NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
356
Measures to prevent the
[ APP. IX.
examination. As Rule II stands at present it permits the grant of a
clean bill-of-health, even though a case of plague is discovered on
board, provided that the patient is removed and that the other pre-
scribed precautions are duly carried out. Rule I of the existing rules
for the treatment of vessels leaving the port of Bombay, which are
contained in the Resolution of the Government of Bombay, No. 656
165/P, dated the 6th February, prohibits the departure of the vessel until
she has obtained a clean bill-of-health, and permits the grant of a
clean bill-of-health if the persons left on board are free from plague,
Neither draft Rule II nor existing Rule I conforms to the requirements
of the Venice Convention, On the one hand, if the measures prescribed
by the Convention are duly carried out, the vessel may be allowed to
depart, even though she cannot be certified to be healthy ; on the other
hand, if a case of plague is discovered on board, the fact must be
stated in the bill-of-health. Chapter II, Section VIII of the Conven-
tion lays down the rule that a ship sailing from an infected port may
only be considered as healthy if no case of plague has occurred on
- board either before departure, during the voyage, or on arrival. The
adoption of the prescribed precautions on the occurrence of a case
before departure cannot alter the fact that the vessel is infected. It is
stated by Dr. MacCartie that during the height of the epidemic it was
generally found necessary to remove some of the crew on suspicion,
and that in some instances the suspected cases turned out to be true
cases of plague. It does not appear necessary to mention in the
bill-of-health the removal of a case on mere suspicion, for instance,
the removal of a person suffering from fever without any other sign
of plague. But if at the time of inspection on board a case is disco-
vered, which is ascertained or believed to be plague, then it is clearly
necessary to mention the fact in the bill-of-health. In such cases the
precautions adopted should also be stated, including, if the patient
has been living on board, the disinfection of the infected part of the
vessel.
5. Apart from the matter discussed in the preceding paragraph,
the draft rules for the inspection of outward bound vessels appear
to the Government of India to be generally suitable and in accordance
with the Venice Convention, and they consider that the rules may be
sanctioned subject to the following remarks. It should be stated in
Rule I, in accordance with the terms of the Convention, that the
Health Officer must examine each person sailing on the ship, and that
the Consular Authority interested in the ship may be present at the
examination. In the case of vessels touching at the port of Bombay
for the purpose of embarking passengers, for which provision is made
in Rule I, the inspection should, in the opinion of the Government of
357
APP. IX. ]
spread of infection by sea.
India, be made on shore, and they consider that this should be stated
in the rule. It also appears from Sir James Campbell's letter of the
24th June that under present arrangements passengers are sometimes
examined on shore. The rules should provide that in such cases
persons suffering, or suspected to be suffering from plague, and their
relatives and attendants, should not be permitted to embark.
6. Rule I commences with the words " no vessel shall leave the
port of Bombay for any of the following ports." A blank is then left
for the insertion of ports. In paragraph 7 of your letter under reply,
it is stated that the Government of Bombay agree with Sir James
Campbell that, when plague cases have become very few in Bombay,
the inspection rules should be applied to certain classes of vessels only.
They consider that so long as Bombay remains an infected port
within the meaning of that expression as used in the Convention,
individual medical inspection must be made of every person sailing
in each vessel proceeding to any part of a country which is a party to
the Convention ; but that, as regards vessels proceeding to other ports,
whether within or outside India, the inspection can be altered or
discontinued at will. The Governor in Council hopes that the time
is near when the inspection of vessels proceeding from Bombay may
in some cases be relaxed or discontinued, and enquiry is made in
your letter whether such alterations or discontinuance should be
made without previous reference to the Government of India. I am
to say that the Governor General in Council considers that for the
present the rules must be maintained in their entirety in the case of
vessels sailing to all ports whether in or out of India. In view of the
great increase in the mortality in Bombay and of the recrudescence
of plague in some of the surrounding districts. His Excellency in
Council is of opinion that it would be unwise to relax any of the
precautions at the present time. His Excellency in Council is also
not at present convinced that the rules for vessels bound for Indian
ports may be ultimately discontinued or relaxed before those for
vessels sailing for ports out of India. The Government of India would
therefore prefer that a reference should be made to them before the
rules are discontinued or relaxed with reference to vessels sailing to
any particular class of ports.
