commenced ten days after the pilgrims commenoed to arrive and four days after the occurrence of cholera on the road to Pooree.' " 

210. The remarks of the Magistrate of Pooree have been extracted from 

opinion based on this a letter addressed by Dr. Mouat, Inspector General 

fact. 

of Prisons Lower Provinces, to the Government of 

Bengal. They are quoted by him, and are made the subject of the following remarks — " The evidence afforded by this communication is extremely interesting, as proceeding from a non- professional observer, who has no theories to uphold, and who simply observes and records facts as they come under his notice. The facts noted are at variance with the conclusions of the Constantinople Conference, that cholera originates at places of pilgrimage, and is extended from those places as great centres of the ' production and propagation of the disease, and that the disease is communicated from man to man by contagion, In this instance, there can be no doubt that the cholera was carried to Pooree, and did not originate at that place, that it was mainly confined to those who brought it with them, and that it did not spread among the many thousands gathered together in the town, as must have been the case had the malady been really contagious." 



89 

211. The question is, however, not so easily disposed of. The evidence of 

Evidence to the contrary. one witness regarding a single epidemic at one 

particular place appears to be hardly sufficient 

basis on which to rest any general conclusion. Nor are facts wanting in regard to this very festival which strongly support the opposite view of the case. " Since the breaking up of this mela," writes Dr. Stewart in his very interesting report on the disease in the neighbouring district of Cuttack, " cholera has marked the track of the pilgrims wherever they went. Every Native acknowledges the fact that pilgrims to or from Pooree carry cholera with them, particularly during the large festivals." "It would appear that pilgrims returning home suffer most and carry most mischief with them." " Pilgrims are a terror to the Native population ; they are known by the red-stained cloth they wear, and are avoided by all who see and know them. Natives fully believe that pilgrims are sources of infection/ 

212. In the appendix to Dr. Stewart's report eight separate cases are given 

Special instances quoted. * n wn iฐ n the disease was attributed to importation 

pilgrims. Of these six may be cited. The 

quotation is long, but the question is too important to admit of any valuable evidence being omitted. "About 10th October thirty persons left Susang Killah, four miles from Cuttack, for Pooree, to be present at the Poornamee or full moon festival for that month. They arrived before the festival came off, and remained three or four days waiting. Before the feast cholera broke out amongst them. The disease was present in Pooree when they arrived ;* many of their numbers dying, they waited no longer, but returned as fast as they could. Cholera followed them. When they reached the ghaut at Dhrosaye, west of Cuttack, there were only eight left. Two were then ill and taken to the village of Dhrosaye, they died and were buried there. Six only arrived at Susang to tell the tale ; of these one died. Susang is a small village and held originally about forty souls. Dhrosaye, the village at the ghaut, holds about 150. Here the disease showed itself; none existed before the two men died and were buried. After this, cholera appeared among them ; eight persons have died. 

" Chassaparrah (another crossing place for pilgrims), here one ferryman and two villagers were attacked, and died. 

"A bearer went with a message from Cuttack to Dhurmsalla, on the Calcutta Trunk Road ; pilgrims were going both ways, chiefly returning ; cholera was amongst tliem. After he returned to Cuttack, he got cholera and died ; his son died the following day, and a neighbour two days after. 

" The instance given by Mr. Goadby is rather striking. He has charge of the Piplee Orphanage. At Piplee the two great roads leading pilgrims from the north and west of Hindoostan meet at this spot. Mr. Goadby has given me the following history of an outbreak which came under his immediate observation. Alluding to the Poornamee festival, which took place about the 13th November 1867, he speaks of pilgrims coming on the Sumbulpore road. He says they began to^ come in large numbers ' about the beginning of October, 

* At variance with the Magistrate's account, but it does not affect the question. 

\ 



90 

and continued to come until the middle of November. Whether they passed through places infested with cholera or not I cannot say. They came chiefly from the Upper and Central Provinces. I cannot say whether it existed in their homes before they left or not. The instance I refer to, which came under my own observation, took place at the end of last month and the beginning of this present month (November) in a village about two miles from the junction of the Khoordah and Pooree roads, the former leading from Sumbulpore and the Central Provinces.^ In the village near which the outbreak took place I have a school belonging to our Mission. No disease existed on the spot previous to the arrival of the pilgrims, nor had there been any outbreak there for the last three years. And three years ago and in every other previous instance, it was during an influx of pilgrims to the Pooree festival. As to when it first appeared I have no information. The facts, as far as I can collect from the school-master, are as follow : — The band of pilgrims reached the above-mentioned school-room situated by the roadside near the village of Bhatapore with cholera amongst them. One or two of their party had previously been left behind, having been attacked by the disease. During the night several more were attacked with such violence that they were unable to proceed. On receiving this information from the school-master, I ordered the school to be closed, as the sick among the party had been laid in the school-room verandah. They remained there for upwards of twelve days, and during that time, among those attacked ten or twelve died. A day or two after their arrival the disease broke out in the village near to which several of their number were repeatedly going to purchase wood, rice, cooking vessels, &c. Among those attacked in this village, half a dozen died. But after the departure of the pilgrims, no other case occurred. No other village in the neighbourhood was visited by cholera, neither has cholera prevailed anywhere excepting in the villages visited by the pilgrims. Up to the above time, as far as we can ascertain, cholera was confined to the pilgrims on their way to Pooree. Instances have, however, since occurred among the returning, as well as the going pilgrims.' 

" Head Constable Soodam Roul was stationed at Tanghy out-post on Calcutta road, ten miles from Cuttack; was there in September and October 1867. Pilgrims commenced to come about 10th October. They were chiefly Bengalees and Ooryas. Por every two or three men there were twenty women. There was no cholera at the time either in the village or amongst the travellers. Nor till they returned from Pooree did cholera appear. The returning meji were seen about 14th or 15th October. Fifteen or sixteen were reported dead in Tanghy out-post up to end of October. The pilgrims said that much cholera prevailed in Pooree at the time. The out-post station was in the centre of the bazar. Cholera cases were very numerous ; sick and dying were carried along in carts, others left on the wayside. This witness was himself attacked with cholera on 6th November and brought into Cuttack, where he had a very narrow escape. 

"A Bundarri (barber) left Jajipore about the beginning of November 1867 for Cuttack. He belonged to Jajipore. Cholera was prevalent on the way to Cuttack. He put up in a bassa or house where rooms are let to travellers. 



91 

Thirty-six hours after arrival in Cuttack, he took ill with cholera and died. A traveller who occupied an adjoining room took ill on the 9th and was carried away from the place by his companions. On the 10th, a prostitute occupying a house opposite took ill and died on the 12th. A cazee lived three houses from the bassa. His wife was attacked with cholera on the 16th and lingered till the 21st. To visit her in sickness two Mussulmanee women came from other parts of the town and remained with her. All three died, the two visitors dying before the cazee's wife." 

213. In Cachar cholera commenced in March and was of a very virulent 

Apparent importation into tv P c - Vv. Barker is of opinion that the disease Cacnar. :Q: Q i-n+vnArtnnH In\r nnnliAo nrvmino' frrvm Dnifilltta for 

is introduced by coolies coming from Calcutta for 

the tea plantations. " That the disease is propagated by human intercourse," he remarks, — " I could advance several instances. That it invariably makes its appearance here after the arrival of batches of coolies amongst whom cholera was prevalent, is also beyond doubt, but it is difficult to show that actual contact had taken place, or was necessary in any of the cases that have come under observation. On the night of the 23rd May 1867, three of the prisoners in this jail were attacked with cholera ; all succumbed within twenty hours. There had been no cholera in or near the station for several weeks prior to this outbreak, with the exception of twelve cases that were admitted into the charitable hospital on the 19th instant from a batch of coolies landed under the Importation Act. On the 20th and 21st several of the prisoners were engaged in burying the fatal cases, and on the 23rd, as stated above, the disease broke out in the jail ; none of the men who were in actual contact with the deceased were affected. Another instance that occurred recently affords some interesting facts. On the 17th January 1868, a wing of the 7th Regiment Native Infantry arrived here in country boats, having had ten deaths from cholera during the voyage from Dacca. The boatmen suffered even to a greater extent. Three days after they landed the disease broke out amongst Mr. Smeal's people, who live within a hundred yards of the ghaut. I have carefully ascertained that seven were attacked and five died. Besides these a vakeel, a court peon, and a boy also succumbed ; they were residing about fifty yards to the west of Mr. Smeal's out-houses. None of those attacked appear to have had direct intercourse with the men of the regiment or boatmen, as they were aware of the existence of the disease, but all were in the habit of drinking the river water which flows towards their houses." 

214. The other districts of Lower Bengal do not call for any special 

remark. General testimony is borne to the fact 

L?wer e ฿engaiฐ ther P&rtS ฐ f that cholera was less prevalent in 1867 than in 

ordinary years, that its appearance was generally 

simultaneous at different parts of the same tract of country, and that any attempt to account for its course, either by the direction of the wind or by communication, in most cases altogether failed. Dr. Wise of Dacca mentions one case of apparent importation of the disease by a person coming from an infected to a previously healthy locality, and another of the same kind is recorded by Dr. Greene of Tipperah. These, however, are quite exceptional, and the general belief of the medical officers appears to be that cholera is due to strictly local causes. 





SECTION 111. THE PREVENTIVE MEASURES ADOPTED AND THE RESULTS OE THE EPIDEMIC. 

215. The nature of the arrangements which were made at the Hurdwar 

Intelligence of the outbreak Fair witn a view to prevent the occurrence of any early telegraphed. enirlp.mi'n rHซPnซA hn.™ ซ.lrpn<W Wn retailed. As 

epidemic disease have already been detailed. As 

soon as it was known that the cholera had unfortunately appeared there, intimation of the fact was telegraphed in every direction without delay. The measures which were adopted to prevent the spread of the disease will now be considered in succession, as they regarded the population generally, the prisoners, and the European troops. 

216. The Government of the Punjab had already provided for such a 

Early instructions issued by contingency. The precautionary instructions which Punjab Government. wprfi \ aanp .A ova fnllv A*t*i]oA in the mnarnl rennrfc 

were issued are fully detailed in the general report 

on the epidemic in that province by Drs. Smith and Dallas. So early as the 13th March a circular order had been issued to the Commissioners of the Delhi, Hissar, Umballa, Jullundur and Lahore Divisions,^directing that, as it was probable large numbers of Hurdwar pilgrims would pass along the more important lines of communication, in the districts of their respective divisions, during the next two months, in places where such pilgrims assemble in large bodies, all practicable measures should be taken for carrying out proper conservancy arrangements, for preventing undue crowding, for maintaining cleanliness, and securing a supply of good food and wholesome water. Commissioners were further to arrange that immediate intimation be conveyed to them of the appearance of epidemic or infectious disease amongst bodies of pilgrims. In the event of such disease appearing, measures were to be taken for preventing the entrance of the disease into towns and cities by the establishment of quarantine, and for providing those attacked with medical assistance. It would be time to warn the districts above Lahore when the stream of pilgrims commenced to flow towards that part of the province. 53 The Government, having heard it reported that cholera had appeared among the pilgrims at Hurdwar before the receipt of the information conveyed by the Seperintendent Dehra Doon, enquired by telegraph, on the 16th April, of the Government North-Western Provinces, whether the report was true, and received next day a reply to the effect that, though the fair had passed off without sickness, after its close cases of cholera had occurred, and that every precaution had been taken to prevent its spreading. alta It was hoped these precautions would be successful. On receipt of this information, the Commissioner of Umballa was by telegraph informed of the circumstance of the disease having appeared, and instructed to take measures to prevent its being introduced into Umballa. On the 18th it was reported that cholera was rife among the pilgrims 

AiJ 



94 

towards Jugadree. On the 19th it was reported to be still severe ; and on the 20th, to be moving forward across the Gugger River. Two deaths had occurred in the cantonments of Umballa among the pilgrims : the deaths were verynumerous. The stream of pilgrims passing upwards was very large : sixty thousand had passed the Gugger Eiver the day before this report. It was now time to take more active measures for the protection of the districts above Umballa and of Lahore. Accordingly, on the 20th, the Government issued a circular order to the Commissioners of Lahore, Umritsur, and Deputy Commissioners of Jullundur and Loodiana. In this order the following instructions, in addition to those circulated on the 13th March, were given. All Hurdwar pilgrims arriving at the bridge- of-boats on the Sutlej at Phillour and Ferozepore, and that over the Beeas at Wuzeer Bhullar, should be stopped on the left bank and examined by medical officers ; all having choleraic symptoms should be detained and treated in temporary hospitals to be formed at those places. Hurdwar pilgrims who had been allowed to pass the Beeas should be again examined a little distance from Umritsur, and any affected with choleraic symptoms detained and treated. District officers were to carry out these arrangements in communication with the Civil Surgeons and Police, and to incur the necessary expense. The Sub- Assistant Surgeons attached to the dispensaries of Jullundur, Ferozepore and Umritsur were to be sent to the several bridges-of-boats above mentioned. Deputy Inspectors General of Hospitals would be applied to for native doctors, for service in the districts of Jullundur, Umritsur, and Ferozepore. Daily reports of the sanitary condition of the pilgrims were to be sent direct to Government. Subsequently it was ordered that pilgrims detained were to beprovided ฆwith wholesome meals gratuitously if they were unable to pay. Copies of these orders were also sent to the districts above Lahore for information and guidance, together with copies of those issued on 13th March. Officers were told of the appearance and gradual approach of cholera, and directed to make their preparations at once. The disease was steadily moving on towards Lahore. Special measures for the protection of that large city and military cantonment had therefore become necessary. Accordingly, on the 23rd, the Commissioner of Umritsur was, by telegraph, instructed to arrange that all Hurdwar pilgrims for Lahore should go by the Grand Trunk Koad and not by train. The Deputy Commissioner of Lahore was directed, in communication with the Civil Surgeon and District Superintendent of Polioe, to take measures at once for forming a temporary hospital at or near " Chubbeel," on the Umritsur road, but not on the ordinary encamping-ground, — for forming a sanitary cordon of Police, chowkeedars, &c, to divert all the Hurdwar pilgrims from entering the city, and placing those who are residents of the city in quarantine outside the cordon. An Assistant Commissioner was to be deputed to carry out these arrangements. Everything was to be held in readiness for carrying out the same arrangements on the Ferozepore road so soon as cholera made its appearance along that route. The Principal of the Medical College was direoted to place a Sub- Assistant Surgeon at the disposal of the Deputy Commissioner. Arrangements were made with the Railway authorities to pass all pilgrims for Mooltan and the stations on that line through, from Umritsur, so as not to allow them to enter Lahore. The Officer Commanding at Meean Meer was addressed, and copies 



95 

of all instructions and reports were forwarded for his information and guidance and it was suggested to him that, for the present, soldiers should be prohibited from wandering in the bazars or vicinity of the bridges-of-boats, and that extra stringency should be enjoined on the sale of spirituous liquors." During the prevalence of cholera in the various districts, the Government forbade the holding of large fairs in such districts. 

217. Maharajah of Cashmere had passed through the Punjab on his 

The camp of Maharajah of pilgrimage to Hurdwar, with a camp nominally of Cashmere diverted. ซ!>ซ„+ n r>nr\ -* u.,i ,• ?^iu,, l^^u, iซ fl vnocn 

about 5,000 strong, but in reality largely in excess 

of that number. His return to his own dominions would necessitate his again (with this large body of followers) passing through the British territory ; a source of considerable danger thus arose. On the 17th April, it was reported by the Civil Officer with the Maharajah, from Saharunpore, that cholera was in His Highness's camp. In consequence he abandoned his idea of going with his entire camp to Puttialla. Instead of this large camp passing up by way of Umballa, the Maharajah was prevailed on to allow the main body to move towards Jummoo, via Roopur and Gurshunkur to Jusrota, — there to be broken up ; the main body to proceed on through the Hoshiarpore district, and away from the Grand Trunk Road ; and an escort, stated to be 300, but in reality 3,000 strong, to proceed with the Maharajah, via Loodiana, Jullundur, and Buttala, to his own kingdom. Eventually the Maharajah gave up marching, and, leaving his camp, proceeded by dak to Buttala, the escort marching up the Grand Trunk Road. They were subjected to quarantine, and their sick treated, at Phillour in the Loodiana, and again in the Jullundur, district.* 

218. The manner in which the general instructions of the Government 

were carried out in different districts need not be detailed. They necessarily varied with the parti- 

Medical arrangements. 

cular circumstances of each, — the geographical features of the country, the relative position of large rivers which offered natural barriers to the advance of travellers, and the ferries and fords over which could be easily guarded, the direction of the main roads and their relation to the larger cities of the district, and to some extent also with the number of the returning pilgrims. The endeavours of the medical and district officers were strenuously directed in the first place to afford relief to the sick. For this purpose the necessary cholera hospitals were established in which those affected were carefully tended and treated, and simple medicines in the form of the well known cholera pills were freely distributed. The camps were visited regularly and frequently by medical officers, and suspicious cases detained. 

219. The second object was to render the return of the pilgrims 

as little dangerous as possible both to their own 

Sanitary arrangements. . , ? ? D ? , ? , homes and those portions ot the country through which they passed. To this end extra conservancy arrangements were made at the halting places. Cordons of police were posted to divert the stream from the larger towns. Quarantine camps were established, in which the pilgrims were detained in some places for 48 hours, in others as long as five days, Before being 



96 

allowed to re-enter their town or village, they were obliged to wash, and their clothes were fumigated. The bodies of the dead were burnt or buried as soon as possible, and the clothes of all persons who had been attacked were destroyed. Food of good quality was provided and supplied gratis to those who were too poor to pay for it. The water supply was carefully supervised, shelter provided, and, in every arrangement that was carried out, ths comfort and convenience of the pilgrims were considered as much as possible. The arrangements generally were under the management both of the medical and district officers, who were indefatigable in the discharge of their difficult and delicate duties. 

220. Nor were the officers in the North-Western Provinces less alive to 

Similar arrangements in the the danger, or less active in doing all that could be North-Western Provinces. done to avert it. In the districts which lie nearer to Hurdwar especially, quarantine, sanitary cordons, cholera hospitals, and general sanitary supervision were had recourse to. It will now be necessary to consider what results are believed to have attended these measures. 

221. The opinions of the civil surgeons are generally to the effect that 

Opinions as to the results of mucil g ood resulted, from them. A few quotations these measures in the Punjab. from their re p O rts will sufficiently illustrate this. At Ferozepore the arrangements are said to have been attended with " very marked success." In Kurnaul city " tolerable success" is reported. The medical officer of Hoshiarpore considers that they were " successful in preventing the spread of the disease." The town of Sirsa is said to have " enjoyed entire immunity from its ravages. This doubtless is owing to the sanitary and precautionary arrangements having been strictly enforced." At Goordaspore there was " great success ; the spread of the epidemic was checked, and the mortality was comparatively small." At Hissar it is said that " the disease would have prevailed more and perhaps assumed a violent type had not timely precautions been employed.'' The Commissioner of Umballa considers that the sanitary cordon was " most effective." Dr. Verchere, in his second report regarding the epidemic in the Jullundur district, writes :—": — " It is worthy of record that none of the principal towns or villages became attacked with cholera to any considerable extent. To all these places orders had been sent by the Deputy Commissioner that quarantine should be established for the returning pilgrims, and the orders were more or less strictly carried out. Imperfect as the arrangements probably were at several places, yet the results were satisfactory. It was to the smaller villages and mouzahs left quite unprotected that the disease was nearly entirely confined." 

222. From the North-Western Provinces opinions to the same effect havo 

opinions from the North been received. The civil surgeon of Budaon Western Provinces. writes. ซ t.hfirp ran hfi no rinnht. t.W +.Via mcAsnre nf 

writes, " there can be no doubt that the measure of 

preventing pilgrims who were not residents passing through the sudder station had the most salutary effect. This accounts for the comparatively few cases that occurred in Budaon city." The Magistrate of Bareilly is of opinion that " the measures taken went a great way in checking the spread of contagion." The civil surgeon of Moradabad states that, "judging from the results the measures 



97 

taken were very successful." Of Roorkee Dr. J. P. Walker says "the preventive arrangements may be fairly credited with the comparative exemption its inhabitants enjoyed." 

223. In other cases even where the disease has not been violent the share 

Doubts expressed as to w^ cn the preventive measures had in attaining this their effects. mmm ,*„ a ™o™ซ ™-uu ซo,,+^ซ T<- ;ซ ™,™™^,i 

result is spoken of with caution. It is supposed 

that they have been attended with good, or it is presumed that without them the course of the epidemic would have been more violent and fatal. In some instances again, testimony borne to the value of quarantine and other sanitary precautions has been subsequently modified by the after progress of events. In Kohtuck, for example, "up to the 27th May no case of cholera had taken place in the town. This immunity, I believe," adds Dr. Dickson, " may be fairly attributed to the measures enforced." Reviewing the events of the epidemic after the year had closed, he is of opinion that the preventive measures were attended with " little or no success." In Mozufferghur and Shahpore quarantine was at first believed to have saved the districts, but afterwards the disease appeared in them both. 

224. To determine how far the preventive measures and the slight prevalence of the disease in certain places stand in the Difficulty of the question. . r relation of cause and effect is a question of very 

great difficulty. There is a natural tendency in the human mind to attribute successful results to the efforts which have been made to attain them, and especially in regard to such a disease as cholera, whose erratic fitful course is so proverbial, it is extremely difficult, if not impossible, in the present state of our knowledge, to say with any accuracy what effect any preventive measures have had upon its progress, and how far after events would have been modified had no such measures been adopted. With reference to the general population of the country no reliable opinion can be formed on such a question, because there are no data regarding previous outbreaks of the disease with which the facts of 1867 can be compared. In considering the nature of cholera and the manner of its spread, the opinions of the medical officers and others which have been quoted on this question cannot be received as evidence, however interesting they are in themselves, and however valuable the grounds on which they are based may become in connection with the events of any future epidemics. 

