NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
APP. IX.]
spread of infection by sea.
299
per cent, of the pilgrims on board, and should provide for each patient
a space of 32 square feet*
Art. 25.—The ship must be provided with the means of segre-
gating persons attacked by plague.
The persons charged with the care of plague patients may alone
have access to them, and the sick must not be brought into contact
with the other passengers.
All bedding, carpets and clothes which have been in contact with
the sick should be immediately disinfected.
The observance of this rule is specially enjoined in the case of
the clothes of persons attending the sick, which may have been con-
taminated.
Those of the abovementioned articles which are not valuable
should be thrown overboard, if the ship is not in harbour or in a canal,
or else burnt.
Other articles should be carried to the stove in impermeable bags
washed in a solution of corrosive sublimate.
The excreta of patients must be received in vessels containing a
disinfecting solution. These vessels should be emptied into the
latrines, which must be rigorously disinfected after each discharge
of matter.
* The Conference having learned the nature of the ho pital accommodation which
must be provided in accordance with rule 53 of the rules framed under the Pilgrim Ships
Act by the Government of India, recommend their adoption in substitution for article
24-.
Extract :—
The hospital accommodation shall be provided on the upper deck either in the poop
or in a deck-house. A permanent hospital shall be provided containing not less than six
bunk, and having a deck area o fat least 144 superficial feet and dimensions of not less
than 864 cubic feet. On every pilgirim ship on which there are 50 or more female pil-
grims, there shall be a separate permanent hospital, containing not less than two bunks
with a deck area of at It ast 72 superficial feer. and dimensions of not less than 288 cubic
feet, which shall be reserved for toe me of women an 1 children under 12 years of age.
The hospitals shall be lighted and ventilated to the satisfaction of the Inspector and
shall be proivided with permanent raised floors or platforms at least 4 inches off the deck.
They shall be made as secure as any other duck-house, and the roof shall be well caulked
and covered with painted canvas. No case of small-pox, cholera, yellow fever or plague
shall on any account be treated in a permanent hospital.
Materials shall be carried for the construction on the upper deck of a separate
temporary hospital for the treatment of such cases of sickness as it may be considered
desirable specially to segregate (such as small-pox, cholera, yellow fever or plague).
The part of the upper deck upon which such hospital shall, if required, be erected shall
be pointed out by the Inspector. It shall be constructed on the same principles as the
permanent hospital, and the superficial area of the floor shall not be less than 144 square
feet.
300
Measures to prevent the
[ APP. IX.
The patients' quarters must be rigorously disinfected.
The disinfection must be carried out in accordance with para-
graph 5, Chapter III of this Convention.
Art. 26.—In the event of a death occurring during the voyage, the
captain must enter the fact opposite the name of the deceased, on
the list countersigned by the appointed authority at the port of depar-
ture, and must also enter in the log the name of the deceased, age,
place of residence, supposed cause of death according to the medical
certificate, and date of death.
In the event of a death from infectious disease, the corpse, wrap-
ped in a shroud, impregnated with a solution of corrosive sublimate,
must be thrown into the sea.
Art. 27.—The bill-of-health given at the port of departure must
not be altered during the voyage.
It must be countersigned at each port of call by the sanitary
authorities, who should enter—
(1) the number of passengers disembarked or embarked at the
port ;
(2) anything that has happened at sea affecting the life or health
of the passengers ;
(3) the sanitary condition of the port of call.
Art. 28.—At each port of call, the captain must cause the list
drawn up in accordance with article 9 to be countersigned by the
appointed authority.
In the event of a pilgrim disembarking during the voyage, the cap-
tain must note the fact on the list, opposite the pilgrim's name.
In the case of persons embarking, their names must be entered
on the list in accordance with article 9. This must be done previ-
ously to the list being countersigned by the appointed authority.
Art. 29.—The captain must see that all sanitary preventive mea-
sures taken during the voyage are entered in the log. This docu-
ment is to be submitted by him to the appointed authority at the
port of arrival.
Art. 30.—The captain must pay all sanitary charges, which should
be included in the price of the tickets.
SECTION IV.—Penalties.
