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requiring the declaration of sickness, early information of seizures
is at once the least irritating and the most efficacious means of
discovering cases. With patience and discretion valuable information
can be generally obtained not only from the employs of the Plague staffs
but from sepoys and peons, and from anxious or needy neighbours.
And when trust is inspired, much assistance is given by rent-collectors,
medical practitioners, and caste-leaders. Efforts were made to encourage
a system of information which would give knowledge of cases of
Plague before they ended fatally, and before the patient had passed into
a hopeless condition. During the rainy months and till December
in certain parts of the city, notably in C Ward, the efforts to secure
information were highly successful.
The Committee's efforts to remove the sick were hampered by the
concealing of cases. To dissuade relations from hiding their sick,
the influence of members of their community, and the counsel and
orders of their religious and social leaders were in many cases of great
service. The opening of caste or community hospitals, with the attrac-
tions of quiet and privacy, where friends could attend, and where the
chance of recovery was greater than at home, in many cases overcame
the passion for concealment.
Death
registration.
Nevertheless during the past ten months the efforts to conceal
Plague cases and deaths, with the object of escaping house disinfection,
segregation of contacts, and other unavoidable annoyances, have been
very successful and have to a great extent been due to the imperfect
registration of the house of death.
During the past epidemic in a large proportion of daily deaths, per-
haps in one-fourth of the whole, the place of death has not been recorded
in the cemetery returns with sufficient clearness to enable the case to be
traced. To remove this serious flaw in the registration of deaths in
connection with Plague operations, three suggestions have been made:-
(a) To require the notification of sickness.
(b) To enforce corpse-inspection.
(c) To secure the correct address at which death took place.
As regards (a);-compulsory notification of sickness is open to the
objection that either every case of sickness must be notified, a require-
ment which would press heavily on the mass of the people, or that, if the
notification is limited to cases of Plague or other epidemic disease, to
secure conviction for default it must be proved that the patients' relatives
were aware of the nature of the complaint.
Asre gards (b);-corpse-inspection has been successfully enforced
both in Poona and in Karachi. The objection to its introduction