NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
347
APP. IX. ]
spread of infection by sea.
No. 3070, dated Bombay, the 2nd July 1897.
From—SIR JAMES MACNABB CAMPBELL, K.C.I.E., I.C.S., Acting
Commissioner of Customs, Sal!, Opium and Abkari,
To—The Secretary to the Government of Bombay, General Department.
In continuation of my letter No. 2915 of 24th June 1897, I have
the honour to forward copy of the Collector Mr. Kennedy's views and
the remarks which, after consulting the Health Officer of the port, I
would offer in support of our original constructions.
2. I see no need for drawing up rules for the definition of the differ-
Collector's paragraph 4.
ent classes oí vessels suggested by Mr,
Kennedy in his paragraph 4. As sug-
gested in my paragraph 4, it seems to me the better course to leave it to
Government, in accordance with changing conditions, from time to
time, to decide to what vessels and port the rules shall apply.
3. In this paragraph, Mr. Kennedy assumes that the crew are not
Collector's paragraph 5.
to be examined on shore. He con-
siders that the rule should be drawn
up on the assumption that the Venice Convention sanctions the board-
ship inspection of crews. I agree with the Health Officer of the port
in doubting whether the framers of the Convention rules intended to
have the crew examination on boardship. Our reasons are —
(a) The use of the expression " cumpulsory medical inspection
Convention, Chapter I, of each person sailing on the
Rule I, Notification II,
pago 3-
ship.
(b) The use of the phrase, in paragraph 5 of the Government
of India's letter under reply, "All passengers and crew
are on board " implying that the crew have been out of
the ship, presumably for inspection, and further implying
that the Government of India's definition of person
sailing in a ship includes both crew and passengers.
(c) If the details laid down in the Convention rules for the
inspection of passengers do not apply also to crews,
then the rules contain no provision for the inspection
of that most important section of those who sail in ships,
who,
I agree with the Health Officer of the port, are
more likely to be infected than passengers for Europe.
The question of the relative danger from passengers
and from crew is treated at length in paragraph 12
below.
2. The Collector holds that, as the Convention rules enjoin shore
Collector's paragraphs 6, 7 and 8
Under Filgrimships, paragraph I,
Chapter I, page 3.
inspection, this procedure must at all
risk and cost be adopted. I venture to
think that the exemption granted, in
348
Measures to prevent the
[ APP. IX.
the case of Batavia, shows that if satisfied of the necessity or of the
advantage of any local system, the Convention are ready to modify
their requirements. I also venture to think that the Health Officer of
the port has shown that apart from the serious difficulties, the existing
mixed board and shore inspection is on sanitary grounds better than
the proposed rule forbidding any inspection except on shore.
5. In reply to the Collector's objection that, if the local system
Collector's paragraph 9.
is introduced, other countries may
raise difficulties on the ground that
shore inspection has not been carried out in Bombay, I would remark
that the Government of India can protect themselves by informing the
signatories to the Convention beforehand of the proposed alterations
and giving reasons for their adoption.
6. The Collector sees no impossibility in shore inspection. I
Collector's paragraph 10.
venture to think that if crews are not
exempted shore inspection will be
impossible. And further that shore inspection of passengers, though
possible, will be very difficult and very costly.
7. The Collector notices that in Bombay shore inspection already
Collector's paragraph 11.
exists in tne case of pilgrim snips. In
paragraph 10 of my letter I have
explained that in Bombay the shore inspection of pilgrims is carried
out under restrictions which could not be enforced in the case of
regular passenger ships. I would further point out that the average
yearly number of pilgrim ships leaving Bombay is 20 ; and that, com-
paratively insignificant as that number is, the inconvenience caused
to the ordinary traffic of the dock by the special procedure connected
with the departure of pilgrim ships is very marked.
