FOOTNOTES:
[8] See Introduction, p. [25].
[9] See Introduction, p. [17].
CHAPTER II
Rats and Men
The bubonic plague, as I said, had been known in India for only eleven years, but from the first the common people had noticed its connection with rats. The sight of a dead rat in a house spread terror, and when rats crept out upon the floors, regardless of man, and lay panting to death, it was early recognized that the plague was at hand. The unlearned observed these warnings, but no one detected their full significance, and for many years the pestilence was attributed to bad water or overcrowded and insanitary houses.
In Poona it was thought there was too much water about, and the officer of health undertook the remedial measure of draining a rather nice pond that used to be behind the Deccan Club, and converting it into as malarial a marsh as I have ever seen outside West Africa. The authorities, in their perplexity, also set about cleansing the quarters and homes of the Indian population, who, I suppose, are, on the whole, the most scrupulous about washing and cleaning of any working people in the world. They tried disinfectants, and poured thousands of pounds in the form of chemicals down drains, ditches, and streets. Sometimes, by mistake, they poured things that do not disinfect, and still the plague went on. They tried “segregation.” They divided the city into compartments under military guard, and sent British soldiers into the homes to examine men, women, and children, and take them off to isolated hospitals if there was a sign of plague. The symptom from which the plague takes its name of “bubonic” is the swelling of the great glands in the groin into hard lumps. No greater profanation of the Indian reverence for home and women could be imagined than this forcible entrance and examination by men—by soldiers of another race. No matter how kindly and decent and respectful our men were, no virtue on their part could prevent their presence and action from infuriating any population, especially in an Asiatic town. Riots broke out, and when I was in Poona, a small stone was put up to mark the spot on the country road to Government House, where the Chairman of the Plague Committee had been murdered, together with a young officer who happened to be with him. When the youth who conceived the deed was sentenced, he said to the judge, “You may hang me to-morrow, but my soul will at once pass into another body, and in sixteen years it will be fighting against the English again.”
The kindly zeal, the strenuous measures, the fatherly concern, the haste to do something, the utter inability to understand another point of view, are alike characteristic of our Government and of the elephant that sat on the orphaned eggs to hatch them.
From that time, I believe, arose a peculiar bitterness and feeling of distrust towards our rule that slowly permeated the country, and are still particularly strong in Poona itself. But their origin is distant now, and when I was there all our old methods had long been abandoned. There was now no examination for suspected cases, and no military searching of houses. The people were not “segregated,” and general disinfection was given up. Inoculation and “health camps” had become the Government methods now. The object of inoculation was the same as similar processes in other diseases, like small-pox or typhoid; the object of the “health camps” was simply to separate human beings from rats.
A Health Camp.
In a Village.
[Face p. 50.
That old connection between rats and plague had lately been examined afresh, chiefly by Dr. Turner, the Public Health Officer in Bombay, and the theory of the rat-flea had sprung into science. Contemplate a dead rat lying on your floor in the day-time, and you will find numerous fleas leaping up and down upon his body. If you are wise and prudent, you will rapidly pour kerosene over him from a distance, and then set him alight. For if, having seen him brewing in the air, you do not thus nip him in the bud, you are likely to fall a victim to the plague after sunset. A rat’s fleas are not the harmless, homely insects that we know. This species of flea has a special predilection for rats, and they will not leave their favourite home if they can help it, at all events by day. At night, when the rat is dead, they have to go, and then, as a last resort, they will take refuge on a human body for want of better sustenance. But with them they bring the germ that has killed the rat.
Whether they themselves infect the rat in the first instance, or whether they only transmit from him a bacillus which the rat has developed from other origins, I have not discovered; but I suppose the latter. Nor am I quite sure whether the fleas die of plague themselves or remain immune. Anyhow, the theory is that when once they have passed the germ into a human being’s blood, the plague is assured. In a climate like India’s the most careful and cleanly people can never be secure against fleas, for, wash as they will, some insect or other is pretty certain to be biting them every minute of the day and night, and it is difficult to distinguish one bite from another. A further terror is that the little grey squirrel with paler stripes, which draws no distinction of race or riches, and swarms throughout India, even on the roofs of the wealthiest bungalows, is quite as much a favourite with the fleas as any rat could be. While I was in Poona they were climbing over my verandah and scampering across my floor by dozens, and I took a peculiarly personal interest in their health, which happily appeared excellent.