Art. 31.—Any captain convicted of a breach of his contract for the
supply of water, food or fuel, will be liable to a fine of 2 pounds
Turkish.* This fine will be paid to the pilgrim who has suffered
* A Turkish pound is of the value oí 22½ francs,
APP. IX, ]
. spread of infection by sea.
301
from the breach of contract on proof that he demanded its fulfilment
without effect
Art. 32.—Any infraction of article 8 is punishable by a fine of
30 pounds Turkish.
Art. 33.—Any captain, who commits, or knowingly allows to be
committed, any fraud with respect to the list of pilgrims, or of the
bill-of-health prescribed in article 9, is liable to a fine of 50 pounds
Turkish.
Art. 34.—Any captain arriving without a bill-of-health from the
port of departure, or without its being countersigned at the ports of
call, or being unprovided with the prescribed list, duly kept up
according to articles 9, 27 and 28, is liable, in each case, to a fine of
12 pounds Turkish.
Art. 35.—Any captain convicted of having or of having had, on
board, more than 100 pilgrims, without the presence of a licensed
doctor, in accordance with the rule in article 11, is liable to a fine of
300 pounds Turkish.
Art. 36.—Any captain convicted of having or of having had, on
board, more pilgrims than he was authorised to carry, in accordance
with the rules in article 9, is liable to a fine of 5 pounds Turkish
for each pilgrim in excess of the authorised number.
The disembarkation of the pilgrims in excess of the authorised
number must be effected at the first station where there is an
appointed authority, and the captain must provide the pilgrims so
disembarked with sufficient money to enable them to reach their
destination.
Art. 37.—Any captain convicted of having disembarked pilgrims
at a place other than their destination, unless with their consent, or
from unavoidable cause, is liable to a fine of 20 pounds Turkish for
each pilgrim thus disembarked.
Art. 38.—All other infractions of the present rules are punishable
by a fine of from 10 to 100 pounds Turkish.
Art. 39.—Any offence reported during the voyage should be
entered in the bill-of-health, and in the list of pilgrims.
The
appointed authority will submit an official report on the offence to the
proper authorities.
Art. 40.—In Turkish ports the offence is tried before and the fine
imposed by the appointed authority, in accordance with the rules in
Chapter V of this Convention.
Art. 41.—All agents required to assist in the execution of these
rules are liable to punishment for any breach of them, according to
the laws of their respective countries.
302
Measures to prevent the
[ APP. IX.
Art. 42.—These rules must be posted up in the language of the
nationality of the ship, and in the languages commonly spoken by the
pilgrims, in a conspicuous and accessible place, on board every pil-
grim ship.
III.
MEASURES TO BE TAKEN TO PREVENT THE IMPORTATION
OF PLAGUE.
(1) BY LAND.
The measures to be taken, on land, with respect to travellers and
goods from regions infected with plague, should conform to the sanitary
principles laid down in this Convention. Modern methods of disin-
fection should be substituted for land quarantine.
For this purpose stoves and other means of disinfection should be
established at selected posts on the routes followed by travellers.
Similar methods should be adopted on railways, constructed or in
course of construction. Merchandise should be disinfected according
to the principles adopted by this Convention.
Each Government is at liberty to close its frontiers to passengers
and goods.
(2) BY SEA.
A.—MEASURES TO BE TAKEN IN THE RED SEA.
Are. 1.—-Healthy ships.—(a] After the medical inspection, ships
passed as healthy, will be allowed to proceed at once, whatever the
nature of their bill-of-health.
The ship must, however, have completed, or must complete, ten
full days from the date of departure from the last infected port at
which she has touched.
The only treatment the authorities of the port of arrival may apply
to such ships, consists in the measures prescribed for suspected ships
(medical inspection, disinfection of soiled linen, pumping out the bilge-
water, and substituting good drinking-water for that stored on board).
(b) Ordinary healthy ships will be allowed to pass through the
Suez Canal, in quarantine. They will complete in the Mediterranean
the ten days' period of observation. Ships carrying a doctor and a
stove will not be disinfected before the passage in quarantine.
Art. 2.—Suspected ships,—Suspected ships are those on board
which there have been cases of plague at the time of departure, or
during the voyage, but no new case for 12 days. Such ships will be
APP. IX.]
spread of infection by sea.
