NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
CHAP. XI. ] Measures to prevent the spread of infection by sea. 379
(9) When these rules have been fully complied with, the Health
Officer shall, by an order in writing under his hand, to be
delivered to the Commander, permit the yellow flag to be
hauled down.
Healthy ships.
" Rules relating to healthy ships—
(1) A healthy ship shall be given free pratique at once, what-
ever may be the nature of her bill of health.
(2) Such a ship may, at the discretion of the Health Officer, be
subjected to the measures prescribed in Rules VIII (2),
VIII (3) and VIII (4), but the ship itself may not be disin-
fected as in Rule VIII (5), except with the consent of the
Commander or Agent.
(3) Passengers who, on medical inspection, are suspected by the
Health Officer to be infected with plague, may be detained
under observation in an isolation hospital appointed for
the purpose, for ten days from the date on which the ship
left an infected port, or, if plague occurs among them
while under observation, from the date of the last case.
(4) The crew will not be allowed to land, except on duty, for
ten days from the date on which the ship left an infected
port.
(5) The crew and passengers may, at the discretion of the
Health Officer, be subjected to surveillance in the manner
described in Rule VIII (8), for a period of ten days from
the date on which the ship left an infected port.
(6) When these rules have been fully complied with, the Health
Officer shall, by an order in writing under his hand, to be
delivered to the Commander, permit the yellow flag to be
hauled down.
(7) None of the above measures will be considered necessary
when the ship has been given free pratique at Colombo or
other intermediate port."
MADRAS.
Publication of
revised rules
for ports in the
Madras Presi-
d ency.
On the 6th of July the Government of Madras issued a set of
revised quarantine regulations under the Epidemic Diseases Act for
all ports in the Madras Presidency. The rules were approved by
the Government of India except in one particular in which they
departed from the principles laid down by the Venice Convention.
The necessary modification was made by the Government of Madras in
380 Measures to prevent the spread of infection by sea. [CHAP. XL
Based on English
Local
Government
Board rules and
Venice
Convention.
a subsequent notification. The rules were based on the English
Local Government Board Rules, which are summarized in Chapter
XIV, modified so as to meet the requirements of the Venice Con-
vention.
Classification of
ships.
In the first place the rules make the threefold classification of
ships and define the terms " observation" and "surveillance " as in
the Venice Convention. They then provide for the hoisting of
signals and for the discharge of bilge-water outside port limits.
Measures on
arrival.
On arrival the Port Officer detains the vessel at an appointed
mooring and sends information to the Port Health Officer. The
latter visits the vessel and after the necessary enquiry certifies
whether it is " healthy," " suspected " or "infected." If the vessel
is suspected or infected it is required to moor at the appointed
anchorage.
Examination of
persons on
board.
Treatment of
the sick.
Treatment of the
healthy.
After certifying to the classification of the vessel the Port Health
Officer examines every one on board. Persons found to be suffering:
*
from plague are, if possible, landed and treated in isolation. If the
vessel is infected all other persons on board are kept under " obser-
vation " or " surveillance," and must, unless stress of weather or some
other cause renders it impossible, be disembarked for the purpose.
If the vessel is healthy or suspected the persons disembarked must
be kept under " surveillance " at their destination or at the port.
Observation and
surveillance.
Persons placed under surveillance must present themselves for
examination at such times and places as the examining medical
officer may direct. The period of observation and surveillance is that
fixed by the Venice Convention, and in the case of persons disembarked
from healthy ships must not exceed ten days from the date of
departure of the vessel from the infected port.
Grant of clean
bill of health.
When the prescribed precautions have been carried out a clean
bill of health may be granted, in the case of infected vessels after
ten days from the last case of plague, and in the case of healthy
vessels after ten days from the date of departure from the infected
port.
Disinfection of
vebsel.
The Port Health Officer gives directions, in accordance with the
Venice Convention, for the disinfection of the vessel. The following;
directions are laid down for the destruction or disinfection of articles
likely to be contaminated :—
Destruction or
disinfection of
contaminated
and suspected
articles.
