Confirming the earlier statements as to the extraordinary filth of the houses—the cattle under the same roof and the baskets of damp and unripe grain—he directs attention specially to the disposal of the dead. The custom of the country is to burn the body beside the most convenient mountain stream terminating in the Ganges. But from that good practice the people have deviated in regard to bodies dead of any pestilence (smallpox, cholera, plague), which are buried. Of all countries the Himalaya is least suited to the burial of the dead. For, by reason of the rocky subsoil, it is seldom possible to dig a grave more than two feet deep; and, as a rule, the pestilent dead are laid in shallow trenches in the surface soil of the field nearest to the place of death, or of the terrace facing the house, or even of the floor of the house itself. This bad practice is begotten of fear to handle the body, and has been long established. Such mismanagement of the dead is sufficient to account for the continuous existence of the active principle of plague-disease, sometimes dormant for want of opportunity, but ever ready to affect persons suitably prepared by any cause producing a low or bad state of health. In the houses of families about to suffer from an outbreak of plague, rats are sometimes found dead on the floor. Planck had seen them himself; all that he had seen appeared to have died suddenly, as by suffocation, their bodies being in good condition, a piece of rag sometimes clenched in the teeth. He mentions nine villages, all of them endemic seats of plague, in which the premonitory death of rats in the infected houses was testified. The affected villages were not one in a hundred of all the villages of Kumaon, and were widely scattered throughout the northern half of the province. Even in each of those few villages, the plague is confined to one house, or one terrace, or one portion of the village.
Let us turn next to the small spots of bubo-plague in the remote province of Yun-nan. Our information comes from members of the British and French Consular services[311].
The plague occurs in towns and villages and is the cause of much mortality. After ravaging villages scattered about the plains, it frequently ascends the mountains, and takes off many of the aborigines inhabiting the high lands. What, in M. Rocher’s opinion, aggravates the evil is the practice of not burying the bodies of those who die of this disease. Instead of being buried, the body is placed on a bier and exposed to the sun. As a consequence of this practice the traveller passing the outskirts of a village where the plague is raging is nearly choked with the nauseous smell emanating from the exposed and rotting corpses. Burial is the usual mode of disposal, although many of the villages are on rocky mountain sides, as in Kumaon. The rats are first affected; as soon as they sicken, they leave their holes in troops, and after staggering about and falling over each other, drop down dead. Mr Baber had the same information from a French missionary in the upper valley of the Salwen, a long, low valley about two miles broad, walled in by immense precipices, so hot in summer that the inhabitants go up the hill sides to live. The approach of bubo-plague (the buboes may be as large as a hen’s or goose’s egg) may often be known from the extraordinary behaviour of the rats, who leave their holes and crevices and issue on to the floors without a trace of their accustomed timidity, springing continually upwards from their hind legs as if they were trying to jump out of something. The rats fall dead, and then comes the turn of the poultry, pigs, goats, etc. The good father had a theory of his own that the plague is really a pestilential emanation slowly rising in an equable stratum from the ground, the smallest creatures being first engulfed. The larger plague-centre at or near the capital, Talifoo, appears to be related to Mohammedan warfare, and possibly to the neglect to bury the dead, which is an admitted fact, although not connected by the narrator with the prevalence of plague.
The other Chinese plague-spot is hundreds of miles away, on the shores of the Gulf of Tonking. The best known centre of plague is the port of Pakhoi, the native quarter of which is described as peculiarly filthy. The houses are little cleaner than the streets, the floors being saturated with excrement, and the drains being either close to the surface or open altogether. An outbreak of plague there in 1882 is minutely described by Dr Lowry[312].