The British Government was, at the time, buying rats alive at some fraction of a farthing a head. They had already purchased 25,000 in the town when I was there, and everywhere one met industrious Hindus carrying rats in cages to the official rat-collector. Whether the price was high enough to induce industrious Hindus to breed rats for the British market, I do not know. But I believe it was found that the reduction of the rat population gave the survivors such increased vitality that never had such active and powerful specimens of rat been seen before.
There is no very strict rule about the season for plague. Sometimes it comes in the rains, sometimes in the drought. Usually it is worst at the end of winter, but in 1907, when nearly 70,000 people died in a week in the Punjab, it was approaching the height of summer. As a rule the season lasts three months, and in bad seasons at Poona the cases go up to 100 a day. While I was there, the rate, as I said above, was comparatively low—only 12, 15, or 20 cases a day. But in the Presidency of Bombay, as a whole, people were dying by 7000 a week, and that seems a good deal, even though the population of the provinces is 18,000,000, including Scinde. The British Isles count for more than twice that number, but if we began dying of plague by 7000 a week, I dare say there would arise such a commotion for escape as when you stir up an ants’ nest with a stick.
In Poona the Government had erected rows of tin huts as a hospital on some vacant ground just beyond the railway station, and there I was able to observe cases of the pestilence in every stage. There were from 80 to 100 men, women, and children admitted as patients, and the men and women were laid in separate rows. But otherwise not much difference could be made between the patients as to caste and habits, though some of the Brahmans had their food sent in from outside when they were recovering, like first-class misdemeanants in our prisons. It is rather peculiar that the Brahmans offer least resistance to the disease, and this the Sister-in-charge attributed to the strictness of their vegetarianism for ages past. To Europeans it is less fatal than to any Indians, but, next to Europeans, the lowest or “sweeper” caste, who will eat anything anyhow, almost like Europeans themselves, are the best patients, and show the most recoveries. There may, however, be other reasons for this difference besides the food—I mean the natural hardiness of the labouring class, and the natural tendency of all highly organized and sensitive beings to collapse under fever.
Each patient in hospital lay in a separate cubicle, and mothers or other relations were allowed to visit and sit there. A plague-stricken mother might, I believe, even bring a young child with her, so great was the confidence in the new theory of infection and in the absence of rats. The stories of instant and unavoidable contagion in other plagues, such as the plague of London, seem to separate those diseases in kind from this bubonic plague; but very likely the stories were not true, or what was considered to be contagion was in reality an underlying common origin.
It was some comfort to a mother to be allowed to watch her thin, bright-eyed child panting its life away, but the absorbed intensity of her watching, as a rule, had not to continue long. The disease begins with violent headache and a rapidly increasing temperature; the breath becomes terrible, and the tongue chalky white or bluish. There is a strong objection to taking food or drink, and milk is often spat out by a spasm in the throat, as in hydrophobia. Delirium supervenes about the third day and usually lasts to the sixth, when most patients die. During the delirium there is an extreme desire to get up and walk about, so that many patients have to be strapped down to their beds. Far the most important thing is to keep the patient absolutely still, as death most frequently comes from collapse of the heart, and recovery depends almost entirely upon the patient’s constitutional power of heart action. An English lady, who had come through the disease, told me that even during the delirium she seemed to be dimly conscious of the strain on the heart; but this memory may have been only suggestion. I think the delirious patients that I saw would be incapable of remembering anything of those three days, even if they recovered.
Meantime, in their benign efforts to work off the poison in the blood, the glands have from a very early stage developed into hard lumps that usually suppurate and have to be incised, but sometimes absorb without operation. When I touched the glands in the groin, they felt like walnuts under the skin, and it is, as I said, the presence of this obvious symptom which gives the plague its characteristic name of “bubonic,” from the Greek word for groin. After incision, the patient’s temperature often goes down rapidly, but, in any case, the pain from the glands is usually very great; indeed, I think it is the chief cause of such pain as the plague gives.