7. I am to observe that the inspection rules for outward bound
vessels forwarded with your letter are framed only for the port of
Bombay, and that no mention is made in your letter or its enclosures
of any other port in the Bombay Presidency. As Karachi is still an
infected port within the meaning of the Convention, the Government
of India presume that vessels sailing from that port will be treated in
the same way as vessels sailing from Bombay, and that the Government
358
Measures to prevent the
[ APp, IX.
of Bombay will, after considering the circumstances of the port,
decide whether inspection should be made on board or on shore.
8. The Government of India consider that the draft rules for the
inspection of vessels arriving at the port of Bombay, appended to Sir
James Campbell's letter of the 24th June, are generally suitable and in
accordance with the Venice Convention, but that they require modifi-
cation in the following respects :-—
(1) In Rule III the Health Officer is given discretion, in the case
of a healthy ship which has not completed ten days from
the date of departure from an infected port, to (a) refuse
pratique until the end of the ten days' period, or (b) until
all persons on board have been subjected to medical
supervision up to ten days from the date of departure. It
is understood that alternative (a] contemplates the
detention of all persons on board ship. The Government
of India consider that this alternative is open to objection,
and that, as is stated in paragraph 12 of my letter No. 1623,
dated the 1st June, the passengers should be disembarked
and kept under observation on shore. In this connection
I am to invite attention to the conveneint provision in
Rule VIII (8) of the draft quarantine rules appended to
the letter of the Bengal Government of the 17th July for
the surveillance at their destination of healthy passengers
on their giving and undertaking to submit themselves to
surveillance by a medical officer.
(2) In the last sentence of Rule IV the period of quarantine should
be definitely fixed by the substitution of the word " should "
for the word " may,"
(3) In Rule VI it should not be left to the discretion of the
Health Officer to allow the healthy passengers and crew
of an infected vessel to land for the purpose of being kept
under observation. As is stated in paragraph 11 of my
letter of the 1st June, it should be obligatory to land the
healthy and keep them under observation on shore. An
exception to this rule should only be made in the case of
those members of the crew whom it is necessary to detain
on board for the care of the vessel.
(4) It appears to the Government of India that the form of the
draft quarantine rules appended to the letter of the Govern-
ment of Bengal of the 17th July is in some respects
preferable to the form of the draft rules appended to Sir
James Campbell's letter. In especial the Bengal rules
are directed to meet the case of all infected and suspected
359
APP. IX. ]
spread of infection by sea.
ships whatever their port of origin, and they follow more
closely the form of the Venice Convention. I am to
suggest that the form of the draft rules forwarded with
your letter might be re-modelled on the lines of the draft
rules for the port of Calcutta.
g. In your letter and its enclosures no mention is made of the
quarantine rules enforced at ports in the Bombay Presidency other
than the port of Bombay. The rules now in force at Karachi, which
were issued under Act I of 1870 in the notification of the Govern-
ment of Bombay, No. 592, dated the 3rd February, and the rules
now in force at other ports on the Bombay Coast, which were issued
under the Epidemic Diseases Act, 1897, in the notification of the
Government of Bombay, No.1211/710-P., dated the 6th March, are not in
.
all respects in accordance with the Venice Convention. I am to
suggest that the rules for Karachi and for the other ports on the
Bombay Coast, where the Government of Bombay consider it necessary
to still maintain an inspection of the inward sea traffic, should be
modified in the same way as the rules for the port of Bombay. If
the present rules for Karachi, which issued under Act I of 1870, are
superseded by new rules framed under the Epidemic Diseases Act,
it will be necessary to cancel the existing rules by a notification
under Act I of 1870.
