7
The pilgrims of the " Pekin " had been in Bombay and living for weeks
in a Plague-infected locality, and all things considered, it is wonderful that more
cases did not occur.
The " Dilwara " case did not come under the Government inspection
system, as the examination of troops and passengers by troop-ships is carried
out by the Military authorities, the Port Health Staff only inspecting the
vessels and crews; and the case occurred amongst the passengers.
Both these vessels were densely populated, and the passengers of one of
them represented the most insanitary class that travels by sea-pilgrims for
Mecca,
Yet the disease did not catch on, from which it would seem that the cir-
cumstances of a sea voyage are inimical to the Plague microbe, and that people
affected by manifest Plague, or in whom the disease is incubating, may be on board
ship without danger to the rest of the passengers, unless indeed the number of
those infected is very considerable.
12. The supreme importance of preventing Plague export abroad, especially
to Europe, doubtless resulted in hardship to some, and many lascars and native
passengers were removed from vessels because a considerable fever from which
they suffered at the time of inspection could not then be known to be not due
to Plague. Moreover diagnosis was not made easier by the fact that a large
number, probably 50 per cent., of the lower orders of natives have chronic
glandular enlargement, and that during the height of the epidemic there seemed
to be an accompanying wave of ill-health which manifested itself by a rise of
temperature and an appearance of illness in the proper natives even when free
from Plague.
18. The number of cases shown as rejected in Table I is 990, i.e., 990 in-
dividuals were prevented from sailing during the six months under report. This
number is not however even approximately correct, and only represents those
whose cases can be found on the records.
During the early period of the inspections, when all concerned were work-
ing at full pressure, large numbers were prevented from embarking, the returns
of which have either been lost or were never made ; and it was only afterwards
that a proper return of the rejected was kept.
It would be interesting to know exactly how many of those rejected after-
wards developed Plague ; but the information cannot be given. In the early
months of the inspection there existed in Bombay no camps of observation to
which suspicious cases could not be sent, and, as it would have been manifestly
unjust to send merely suspicious cases to a Plague hospital, those rejected on
suspicion were simply turned back into the town, their addresses, if they had
any, having been, as far as possible, registered. A rough idea of the number
of Plague cases amongst those rejected may perhaps be found from a
consideration of the fact that out of 29 suspicious cases sent to the first
observation camp available (Port Trust) 19 developed Plague, and the
11 cases sent to the Gokuldas Tejpal Hospital were all refused admission
and transferred to the Arthur Road Hospital as bond fide Plague cases. There
is. therefore, a strong presumption that a large percentage of those turned back
into the town before the creation of the observation camps were Plague cases, some
of whom, doubtless, died in their homes, whilst any who were subsequently re-
moved to Plague hospitals were simply entered in the hospital records as cases
from the city. When the observation camps erected by the Plague Com-
mittee were instituted in April all rejected cases were transferred to them, and
kept under observation until free from all suspicion of Plague. By that time,
however, the Plague mortality was rapidly dropping, and comparatively few of
those sent for observation developed the disease. Accordingly, and for the
reasons stated, it can only be officially stated that the number of authenticated
Plague cases discovered at the outward inspection was 47 ; and that not even an
approximate return can be furnished of the presumably very large number of
those who rejected as suspicious at the inspections afterwards proved to be
genuine Plague cases.