Next to heart failure, the commonest cause of death is lung complication after the crisis of fever is passed. The prostration when the temperature begins to decline is usually extreme, and some patients whom I saw were so emaciated that they appeared to be parodies of famine—legs and arms like sticks, back and ribs like frameworks of bone. It is true that probably they were not very fat when they went into hospital. The delirium often leaves the patients silly, and if I had been in Central Africa again, I should have said at once that several of them had sleeping sickness in the third or fourth month—the time when, in sleeping sickness, the control over the emotions begins to fail. The nurses in the hospital were Indian women, under the direction of a European Sister.[13]
While I was still in Poona, Sir George Clarke, the new Governor of Bombay, who was already winning the confidence and respect of Indians in all parties by his straightforward ways and his freedom from official routine, issued a proclamation giving the actual statistics of the plague, and calling on the people to submit themselves voluntarily to inoculation as the only means of defence yet discovered. The proclamation was read about the streets in Mahrati, the people listening patiently, and then reflecting. Many Indians have a feeling against inoculation, just as thousands of English people have. They regard it as some sort of contamination, even when it is voluntary, and the memory of an old error in the serum that poisoned a village dies hard.[14] There is also a certain amount of national and even religious prejudice on the subject. The thing is European; it does not fit in with Hindu tradition, and Mr. Tilak, the most powerful political and religious force in Poona, was known at that time to oppose it. Still, it had been proved that, as a rule, no great harm was done, and, on the off-chance that it might save their lives, many took it. For inoculation there was the further inducement of sixpence bestowed on each patient by a considerate Government, so as to tide over the two or three days’ gentle illness that usually follows the operation.
A Village Street.
A Street in Plague.
[Face p. 58.
It naturally occurs to one that many a poor but dishonest man would gladly be inoculated every day of his life for sixpence, or would, at all events, induce his wife and children thus to contribute to the family budget. Very likely that happens from time to time in the case of far-seeing people who are resolved to avail themselves fully of the Government’s prophylactic measures. But some real check upon this form of prudence is imposed by the appearance of the arm, and an official check is also kept by an elaborate system of finger-print records—one of the most official farces I have ever seen. Even more embarrassing, however, than the thrifty man is he who, feeling rather unwell, hastens up to be inoculated, and is found to be developing the plague already. Of course, nothing will persuade him that his visit to the inoculator was not the cause of the disease, and much suspicion is spread in this way among the people. It is, in any case, extremely difficult to induce women to take the inoculation. Everything possible is done to shelter their feelings; a most discreet curtain is hung to protect them from sight and make them feel at home; one of their own people is the operator, and only an inch or two of arm is exposed, whereas they never have the slightest objection to walking in the crowd with legs and waist quite bare at any hour of the day. Yet the whole traditional instinct of Indian womanhood, from the day of Sita, Rama’s wife, rises up in protest against such a profanation.
At four separate points of the native city the Government had set up stations where all comers might be inoculated free—not only free, but with that sixpenny reward. In the midst of the central market-place, where elderly bangle-merchants, with the help of soapy powder, were squeezing gorgeous glass bangles from China over women’s hands, and men and women were squatted on the stones, chaffering over little heaps of queer vegetables and fruit, I found a native apostle of science and fatherly Government preaching the terrors of plague and the glory of redemption by serum. Before him was fixed a little spirit stove, on which boiling vaseline simmered. At his side was a glass saucer containing scraps of cotton wool dipped in strong carbolic. One hand gesticulated the truths of nature, the other held a little glass syringe, with a long, sharp beak, and any one could see that the syringe was half full of yellow salvation. Under the mingled influences of rhetoric and fear of death, a man stepped forward from the listening half-circle. With the carbolic wool the expositor washed the dust from the thin brown arm, told the patient to admire an imaginary bird in the opposite direction, just like a Margate photographer with a child, and plunged the sharp-nosed syringe first into the boiling vaseline and then under the brown skin. Instantly it was withdrawn, but a drop or two of the yellow salvation had gone, and for three or four months—say, for the length of one plague season, but only for that—the man was fairly safe. The crowd sighed its satisfaction, as when a rocket bursts. The place on the arm was wiped with carbolic wool. “Take his thumb mark, give him the paper of instructions, pay him his six annas,” said the apostle of bacillary science in Mahrati to a subordinate, and the labour of a fatherly Government struggling with adversity went doggedly on.