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24
At ports of call the medical enquiries had shown no reason for changing the
diagnosis ; I was subsequently informed, however, that two cases which were
landed into hospital at Marseilles had the malaria parasite in their blood.
It was hoped that light would be thrown on the nature of the outbreak by
examination of the cases from the ship in the Seamen's Hospital, Greenwich.
The illness, whatever its nature, was not one included among the dangerous infectious
diseases, but the ship provisionally underwent a complete fumigation at
the request of and by arrangement with the P. & O. Company.
The clinically elusive nature of the various febrile and catarrhal states leads
to a close scrutiny of the diagnosis " influenza " on arriving ships. It may be
accepted for febrile states as an equivalent of the term eczema for skin conditions.
From the too convenient generic term such a diagnosis as plague may be, and has
in the past been made on close enquiry.
In the case of the " Caledonia " there was a probable predominant element of
malignant malaria. The parasite of malaria was found in each of the cases admitted
to the Seamen's Hospital, and notification made to this Authority in due course.
The curious distribution of the illness in the ship is probably associated with
the position of the ship in dock at Bombay whereby access of mosquitoes to the
starboard side was facilitated.