It occurred in the hot weather of June (85° Fahr. day, 76° Fahr. night); for fear of thieves the houses are carefully shut up even on the hottest night. The epidemic caused about 400 to 500 deaths in a population of 25,000. The disease does not spread. In nearly every house where the disease broke out, the rats had been coming out of their holes and dying on the floors: Dr Lowry dissected several of them, and found the lungs congested. In the human subject, except for the buboes, the disease resembled typhus: “anyone going to the bedside of a patient would certainly at first think it was that disease he had to deal with.” The same disease occurred at Lien-chow, a city twelve miles off. Another English physician in the service of the China Maritime Customs heard of a malady with the symptoms of plague in certain districts of Southern Kiangsi in the autumn of 1886; but no particulars were to be had. Typhus was prevalent, and very fatal, every year in the towns, villages and hamlets of Northern Kiangsi.
One curious piece of evidence as to the death of rats, not associated with plague in men, comes from a more northern province of China. In the autumn of 1881, on the opposite side of the Yang-tsi from Nanking and in the western suburbs of the ancient capital, the rats emerged from holes in dwellings, jumped up, turned round, and fell dead. Baskets and boxes filled with their bodies were cast into the canal. “Here,” says Dr Macgowan, “was evidently a subsoil poison which affected the animals precisely in the same way as the malaria of the Yun-nan pest. Happily the subterranean miasm at Nanking did not affect animals that live above ground[313].”
The evidence from Kutch, Kattiwar, and Marwar relates to the years 1815-20, and 1838. In circumstances peculiar in some respects, namely, of walled towns and stockaded villages, but the same as those already given in the matter of filth from cattle crowded into the human dwellings, we find bubo-plague breaking out so long as the unwholesome state of things lasted under Mahratta rule and until British rule had been fairly at work. The causes of the bubo-plague, says Whyte, were the same as of typhus—walled and crowded towns, cattle housed with human beings, slow wasting diseases among the cattle, which were not killed for food but kept for milk and ghee. He questions whether, in shutting out their enemies, they had not shut in one far more powerful[314]. Here also we have various independent witnesses[315] testifying to the premonitory death of the rats; they lay dead in all places and directions—in the streets, houses, and hiding-places of the walls. This happened in every town that was affected in Marwar, so that the inhabitants of any house instantly quitted it on seeing a dead rat.
Relation of Typhus to Bubo-plague.
The smallest and the most easily surveyed of all the recent foci of bubo-plague, is that among the Bedouin of the Cyrenaic plateau in North Africa (port of Benghazi), a desert region corresponding to one of the most famous corn-lands of antiquity.
There was no difference of opinion that the small outbreak of plague in 1874 began simultaneously in the tents of Orphas and the tents of Ferig-el-Hanan, containing together about a hundred souls[316]. These Arabs keep cows, sheep and goats; some of them also cultivate small patches of corn. They are subject to periodic famines, and there had been much want among them in 1869, 1870, 1871, 1872 and 1873, attended by epidemics of typhus, cholera and smallpox. In the winter they found employment among the traders of Merdjé, and at the end of March, 1873, had quitted that village to place their animals in the neighbouring hill-pastures. The ground had been saturated, after long drought, by the rains of the winter. Their tents are pitched in hollows which may be filled by water in a few minutes. The encampments, like those of the Bedouin in Arabia, are excessively filthy and are often the scene of typhus fever. In April, 1874, the plague began, the first case being in a child; the buboes were in the groin, armpit or neck. The other symptoms were bilious vomiting, black vomit, haematemesis, petechiae, anthraceous boils, pains in the head, collapse, and delirium. A few cases were mild, but the majority grave and fatal; in several cases there was a relapse with new buboes. The disease was brought from the tents to the village of Merdjé, in which 270 were attacked in a population of 310, with 100 deaths. The total known attacks from 5 April to 24 July were 533 in a population of 734, with 208 deaths and 325 recoveries, 201 resisting the infection. The sanitary state of the village was as bad as that of the tents: the houses, entered by a low door, had windows not to the sun, but to the courtyard, which is a stable choked with filth; the floors of the houses are covered with filth. The graveyard is in the centre of the village, beside a pool of standing water: the graves are shallow, and the corpses are sometimes unearthed by jackals. Both in the village and in the encampments a fall of rain was followed by a new series of attacks. The advice of the sanitary commisioner was to make graves at least six feet deep, and to cover them with lime.