cholera
and
preventive
inoccla
TION IN GAY A JAIL. By Surgeon-Major It. Macrae, m.b., i.m.s.,
Superintendent and Civil Surgeon of Gaya District.
Awaiting, as all are with great anxiety, the issue of the momentous question whether preventive inoculation is to prevail against cholera or not, it seems to me opportune to publish the results obtained during a recent epidemic in Gaya Jail, under circumstances which have hitherto not been paralleled. I trust therefore that the following account of M. Haffkine's anti-cholera inoculations will prove of interest to your readers. Cholera has been excessively prevalent in the Behar districts since the commencement of the rainy season, as well as in the N.-W. Provinces. In the Gaya district it has spread with great violence, and caused a mortality in the month of July which has not been equalled in any month for the past ten years. The disease was reintroduced into the district by pilgrims and others returning from the Kumb Mela at Allahabad in the month of February, and spread to some extent; but it was not till the rains set in?as is its usual course in Behar?that it assumed severe epidemic dimensions. A very marked contrast in this respect of prevalence appears between this and the previous year, when only 748 deaths were recorded during the year for the whole district; while in the month of July alone G,005 deaths from this disease were
registered.
,
Sept. 1894.]
CHOLERA AND PREVENTIVE INOCULATION IN GAYA JAIL.
Cholera broke out in the Gaya Jail on the 9th July, and from that date to the 2nd August 34 cases occurred, with 20 deaths, there being on date of first attack 422 prisoners in jail. The disease was clearly traceable to importation, hut its diffusion among the prisoners was a question of much greater difficulty. The sanitary condition of the jail is excellent; it was built quite recently on the latest plans, and is generally considered a model jail. The watersupply, which is from a well, is of excellent is quality and protected from pollution, and it believed that the spread of the disease was of flies finding aclargely due to the agency after milk cess to food and being in contact with cholera poison, and contaminating them. From the Oth to the 17th July, 6 cases occurred with 5
deaths.
Many
of the
prisoners
on
being
told about
preventive inoculation wished to be inoculated, and M. Hafikine, who had previously been communicated with, and whose zeal and enthusiasm
that he so well advocates are beyond the pi'aise, arrived here on the 18th July, and in who kindly Harvey, presence of assisted, and myself, inoculated i 47 prisoners, and on the 19th G8, making a total of 215 out of 433 in the jail on that date. in the
cause
Surgeon-Colonel
present
335
results that the inoculations wei*e placed at a disadvantage in so far as the epidemic continued to progress during the period which is required before their full effect can be anticipated. I have stated that up to the 17th six cases and five deaths occurred. I As, owing to the progress of the epidemic, a large number of prisoners were removed from the jail into camp, it will be found convenient to consider the effect produced by the anti-cholera inoculation under three headings:? (a) The first will include the period from the '18th July, the date of first inoculations, to the 24th July, the date on which final reinoculations were made, and refers to all the prisoners. (b) The second concerns the prisoners who remained in jail after the majority were removed into camp, and comprises the period from the 25th Juty to the 2nd August, on which date the final case occurred among this body of
prisoners.
(c) The third refers to the body of prisoners who were moved into camp on the 25th Julyand includes the period between that date and the 1st August, when the final case occurred among o this body. J The subjoined Table No. I gives from day to day details of the occurrences during the first o
period. no selection of pri" Being purely voluntary, There being nothing but all cases in the jail
possible; represented, male and female, old and
soners was
young, habituals and less frequent offenders, strong and even hospital patients weakly, convalescent and were
No difference of any inoculated and nonbetween kind was made inoculated prisoners; they were under absolutefood, water, ly identical conditions as regards in in short, every possible &c., sent their
representatives.
accommodation, respect. The method adopted by M. Haffkine he has your pages and need not be already described inhere. to further referred No test of anti-cholera inoculation, approachI
about ing in importance the been undertaken. Thouhitherto has describe, have been inoculated one
am
to
sands of the general public in various parts of India, and results of the been obtained notably in greatest promise have instances it cannot be these all in Calcutta; but said that the people inoculated remained under not inoculated, and similar conditions with those attacked by the disease. who were
It
subsequently
cannot be said that
to the
possibility
they
were
of infection.
to record on the 18th and 19th, the dates of first inoculations, they are excluded from the Table, which commences with the occurrences of the 20 th. The daily totals, shewn day by day, are those actually present after deducting cases attacked and releases, and adding admissions if any. A footnote shews dates on which fatalities occurred.