303
treated in a different manner according as to whether or not they have
on board a doctor and disinfecting apparatus (stove).
(a) Ships having a doctor and disinfecting apparatus (stove) ful-
filling the required conditions, will be allowed to pass through the Suez
Canal, in quarantine, in accordance with the rules prescribed for the
passage.
(b] Suspected ships, having neither doctor nor disinfecting appa-
ratus (stove) on board, will, before being allowed to pass through the
Canal in quarantine, be detained at Moses' Wells for the time neces-
sary to disinfect soiled linen, personal linen and other susceptible
articles, and to ensure that the ship is in a sanitary condition.
Passage in quarantine will be permitted in the case of a mail boat,
or steamer specially adapted for passengers without a disinfecting
apparatus (stove), but with a doctor on board, if the local authority is
satisfied by an official statement, that sanitary measures and measures
of disinfection have been properly carried out, either at the time of
departure, or during the voyage.
Free pratique may be given at Suez, after disinfection, in the case
of mail boats or steamers specially adapted for passengers without a
disinfecting apparatus (stove) but with a doctor on board, if the last
case of plague took place more than 14 days before the date of arrival
and if the sanitary state of the ship is satisfactory.
In the case of a steamer having a healthy passage of less than
14 days, passengers for Egypt will be disembarked at Moses' Wells
and isolated for the time necessary to complete ten days ; their soiled
linen and personal effects being disinfected. They will then obtain
free pratique. Steamers having a healthy passage of less than 14
days and requiring free pratique for Egypt will be detained at Moses'
Well 3 for the time necessary to complete ten days ; they will undergo
the prescribed disinfection.
Art. 3.—Infected ships, that is to say, those with plague on board,
or on which cases have occurred within 12 days. These are divided
into ships with a doctor and disinfecting apparatus (stove), and those
without a doctor, and without a disinfecting apparatus (stove).
(a) Ships without a doctor and a disinfecting apparatus (stove)
will be detained at Moses' Wells and persons suffering from plague
will be disembarked and isolated in a hospital. The disinfection
will be thoroughly carried out. The other passengers will be disem-
barked, and isolated in as small groups as possible, so that if plague
breaks out in one group, the whole party will not be affected.
The soiled linen, personal effects and clothes of the crew and
passenger, and the ship, will be disinfected.
304
Measures to prevent the
[ APP. IX.
It is to be understood that this does not require the discharge of
the cargo, but only the disinfection of that part of the ship which
has been infected.
The passengers will remain ten days at the quarantine station at
Moses' Wells ; when the cases of plague have occurred several days
previous to arrival, the term of isolation will be diminished and will
vary according to the date of the occurrence of the last case.
Thus if the last case occurred 9, 10, 11 or 12 days before arrival,
the term of observation will be 24hours ; if it took place 8 days before
arrival, the observation will be for 2 days ; if it took place 7 days before
arrival, it will be for 3 days ; and so on according to the table given
below.
(b) Ships with a doctor and disinfecting apparatus (stove).—Ships
with a doctor and disinfecting apparatus will be detained at Moses'
Wells.
The ship's doctor will state, on oath, what persons on board are
suffering from plague. These patients will be disembarked and segre-
gated.
After their disembarkation, the soiled linen of the other passengers
and of the crew will be disinfected on board.
If the plague has only attacked the crew, the disinfection will be
confined to the soiled linen and bedding of the crew.
The ship's doctor will also declare, on oath, the portion or com-
partment of the ship occupied by the patient or patients, and the section
of the hospital to which they were removed.
He will also state, on oath, what persons have been in contact with
the plague patients, since the appearance of the malady either directly
or by contact with objects capable of transmitting infection. These
persons only will be considered as suspected.
The part or compartment of the ship, and the section of the
hospital in which the patients have been located, will be thoroughly
disinfected. By "the part of the ship" is meant the cabin of the
patient, the adjoining cabins, the passage to these cabins, the deck,
and the parts of the ship in which the patient or patients have been
lying.