225. The number of cases of cholera which occurred among the civil population can never be accurately known, but an Mortality among the civil r . . „ , , . ?. ซ , population in the North- approximate estimate of the total mortality from the Western Provinces. -? • ฑi_ xt -_j.i. xxt ฑ t> ? • i.l.^ tป • v 

wesxern provinces. disease North . Western p rov inces, the Punjab and Oude may be formed from the annexed statements. 



98 

Return of deaths from cholera and all diseases in the North- Western Provinces 

for the year 1867. Total. Divisions. Districts. Population. , Cholera. All diseases. r DehraDoon ••• 1,02,831 877 1,035 f ?aharunpore .. 8,66,483 877 12,575 &*• ::': ::: ปฆ &\ ป Total ... - 45,76,539 9,439 59,831 , Muttra •• 8,00,321 773 9,146 A "• 10,28,544 1,438 14,505 M nnnnnV '" "" 7,00,324 678 8,875 AGRA ...\ ฃ nn w P a ฐhฐ rie 6,26,444 120 5 716 I Rtrrackabad '" 9'l9 ' 15 ' 943 611 7,811 I Etah '.'.; ... ... 6,14,351 1,402 5,946 Total ... ... 46,85,927 5,022 51,999 r Biinour . . 6,90,975 78 4 12,883 I Moradlbad '" '" 10,94,969 4 ,249 20,454 J Budaon '." B'B8 ' 89 ' 810 796 11,392 HOHIICT7ND ...>! RareX "' 14,70,359 7) 828 22,484 [gUป; ::: :::_ 9 t^ 7 'S5 ซfe Total ... ... 51,71,894 22,060 83,591 f Allahabad 13,93,183 492 8,731 Banda .. ... 727 ' 24 ' 372 2,534 11,718 I Cawnpore ... 11,88,862 1,816 13,542 AIIAHABAD ...^ Futtehnore '" .. 1,81,284 7],2 8,572 Jounpore "' ... - 5,57,937 262 6,715 I Humeerpore .'.: ... ... 525 ' 20 ' 941 223 3,443 Total... ... 45,66,579 6,039 52,721 r Mirzapore ... 10,54,329 365 8,093 Benares " ... 7,06,442 ฃ02 7,065 Azimgurh " I ... 13,85,872 872 6,701 BENARBS 'ฆ< Ghazeepore !! ... 13,42,234 1,380 9,662 Goruckpore '.'.. .. 19,83,816 4,440 11,151 I Bustee 14,55,697 4,781 5,338 Total 79,28,390 12,340 48,010 r Jhansie .. ... ... 3,57,774 ... 3,020 JhanSlE . < Jaloun ... ... ... 4,05,272 20 2,078 I Lullutpore ... ... 2,48,146 ... 4,051 Total ... ... 10,11,192 20 9,149 f Kumaon .. ... 3,85,790 1,612 3,327 KUMAOK - \ GurLwal ... ... 2,48,742 616 3,155 Total 6,34,532 2,228 6,482 Ajmebe ... Ajmere and Mhairwarah ... ... 4,26,268 376 4,465 Total ... ... 4,26,268 376 4,465 Grand Total ... ... 2,90,01,321 57,524 3,16,248 



99 

226. The following statement, which shows the deaths from the disease in 

Deaths from cholera in the the Punjab, has been supplied by the Sanitary Corn- Punjab, -missioner. T)r. De฿enzv :—: — 

missioner, Dr. De฿enzy :—: — 

rtement shewing the estimated mortality from cholera in the districts of the Punjab during the year 1867. 

fe xt r> Supposed popu- Deaths „ Name of Districts. lation from hem arks. Cholera. 1 Ambala ... ... ... 10,35,488 2,617 2 Umritsur ... ... ... 10,81,161 3,561 3 Bannu ... ... ... 2,87,547 632 4 Delhi ... ... ... 6,08,850 1,321 5 Dera Ghazi Khan ... ... 3,08,840 857 6 Dera Ismael Khan ... ... 3,94,864 232 'S a 7 Ferozepore ... ... ... 5,49,253 2,185 8 Gujeran walla... ... ... 5,50,576 1,624 9 Gujerat ... ... ... 6,16,347 433 "fL s 10 Gurdaspore ... ... ... 6,55,362 269 U Gurgaon ... ... ... 6,96,495 3,148 J 12 Hazara ... ... ... 3,67,218 1,565 ซ 13 Hissar ... ... ... 4,84,681 3,265 14 Hoshiarpore ... ... ... 9,38,890 875 15 Jullundhur ... ... ... 7,94,764 739 fc s 16 Jhelum ... ... ... 5,00,988 857 ซ 17 Jhung ... ... ... 3,48,027 103 18 Khangra ... ... ... 7,27,148 1,802 to 19 Kurnaul ... ... ... 6,10,927 1,652 20 Kohat ... ... ... 1,40,209 1,176 21 Lahore ... ... ... 7,88,902 2,095 g 22 Ludianah ... ... ... 5,83,245 1,538 #aj 23 Montgomery... ... ... 3,59,437 498 24 Muzufferghur... ... ... 2,95,547 1,144 J 25 Mooltan ... ... ... 4,71,509 616 26 Peshawur ... ... ... 5,23,152 1,909 27 Rawulpindi ... ... ... 7,11,256 2,722 Jg 28 Rhotak ... ... ... 5,36,959 1,066 % 29 Shahpore ... ... ... 3,68,796 621 30 Simla ... ... ... 33,995 283 3 31 Sirsa ... ... ... 2,10,795 1,077 I* 32 Sealkote ... ... ... 10,05,004 664 Total ... ... 175,86,232 43,146 



100 

227. The returns from Oude show that, in the different districts the DeathsfromcholerainOude. deaths from cholera durin & 1867 haVG been aS 

follow : — 

Statement shewing the deaths from cholera in each of the districts of Oude 

during the year 1867. 

Supposed population. 

Deaths from Cholera. 

DISTBICTS. 

Lucknow ... ... .- 6,30,259 2,468 Luckimpore ... ... ... ••• •• 7,31,661 12 Gonda ... ... ... ... ... ป. 7,50,000 2,513 Fyzabad ... ... ... ... .-• 10,38,195 2,339 Baraitch ... 5,70,778 3,383 Sooltanpore ... ... ... ... — 4,33,016 76 Koy฿areilly ... ... ... ... - 6,76,249 231 Pertabghur ... ... ... ... .-• 7,24,739 42 Hurdui ... ... ... ... ... ... 9,09,984 364 Seetapore ... ... ... ... - 7,43,235 319 Kheree ... ... ... ... ... 5,27,390 4,764 Total ... 77,35,506 16,511 

228. When the epidemic was prevailing an attempt was made in 

many of the districts to ascertain ] Returns of cases incorrect. -, ? , . , ? , c deaths but also the number or 

not only the 

cases that 

occurred, but the very marked disproportion which is exhibited in different parts of the country in regard to the ratio of mortality shows how unreliable these returns are. Again, both in the North-Western Provinces and the Punjab not a few cases are entered in every month of the year, and for that reason the monthly statement of mortality has not been considered in the history of the epidemic. Every disease which is attended with sickness or violent purging is apt to be returned as cholera. 

229. The North- Western Provinces' statement shows a mortality of 

Total mortality among the 57,524 from cholera. The Punjab return gives people. .o -i a a j,, o j.i. a f~ nrn +u~ an ™a. ?.,ฆฆ,..,. TK Q *v.™.+oi;+™ 

p p ' 43,146 deaths from the same cause. The mortality in the three provinces stands thus :—: — 

NorthWestern Provinces ... ... ... ... 57,524 Punjab ... ... ... ... ... 43,146 Oude ... ... ... ... ... 16,511 

Total ... 117,181 



101 

Giving a grand total of 117,181 persons amongst the ordinary population of Upper India who lost their lives from cholera in 1867. The ratio of deaths to population in the different provinces according to the figures given was in the North -Western Provinces I*9 per 1,000, in Oude 2*4, and in the Punjab also 2"4. The returns cannot be regarded as strictly correct, and in India a good census is wanting, but they contain a fair approximation to the truth. The death-rate to those treated among Natives may be safely taken at about 50 per cent., and on this calculation the number of persons attacked must have exceeded 230,000. 

230. Among the preventive measures adopted in the jails of the Upper Pro- 

Measures adopted in the vinces, a modified quarantine has been imposed on all J a " s ป ! mi i • c _J1 : *•„„*. 

new prisoners. The system is confessedly imperfect, 

because a perfect quarantine is almost impossible, and also because suitable buildings have not yet been provided for carrying it out. But, imperfect as it is, most excellent results have attended its institution, and several instances have occurred in which jails have escaped epidemic visitations for the first time in the course of several years, by preventing the introduction of contagious disease. When cholera was known to be abroad particular attention was devoted to rendering quarantine as stringent as the imperfect means which existed would allow. 

231. In only one instance during the late epidemic has a genuine ease 

Testimony to the value of of cholera occurred in the quarantine ward of a quarantine in jails. . ป rp,- _ , TT _ Um n- in,~ t,ซj :.,ซ.* 

jail. This was at Umballa. The man had just 

been received from Simla ; he was immediately isolated, and proper means of disinfection used. In the Lahore Jail two cases of choleraic diarrhoea were discovered in the quarantine quarter, and if recent opinions are correct a person suffering from choleraic diarrhoea is as dangerous an arrival as a person suffering from cholera. The Inspector General of Prisons in the Punjab is of opinion that the benefit of isolation as a preventive to the extension of the disease amongst the prisoners has been " instanced in cases of the jails generally throughout the province and remarkably in the Central Jail at Lahore." 

232. Considering the extent to which the disease prevailed among the free 

Comparative immunity of population, the comparative immunity which the the jails. nriermova oniiwprl is vpr v r Arrm rlrn hi a Tn flifi Nnvtll- 

prisoners enjoyed is very remarkable. In the North - 

Western Provinces, out of thirty-six jails only eleven were attacked, and of these only two, Allahabad and Shajehanpore, suffered with any severity. In four others out of the eleven only one solitary case occurred in each. No less than twenty-five escaped entirely, and many of these, such as Meerut, Benares and others, were large prisons in the centre of an infected population. In the Punjab, out of twenty-nine jails, eight were attacked, but in two of these the disease was trifling ; twenty-one escaped entirely. Out of eleven jails in Oude, six suffered, but excepting at Seetapore the cases in each were few. 

233. In 1861, out of an average strength of 17,393 prisoners in the North- Comparison of the jails in Western Provinces, 524 died of cholera, or a ratio of 

1861 and 1867. 

30-1 per 1,000. In 1867, the mortality from the 

disease has been 31 out of a daily population of 16,034, or I*9 per 1,000. In the 



102 

Punjab in the year 1861, out of 11,185 prisoners 65 died of cholera, the disease being confined to the four jails of Rohtuck, Delhi, Umballa and Thanessur. In 1867 there were 41 deaths from cholera out of an average strength of 10,506. Two facts, however, prevent a fair comparison being drawn between the results of the epidemics of 1861 and 1867 among the prisoners in the Upper Provinces. The former year was one of famine and distress, and many were admitted into jail after having suffered great privation. On the other hand, the epidemic of 1861 was confined to a smaller area than that of 1867. Cholera in the former year did not extend beyond Lahore, and resumed its progress upwards in the year following. In estimating the comparative results of the two visitations these points must be kept in remembrance. 

234 The comparative sickness and mortality from cholera in the several 

Cholera in the jails from J ails in tne -Bengal Presidency, arranged according 1859 to 1867. to the g roups gi yen i n j) r> Bryden's Tables between the years 1859 and 1867, are shown in the following statement :—: — Statement shewing the admissions and deaths per 1,000 from cholera among the prisoners in the Jails of the Bengal Presidency from 1859 to 1867. V j.._ Bengal Proper „ Dinapore j^pore and Agra, Meerut t, n - oli Total of Ben- IEAE - and Assam. Jjg^J Central India, and Koliilcund. Pun J ab - gal Presidency. Admitted. Died. Admitted. Died. Admitted. Died. Admitted. Died. Admitted. Died. Admitted. Died. 1859 40-G 18-95 24-5 12-55 1-0 -21 2-0 0 01 0 18-4 8-58 1360 84-5 38-29 47-3 2O'S2 38-0 IG-0G 107-9 230 0-1 0 577 21-60 18G1 340 13-21 32-1 11-S4 5-5 2-3G 92-2 40-85 9-2 4-43 3G-5 15-21 1862 28-9 9-94 3-2 -79 11-9 4-70 4-0 1-99 22-8 8-98 15-2 5-52 18G3 53-2 20-15 SG-4 2394 25-8 10-05 14-3 5-72 0 0 35-8 14-33 J864 45-4 17-31 25-5 8-80 28-5 11-56 0-1 0 0-1 -10 22-9 8-5G 23-8 10-15 120 4-59 51-1 2739 5-5 2-86 0-5 -19 15-8 7*19 3S6G G2-2 29-48 243 8-25 20-2 11-50 0-1 -13 0 0 272 12-10 18G7 17-9 7-58 13-4 5-73 07 -23 G-l 176 7-2 390 11-5 4-93 235. The remarkable fluctuations in the same groups in different Tll . years may be better illustrated by the annexed Illustrated by a diagram. v . . J . ? diagram, in which the ratios are conveniently 230. There are several striking facts which are prominently illustrated by 

Points illustrated by the a diagram. There is the persistent high deathdiagram. . a o — , , . ? „ . . „_ 

rate from cholera in the first group ranging from 

7-58 in 1867 to 38-29 in 1860. On the other hand, there is the very variable death-rate in the Upper Provinces, ranging in the case of the Meerut group from an almost total absence of the disease in 1564 and 1866 to 107 admis- 



Per 1000 of Average* Strength* งง%.งงงฆs?& 8 5? $ ง '^ I I Jletujal Proper and jZanj fe^^^^^^^^^^WH|t|M 111 1 111 1 1 iTTj [|j|jjj|||[||| | | 1 1 1 1 [ | j | | | | | , |||i[j|||||||| j | | ' | p | I | y j | | j S Migjiore and Central bulia, |j | Agra; Meerut>anjl Rohilenrui, PPLL ' " Q Driiapore, Benares, (hide/ __JHlB^^^B^tlilTH gagiBgaa฿ ' ggg ''''"'" """ "~ 7 *ฆฆ * Agra Meerul.and RchilcuncL, j^^^^^^^^^^^^^^^^^^^i^^i^i^^ii^iiiiiiiiii฿iiis฿igg Eass^ssss^iaiai฿฿. ฆ ฆฆป..ฆ.-- ป-~Z i!-ปZ ZZIIZ lir~ tfagpore arul CeniraZ Irtcbuis, r-rฆ - - ฆ r ----- r— * mi ฆ -mmiii - 1 i him ฆ n ฆ i—^^H 1| | : iJ fi [ j I j Bengal Proper duel, Assam, flfipPpP"'"'* I Dinapore, Benares Ovules, mv II CC Nagpore and Central IndzJjuj gggjjgpga*i-- Agrw, Meerivt, anM. RohCLaAMtl, B| j 'Bengal Proper and Assam, 1 1 g p p I iiiiiii^iiiiSSSS^SSS::::=:i:::" = T--" r-r --- -— Xagpon. and Cmiral Indies, HBH ฆ-ฆซ<—:• 5 Agra, Meerui, and/ RoTuLawsl,^^fe jaaป-— -- H ~lfa^e arul Central ;^j฿l| jlJSl?* l^ 5 iS^T" "^ Agni; Meerwts a*uL J฿jjhzfavtndj \\ - "^ Agrcu,Meerwt > anrf ftdhJlmrul, ""^ Agraj, MewiU? and Roh Ucurt //> Fj| J ฆ Di'rmpom฿exsireSsOMl^ giissas^-^* ~ i CO Mtgport, and l Central Xruha^ W\ i *4gra*J/eeriifsamฃ Rohzlciui at, SB """' , 

Diagram ilbistrajhhg the comparative Pnvaknee ofiarid MorfxiUly from Cholera uv the Several |^ eral groups of Jails* in Ike Berujai Pnwtldmg; from 1859 to 1867. 





103 

sions per 1,000 in 1860, and 41 deaths per 1,000 in 1861, when there was so great a scarcity in Northern India. Again, and this is a very remarkable fact ; the epidemics which spread over the North- West both in 1861 and 1867 were preceded by an unusual prevalence of cholera in the jails of the Lower Provinces during the years immediately previous, while in 1861 and 1867, when the disease was so rife in the Upper Provinces, the mortality among the prisoners in Bengal was in the former year considerably below the average, and in the latter the deaths from this cause were at a minimum. Still more remarkable and encouraging is it that, at a time when the pestilence was causing such havoc among the free population of Upper India, the prisoners, owing, we may hope in some measure at least, to the precautions which were adopted, and to the improved sanitary circumstances in which they were placed, suffered less than in any previous year of which there is any record. 

237. The results in the jails of Upper India during 1867 are certainly 

very satisfactory. It may be an open question how 

jaufhfise?^ resultB in the far they are to be attributed to quarantine and how 

far to the great advances which have been made of 

late years in general sanitary arrangements. The value of the latter certainly is very great, but quarantine has also proved of signal service in preventing the access of other diseases, and it is of great practical importance that its influence in warding off cholera should be further tested. 

238. Before proceeding to detail the measures of precaution which were 

adopted as regards the troops and the results of 

cholera in the European and the great epidemic of 1867 among them, it will be Native Armies in previous .... , .ฆ, ? , , ? , ? years. instructive to consider the extent to which the 

disease has prevailed both in the European and 

Native Armies in previous years. The sickness and mortality among European troops in the Bengal Presidency between the years 1818 and 1846-47, have been arranged in quinquennial periods by Dr. Ewart.* From 1847-48 to 

1853-54 the annual results have been tabulated by Dr. Hugh Macpherson.f Por the other years the details are supplied by Dr. Bryden. The information derived from all these sources is embodied in the following table :—: — Statement shewing the admissions and deaths from cholera among European Troops in the Bengal Presidency from 1818 to 1867. Ratio pee 1,000 Periods. Strength. Admissions. Deaths. Admissions. Deaths. For five years periods. 1818 to 1822 ... ... 47,017 ],018 272 21-6 57 1823 to 1827 ... ... 54,168 2,005 625 37-0 11-5 1828 to 1832 ... ... 62,800 2,495 544 397 86 1833 to 1837 ... ... 57,549 1,561 420 27-1 72 1838 to 1842 ... ... 68,238 2,406 855 35-2 125 1843 to 1846-47 ... 87,086 2,599 1,177 29-8 13"5 * Vital Statistics of the European and Native Armies in India. t Analysis of the late Medical Returns of European Troops serving in the Bengal Presidency. 



104 

Statement shewing the admissions and deaths from cholera among European Troops in the Bengal Presidency from 1818 to 1867— (continued.) Ratio pek 1,000. Periods. Strength. Admissions. Deaths. Admissions. Deaths. | Annually. 1847-48 ... ... 18,228 262 89 14-3 4'B 1848-49 ... 16,235 377 110 23-3 67 1849-50 ... ... 18,524 507 234 27-3 12-6 1850-51 ... ... 21,063 23 8 I*o9 0-3 1851-52 ... ... 20,710 168 61 8-1 2-9 1852-53 ... ... 20,865 708 260 33-9 12-4 1853-54 ... ... 21,505 423 258 19*6 11-9 1854-55 ... ... 20,046 92 47 4-6 2*85 1855-56 ... ... 19,885 100 55 55 2-77 1856-57 ... ... 21,304 1,313 704 81:6 33-05 1858 ... ... 43,771 738 401 3 68 9-16 1859 ... ... 55,104 924 478 16.8 8-G7 1860 ... ... 48,901 1,106 589 226 1204 1861 ... ... 44,879 1,663 1,065 37-1 2373 1862 ... ... 42,980 674 413 15-7 961 1863 ... ... 41,351 225 169 5-5 4-09 1864 ... ... 40,385 148 103 37 255 1865 ... ... 37,210 160 116 4-3 3-12 1866 ... ... 35,013 80 48 2-3 1*37 1867 ... ... 34,603 722 479 209 13-84 From this table it appears that the highest annual ratio both of admissions and deaths from cholera among European troops during the past 20 years was reached in 1856, and the second highest in 1861 ; next comes the year 1852-53, then 1849-50, then 1848-49, and then 1867. 

239. These results are more strikingly exhibited in the following Results illustrated by a diagram which embraces the 20 years between 

diagram. 

1847-48 and 1867. The statistics before that period 

hare not been entered as there is no separate record of them for each year. 

210. Since Dr. Bryden's valuable tables commenced, more details are 

available, and information regarding the relative prevalence of cholera in different portions of the 

Details since 1859 

country can be obtained. Taking both European and Native troops together from 1861 to 1867, the relative prevalence and fatality of the disease are traced in different colored lines in the annexed diagram. 