"The master shall cause to be destroyed any articles on board his
vessel that may have been soiled with plague discharges, and he shall
also cause to be disinfected or destroyed the clothing and bedding,
and other articles of personal use likely to retain infection which are
on board his vessel and which have been used by any person who
has suffered from plague on board such vessel, or who, having left
such vessel, shall have suffered from plague during the stay of
CHAP. XI. ] Measures to prevent the spread of injection by sea. 381
such vessel in the port. If the master shall have neglected to
do so or have done so ineffectually before the vessel arrives in
port, he shall forthwith, upon the direction of the Sanitary
authority or the Port Health Officer, cause the same to be
disinfected or destroyed to the satisfaction of that authority, and in
accordance with the instructions as to disinfection contained in the
appendix to these regulations. If the said mister neglects to
comply with any such directions within a reasonable time the Sanitary
authority or the Port Health Officer shall cause the same to be
carried into execution at the expense of the said vessel''
Water-supply.
The water tanks of infected or suspected vessels must be emptied,
cleaned and. re-filled, provided facilities exist for obtaining a fresh
supply. The Port Health Officer may direct the same precaution in
the case of healthy \essels.
Mails and cargo.
Mails and cargo may be landed under due precautions.
The Port Health Officer must facilitate the conveyance, under Supplies.
clue precautions, of provisions, etc., to vessels under detention.
BURMA.
Draft rules for
Rangoon.
The Government of Burma submitted a revised set of draft
quarantine rules for the port of Rangoon with a letter dated the 8th
September. The Government of India approved of the draft
rules on the 28th of this month.
Based on the
Bengal Rules.
Definition of
infected port.
The Rangoon draft rules were based on those issued by the
Government of Bengal for the port of Calcutta, with a few slight
modifications. Amongst other modifications the Government of
Burma introduced a definition of the term "infected port," which it
defined to mean "Bombay or Goa." The Government of India
stated in the letter of the 28th September that it appeared
to them hardly necessary to introduce a definition of the term "in-
fected port," since the Local Government could at any time issue
instructions to its officers stating the ports that should be treated as
infected. If, however, the Government of Burma preferred to retain
a definition of the term, the Government of India thought that the
definition should be one of general applications, and not limited to
meet the circumstance of the existing case. They suggested that the
definition might be altered to the following :—
" Infected port means any port which the Government of Burma
may declare to be infected."
Publication of
revised rules for
Burma ports.
On the 7th of October the Government of Burma issued notifica-
tions under the Epidemic Diseases Act introducing the new rules at
383 Measures to prevent the spread of infection by sea. [ CHAP. XI.
the Ports of Rangoon, Akyab, Moulmein, and Bassein, and a sub-
sidiary notification declaring Bombay and Goa to be infected ports.
At the same time a notification was issued under the Quarantine Act
cancelling the rules which were at the time in force.
Regulations for inspection of outward bound Vessels
based on the Venice Convention.
INSTRUCTIONS OF THE GOVERNMENT OF INDIA.
In the circular of the 1st June forwarding the Venice Convention
to the Maritime Local Governments the following instructions were
given with regard to the inspection of the outward bound sea
traffic :—
Inspection to be
conducted
exactly as
prescribed in
the Venice
Convention.
" In order that the obligations imposed by the Convention may be
fulfilled at an infected port it is essential that the medical inspection
and disinfection should be conducted exactly in the manner pre-
scribed by the regulations and summarized above. The Government
of India consider that it is also desirable that all non-professional
attendants and relatives of any persons, who on examination appear
to be suffering from plague, shall be prevented from embarking. If
after the medical examination has been completed and all the passen-
gers and crew are on board, a case of plague occurs, the patient and
his non-professional attendants and relations must be landed and
isolated on the first opportunity. The ship will then become an
infected vessel within the definition given below in paragraph 7.
Although the ports of Madras and Calcutta are not infected,
the Local Governments have, with the approval of the Government
of India, made the special rules for medical inspection referred to
above, and, in the opinion of the Governor General in Council, it
is desirable that they 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."
