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.
[Illustration: A HEALTH CAMP.]
[Illustration: 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.
[Illustration: A VILLAGE STREET.]
[Illustration: 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.
FOOTNOTES:
[13] For the sake of comparison it may be of interest to quote a few
of the symptoms given in descriptions of other plagues. The account
by Thucydides (ii. 49) of the plague in Athens, 430 B.C., is the
most detailed: “All of a sudden,” he says, “people who were quite
well before were seized with violent pains in the head, together
with redness and inflammation of the eyes; the throat and tongue
became blood-red, and the breath strangely disagreeable. Sneezing and
sore throat ensued, and after a short time the lungs were affected
and there was violent coughing. When the disease settled in the
stomach it caused great disorder, with every known kind of purging
of bile, accompanied by severe pain. Most patients suffered from an
empty retching, with violent spasms, that sometimes gave relief at
once, sometimes only after a long time. The surface of the body was
not very hot to touch, nor was it pale, but suffused red or livid,
covered with small spots and ulcers. But the internal heat was so
great that the patients could not endure even the lightest clothes or
muslins, but insisted on being naked, and longed to throw themselves
into cold water. Many who were not looked after actually jumped into
wells, overcome with unquenchable thirst; but it was just the same
whether a patient drank much or little. All through the illness they
were unable to keep still or get any sleep. Whilst the fever was at
its height the body did not waste away, but resisted the disease
beyond all expectation, so that most patients died from the internal
fever on the seventh or ninth day with a good deal of strength still
left; or, if they survived the crisis, the disease descended to the
bowels, where it set up ulceration and such violent diarrhœa that in
most cases death ensued from weakness.”
The chief symptoms given by Boccaccio in the Introduction to the
“Decameron,” where he describes the plague in Florence (1348),
are: “At the beginning of the disease both men and women developed
swellings in the groin or under the armpit. These swellings grew to
the size of a crab-apple or an egg, sometimes larger, sometimes less,
and the common people called them ‘gavoccioli.’ In a short time this
deadly sore began to spread to all parts of the body, and the nature
of the disease gradually changed into black or livid spots, which
appeared on the arms and thighs and other parts, sometimes large and
scattered, sometimes minute and thick together.” He goes on to speak
of the entire inability of doctors to deal with the plague, and of
the readiness with which the smallest association or contagion spread
it from one to another.
Defoe wrote only at secondhand about the plague of London (1665),
but such symptoms as he gives of that “spotted fever” were probably
taken from eye-witnesses with whom he had conversed. He mentions
violent pains in the head, vomitings, and spots on the thighs; also
“swellings, generally in the neck and groin, which, when they grew
hard and would not break, grew so painful that it was equal to the
most exquisite torture.... In some these swellings were made hard,
partly by the force of the distemper, and partly by their being too
violently drawn, and were so hard that no instrument could cut them,
and then they burnt them with caustics, so that many died raving mad
in the torment, and some in the very operation. In these distresses,
some for want of help to hold them down in their beds, or to look to
them, laid hands upon themselves. Some broke out into the streets,
perhaps naked, and would run directly down to the river, if they were
not stopped by the watchman or other officer, and plunge themselves
into the water, wherever they found it.”
[14] In 1902, nineteen died from this cause at Mulkowal, a village
in the Punjab, and the Punjab Government abandoned the hope of
inoculation for the time.