partly to the religious and partly to the fatalislight in which disease and death are viewed.
tic
The doctrine that mauy diseases are preventable is a new one which is not yet understood in India
time to
directed in render it become
Village sanitation is the subject of in
a
first paper
present issue by Assistant-Surgeon Purna Chandra Das. The account given clearly our
sets forth the
unhealthy conditions under which placed, and describes some of villagers the customs which contribute towards the rapid extension of periodic visitations of epidemic the
are
diseases in the rural districts. writer affairs
are
getting
According
worse, and
he
to the
fully
which appear to explains liim to be the main factors instrumental in the some
of the
causes
manner
a
considerable influ-
of
but also
take
application
been
so
garrisons
of
to
the
laws.
sanitary
of these Laws of Health had
Army
at
home,
obligation
as
it
successful in the British much
was as
only it
carryIt is easy to in India being the
advantage
The
in
not
cause
reforms.
sanitary
for the
to
that it
which would
powerful, important agent
an
account
VILLAGE SANITATION IN INDIA.
general community
a
more
out
ing
trained
but that influence might be fostered and
ence,
JULY 1890.
the
have
they
graduates
views will not fail in
Their
slowly permeate
among whom
Sfltq Jmlimt ^"ftcdial (Sasqttc;.
the medical
except by colleges.
at the
a
moral
was
natural consequence to try its effects on the Army in India. The results attained were
a
even
better than in
in the Indian
previously
England,
for the
Army, European
been
so
and
mortality Native, had
great that the reduction in
the death-rate that followed the introduction of
sanitary regulations
was
even
apparent
more
than that which had been obtained in
England. one for disease which To take, example, always deterioration of the health conditions of the under it is thrives insanitary conditions; villages. To remove these and prevent others iu the Hutchesou shown by Surgeon-Major equally dangerous from arising, certain profor of 1887 the Report Sanitary Commissioner posals are made, and we think some of the sugthe Government of India that all the imwith gestions are worthy of attention, though we are garrisons of India enjoy now an iminclined to think they are incomplete, and will, portant munity from cholera unknown in former years, in consequence, briefly give our own views as to and that this decrease in mortality from cholera what we consider necessary to meet the sanitary is not confined to European troops, but correrequirements of this country. It is an unAvith a marked in the death-rate
doubted fact that sanitation in India has been mainly confined to the garrisons and a few of the
larger towns. Even now Benares, Allahabad, Agra, and other important towns are but preparing to provide themselves with a public water-supply; while towns such as Puri and other holy places where pilgrims annually flock from tute as
nearly every part of India are still destiof a public and safe water-supply, and are
backward in the
tary regulations for as
might
The
be
cause
adoption of ordinary sanithe prevention of disease
expected in a less civilised country. indifference to health is due
of this
decrease
sponds
from the
among Native troops and small scale, the general popula-
same cause
prisoners. On
a
tion have been also tried and with very encourins results, for a similar reduction in deathrates
have followed
the progress ot
works iu Calcutta and Bombay. With these gratifying instances of animate the
authorities,
it is time that
sanitary
success to some
gen-
eral scheme should be adopted to give to every town and village the benefits which are sure to follow a properly regulated system of sanitation. iu the right direction has been the forOne
step
July
MEDICAL EDUCATION.
1890]
mation of a Sanitary Board for each province. But this Board will soon find that its influence for good will depend on whether it has a local
211
tively inexpensive
to
provide
and pure proper disposal of the a
good
water-supply, night-soil, refuse, and slop water, to drain the subsoil* to regulate the building of healthy huts agency in the form of Medical Officers of Health distributed throughout the province, who shall, and houses, to keep an accurate account of the one hand, be to the local authorities on the births and deaths, to obtain thorough aud efficient advisers, inspectors and reporters on all sanitary vaccination, aud to have always provided and in matters, and who shall, on the other hand, be the readiness arrangements for the prompt checking connecting link between the Central Board of epidemic diseases. and the local authorities. Rules and regulaThe most, essential thing, however, is to know tions may be framed by a Central Board, but precisely what requires to be done. With this a distinct medical sanitary service is required knowledge before competent authorities emto assist the Municipalities, Village Unions, and powered to act aud with the agency sketched Punchayets in the proper apprehension, and above, a great change in the public health of application of these rules and regulations and in India would be quietly effected in the course of sharing the responsibility of their being systema- a very few years, and in a manner engaging the tically and regularly carried out in a right and hearty co-operation of the people themselves. inexpensive manner. Without a sanitary service real progress can be insured or even expected, for whatever may be done without it will only
no
accomplished at irregular intervals under the influence of panic or under such pressure as to
be
it is grave doubts in many minds whether for whenever advisable under any circumstances, the panic or pressure is over, a return to the old conditions will quickly follow.
cause
service, however, whose duty it would attend to the gradual and steady improve-
From be
to
a
ment of the health conditions
of the country,
might be expected. The service need not be an expensive one. It might very well be purely native in its composition with the exception that the Civil Surgeon of the district would hold the position of consultant, and the Central Board might, if found necessary, have several European Medical Inspectors. A career would be opened up thereby for a number of
much
native medical men, and an educated and influential class of men would be at once raised in favor of sanitation, who would also at the
good
same
the
time be in
people
With
a
sympathy
and close touch with
of the country.