8. The Collector selects the case of a Peninsular and Oriental
Collector's paragraphs 12 and 13.
mail steamer. In doing so he selects
the class in which difficulties are least
though still noticeable. As passengers can hardly be prevented from
going on board at any time, it follows that to secure inspection on
shore medical attendance must be available throughout the day at one
particular place, while for the departures by all other boats, including
those from the docks and bandars, additional medical attendance must
be provided at other places. Moreover, the Collector ignores any con-
Health Officer of Port, note 591,
paragraph 10 (c), my letter, para-
giaph 7.
sideration oi tne difficulties pointed
out both by the Health Officer of the
port and by myself in regard to the
departures of vessels from the wet clocks with large numbers of native
passengers.
349
APP. IX. ]
spread of infection by sea,
9. The Collector considers that the rules he has formulated (para-
Collector's paragraph 14.
graph 13) for Peninsular and Oriental
departures can be adopted by other
passenger steamers to Europe, China and Japan.. On this point I
have obtained the following note from the Health Officer of the
port :—-
" It is not clear why the Collector selects China and Japan as
countries to which the Venice rules should apply ; or why he omits
Africa which, judging by the numerous telegrams from the Govern-
ment of India directing a most careful examination of all persons
sailing for its ports, must be considered of sufficient importance to
warrant its inclusion in the list of countries entitled to protection
under the Convention rules. Nor is it evident on what grounds
he omits Mauritius which can truly be described as the most
quarantining place in the world. China, which the Collector in-
cludes, is the natural home of plague and its Emperor has not signed
the Venice Convention ; while Africa is now largely under the British
Government and thus comes indirectly, if not directly, within the
scope of the Convention."
10. The Collector holds that the Local Government can supply its
Collector's paragraph 15.
own rules in the case or vessels tor
any Indian or British port irrespec-
tive of the rules of the Venice Convention. Still it is to be remem-
bered that under a recent order of the Government of India letter
No. 1623, dated 1st June 1897, the Local Government rules regard-
ing the inspection of ships are to be adjusted to the Convention rules.
11. With reference to the Collector's opinion that two small exa-
Collector's paragraph 16.
mination rooms on the Ballard pier
and in the docks would suffice for
inspection, the experience of the Health Officer of the port detailed
in paragraph 7 of his note shows that, owing to the peculiar nature
of the signs of plague, a somewhat elaborate arrangement for private
examination is necessary.
12. The Collector does not think much danger of infection need
Collector's paragraph 17.
be apprehended from the crew. As
his view is opposed to that held by
me and by the Health Officer of the port, I quote from a minute by
Dr. MacCartie—
"The Commissioner's letter No. 2916, paragraph 7, points out that,
in the case of vessels bound for the places mentioned by Mr. Ken-
nedy, namely, Europe, China and Japan, the danger from the crew is
much greater than from the passengers. That the Commissioner's
350
Measures ¿o prevent the
[ APP. IX,
view is correct can easily be shown. Every Peninsular and Oriental
Company's liner during the height of the plague on arrival in Bombay
was, under the law and practice of the port, forced to discharge its
native crew : by law the crew can and do claim their discharge.
Three or four days, sometimes one day, before a vessel's departure
another crew has been signed on the articles. This fresh crew has
come from the slums of plague stricken Bombay, whilst the pas-
sengers who are almost all Europeans have come from up-country
stations and boarded their vessels direct from the train. Even
in the case of local passengers they have come from ports of
Bombay comparatively free from plague. The natural result has
been that during the height of the epidemic no passenger, except
two postal officials, both natives, was removed on suspicion from any
vessel. Whilst it was found necessary, in almost every instance to
remove several of the native crew. The information Mr. Kennedy
asks for as regards instances of vessels becoming infected through
their crews has already been practically furnished in paragraph 12'of
my note 591. This is the return on which the argument was
based that as plague cases have been removed from vessels without
infecting the rest of their passengers and crews, the Bombay rules
which permit a person to board his vessel before inspection, whilst
much more workable and cheaper, are no less efficient for the pre-
vention of the export of plague than the Venice Convention Rules."