10. The case of the Aden quarantine rules requires special notice.
With effect from the 5th October and the I3th October, respectively,
the Government of Bombay published, under Act I of 1870, quarantine
rules against Bombay and Karachi for the ports of Aden, Perim, and
the Somali Coast. These rules were the usual quarantine rules based
on the model B Quarantine Rules framed by the Government of India
in 1888. They are still in force, but certain alterations, have been
made in them, of which the most
* Notification of the Government
.
'
of Bombay, No. 583, dated the 3rd important is the imposition * of ten
February 1897-
days' quarantine from the date of the
departure of the vessel on persons landing at Aden. It was also
decided in the correspondence ending with your telegram of the 30th
April that the Health Officer must not visit the vessel until the ten
days' period expires, and that vessels merely using Aden as a port of
call need not be examined at that port.
In my telegram No. 1007, dated the 18th March, it was requested
that revised rules giving effect to these decisions might be drawn up,
and in your reply of the 30th April it was stated that the Resident
at Aden had submitted proposed rules which required some revision.
The Government of India have not yet received these revised rules,
360
Measures to prevent the
[ App. IX,
The rules at present in force at Aden are in several respects opposed
to the Venice Convention and the instructions contained in my letter
of the 1st June. Rule IV prescribes fifteen days' quarantine for
infected vessels. There is no provision in the rules for landing the
sick and keeping them in an isolation hospital. The healthy are
only landed and kept in segregation at the discretion of the Health
Officer. The rules thus permit the detention of the sick and healthy
together on board ship, a procedure which, in the opinion of the
Government of India, is open to grave objection. There is also no
provision in the rules for the disinfection or destruction of contaminated
articles and for the disinfection of the ship. The Government of
India recognize that in the case of Aden the imposition of quarantine
rules is complicated by the importance of keeping the port clean in
the eyes of the world. But if proper arrangements are made and
proper precautions taken, the enforcement of the regulations pre-
scribed by the Venice Convention will not, in the opinion of the Govern-
ment of India, injure the reputation of the port. I am to say that
the Governor General in Council will be glad if the Government of
Bombay will, bearing these matters in mind, consider the measures
to be taken for the treatment at Aden in accordance with the Venice
Convention, of vessels from infected ports, in such a manner that the
health of the port may not be injured nor its reputation endan-
gered.
No. 91,
No. 5380, dated Bombay Castle, the 4th October 1897.
From—J. DEC. ATKINS, Esq., I.C.S., Secretary to the Government of
Bombay, General Department,
To—The Secretary to the Government of India, Home Department (Sani-
tary).
Letter to the Government of
India, Home Department, No.
777, dated I2th February 1897,
Telegram from the Govern-
ment of India, Home Depart-
ment, No. 683, Sanitary, dated
22and February 1897.
Telegram to the Govern-
ment of India, Home Depart-
ment, dated 25th February 1897.
Telegram from the Govern-
ment of India, Home Depart-
ment, No. 889, Sanitary, dated
9th March 1897,
Telegram to the Government
of India, Home Department,
dated ¿joth April 1897.
With reference to the correspondence noted in the margin, I am
directed to submit, for the approval of the
Government of India, the accompany-
ing draft of rules framed in accordance
with the principles of the Venice Con-
vention for the treatment at Aden of
vessels arriving there from ports declared
to be infected with plague. I am at the
same time to forward extracts from a re-
port by the Resident at Aden on the sub"
ject,
361
ÁPP. IX. ]
spread of infection by sea.
2. With reference to the remark of the Resident that the Port Sur-
geon cannot proceed on board a vessel in quarantine " without
compromising himself," I am to observe that though this consideration
was of some importance so long as Egypt or European nations
were at liberty to impose quarantine against Aden without assigning
definite reasons for their action, yet now it ceases to have any
weight, as, in accordance with the principles of the Venice Conven-
tion, Aden can only be treated as an infected port if plague actually
exists there. It would in the opinion of this Government be out
of the question to consider a scheme for maintaining a floating hos-
pital with a medical officer perpetually in quarantine so long as
plague existed at any port wherefrom vessels might arrive at Aden.
3. His Excellency the Governor in Council is inclined to agree
with the Resident at Aden that, with the existing medical staff, it is
impossible to arrange for the proper medical inspection of a ship,
except by day light.