241. The points specially illustrated by this diagram are sufficiently 

obvious. In the first two groups cholera almost 

diaฐram illustrated by the always contributes considerably to the death-rate 

among Europeans. The admission and death rates 

from cholera in the first, second and third groups during 1867 afford a very remarkable contrast to the wide-spread virulence of the disease among British soldiers in the garrisons of Northern India during that year. In the other 



I" "If I IZZT lZ ----- 6ฃ_ ZT~~ ZZ~"Z!!ZZZZ IEzZZZZZZZIZZZZZZZIZZZZZZZZZZZZZZ - 60 60 ฆ 1 Z ~ ~ ~"~" — zzzzzzzzzzzzzzz: —— g$ pt) _ — _ . _ — — — ซฆ I ————"— — — -~ ฆ"*"" "~" "" "' mm ~~~ mm ~~ ~~~ ' lI^I~ZIZZZ_I__ '. ' — - 50 !ป * i;'.i s ii'siง ง i s ง s 1 1 1 1 Jto jl iil 5 i tIซ2? $ ! $5?.% .8 5 5 ซ J| Duujm/H t/> ittn*trat4ป thf comparative ratios <f Admission, and Jke&ui % fhfm/ 

CkoUras nmonif Mrttiih Tr<wps tป theJ Bengal Plvn&mqr (hirmy th*/ twenty 

rears frorrp 18^-^8 to 18GX 



ftrtOOOof Average, Jtrongth, 8 fi fe '' ft *a t* * ?* fe ป ft I I It .... I .... ii i ฆฆฆฆฆ.— r^ Ox ' S^ V> | < Mtvipmr. #eiuire*,<mj.oude> \V\^ ~ I I I 5? I s X fJbm 9M789 M78 €oui ' Meerut, %> -****- *&&&*&&*& 1 j JJJrEr: :Hr|l lIIIIIIIIIII IZIIIIZZII J* Dmsipone. Benares, fuui '-Ond/-; .J^'Bgarr -4— ZjZ.l | ._._ H..J , ง Ommpore cuul Mwitt ป =:ilg= | <l pp i p ::= TT — — U-4-- 1 1 X Agra/ cuuL> Central In dm/, Kffllff * B '__ _ — j i^ fl/suip<)re<,J฿<w/tre#, and* thidf. y-V W^n^'"' 3 \^~ 1 : (lm>npore and- Meerttfy # zzisn ฆ*ฆฆฆฆ me g > % rm Agra an// CtwtraL ฆ ft-rrha, ':g: g ฆfff^^T J *^ $ "S Dmapore,/?en<ireSjOcide+ — iyi — Ijbhii^Aa- 11 ZL s > >, Meerid' and? JldhzlcujtcU —iMr- hh **s •^ Agra ftnds Ckntni/ Iridiiy *$ V Dzruiporej, Benares, ottdes "f'.g OTTT^ i > v .JfcervU l and ', RoJulamds, -I WH — H H ง A<jra <mA (tyUralt fwduh* ~fs— m^^ffl&Sa % \J>maporr,Jtt>nare<s. Oadej j~^j~ WfT" -4- — f- H — H~ I H 1 1 1 ' ฆ""! ' n 5 I <z/?^ Caw*tpore> 7 ;|^ |P| J ; . I Meerut and /to^uZciuiiL, - ~t m\ JJJ J Acjru an/t Cenb*al frubji, iy |p|~ | 7" ~J?uvapore. JBenares,, On (let -ฃ%- '- \nrr~r} - J ~^ MIIIIIIII 1 1 I 1 1 1 l" 4' | | ซ Mena- and- JUhOewd, I fffWfW J - J, 7 ,n and- OnlntL fndiiy rfel^ff — T I M """1111111111 - - ฆ— If-- 



105 

groups the disease fluctuates between almost total absence and an intensityunknown even within its endemic limits, the admission rate per 1,000 ranging from less than one to upwards of sixty. Another point worthy of notice is that in these severe epidemic visitations, the Native troops have, as a rule, suffered comparatively little, while in the first group the admissions and deaths from lolera have been almost invariably higher among them than among the uropeans. In the latter respect the comparison is open to the fallacy that le stations occupied by the two are not always the same, but as regards the mmunity observed in Upper India this disturbing element exists to a very light degree. It will be seen hereafter how remarkable this immunity has )een even in cases when the epidemic has been most virulent among British ldiers at the same stations. 

242. The special measures for the prevention of cholera among European 

troops in India, which were promulgated by His Special measures for the _ „ ? _ . .ซ,.*. n r\ c prevention of cholera among Excellency the Conimander-in-Chiei in (i. U. 01 European troops the 7th April 1862, were founded on the recommendations of the Cholera Commission of 1861. Slight modifications have since from time to time been instituted, but the general principles remain the same that the great safeguard against the spread of the disease is early removal from the infected locality, and that, in spite of any unfavorable condition of the weather, the move into camp must be made at the shortest notice on the appearance of the disease in an epidemic form. "To obviate the possibility of this most important measure being improperly delayed by any peculiar views regarding the epidemic character of the disease, it must be ordered that if within one week after the first case of cholera two or more other cases occur, it shall be considered that the disease has assumed an epidemic form, and the men must be removed accordingly." This quotation is taken from the 479 th para, of the 3rd Section of the Cholera Commission Report, which was somewhat modified by the Sanitary Commission for Bengal and circulated for general guidance under the orders of the Government. The rules were in force when the outbreak of 1867 took place, and it will now be necessary to examine the results which attended their being carried out. 

243. Particulars of what occurred in each station which was visited by 

Isxamination of the resuita the epidemic have been in a great measure anticieach station. -nafprl in n. TVPfivirme sspnf.i rปn nf fill a TJpnnvf • Hi if. if. 

pated in a previous section of this Eeport ; but it 

111 be necessary to examine them now with special reference to going int mp, and to the actual sickness and mortality which occurred ; to compar 3 results of the epidemic of 1867 with those of 1861 ; to ascertain, as fa possible, to what extent these results have been affected by the differen Dcedure adopted in the two years ; how far the spread of cholera was prevent , and how far the prevalence of any other diseases may have been favora the exposure of Europeans, men, women and children, under canvas in th ttest season of a tropical climate. 

244. It would be tedious to criticise the particular movements which 

tder in which the stations were made by each separate body of men who be considered. went into fiamn in oonspnnpnrปp, of thp. armparanee 

went into camp in consequence of the appearance 

of cholera. Much, doubtless, depends on the manner in which arrangements 

d 2 



106 

of this nature are actually carried out ; but it will, as a general rule, be assumed that the moving into camp was conducted exactly according to the instructions of the Cholera Commission, and in such a manner as was calculated to secure the most favorable results. In recording the sickness and mortality which attended the epidemic among the troops, it will be convenient for the purposes of comparison to consider the stations in four groups ; — Ist, those attacked in 1867 which were also attacked in 1861 ; — 2ndly, those attacked in 1867 which were not attacked in 1861 ; — Srdly, those which escaped in 1867 but which suffered in 1861 ; and, Uhly, those which escaped in both epidemics. 

245. The stations which suffered in both the great epidemics of 1861 

stations attacked both in and 186 7 were seventeen in number. The follow-1867 and 1861. j n^ statement exhibits what occurred among the European garrisons in each epidemic, women and children not included : — Comparative Statement sheicing the results in those Stations which were attacked in the great epidemics of 1861 and 1867. 1861. 1867. Ratio peb Batio peb STATIONS. .„„,„„„ Number of Number of I'ooo1 ' 000 - Avor-im. Number of Number of lfio ฐ R A 2J admissions deaths from . | afrlS admissions deaths from .1 3 Strength. frQm cholol . a _ cholera. 8 3 stren S th - from Cholera. Cholera. g 5 "3 Q O I P Fyzabad 1,114 5 1 887 3 2 Lucknow 2,215 9 3 ... ... 2,535 11 6 ... ... Allahabad 1,277 32 21 958 28 18 Cawnpore 1,230 48 35 ... ... 691 3 2 Bareilly 1,188 4 5 805 3 2 Moradabad 459 2 2 299 7 5 Meerut 2,535 118 87 1,579 123 111 Delhi 1,127 84 50 351 1 1 Muttra 347 19 4 412 1 1 Morar 1,106 210 152 868 15 10 Gwalior Fort. 244 8 7 219 8 4 Umballa 1,820 71 53 1,329 29 21 Jullundur ... ... 1,015 1 ... 788 12 9 Ferozepore 889 4 1 773 16 8 MeanMeer 1,700 725 450 1,030 86 52 Lahore Fort 149 46 29 140 4 2 Govindghur 481 50 41 138 1 1 Total ... 18,896 1,436 941 75-9 49-7 13,802 351 255 25"5 18-4 246. The results of 1867, in these stations, have generally been very much more favorable than those of 1861. In none of Generally favorable results xi !• •ป*• j. t i j.i a. -j.i v of 1867 in these stations. them, excepting m Meerut, did the rate either oi admissions or deaths during the past year reach the fearfully high figures to which they attained in the former outbreak. 

The fearful mortality which occurred at Meean Meer and Morar in 1861 found 



107 

no parallel at thos6 stations in lob 7 • An lbol the ratio ol admissions iroin cholera at these seventeen stations was 75*9 per 1,000, and of deaths 49*7. Iv 1867 the ratios were 25*5 and 18*4. These results are very favorable. Had the death-rate from cholera in these stations been at the same ratio in 1867 as it had been in 1861, the loss of life, instead of having been only 255, would have amounted to a total of 687, or more than double of what actually occurred. Looking only at results, there has, in other words, been a saving of 432 lives. 

247. The results in Meerut were certainly unfavorable. The disease 

The case of Meerut an ex- ere was very severe, but its extreme severity was Ception. mnfinwl tn tliA 1 -Sri TlnflPc TTia rmr+.imilaro of 

confined to the l-3d Buffs. The particulars of 

admissions and deaths in the different corps composing the garrison at this 

station are shown in the following statement : — Admitted. Discharged. Died. CORPS. „, , Choleraic „, , Choleraic Choleraic. Cholera. Diarrhoea. Cholera. Dia rrha3a. Cholera. Diarrhoea R. A.— Men ... 4 1 ... ... 4 1 „ Children ... 5 ... ... ... 5 19th Hussars — Men ... 1 ... ... 1 „ Women ... 1 ... ... ... 1 3rd Buffs— Officers ... 1 ... ... ... 1 „ Men ... 106 11 4 8 102 3 „ Women ... 14 3 2 3 12 Children ... 25 2 5 2 20 Total ... 157 17 11 13 146 24*8. The sanitary and prophylactic measures which were adopted at Sanitary measures adopted Meerut are thus detailed by the Deputy Inspector General of Hospitals, Dr. Huntly Gordon—" As soon as possible after the epidemic declared itself, 800 men were removed from the infected range of barracks; the bungalows were fumigated with nitrous acid, thoroughly cleansed and whitewashed ; the latrines and drains were 

purified ; disinfectants in the form of McDougall's Powder freely used ; the men were warned of the danger of neglecting any slight diarrhoea, and invited to apply at once for medicine, which was always kept in readiness, — this they did in large numbers ; medical inspections were held twice a day, and tents were pitched near the hospital, where all sickly-looking men were kept under observation. All who were observed going frequently to the latrines were at once taken to hospital ; non-commissioned officers and camp-police were told off to watch ; boxes of astringent pills were given to non-commissioned officers for issue ; any one applying more than once to be taken to hospital. Particular pains were taken to ensure the men wearing their flannel belts ; the camp-police were ordered to prevent the introduction of any vegetables or fruits into the camp by Natives. The issue of beer was stopped for a time, as it became thick and shaken up by frequent moves ; subsequently the supply was carefully strained into fresh casks, and sent out to the camp daily by the Commissariat. An early cup of tea or coffee was given. In moving into or changing encampments, every thing was done both as regarded a liberal 



108 

allowance of transport, and the short distances marched, to reduce fatigue to a minimum ; extra charcoal was issued, so that the drinking water should be boiled ; and in a doubtful case as regarded the well water, a daily supply for drinking purposes was sent out by the Commissariat. Filters were used in camp ; cots were used, eight for an ordinary, four for a hospital tent ; extra tents were set apart for the use of cholera patients. Disinfectants were freely used, especially in connection with the excreta of the sick, which were promptly removed and buried in a trench. The latrines were carefully attended to. The clothes and bedding of infected persons burned." " Perhaps, it may be said or thought," writes Dr. Beatson in his general report on the Epidemic, " that the arrangements for the camping out of the Buffs were not as judicious as they might have been. There can be no more unfounded supposition. I have had the fullest evidence to the contrary; both from previous correspondence as well as more lately from personal communication with the Military and Medical authorities at Meerut. I feel bound to put on record that I believe no regiment could have been more earnestly watched and more judiciously handled during its severe trial." 

249. And yet, in spite of all the precautions taken, the results were most 

unfortunate, the loss of life most lamentable. The 

buffs^nkn^n^^ 11^ 111 * 116 disease was as virulent in the other arms of the 

service at Meerut as in the Infantry. Every case 

which occurred in the Artillery and Hussars proved fatal, and yet it did not spread among them to any extent. In the Artillery there were only nine cases and in the Hussars two ; in the Infantry 146. "Why it clung so persistently to the Buffs and caused such terrible sickness and mortality is a mystery which in the present state of our knowledge cannot be solved. 

250. The next group of stations embraces those which were attacked in the epidemic of the past year but escaped in whShescaped^nftef 1867 1861. The particulars regarding them are thus detailed :—: — Statement shewing the Stations attacked in 1867 which escaped in 1861. 1867. 1861. *ฐj "S | Ratio pkb 1,000. | "So oS Ratio pee 1,000. STATIONS. j= fci Sฃ _• j5 g* 121 2 . 11l Cases. Deaths. g Iป . |.s| Cases. Deaths. 03 5 .a ฆqp <ซ ซซ ฃ5 Mteeee Depot and Family Camp ... 316 7 3 j 229 Nowsheea ... ... ... 730 5 2 805 Peshawue ... ... ... 1,754 274 163 ... ... 1,955 2* Shajehanpoee ... ... ... 472 24 19 525 Seetapoee ... ... ... 574 8 6 628 Subathoo ... ... ... 751 40 19 | 1,019 Kfssowlie ฆ•• ••• ••• 32 ? 1 1 223 Total ... ... ?. 4,954 359 213 72-4 42-9 15,384 ... • • Two cases are entered as hnvmsr occurred at Peshawur In 1961, one in June and one in September ; neither was fatal. Peshawur wai 

outside the area of the epidemic of that year. 



109 

251. But although none of these stations suffered in 1861, excepting 

two cases at Peshawur referred to in the foot- 

sSSSdS iBeฃ d PeBhawur note, both Nowshera and Peshawur were attack- 

Ed by epidemic cholera in 1862, and the loss of 

life from the disease in the last station was severe. Out of a strength of 1,970 European soldiers 168 were admitted and 97 died. The disease appeared in the months of July, August, September, October and November. It was most severe in the 93rd Highlanders. An excellent account of the epidemic is to be found in the Army Medical Department Reports for that year by Dr. Munro, the Surgeon of the Regiment. 

252. In the epidemic, of 1867, the Highland Regiment, which formed Epidemic in the 42nd P art of the garrison, again suffered most. Out of a Highlanders. strength of 765, including men, women and children, 129 were attacked and 72 died within the short space of twelve days. The daily admissions and deaths from the disease are shown in the following diagram : — 

DIAGRAM 

TO ILLUSTRATE THE DAILY ADMISSIONS AND DEATHS IN 

H. M. 42 R HIGHLANDERS AT PESHAWUR. 

E2 



110 

The outbreak was very sharp, but compared with what occurred in different regiments in 1861, it was of short continuance. In Her Majesty's 51st Regiment for example, which suffered so severely at Meean Meer in that year, the epidemic lasted from the sth of August to the 16th of September, or a period of 42 days. In Her Majesty's 94th Regiment at the same station it continued from the 13th August to the 14th of September, or a period of 33 days. 

253. The Return B. appended to Dr. Beatson's Report shows that the 

Particulars regarding the 42nd moved into cam P in three detachments,— five 42nd Regiment wanting. companies on the 21st and the remaining portions of the Regiment on the 23rd and 24th. It is of the greatest importance to know how many of the cases were admitted from each of these bodies and how many cases had occurred in each before it left cantonments. But these details are not now procurable, as the Regiment has left India. 

254. In the 77th Regiment the first man was seized on the 21st of May 

The 77th Regiment and about UA ' M *> and tlie last On the 24th June " Royal Artillery. T ne disease thus clung to the Regiment for more than a month, but the sickness and mortality were little more than one-half what they were during the short but sharp attack from which the 42nd Highlanders suffered. In the Artillery the disease was very severe. In one of the Batteries (E — 19 R. A.) the deaths to strength were in the ratio of 12 "19 per cent ; all the four Batteries suffered more or less severely. 

255. The following statement, prepared by the Deputy Inspector General 

of Hospitals, shows the admissions and deaths in 

Comparison of admissions , _T , . , _ . . , _ . .. and deaths in the European each Regiment and Battery at Pesnawur during Garrison, Peshawur. ? ? 

the epidemic : — Statement shewing Hip. admissions and deaths from cholera in each Regiment and Battery of European Soldiers at Peshawur in 1867. STBEI> ' "hcmen"! C 0M ' Admissions. Deaths. lUtio *n cekt. REGIMENT AND BATTERY. a . . a . a Deaths to deaths te a . | | J . g I I . ง ง | Stre^ A i m nt E. Bat., F. Brig., R. H. A. ... 132 5 13 19 26 1 14 1 10-60 53-84 F. „ F. „ R. H. A. ?. 127 3 16 22 16 ... 11 8-66 6875 E. „ 19th „ li. A. ... 123 4 13 16 29 15 ... 12-19 51-72 4 „ 22nd „ R. A. ... 58 3 7 13 6 ... 1 ... 5 ... 1 ... 862 83-33 42nd Highlanders ... ... 674 21 27 43 124 2 3 5 68 1 1 4 1008 64-83 77th Regiment ... ... 857 28 23 33 74 1 1 2 50 1 1 2 5-83 67-58 Total ... 1,971 j64 99 146 275 3 5 8 163 2 3 7 8-26 8018 * This strength differs from that given in the Tables at paras. 250 and 281. In the first of these the strength taken is the average strength for the year, and that is the basis of calculating ratios of admissions and deaths where comparisons between the results of 1861 and 1867 are made as it is the basis taken in Dr. Bryden's Tables. In the second the strength is the strength of the month of May. In the above Table it will be observed that the strength taken by the Deputy Inspector General of Hospitals is that of the commencement of the epidemic. Any apparent diarepancies as regards the statistics of other stations are similarly accounted for. 



111 

256. No direct connection can be traced between this severe outbreak at Peshawur and the return of the pilgrims. The No direct connection trace- i, ? able between the epidemic great body 01 them appears to have reached on the and the pilgrims. OQ ,, A ., n ? , ? , n^.- „. , „„ i ?, , 

28th April. On the 1 lth of May, as has been already 

stated, there was one solitary case in the city, and none others were reported there till the 22nd and 23rd, when the disease became general. On the 2nd of June 80 persons are said to have died, and this was the highest mortality reached on any one day. It is stated, however, that on the 19th May, the day prior to that on which cholera broke out in the European garrison, the pilgrims for Jellalabad passed through the district on their return to their homes. The facts connected with the first appearance of cholera in the city of Peshawur, and the discrepancy in the statements connected with its history, have already been discussed. 

257. The European troops in five stations which were attacked by 

cholera in 1861 altogether escaped the disease 

Stations attacked in 1861 { n 1867. Agra was the scene of one of the which escaped in 1867. D 

severest outbreaks in 1861. Out of 1,153 men 

109 were seized and 67 died; among 80 women there were 7 cases and 2 deaths, and among 107 children, 5 cases and 4 deaths. During 1867, out of a 

strength of 967 soldiers, not a single man suffered from the disease. The immunity of the European garrison at Agra, surrounded as it was by cholera on all sides, is very remarkable. Statement sharing the Stations attacked in 1861 which escaped in 1867. 1861. 1867. STATIONS. j J Ratio per 1,000. . j Ratio per 1,000. t 18 I t II I ง uo I Cases . Deaths . g B ?- 1 Cases. Deaths- Futtehghur ... ... 434 11 5 268 Nagode ... ... 203 1 0 203 Roorkee ... ... 588 1 1 360 Agra ... ... 1,220 114 69 967 Sealkote 1,494 1 1,262 Total ... 3,939 128 75 324 190 3,060 Nagode, Roorkee and Sealkote hardly suffered even in 1861, nor was cholera very prevalent among the European garrison of Tuttehghur in that 



112 

258. The only stations within the epidemic areas in which the European 

soldiers entirely escaped cholera both in 1861 and 

boto a l iO Se^ics Ch escaped in 1867 were Roy Bareilly, Nynee Tal, Landour, 

Phillour, Dugshaie, Mooltan, Dera-Ismael-Khan, 

Kangra, Rawul Pindee, Campbellpore, Attock, and Sealkote. It is to be observed, however, that in several of them a few cases occurred among the women and children, as will afterwards be shown. 