13. As regards the Collector's view that the master of the vessel
Collector's paragraph 18.
should be made responsible for the
carrying out of plague rules by
passengers, the Health Officer of the port holds that no such respon-
sibility can be enforced. The following remarks seem to me to carry
weight :—
" Ship commanders have stated to me over and over again that
they cannot exercise complete control even over their crews, much
less over their passengers. During the plague time when com-
manders have been asked to prevent their crews going on shore even
from the stream, they have stated they were powerless to prevent
them." Dr. MacCartie continues : "Even if Government considers
that a responsibility thrown on the commander and a few simple
directions to the dock gate-keeper, as suggested by Mr. Kennedy
be sufficient to ensure that the passenger inspected in the dock at
say 5 P.M. is the same who sails in the vessel at 4 A.M., and that that
passenger has had no communication with Bombay after boarding
his vessel, I, as Port Health Officer, for the following reasons, refuse
to consider that these simple checks are sufficient. Should any case
of plague appear on a vessel after leaving this port upon whom will
351
APP. IX.]
spread of infection by sea.
the odium fall if not on the officer who signed the bill-of-health ?
The bill-of-health certifies to the health of all on board and no man
can be asked to sign it unless he is certain that it is a true bill?
And that all those inspected on shore have had no communication
with shore after bearding their vessel and are those who were
inspected by his staff. He could not possibly accept the ineffective
and simple checks described as sufficient in paragraph 18 of Mr.
Kennedy's letter."
14. The Collector seems to contemplate the disinfecting of
Collector's paragraph 19.
pilgrims' baggage leaving Bombay.
The reason why there is no special
notice of disinfecting outward baggage is that provision is made for
the treatment of the baggage of all infected passengers. The rules
do not, it seems to me, contemplate any interference with baggage,
except with baggage belonging to an infected passenger. In the
second part of this paragraph (paragraph 20) the Collector expects
that inspection work will not be permanently increased, because a
few isolated or imported cases will not be held to make the port
infected; but section II, Chapter II of the Convention lays down
that one indigenous case officially reported sets agoing the whole
machinery of the Convention rules. As has been noticed in my
former letter to Government unless the concession of part shore part
ship inspection is secured, this machinery includes the inspection of
the ship and crew in one place and of the passengers in another
place.
15. I trust that these further explanations may make more clear to
Government the necessity of obtaining from the Convention the
concession of an alternative inspection either on shore or on ship
board.
No. II52I-C., dated Bombay, the 28th June 1897.
From—R. M. KENNEDY, Esq., Collector of Land Revenue, Customs and
Opium,
To—The Commissioner of Customs, Salt, Opium and Abkari, Bombay.
I have the honour to report with reference to your No. 2917, dated
25th instant.
2. I have no sufficient experience to offer comments on the rules
accompanying your letter.
3. However, there are a few points to which I should wish to
draw attention and a few supplementary points on which I may offer
comment.
4. In the first place it does not seem to me clear to what outward-
bound vessels the Venice Convention rules should apply whether (a)
to all vessels leaving Bombay during epidemic as the wording " for
352
Measures to prevent the
[ APP. IX.
the prevention of the spread of the plague " seems to imply, (b) or to
vessels for ports of foreign powers who are signatories to the Con-
vention, (c) or to vessels for any foreign port, (d) or for vessels leav-
ing for Europe only. I venture to think this requires definition before
any rules can be finally accepted.
5. Secondly, I do not understand whether the rules of the Venice
Convention for medical examination of outward bound ships include
the case of the crew of the vessel or that of the passengers only.
As the crew of a vessel is already embarked and covered by a bill
of health, and the Convention rules are intended to prevent a vessel
becoming infected by embarkation, I am inclined to suppose that the
medical examination on shore refers to passengers only. Obviously
if the crew is infected, the ship is an infected ship, the object of the
rules seems to be to prevent a ship becoming infected, so then the
special medical examination on shore cannot affect the crew, but those
intending to embark, i.e. } the passengers.
