NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
APP. IX.]
spread of infection by
sea.
365
precautions as the officer appointed for the purpose may deem ne-
cessary to prevent the spread of the disease.
Rule X.—It will be the duty of the port officer to facilitate the
conveyance to all vessels in quarantine of such supplies of provisions,
stores and other articles as may be required by those on board. Such
supplies will be placed on the boats of the vessels in quarantine to be
subsequently removed by members of their crews.
Rule XI.—All vessels arriving at Aden, which may have commu-
nicated with vessels coming from an infected port, shall be subjected to
the same rules as vessels arriving at Aden from an infected port.
Rule XII.—All vessels which have undergone medical inspection
and quarantine in the manner above prescribed should have the fact
clearly stated on their bills of health.
Extracts from the letter from the Political Resident, Aden, referred fo in paragraph
1 of the letter to the Government of India.
Rule IV, paragraph 2.
The view hitherto held at Aden is that the Port Surgeon cannot
proceed on board a ship in quarantine without compromising himself.
If this view is correct—and by " inspection " in this paragraph personal
inspection on board is meant—it would follow that the Port Surgeon
would himself be in quarantine if he inspected a vessel before the
completion of the ten days therein referred to.
Were there to be in Aden a floating hospital, with a medical
officer or officers practically in perpetual quarantine, this would not
matter ;.but so long as the Port Surgeon is the " officer appointed for
the purpose," and assuming that the fact of his boarding a vessel in
quarantine would compromise him, I would suggest the omission of
the words " and inspection " in the second line of this paragraph.
If it is held that a medical officer can proceed on board a vessel
in quarantine without compromising himself, then the words above
noted may stand.
Rules IV and V.
In both these rules it should be made clear that the " inspection "
therein referred to can only be made by day-light.
Any inspection by night must necessarily be incomplete and un-
satisfactory, and with no one to assist him, the Port Surgeon could not
be expected to do this duty by night.
I would suggest the addition of the words " by day-light " after the
word " inspection " wherever it occurs in these two rules.
In regard to giving effect to the rules the Port Surgeon has drawn
attention to the following facts :—
(a) That while disinfection is to be mainly relied on in future
for the treatment of infected ships, there is no disinfecting stove
366
Measures to prevent the
[ APP. IX.
or other appliance in Aden, nor has the Port Surgeon any staff
or means at his disposal for carrying out the disinfection provided
in Rule VII, and that this work if left to the vessels themselves,
especially when there is no medical officer on board, will be
certain to be imperfectly done.
(b) That as medical inspection cannot, under present condi-
tions, be held at night, vessels arriving from infected ports during
the night-time and departing before day-break cannot be ad-
mitted to free pratique.
(c) That if all onward bound vessels (such as are referred to in
Rule V) arriving at night-time are to be visited on arrival, it will
be necessary to appoint a special officer for that purpose, as one
officer cannot carry on such duties by night as well as by day.
The Port Surgeon suggests that in such cases, as the vessel cannot
be admitted to pratique during the night-time, it would be sufficient
to send the usual form of report on board to be filled in by the com-
mander or medical officer, instead of taking the report orally from him
alongside.
In this case the appointment of a special officer would not be neces-
sary.
In this proposal I am prepared to concur so long as the work is
carried on unaided by the Port Surgeon.
BENGAL.
No. 3718 (Medical), dated Calcutta, the 17th July 1897.
NO. 92.
From—C. E. A. W. OLDIIAM, Esq., Officiating Secretary to the Government
of Bengal, Municipal Department,
To—The Secretary to the Government of India, Home Department.
I am directed to acknowledge the receipt of your letter No. 1625
dated 1st June 1897, addressed to this Government in the Marine
Department, forwarding, with the comments of the Government of
India, a copy of a translation of the Convention framed at the Sanitary
Conference recently held at Venice for the purpose of considering
measures to prevent the spread of the plague.
2. The principal peints in the letter which call for remark at
present are the following :—
(a) Notification under Chapter II, section I of the Convention.
(b) Measures to be taken on the departure of vessels from infect-
ed ports.
(c) Measures to be taken at ports of arrival.
3. As regards notification of plague cases, it appears to the
Officiating Lieutenant-Governor that no action is needed at present,
APP. IX. ]
spread of infection by sea.
367
If plague broke out anywhere, information of the occurrence would
be communicated to the Government of India, by whom the necessary
notification would be issued. Paragraph 2 of section I, Chapter II
of the Convention, enjoins that medical men should be obliged
to report all cases of plague, in order that each Government may be
informed of real or suspicious cases occurring within its jurisdiction.