259. Before proceeding to consider other particulars, it will be advisable to trace the extent of the disease among European European troops in 1861 ?. , ?ฆฆ,• , , ? ? , and 1867 in parts not visited soldiers quartered m those cantonments which do by the epidemics. ?. ?, . + , nnmi ~>A W +i,ซ ~~SAA~>i~ ~c 

not lie within the area covered by the epidemic of 

1867, and to compare the facts with those of the same localities in 1861. The following comparative statement has been prepared from Dr. Bryden's Tables :— 

Statement shewing the results of 1861 and 1867 in those Stations which were not within the epidemic area of either. 1861. 1867. I j, B y.s B ,r- 1 j i "s-s^ BTATIONS. o 2 .g ; 1 rf J3 _ tl, &" |S m - 'ฆJ 6 0 ฃ fc " Q 5 !ง & J | Fort William ... 1,056 18 9 7 39 3 2 Dum-Dum... ... 803 11 4 472 1 l Barrackpore ... 1,141 13 6 357 1 1 Chinsurah Depdt ... 204 2 2 ot 4 2 Hazareebaugh ... 846 3 0 876 1 1 Dinapore ... ... 783 3 2 907 1 1 Benares and Eajghaut... 897 4 4 595 none Jhansie ... ... 623 608 Nowgong ... ... 240 193 Saugor ... ... 860 657 Jubbulpore ... 861 1 634 It will be observed that there was a greater proportion of cholera among the European troops in these stations in 1861 than there was in 1867, though even in the former the disease cannot be said to have been prevalent. 260. The comparison between the extent and fatality of cholera among Cholera among Native Native troops at the same stations in 1861 and troops in 1861 and 1867. 1867 cannot be made fa &g have not been particularized in Dr. Bryden's Tables for the earlier year. Some information can, however, be supplied from the Report of the Cholera 

Commission of 1861 and that has been embodied in the following general 



113 

table in which the statistics of the disease in 1867 as given by Dr. Bryden have also been entered :—: — 

Statement shewing the results among Native Troops in 1861 and 1867. 1861. 1807. — — | — 5 Ratio per 1,000 ฃ | Ratio per 1,000 I Is S | g ; STATIONS. ta | j ง I I I I I ฆ* TTi MeeanMeer ... ' 665 41 20 ... 1,3-24 13 5 Umritsur ... ... 213 13 11 144 1 1 Umballa ... ... 720 4 2 937 6 3 Delhi ... ... 1,175 28 9 618 1 1 Meerufc ... ... 623 4 2 888 Agra ... ... 662 15 5 703 1 Morar ... ... 1,372 1,694 3 2 Total ... 5,430 105 48 19-3 8-8 6,308 25 12 39 I*9 Erom this table it will be seen that, excepting Morar, the Native troops at all the stations suffered very much more in 1861 than they suffered in 1867. As a whole, the admissions were 193 per 1,000 in 18fll and the deaths B*B. In 1867 the ratios were only 39. and I*9. 261. In common with the European soldiers the Native troops were Native troops attacked in attacked in several of the stations of the Upper 

1867 at stations which did t>--u- 1.1,1 i-i ฑ a? j not suffer in 1861. Punjab in which they had not suffered 

in 1861. 

Indeed the epidemic among them was more severe here than anywhere else. The details will be found in the general table given in the Appendix, but it may be mentioned that at Peshawur there were 63 cases and 27 deaths, and in the frontier stations 86 cases, of which 39 proved fatal. 

262. There is a slight discrepancy between the figures given in Dr. Bryden' s General results of the epi- Tables and those which are appended to Inspector 

domic among British sol- General Be atson's report. According to the former there were altogether 722 cases of cholera among the European troops in the Bengal Presidency in 1867, of which 479 proved fatal, or a ratio of 20 f 9 of admissions and 13-84 of deaths per 1,000 of average strength. In 1861 the cases were 1,663 and the deaths 1,065, the ratios to strength being 371 and 237 per 1,000. 

263. According to Dr. Beatson's return the total sickness and mortality . „. amonป officers, men, women, and children belon";- Total mortality among men, " =ป ' ' a 

women, and children. m g to the European army of the Bengal Presidency during 1867, were as follows :—: — 

Admissions. Deaths. 

Officers ... ... ... 13 9 Men ... ... ... 719 . 463 Women ... ... ... 87 56 Children ... ... ... 104 83 

Total ... 923 617 

f:J 



114 

The strength of these different classes is not separately shown in his tables, and the comparative prevalence and fatality of the disease amongst them cannot therefore be deduced from them. 

264. Such have been the results in the army during 1867 as compared 

Effects of going into camp **<& those of 1861 ' Xt has been shoWn that COn COnon the spread of cholera. fini™ the*. Tiistnvips nf flip t,wn vftars to those 

fining the histories of the two years to those 

stations which were attacked in both, the comparison tells largely in favor of the former. It is important to learn how far these results can with justice be attributed to the moving into camp. At the outset it must be admitted that the question is one of very great difficulty. Instances have occurred in all epidemics of cholera in which the troops attacked by the disease never left their barracks and yet did not suffer, and it may fairly be argued that no decided conclusion can be drawn as to what would have occurred if those regiments which went into camp had never left cantonments. On the other hand, there is the strong fact that the epidemic affected the general population of the country to an extent certainly as great, if not greater, than that of 1861, and that such a violent and wide-spread diffusion of the disease was to all appearance fraught with as much danger to the European troops as had ever previously been known. 

2G5. It will, however, be necessary to examine this important question 

more in detail, and to learn the opinion of the 

enSy 'd^peared tnfl medical officers as regards the results of the movemoval into camp. ments which were made on the outbreak of the disease. In the return B which accompanies the special report on the cholera of 1867 by the late Inspector General, Her Majesty's British Troops, a statement is given with a view to show the effect of moving into camp, but it is difficult to learn from it with any clearness what actually took place. In the following cases it would appear that the disease altogether disappeared on removal into camp, no further case having occurred :—: — 

Statement shewing those cases in ichich Cholera entirely disappeared on moving into Camp. 

No. 

Sliitions 

Regiment, Battery, or Detachment. 

I 2 

Meean Meer Ditto 

B. A, R. H. A. Y. 19, R. A. 

Snbathoo 

Detachment of 90th Regiment which moved to Solon. 4 Batteries of Artillery moved and 2 cases only occurred. It is 

ฆ> 

4 

Meerut \ Ditto V . 

r> 

r, 

not shown in which of them they appeared, but two at least must have escaped altogether. 

6 

Seetapore 

Man'ied families and one Company. 37th Regiment. 

7 

Bareiuy 

8 

Morar Ditto 

R. H. A. 

9 

E. 11th R. A. 

10 i I 

Gwalior 

Detachment 103 rd Regiment Married families. 

Ditto Fort . Allahabad Ditto 

[2 

R. A. 

In twelve 

instances 

In twelve instances regarding which there is no doubt the disease disappeared coincident with the movement in camp. 



115 

C. Leaving the infected locality may not always be attended with which no fresh sei- immediate benefit and yet may be productive of 

zures occurred after third day. gOOg 00( j t r^ per i 0( i o f the incubation of cholera has not yet been ascertained, but assuming that the disease may remain latent for three days, it will be fair to attribute any cases, which occur within that period after removal, to the locality from which the detachment came, and those cases in which no fresh seizures occurred after the lapse of that time may fairly be considered as favorable. Under this head the following movements may be classed : — 

Statement shewing the cases in which no fresh seizures occurred after the third day in Qamp. 

No. Stations. 1 Subathoo 2 Peshawur 3 Meean Meer ... 4 Ditto 5 Moradabad 6 Morar 

Ferozepore 

7 

Ditto 

8 

Eegiment, Battery, or Detachment. 

Detachment which marched to Barraloghee had only two cases. 

Hospitals 77th Regiment, two cases, one on second and one on 

third day. 

Detachment 106 th Regiment to Ummursiddoo, one case on first day. 

Detachment ditto, to Hullokee, two cases on second day. 

Families 36th Regiment, two cases, one on first and one on second day. 

103 rd Regiment only one case of choleraic diarrhoea. 

Detachment l-sth Regiment. 

Ditto. 

In 20 cases, favorable. 

therefore 

, the results of moving into camp were decidedly 

267. In spite of removal into camp the Royal Artillery, 42nd and 77th Regiments which suffered Regiments at Peshawur, the 106 th at Meean Meer, 

severely in spite of moving. the at Meerut, the 107 th Regiment at Allahabad, and the 36th at Shajehanpore, all suffered more or less severely. Excepting these corps, however, the disease was generally slight. Instances have been given in which the epidemic ceased with going into camp. On the other hand there were several cases during the late outbreak in which no movement was considered necessary and in which nevertheless the disease did not spread. Doctor Beatson's table shows that this occurred in the Artillery and Hussars at Umballah, in the Artillery, Lancers and two Infantry Regiments at Lucknow, and in the 1-llth at Fyzabad. 

I^6B. Although the evidence is thus conflicting and perplexing in its 

details, the only conclusion which can be legitimate- 

gSteZwS?™ 11 ™ 10 * aS re " ly from the results of 1861 and 1867, is in 

favor of an early removal from the infected quarter 



116 

as tnc DGst prGVGntivG measure yet Known lor arresting tne spread 01 me disease. Although in some cases the epidemic was not checked, and the losses sustained were very heavy, the ratios of admissions and deaths in the latter year when the disease was much more widely spread, compare very favorably with those of 1861. In 1861 the admissions from cholera were 371 and the deaths 2373 per 1,000. In 1867 the admissions were 209 and the deaths 1384. If the comparison be confined to the stations attacked in both years, and this is the fairest mode of comparison, the results are much more striking. The only marked difference in the management of the two epidemics consists in the fact, that in the one case moving into camp on the appearance of cholera was the exception, and in the other the rule. 

269. But it has been argued that even if moving into camp be the best 

After-results of moving into means of checking the progress of cholera among camp. "Fliirnnflan troons. thfi nnmiifir of rtanfhs from sun. 

European troops, the number of deaths from sun- 

stroke, fever, and other diseases, which is thereby occasioned, more than counterbalances any good that may be derived. In this manner during 1867 the 103 rd Regiment at Morar and l-sth at Ferozepore lost several men from sunstroke, and the prevalence of fever in the 77th Regiment at Peshawur was believed to be due to previous exposure under canvas. It is remarkable that in not a few cases the general health of the men has really benefited by the change. In 1865 for example, in the month of- August, when the troops at Saugor moved into camp on account of cholera, Brigadier General Travers brought to notice " the much improved general health of the men (of the 97th) since they have been under canvas." He also stated that " the general health of the Royal Artillery had much improved in camp." In August 1863 when one wing of the 23rd Regiment moved into camp from Agra, Dr. John Murray reports that there were only 66 per cent, of sickness in it during the following five months, whilst there was 101 per cent, in the other half of the regiment which had remained in cantonments. 

270. The effects of moving into camp can only be fairly judged by 

After-results of moving into comparing the subsequent sickness among reg camp in 1867. ments which went under canvass, with the result in those which never left the station. In those few cases, in which part of corps moved, while the other part remained in barracks, the comparison can b made with even greater accuracy. The whole of the statistics on this impor tant question have been very carefully analyzed by Dr. John Murray, Inspecto General of Hospitals, and the following particulars are extracted from hi valuable report. 

271. At Umballa, Lahore and Meerut a portion of the European garrison went into camp and a portion remained Results in which portion • nani , nnvnavi + B rm_ „.,,ซ. _ A . , 

only of thegarrison moved in cantonments. The subsequent sickness among 

the two is shown in the annexed table. 



117 

Statement shewing the subsequent admissions in the Garrisons of Umballa, Lahore, and Meerut, part of which remained in Cantonments and part removed into Camp. Subsequent admissions pee 1,000 in the pobtion Stations CorDS Months on which the admis' P ฆ Which re- Which went sions are taken. mamed in into Camp . Cantonments. Umballa ... | R< H^j^ lst } 454 ... September and October. Ditto ... ... 94th ' 276 Ditto. Lahore ... {(tari-WJ 698 ... D;tto . Meean Meer ... R. A. ... ' ... 375 Ditto. Ditto ... ... 106 th Regt. ... 936 Ditto. Meerut ... ... 19th Hussars 427 ... Sept., October & November. Ditto ... ... R. A 356 Ditto. Ditto ... ... i_3d Regt. ... 547 Ditto. At Umballa the results are decidedly in favor of the Regiment which went into camp. At Meean Meer the subsequent sickness among the Artillerywas very slight. In the 106 th it was heavy ; the admissions were in a higher proportion than they were during the same months, September and October, in the garrison of the fort which never moved out. The result is all the more unfavorable, because the statistics of former years show that the admissions 

among the garrison of the fort have always been higher than those among the troops in the cantonment of Meean Meer. Still, if any very serious increase of sickness had been due to the mere moving into camp, it is natural to expect that the Artillery would have suffered. At Meerut the Artillery which went into camp had less sickness than the Hussars, which did not move. Among the Buffs the results were not so favorable. In three out of the five instances given in the table, the subsequent sickness among those who went into camp was less than among those who remained under shelter of their quarters. 

272. The results at Peshawur at first sight appear to be very unfavorable. 

The Royal Artillery and 77th Regiment had both been in cholera camps. Between the Ist June 

Results at Peshawur. 

and Ist November, the Artillery out of a strength of 344 had 563 admissions, and the 77th out of 520 had 1,025. It is to be observed, however, that the 42nd, which had also been in camp in May, but which moved to a neighbouring hill called Cherat, instead of returning to Peshawur, did not suffer. Out of 566 only 258 were admitted into hospital, and the men suffered very slightly from the fever which was so prevalent in the other Regiments. It is but fair, therefore, to ascribe the sickness not to camp, but to influences which were afterwards at work, and the climate of Peshawur in the end of the rains is quite sufficient to account for what occurred. This view of the case is moreover borne out by the fact that at this season, as has so frequently happened at Peshawur in other years, the Native Troops suffered severely from fever, and they had not as a body been exposed in camp. Indeed, it is remarkable that the detachments of Native Corps which had been on duty at the 



118 

cholera camps suffered less than the men who had never left cantonments. Excepting the 77th and Artillery at Peshawur, the 106 th at Meean Meer, and the l-3d at Meerut, no Corps which moved into camp on account of cholera appears to have afterwards suffered from unusual sickness, and excepting the cases of sunstroke which occurred in the l-sth and the 103 rd Regiments, evidence is wanting to show that the sickness which subsequently occurred was due in any great degree to exposure under canvas. 

273. At eight stations Native troops were moved into camp on the 

Good results of moving a PP earance of cholera, viz., at Deolee, Kohat, Native troops into Camp. Bunnoo, Ferozepore, Attock, Shajehanpore, Allahabad, and Moradabad. At the first of these places the benefit derived was very decided. "The move of the troops and followers into camp," remarks Dr. Crawford, "had thus at once a most marked and beneficial effect in cutting short the epidemic, and on referring to the tables of the comparative sickness from fevers, &c. for July and August 1866 and 1867, it will be seen that as far at least as the 2nd Bengal Cavalry was concerned, it was in no way injurious, nor was there any increase in the average number of admissions from fever and bowel complaints in consequence, as might have been anticipated from a move into camp at such a season of the year." Again, he says : "It will be seen that there were three distinct waves of the epidemic, that each of these invaded a fresh section of the inhabitants, and that the third which invaded us on the 20th July was cut short by the move of the troops into camp on the 22nd." Of the movement at Umballah Dr. Homan states that it was made " apparently with great benefit." Particulars of the other movements have not been given in the Annual Regimental Reports, but the favorable results in every case are in themselves the best evidence that the procedure was attended with success. 

274. In the following jails also during 1867 prisoners were removed into 

Good results in checking Cam P in Order to ehe ฐ k the S P read ฐ f cholera the disease among prisoners. Dhurmsala, Seetapore, Allahabad, Shajehanpor Goojranwallah, Eawul Pindee, and the Lahore Female Penitentiary. As whole, the results were very satisfactory. In none of the jails did the diseas spread with any great virulence except at Seetapore. Pull details of the outbrea here and of the influence of the movement into camp are wanting. Th remark of the Civil Surgeon, Dr. Ellis, with reference to quarantine, may b here quoted. " The only disease," he states, " that occurred during the year in which the beneficial effects of quarantine might have been expected to appea was cholera, but in that disease the quarantine of new arrivals seemed t exercise no influence." 

275. The benefit of leaving a locality infected by cholera is strikingly 

illustrated in the following narative which has been 

Benefit of moving illustrat- t i i tv tt . ? ซ. .i n ,™. Ed at Shajehanpore? supplied by Dr. Harris, the Civil Surgeon at Shaje- 

hanpore :—": — " In an orphanage the disease appeared 

in certain huts detached from the other buildings. As soon as possible all the healthy boys were removed into tents, leaving only the diseased boys in the infected quarter, but a storm coming on a day or two after, the healthy boys 



119 

were removed back into the infected yard, in which one or two immediately fell victims to the disease ; the remaining healthy ones were then again immediately removed into tents, upon which the disease a second time at once disappeared." 

276. The opinions of the medical officers as to the effect of moving 

naturally vary with the result of their experiences 

effect™? moving? 8 ฐ n the during the late epidemic. Dr. Summers, the De- 

puty Inspector General of Hospitals at Peshawur, 

writes, that "the result of encamping out of troops at this station affected with epidemic cholera has been unusually disappointing." Dr. Jephson, the Deputy Inspector General at Lahore, expresses his opinion that "the expediency of a move from cantonments immediately on the appearance of cholera in the cold or hot weather, if the men have local temporary barracks, similar to the ones round the station of Meean Meer, to get to, cannot, I think, be questioned, but in such a fearfully hot and trying climate as that of this division in May, June, July, or August, I think moving about in tents would in many cases be attended with a greater amount of mortality from sunstroke or other diseases than keeping men in barracks and pitching tents close to the barracks for the men to sleep in, and so preventing overcrowding and admit of a barrack being fumigated and limewashed if necessary. The l-sth Fusiliers lost the same number of men from sunstroke as they did from cholera, and in the 106 th 12 men died of sunstroke, and only 47 of cholera, although the corps was a very short time under canvas." Dr. Munro, Deputy Inspector General of Hospitals at Umballah, considers that the movement of troops into camp in his division was attended with good results. Speaking of the after-experience of the 94th Regiment, he says : " This Regiment has been remarkably healthy while in camp ; it did not suffer in the least from exposure to solar influence, though the Thermometer stood at 112ฐ in the tents." Dr. Menzies, the Superintending Surgeon Major, Gwalior Circle, states that the march of the 103 rd Regiment " had the effect of completely arresting the disease." Dr. Innes, Deputy Inspector General of Hospitals, Lucknow, remarks that " the results of moving into camp throughout his circle were, as a rule, most satisfactory. The only instance of an opposite character is found in the history of the detachment of Her Majesty's 36th Regiment at Shajehanpore, to which for a number of successive marches the disease clung with a tenacity altogether unaccountable." 

277. The difference in the results of moving two separate detachments 

of Her Majesty's 36th Regiment at Shajehanpore 

iu E frvofof e eari y ?emovaL POre has already been noticed. Dr. Ball's opinion on the 

value of early removal is thus recorded : " One fact, 

however, stands prominently forward in the above melancholy history. The head quarters were comparatively exempt from the disease, and the mortality correspondingly trivial. In the detachment the disease was virulent and the mortality excessive. The two bodies of men had been exposed to precisely the same influences, in the same locality, in the same sanitary conditions, and under circumstances not only similar and analogous, but nearly absolutely 



120 

the general hygienic arrangements to account for so remarkable a difference, nor a priori is it probable that foci of disease should have been repeatedly pitched upon, notwithstanding every care and anxiety in one case and avoided in the other. But there was one important difference in the conditions to which these parties were subjected ; one marched out of the infected locality on the appearance of the disease, the other from unavoidable causes was detained in it nearly a week." A portion of this statement has already been quoted in the second section of this Report, but the evidence has a very important bearing on the question of moving into camp, and the passage has therefore been here extracted in full. 

278. It has already been shown that the epidemic of 1867 was much 

more wide-spread than that of 1861; that it 

epidemics of^se^and 186*?.ฐ extended from Allahabad to Peshawur and along 

the frontier, while the disease in the previous year 

with a south-eastern limit somewhat similarly denned had not travelled beyond Lahore. It has been further shown that in spite of having covered so much larger an area the epidemic of 1867 proved much less fatal among European troops, than that of the former year. There is another point of marked difference between the two outbreaks, and that is, that the visitation of last year commenced in many places much earlier in the season. Taking the stations which were attacked in both years, the results are as follow :—: — 

Comparative Statement shewing the season of the year during which the epidemics of 1861 and 1867 prevailed. 1861 * 1867. STATION Date of first case Date of first ease among European Date of last case, among European Date of last case. Troops. Troops. Meean Meer ... ... 6th Augt. ... 23rd Sept. ... 27th June ... 2nd Sept. Govindghur Fort ... ... 11th Sept. ... 14th Sept. ... 4th Aug. ... 15th Sept. Umballa ... ... ... 29th July ... 4th Sept. ... 2nd May ... 25th Sept. Delhi ... ... ... 4th July ... Ist Aug. ... 25th April ... 25th April. Meerut ... ... ?, Bth July ... 7th Aug. ... 15th Aug. ... 6th October. Moradabad ... ... ... 2nd Augt. ... 14th Aug. ... 28th July ... 21st Aug. Bareilly ... ... ... 23rd Augt. ... 24th Sept. ... 10th May ... 26th Aug. Muttra ... ... ... 16th July ... 9th Aug. ... 14th May ... 14th May. Morar ... ... ... 22nd July ... 20th Aug. ... 12th Aug. ... 15th Sept. GwaliorFort ... ... ... 25tb July ... 21st Aug. ... 19th July ... 15th ditto. Cawnpore ... ... ... 2nd April... 23rd Aug. ... 13th May ... 15th ditto. Allahabad ... ... ... 19th May ... 6th Aug. ... 28th July ... 24th Aug. 279. The comparative prevalence and fatality of cholera among the different arms of the service during 1867, will he choiSa irtie^fffeJent^nnsJ seen from the annexed Tahle. In order to make 

the comparison fair, only those corps have been 

• The dates for 1861 have heen taken from the Report of the Cholera Commission of that year, and those for 1867 

from Dr. Beatson's Report. 



