If the Disease appears on Board.

   Remove the actual or suspected case to the deck, and rig up a place for the patient's accommodation there. Do not keep the patient between decks, or in the forecastle, deck-house, or after-cabin unless the weather be so hot, cold, wet or stormy, as to prevent the patient remaining on deck. If there be such weather, and the ship have a roomy topgallant forecastle, and is not a wet ship, bulkhead the forecastle amidships and convert one half, preferably that oftenest to leeward, into a sick bay, or if the ship have a deck-house, use that as a sick bay. But in either of these cases clear out before the patient enters all clothes, bedding, and other articles not required by the sick person, and forbid the entrance of any into the sick bay except such as are in attendance upon the patient, and those who are thus in attendance should be kept apart from other persons.
   REMEMBER THAT THE SAFETY OF HEALTHY INDIVIDUALS OF THE CREW AND PASSENGERS, AND MORE PARTICULARLY OF THE ATTENDANTS ON THE SICK, WILL BE MOST CERTAINLY ATTAINED BY SECURING THE FREEEST CIRCULATION OF AIR ABOUT THE PATIENT, CONSISTENT WITH HIS PROTECTION FROM INCLEMENT WEATHER, AND BY AVOIDING HIS CONFINEMENT IN A CLOSE SPACE.

How to know Plague.

   An attack of plague commonly begins some three to eight days after exposure to the disease, either suddenly or gradually. As commonly met with there is much fever, as shown by high temperature, rapid pulse shivering, headache, hot skin, thirst and often vomiting ; the eyes are frequently red and bloodshot as if inflamed, the expression is vacant, the utterance thick and the gait unsteady, as if the patient were under the influence of drink, and there is sometimes a tendency to faint. The tongue is at first covered with a moist white fur except at the edges, which are red, but later on it becomes dry and of a mahogany colour.
   The most distinctive sign of plague is, however, the presence of swellings, or "buboes," which led to the disease being called "bubonic plague," and which have no relation with venereal complaints, appear, as a rule, about the second or third day of the disease, but sometimes earlier. They are usually painful and tender on pressure, and in size they may vary from that of an almond to that of an orange. Later on they may "gather" and first like an ordinary abscess. Purple spots and carbuncles may also appear about the body.
   It is of great importance to bear in mind that at times when plague is prevalent mild cases may occur which present no other obvious symptoms than a painful swelling in the groin or armpit, and a man who has been exposed to plague and who presents these symptoms should be isolated and watched until medical advice can be secured, since the disease may be spread through cases of this description. It should also be noted that when the disease appears in what is known as the "pneumonic" form, which is a highly infections variety, inflammation of the lungs is the most marked feature ; there is much fever, a short troublesome cough, painful and hurried breathing, and the coughing up of prune-juice coloured phlegm. All expectorations should be looked upon as highly infections, and should be received into a receptacle containing a disinfectant.

Treatment of Sick. 

   The conditions which contribute most to the safety of crew and passengers are those also which contribute most to the welfare of the patient. THE FOREMOST CONSIDERATION IN THE TREATMENT OF THE SICK IS PLENTY OF AIR SPACE AND FREEDOM OF VENTILATION; and this is of special importance when the disease, as often happens, runs a rapid course.
   The first care for the patient, after his removal to the sick quarters, should be to tell off two hands to attend upon him in short watches, watch by watch alternately, and to set apart an isolated cabin or compartment for the exclusive use of these attendants, who should not be employed on other duties or associate with other persons.
   As regards the general principles of the treatment of the sick, and of the "buboes," &c., seek medical assistance as soon as possible, and in the meantime reference may be made to the "Ship Captain's Medical Guide." All poultices and dressings, as also everything which passes from the sick man, upwards or downwards, should, if the ship is well out at sea, be immediately thrown overboard. But this practice should not be followed when near land, in which case disinfection and burning must as far as possible be resorted to. The utensils should be reserved for the sick man alone, and should be at once thoroughly cleansed after each use.

Cleansing and Disinfection of the Sick Quarters.

   Let the berth and quarters that the patient occupied when first taken ill be well washed and disinfected, and keep that part of the ship well ventilated by a good windsail let into it. Keep it empty for a few days, if the weather will allow your men to sleep on deck.
   When the case has ended, destroy all bed and body linen used about the patient and the hammock he may have occupied, and thoroughly fumigate the quarters where the sick person has been treated, as directed in the "Medical Guide," Follow generally the instructions there given as to subsequent cleansing; and keep the place uninhabited for (say) a week afterwards.

Disposal of the Dead. 

   If the patient die while at sea, let the body, sufficiently weighted, be sunk in deep water as speedily as practicable.

To prevent Plague. 

   General precautionary instructions. --Before entering a port where plague may exist, call the crew aft, give them a general warning as to the disease, and caution them as to frequenting low resorts and taverns and against drinking hard, urge them to keep their persons and clothing clean. and to come aft and report any symptoms of sickness however slight. If possible stop all shore leave, certainly all night leave, while in an infected port.
   Avoid overcrowding of the quarters occupied by the men, remove from them all unnecessary articles, and keep them as well ventilated, clean, and dry as possible. See that the morning watch have tea or coffee or cocoa and biscuit directly after turning out. Cause the men to change any wet clothes for dry ones, whenever and as often as practicable. Keep every part of the ship sweet and clean. See that no ballast or dunnage is taken in, except what is composed of clean material. Give the greatest care to the closets, to keep them free from filth : flushing them once a day at least with abundant water, and mopping them afterwards with carbolic acid water. Pump the ship every day, whether she be a wooden or an iron vessel, and then charge the well and every water tight compartment each time with such disinfectants as are recommended for the purpose in the "Medical Guide" above referred to. Be careful that the water supply is obtained from a pure source.

Rats and Mice in relation to Plague. 

   Rats and mice are peculiarly liable to die from plague, and it is probable that they are the means of conveying the disease. Therefore every effort should be made to destroy rats and mice, and any of these animals found dead on board a vessel coming from an infected port should be burnt, or thrown overboard if the vessel be at sea. Any illness among the rats should be regarded with suspicion.