BOMBAY.
Draft rules for
the Port of
Bombay.
With their letter of the 22nd of July the Government of Bombay
forward a set of draft rules, based on the then existing rules and
the Venice Convention, for the examination of outward-bound vessels
sailing from the port of Bombay. The provisions of the draft rules
were briefly as follows :—
Substance of
rules.
No vessel may leave the port until she has been inspected by the
Health Officer, and a certificate given that the officers, crew, and
CHAP. XI ] Measures to prevent the spread of infection by sea. 383
passengers are free from plague. If the vessel only touches at
Bombay en route from some other port the inspection may be limited
to the examination of the persons embarking, the fact that they are
free from plague being certified on an endorsement to the bill of
health. If an ascertained or suspected case of plague is discovered
the bill of health may not be granted until the sufferer, together with
his attendants and relatives, and their baggage and personal effects,
have been removed from the vessel, and the vessel has been dis-
infected in such manner as the Health Officer directs; the removal
and disinfection to be noted in the bill of health. The baggage and
effects of the person removed or prevented from sailing to be dis-
infected on shore. After the bill of health has been granted, no
person or cargo may be embarked or disembarked unless the vessel
is again inspected, and re-inspection is also required if the vessel
does not leave port before 6 A.M. of the day following the first in-
spection. Port clearance may not be delivered until the bill of health
is produced. The medical inspection must be carried out between
sunrise and sunset. Plague cases removed from the vessel must be
isolated, and persons removed as suspicious may be kept under ob-
servation.
Inspection on
board and on
shore.
Inspection on
shore not made
obligatory at
Bombay.
It will be observed that these draft rules do not follow the Venice
Convention in the one particular that they authorise inspection on
the ship as well as on shore. The advisers of the Government of
Bombay pointed out that there are very grave obstacles to the examin-
ation on shore of all persons sailing, and the Governor in Council
accepting this view asked that the Convention might be so modified
as to allow of inspection on shore or on board, as the circumstances of
any particular port might render necessary. After a careful consi-
deration of the subject, the Government of India were constrained to
accept the opinion of the Government of Bombay and their advisers,
and to authorise the continuance of the practice hitherto 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 was specially influenced by the following
considerations. The advisers of the Government of Bombay pointed
out that the most important portion of the examination is the examin-
ation of the crew, firstly because of the persons examined the greater
number belong to crew of vessels, and secondly because experience
has shown that the crews are much more likely to be infected than
the passengers. In the case of the crew it is practically impossible
to examine the men all on shore, and 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
384 Measures to prevent the spread of infection by sea. [CHAP. XI.
working of the port arrangements. The difficulties are mainly due
to the wide extent of the port. The large bulk of shipping which is
always present in the harbour is scattered amongst numerous
moorings and berths extending over an area of many miles. The
crews often go on board some days before the vessel starts, and when
the vessel lies a long way from the wharfs to bring the crews on shore
for inspection would, if practicable arrangements could be made for
the purpose, entail great trouble, expense and delay. It was also
represented that police surveillance over the scattered shipping would
be so difficult that satisfactory arrangements could not be made to
prevent the passengers and crew from exposing themselves to the
risk of infection after the examination on shore, since a whole night
would often elapse between the examination and the departure of
the vessel. Lastly, the Government of India attached particular
importance to the great success that had attended the examination
under the arrangements hitherto prescribed by the Government of
Bombay, and they considered this success to be the strongest argu-
ment that could be urged for the continuance of those arrangements.
Mention of
plague cases dis-
covered on board
in the bill of
health.
The Government of India at the same time pointed out that if
inspection on board resulted in the discovery of a case of plague the
ship became infected within the meaning of the Venice Convention,
and that the fact must therefore be stated in the bill of health. " 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 sus-
picion, 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
discovered 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."
Other matters.