Such an obligation has been enforced in the case of Calcutta by
Rule 2 of Plague Notification No. 7 of this Government, dated the
12th March 1897, under which every medical practitioner, police
officer or municipal servant is bound to report cases of plague to the
Health Officer of Calcutta, who in his turn would report the same to
Government through the Chairman of the Corporation. For the rest
of Bengal, the reporting of plague cases has not been enjoined in
order to discourage the reporting of bogus cases, but in the executive
orders issued with Mr. Risley's letter No. 1366-Medical, dated the
12th M arch 1897 (copy enclosed), it was directed that enquiries should
be made at all chaukidari parades in the mufassal whether any
Marwari or other traders have arrived in the village recently from
the Bombay Presidency or Sind, and whether any deaths from fever
have occurred among such persons or among persons living in the
same house with him. In mufassal towns the registration of deaths
O
is in the hands of the police, and any case of plague would at once
be brought to the notice of the Civil Surgeon. His Honour considers
these measures as sufficient, and does not propose to issue any formal
notification on the subject, which would only alarm people and lead
to fever cases being reported as plague.
4. As regards the measures to be taken on the departure of vessels
from infected ports, it is laid down- in the Convention that every
person sailing on the vessel must be examined on shore and by day
at the time of embarkation by a medical officer appointed by Govern-
ment, and that the Consular Authority interested in the ship may be
present at the inspection. Although the port of Calcutta is not
infected, the Government of india consider it desirable that the special
rules made for this port should be assimilated, in the case of vessels
sailing for ports out of India, as far as possible to those which will
under the terms of the Convention, have to be adopted at the infected
ports of the Bombay Presidency. Owing to the peculiar conditions
of the port of Calcutta, stretching as it does along the bank of a tidal
river at all times difficult of navigation, and where the departure of
vessels is regulated by the flow of the tide, and necessarily confined
to a short period of time, it appears to Mr. Stevens to be no easy
matter to comply with the requirements of the above provision of the
Convention without interfering with the convenience of passengers
and possibly causing steamers to miss a tide, These difficulties are
368
Measures to prevent the
[ APP. IX.
enhanced by the practice of passengers going on board at other
points than the jetties, and when pressed for time proceeding by
train to Diamond Harbour to embark there. The inconvenience felt
was brought to the notice of Government in the representation from
the Liners' Conference of Calcutta and the Bengal Chamber of Com-
merce (a copy of which was communicated to the Government of
India with this office letter No. 355-T.-M., dated 12th June 1897) in
connection with the working of Rule 4 of Plague Notification No. 3
of the 25th May. It was urged that before that rule was enforced, it
was the invariable custom to obtain the bill of health, port clearance,
etc., while the loading was being completed, so that the vessel might
leave the next morning. In the case of steamers, work went on
throughout the night, and often up to the very moment of starting.
Under Rule 4 this could not be done, for a vessel completing her
loading on a Friday evening had to wait for her bill of health which,
when obtained, had to be presented at the Custom House for port
clearance, and, if the vessel were foreign bound, taken to a Consul
for countersignature. By the time all this was done, it would be too
late for a start, and the ship would have to remain where she was till
Sunday. In the case of a ship finishing her loading on a Saturday,
two days would be lost, as a bill of heath, or certainly a port clearance,
could not be obtained on Sunday, and the vessel would, therefore, be
detained till Tuesday. Then, again, by the time the Custom House
was open, the tide would usually be lost ; and, further, there are fre-
quently two or more vessels clearing in one day, which would
naturally delay the Port Health Officer,
5. The Plague Notification No. 3 of the 25th May has, therefore,
been further revised, so as to bring its provisions into accord with the
instructions contained in paragraph 5 of your letter under reply and
paragraph 3 of your letter No. 1674 of the 9th June 1897, and with a
view to meet at the same time the objections urged upon this Govern-
ment by the shipping representatives, and the difficulties which must
attend the carrying out of such regulations in a tidal port like
Calcutta. A copy of the revised draft of the notification is submitted
for the approval of the Government of India. An endeavour has been
made to minimise the inconveniences complained of by the Liners'
Conference by the expedient adopted in Rule 1 of the notification of
appointing commissioned medical officers to grant certificates to
passengers and making them form part of the bill of health, and by
omitting all reference to cargo in the bill of health. People who want
to go on board at Diamond Harbour or Garden Reach, instead of at
the docks or jetties, will obtain a certificate from one of the Presidency
Surgeons, and this certificate will be attached to the bill of health.
As it is proposed to invest only Presidency Surgeons with power to
APP. IX. ]
spread of infection by sea.
