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On the Epidemiology of Plague

Published online by Cambridge University Press:  15 May 2009

E. H. Hankin
E. H. Hankin
Affiliation:
(From the Government Laboratory, Agra, India.)
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In areas in which plague is present, or has recently been present, in India, as an epidemic, no definite relation has been observed between intensity of plague (apart from its persistence), and badness of sanitary condition of dwellings. On the other hand, in areas in which plague is present endemically, so far as evidence goes, very unsatisfactory sanitary conditions exist. Such areas are generally situated in mountainous countries (Garhwal, Yunnan, Beni-Cheir, Transbaikalia). The inhabitants of such places, owing to the difficulty of obtaining water for domestic purposes, are apt to be filthy both in their houses and persons. In Garhwal, Yunnan, and Beni-Cheir domesticated animals are stabled in the houses, the paucity of level area making separate provision for cattle a matter of difficulty. Stable refuse consequently is liable to accumulate in the lower floors of the houses, producing conditions favourable to the presence of swarms of fleas.

Type
Research Article
Information
Journal of Hygiene , Volume 5 , Issue 1 , January 1905 , pp. 48 - 83
Copyright
Copyright © Cambridge University Press 1905

References

page 48 note 1 In Bombay only 8·6 per cent. of tenements condemned as unfit for human habitation in 1897 were situated in wards F and G, which were the portions of the town most severely attacked by plague. For other facts of the same nature see Hankin, , “La propagation de la Peste” (Annales de l'institut Pasteur, 11, 1898, p. 705Google Scholar). Dr Weir, the Health Officer of Bombay in 1896, stated that the houses in the suburban villages near Bombay which suffered severely from plague were not so overcrowded as the houses in the slums of the city which were far less severely attacked. (Evidence before the Indian Plague Commission, Vol. III. p. 311.) Mr Winter, who was in charge of the plague operations in Jawalapur, stated that more cases of plague occured in large well-built houses than in mud huts, at any rate at the commencement of the outbreak. In a later paragraph it will be pointed out that a large proportion of the earlier cases in Jawalapur were of grain dealers, that is to say of persons who, though well-to-do and living usually in well-built houses, were likely to come into places infested with rats. (Evidence before the Indian Plague Commission, Vol. II. p. 52.)

page 49 note 1 Annual Report of the Sanitary Commissioner for the North-West Provinces and Oudh for the year 1876.

page 50 note 1 The phrase “endemic area” will, I hope, be regarded as an allowable contraction for the phrase “area in which the disease is endemic.” Convenience may justify a use of the word not implied by its derivation.

page 50 note 2 loc. cit.

page 50 note 3 For facts included in this table I am chiefly indebted to “The Plague in India” (Official Report, compiled by R. Nathan, Indian Civil Service), and to Hutcheson, “Mahamari” (Transactions of the Indian Medical Congress held at Calcutta in December 1894, p. 304).

page 55 note 1 Thesis on the Nature and History of Plague as observed in the North-Western Provinces of India (published in Edinburgh in 1840 by Machlachan Stewart and Co.), p. 34.

page 57 note 1 Nathan, loc. cit.

page 57 note 2 See Haeser, Geschichte der Medicin und der epidemischen Krankheiten, pp. 142 and 170.Google Scholar

page 57 note 3 History of Epidemics in Britain (Cambridge, 1891).

page 58 note 1 loc. cit. p. 233.

page 57 note 2 Haeser, loc. cit. Vol. III. p. 157.

page 59 note 1 Haeser, loc. cit. p. 161.

page 60 note 1 Creighton, loc. cit.

page 60 note 2 Quoted by Des Guignes in Histoire des Huns.

page 61 note 1 Alberuni, a Persian writer, was born in A.D. 973, and lived at the court of Mahmud of Ghazni. In his description of India he refers to “the Tree of Prayaga…the place where the waters of the Jaun join the Ganges, where the Hindus torment themselves with various kinds of tortures.” Prayaga is the place now known as Allahabad. With little doubt his statement refers to the tricks of fakirs at the pilgrim festival that is still held there. See Alberuni's India by Dr E. C. Sachan, London, 1888, Vol. I. p. 200.

page 61 note 2 History of India, Fifth Edition, 1866, p. 46.