If it is impossible to disinfect the part or the compartment of the
ship, which has been occupied by persons attacked by the plague,
Without disembarking the persons declared to be suspected, these per-
sons will either be put on another ship specially set apart for this pur-
pose, or will be disembarked and detained in the quarantine buildings,
but not ill contact with the patients, who will be placed in the hospital.
APP. IX. ]
spread of infection by sea.
305
The duration of this detention on board, or on land, for the pur-
pose of disinfection, will be as short as possible, and must not exceed
24 hours.
The suspected persons will be kept under observation either on
their own ship, or on a ship provided for this purpose ; the duration
of this observation will vary according to the following table :-—
When the last case of plague occurred on
the 1 2th, nth, i o th or gth day before
arrival at Suez.
The observation will
be for 24 hours.
it has occurred on the 8th day before arrival at Suez ...
2
days.
,,
,,
,,
7th
,,
,,
,,
...
,,
,,
,,
6th
,,
,,
,,
...
,, ,, ,, 5th or 4th day ,, ,, ,, ...
,, ,, ,, 3rd or 2nd ,, ,, ,, ...
,,
,,
,,
1st
day
,,
,,
,,
...
3
4
5 or 6
7 or 3
9
Passage in quarantine may be permitted before the expiration of
the periods stated in the above table, if the sanitary authority deems
ut possible ; it will, in any case, be permitted on the completion of the
disinfection, if the ship leaves behind, in addition to the sick, the
persons classed above as suspected,
A pontoon, with a stove on board, may be brought alongside the
ship to hasten the process of disinfection.
Infected ships seeking free pratique in Egypt will be detained
for ten days at Moses' Wells, dating from the last case on board, and
will undergo the prescribed disinfection.
The time taken in disinfecting is included in the term of obser-
vation.
Organisation for carrying out the measures of observation and
disinfection at Suez and at Moses' Wells.
1. The medical inspection, prescribed by the regulations, of
every ship arriving at Suez will be made by one of the doctors of the
station. Arrivals from infected ports will be inspected by day.
2. There will be seven doctors—a Principal Medical Officer, four
doctors and two assistants. Should this medical staff be found in-
sufficient, the services of the naval doctors of the different Powers will
be utilised, under the orders of the Principal Medical Officer of
the sanitary station.
3. The medical officers must have a regular diploma, and should
be selected from amongst those who have gone through a special
course of epidemiology and bacteriology.
C 39
306
Measures to prevent the
[ APP. IX.
4. They will be appointed by the Minister of the Interior on the
recommendation of the Sanitary, Maritime, and Quarantine Board of
Egypt.
5. The pay of the assistants will be at the rate of 6,000 francs a
year, the pay of the four doctors will be at the rate of 8,000 francs a
year, rising to 12,000 francs, and the pay of the Principal Medical
Officer will rise from 12,000 to 15,000 francs.
6. The disinfecting and quarantine station of Moses' Wells is
under the authority of the Principal Medical Officer at Suez.
7. When patients are disembarked at this place, two of the Suez
doctors will be posted there, one to tend the plague patients, the
other to tend persons not suffering from the plague.
8. The number of sanitary guards will be 20. One of them will
be in special charge of the disinfecting apparatus at Moses' Wells.
g. The disinfecting and quarantine station of Moses' Wells will
be provided with—
(1) At least three disinfecting stoves, of which one will be placed
on board a pontoon.
(2) A new segregation hospital containing 12 beds, for the sick
and suspected,
This hospital will be so arranged that the sick and suspected, and
men and women, can be separately segregated.
(3) Barracks, hospital tents, and ordinary tents, for the use of the
persons disembarked.
(4) A sufficient number of baths and washing-places.
(5) The buildings required for the usual offices, the medical staff,
the guards, etc. ; a magazine and a laundry.
(6) A reservoir for the water-supply.
The passage, in quarantine, of the Suez Canal,
1. Permission to pass the Canal in quarantine is granted by the
sanitary authority at Suez ; the Board must be immediately informed
when such permission is given. In doubtful cases, the decision rests
with the Board,
2. A telegram must be at once sent to the authority appointed by
each Power. The telegram will be sent at the expense of the ship.