369
grant such certificates, the Officiating Lieutenant-Governor does not
anticipate that any objection can be taken to this course. As regards
cargo, no inspection or examination of it is, or can possibly be, made
by the Health Officer ; he cannot ascertain by merely looking down
the hatchways whether the cargo is infected or not. The Convention
requires the Health Officer to disinfect suspected articles, and this
has been provided for in Rule 3. Under paragraph 9 of your letter,
the mercantile community of Calcutta will be asked to consider
whether, in order to protect the clean ports, prohibitive orders should
issue with regard to all or any of the susceptible articles mentioned
in the Convention. If it is decided to issue such orders, both Rule 3
of Plague Notification No. 3 and the bill of health will have to be
modified. But the reference will take time, and His Honour does not
consider it necessary to delay the issue of the Plague Notification on
this account.
6. In connection with the use of a " disinfection lighter," referred
to in Rule 3, I am to observe that a proposal is now under considera-
tion to have a floating disinfector for the Port of Calcutta. A large-
sized Equifex disinfector, which has been ordered by the Calcutta
Municipality, will be mounted on a barge or cargo-boat and kept on
the river, and will be available for use by the Town and Port of
Calcutta, as well as by the Municipality of Howrah and other Muni-
cipalities on the river's edge. This will in many cases be more con-
venient for suspected articles than disinfection on shore, and will fre-
quently be the only means of effectually disinfecting a ship which has
no disinfecting stove.
7. Rule 5 has been drafted so as to avoid, as far as possible
causes for detention, while maintaining sufficient precautions against a
breach of the terms of the Convention. Under clause (b) of the rule,
the Collector of Customs has been authorized to grant port clearance
under section 66 of the Sea Customs Act on a guarantee being given
by the agents of a vessel that within 48 hours of departure they will
produce a duplicate copy of the bill of health, as finally granted,
signed by the Port Health Officer, or an additional Port Health Officer,
and that if for any reason the Health Officer should refuse to grant
the bill of health, they will bring the vessel back to her moorings.
8. No provision has been made in the notification for a Consular
Officer being present at the medical inspection of passengers who are
passed by a medical officer other than the Port Health Officer, under
the proviso to Rule 1. But this point is not likely to be pressed. Only
Presidency Surgeons would be appointed under the proviso, and
Consular Officers would doubtless accept their certificates.
9. I am at the same time to submit, for the approval of the
Government of India, a copy of a draft of the quarantine rules for the
c .47
370
Measures to prevent the
[ APP. IX.
port of Calcutta, which have been revised with reference to Chapter II,
section VIII of the Convention and paragraph 10 of your letter com-
menting thereon, which it is proposed to issue in the Marine Depart-
ment of this Government. Rule IV enjoins that if there is any case
of sickness on board, and the pilot has reason to believe that it is
plague, he shall telegraph to the Health Officer from Saugor, and shall
not proceed beyond Diamond Harbour without the permission of the
Health Officer. In this connection, I am to observe that strong feeling
was evoked in Calcutta some months ago by the proposal to embark at
Diamond Harbour pilgrims proceeding to the Hedjaz. In point of
fact the scheme was a pis-aller. It was argued, however, that in the
view of foreign nations Diamond Harbour was the same as Calcutta,
and that the formation of a plague camp there would lead to Calcutta
being quarantined. To this argument it may be replied that Diamond
Harbour has, ever since 1894, and, indeed, long before that, been the
quarantine station of Calcutta, and plague patients disembarked there
for isolation, etc., are just as likely to damage the reputation of Calcutta
as pilgrims embarked there. Only recently, in fact, a return ship load
of 443 pilgrims, who had come from the infected port of Jeddah, was
disembarked and disinfected there. But, apart from this possibly
sentimental objection, there is some real danger that whatever pre-
cautions may be taken plague may be communicated to the coolies,
stevedores and other persons connected with shipping who work at
Diamond Harbour, and pass between there and Calcutta. For these
reasons it seems to the Officiating Lieutenant-Governor desirable that
an attempt should be made to find another quarantine station, and the
Sanitary Commissioner, Bengal, has been requested to report on the
question in communication with the Port Officer and the Port Commis-
sioners. A separate communication will be addressed to the Govern-
ment of India as soon as this report is received.
10. Meanwhile, I am to ask that any orders that the Government
of India may pass on the revised Plague Notification No. 3, and on the
revised Quarantine Rules, may be communicated to this Government
at an early date.
No. 93.
No. 1905, dated Simla, the 6th August 1897.
From—J. P. HEWETT, Esq., C.I.E., Secretary to the Government of
India, Home Department,
To—The Officiating Secretary to the Government of Bengal, Municipal
(Medical) Department.
I am directed to reply to your letter No. 3718 (Medical), dated
the 17th July, on the subject of the revision in accordance with the
Venice Sanitary Convention of the rules issued by the Government
of Bengal for the prevention of the spread of plague infection by
APP. IX.]
spread of infection by sea.
