That may look like a Sulzer or BW.
Spent many a day in the crank case, doing bearing leads.
Taking off a bearing cap from a piston rod, and fitting strips of lead, the tightening the bearing cap back down.
Then opening it up again to measure the thickness of the leads.
They typically run at 120 RPM full speed, and yes, started with a kick of compressed air, via an air distributor.
FOR'd or astern, make no difference, however, generally easier to start in astern, as the prop was not as efficient is astern, so less water to move.
These are crank shaft, directly coupled to the propeller shaft.
Many of the slow speed diesels had a cylinder bore diameter of 1,10 M and a stroke of 3 meters, it was interesting to lift the cylinder heads, (individual) then use a ladder to get down the the piston crown
Oh the good days..................
Typically 170,000 HP, all mine !