which

ment

seems to

in

application

in

dealing

be of all others the easiest promising of success

and the most

with

tion of

plague

in India.

The segrega-

epidemic disease iu an Indian city is, under the existing law, and in the present state of the people's minds, an impossible task. Every move calculated to assist the early detection and isolation of disease treads upon the religious the social habits of this or that comand is at once met either by respectful

customs

or

munity,

deputations

the influential of the threatened community or by a stubborn and open resistance from the lower

Indian Htcdiqal (Sazqtte,

classes.

APRIL, 1898. SEGREGATION VERSUS INOCULATION". Under the above in the were

heading

a

to the Local Government from

strife has arisen

Bombay dailies that, if the issue at stake not so grave, would almost provoke a smile.

There is

Disease,

on

its appearance, is

carefully

concealed,and may, as it actually did in Bombay, gain a firm footing before detection, thus rendering the work of the sanitary officers to entirely surround and isolate the disease too late, and causing among the ignorant in consequence a firm belief that all sanitary measures are undertaken with the express object of harassing them the enjoyment of their religion and their

in

not the slightest scientific, or common ground for arraying the two measures the homes. This is to our minds the grave danger one against the other; the first represents the now threatening the large cities of this country, present state of scientific knowledge in dealing and they should look to it that they do not with communicable diseases throughout the civi- discover the plague in their midst when, as iu lised world, the second is new and is so far Bombay, it is too late to get ahead of the disease with it are thereby on its trial, though none the less deserving of and their efforts to deal their strength. Nothing short of a consideration on that account. We have already shorn of of death certification will be should that system thorough steps urged in these columns sense

taken to investigate Professor Haffkine's results with the view of placing the question of the of the preventive serum on a sounder and of affording the profession at large

efficacy basis,

firmer ground on which to base their opinion. Until more is known of the prophylactic and its effects, the attitude of the profession should

safeguard iu this tection, surely this is

prove

a

and

dealt with

by

those who

matter of disease dea matter that can be

know and rule the

There are in these days hundreds of native medical men turned out from our young medical schools, to whom a small salary as regis-

people.

trars of deaths in the districts in which

they reside would be gladly accepted ; and under such Opposition will be blind belief, and, seeing how great are the bene- a system, gradually introduced, the record of fits hoped for, we are all bound to give our assis- death-causation would become year by year tance in procuring the truth by whatever means more efficient and accurate. This is a matter lie in our power. worthy of a larger field of discussion and is outThe danger of drawing too hasty inferences side the scope of this article, but is at least to be be decided.

as

mistaken

as

a

from statistics has been demonstrated too often to allow us to overlook it here, and, tempt-

considered

ing though Professor Haffkine's first group of figures are, yet we must bear in mind that they are after all only, as it were, negative proofs of the result, and that the of fallacy

value.

This,

has

to prove itself.

loopholes

both obvious and nuni tous. All the more need for help from us all by careful experiment and observation to verify the utility of treat-

are

epidemic

as

an

disease

aid to efficient treatment of

by

we

methods of

fully recognised

maintain, plague inoculation

We cannot believe that, ever is proved of real value, there will be more difficulty in introducing it than there has

yet

if it

been in the case of vaccination. With the latter there was a long struggle, but the victory is ours: thanks to the untiring efforts of medical

142

INDIAN MEDICAL GAZETTE.

men throughout the country for years, each convinced that he taught the truth and beinoO -3 able to prove his words daily by examples of immunity from the disease that hitherto had

ravaged humanity

without

a

check ;

so

may

it be with the have

plague-serum, but we must first light and be not content with calling

more

to others for

personal

it,

but must strive to obtain it

efforts.

lends itself to

us

Curiously enough for

experiment

the

iu this

by our plague regard

by the method of its attack on a new community. First the imported case or cases, then the dead rats, and after, in some cases, weeks, the cases and the outbreak of the epidemic. Here are lines oti which research might be con-

local

ducted with benefit of the first

to

imported

all ; on the appearance case, let half the commu-

whether it is a jail- or a village- submit to inoculation and let the results be recorded. Jail

nity,

experience would be especially valuable,

as the life and to of infection are conditions exposure and the similar sources of many fallacy perforce

in the latter respect, which are inevitable in dealing with a free village population, are eliminated. Town and more

city experiments

fallacious and

are

to

be

would

a

fortiori be

deprecated

on

that

Let the two

account. new, work

on

side

methods, the old and the by side. At present both

cloud of disadvantage : the first in are that it cannot be efficient unless thorough, and the second in that it has not yet won its spurs as a tried and proved weapon. under

a

[April

1898.

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