6
As a matter of fact, however, the great majority of the passengers during·
the six months shown in Table I were examined on shore, prior to embarkation,
in sheds specially arranged for the purpose ; and these were of the classes most
likely to be carriers of the Plagile, i.e., passengers by Shepherd's local and coast-
ing steamers and the British India boats bound to Káthiáwár, Cutcli and
Karachi.
Those inspected on board ship were as a rule passengers by the ocean-
going steamers. In all instances the crews of vessels were examined on
Board ship. Their inspection elsewhere would have been impossible, or, if possible
in few instances, could have been attended by no sanitary benefit whatever ; for,
if any one of a crew during inspection on shore was found to be a Plague case,
he must have been considered to have already infected the vessel be came from.
The importance of crew inspections will be seen from a glance at Table I which
shows that considerably more than half of all persons inspected came under the
crew class, and consisted of the very people who under the conditions prevailing
were the most likely, in the case of vessels going to Europe and foreign ports,
to be carriers of infection. Thus a P. & O. Liner arrives from Europe, and at
once proceeds to discharge its native crew. The crew by law can claim dis-
charge, and the lascars rarely fail to do so. Another crew is then entertained
in Bombay, and its members join the vessels some days before it sails from this
port. During the plague epidemic the new crews in these cases came from some
of the most infected areas in the town, and were, therefore, much more likely to
be carriers of the Plague than the passengers who were chiefly Europeans and
most of them from up-country stations free from the disease.
11. It is of course impossible to accurately gauge what is the real and
exact value to be attached to any system of medical inspection as a preventative
to the spread of Plague. It cannot discover the disease in its incubating stage,
but it can detect signs and symptoms suspicious of the disease ; and if all persons
with suspicious signs and symptoms are removed from a vessel, the odds are
much in favour of that vessel remaining uninfected. There is also an indirect
effect which follows a strict inspection system, and that is the check on the
spread of the disease which arises from. Plague and suspicious cases not caring
to risk the chance of detection once the severe nature of the medical examina-
tion has been recognised. This was very marked during the first months of the
inspections when it Was noticed that after the system had been acting for a short
time the number of Plague and highly suspicious cases presenting themselves
for examination considerably lessened ; and the Port Health Office was deluged
with letters and certificates relating to persons who wanted to leave Bombay
but feared being prevented from doing so by the rigour of the inspection.
"When it is remembered that only two ocean-going steamers are known to have
Plague on board after leaving Bombay from the first appearance of the disease
in September 1896 to the present time, it is allowable to claim that the measures
adopted by the Bombay Government shall be considered the leading factors in
that result, and that a proper system of medical inspection if applied in time is
capable of preventing Plague from seriously spreading beyond its centre of first
appearance to neighbouring parts. It is of course impossible to trace the move-
ments of each passenger who left Bombay by sea for ports across the harbour,
and down the coast ; and cases of Plague may have got away, by sailing craft and
small coasting steamers, even after the strict system of inspection was introduced
for passengers by such vessels. But enquiry has failed to show any ; and
amongst the large number of passengers who left for Karáchi, where they came
under official observation, and statistics accordingly are reliable, only one case of
Plague occurred, and this might equally be called a Karáchi case, as the man only
complained of illness five days after landing at Karachi and 7 days after departure
from Bombay.
The two ocean-going steamers mentioned above as Plague-infected were the
S.S. " Pekin " which left Bombay with 1,045 pilgrims for Jeddah on the 28th
December 1896, and the hired Government Transport S.S. " Dilwara" which
left Bombay for Southampton on 10th March with 172 crew and 1,003 passen-
gers.