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A' 
 
COAST DEFENSES AGAINST ASIATIC CHOLERA. 
 
 / 
 
 REPORT OF AN INSPECTION 
 
 OF THE 
 
 Atlantic and Gulf Quarantines 
 
 ■hi 
 
 IlETWEKN THE 
 
 fkH. 
 
 ST. LAWRENCE AND RIO "iRANDE. 
 
 JO^N H. RAUCH, M. D., 
 Secretary Illinois State Board of Health. 
 
 SPRINGFIELD, ILL.: 
 H. W. KoKEBB, State Printeb and Bimdeb. 
 
 1886. 
 
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COAST DEFENSES AGAINST ASIATIC CHOLERA.^ 
 
 Eei'ORT of an Inspection of the Quarantines Maintained upon the 
 
 Atlantic and Gulf Coasts from the St. Lawrence 
 
 TO THE Rio Grande. 
 
 By John H. Rauch, M. D., Secretary Illinois State Board Health. 
 
 At the July, 1885, meeting of the Illinois State Board op Health 
 tlie Secretary was instructed by a resolution of the Board "to inspect 
 "the methods of quarantine of the Louisiana State Board of Health 
 "iind their actual operation at the stations below New Orleans ; and 
 ■'also to extend his inspection of quarantine methods and regulations to 
 "such other ports and places as he may deem necessary in the interests 
 "of the public health of the State, with especial reference to the exchi- 
 "sion of Asiatic cholera and small-pox." 
 
 Such inspection was designed to supplement the action of the 
 Board — inaugurated on receipt of the first information that Asiatic 
 cholera had again invaded Europe, threatening another pandemic 
 extension — and which action aimed to secure the best attainable sani- 
 tary condition of the territory under its immediate jurisdiction as one 
 of the most important preparations against the spread of the disease 
 ^vithin the State, should the contagion be introduced. 
 
 The geographical position of Illinois — within 24 to 48 hours of all the 
 imporiant ports on the Gulf and Atlantic Coasts — its commercial re- 
 lations, the extent and character of its means of communication, and 
 the fact that fully one-half of the immigrants to this country come 
 into or pass through the State, most of them remaining at least long 
 enough to communicate contagion and under conditions favorable to 
 such communication, obviously make the administration of these 
 quarantines — with especial reference at this time to the exclusion of 
 Asiatic cholera — a matter of sufficient importance to warrant the 
 Board in securing all accessible information concerning them, the bet- 
 ter to enable it to discharge its duty in connection with the protection 
 of the lives and health of the citizens of the State. 
 
 In the present epoch of quarantine Illinois has a direct interest — 
 chiefly commercial — in the exclusion of yellow fever from the Mis- 
 sisi])pi Valley; in the exclusion of vaccinally-unprotected immigrants 
 at the North Atlantic ports for the protection of her own territory from 
 sninll-pox ; and in the exclusion of Asiatic cholera generally, whether 
 it threatens by direct importation from Europe or mediately through 
 tlio West Indies, Mexico and South America. In brief, the State is 
 concerned in the condition of the sanitary coast defenses from the 
 mouth of the St. Lawrence to the mouth of the Rio Grande. 
 
 
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 PRRSKNT HTATUH AND PROSPECT'S. 
 
 It is hardly necessary to say that this country is not yet free from 
 danger of an invasion of cholera simply hecause there is now a cessa- 
 tion of alarming reports from Europe. Periods of remission, more or 
 less complete, have characterized every epidemic spread of cholera 
 since it first invaded the latter country, lentil it entirely disappears 
 from the European continent it will not do for us to relax our vigilance 
 or to remit a single precaution. On the contrary, this delay in its 
 march should he utilized to strengthen our defenses, and to perfect 
 our precautionary system. It must he rememhered that the duration 
 of a cholera invasion of Europe is not limited to two or three years. 
 From the date of its first appearance in 1829-30 in liussia, to its final 
 extinguishment in Italy, Austria and Germany, a period of seven 
 years elapsed, during which, at one time or another, every one of the 
 Continental countries was invaded — some of tiiem more than once. 
 Similarly in 1847, it again entered Russia at two points, and hefore its 
 final disappearance in the Levant in the winter of 1855-56, it had 
 traversed every part of the Continent and invaded Great Britain. In 
 its last pandemic spread it appeared first at Malta in 1865, continued 
 to ravage various parts of Europe until 1869, when there was a com- 
 plete remission, only to break out again in 1871, and finally disappear 
 in 1873. 
 