121 

Dr. Beatson's Return A, but as the strength of men, women, and children is not separately stated, although the admissions and deaths from cholera are given for each class, it will be necessary to compare the results of all taken together. Table shewing the comparative Sickness and Mortality from Cholera in the different Arms of the Service. ARTILLERY. CAVALRY. INFANTRY. Numbers. Numbkhs. K*^™ Numbeps. ""i^™" STATION. _____ ' _ ' ฆฃ id ฆ ฆo . • w v (S <ง n 02 o a o J ' SoooO Peshawur .., 534 76 45 ... 1,500 212 129 Fort Lahore ... 72 4 2 ... j 103 1 1 MeeanMeer ... 470 8 4 ... ... 772 88 54 Ferozepore ... 163 14 3 ... ... 888 16 12 Umballah ... 120 1 1 465 5 3 722 29 22 , Meerut ... 553 9 9 505 2 2 963 155 133 Morar ... 474 7 6 69 4 n 5 Cawnpore ... 157 2 2 ... 667 8 6 Allahabad ... 267 5 4 I ... 842 32 20 Bareilly ... 169 2 | ... 878 6 5 Lucknow ... 356 2 2 i 606 4 4 2,152 13 7 Total 3,335 130 78 389 23-3 1,576 11 9 69 57 10,181571 394 560 387 The Cavalry have escaped in a remarkable degree, and, as a rule, the Artil lery have suffered much less than the Infantry. The Cholera Commission of 1861, in commenting on the unduly high proportion in which the Infantry suffered, observed that, if the returns for Meean Meer and Morar in which there had been great mismanagement were omitted, the disproportion also in a great measure disappeared, and the ratios in which the different arms 

of the service were attacked became nearly the same. " There is no reason to suppose", they observe, "that the men of any one branch of the service were more generally liable to the attack of cholera during the late epidemic than those of any other branch. Any slight apparent differences which remain against the Infantry may probably be accounted for by the fact that their numbers were greater." However the differences may be explained or accounted for, there is no doubt that the Infantry suffered more in the epidemic of 1867 than the Artillery, and very much more than the Cavalry. 

280. There are no statistics to show the comparative prevalence of the Comparative prevalence disease among Officers and Non-Commissioned 

among Officers and men. 

Officers, as compared with the rank and file. Among 

the first there was 13 cases and 9 deaths, but the strength is not recorded, while the cases among the Non-Commissioned Officers are returned along with those among the Privates. 



122 

EBl. The following very complete table, which has been prepared by Dr. Bryden, illustrates the comparative prevalence parative prevalence J A i m-, men, women, and o f the disease among men, women, and cnildn. 'ement shewing the comparative prevalence and fatality of epidemic Cholera among European soldiers, women and children in 1867. I STRENGTH OF MAY NUMBER OP ADMISSIONS AND I ADMITTED PER 1,000. DIED PER 1,000. 1867. DEATHS- Men. Women. Childben. STATION. „ -• T3 ฃ _lli*, i ! _ i I I | ซ |_|__s__l s_ J__a_ ____! * Fyzabad ... 922 115 215 3 2 3 2 2 2 ป3 261 93 217 17-39 9-30 Lucknow ... 2,558 243 402 11 6 5 4 4 3 4-3 20-6 99 2-35 16-46 7-44 Seetapore ... 576 55 95 8 6 4 3 3 3 l^ 72.7 316 10-42 54-55 31-58 Allahabad ... 984 103 160 28 18 3 1 5 5 28-4 29-1 31-2 18-29 971 31-25 Cawnpore ... 768 81 152 3 2 3 3 3 2 39 37-0 19"7 260 3704 13-16 Shahjehanpore ... 46 6 51 85 24 19 1 1 1 1 51<5 W6 n ' 8 40 " 77 19>61 1176 Bareilly ... 803 87 124 3 2 4 3 1 1 3-7 46-0 8-1 2-49 3-48 8-06 Moradabad ... 307 30 55 7 5 10 5 8 6 228 333-3 145-5 16-28 166-66 109-09 Meerut ... 1,655 193 296 124 112 18 11 28 22 7*9 932 94-6 67"67 57-00 74-33 Delhi ... 354 30 36 1 1 2>B 2 8 2 Muttra ... 405 29 50 1 1 2 5 2 4 7 Morar ... 867 97 165 15 10 5 5 17"3 ... 30-3 11-53 ... 30-30 Gwalior Citadel ... 220 39 70 8 4 1 1 4 3 364 257 57-1 18-18 25.64 42-86 Umballa ... 1,325 68 126 29 22 3 3 219 441 ... 16-60 4412 ... Kussowlie ... 334 26 53 1 1 5 3 3-0 ... _ 5 - 0 3-00 ... B*oo Subathoo ... 792 48 72 40 19 5 1 10 8 50-5 104-2 138-9 24-00 20-83 111-11 Jullundur ... 792 67 107 12 9 3 3 4 3 151 44-8 37-4 11-36 44-78 28-04 Ferozepore ... 829 96 107 16 8 8 5 3 2 193 833 280 9-64 52-08 18-70 Sealkote ... 1,306 98 184 2 2 ••• 204 ... ... 20-41 ... Dhurmsalla ... 109 1 2 11 9 2 9 ' lB Umritsur ... 136 4 4 11 ••• ••• 7*4 735 Fort Lahore ... 164 7 9 4 2 1 1 24-2 ... 1111 12-20 ... lUli MeeanMeer ... 1,132 91 186 86 52 5 3 2 2 76-0 55-0 10-8 45-94 32-97 -0-75 Rawul Pindee ... 1,346 159 234 5 2 18 13 ... 31-5 76-9 ... 12-58 55-56 Murree^and Family „ f ?,,-.,. .4 ..4 2 5-l 28-2 27-8 10-75 28-17 2778 Nowshera ... 788 54 89 5 2 6-3 2-54 ... Peshawar 1,755 117 174 1 274 163 5 3 9 7 156-1 42-7 51-7 92-88 25-64 40-23 Agra ... 974 102 137 1 1 I o ' o - • 9>B ฐ " Total ... 22,946 2,162 3,529 712~ 471~ In" 59 120 96 310 42-0 34-0 20-5 27-2 27"2 It will be observed that at the stations of Sealkote, Rawul Pindee, and Agra, in which the men entirely escaped the disease, their wives and children suffered • The results here shown vary from those in the general Tables, as the strength given is that for May and not the ™. . , * , . ฆ% 1 .1 nni<lpmip -i r "i fltif! nnt thp whole Presidency 



123 

to a slight degree. In others again, where the men were attacked, their families preserved a complete immunity from the disease. In individual stations the numbers are too small to form the basis of any accurate conclusions, but taken as a whole, it appears that the admissions were highest among the women (42*0 per 1,000), next among the children (34-0), and lowest among the men (31*0) ; among women and children the death-rate, 27"2 per 1,000, was the same, and among men it was 20*5. 

282. Taking admissions and deaths among men and women together, the 

Comparative prevalence ra tios are respectively 31 "9 and 211 per l,000ซ among children and adults. Among children the admission rate has been 34, and the death-rate 27*2. The large proportion of the cases among children which terminated fatally is deserving of notice. Out of 120 attacked 96 died, or a ratio of 800 per 1,000. Among women the mortality was 64*8 per cent, of cases. 

283. Dr. Bryden's Table also further illustrates the comparative prevalence 

Comparative prevalence at and fatality of the disease among all classes at the different stations. /qiflp Qva n+ e+of*,™ci af.fa/>lrod Tn nr/W nf nrlTrn'ssirvnH 

different stations attacked. In order of admissions 

per 1,000 British soldiers, Peshawur with 156*1 occupies the highest place, and after it come Meean Meer 76, Meerut 74*9, Shajehanpore 51*5, Subathoo 50*5 ; according to relative death-rates, the order is somewhat altered. Peshawur is still first (92-88), then comes Meerut (67*67), Meean Meer (45*94), Shajehanpore (40*77), and Subathoo only 24*00. 

284. Taking the deaths from cholera among European soldiers according 

to age, it will be seen that all have suffered to nearly an equal extent, the ratios of deaths at different 

Influence of age. 

periods of life having varied during 1867 only from 11*65 to 15*82 per 1,000. If the results of the past five years be compared as a whole the facts are still more remarkable, for the average death-rate from cholera at different ages varies only from 4*06 to s*lo, or little more than 1 per 1,000. The particulars may thus be shown :—: — 

Statement shewing the relation of age to mortality from Cholera among British Soldiers in the Bengal Presidency during the five Years 1863 to 1867. Yeabs. Under 20. 20-21. 25-29. 39 and upwards. 1863 149 491 368 250 1864 ... 3-97 182 271 221 1865 ... ... ... 207 I'9B 359 354 1866 ... ... ... -00 1-00 1-39 I*2B 1867 12-81 15-82 1165 1299 Average of deaths from cholera during the five years ... 406 5.10 4-60 4-50 



124 

This table may with advantage be compared with the following :— 

Pment shewing the relation of age to mortality among British Soldiers in the Bengal Presidency from all causes except Cholera during the five Years 1863^1867. 

Yeabs, Under 20. 20-24. 25-29. 30 and upwards. 1863 5-98 1395 2446 2616 1864 9-92 9-51 2078 27"54 1865 ... ... 6-20 1035 21-15 3478 1866 ... 4-80 1078 16-60 26-03 1867 3-90 10-63 14-19 26-25 Average deaths from all other causes during the five years. 6 - 16 11 - 04 19 - 43 2815 The equable ratio which is maintained as regards cholera altogether disappears when other causes are considered, and here the death-rate steadily rises with age 

from 6*16 to 28-15 per 1,000. 

285. Regarding the influence of habits in pre-disposing to attacks of 

cholera very little definite information can be nobtained. The returns of temperate and inter- 

Influence of habits. 

perate soldiers and their relative liability to disease during 1867 have not yet been received, but even had they been prepared, no reliable conclusions can be drawn from the data they contain. Very different meanings attach to the words " temperate" and " intemperate," and there can be no doubt that the number of those who indulge in intoxicating liquors is much larger than what is stated in the returns. From a special return prepared by the Inspector General of Hospitals, in which the habits of those attacked have been noted, it would appear that out of 793 men and women attacked 744 were temperate and only 49 intemperate. 

286. The influence of previous state of health as affecting the liability 

influence of previous state to attack > h as received attention during the late OI llCtlitll. evnirlomir* on/1 vo+n-pno liovo lioon -rvvot-ปovorl elinTtrinrv 

epidemic, and returns have been prepared showing 

the condition of those who suffered from the disease. The results are as follow :—7OB: — 708 persons were reported to have been previously in " good" health, 26 in " fair" health, 103 in " indifferent" health, 8 were " weakly," 13 " delicate," and 52 were in a " bad" state of health. If these data, which include men, women, and children, be correct, they appear to show that previous condition lias little, if any, influence in determining or warding off an attack. 

287. Of 895 cases in which the place of seizure has been noted, it 

Number attacked in hos- a Ppears that 304 were attacked in barracks, 536 Pซ8l. in ramn nnrl XX in Vinonifal TTm TiiimW nf 

in camp, and 55 in hospital. The number of 

those under the last head is much smaller than it was in 1861, when 173 



125 

Eatients in hospital suffering from other diseases were seized with cholera, his result must be considered so far satisfactory. There is no return to show ow many of those on duty in the hospitals suffered, but from the narratives [ready given, the proportion must have been small. 

288. The returns showed that in 521 cases, the hours at which the 

Hours of attack and admis- attack took place were as follow :—: — 

A. M. P. M. Hours at tacked... 122J33i3|4 4J 6 5$ 6 6J7 7J 88i99J 10 10J 11 11* 12 12$ 11j2212f344^55J5J 6 6} 7 8 8ฃ 9 9} 10 10} 11 11 J 12 12J Number of attacks at each hour 17 18 2 24 3 1 21 5327 28 525 3 28 2 24 522 3 21 1 19, 4 14 120 4 1 23 14 1 11 1 21721315 2 10 3 7 2 16 2 22 2 The hours at which 902 cases were admitted into hospital have also been recorded, and the result is shown in the following statement : — A. M. P. M. Hours at which admitted 1 22J 3 441 551 661 774 88J81 99J 10 10J 11 Hi 12 i 1 1J- 22i3 3ฃ 441 5656 7 7J BSi 991 10 11 11$ 12 Number admitted at eachhour 3134 23425 143 185 559 342 1 251 540 1 45 1 21 33 146 233 438 127 15626 218 124 12112 1 21 From these data no general conclusions appear to he warranted, but the facts are worthy of record. The large numbers admitted in the mornings and 

lenings would lead to the belief that early treatment was not had recourse to many cases in which it would have been beneficial. 

289. An examination of the duration of the disease in the fatal cases shows 

that the average length of time in which death took place was 34 hours. Some are reported 

Duration of disease. 

thave died within three hours after being first attacked, while others lingered long as 29 days. In 555 cases, in which the period of the disease at rich death took place has been noted, 437 died in the state of collapse, d 118 in reaction. In 600 cases, suppression of urine is said to have jurred. 

290. Between the years 1818 and 1853-54, the proportion of cases of 

cholera among European troops which proved fatal, 

eaSs. POrtiOn ฐ f d6athS t0 had risen from 26 7 t0 42 P er cent> in the Ben S al 

Presidency. In Bombay and Madras the increase 

of mortality had been even greater, for in the one the ratio of deaths to cases 

i 2 



126 

had increased from 185 to 45-5, and in the other from 27*1 to 62-3. Since 1853-54, the results in Bengal have been as follow :—: — Statement shewing the proportion of deaths to cases of Cholera among European Troops, Native Troops and Prisoners. Died peb cent, of Admissions. YEAR European Troops. Native Troops. Jails. 1854-55 ... ... ... ... 50-54 No records 3929 1855-56 50-00 ... 47-50 1856-57 5362 ... 4595 1858 54-33 ... 4MB 1859 50-17 37-67 4657 1860 ... ... 53-25 46-33 3755 1861 ... ... ... ... 6404 41-90 4163 1862 61-28 5028 3636 1863 75-11 57-00 4010 1864 ~ 69-59 43 97 3731 1865 ... ... ... ... 72-50 49-73 4569 1806 ... ... ... ... 6000 54-60 4433 1867 ... ... ... ... ... 66-07 5082 4288 The increase in the fatality of the disease among European troops since 1861 has been even more marked than previously. The results of the past seven years show, that out of every hundred Europeans attacked with cholera, 6694 on an average died, while the average of the previous six years was only 51*9. If women and children were included, the death-rate would be even higher. Such unsatisfactory results need no comment ; when medicine is so nrvTitrOT'looa Vr\ nmna rtri+li +VlO rlicaoca Qani+.ow an/1 typo t7OTTf Tiro moaonvoo aooiima 

powerless to cope with the disease, sanitary and a paramount importance. 

preventive measures 

assume 

291. To this table have been added the ratios of fatal cases among Native 

troops and also among prisoners. It is remarkable 

cafes P amoSg European^and tnat tne largest proportion of recoveries should Natives compared. >,„,„ nn p miT ,,,J omrmo- +110 IQOfl QO f -mo^Tr r>f ™lir>™ ซ•ซ 

have occurred among the last, many of whom are 

received into jail old, weak and ill-nourished. The explanation may perhaps consist in the fact that a sick prisoner can hardly escape observation, and that medical treatment in cholera is successful in proportion to the promptitude with which it is had recourse to. In each of the years regarding which information is available,* the ratio of fatal cases has been less amongst prisoners than among Native soldiers, and very much less among Native soldiers than among European troops. 

292. The comparative prevalence of cholera among European and Native 

soldiers has already been illustrated by the admis- 

Comparative prevalence of t n ? D ,i j. , cholera among European and sions and deaths from the disease among each Native soldiers. -, i,* -U v . „ i • ฑv j'& *. 

class which have occurred in the different groups 

• Excepting 1859. 





I^oagrams f*> rfJju#tra/# (Jmnparafvw Ratios of Admifisihns. and, JDeati* from/ Choleras arrtvng JEuropetuv asuf JVUin>& Troops in; &10 Bern, gal Pre#islrrLCK from/ 186 V to 1867. 



127 

shown in Dr. Bryden's Table. The comparative immunity of the Natives will be more distinctly seen by taking the totals of each year. Statement shewing the comparative prevalence of Cholera among European and Native Soldiers in the Bengal Presidency from 1861 to 1867. EUROPEAN SOLDIERS. NATIVE SOLDIERS. PRISONERS. YEAR. Ratio pbb 1,000. Ratio peb 1,000. Ratio pbb 1,000. Admitted. Died. Admitted. Died. Admitted. Died. 1861 ••• ••ฆ 371 2373 98 409 365 15' 21 157 961 50 251 152 5-52 55 4-09 26 1-52 358 14*33 1864 ••• ฆฆฆ 37 2-55 38 1-67 22-9 8"56 1865 •ฆ• ป. 43 312 57 2-83 158 719 1866 ••• •ฆ• 23 1-37 47 2-54 272 12-10 209 1378 62 296 U'ซ 494 The remarkable immunity which the Native soldiers have enjoyed, when compared with Europeans, is more strikingly illustrated in the annexed diagram. 

293. The immunity which the Native troops have enjoyed is not only 

shown in the general results, especially of epidemic 

1 Cause of comparative im- ฆ, , . .-., ?-, , ? ? , „,, ? unity of Native soldiers. years, but is illustrated by the history of the disease 

in every cantonment in which it has prevailed. 

In no single instance, excepting that of Deolee, have the Native troops, durin the past year, suffered to any considerable extent, and at every station whic was visited by the epidemic, even when the European soldiers were attackec in large numbers, the loss of the Native regiments was trifling. Such persistent and remarkable contrast cannot be due to any mere fortuitous cause but no satisfactory explanation has yet been offered to account for it. Tha Natives are by no means exempt from the disease is sufficiently shown b its prevalence and fatality among the ordinary population of the countr during 1867. The sepoys are better fed, better clothed, and placed altogether in much better sanitary conditions than the inhabitants of towns, and it is therefore easy to understand why they should suffer less. But the condition of the sepoy is in no respect better than, nor indeed by any means so good in a sanitary point of view as, that of the British soldier. In the epidemic of 1861, it was suggested that there were only two essential conditions of this nature in which the two differed. The one lived in small separate huts and did not use latrines, while the others were brought together in barracks and frequented privies common to a number of men. Additional force was given to these statements, as in all probability explaining the very different degree in which the two classes were attacked, by the facts that the Goorkhas, who suffer to a much greater extent than ordinary sepoys, are singular in having their families with them and in providing latrines in their lines, while at the same time a similar difference appeared to explain the prevalence of 





* 

cess-pools. But since 1861 considerable changes have been effected in the sanitary administration of cantonments. The Native soldiers no longer are allowed as a rule to resort to the jungle, and it has been ascertained that during the epidemic of 1867, in nearly every station which was attacked, they had recourse to the regimental latrines. The only essential difference, therefore, that remains in the circumstances calculated to affect the sanitary condition of the British soldier, compared with the sepoy, is, that while the former is one of a number occupying the same barrack, the latter has generally a hut shared with one or more comrades. 



SECTION IV. GENERAL CONCLUSIONS. 

294. Such are the facts which have heen collected with regard to this great Conclusions to be drawnfrom epidemic. In some respects they are imperfect, the history of the epidemic. and many detailg which wouM haye proved both interesting and instructive are wanting. Still, as a whole, the mass of information is very great, and it now remains to consider what general conclusions can be drawn from it, how far our knowledge of the nature of cholera and of the manner of its spread has been increased or modified, how far the measures which have been recommended for its prevention have been attended with benefit, and to what extent, if any, these measures may be altered or improved. These great and important questions may be discussed as they affect the general population, the prisoners and the troops — the order in which the different portions of the community have already been considered in the preceding sections. 

295. The cause of the outbreak at Jlurdwar remains unknown. The 

Arrangements regarding history of the fair for years conclusively shows that I? till b. ฆhlfll alr-kYlฃk rปovป-n r\i~ rvcm Ckv*a4-f\ 4-Vi r\ /1-icistn ris-t rwrrwy i^rVi r*i^ 

filth alone cannot generate the disease, even when 

aided by such favorable conditions as were afforded by an immense mass of human beings collected together in circumstances best calculated to foster it. But the history of the fair of 1867 also conclusively shows the great advantages of good general arrangements, and the necessity for a better mode of conservancy. The measures for treating the sick were well planned and carried out, and the endeavor to prevent the entrance of all contagious diseases was also excellent. But in dealing with so great a multitude, such an endeavor, however patiently and energetically executed, is always liable to fail, and this great risk of failure necessitates that the conservancy arrangements should be as nearly as possible perfect, and that the sewage should be so disposed of as to render all pollution both of air and water impossible. In this view of the case trench latrines within the camp should on no account be allowed, but all ordure should be removed outside. The necessity for removal may be obviated to a considerable extent by obliging the people to resort to latrines placed without, or if the distance to be thus travelled be too great, they can at all events be erected towards the outer margin of the ground on which the multitude is residing. There will doubtless be great difficulty in carrying out such a scheme, there will also be great expense, but it is indispensable that no flaw should exist in any measures adopted for the protection of the people. 

296. In order to carry out proper measures for the safety both of the Great expenditure requir- health and lives of the pilgrims, a large expenditure 

cd. 

will be entailed. In the fair of 1867, Rs. 3,098 were 

spent on filling up holes in, and reducing the depth of the river in front of, the ' 

k2 



130 

ghauts, and Rs. 22,500 on the bridges made to facilitate the passage of the vast number of bathers. The extension of the bathing-places besides cost Rs. 2,232, and the cost of the conservancy, sanitary, and medical arrangements amounted to Rs. 14,689-2-10, or a sum total of Us. 42,519-2-10. In smaller 'airs so large an outlay would not perhaps be required, but if more efficient disposal of the sewage were ensured, the expense under this head would )e much increased. 