6. You have proved conclusively the adequacy of the present
regulations in Bombay to prevent infected ships leaving the harbour,
and the difficulties attending any change in present methods.
7. The weakness, however, in the present system appears to be
that it is not the method approved by the Venice Convention which
enjoins (and especially enjoins) medical examination on shore ; and
the principles of the Venice Convention rules have been accepted by
the Government of India.
8. It seems to me that we are bound to carry out the rules which
have been accepted by superior authority.
g. Moreover, there seems a danger that at any moment in the
case of an outbreak of plague, it may be alleged by any country
disposed to raise difficulties that the measures now taken in Bombay
are inadequate and contrary to the express intention of the Conven-
tion rules.
10. It does not seem to me impossible to secure medical inspec-
tion on shore.
11. This is already done in the case of pilgrims.
12. It appears to me that it could be done in the case of vessels
carrying passengers to Europe and to China and Japan.
13. I will take the case of the P. and O. Mail Steamers. It
seems to me that passengers could be examined at little extra cost at
the Ballard pier, and then embarked by launch on to the steamer. A
few precautions would be necessary—
(a) The production by passengers of their tickets, which should
be stamped after the passengers had been medically ex-
amined,
353
APP.
IX.
]
spread of infection by sea.
(b) The issuing of steam launch tickets to friends seeing
passengers off. Such friends should also be examined,
and a small fee might be charged if this were held ad-
visable.
(c) The rigorous examination of all without tickets from the
steamer.
(d) The rigorous exclusion from the steamer of all who do
„not come by the Company's launch from the Ballard
pier. I would point out that such regulations would not
only comply with the Venice Convention rules, but would
also further order on the P. and O. Mail Steamer, and
would prevent the danger which at present exists from the
crowding of the steamer with all sorts and conditions of
men (native servants and the like) for whose health there
is no guarantee, and who, however, may introduce plague
and render the steamer infected. Under regulations, such
as are suggested, only those interested in passengers em-
barking would be likely to obtain admission on the ship,
14. Similar rules could be adopted for other passenger steamers
for Europe, China, and Japan.
15. I believe there is already efficient examination on shore of
coasting steamers. But I do not understand that the Venice Conven-
tion rules are intended to apply to vessels between British ports only,
either in India, or between India and any other British port outside
India. Rules for such ships in time of plague would be made by the
British Government irrespective of the Venice Convention rules.
16. For shore examination of passengers it would be necessary
to supply two small examination rooms on the Ballard pier and also
in the docks. The cost of such rooms need not be excessive.
17. As I have already stated, I do not understand that the Venice
Convention rules are intended to apply to the crews of vessels as (a)
their examination on shore is impossible and (b) useless, as it could
not prevent a vessel being an infected vessel by the discovery of any
member of the crew being infected, as he would have come from the
ship, and would therefore have made the ship infected before he
came on shore for examination. Moreover, I do not think there is
much danger to be apprehended from the crews, and it would be
interesting to know if, during the recent plague epidemic, Surgeon-
Major MacCartie has found any case in which a ship has become
infected from illness among the crew.
18. In the case of the crews (and passengers) I think responsibi-
lity after medical examination should be thrown directly on the
master of the ship, who should see that no one leaves the ship for any
length of time, and in case any one does, that person should be
precluded from returning to the ship. In the stream this could be
c 45
354
Measures to prevent the
[ APP. IX.
easily arranged, and in the docks the master could be materially
assisted after dusk (when there would be most danger of such an
occurrence) by a few simple instructions to the dock gate-keeper.
19. In the proposed rules for Bombay nothing seems stated as to
the disinfecting of baggage of outgoing steamers. In the case of
passengers for Europe, I do not think any disinfecting of the bag-
gage of passengers who are themselves free from infection would be
necessary. In the case of pilgrims it would seem advisable in times
of epidemic to pass baggage through a disinfecting chamber.