Apart from the matters discussed above the draft rules ap-
peared to the Government of India to be generally suitable and in
accordance with the Venice Convention. They made the following
additional observations with regard to them: " 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,
CHAP. XI. ] Measures to prevent the spread of infection by sea. 385
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 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 suspect-
ed to be suffering, from plague, and their relatives and attendants,
should not be permitted to embark."
BENGAL.
Draft rules for
ports in Bengal.
Difficulty of
examination on
shore.
Examination on
board authorised.
Mention of cases
discovered on
board in the bill
of health.
On the 17th July, the Government of Bengal forwarded a set of
revised draft rules for vessels sailing from ports in Bengal for ports out
of India. The rules were framed in accordance with the Venice Con-
vention and made examination on shore compulsory in the case of
everyone sailing on the vessel. At the same time the Government of
Bengal stated that, owing to the peculiar conditions of the Port of
Calcutta, which stretches along the bank of a tidal river at all times
difficult of navigation, it was difficult to arrange for examination on
shore without occasioning inconvenience, and possibly causing
steamers to miss a tide. As it had been found impossible to comply
literally with the requirement of the Convention at the infected port
of Bombay, the Government of India did not consider it necessary
to press for compliance in the case of the uninfected port of Calcutta,
and they therefore authorised the continuance at that port of the
more convenient procedure of examination on board. It was at the
same time pointed out that if a case of plague is discovered on board
during the inspection, the ship becomes infected and the fact
must be stated in the bill of health together with the precautions
taken.
Issue of modified
rule by the Gov-
ernment of
Bengal.
On the receipt of these instructions the Government of Bengal
issued, on the 17th August, a modified set of rules for vessels sailing
from Calcutta, Chittagong, Balasore, Chandbally, False Point, and
Puri for ports out of Europe. The substance of these rules is briefly
as follows.
Substance of
rules.
No vessel may leave the port until it has been inspected
and a bill of health has been granted by the Health Officer
stating that the officers, crew and passengers were examined by him
at the time of embarkation, and are free from plague. In the
49
386 Measures to prevent the spread of infection by sea. [ CHAP. XL
case of passengers a certificate by a Commissioned Medical Officer
appointed for the purpose, dated not more than twelve hours before the
departure of the vessel, may be accepted in lieu of examination by
the Port Health Officer.
If a case, ascertained or believed the plague, is discovered during
the course of the inspection, the sufferer and his relatives and non-
medical attendants must be removed from the vessel and segregated
on shore. The infected parts of the vessel must be disinfected,
and the occurrence and the precautionary measures adopted must
be stated in the bill of health.
All contaminated and suspected articles must be disinfected on
shore or in a disinfection lighter. After the grant of the bill of health
no person may be admitted on board unless there is a fresh inspec-
tion. Port clearance may not be delivered until the bill of health has
been granted, provided that the Collector of Customs may grant port
clearance under section 66 of the Sea Customs Act on a guarantee
being given by the agents of a vessel that within forty-eight 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 addi-
tional 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 its moorings.
MADRAS.
Vessels using
ports in the
Madras
Presidency as
ports of call.
The Government of Madras enquired on the 6th of July whether
in the case of a vessel starting from, say, Calcutta, and calling at
Madras or any other port in the Madras Presidency on its way
home, the crew and passengers already on board need be brought
on shore and inspected there. The Government of India replied
that only the persons who join the vessels at Madras or other port of
call need be inspected.
Revised rules
issued by the
Government of
Madras.
The Government of Madras issued their revised rules for the
inspection of vessels sailing from ports in the Madras Presidency
for ports out of India on the nth of September. They followed
the lines of the draft Bombay rules.
Residents of
infected
localities.
Labourers sailing
from Tuticorin to
Colombo.
The first rule repeated the provisions of the previous Madras regu-
lations that no person may embark who has within the preceding ten
days resided in a part of India believed to be infected with plague.
The second rule repeated the existing prohibition against deck
passengers belonging to the labouring classes sailing from Tuticorin.
to Ceylon without a certificate from the officer appointed for the pur-
pose by the Colonial Government.