297. It is undoubtedly right and fair that those who necessitate the 

__ '•, , expenditure of so much money, and for whose Funds how to be raised P „ , ? tit 

comfort and convenience it is laid out, should con- 

;ribute towards its payment, but in what manner this payment is to be made s a question of some difficulty. It has been proposed by the Madras Sanitary Commissioner that tickets should be issued "on the payment of a small fee to all persons actually resorting to the place of congress, on the understanding hat without such tickets admission will not be granted." At Conjeveram, where the number of pilgrims does not exceed 200,000, such a plan might be carried out, but with three millions or even only one million it would be practially impossible, and no matter what the number, its adoption would prove a ruitful source of extortion by the native officials. At Hurdwar, after deducting costs of collection, the receipts on account of rent of Government land in road rontages, &c, amounted to Rs. 9,672, and such a mode of raising money is vidently the simplest and least liable to be abused. A ground rent levied in uch proportion as to meet all expenses should be imposed at all fairs and eligious assemblies where such a mode of raising funds can be conveniently 

298. Although there appears to be a general concurrence of opinion 

Amount and nature of the tnat tne multitudes who frequent shrines and fairs rate to be levied. oi^,,iri ™^ฑ +!,„ n? +1^ omnifompnk 

should meet the expenses of the arrangements 

which their presence renders necessary, very different views have been expressed as to the manner in which the money should be raised. At some places the system recommended by the Sanitary Commissioner for Madras has been already successfully carried out. At Punderpore in the Bombay Presidency, a tax of 4s annas has been taken from each pilgrim. By others an octroi duty on articles of consumption taken to the fair has been recommended. The exact mode in which the requisite funds are to be procured is not a sanitary question, and perhaps diversity of practice might best suit the natural peculiarities of the places of pilgrimage, and also the very varying numbers which assemble at each. A tax raised not for the benefit of imperial revenue could hardly be misunderstood. It should be called a conservancy rate and should be devoted exclusively to an efficient system of conservancy for the particular place at which it is collected. It might also serve to remove any prejudices on the part of the people, and help to disabuse their minds of any mistaken ideas on the subject if the receipts and disbursements at each fair were published for general information in the Government Gazette. The amount of rate in each case would naturally vary with circumstances, but it appears advisable that it should be such as to provide for efficient conservancy and no more. 



131 

299. Again it has been suggested that persons ought not to be allowed 

Diminution of the number *ฐ undertake a pilgrimage until they have satisfied of pilgrims. + r, Q Qll +T lrt ซi+;ซ a n f Ai B *^ti.i. f*.~™ ™T,,*^u +V, Q tt 

the authorities of the district from which they 

toceed that they have the requisite means, and have been provided with a pass, eh a measure could not be carried into effect without exciting the suspicions of the Natives, and leading them to believe that their religious liberties were being invaded. Any control over the freedom of a people, unless absolutely necessary, is extremely objectionable, and such a scheme, however well planned, could not be put in execution without opening a way to great oppression. It has further been proposed that whenever cholera or other epidemic disease prevails in a district, its inhabitants should not be allowed to frequent any of the great national fairs. But to this proposal the same objections exist as have already been stated with regard to the general question of control. As education increases and the light of civilization srcreads, the virtues of a visit to the Ganges or to the temple of Juggernath will become smaller and smaller in the estimation of the people, and the shrines which their forefathers reverenced will be held less and less holy in their eyes. In the present day all that appears to be advisable is to suggest that every district officer should annually warn the inhabitants of the great danger with which fairs are fraught both to their health and lives. 

300. Having noticed the chief points which demand attention in relation 

The effect of the dispersion to the &*ป* Hurd ™ gathering of 1867, the next of the pilgrims in spreading point to be considered is the dispersion of the pilthe cholera. . .. . . . . . ? 

grims, and the effect which they had in the dissemi- 

nation of the disease. On this question the facts have been narrated with great care ; every statement of any importance has been given, for the evidence has been considered not with the object of supporting any preconceived theory on the mode of propagation of the disease, but with the sole view of endeavoring to ascertain the truth. Did the pilgrims as they returned to their homes carry cholera with them, and thereby occasion the outbreak which subsequently followed in the various districts through which they traversed, or to which they themselves belonged ? 

301. On the first part of this question there can be no difference of That the pilgrims carried opinion. That cholera went with the pilgrims from 

cholera is indisputable. 

Hurdwar and accompanied them to a greater or less 

distance in every direction from it is a fact which admits of no dispute. The history of their return which has been already given illustrates this point so clearly that it is not necessary to recapitulate the facts. Suffice it to say that the pilgrims bore the disease with them to a distance varying from 50 to 300 miles in almost every point of the compass. 

302. This fact in itself may be regarded as evidence of communicability This fact an evidence of of the disease ' That the P^™ 8 imbibed the 

communicability. 

poison at Hurdwar in large numbers cannot be 

doubted, but it is not probable that the disease should remain latent so very long as to appear among some of them only when they had reached places so far distant as the Upper Provinces of the Punjab, At Goojerat, for example, the 



132 

first case was a pilgrim who was attacked there on the 28th April. In Cashmere the first cases were pilgrims who were attacked in the second week of June. Judging from all that is yet known of the disease, it appears much more probable, that these and others who were seized weeks after they had left Hurdwar were infected by pilgrims in whose company they had travelled, than that the germ of the disease had remained all that time undeveloped within their systems. 

303. But the details regarding the advent of cholera-stricken pilgrims General facts of importation and the subsequent appearance of this disease examined. among the general population of the districts wno had previously been altogether free from it, are very much stronger. It will be necessary in this point of the enquiry to separate the facts as they have been stated from the opinions with regard to them which have been expressed by the various observers, for though the latter are very valuable* they cannot be accepted in evidence as carrying the same weight as the former. The facts have been already recited. Below Allyghur on the south, andShajehanpore on the south-east, no connection can be traced between the return of pilgrims from Hurdwar and the subsequent appearance of cholera. The history of the occurrence of the first case in all those districts which lie to the north and north-west is shortly recapitulated in the annexed statement. 

Statement showing the facts connected with the appearance of Cholera in 51 Districts or Stations in 1867. 

No. District or Station. Date ฐt^ ncaBen ca8e of Whether a Pilgrim or not. Bbmabks. I/O 01 era. 1 Seharunpore ... 13th April ... A pilgrim. 2 Roorkee ... 13th „ ... Ditto. 3 Deyrah ... 16th „ ... A traveller and probably a pilgrim. 4 Mozuffernuggur .., 15th „ ... A pilgrim. 5 Bijnour ... 13th „ ... Ditto. 6 Moradabad ... 15th „ ... Ditto. 7 „ Cantonment ... 16th „ ... Ditto. 8 NyneeTal ... 22nd „ ... Ditto. 9 Almorah ... 25th „ ... Ditto. 10 Foot of Kumaon Hills ... 19th „ ... Ditto. 11 Bareilly ... 18th „ ... Ditto. 12 Budaon ... 18th „ ... Ditto. 13 Shajehanpore ... 24th „ ... Ditto. ปป..,ป, . •, f A doubtful case in a non-pilj grim on the 14th instant ; 14 Meerut ... 16th „ ... Ditto. 1 pilgrims had by that time (^ commenced to return. 15 Boolundshuhur ... 19th „ ... Ditto. ._,, , J Pilgrims had commenced to 16 Allyghur ... 20th „ ... Not a pilgrim. | return. Between Ist March and 21st 17 Goorgaon ... 21st A pilgrim. April, two doubtful cases. 18 Delhi ... 15th „ ... Ditto. 19 Rohtuck ... 13th „ ... Ditto. 20 Hissar ... 20th „ ... Ditto. 21 Sirsa ... 22nd „ ... Ditto. 22 Kurnaul ... 16th „ ... Ditto. oo tt v n i, „,, tv,, fA non-pilgrim also attacked 23 Umballah ... 13th Ditto. [ same day. 24 Lawrence Military Asylum ... 25th „ ... Ditto. 25 Simla ... 20th „ ... A traveller. 26 Loodianah . . . 18th „ ... A pilgrim. 27 Perozepore ... 22nd „ ... Ditto. 28 „ Cantonment ... 24th „ ... Ditto. 29 Jullundur ... 19th „ ... Ditto. 30 Kangra ... 25 th „ ... Ditto. 





133 

Statement showing the facts connected with the appearance of Cholera in 51 Districts or Stations in 1867,— Continued. No - District or Station. Date of^cwe of whether a Pilgrim or not. . RBMiHKS . 31 Hoshyarpore ... 19th April ... A pilo-rim. 32 Umritsur ... 22nd „ ... Ditto. 33 I Goordaspore ?, 25th „ ... Ditto 34 Sealkote ... 20th „ ... Ditto. 35 Lahore ... 24th „ ... Ditto. 36 I Montgomery ... 25th „ ... Ditto. 37 | Mooltan ... 26th „ ... Ditto. 38 Mozufferghur ... 13th July ... First case hot traced to pilgrims. 39 Jhung ... Ist June ... Ditto. 40 Goqjeran wallah ... 29th April ... A pilgrim. 41 Goojerat ... 28th „ ... Ditto. 42 Shahpore ... June ... Not traced. COn the bridge passed by 200 43 Jhelum ... 30th April ... A boatman. ) pilgrims the day he was C attacked. 44 Rawul Pindee . . . 30th „ ... A pilgrim. 45 Murree ... 10th June ... Not a pilgrim. 46 Huzara ... 17th May ... 2 Policemen. 47 Peshawur ... 11th „ ... Not a pilgrim. rr> , C Returned from Kangra Dis-48 Bunnoo ... 31st July ... 2 Sepoys. j triet where cholera was pre- C valent. 49 Dera Ishmael Khan ... sth August ?. Not pilgrims. 50 Dera Gazee Khan ... June ... No information. 61 Cashmere ... Bth June ... PiK-ims. (S( Se Pฐy s wn o had been at (, Hurdwar. 304. The facts exhibited in this statement are conveniently shown in General evidence of import- the annexed map, in which the relative position of atlon ' the different places, the main lines of communica- 

tion, and the dates on which the first well authenticated cases occurred have all "been entered. The results may thus be summarized. Excepting Goorgaon in which the history of the first case is doubtful, no cholera appeared in any of these 51 stations or districts until ample time had elapsed for the pilgrims to re-appear or for others to enter them from infected places. There was no simultaneous outbreak of the disease over a large area. But the general evidence is not merely negative, for excepting Goorgaon there was no cholera in any of the fifty-one places named, until the pilgrims actually had returned, and even in Goorgaon the epidemic prevalence of the disease dates from their return. The fact is of importance even although the outbreak of cholera took place in a few districts at so late a date as to render its having any direct connection with pilgrims very improbable. 

305. But even more remarkable is the evidence that in most instances 

The first cases nearly al- the first cases in the district were pilgrims who ways pilgrims. }, af i i, ftfiTl in TT im i wnT . Tv, fWfv-five out of the fifty- 

had been to Hurdwar. In thirty -five out of the fifty- 

one districts the first persons attacked were pilgrims, and after they had been seized, the disease appeared and spread among the residents. In this number is not included the case of Deyrah in which the first seizure was a traveller and probably a pilgrim, nor Meerut where the first case occurring in a resident was doubtful, nor Allyghur, nor Goorgaon nor Umballa in which two persons, a pilgrim and a non-pilgrim, were seized the same day, nor Jhelum where the first person attacked was a boatman at the ferry crossed by the pilgrims, nor 



134 

any other place regarding which any doubt has been expressed, and yet there remain thirty-five cases out of fifty-one in which there is the clear statement of the Medical or district officer, and sometimes of both that the pilgrims were 

the first victims. 

addition to these facts there are the decided opinions of of the numerous Medical and Civil officers by whom the 

306. And 

in 

Decided opinions Medical Officers. 

facts were observed. Thirty-two Medical officers,* great experience, who were indefatigable in carrying 

many of 

them men of 

out arrangements for the care of the 

• Dr. Cutcliffe, Seharunpore. Dr. J. P. Walker, Roorkee. Dr. Bani฿ter, Deyrah. 

Dr. Bateson, ITmballa. ? . . ntn -t • 1 • • Dr. Wilson johnstone, Loodi- devotees, and most careful in ascertaining Iฃ:vjta'jstaX?' the facts connected with the appearance Mr. Barnes, Hoshyarpore. „ .. ... ... . ,-. <ฆ• ? „ .-. • Dr. oidham, Goordaspore. of the disease withm the limits ot their Sub-Assistant Surgeon 800- 

Dr. Kirton, Mozuft'ernuggur. Dr. Gardner, Bijnour. 

Dr. Collison, Moradabad. Dr. Govan, Almorah. Dr. J. C. Corbyn, Bareilly. Dr. Walsh, Budaon. 

bun Mohun Mitter, seal- own c h ar g eSj are decidedly of opinion that Dr. C. M. Smith, Lahore. .- .-, . i. i 1 j_i "i • Dr. Kingsmin, Montgomery, the cholera was imported by tne pilgrims. Dr. De฿enzy, Mooltan. r * * ฐ Mr r :MitTisn?jhu o ng ffergbur> In the instance of Allyghur Dr. Kilkelly Dr. Dallas, Inspector General . . n , . .. iii i*i T. of Prisons, Punjab. has stated his opinion that while ne Dr. D. Wright, Katmandoo. 1 

Dr. Harris, Shajehanpore. Dr. Moir, Meerut. 

Dr. Birch, Goorgaon. Dr. Taylor, Delhi. Dr. Penney, „ 

Dr. Dickson, Rohtuck, Mr. Jl inns, Hissar. Mr. Nulty, Sirsa. 

Dr. Newton, Kuruaul. 

believes much of the spread of the disease 

was due to importation, there was also much which could not be traced to this cause. In other districts the Medical oflicers have been unable to satisfy themselves that the epidemic was due to importation, or they see no reason to believe that it was imported, but it is a very noteworthy fact that in no case has any positive evidence been advanced to show that such a cause was improbable, much less that it was impossible. 

307. There are only two ways in which these facts can be satisfactorily 

The evidence cannot be set disposed of. Either they must be set aside altogether aside. o C T . i,| i. ฆ lolurni'l li \r rปtป -fl-ioir much Via n rปnpmi,prl fls 

as untrustworthy, or they must be accepted as 

making out a very strong case in favor of the opinion that cholera is spread by human intercourse. It is very possible that the facts may, to some extent, be incorrect, but it is quite impossible that the whole story of the returning pilgrims carrying cholera with them from Hurdwar to Rawul Pin dee, with the dates of its appearance in the successive districts through which they passed, can have been invented. Besides, many of the circumstances came to the personal notice of the officials by whom they have been narrated. The facts, therefore j cannot be set aside, and if they be admitted as conveying even an approximation to the truth, the history is very instructive. It cannot be regarded as a mere coincidence that in thirty-five districts of Upper India, covering an area larger much than that of Great Britain, the epidemic should have gradually appeared in one place after another immediately after the return of a body of persons stricken with the disease. 

308. If not by the pilgrims how was the disease spread? It could not If not by the pilgrims, how na ve been carried by th j wind in all directions at 

was the disease spread ? 

one and the same time, nor is it probable that the 

force of the wind should have exactly kept pace with the speed of the pilgrims. There are, no doubt, difficulties to be explained under any theory which attempts to account for the facts. How, for example, did it happen that while 



135 

the pilgrims proceeding upwards appear to have carried the disease among the whole community, the pilgrims travelling in the Agra and Allahabad directions did not disseminate it ? To this, all that can be said is, that in the present state of our knowledge the question admits of no satisfactory explanation. 

309. But it is to be remarked that similar difficulties exist in regard to 

the spread of diseases the communicable nature of 

Analogy of other diseases. which ig undisputed# Can it be explained, for example, why small-pox prevails in some years and not in others ; why it is much more prevalent in India during April and May than in any other months of the year, and why it altogether disappears in September ; why a case of any known contagious disease sometimes occurs single and alone, and at other times appears to be the signal for the outburst of an epidemic ? It is a singular fact that all epidemic diseases, of which we have any accurate knowledge, are communicable, and, however fitful and inexplicable their course may be, it may fairly be assumed that every new case is usually, if not always, the progeny of a parent of a like kind, although the parentage often, and indeed generally, cannot be traced. The seed of a plant affords a not inapt analogy to what appears to be the most rational view of the germ of epidemic disease. In order to germinate and bear fruit, the seed must be good, it must fall in and be received into a suitable soil, it must be planted at the proper season and enjoy the advantages of climate and circumstances which are best adapted for its growth. Similar conditions appear to be necessary for the propagation of epidemics. With little doubt the germ of epidemic cholera appears to reside in the evacuations of a person suffering from the disease ; the circumstances favorable for its development are filth and the want of proper sanitary arrangements. What the condition of the human body which constitutes a good soil for its reception, and what the climatic and other circumstances favorable to its growth, have yet to be determined. 

310. Dr. Bryden, who has studied the general facts of the actual distri- 

bution of cholera in India with an industry and research which have been unsurpassed, and who, in 

Dr. Bryden's opinion. 

his capacity of statistical officer, has enjoyed opportunities for the investigation which have never been afforded to any other enquirer, holds a very different opinion. So early as the 25th February he predicted the occurrence of the epidemic ; his fears of its appearing being founded not on the dangers of the large mass of people to be collected at Hurdwar, but on his belief in the general laws, which, in his opinion, govern the disease. His very remarkable letter is as follows :—: — 

" I think it worth while to suggest to you the chance of an outbreak of cholera at Hurdwar and over Kumaon and Ghurwal in April and May. The invading epidemic of November was, I think, spread over the whole area of Eohilcund even up to the hills, and if this was the case, we are bound to expect its re-appearance from all parallel history; 1783, 1852, 1857, 1862 all teach the same lesson that a cholera of this distribution will re-appear in ApriL You should have specific enquiries now made as to the cholera of November and December 1866. To me it is indicated in five deaths of the 36th IJative 



136 

Infantry at Ghazeeabad, one in the Bth Native Infantry at Moradabad ; a sepoy of the 3rd Goorkhas died on detachment at Ramghur on 17th December, and another man of the Sappers was attacked while returning to Roorkee from his home in the Putteala District. Dr. Walker notices two fatal cases in the Roorkee Bazar on 4th and 23rd December, and we know generally the fact of its appearance in Delhi and the neighbourhood at the same time. I do not know the strength of the body of cholera so distributed. As I have told you, I dread universality of spread as much as the strength 'of special outbreaks. We never know what the main body may be, of which these trifling indications are the mere index." * * * " I shall be glad to show you upon what my apprehensions are founded." The object of this communication was to direct attention to the probability of a distribution of cholera in 1867 parallel with that of the cholera of 1857-58 and 1862 ; and Dr. Bryden is prepared to shew that the anticipation has been realized. 

311. But whatever theoretical differences of opinion may exist as to the 

propagation of cholera, the facts of the great epi- 

practical conclusions to be demic of im> gpread Norfhem Indiaj 

teach no doubtful lesson, and it is this that human 

Itercourse plays a very great part in the diffusion of the disease, and that turning pilgrims, in particular, are very dangerous arrivals. How is their turn to be regulated, and what measures can be adopted, as far as practical, diminish the danger ? The question is one of very great difficulty. Were saniry considerations alone to be kept in view, it could be easily answered, i my letter to the Government of India, in the Military Department, No 312, /ted the 29th May 1867, an opinion was expressed that quarantine should be established. Regarding the matter merely in a sanitary light that opinion remains unaltered, but a careful consideration of the many important points involved leads to the conclusion that any general attempt to enforce this measure is undesirable. 

312. The difficulties attending any general enforcement of quarantine 

are practically very great, and it would certainly 

possible!™ 1 quarantine im " be attended with much hardship and oppression 

to the pilgrims. Quarantine was attempted in 

nearly every district in the Punjab and the upper part of the North- Western Provinces, and the results are generally spoken of as having been very successful. It is very doubtful, however, how far the two things can be regarded as cause and effect. The Civil Surgeon of Umritsur mentions in his report that "the pilgrims complained bitterly of the treatment they had received near being driven off the regular road and forced to walk during the heat of the day for miles through heavy sand without food or water. In fact, they attributed a great many of the deaths to this cause." No system of strict quarantine can be carried out without great suffering to those concerned. 

313. Strict quarantine against cholera was one of the measures recom- 

mended by the Constantinople International Con- 

tie^SqSarintiJe! 811 autbori ' gress, but there is a strong and growing opinion that 

such a measure is practically impossible. Mr. 



137 

Simon's testimony at once to the value of such a measure, if it could be fully carried out, and also as to the impossibility of fulfilling this condition, is given at page 40 of his Eighth Report. " Subject to one qualification" he remarks " which is not an important one for the present argument, it may, I think, be accepted as certain, that quarantine, conducted with extreme rigour and with the precision of a chemical experiment, will keep cholera out of any part of Europe in which the extremely difficult conditions can be absolutely fulfilled, and thus if I speak to the dry question of medical practice, I have no hesitation in saying that England ought to resist cholera by quarantine. On the other hand, though I cannot pretend to discuss with any kind of authority the nonmedical aspects of the question, it would be mere pedantry for me to ignore the facts which are of common notoriety, and considerations which are of common sense conflict with that medical conclusion. A quarantine which is ineffective is a mere irrational derangement of commerce ; and a quarantine of the kind which ensures success is more easily imagined than realized.' ' In his Ninth Report he refers to these remarks as still embodying his opinions on the subject, but quotes two instances " where quarantine seems to have been effectual." 

314. On similar grounds, although it is admitted they do not apply with „ . .. a QODllwsa the same force to returning pilgrims, to attempt General preventive measures . , l 

recommended. 

a general quarantine throughout India seems to 

be unadvisable, but the other general measures which were adopted are highly to be recommended. Setting apart special camps at easy distances, well supplied with good and pure water, and provided with proper conservancy arrangements ; placing these halting places, as far as possible, off the main lines of communication ; diverting the stream of pilgrims from large cities, towns, and Military stations ; providing hospital accommodation and Medical treatment for the sick ; disinfecting the discharges and clothes of all suffering from the disease ; disposing of the dead, and insisting on general cleanliness among the concourse ; these measures are no doubt calculated to effect much good. 