4. With reference to the want of a disinfecting stove at Aden
1 am to state that the Surgeon-General is being consulted on the
subject, and, if necessary, a further reference regarding it will be
made to the Government of India.
5. The Resident proposes that, as vessels cannot be admitted to
pratique during the night time, the usual form of report should be
sent on board of onward bound vessels to be filled in by the com-
mander or medical off cer. To this there seems to the Governor in
Council to be no objection,
ACCOMPANIMENTS TO THE LETTER TO THE GOVERNMENT OF INDIA,
NO. 5380, DATED 4TH OCTOBER 1897.
Rules applicable to vessels arriving at Aden from Ports infected
with Plague.
Rule I.—The commander of every vessel, including buggalows
or other native craft, arriving at Aden from an infected port shall, be-
fore entering the harbour, hoist a yellow flag (or, if entering the port
at night-time, exhibit two red lights one above the other at the main)
and indicate by signal the port from which such vessel has come, and
shall keep such flag and signals flying until permitted to take them
down. The pilot on going alongside a vessel from an infected port
shall direct the flag prescribed above to be hoisted if it has not been
already done.
Rule II.—Such commander shall not, except as hereinafter provid-
ed, allow any communication, except orally, with the shore or with
ç 46
362
Measures to prevent the
[ APP. IX.
any other vessel or boat, except the pilot boat, with which communica-
tion shall be limited to receiving the pilot who shall proceed straight
to the bridge.
Rule III.—No vessel shall be given pratique until ten days
from the date of its departure from an infected port. A vessel which
carries no qualified medical officer shall not be given pratique until
ten days from the date of its arrival in- Aden. Until the ten days'
period has expired, a vessel shall, during its stay at Aden, remain at the
quarantine anchorage appointed from time to time by the Resident by
general or special order in this behalf. Until a vessel has been given
pratique, it shall have no communication with the shore.
Rule IV.—On the arrival of a vessel, whose destination is Aden, an
officer appointed for the purpose by the Resident shall go alongside
and ascertain whether ten days have or have not expired since its
departure from an infected port.
(a] If ten days have expired since its depaiture from an infected
port, and if it carries a qualified medical officer, the officer appointed
for the purpose shall board the vessel and make such inquiries and
inspection as he thinks necessary, and may require a declaration on
oath from the medical officer of the vessel or the captain, or both, as
to the existence of plague or suspected plague on board the vessel
either during the voyage or before its departure. He shall then
declare whether the vessel is " healthy, " " suspected " or" infected, "
as defined in Rule VII. If he is satisfied that the vessel is " healthy "
it shall be given pratique forthwith. If he declares it to be " suspect-
ed " or " infected,"' it shall be dealt with in the manner prescribed
in Rule VII.
(b) If on the arrival of a vessel it is ascertained that ten days
have not expired since its departure from an infected port, or if it
carries no qualified medical officer, it shall be detained at the quaran-
tine anchorage until, in the former case, ten days have expired since
its departure from an infected port, or, in the latter case, ten days
have expired since its arrival at Aden, after which the officer
appointed for the purpose shall take the measures specified in clause
(a) of this rule, and classify the vessel :
Provided, however, that the officer appointed for the purpose may,
at. any time before the expiration of the aforesaid period of ten days
make" such inquiries and inspections as he thinks necessary ; and if,
as the result thereof, he comes to the conclusion that the vessel is
" infected, " he shall forthwith, and without waiting for the expiration
•of the ten days' period, order it to be treated as infected.
363
APP. IX, ]
spread of infection by 'sea.
Rule V. — On the arrival of a vessel, which is onward bound, and
which uses Aden as merely a port of call, the officer appointed for the
purpose by the Resident shall go alongside and ascertain whether
ten days have or have not expired since its departure from an
infected port.
