"That in the opinion of this meeting the bubonic plague is not a contagious disease. It originates from poisoned air, and this poison is created in the air on account of atmospherical germs and the excess of terrestrial humidities.
"That this meeting, having carefully considered the Resolution of the Punjab Government (11th January 1898), is of opinion that the rules embodied in that Resolution (isolation, disinfection, etc.), are unnecessary under the principles of Unani medical science."
And among statements to be made to the Plague Commissioners was the following, from a native practitioner in Bombay (April 1899):—
"I do not think the plague was imported in Bombay from Hong Kong or anywhere else. I attribute three sources of causes of outbreaks of plague in Bombay:
(a) The predisposing cause was the Bombay Municipality; (b) The exciting cause was the Nature herself; (c) The aggravating cause was the Plague Committee."
All these difficulties were well stated by Surgeon-General Harvey, Director-General of the Indian Medical Service, at the discussion on Haffkine's discourse before the Royal Society, June 1899:—
"The people of England should consider the difficulties attending the work of a bacteriologist in India.... He had no doubt as to the value of the inoculations. At Undhera he carefully examined the results of the experiment, and, as far as he could judge, there was no possibility of error. The results in that experiment were such as to be 90 per cent. in favour of the inoculated against the uninoculated. The natives of India were, however, a strange people, and it was difficult to prophesy how they would act. In Calcutta, the mention of inoculations had driven in hot haste from the city 300,000 people, many of whom afterwards returned and were inoculated; while at Hubli he had seen the inhabitants come in their thousands to be inoculated and pay for the inoculations. The medical officer in charge at Hubli had performed about 80,000 inoculations, and had only observed some 12 abscesses. He thought that 12 abscesses only, in 80,000 inoculations, showed good results. But, after all, what were the numbers of inoculations performed to the 300,000,000 inhabitants of India? He felt that even if every one consented to be inoculated it was impossible to provide the vaccine or the medical officers for such a demand. It was accordingly to sanitary improvements that he looked with the most confidence to protect India against the plague."
Therefore, now and for many years to come, preventive inoculation must fall into line with the other world-wide ways of fighting plague—quarantine, notification, isolation, all sanitary measures, destruction of rats—le rat, le génie de la peste—evacuation of infected towns, disinfection or unroofing of infected houses. Happily, this is just what it does. That admirable paper, the Indian Medical Gazette (September 1901), has put this fact very simply: "No one ever imagined that inoculation was the only means of fighting plague. Its great value consists in its immediate application. To sanitate, ventilate, and practically rebuild a town or village takes time; and in the meantime thousands die." For sudden outbursts of plague—since rats are one chief source of infection, and notification is fundamentally abhorrent to native custom, and evacuation may ruin trade, or spread infection, or be impossible by reason of the rains—since "East is East, and West is West"—it is not always possible to provide, for an Indian village smitten by plague, the excellent arrangements of the Western world. In all such cases, and in all cases of epidemic plague within narrow limits, as in jails, barracks, mills, and the like centres of human life; and in all inner communities, such as the Parsee community at Daman, or the Jewish community at Aden—by every test of this kind, the saving power of preventive inoculation has been proved, again and again, past all doubt. As for those larger death-traps, Hubli, Dhárwár, and the rest of them, here, though the statistics are inexact, we have the word of the men and women themselves who stood between the dead and the living, and the plague was stayed. Such faults as there were, in 1899, in the treatment—the contamination of this or that stock of the fluid, and the inadequate method of standardisation—have been duly noted by the Commission. The rush for the fluid in 1899 may be estimated from the following paragraphs:—
(i.) Paris. "The preparation of anti-plague serum is being rapidly proceeded with; up to the present time the Institute has supplied it, in response to all the very numerous requests which have come from Portugal, Spain, Italy, and Turkey, without encroaching on the reserve kept in readiness for Paris and the departments." (Lancet, 16th September 1899.)
(ii.) India. "The spread of plague westward to Spain and Portugal seems to have excited more or less general alarm, and I hear that an unprecedented demand has suddenly arisen for the plague prophylactic fluid. The Government of India have been asked the cost of supplying from 50,000 to 100,000 doses, and the earliest date at which this quantity could be despatched. It is also desired to know if in case of need 50,000 doses a week could be sent to London. Russia desires to obtain a considerable stock for Port Arthur. Italy has been making inquiries for home use; and also Portugal, in order to inoculate at Mozambique. The present laboratory is at Government House, Parel, Bombay, and has only recently been fitted up by the Government of India. About 10,000 doses a day can be turned out, but it is thought that still further enlargements will be required if the demand should increase beyond this amount." (Lancet, 23rd September 1899.)