112 GEOGRAPHIC DISTRIBUTION OF BUBONIC PLAGUE 



"Twice before Poena has been ravaged by the plague, and eacli succeeding 

 epidemic, unfortunately, has been worse than the preceding. In February of 

 the present year (1S99) the chief plague authority stated that the <lisease iiad 

 been staini)od out of the city. In ^larch and Ai)ril the death rate considerably 

 increased, and in July the disease appeared in its worst form, carrying off from 

 150 to IGO people a day. Normally, the city has a population of 140,000, l)ut in 

 five month.s it has dwindled to 60,000. But as the pojjulation went down, the 

 mortality went up, and even at the time of our visit still persisted at the rate 

 of'150 deaths a day. Such a rate of mortality in New York would mean about 

 10,000 deaths per day, 70,000 per week. p]ven in Poona enough people die in 

 a month to populate a prosperous American city. During August there wa.s an 

 average of 100 hospital admissions per day and over 80 deaths. 



"The excursion to Poona was most impressive. Traveling upward for hours 

 through the Western Ghats, the country was so beautiful and the air so much 

 cooler than at the seadevel that one could scarcely believe that he was approach- 

 ing, in the plain a little lower down on the other side, the pest-stricken city of 

 Poona. On arrival at the railway station, however, the first signs of distress 

 were noticed. Train-loads of people were fleeing from the place. A drive 

 through the town to the office of the chief plague authority showed how rapidly 

 it was being deserted. ]Many of the streets were almost empty, shoj) doors and 

 windows were closed and barricaded, plague notices were jjasted on the wall, a 

 preternatural stillness was everywhere noticeable, tlie few people encountered 

 walking quietly along with heads bowed and faces sorrowful. A visit was made 

 to some houses whence i)lague cases had just been reported, with the native 

 editor of the principal Poona newspaper, this gentleman having volunteered 

 his services as plague inspector. In a small hovel, scarcely larger than a ship's 

 cabin, one might find a patient surrounded by several of his friends awaiting 

 the arrival of tlie inspector. The chances for contact contamination were mani- 

 fold. 



"At the general plague hospital tlierfe were some eight hundred cases of the 

 disease under the ciiarge of JNIajor Windle. He was assisted by eiglit European 

 nurses and a number of native helpers. He complained that it was almost im- 

 possible to retain natives as workmen. Even washermen and grave-diggers could 

 not be employed in sufficient numbers, owing to the fears and prejudices of the 

 people. Cart-loads of the newly attacked were being brought into the hospital 

 at its entrance, while a body was can-ied out from the wards every ten minutes 

 to the morgue at the rear. Those who live in the West can scarcely appi-eciate 

 the enormous disadvantages under which medical men fight plague in India. 

 The people are ignorant and superstitious, the rigid caste rules prevent any 

 successful application of modern hygienic measures, and even the preventive 

 inoculation cannot be utilized to any great extent, owing to the fact that thus 

 far the bacilli have been grown in beef broth, and the natives will not counte- 

 nance such a profanation of the sacred animal. Even in death, caste rules have 

 to be observed, and it was found at the morgue that partitions had to be put up 

 separating the low-caste Hindoos from those of high caste, from the Moham- 

 medans, and from the Parsees and Christians. The floor of the morgue i)re- 

 sented a melancholy sight. In one of the rooms no less than thirty-two bodies 