(a) If ten days have expired since its departure from an infected
port, and if it carries a qualified medical officer, and if the officer
appointed for the purposs is permitted to make such inspection as he
thinks necessary, and, as the result thereof and as the result of any
inquiries he may make, is satisfied that the vessel is " healthy, " the
vessel shall be given pratique. Otherwise it shall remain in
quarantine at the anchorage appointed for the purpose by the
Resident during its stay in port: no persons shall be landed therefrom,
except at the quarantine camps appointed by the Resident, and no
communication with the shore or with other Vessels shall he allowed,
except the landing of mails in quarantine and the embarkation and
disembarkation of passengers in quarantine.
(b) If ten days have not expired since its departure from an in-
fected port, or if it carries no qualified medical officer, it shall remain
in quarantine at the quarantine anchorage appointed for the purpose
during its stay in port,
N.B.— No inspection of a vessel under Rules IV and V shall ordinarily be
made, except by day-light.
Rule VI.—These rules shall not prevent the transhipment, in
quarantine, of passengers or other persons or mails or cargo from a
vessel in quarantine to another ; provided that thereafter the latter
vessel shall be in quarantine.
Rule VI!.—For the purposes of these rules a " healthy " vessel
means—
"A vessel which has had no case of plague on board and which has left an
infected port ten days or more previously."
A " suspected " vessel means—
" Any vessel, on board which there has been a case of plague at the time of
departure or during the voyage, but on which no fresh case has occurred for
twelve days."
An " infected " vessel means—
" Any vessel with plague on board, or on board which one or more cases have
taken place within twelve day."
The only measures which the authorities of the port of arrival may
enforce with regard to " healthy " vessels are those which are pre-
scribed for " suspected " vessels (medical inspection, disinfection,
pumping out the bilge-water and the substitution of good drinking
water for the water on board), except that the measures prescribed
364
Measures to prevent the
[ APP. IX.
for the disinfection of the vessel itself may not be enforced in the case
of healthy vessels.
The following treatment is prescribed for " suspected " and
" infected " vessels, respectively :—
Suspected vessels are subject to the following measures which will be carried
out under the orders and supervision of the officer appointed for the purpose :—
1. Medical inspection.
2. Disinfection ; the soiled linen and personal effects of the crew and pas-
sengers, which in the opinion of the officer appointed for the purpose may be
regarded as contaminated, should be disinfected.
3. Pumping cut the bilge-water after disinfection, and the substitution of good
drinking water for the water stored on board.
4. Disinfection of all parts of the vessel which have been inhabited by
plague patients, and any other measures of disinfection that may be ordered by
the officer appointed for the purpose.
A watch should be kept over the health of the crew and passengers for ten
days from the date of arrival of the vessel ; and
the crew should not without the special permission of the officer appointed
for the purpose be allowed to land, except on duty.
Infected vessels are subject to the following rules :—
1. The sick will be immediately disembarked and isolated.
2. The other persons on board should also, if possible, be disembarked and kept
under observation or surveillance* for a period varying according to the sanitary
condition of the vessel and the date of the last case, but which must not exceed ten
days.
3. The soiled linen and personal effects of the crew and passengers, which in
the opinion of the sanitary authority of the port may be considered as infected
will be disinfected.
4. The bilge-water will be pumped out after disinfection, and good drinking
water will be substituted for the water stored onboard.
5. All parts of the vessel which have been inhabited by plague patients should
be disinfected, and such other measures of disinfection shall be taken as may be
ordered by the officer appointed for the purpose.
Rule VIII.—The Resident shall have full power, subject to any
orders that may be issued by the Government of Bombay, to make re-
gulations or pass orders regarding the administration of quarantine
camps and hospitals, whether ashore or afloat, and regarding
quarantine anchorages, and all persons concerned shall be bound to
obey such regulations and orders. Any vessel objecting to submit
thereto, or to any of the measures indicated in these rules, shall, how-
ever, be free to put back to sea.
Rule IX.—Any mails or cargo which may be brought by any
vessel arriving from an infected port shall be landed under such
*The expression ' observation ' means segregation of the passengers, either on board
a vessel or in a lazaretto, till they have obtained free pratique. Th« expression* sur-
veillance ' means that the passengers will not be isolated ; they will at once obtain free
pratique, but on arriving at their destination they will be kept under medical surveillance»