20. Apparently it lies with the Bombay Government to declare
when the port is infected. I trust the plague will not be endemic in
Bombay ; the decreasing mortality from plague (now almost at zero)
does not indicate this. I presume, after it has once gone, the occasion
hereafter of a few isolated and imported cases will not be held to
render the port infected. The inspection work will not therefore be
permanently increased, though it appears from Surgeon-Major Mac-
Cartie's report that medical staff may require some increase.
No. 90.
No. 1904, dated Simla, the 6th August 1897.
From—J. P. HEWETT, Esq., C.I.E., Secretary to the Government of India,
Home Department,
To—The Secretary to the Government of Bombay. General Department.
I am directed to reply to your letter No. 4021, dated the 22nd
July, on the subject of the contemplated alteration of the rules issued
by the Government of Bombay under the Epidemic Diseases Act,
1897, and Act I of 1870, so as to bring them into accord with the
provisions of the Venice Sanitary Convention of 1897. I am at the
same time to forward, for the information of the Government of
Bombay, a copy of correspondence with the Government of Bengal
on the modification of the rules issued by that Government for the
port of Calcutta.
2. The draft rules prepared by the Acting Commissioner of
Customs, Salt, Opium, and Abkari, with the assistance of the Health
Officer of the Port, which are forwarded with your letter, deal with the
inspection of outward and inward bound vessels and are drawn up for
the port of Bombay.
3. The most important point in connection with the rules for the
inspection of outward bound vessels is the fact that these rules do
not provide that the medical examination of each person sailing shall
be made on shore. The advisers of the Government of Bombay point
out that there are very grave obstacles to the examination on shore
of all persons sailing, and the Governor in Council accepting this
view asks that the convention may be so modified as to allow of
355
APP, IX. ]
spread of infection by sea.
inspection on shore or on board, as the circumstances of any parti-
cular port may render necessary. After a careful consideration of
the subject, the Government of India are constrained to accept the
opinion of the Government of Bombay and their advisers, and to
authorize the continuance of the practice at present adopted at
the port of Bombay, under which the examination is made on board
or on shore as may be convenient. In arriving at this conclusion the
Governor General in Council has been specially influenced by the
following considerations. Section II of Chapter I of the Venice Con-
vention, relating to sanitary measures for ships sailing from infected
ports, is divided into two portions — the first relating to ordinary
vessels and the second relating to pilgrim ships. In the case of the
latter the direction to examine on shore is followed by a remark that
in carrying out this measure each Government may take local con-
siderations and conditions into account, and a footnote explains that
the Conference decided that in the Dutch Indies the inspection may
be carried out on board ship. The Government of India agree with
Sir James Campbell that, if the concession of examination on board
can be made in regard to the most dangerous class of passengers,
namely, pilgrims, it ought also to be made in the case of other persons
should circumstances render this desirable. And it is shown that the
circumstances of the port of Bombay render the concession impera-
tive. It is pointed out that the most important portion of the examina-
tion is the examination of the crew, firstly because of the persons
examined the greater number belong to crews of vessels, and secondly
because experience has shown that the crews are much more likely
to be infected than the passengers. It is further shown that in the
case of the crews it is practically impossible to examine them all on
shore, and that in the less important case of the passengers, though
it is possible, it would give rise to very serious inconvenience both
to the passengers and to the regular working of the port arrange-
ments. Lastly, the Government of India attach particular importance
to the great success that has attended the examination under the
arrangements hitherto prescribed by the Government of Bombay, and
they consider that this success is the strongest argument that can be
urged for the continuance of those arrangements. I am to take this
opportunity to state that the Governor General in Council fully shares
in the appreciation of the admirable work done by Dr. MacCartie and
his staff during the past six months, which is expressed by the Govern-
ment of Bombay.
4. If, however, inspection on board is permitted, it will be necessary
to modify the portion of Rule ÍI of the draft rules for outward bound
vessels which deals with the discovery of a case of plague during the