315. But although a general quarantine is unadvisable, and, indeed, 

Quarantine as regards Can- impossible, such a measure should certainly be tonments. adonted as regards the entrance of any nersons 

adopted as regards the entrance of any persons 

into Military cantonments who are likely to convey the disease ; and whenever the disease is abroad, communication should, as far as possible, be cut off between the station and the neighbouring city. Even here the system cannot be carried out in a perfect way, but it would appear that, the larger the body of infected people, the greater is the danger which they bring with them, and if the result be only to diminish the centre of infection and not to prevent its introduction altogether, much good may be anticipated. 

316. And, although any general legislative enactment insisting on Quarantine to be permitted quarantine is open to great objections, Munici- 

by Municipalities. palities might be permitted to carry out such a measure whenever any unusual danger threatened. The general testimony which has been borne to the benefits of such an isolation of 

m 2 



138 

suspected persons, although it does not amount to proof, cannot be altogether ignored, and wherever the inhabitants of any city or town are in favor of such a mode of protection they should be allowed to adopt it. The mere knowledge, that all persons attending fairs might be liable on their return to such temporary restraint, would bring prominently into notice the danger of pilgrimages, and might diminish the number who would otherwise frequent them. 

317. As regards the general population a most important measure which 

General sanitation of urgently requires attention is the general sanitation towns and villages. ft f + ftWTls nnf i villas V\Uh nlnrm ne Tms Vtcati 

of towns and villages. Tilth alone as has been 

shown cannot generate cholera, but once the germ of the disease has been introduced, there is no more powerful agent in favoring its spread. Erom the recent appointment of Sanitary Commissioners in the different provinces, and the carrying out of a general scheme of sanitary administration which will doubtless follow as one important part of their labors, many improvements which have not hitherto been possible may be looked for. 

318. In September 1865 the Sanitary Commission for Bengal having been 

Measures for preventing called on by the Government of India to advise Cholera in jails. wlinf. mpasnwe mio-Tit. tn Tip. nrlrvntprl in nrpvpnt, f.TiP 

what measures ought to be adopted to prevent the 

spread of epidemic diseases within jails and so reduce the very great mortality which had so frequently arisen from this cause, prepared a series of rules, and in these the precautions to be adopted with reference to cholera occupied a prominent place. These recommendations met with approval and were at once adopted in all the local Governments and Administrations with the exception of Lower Bengal, but here their introduction was opposed by the Inspector General of Prisons, who stated that " they contain much that is crude and erroneous with not a little that is absolutely impracticable, and that as they stand they are not suited for the management of the prisoners under his charge." It would not be necessary to advert to these objections had not Dr. Mouat's letter containing them been reprinted as an appendix to his last annual report. It is very desirable to ascertain how far they are supported by European investigation and research. 

319. The rules with reference to cholera in jails which were framed 

Rules drawn up by Sani- the Sanitary Commission were issued, as has tary Commission. nliwudv hppn stn.tp.d. in SeTrtemhfir 1 865. The nesnnrt 

already been stated, in September 1865. The Report 

of the Medical officer of the Privy Council for 1866, copies of which reached India in the beginning of 1868, or two and a half years after the recommendations of the Sanitary Commission had been made, contains the latest orders and opinions of the highest English sanitary authorities on the preventive measures which ought to be adopted with reference to cholera. Without any word of comment, each rule which was objected to will be compared side by side with the ruling or opinion on the point which has been given by these authorities. The question of moving into camp on the appearance of the disease is a purely Indian question, and has no parallel in England. On this point no comparison can therefore be made. 



139 

320. The question of establishing quarantine in all jails with a view ..... .- „ to prevent the entrance of cholera and other Quarantine in jails consider- r 

ed separately. communicable diseases may also best be separately considered, for the case of prisoners differs very materially from the circum stances of the free population of England. The measure was recommended for adoption in all jails, and it has been adopted throughout Northern India A perfect quarantine, even as regards the convict population, is almost impos sible, but a quarantine possessing a considerable degree of stringency can easily be carried out, and it can be effected without any of the objection which would attend its introduction among the people generally ; it can lea to no oppression and can in no way disarrange commerce. It is not necessar to discuss this point at any further length. Practical results are of muc greater value than mere theoretical opinions, and the introduction of even such an imperfect quarantine as has been practicable in the jails of the Upper Provinces has been attended with most excellent results. 

321. With these exceptions the rules which were recommended bythe sanitary Commission's Sanitary Commission for Bengal will now be com- Rules compared with the pared with the views of the latest English authoviews of latest English autho- * rities. rities in the annexed statement. 

Eulcs and opinions given in the Ninth Report of the Eules recommended by the Sanitary Commission for Medical Officer of the Privy Council, which 

Bengal in September 1865. 

reached India in the beginning of 1868. 

Measures to be taken for securing early intelligence 

regarding the approach and progress of cholera. I. "On the occurrence of cholera in any portion of a district, 

the Magistrate should at once inform the Superintendent of the jail, and in the event of any cases appearing in cantonments, the Deputy Inspector-General of Hospitals, or senior medical officer, should communicate the fact, without delay, to the medical officer in charge." 

11. " Any case occurring in a jail should be reported, without delay, to nil the neighbouring jails, to the nearest civil, military, and medical authorities, and a daily report of the progress of the disease, and of the means taken to arrest it, should be made to the head of the department." 

"The object should be to spread information of the appearance of the disease in every direction in which it is likely to be of any use. Early information is particularly desirable, for in such a case to be forewarned is to be forearmed." 

11l and IV. Not objected to. 

V. Regards quarantine arrangements. 

VI. "No lotahs should be allowed for drawing water from wells. A filthy string, tainted with choleraic diarrhoea, has been supposed to pollute a whole well and to cause cholera among those who drank of its water." 

I and 11. "In order that these objects should be promptly and adequately fulfilled in any district where cholera may show itself, it is necessary that all authorities who will be responsible for fulfilling them should betimes in their respective districts pre-consider and pre-arrange the measures which in case of need are to be taken," p. 228. " It is always to be desired that the people should as far as possible know what real precautions they can take against the disease which threatens them, what vigilance is needful with regard to its early symptoms and what (if any) special arrangements have been made for giving medical assistance within the district. Especially in case of small-pox or cholera, such information ought to be spread abroad by printed hand bills or placards." p. 235. Vide also p. 296, wherein example is quoted of " the wisdom of these proceedings." 

VI. " There are two principal dangers against which extreme and exceptional vigilance ought to be used. First there is the danger of drinking water which is in any (even the slightest) degree tainted by house refuse or other like kinds of filth," p. 228. 

" It (the infective material) can infect in the most dangerous manner very large volumes of water," p. 230. 

"In the above described ways (of which the water is one), even a single case of disease, perhaps of the slightest degree, and perhaps quite unsuspected in its neighbourhood, may, if local circumstances co-operate, exert a terribly infective power on considerable masses of population,' p. 230. 

" I have shown that the river Lea was infected with the discharges of cholera patients on the 26th and 27th June, (the discharges of the first two patients who died of epidemic cholera iv the east districts"). , 



140 

Rules and opinions given in the Ninth Report of the Medical Officer of the Privy Council, which reached India in the beginning of 1868. 

Rules recommended by the Sanitary Commission for Bengal in September 1865. 

VII. " Regards moving into camp.' 

VIII. " Not objected to." 

IX. "The barrack should be at once disinfected by means of sulphurous acid ; the walls should be thoroughly scraped, the floor dug up to the depth of two or three inches; and the roof and rafters dusted, applying thereafter, if available, three coats of a solution of Macdougall's powder of the strength of one pound to a gallon of water, or Condy's fluid or some other disinfectant, and laying fresh earth for the floor." 

" Sulphurous acid has been recommended, because it can be had at once in any station. All that is necessary for its production is to melt one or two ounces of common sulphur in a metal vessel over a fire. After a time, set fire to the whole and allow it to burn out." 

X. " The yard and all it contains should be thoroughly purified, and especially the privies, in the same manner as the barracks. If earthen pans or naunds have been in use in the privies they should all be immediately broken and buried." 

" All the scrapings, &c, resulting from these operations should be carefully collected and buried without delay." 

" These purifications ought, if possible, to be carried out by prisoners, who occupied the barrack where the case of cholera occurred." 

XI. " The clothing and bedding of all the inmates of the affected barracks should be immersed for ten minutes in boiling water, dried, and returned to them, they themselves having first well bathed." 

XII. " The man seized with cholera is on no account to be taken to hospital ; a tent must be pitched for his reception. He must be attended by men from the affected barracks, who should be encouraged by sweetmeats and other rewards to do their duty well." 

XIII. "One Native Doctor should, wherever practicable, be told off for this temporary hospital, and neither he nor any of the attendants employed there should be allowed to enter the ordinary hospitals. 

" This conclusion (that the pollution of the water in common use, distributed from old Ford, with cholera poison was the cause of the explosion of cholera in the east districts), if admitted, brings the whole of the facts of the explosion into ready accordance, one with another, and supplies a sufficient and legitimate explanation of its origin. It is true, indeed, that the conclusion involves the assumption of the propagation of choleraic decomposition to a larger volume of water laden with excrementitious matter, (the locked portion of the Lea from Old Ford to Bromley), than hitherto supposed, and the efficiency of the choleraic poison under a condition of enormous dilution, not previously surmised, and these assumptions must not be lost sight of in estimating the probability of the conclusion," p. 311. 

"It must be borne in mind that chemical investigation is utterly unable to detect the presence of choleraic poison amongst the organic impurities of water, and there can be no doubt that this poison may be present in quantity, fatal to the consumer, though far too minute to be detected by the most delicate chemical research," Professor Frankland, p. 344. 

Speaking of Mr. Radcliffe's conclusion, " that the water of the reservoirs considered as drinking water had in it a power of direct infectiveness for those who drank it," Mr. Simon remarks, " after giving my most careful judgment to the case, I feel bound to say that the facts adduced by him, seem to me as a whole almost irresistibly to force the substance of his conclusion on the mind; but some of the exceptional cases are apparently strong facts to the contrary," p. 366. 

IX. " For the disinfection of the interior of houses the ceiling and walls should be washed with warm quick lime water, &c, &c," p. 238. 

"A room no longer occupied may be disinfected by chlorine gas or nitrous acid gas or sulphurous acid gas. * • * * The gases may be produced — sulphurous 

acid by burning an ounce or two of flowers of sulphur in a pipkin," p. 238. 

X. "During the emptying of privies and cesspools, and whenever else temporary disinfection is required for them, carbolic acid or sulphate of iron or perchloride of iron, &c, will be found available, * * * * especially where cholera is present, privies ought to be very carefully flooded in this manner," p. 237. 

XI. " Linen or washing Apparel requiring to be disinfected * * * ™ or the articles in question may be plunged into boiling water and afterwards when at wash be actually boiled in the washing water," p. 238. 

XII and XIII. One of the directions and regulations in relation to Asiatic Cholera issued by the Lords of the Privy Council in J uly 1 866, is framed "to provide for the separation of the sick from the healthy, in the same dwelling," p. 225., "all reasonable care should be taken not to spread infective disease by the unnecessary association of sick with healthy persona." Directions relative to Asiatic Cholera," p 235. 



141 

Rules recommended by the Sanitary Commission for Bengal in September 1865. 

Rules and opinions given in the Ninth Report of the Medical Officer of the Privy Council, which . reached India in the beginning of 1868. 

XIV. " The dejecta should be received in earthen vessels containing dry earth and some disinfectant and be immediately buried." 

XV. " The attendants should invariably wash their hands with some disinfectant when leaving the sick man." 

XVI. " A privy or"stool-pan used by the cholera patient should on no account be used by any one else." 

XVII. "On the recovery or death of the patient, his bedding and clothing must be immediately burnt or boiled, and the tent fumigated with sulphurous acid." 

" The_ action of boiling water for ten minutes is believed to be quite sufficient to destroy any infectious matter adhering to clothes, &c., but care should be taken that the water is actually boiling, and whether boiling or burning be resolved on, no delay should occur." 

XVIII. "Attention should be paid, not only to the inmates of the affected barrack, but to the prisoners generally." 

" AH the prisoners should be individually questioned twice daily, as to the condition of their bowels, and every man who has the slightest diarrhoea should have medicine administered at once on the spot. In a large jail this will require the co-operation of the lumberdars, or convict overseers, and they may also be entrusted with a few astringent pills for immediate use. The earlier the treatment, the more chance of success. During the night, enquiries as to the health of the inmates of each barrack should be made by the sentries every hour, and any man attacked by premonitory symptoms should be at once removed for treatment. 

XIX. Not objected to. 

XX. " The drinking water, if possible, should be boiled and filtered." 

XXI. " Fires of green wood should be burnt in all barracks and barrack yards." 

XXII. "So far as it conveniently can be arranged the prisoners should bathe outside the jail. Any water used for ablution within should be carried out and buried." 

XXIII— XXVII. Not objected to. 

XXVIII. " Any case occurring should be reported to the neighbouring jails, and to the nearest civil, military, and medical authorities, and a daily report should be sent to the head of the department of the progress of the disease, and of the measures taken to meet it." 

XXIX — XXXVII. Refer to moving into camp. The principle of the objections to tK remaining rules and recommendationshas been already discussed. 

XIV— XVI. " When it is desirable to disinfect before throwing away the evacuations from the bowels of persons suffering from cholera, some of the disinfectant should be put into the bed pan or other vessels before it is used by the patient, and some more should be added immediately after, * * care should also be taken that portions of the discharges do not remain about the patient's body or in his dress," p. 238. 

" Too much importance cannot be attached to the duty of thoroughly disinfecting without delay, all discharges from the stomach and bowels of persons under the epidemic influence, as well as all bedding, clothing, towels and the like which such discharges may have inbued, and measures for keeping all privies and like places in a thoroughly clean and uninfected state become more and more important as the discharges in question are likely to have access to the places," pp. 232 and 233. 

XVII. Vide last quotation and also extract opposite Rule XL 

XVIII. "It is essential when cholera ia epidemic, that arrangements should be made for affording medical relief without delay, to persons attacked even slightly with looseness of bowels," p. 235. 

"In places where cholera is present or threatening, one particular bodily ailment requires exceptional vigilance. That ailment is diarrhoea, * * * every looseness of bowels or sickness of stomach, ought as quickly as possible to be brought under skilled medical treatment," p. 232. 

XX. (Objected to chiefly on the ground that the Hindoos would not touch it, but the measure has been carried out in the Punjab, and it is recommended by Dr. Mouat, himself, in his Circular of 1855.) 

XXI & XXII. No corresponding orders or opinions in Mr. Simon's report. 

XXVIII. Vide remarks opposite 1 and 2. 

322. The objections urged by the Inspector General of Prisons against the 

introduction of these rules in his letter of the 3rd 

Agreement between the rules and those of the English April 1867, are to the effect that they would "excite authorities. , , ? /T , TT n • i ? • * 

general alarm" (I and II), or involve a "violent 

supposition" (VI), or are " based upon an erroneous estimate of the contagiousness 



142 

of cholera" (IX), or are "founded upon a want of acquaintance with the scientific researches formerly and recently conducted" (XI and XXXVI), or "not necessary for the protection of the other prisoners" (XII and XIII), or agreed to " with the omission of the disinfectants" as he believes " dry-earth to be the best of disinfectants, when properly applied (XIV, XV and XVI), or because they are " ridiculous and unnecessary" (XXI), or " impracticable and unnecessary" (XXII). It will be satisfactory for the Government to know that all the rules of the smallest consequence which were prepared by the Sanitary Commission, and which have been introduced into the jails of Upper India have their exact counterpart in similar directions or recommendations which have since been made by the Lords of the Privy Council or their medical adviser, and that the principle which guided the preparation of the one is exactly the same principle which has guided the preparation of the other. It is of the utmost importance, not only to the prisoners, but to the whole world, that in Lower Bengal, where cholera is said to have its home, no measure should be left untried which is in any degree calculated to arrest its progress or throw light upon the mode of its propagation. In the jails opportunities and facilities for the enquiry exist which can be found nowhere else, and the measures which have been recommended by the Medical Officer of the Privy Council and which are to all intents and purposes the same as those prepared by the Sanitary Commission, should have a fair and complete 

323. In spite of failures, the general results of moving European troops 

Measures to prevent cholera into cam P> although far from satisfactory, yet admit among European troops. n f ft, iVnrn M ft nnrnnnn'snTi with tliosfi of former ereat 

of favorable comparison with those of former great 

epidemic visitations of cholera in which the plan was not generally adopted. It has been shown that the movement into camp has been attended in very many instances with great benefit, and, even where it has not produced such decided good as might have been anticipated, the sickness and mortality with the exceptions of Meerut and Peshawur, have been considerably less than in former years. It may be stated generally that movement into camp is the best means which is yet known for arresting the spread of cholera among European troops, and that this movement can be carried out in general with little if any addition to sickness from other diseases. 

324. In General Orders by His Excellency the Commander-in-Chief some 

Recent modifications of recent alterations and modifications have been made Generaiordersonthesubject. in the rules regarding cholera camps. G.O.C. C, dated 26th August 1867, directs " that all encamping grounds used as cholera camps be ploughed immediately after the troops have quitted them." A supplementary order of the 26th September enjoins that " the ground, especially latrine trenches and such like, within the limits of an encampment is not to be disturbed during occupation, but all refuse, &c, are to be buried at a distance of at least 500 yards. Cholera encampments after being ploughed up are not, except when unavoidable, to be re-occupied within twelve months." The circumstances under which the movement is to be made are modified in G. 0. C. C, No. 159, dated 9th May 1868. 



143 

:t The following para. 481, of the ฆ measures for the prevention of cholera among European Troops/ is re-published for general information :— 

1 All therefore that need be laid down as an invariable rule is, that the particular body of men, among whom cholera has appeared in an epidemic form, must be removed from the cantonments. If for example, this body consist only of the inmates of some one building the measure need only be applied to them ; if some particular company or troop be attacked it will be similarly dealt with . A whole regiment or the whole of the troops at the station need only be sent into camp, when it is found that the measures already adopted have not stopped the progress of the disease, or there is reason to fear that they will be insufficient." 

"2. Withthe sanction of Government, His Excellency the Commander-in- Chief begs General Officers and the Chief Administrative Medical Officers to adopt in practice the principle contained in the foregoing paragraph, and on no account during the hot and rainy seasons to vacate whole suites of barracks, because one or two or even more have been infected with cholera. It is necessary only to evacuate such buildings as have actually presented cases. During the hot and rainy seasons, if other buildings are available, they should be used in preference to placing the men in camp. In short, at such seasons of the year, the camp must be held to be the last resource. This is more especially necessary when the ground is either covered with water, or when it is drying up in the months of August and September/ " 

325. It is worthy of consideration whether it would not be advisable to estab-* 

Permanent cholera en- lish several permanent encamping grounds in the camping grounds proposed. neighbourhood of all large stations occupied by European troops. They should be well drained, being raised above the surrounding level, if this is necessary to secure the important object, and they should be planted with trees. In many of the recent out-breaks it was found impossible to find proper encamping grounds, and movements which were desirable were rendered on this account impracticable. 

326. In order to judge more clearly of the results of moving into camp, 

More detailed information ** is yei T important that the information regarding required. +i lfi ซ mfl p r o SS n f flip fli<jpn.ซp. sTinnlrl bfi rnnoli more 

the progress of the disease should be much more 

detailed. It is impossible to draw any correct conclusions if all the men are entered in one return. Each detachment should be treated as a distinct body, and particulars regarding it should be separately stated — how many cases of cholera occurred in the barracks or buildings occupied by the particular party before its removal, and how many after it went into camp. Wherever such a course can be avoided, fresh detachments should not be sent to join any already in camp as was done in the case of the 42nd regiment at Peshawur. 

327. The movement of European troops under canvass in the hot and rainy 

seasons requires considerable tact and care. The 

Points to tปe observed in necessity of pitching a preliminary camp on the 

first appearance of any danger has been much 

insisted on by Doctor Murray, Inspector General of Hospitals, who has had 



144 

very great practical experience in conducting such movements, and there can be no question that this early precaution is of the greatest importance. It saves time and prevents hurry and confusion. The march should be short so as not to tire the men. As a rule it should be made in the early morning, but it should be borne in mind that time is valuable and that the sooner the body of men which has been attacked is removed from the infected locality, the greater are the hopes of speedily shaking off the disease. 

328. There are two terms in common use with regard to cholera which are open to serious objection. The term " spora- The terms "sporadic" and ? „ . ? , . * ? ? ? . , t ? • n "choleraic diarrhoea," objec- die is applied in contradistinction to "epidemic, tionable. m , . rr ,.ซ. , , ? . - _ 

There is no difference between the symptoms of a 

so-called '* sporadic " case and one which commences an epidemic, while the use of the term is calculated to do harm by allaying alarm and so preventing proper precautions. The term " choleraic diarrhoea " although it may be correct has in practice led to much abuse. If the present state of scientific knowledge with regard to cholera be accepted, choleraic diarrhoea is as truly cholera as the most virulent form of the disease, inasmuch as it appears as capable of spreading the poison and is therefore as dangerous to the community among which it occurs. The addition of the word " diarrhoea" is very apt to conceal this danger, and, where the question of going into camp has to be decided by the number of cases which indicate the presence of a specific disease, it is of the utmost importance that the whole truth should be faced and acted on. In one return which reached this office the ratio of deaths from " choleraic diarrhoea " was really greater than it was from cholera. Diarrhoea attended with the characteristic rice water evacuations should for all practical purposes be considered as cholera. 