Table No. I. ?
,
?ua
No. of inoculated
No. of uninoculated
prisoners present.
prisoners present.
215 20tli July 1894... Cases Fatal
21st
July
...
...
...
2 Cases 2 Fatal
213 Nil.
1894...
Fatal
210 1 1
210
...
...
...
...
2 Cases 2 Fatal
209
>3rd July 1894... Inoculated Reinoculated Cases
2 1
Cases Fatal
211
>2ndJuly 1894... Cases
... ...
...
...
206 mi.
164 45 1
(in prisoner inoculated once.)
equally exposed
within the four In this instance, however, no loophole for doubt, the is there walls of a jail not inoculated were conditions of inoculated and is further the there and absolutely identical, it was to Check that possible great advantage It the results obtained with absolute accuracy. in judging the however, must not be forgotten,
213
...
208
206
!4th July 1894... Inoculated Reinoculated
...
20
...
188
Nil. *
Fatalities occurred
on
Nil,
20th and 25th ; 23rd and 24th
July 1894. Those dates refer to those
on
*
Fatalities occurred on 25th and 22nd; 22nd, 23rd and 24th July 1894.
which the patients
died,
INDIAN MEDICAL GAZETTE.
336
The next two Tables
are
of
a
still
as
period of time. It ma}' be here stated that the 23rd 45 prisoners and on the 24th 143 were reinoculated with the second vaccine, which completes the treatment as practised by M. Haffkine. On the morning of the 25th 325 prisoners were moved into camp, while 84 remained in jail. same
Table No. III.
on
j)
Date.
25th
25th
July
...
Cases
July 1894...
33 Inoculated Reinoculated
33 Reinoculated
...
3 30
July 1894...
1
July
...
...
...
...
...
29th
July 1894...
...
...
2 30
July 1894...
31st
July
Nil.
47
July 1894...
...
...
17 153
Nil.
141
170 Inoculated Reinoculated
... ...
17 153 Cases
Aug. 1894...
141
Inoculated Reinoculated
...
...
17 151 Oases
Fatality
occurred on 27th
*
July 1894.
46 ...
...
2 Cases 30 Fatal
1
...
,,,
1
Nil. *
1894... Inoculated Reinoculated
Fatalities occurred on 26th July 1894.
Ditto.
1 1
Summaries of the three preceding Tables are in juxtaposition for convenience of reference.
subjoined
Nil. '
17 153
Nil.
1st
Nil.
30th
...
Inoculated Reinoculated Nil.
Nil.
32
1
...
144 ...
170 30th
45
Inoculated Reinoculated
...
17 154 Oases
168
32
July 1894...
150 ...
Inoculated Reinoculated
Nil.
29th
?
Nil.
3 1
3 Cases 30 Fatal
Nil.
170 1 1
49
1894... Inoculated Reinoculated
...
...
17 157 2 1
Nil.
Nil.
28th
2 3
147 ...
171 Inoculated Reinoculated
Nil.
33
...
17 Oases 157 Fatal
(in prisoner reinoculated.)
48 ...
...
Reinoculated Oases Fatal
2Sth
3 Cases 30 Fatal
Nil.
174
prisoners present. 3 31 1 Cases
17 157
151
July 1894... Inoculated
Nil.
27th July 1894... Inoculated
...
27th July 1894... Inoculated
.
48 ...
...
Reinoculated
(in prisoner reinoculated.) 26th
151
Inoculated
Nil.
50
Reinoculated
July 1894...
Reinoculated
34 ...
prisoners present.
174 26th
No. of uninoculated
1894... Inoculated
No. of uninoculated
of inoculated
prisoners present.
Nil.
inoculated prisoners present.
"^9*
No.
+
174
The following Table No. II gives the number of inoculated, reinoculated, and non-inoculated prisoners and the occurrences in the jail from 25th July to 2nd August:? Table No. II.
1894.
the daily occurrences till the 1st August. I will be noted that the average present in column Inoculated' in this and the preceding Tables includes both inoculated and reinoculated.
more
they do, ati opportunity of contrasting two independent groups of observations occurring during the
interesting character, affording,
[Sept.
49
32
31st July 1894... Inoculated
..
Reinoculated
...
2 30
Table No. IV.
Nil.
{Summary of
Nil.
Nos.