page 61 note 3 The word “waba” used to describe this outbreak is translated as “cholera” in Elliot's translation of Ziaud Din Barni. The word is more usually translated as pestilence and is commonly employed for plague. The known comparatively recent origin of the chief cholera deity in the United Provinces is one reason, among others, for doubting whether at the time we are discussing cholera was so prevalent a disease as it has since become. From Ziaud Din Barni's and also from Ibn Batuta's accounts it appears that the Emperor, when attacked, remained ill from the pestilence for some months, a fact that agrees better with the view that the malady was plague, and not cholera.

page 61 note 4 By Ziaud Din Barni. See a translation in Elliot's History of India by its own Historians, Vol. III. p. 243.

page 61 note 5 loc. cit. p. 244.

page 62 note 1 Referring to Akbar, Abul Fazl makes the following statements: “His Majesty being very fond of horses, merchants bring them from the two Iraks, Room, Turkestan, Badakshan, Shirvan, Khergez, Tibbet, and Cashmere.” (Ain-I-Akbara, Gladwin's Translation, Vol. I. p. 130.)

page 62 note 2 According to Ziaud Din Barni this pestilence broke out at Arangal (spelt by Elphinstone Warangal). According to Ibn Batuta it commenced at Badrakote. In either case it is probable that the infection was brought to the army by reinforcements that had travelled by the ordinary route through Malwa, and crossed the Nerbudda and Tapti rivers, that is to say, who, for some distance, had travelled along the same route as the fakirs on their way to Nassik. The fact that the Emperor halted at Deogiri (on the Godavary below Nassik), and that he was still weak from his illness when he arrived at Delhi three months later, strongly suggests that he was infected not far from the former locality. For the route followed by an army from Delhi that originally conquered Ma'bar in A.D. 1310, see the Tarikh-i Alai by Amir Khusru, translated in Elliot's History, Vol. III. pp. 86 and 87.

page 63 note 1 See Kremer, “Ueber die grossen Seuchen des Orients nach arabischen Quellen,” Sitzungsberichte der Philos. Histor. Cl. d. Kaiserl. Akad. d. Wiss. Bd. XCVI. p. 69, Vienna, 1880. (I am indebted for this reference to Mr A. W. Thomas.)

page 63 note 2 “La propagation de la Peste,” Annales de l'institut Pasteur, October, 1898, p. 625.

page 63 note 3 loc. cit.

page 64 note 1 The outbreak of plague in Kankhal exhibits strikingly the phenomenon of the disease attacking different species of animals at different periods. The infection appears to have been introduced on the 14th May, 1897, by a priest who had been present at the disinfection of a house in Hurdwar on the 7th of May. He died on the 16th May in Kankhal. No further plague was reported till about the 20th June, when an outbreak among rats, bacteriologically diagnosed, occurred in the locality where the first human case had died. The succeeding outbreak among human beings is suspected to have commenced, in the same locality, on the 3rd or 4th August, 1897, though the first case definitely diagnosed occurred on the 6th September. The outbreak among human beings comprised 61 cases, and lasted till the 6th January, 1898. An outbreak of plague among monkeys, bacteriologically diagnosed, began about the middle of October, 1897, and lasted for about a fortnight. Twenty-five dead bodies of monkeys were found, but it is supposed that a larger number were attacked, as when ill these animals are reputed to go into the jungle to die alone. As a precaution about 650 monkeys were caught and kept in cases until the epidemic was at an end. Other monkeys emigrated from Kankhal, and destroyed crops near the village of Jaggitpur, about a mile and a half distant from the town. It was suggested that these monkeys may have been the cause of the epidemic of human plague in that village, that commenced, so far as is known, on the 29th December, 1897, and amounted to 23 cases of the disease. (See Evidence before the Indian Plague Commission, of Mr Winter, Vol. II. p. 42, and of Mr Kendall, Vol. II. p. 58.)

page 65 note 1 Since writing this sentence I have had the curiosity to look up the authorities for the story of the Pied Piper. According to Verstegan, the first English writer to describe the incident, it occurred in the year 1376. But according to the brothers Grimm (Deutscher Sagen, 1816, Vol. I. pp. 330–333) it happened in the year 1284. According to the story, the Pied Piper appears to have been an indigent person who had witnessed a disappearance of rats in the dominions of the Cham of Cathay whence he had come. After his arrival at the town of Hameln in Brunswick, there was a disappearance first of the rats, and then of the children, the number of the latter being 130. In the following year, according to Schnurrer (Chronick der Seuchen) there was so great a mortality in Italy, Lombardy, and Apulia, that many bishops and prelates remained unburied. In 1284 there had been a severe plague outbreak in Egypt. For other authorities see Furnival, Bibliography of Robert Browning, pp. 113 and 158. From the facts that tradition associated the event with a particular street in Hameln, and that the archives of the town for some centuries were dated from the time of the disappearance of the children, it appears to be probable that the legend was based on an importation of plague rather than on an ordinary folk-lore tale.