3. Each Power will prescribe penal rules for those vessels, which
depart from the course declared by the captain, and enter without
license one of the ports of that Power. Exception will be made in
the case of absolute necessity or if the vessel is compelled to put into
port for shelter.
APP. IX. ]
spread of infection by sea.
307
On arrival the captain must declare if he has on board gangs of
native stokers, or hired servants, of any description, not included in
the roll of the crew, or the register kept for the purpose. The fol-
lowing questions will be put to the captains of all ships arriving at
Suez from the south and must be answered on oath :—
Have you any supernumeraries, stokers or other hands not-
included in the ship's roll or in the special register ?
What is their nationality?
Where did you embark them ?
The sanitary doctors must satisfy themselves as to the presence'
of these supernumeraries, and if they find that any of their number
are missing, they must inquire carefully into the cause of their
absence.
4. A sanitary officer and two sanitary guards will go on board, and
accompany the ship as far as Port Said ; their duty is to prevent com-
munication, and to see to the execution of the measures prescribed
for the passage of the Canal.
5. Passengers may embark at Port Said, in quarantine, but all
embarkation and disembarkation, and all transfer of passengers or
cargo, is forbidden during the passage of the Canal from Suez to Port
Said.
6. Ships passing, in quarantine, must make the journey from
Suez to Port Said without trying up.
In case of the vessel running aground, or being compelled to tie
up, the necessary operations must be carried out by the staff of the
ship, all communication with the staff of the Suez Canal Company
being avoided :
Transports passing through in quarantine must do so only
day.
If they are compelled to pass a night in the Canal, they must
anchor in Lake Timsah.
7. Ships passing in quarantine are forbidden to stop at Port Said,
except in the cases provided for in paragraphs 5 and 8. The opera-
tion of revictualling must be carried out with the means on board.
All stevedores and other persons who have come on board the
ship will be isolated on the quarantine pontoon. Their clothes will
there undergo the prescribed disinfection.
8. When it is absolutely necessary for ships, passing in quarantine,
to coal at Port Said, they must do so at a place, to be fixed by the
Sanitary Board, where the necessary isolation and sanitary super-
vision can be secured. When effective supervision is possible, and all
contact with the people on board can be avoided, the coaling may be
308
Measures ¿o prevent the
[ App. IX.
done by the labourers of the port. At night the place must be
lighted by the electric light.
9. The pilots, electricians, agents of the company and sanitary
guards will be disembarked at Port Said, outside the port, between
the jetties, and from thence will be taken direct to the quarantine
pontoon, where their clothes will be thoroughly disinfected.
Measures to be taken in the case of ships arriving in Egypt from
an infected port by way of the Mediterranean.
1. Ordinary healthy ships, coming from a European or Mediter-
ranean infected port, wishing to pass the Suez Canal, will be allowed
to do so in quarantine. They will continue their voyage, remaining
under observation for ten clays.
2. Ordinary liealthy ships, wishing to land in Egypt, can put in at
Alexandria or Port Said, where the passengers will complete the
period of observation, either on board, or in the Lazaretto of Gabari,
as the local sanitary authority may direct.
3. The measures to be taken as regards infected and suspected
ships, coming from an infected European or Mediterranean port, and
desiring to call at an Egyptian port, or to pass the Suez Canal, will
be settled by the Sanitary Council, in accordance with the regulation
adopted by this Convention.
These measures must, before they can be carried out, be accepted
by the different Powers represented on the Board. They will
regulate the conditions to be imposed with regard to ships, passen-
gers and goods.
The Board will, similarly, submit to the Powers a code of rules,
dealing with cholera.
These two codes should be submitted as soon as possible.
Sanitary supervision of Pilgrims in the Red Sea.
Sanitary rules for pilgrim ships from infected ports in the (re-
organised) sanitary station of Kamaran.
Pilgrim ships coming from the south, and bound for the Hediaz,
will be detained at the sanitary station of Kamaran, and then undergo
the following treatment :—
Ships declared healthy will, after medical inspection, and on
completion of the operations detailed below, be given free pratique.
The pilgrims will be disembarked, they will wash or take a bath
in the sea ; their soiled linen, and any portion of their personal