proper directing
Sanitary
Board and
described, work with the a local agency, local authorities, it would be found that effective sanitation of small towns and villages is not a.3
after all
a
difficult
but that it is
problem
to
nor a
exceedingly simple
costly scheme; and compara-
to secure
a
tic
The doctrine that mauy diseases are preventable is a new one which is not yet understood in India
time to
directed in render it become
Village sanitation is the subject of in
a
first paper
present issue by Assistant-Surgeon Purna Chandra Das. The account given clearly our
sets forth the
unhealthy conditions under which placed, and describes some of villagers the customs which contribute towards the rapid extension of periodic visitations of epidemic the
are
diseases in the rural districts. writer affairs
are
getting
According
worse, and
he
to the
fully
which appear to explains liim to be the main factors instrumental in the some
of the
causes
manner
a
considerable influ-
of
but also
take
application
been
so
garrisons
of
to
the
laws.
sanitary
of these Laws of Health had
Army
at
home,
obligation
as
it
successful in the British much
was as
only it
carryIt is easy to in India being the
advantage
The
in
not
cause
reforms.
sanitary
for the
to
that it
which would
powerful, important agent
an
account
VILLAGE SANITATION IN INDIA.
general community
a
more
out
ing
trained
but that influence might be fostered and
ence,
JULY 1890.
the
have
they
graduates
views will not fail in
Their
slowly permeate
among whom
Sfltq Jmlimt ^"ftcdial (Sasqttc;.
the medical
except by colleges.
at the
a
moral
was
natural consequence to try its effects on the Army in India. The results attained were
a
even
better than in
in the Indian
previously
England,
for the
Army, European
been
so
and
mortality Native, had
great that the reduction in
the death-rate that followed the introduction of
sanitary regulations
was
even
apparent
more
than that which had been obtained in
England. one for disease which To take, example, always deterioration of the health conditions of the under it is thrives insanitary conditions; villages. To remove these and prevent others iu the Hutchesou shown by Surgeon-Major equally dangerous from arising, certain profor of 1887 the Report Sanitary Commissioner posals are made, and we think some of the sugthe Government of India that all the imwith gestions are worthy of attention, though we are garrisons of India enjoy now an iminclined to think they are incomplete, and will, portant munity from cholera unknown in former years, in consequence, briefly give our own views as to and that this decrease in mortality from cholera what we consider necessary to meet the sanitary is not confined to European troops, but correrequirements of this country. It is an unAvith a marked in the death-rate
doubted fact that sanitation in India has been mainly confined to the garrisons and a few of the
larger towns. Even now Benares, Allahabad, Agra, and other important towns are but preparing to provide themselves with a public water-supply; while towns such as Puri and other holy places where pilgrims annually flock from tute as
nearly every part of India are still destiof a public and safe water-supply, and are
backward in the
tary regulations for as
might
The
be
cause
adoption of ordinary sanithe prevention of disease
expected in a less civilised country. indifference to health is due
of this
decrease
sponds
from the
among Native troops and small scale, the general popula-
same cause
prisoners. On
a
tion have been also tried and with very encourins results, for a similar reduction in deathrates
have followed
the progress ot
works iu Calcutta and Bombay. With these gratifying instances of animate the
authorities,
it is time that
sanitary
success to some
gen-
eral scheme should be adopted to give to every town and village the benefits which are sure to follow a properly regulated system of sanitation. iu the right direction has been the forOne
step
July
MEDICAL EDUCATION.
1890]
mation of a Sanitary Board for each province. But this Board will soon find that its influence for good will depend on whether it has a local
211
tively inexpensive
to
provide
and pure proper disposal of the a
good
water-supply, night-soil, refuse, and slop water, to drain the subsoil* to regulate the building of healthy huts agency in the form of Medical Officers of Health distributed throughout the province, who shall, and houses, to keep an accurate account of the one hand, be to the local authorities on the births and deaths, to obtain thorough aud efficient advisers, inspectors and reporters on all sanitary vaccination, aud to have always provided and in matters, and who shall, on the other hand, be the readiness arrangements for the prompt checking connecting link between the Central Board of epidemic diseases. and the local authorities. Rules and regulaThe most, essential thing, however, is to know tions may be framed by a Central Board, but precisely what requires to be done. With this a distinct medical sanitary service is required knowledge before competent authorities emto assist the Municipalities, Village Unions, and powered to act aud with the agency sketched Punchayets in the proper apprehension, and above, a great change in the public health of application of these rules and regulations and in India would be quietly effected in the course of sharing the responsibility of their being systema- a very few years, and in a manner engaging the tically and regularly carried out in a right and hearty co-operation of the people themselves. inexpensive manner. Without a sanitary service real progress can be insured or even expected, for whatever may be done without it will only
no
accomplished at irregular intervals under the influence of panic or under such pressure as to
be
it is grave doubts in many minds whether for whenever advisable under any circumstances, the panic or pressure is over, a return to the old conditions will quickly follow.
cause
service, however, whose duty it would attend to the gradual and steady improve-
From be
to
a
ment of the health conditions
of the country,
might be expected. The service need not be an expensive one. It might very well be purely native in its composition with the exception that the Civil Surgeon of the district would hold the position of consultant, and the Central Board might, if found necessary, have several European Medical Inspectors. A career would be opened up thereby for a number of
much
native medical men, and an educated and influential class of men would be at once raised in favor of sanitation, who would also at the
good
same
the
time be in
people
With
a
sympathy
and close touch with
of the country.
proper directing
Sanitary
Board and
described, work with the a local agency, local authorities, it would be found that effective sanitation of small towns and villages is not a.3
after all
a
difficult
but that it is
problem
to
nor a
exceedingly simple
costly scheme; and compara-
to secure
a