page 66 note 1 Haeser, loc. cit. p. 170.

page 66 note 2 See Abel, “Was wnssten unsere Vorfahren von der Empfänglichkeit der Ratten und Mäuse für die Beulenpest des Menschen” (Zeitschr. f. Hygiene und Infectionskrankheiten, Vol. XXXVI. p. 89). Abel shows that supposed references to a connection between rats and plague in European medieval authors are for the most part based on a quotation from Avicenna. There is no adequate reason according to Abel for believing that any noticeable rat mortality ever accompanied plague in the Middle Ages in Europe. Eastern authors not infrequently refer to rats staggering about as if drunk in times of plague. In Chaucer's Canterbury Tales, in the Knightes Tale (circa A.D. 1380), I noticed the phrase “as dronke as a mous.” It would be interesting to know the origin of the expression.

page 67 note 1 Report of the Commission sent by the Egyptian Government to Bombay to study Plague (Cairo, 1897), p. 64.

page 67 note 2 Proust, La défense de l'europe contre la Peste, p. 161.

page 69 note 1 Condon, The Bombay Plague, being a history of the progress of plague in the Bombay Presidency from September 1896 to June 1899. This important official report contains a vast amount of information. I have made extensive use of it in this and the following paragraphs.

page 71 note 1 See Evidence before the Indian Plague Commission, Vol. II. p. 50.

page 74 note 1 See Zeitschr. f. Hygiene, Bd. XXXVI. p. 202.

page 77 note 1 Loc. cit.

page 77 note 2 Loc. cit.

page 80 note 1 The Emperor Jehangir in his diary thus refers to this outbreak in Agra:— “During the last three years the disease has caused many deaths during the winter; but at the beginning of the summer it dies down to reappear at the first commencement of the cold weather.” Jehangir mentions the mortality among rats. I am indebted for this reference to Colonel Lukis of the Indian Medical Service.

page 80 note 2 “Report on Ectoparasites of the Rat,” by Dr F. Tidswell, published in Ashburton Thompson's Report on a Second Outbreak of Plague at Sydney in 1902, p. 71.

page 80 note 3 Ashburton Thompson's Report on a Second Outbreak of Plague at Sydney in 1902, p. 78.

page 81 note 1 Loc. cit.

page 81 note 2 “ Ueber die Pestepidemie in Formosa.” Centralbl. f. Bacteriol., Vol. XXI. 1897, pp. 769–777.Google Scholar

page 82 note 1 Loc. cit.

page 82 note 2 Hankin, “La propagation de la Peste,” Annales de l'institut Pasteur, 1898, p. 705.Google Scholar

page 82 note 3 Nuttall, “On the rôle of insects, arachnids, and myriapods as carriers in the spread of bacterial and parasitic diseases of man and animals. A critical and historical study.” Johns Hopkins Hospital Reports, Vol. VIII. 1899, p. 21.Google Scholar

page 82 note 4 Thompson and Tidswell, Report on the Outbreak of Plague at Sydney, 1900.

page 82 note 5 Galli-Valerio, “Quelques observations sur la morphologie du Bacterium Pestis et sur la transmission de la Peste bubonique par les puces des rats et des souris.” Centralbl. f. Bacteriol., Vol. XXVIII. 1900, p. 842.Google Scholar

Galli-Valerio, “ The part played by the fleas of rats and mice in the transmission of Bubonic Plague,” Journal of Tropical Medicine, 02. 1902.Google Scholar

Galli-Valerio, “ Les nouvelles recherches sur l'action des puces des rats et des souris dans la transmission de la Peste bubonique.” Centralbl. f. Bacteriol., Vol. XXXIII. 1903, p. 753.Google Scholar

page 82 note 6 Tiraboschi, “Beitrag zur Kenntniss der Pestepidemiologie. Ratten, Mäuse, und ihre Ektoparasiten.” Archiv für Hygiene, Vol. XLVI. p. 251.Google Scholar

page 83 note 1 Loc. cit.

page 83 note 2 Kolle, “Bericht über die Thätigkeit in der zu Studien über Pest eingerichteten Station des Instituts für Infectionskrankheiten.” Zeitschr. f. Hygiene, Vol. XXXVI. 1901, p. 397.CrossRefGoogle Scholar