Fighting Cholera & Plague in India in the 1920's

Reproduced by permission from Felix d'Herelle and The origins of Molecular Biology by William C.Summers,
Yale University press, New Haven 1999; pp.125-144. http://www.yale.edu/yup

While Asheshov's laboratory classification and bacteriophage collection would continue to be used by cholera workers, he did not continue with the Bacteriophage Inquiry. He published no more papers in India and left in 1935.

Morison, on the other hand, used his position as the director of King Edward VII Pasteur Institute in Assam to organize hundreds of villages in endemic cholera regions to try anti-vibrio phage therapy. He selected Naogaon and Habiganj, two widely separated but rather comparable regions in Assam for the test of phage prophylaxis. Both had histories of serious and repeated cholera outbreaks throughout 1920s.In 1928 and 1929 Morison issued phage to "Tea Garden Doctors[Physicians employed to care for the workerson Tea plantations], Civil surgeons and Assistant and Sub-Assistant surgeons of rural dispensaries," but there was little co-operation, perhaps reflecting the general attitudes fostered towards centralized authority by the past satyagraha campaigns.

His next approach was to bypass the trained medical personnel and make the phage available directly to the village leaders, the headmen. The project worked as planed in Naogaon region, but the district official in the Habiganj region objected for unknown reasons and so this region became the control group in the Morison's study.

In December 1929 phage was issued along with the instructions for its use to every village headman along ninety miles of Kalang River. In the first six months, sixty-three scattered cases of suspected cholera were treated this way. No epidemics occurred in Naogaon in 1930-35, the duration of the study.

In contrast, in the Habiganj region, in both 1930 and 1931 there were spring and fall epidemics of cholera. In the first half of 1932 there were 474 deaths, at which time the government ordered the use of bacteriophage in the district. For the next three years the two districts had similar low death rates from cholera, that is, about 10 per year. In the nearby district of Sunanganj, for example, where no phages were used, in 1933, 1,505 people died from cholera.

The chart shows the mortality data for one village for patients given bacteriophage and those who did not receive it. The chart shows the cholera mortality in the two districts for the period during which phage was available in only one of the two districts.

Adapted from Transactions of the Royal Society of Tropical Medicine & Hygiene, Volume 28,pp 563-570,1935.