I,
II and
III.)
and
preventive
inoccla
TION IN GAY A JAIL. By Surgeon-Major It. Macrae, m.b., i.m.s.,
Superintendent and Civil Surgeon of Gaya District.
Awaiting, as all are with great anxiety, the issue of the momentous question whether preventive inoculation is to prevail against cholera or not, it seems to me opportune to publish the results obtained during a recent epidemic in Gaya Jail, under circumstances which have hitherto not been paralleled. I trust therefore that the following account of M. Haffkine's anti-cholera inoculations will prove of interest to your readers. Cholera has been excessively prevalent in the Behar districts since the commencement of the rainy season, as well as in the N.-W. Provinces. In the Gaya district it has spread with great violence, and caused a mortality in the month of July which has not been equalled in any month for the past ten years. The disease was reintroduced into the district by pilgrims and others returning from the Kumb Mela at Allahabad in the month of February, and spread to some extent; but it was not till the rains set in?as is its usual course in Behar?that it assumed severe epidemic dimensions. A very marked contrast in this respect of prevalence appears between this and the previous year, when only 748 deaths were recorded during the year for the whole district; while in the month of July alone G,005 deaths from this disease were
registered.
,
Sept. 1894.]
CHOLERA AND PREVENTIVE INOCULATION IN GAYA JAIL.
Cholera broke out in the Gaya Jail on the 9th July, and from that date to the 2nd August 34 cases occurred, with 20 deaths, there being on date of first attack 422 prisoners in jail. The disease was clearly traceable to importation, hut its diffusion among the prisoners was a question of much greater difficulty. The sanitary condition of the jail is excellent; it was built quite recently on the latest plans, and is generally considered a model jail. The watersupply, which is from a well, is of excellent is quality and protected from pollution, and it believed that the spread of the disease was of flies finding aclargely due to the agency after milk cess to food and being in contact with cholera poison, and contaminating them. From the Oth to the 17th July, 6 cases occurred with 5
deaths.
Many
of the
prisoners
on
being
told about
preventive inoculation wished to be inoculated, and M. Hafikine, who had previously been communicated with, and whose zeal and enthusiasm
that he so well advocates are beyond the pi'aise, arrived here on the 18th July, and in who kindly Harvey, presence of assisted, and myself, inoculated i 47 prisoners, and on the 19th G8, making a total of 215 out of 433 in the jail on that date. in the
cause
Surgeon-Colonel
present
335
results that the inoculations wei*e placed at a disadvantage in so far as the epidemic continued to progress during the period which is required before their full effect can be anticipated. I have stated that up to the 17th six cases and five deaths occurred. I As, owing to the progress of the epidemic, a large number of prisoners were removed from the jail into camp, it will be found convenient to consider the effect produced by the anti-cholera inoculation under three headings:? (a) The first will include the period from the '18th July, the date of first inoculations, to the 24th July, the date on which final reinoculations were made, and refers to all the prisoners. (b) The second concerns the prisoners who remained in jail after the majority were removed into camp, and comprises the period from the 25th Juty to the 2nd August, on which date the final case occurred among this body of
prisoners.
(c) The third refers to the body of prisoners who were moved into camp on the 25th Julyand includes the period between that date and the 1st August, when the final case occurred among o this body. J The subjoined Table No. I gives from day to day details of the occurrences during the first o
period. no selection of pri" Being purely voluntary, There being nothing but all cases in the jail
possible; represented, male and female, old and
soners was
young, habituals and less frequent offenders, strong and even hospital patients weakly, convalescent and were
No difference of any inoculated and nonbetween kind was made inoculated prisoners; they were under absolutefood, water, ly identical conditions as regards in in short, every possible &c., sent their
representatives.
accommodation, respect. The method adopted by M. Haffkine he has your pages and need not be already described inhere. to further referred No test of anti-cholera inoculation, approachI
about ing in importance the been undertaken. Thouhitherto has describe, have been inoculated one
am
to
sands of the general public in various parts of India, and results of the been obtained notably in greatest promise have instances it cannot be these all in Calcutta; but said that the people inoculated remained under not inoculated, and similar conditions with those attacked by the disease. who were
It
subsequently
cannot be said that
to the
possibility
they
were
of infection.
to record on the 18th and 19th, the dates of first inoculations, they are excluded from the Table, which commences with the occurrences of the 20 th. The daily totals, shewn day by day, are those actually present after deducting cases attacked and releases, and adding admissions if any. A footnote shews dates on which fatalities occurred.