371
vessels departing from and arriving at the port of Calcutta. I am
at the same time to forward, for the information of the Government of
Bengal, à copy of correspondence with the Government of Bombay
with regard to the alteration of the rules issued by that Government
under the Epidemic Diseases Act, 1897, and Act I of 1870, so as to
bring them into accord with the provisions of the Venice Convention.
2. Paragraphs 4 to 8 of your letter under reply discuss the draft
rules prescribing the measures to be taken on the departure of
vessels from the port of Calcutta, contained in draft Plague Notifi-
cation No. 3 appended to your letter. In paragraph 5 of my letter
No. 1625, dated the ist June, and in paragraph 3 (ii) of my letter
No. 1674, dated the 9th June, it was desired that in conformity with
the Convention all persons sailing on the vessel should be examined
on shore prior to the departure of the vessel. In paragraph 4 of your
letter under reply the Government of Bengal represents that, owing
to the peculiar conditions of the port of Calcutta, it is difficult to
comply with this requirement of the Convention without interfering
with the convenience of passengers, and possibly causing steamers to
miss a tide. In the succeeding four paragraphs an account is given of
the measures proposed with a view to minimize this inconvenience
and the possibility of delay. It will be seen from the correspon-
dence with the Government of Bombay forwarded with this letter
that it has been found impossible to insist on the examination of all
persons on shore in the case of vessels sailing from the port of
Bombay, and that the Government of Bombay have been authorized
to retain the existing procedure which has been worked with marked
success, and under which the examination is made on board or on
shore as may be the more convenient. As it has thus been found
impossible to comply literally with this requirement of the Conven-
tion at the infected port of Bombay, the Government of India will no
longer press for compliance in the case of the uninfected port of
Calcutta, and they therefore authorize the continuance at that port
of the more convenient procedure of examination on board. I am to
add that the Government of India have no objection to the proposed
arrangements under which (1) the bill of health will contain no refer-
ence to the cargo ; (ii) the Collector of Customs will be authorized
to grant port clearance on a guarantee being given by the agents
of a vessel that within 48 hours of departure they will produce a
duplicate copy of the bill of health as finally granted, signed by the
Port Health Officer, and that if for any reason the Health Officer
should refuse to grant the bill of health, they will bring the vessel
back to her moorings ; and (iii) the disinfection of contaminated or
suspected articles will be performed either on shore or on a lighter.
372
Measures to prevent the
[ APP. IX.
3. The only matter in connection with the regulations about
which I am to invite the special attention of the Government of
Bengal is the procedure to be followed when a case of plague is
discovered at the time of the examination on board. Rules 2
and 3 of draft Plague Notification No. 3 correctly define the
precautionary measures which are to be adopted when a case of
plague is discovered on board, but Rule 8 permits the grant of a
clean bill of health when these precautions have been duly carried
out. This latter provision is not in accordance with the terms of
the Convention which permit a vessel sailing from an infected port
to be treated as healthy only when no case of p.lague has occurred
either before departure, during the voyage or on arrival (Chapter II,
section VIII). The adoption of the prescribed precautions cannot
alter the fact that the vessel is infected. If, therefore, a case
which is ascertained or believed to be plague is discovered during the
examination on board, the fact must be stated in the bill of health,
together with the precautionary measures adopted.
4. I am to request that, with the permission of His Honour the
Lieutenant-Governor, the rules in draft Plague Notification No. 3
may be revised in accordance with the remarks in the preceding
paragraph.
5. The draft quarantine rules forwarded with your letter appear
to the Government of India to be generally well adapted to meet the
requirements of the Venice Convention. I am to convey the follow-
ing observations with regard to them for the consideration of His
Honour the Lieutenant-Governor :—
(1) The draft notification is framed under the Quarantine Act,
I of 1870, arid the Epidemic Diseases Act, 1897. The Gov-
ernment of India consider that it will be more convenient
that the rules should issue under the Epidemic Diseases Act
alone. The reference in the draft notification to the sanc-
tion of the Governor-General in Council will then be un-
necessary, but a notification should issue under Act I of
1870, cancelling the existing quarantine rules for the port of
Calcutta which have been issued under that Act.
(2) The draft notification states that " the Lieutenant-Governor
of Bengal has been pleased to make the following rules for
quarantine against plague, etc." In this form the rules
would be of permanent application, and would therefore be
contrary to the orders contained in paragraph 4 of Home
Department Resolution No. 8—95 (Sanitary), dated the
9th May 1897. I am to suggest that the wording might be
altered to the following: "The Lieutenant-Governor of