329. In answer to a reference from the Government the following 

_, ._ ? ... measures for the purification of barracks were Purification of buildings. r , , ?, . . ? , 

recommended. " Every hut or building in which 

a case of the disease occurs, or which there is reason to suspect has been contaminated by cholera discharges, should at once be fumigated with sulphurous acid (the fumes of burning sulphur) ; the flocr to the depth of six inches should be dug up, the old earth buried and fresh earth placed o n it, the inside should be washed over with a solution of McDougall's powder or other disinfectant and the walls smeared with fresh mud. The last named process will be more efficacious and at the same time more economical than whitewashing. Where the floor is not earthen, but of brick or other permanent construction, it should not be dug up but washed with s ome disinfectant in the same manner as the ceiling." These recomme ndations were intended specially to apply to huts and buildings occupied by Native Troops, but the principle is equally applicable to barracks occupied by European Troops. The walls in this case should be washed with warm quick-lime water. In every station there should be an ample supply of disinfectants. 

330. There is one subject of very great practical importance which has The period of incubation. not been adverted to > and that is the P eriod of 

incubation which the disease generally assumes. 





On this point numerous replies have been received, but the information is generally wanting in precision. In some cases the poison would appear to have been dormant for many days ; in others it would seem to have borne fruit within a few hours. The subject is one of great interest, and its solution is intimately connected with proper preventive measures, but for the present it appears better to await further and more specific data than to draw conclusions without adequate grounds. 

331. It may not be out of place to note as the result of the experience 

Information to be obtained of the P ast > what P oints specially demand attention in any future epidemic. j n any figure emdemic. In all enidemifis. not rmW 

in any future epidemic. In all epidemics, not only 

of cholera but of any communicable disease, it is very important to trace the first case and to leave no means untried to discover its source. Once the disease has spread, the enquiry becomes much more difficult. If associated with pilgrims returning to their homes the following points should be kept in view : — 

Ist. — How many pilgrims are supposed to have gone from each district to the fair ? 

2nd. — When did the first of them return ? 

3rd. — "Was there any cholera m their company on their way back ? 

4<th. — If so, when did the last case occur ? 

sth. — "When did the first case occur among the residents who had not been to the fair ? 

6th. — Can any communication be traced between this case and new arrivals ? 

332. In conclusion it only remains to acknowledge the very valuable assist- 

Assistance received in pre- ance wllicn many officers have furnished in the paring this report. preparation of this report. To the Heads of the Medical Department, both British and Indian, to their Secretaries, to Dr. John Murray, Inspector General of Hospitals in the Upper Provinces, to Dr. Bryden, Statistical Officer, and to the Civil Surgeons generally throughout the country such acknowledgments are particularly due. Dr. Lees who officiated as Secretary during a few months in the beginning of the year has also aided in collecting data and in abstracting reports regarding the history of the disease among the European Troops at different stations. 

G. B. MALLESON, Lieut.- Colonel, Sanitary Commr. with the Govt. of India. 

J. M. CUNINGHAM, m. d., Surgeon, 

Secretary. 

o2 





Tables showing the Distribution of the Cholera of Iง6j among the ฆEuropean and Native Armies and the Jail Population of the Hengal Presidency. 





TABLE showing the PREVALENCE of CHOLERA in each MONTH, and the DISTRIBUTION of the DISEASE ly STATIONS and PROVINCES. Averaee Number or Admissions into Hospital iit each Month. t m Admitted Tt , Died per sireng'th Admis- percent. ™ t ซฃ g 1000 of STATIONS. during — — g- &$ป fth ฃ> occupation. Jan Fcb Mar _ Apl May . June . July . Aug . Sept . Oc t. Nov. Dee. Year - stren & th - Strcn & th ' Chinsurah Dep6t 2 1 1 4 ... 2 Pccruits, Invalids, and Timeexpired men on march ... ... Fort William ... ป39 1 -. 1 1 - 3 ... 2 ... Ilum-Dum ... 472 1 - j - * Barraukpore ... 3f - -ฆ .'" Uerhampore . . • i^ฐ - - — - - "' "' "' „'". '" _Z Z Z - 1,600 1 1 3 ... 6 -31 | 4 2-50 Sinchal, Darjeeling ... 518 Darjeding Depot ... 110 PanWh Depot ... 22 •ฆ• - •ฆฆ Hazareebaugh ... ป<b 1 .. • Dinaporo - ซ* - J - \" ... || ... X, ::: | ฆ ฆ ~ "} "} ฆฆ ;: - :: ; :: ... 3 •;; ... 2 :: S"f y 4 I ::: ป = I ฆ ? "> ป :: - s :;: Seetapore • - ฐ<* * Futtehgta฿ ... 286 ... ... ... - ... •ฆ• .-. ฆฆ• • 3 ฆ•ฆ - 2 Cwnpore - ... •ฆ Allahabad •ฆ• ป™ Xagode ฆฆฆ Mi - -__ '. Z , 9 )58 o 2 I 3 ... 6 37 7 ... 1 ... 55 -58 3(i | 376 S— c ::: g™ป: ซ :;: ?: " ? ? ••• ::: ::: ::; " ;;: " ::: Xynee Tal Depot ... 313 Lindour Depot ฆฆฆ Roorkco ••• gbO ฆ•• ฆ•ฆ 7 ฆฆฆ ฃr d ::: J ::: ::: ::: ::: ฆฆ - a 106 "} ฆฆฆ ฆฆฆ 12 ? ::: "j ::: SU ::: _^JLJLJL-jiJIJLJLJLJLJLJLi! L_i l_l__ 4747 1 2 ... 5 I 13 107 1 159 335 140 2949 Sor Citadel -. 219 15 2 _ 8 4 Seopreo ฆฆ• },™ Jhansi - 60| ฆ•ฆ - ••ฆ Sausror ... ™ Jubbulpore ••ฆ _ bii Z——^— —-' — — -'ฆ ฆ - •" 4)2 46 1 5 13 4 23 -54 | it 330 imballa ... l^J ~~~ ~ 7~23~T~ 2 ... 89 "IT Liursliaic ฆ•ฆ 8"ฐ ... ... ... •ฆ• ••• ••• ฆฆฆ^ 'ฆฆ &Soo eDep6t ::: wi ป: z ::: - "i ป: "• 3 "26 '"2 :ป ••: 'ฆ'ฆ'ฆ z w ::: Hriikmr 6S "jซ '"l 2 "' "' 9 Icrozepore ••• "% Dera Ismail Khan ... 1 01 Scalkote ... I- 26 -* -, - " x '" "• . Nป. - ,42 : ;;; ""i ::: ::: ::: "1 ;;; •ฆฆ 1 ;•; (.ovindghur ... "ป ••• 1 . S Fort Lahore ... 140 ฆฆฆ J 1 1 ... ป ... 2 JleeanMcer ... 1,030 6 8 02 10 ป•> ... 5i Rawul Pindee .•• M" 2 Campbellpore ... 4 06 Attwk ... 160 Eoad-making Detachments, Murree Hills ... 644 Murree Depot and Family 5 2 7 3 & Ei JS ::: ::: ::\3"j = = = = = ซj : ป = Cheerat ... J Troops on the march, Punjab ... 13)5 70 ... ... ... 5 191 131 91 40 18 476 351 283 2086 Troops on the march, Bengal and X. W. Provinces ... ... I Bengal Presidency ... 8^603 2~ ... ~7 8 197 132 106 131 137 1 4 1 722 209 479 13-81 





['ABLE showing the PREVALENCE of CHOLERA in each MONTR, and the DISTRIBUTION of the DISEASE ly STATIONS and PROVINCES. Average Nitmbeb of Admissions into Hospital nr each Month. Total si on-Tte T D , ieil P" Strength Admia- percent. ]™X STATIONS. during the sions of v f{™ ™™jH period of of the Strength ฐJJ e ™ฐ "/n occupation. Jan Feb Mari Apl May _ Jmle _ Ju]y . Aug , Sept . Oct> Nov , D ec . ซar. y^ r rovin j Fort William ... ... 612 ... 1 3 1 5 1 2 1 Alipore ... ... 1,078 1 ... 3 3 1 2 6 ... 15 2 1 25 9 Dum-Dum (9 months) ... 615 9 11 ... 1 2 10 24 15 Barrackpore ... ... 953 1 1 ... Berhampore .. •ฆ• 128 Dacca ... ... 320 1 1 1 Cachar ... ... 242 5 ... 5 2 1 Cherrapoonjee & Shillong ... 834 2 2 }ฆ I'OO m 458 Gowhatty ... ... 318 Kowgong ... ... 87 ... ฆฆฆ •ฆ• ... ... ••• ฆฆ• 1 ••• •ฆ• •ฆ• ฆ•• 1 Tezporc ... ... 421 1 5 1 8 3 Debrooghur ... .. 912 1 1 1 ... 12 11 8 3 liuxa Dooar ... ... 698 1 1 Julpigoree ... ... 622 Bhaugulporc ... ... 4CO ... J ... - 1 Dinaporc ... ... 639 2 4 12 9 1 6 Pi Scgowlio ... ... 293 Benares ... ... 611 2 ... 1 3 2 Goruckporc ... ... 623 Fyzabad ... ... 681 Lucknow ... ... 1,590 2 3 5 . .„„ 4 ! ซ.ซ,l Scetapore ... ... 353 2 1 3 ( 3 I Futtehghur ... ... 181 Cawnporo ... ... 790 1 ••• 1 1 Banda ... ... 300 Allahabad ... ... 627 7 7 4 Nagode ... ... 703 ... J ... J Shahjchanpore ... ... 207 2 3 5 1 3 1 Bareilly ... ... 883 Eoorkee ... ... 809 2 2 1 Almorah ... ... 412 ... 1 1 ' 1 Deyrah ... ... 63 ... ... I ..,•. ... <>.., Moradabftd ... ... . 352 4 1 5 f dl 6 iM Jloerut ... ... 838 ... j Allyghur ... ... 450 ' i 1 1 Delhi ... ... 618 ... 1 1 I 1 Agra ... ... 703 . 1 1 J ... J Morar ... ... 1,697 ill 31 2 Jhansi ... ... 679 ... ••• ••ฆ ... ... ... ••ฆ ... ... ... ... ฆ•• ... { Nowgong ... ... 423 ... 1 1 Jubbulporo (11 mouths) ... 701 ... ... }ฆ '20 ... V '91 Deolee ... ... 262 ... 6 6 3 Erinpoorah (9 months) ... 105 ... ... I Saugor ... ... 993 ... ••ฆ ... J Umballa ... ... 937 ... ... 6 ••ฆ 6 1 3 1 Simla (7 months) ... 151 ... Loodianah ... ... 128 1 1 ... 2 1 I .lullundur ... ... • 4SO 2 ฆ•ฆ 1 3 1 Ferozeporo ... ... 583 ... ... 5 ••ฆ 6 1 I Mooltau ... ... 1,010 . 3 3 2 Scalkote (9 months) ... 3^9 .. ... ... I Dhurmsalla (0 mouths) ... 613 ... 3 ... 3 )ฆ '85 3 )ฆ 3'Sl Bukloh ... ... 388 ... Umritsur ... ... in ... ... ... " 1 1 1 Meean Meer ... ],321 1 11 1 13 6 Kawulpindeo ... 1,503 2 1 3 2 Attock • ... 148 ... ... 2 1 3 2 Peshawur ... 4395 . . 25 32 4 ... 2 63 27 Troops on the march, (Punjab) ... ... j ... J Troops on the march, Bengal ~~~ 'and N. W. Provinces ... ... ... 3 ... . 1 4 ... 2 Bengal Presidency ... 39,114 1 4 15 26 40 55 41 20 9 9 8 16 244 '62 124 317 Augur ... 499 Goonah ... 417 Sehore ... 769 Sirdarpore ... 331 Kherwarrah ... 585 Erinpoorah ... 819 Deolee ... 759 20 20 ... 3 Central India Force ... 4,212 20 20 -47 3 fl Abbottabad ... 1,461 2 9 15 1 27 ... 5 Murdau ... 759 2 1 3 . . 2 Kohat ... 8,808 11 22 13 46 ... 28 I Bunnoo ' ... 1,452 1 ... 6 7 ... 4 I Dera Ismnel Khan ... 1,155 I Dora Ghazec Khan ... 1,1)0!) ... ... ... ... ... ... 2 ... 1 ... ... ... 3 ... ... ... I iKajanpore ... 412 j Punjab Frontier Force ... 9,135 2 24 39 15 6 86 '94 39 4- 6 ' 01 ! — I 







TABLE showing the prevalence of CHOLERA in each Month, and the distribution of the DISEASE by STATIONS and PROVINCES. Numbee of Admissions into Hospital in each Month. Average Total Ad- Total Died per D rr4TTr>i*rซ Strength missions P er^m. Deatha 100 0 of STATIONS. tort l e ofthe of ofthe Avmge Year. Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dec. Year. st™ n gf hi Year. Strength. I Alipore ••ฆ 2>3582 > 358 ฆฆ 2 36 8 5 2 15 ... 2 12 4 77 ... 20 Zr re ฆฆ• 598 1 3 5 ... 3 ... 12 ... 2 KMinaghur^ 382 1 1 ... .. 2 ... tJSw ... 693 !!! 9 ..'. ... "| ..'. 1 ... 10 ... 5 "ranipore ... 40 2 1 3 I'li rdwan ••• 392 S''?' 8 ... 226 1 2 1 ... ... 4 ... 1 Raneeirunge ••• 30 • ฆฆฆ - , 371 1 1 2 ... 1 i'limehal and Pakour ... 105 1 1 2 ... 2 IVwda ••ฆ 6S iini'cDoro ฆ•ฆ 403 1 1 1 3 ... 1 I'lMiahvo ••ฆ 568 2 ... 2 4 ... 2 iwnofe •ฆฆ 361 iWah •ฆฆ 121 Mymcnsing ฆ•ฆ 401 Ip'ubna . ฆ•ฆ Hฐ ••• S.rajfmnge - 36 I Kurreedpore •ฆ• 40/ ... ฆ•• •ฆ• liatkerpunge •ฆฆ 434 7 3 ... 1 1 12 ... 5 Xoacolly ฆ•• 191 Chittapong - 229 - - Tinnerah ฆฆฆ 842 ... 1 1 ••• 1 DaVca •ฆ• 459 ... gv i he t ••• 362 ... 1v.... . ... 4^ .. ... ... ... ... ... ... ... IfVhir ฆฆฆ 212 22 3 ... 25 ••• 16 liowalparah •ฆฆ 134 1 ฆฆ• 1 ••• 1 (owhattv ฆฆฆ 2 ฐl 2 1 1 3 6 •• 1 IBMbMgta ••ฆ 127 ... ฆฆฆ Xoweong ฆ•ฆ 91 ... iTezDore ••• 185 ฆฆฆ i,broo"hur ••ฆ 85 •ฆ• 1 1 Midnapore •ฆ• 539 1 ••• 1 2 iialasoro ฆ•• 196 1 1 613 2 1 1 'ฆ 4 ... 1 In 1 ......... Siiralmlpore ••• 118 ฆฆ• Idiyebassa ••• 159 ••• I Kauehec ฆ•• 199 ... •ฆฆ ••• ฆฆฆ ฆฆฆ ฆฆฆ ••• ••ฆ •ฆ• I Hazarcebaugh, Central ... 642 Hazareobaugh District ... 197 ... ••• ••• Monghyr ... 394 2 1 ... 24 27 ... 8 Illiauffiilpore - 317 3 1 10 14 ... 6 Pumcah •ฆ• 332 3 62 65 ... 43 Darjeeling ... 60 15,092 5 2 49 60 77 4 42 13 12 3 8 6 281 179 119 7'S5 Gyah ••• 374 1 ... 1 2 Patna 513 ' 13 1 1 7 21 ... 43 ... 2o hwah ••• 694 3 36 39 ... 26 Arrah ... 387 2 3 5 3 13 ... 3 ll'humparuTi ... 193 ... ... ... ... ... ... ... ... ... ••• •ฆฆ ฆฆ• •ฆ• ฆฆฆ ••ฆ Jlozuflerporo - 297 2 1 9 ... 12 , ... 6 Chuprah ... 331 1 1 ... 2 1 ... 1 6 ... 1 I fthazeepore] ••• 417 Benares ... 1,240 Mirzaporo — 228 I Azimirhur ฆฆฆ 285 I Juuni>orc 222 ... ... ... -ฆฆ ••• ฆฆ• ... ••• •*ฆ "ฆ '" GoniL'kpore •ฆฆ 395 ... ... ... ... ... ... ... 2 <j ฆ*• •*• ••• Bustee (8 months) ... 168 2 2 Gonda ... 836 1 1 ฆฆ J ••• - Baraiteh ... 214 * ... 2 2 ... 4 ... 1 Fyzabad ••ฆ 948 Sultanpore ... 328 Rae฿areilly ... 141 Pcrtabgrhur ... 143 1 1 2 Hurdui ... 193 Luckimpore ... 142 •ฆ• . ••• ฆ•• ฆฆฆ ••' . Lueknow, Central ... 1,765 4 4 2 1 ... '•• 11 •ฆฆ 1 Lufknow District (11 months) ... 717 1 1 1 ••• '" ,- Scetapore ... 915 51 2 53 ... ซ Xawabgunge ... 83 ••• ••• ฆ•• , Oonao ... 215 1 1 - } Etah ... 238 2 2 ... * Humeerpore . ... 138 Oraie ... 88 Futtchghnr, Central ... 354 Futtehghur District ... 336 Cawnpore ... 283 Futtehpore ... 330 Banda ... 323 Nagode ... 77 ฆ•• ••• ฆ" 1t Allahabad, Central ... 1,985 21 3 27 ... " Allahabad District (10 months)... 560 16,940 34 27 6 4 10 GO 56 9 22 ... 227 131 97 673 



Ncmbee of Admissions into Hospital ik each Monih. Admitted Average TotalAd- t . T^ Die^ STATES. ซ " Av S Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dec. I Raipore ••ฆ 417 ") j" ||| )|| !!! ... '..'. \" I Belaspore ฆ•• "6 Baudhara ฆฆ• 130 Chanda ••• 133 ™ '" " \" ... - Nagpore ฆ•• 930 Chindwara . ฆ•• 102 Wnrdah ฆฆฆ 61 Sironcha ••• &4 Mundia ฆ•• 36 • " Jubbulporc ••ฆ 660 Dumoh ... so ;;; Saugor ••• 204 ._ __ Nursingporc •ฆ• H' ••• ฆ•• "' "' "' '" rM ... ?, ?' Lullutpore ฆฆ• 113 jhansi - 206 - ;;; ;;; ;;; Seonee ••ฆ 13' Baitool ฆ•ฆ 73 Sehore ฆฆ• 10 ... ... , tl Hoshungabad ... 308 Niraar ... 74 A J™ere - %\ 2 '"l '.'.'. '.'.'. '.'.'. " 3 ... 1 Beaur ••ฆ ซ' ซn ... ... 2 i 3 Muttra ... 153 7 { \ ฆ'* Agra, Central ... 1,826 - x { Agra District ... 340 * 1 " - ™ Etawah ... 378 Mynpoorie ฆฆ• 267 ••• "' , "' j Allyghur ... 328 - 1 X ;|| ;ซ Bolundshuhur ... 118 ฆ;„ •ฆฆ 22 ... 6 Shahjehanporc ... 2/7 1 ••• 3 is Bareilly ... 1.342 "• _ || m Budaon •ฆ 289 ฆ•ฆ ... ••ฆ •ฆ• ••ฆ ••• •ฆ• "' Seharunpore .ฆ• 1<ป mnorc ... ii- 4 - ••; ฆ" ;;; ;;; ;;; "'l2 .:. '" 2 ฆ.'.; Deyrah ... 41 ••• * a x , Almorah ... 139 1 1 Mozufl'ernuggur ... 95 Moradabad ... 241 •ฆ• 'ฆ_ '| Meerut •ฆ• 1,-'' '" 7)403 ... ... 11 9 ... 3 20 2 45 "61 13 176 Delhi ... 287 Rohtuk ... 217 Hissar ... 210 Sirsa ... 243 - '" '.'.', Kurnaul ... 88 Umballa ... 487 , -' "' j Gang at J hugger ... 201 1 x "' ; Loodianah ... 184 - " Jullundur ... 326 "" " Ferozepore ... 363 ... •ฆ• •••„ - •" 4 Umritsur ... 571 3 3 5 . Lahore, Central ... 1.917 • ฆ-,„ 9 Lahore Female Jail ... 166 11 ••• 1 ** Sealkote ... 265 ... •-? ••• ? •' Dhurmealla ... "2 6 6 ... 2 M ••ฆ ' Goordaspore ... 246 •• ฆฆ• •ฆ• - ? ;;; ••ฆ 4 ; Goojranwalla ... 058 * ฆ Goojrat ... 234 Shuhpore •ฆฆ 267 "• "' [[ Jhelum ฆฆ• 202 Montgomery ... 323 Mooltan ... 660 Jhung ฆฆฆ 390 •ฆฆ ... ฆฆ• ••• ••ฆ ••• ••• •• „ Dera Ghazee Khan ... 361 - Dera Ismael Khau ... 298 Kohat ... HI Z Bunnoo ฆ•• 86 Rawulpindee ฆ•• 869 •• ... ฆ•• ••• ฆฆฆ „ Sohan (Temporary Jail) ... 112 13 1 ... 2 ... lซ ... ป Peshawur ... 406 2 " ซ ••• ฐ^ 10,506 22 21 17 11 5 76 '71 41 3'9o^ Bengal Presidency ... 64,962 5 2 83 98 113 29 72 106 70 12 30 6 632 115 271 * 83 _ 







<-'i 

EEPOET 

ON THE 

CHOLEEA EPIDEMIC OF 1867, 

NORTHERN INDIA. 

CALCUTTA : 

OFFICE OF SUPERINTENDENT OF GOVERNMENT PRINTING. 

1868.