Table No. I. ?
,
?ua
No. of inoculated
No. of uninoculated
prisoners present.
prisoners present.
215 20tli July 1894... Cases Fatal
21st
July
...
...
...
2 Cases 2 Fatal
213 Nil.
1894...
Fatal
210 1 1
210
...
...
...
...
2 Cases 2 Fatal
209
>3rd July 1894... Inoculated Reinoculated Cases
2 1
Cases Fatal
211
>2ndJuly 1894... Cases
... ...
...
...
206 mi.
164 45 1
(in prisoner inoculated once.)
equally exposed
within the four In this instance, however, no loophole for doubt, the is there walls of a jail not inoculated were conditions of inoculated and is further the there and absolutely identical, it was to Check that possible great advantage It the results obtained with absolute accuracy. in judging the however, must not be forgotten,
213
...
208
206
!4th July 1894... Inoculated Reinoculated
...
20
...
188
Nil. *
Fatalities occurred
on
Nil,
20th and 25th ; 23rd and 24th
July 1894. Those dates refer to those
on
*
Fatalities occurred on 25th and 22nd; 22nd, 23rd and 24th July 1894.
which the patients
died,
INDIAN MEDICAL GAZETTE.
336
The next two Tables
are
of
a
still
as
period of time. It ma}' be here stated that the 23rd 45 prisoners and on the 24th 143 were reinoculated with the second vaccine, which completes the treatment as practised by M. Haffkine. On the morning of the 25th 325 prisoners were moved into camp, while 84 remained in jail. same
Table No. III.
on
j)
Date.
25th
25th
July
...
Cases
July 1894...
33 Inoculated Reinoculated
33 Reinoculated
...
3 30
July 1894...
1
July
...
...
...
...
...
29th
July 1894...
...
...
2 30
July 1894...
31st
July
Nil.
47
July 1894...
...
...
17 153
Nil.
141
170 Inoculated Reinoculated
... ...
17 153 Cases
Aug. 1894...
141
Inoculated Reinoculated
...
...
17 151 Oases
Fatality
occurred on 27th
*
July 1894.
46 ...
...
2 Cases 30 Fatal
1
...
,,,
1
Nil. *
1894... Inoculated Reinoculated
Fatalities occurred on 26th July 1894.
Ditto.
1 1
Summaries of the three preceding Tables are in juxtaposition for convenience of reference.
subjoined
Nil. '
17 153
Nil.
1st
Nil.
30th
...
Inoculated Reinoculated Nil.
Nil.
32
1
...
144 ...
170 30th
45
Inoculated Reinoculated
...
17 154 Oases
168
32
July 1894...
150 ...
Inoculated Reinoculated
Nil.
29th
?
Nil.
3 1
3 Cases 30 Fatal
Nil.
170 1 1
49
1894... Inoculated Reinoculated
...
...
17 157 2 1
Nil.
Nil.
28th
2 3
147 ...
171 Inoculated Reinoculated
Nil.
33
...
17 Oases 157 Fatal
(in prisoner reinoculated.)
48 ...
...
Reinoculated Oases Fatal
2Sth
3 Cases 30 Fatal
Nil.
174
prisoners present. 3 31 1 Cases
17 157
151
July 1894... Inoculated
Nil.
27th July 1894... Inoculated
...
27th July 1894... Inoculated
.
48 ...
...
Reinoculated
(in prisoner reinoculated.) 26th
151
Inoculated
Nil.
50
Reinoculated
July 1894...
Reinoculated
34 ...
prisoners present.
174 26th
No. of uninoculated
1894... Inoculated
No. of uninoculated
of inoculated
prisoners present.
Nil.
inoculated prisoners present.
"^9*
No.
+
174
The following Table No. II gives the number of inoculated, reinoculated, and non-inoculated prisoners and the occurrences in the jail from 25th July to 2nd August:? Table No. II.
1894.
the daily occurrences till the 1st August. I will be noted that the average present in column Inoculated' in this and the preceding Tables includes both inoculated and reinoculated.
more
they do, ati opportunity of contrasting two independent groups of observations occurring during the
interesting character, affording,
[Sept.
49
32
31st July 1894... Inoculated
..
Reinoculated
...
2 30
Table No. IV.
Nil.
{Summary of
Nil.
Nos.
I,
II and
III.)