 With immigrants from every portion of Europe continuously land- 
 ing upon o"r shores and rapidly distributed throughout the interior, 
 we will no+ freed from this menace until every trace of the conta- 
 gion in t' : ^untry has vanished. At the close of the year the dis- 
 ease still • viained in southern Spain, in France at Brest, in Italy near 
 Venice, whence it had spread to the Austrian port of Trieste, and it 
 has also effected a landing on the Western hemisphere, in the French 
 penal colony Cayenne. Thus far the disease has not extended in 
 Europe to the regions whence our heaviest foreign immigration is de- 
 rived, and to this fact is probably largely due our present immunity. 
 When the German and Scandinavian countries and the British Islands 
 become infected, if they should, our serious danger will then begin.* 
 
 I am often asked: "Do you expect to keep cholera out?" To which 
 my reply is, that it is the duty of every sanitary authority to try to do 
 so ; to strengthen the weak places and perfect the strong ; to utilize 
 every possible resource; to secure the best attainable condiHon of 'us 
 OAvn immediate territory, and to put himself in a position to receive 
 help from, or to extend help to others in fighting and excluding a com- 
 mon foe. We may not be able to entirely shut it out, but it will be a 
 great achievement if its invasion be postponed and its spread limited, 
 and greater still, if it is prevented a lodgment in this country. If an 
 outbreak at a port or locality can be deferred until toward cold 
 weather, that ally would itself help us to extinguish it, and it might 
 require a fresh importation the next season to start another. It is our 
 duty to try to shut it out, and not fold our hands supinely and join in 
 the condemnation of quarantine and preventive methods, which, in a 
 great measure, are a new outgrowth since the Fever-Summer of 1878; 
 which have received a great stimulus to development by the present 
 dread of cholera, during the past two years ; and which, so far as they 
 
 ♦ Reports continue to appear in the public press of new outbreaks in Spain and else- 
 where. 
 
 4- 
 
liavo been tested in small-pox and yello\y fever, give promise of suc- 
 cess with the Asiatic pestilence. With a sufficient number of National 
 icl'uge stations, (there should be at least one on the Texas coast 
 iiiid one tor New England, in addition to those on the Delaware Bay, 
 Hampton lioads and Sapelo Sound, and all of them should be aS fully 
 i(|iui)ped as that at Ship Island,) with properly-appointed quarantine 
 2Htiil)lishments at the larger ports, and mspection stations at the 
 siiiiiller ones, the entire system to be mutually cooperative, gov- 
 erned by the same general rules and regulations, kept fully informed 
 of public health conditions abroad by consular agents and intielligent 
 medical inspectors when necessary, there would be no reason to appre- 
 lu'iid the introduction of cholera or any other foreign pestilence. 
 
 n Spain and else- 
 
 QUARANTINE IN THE PAST. 
 
 A brief summary of the origin and varying phases of quarantine in 
 North America will be useful in this connection, mainly as serving to 
 emphasize the distinction between the ancient and modern systems, 
 and also for information. 
 
 From the date of the earliest establishment of quarantine in this 
 country down to the present time, its efficiency and the public interest 
 in it have been fitful and spasmodic, dependent upon some real or 
 fancied pressing emergency. The ravages of imported small-pox led 
 to the passage of the first quarantine laws in 1698, and these were 
 added to from time to time, and either vigorously enforced or more or 
 less neglected as that disease increased or declined with the conditions 
 of immigration, and the slave-trade. The plague through Mediter- 
 ranean commerce and outbreaks of yellow-fever at long intervals, also 
 affected quarantine laws and practice until near the close of the last 
 century. For nearly 30 years, ending in 1791. the country was exempt 
 from yellow fever, and during this period little attention was paid to- 
 the subject. That exemption, it may l)e noted, was due to the suspen- 
 sion of direct commerce with the West Indies through the enforcement 
 of the colonial acts by Great Britain ; but after the Declaration of 
 hidependence, commerce with the West Indies and the Spanish Main 
 Avas gradually re-established, and in 1791 began the yellow-fever epoch 
 of {[uarantine following the increasing ravages of the pestilence in the 
 principal seaports of the country, while small-pox gradually lost much 
 of its importance after the introduction of vaccination by Jenner in 
 17!li>. To yellow-fever, after the war of 1812, and taking the place of 
 small-pox as a quarantinable disease, there was added typhus or ship 
 fover and this disease — aggravated and often developed during the 
 long voyages in sailing vessels with crowded steerages and a gross 
 ne<ilect of hygienic observances — confined to increase in frequency 
 and severity with the increase of immigration. 
 
 In 18B2, Asiatic '•holera was added to ship fever and yellow fever, 
 and although this new plague has only affected quarantine by its four 
 ei)idemie visitations separated by long intervals throughout more than 
 half a century, it marks another epoch in quarantine. Meanwhile, 
 the yellow-fever zone in North America had become practically con- 
 tracted tc south of Philadelphia — once the most terribly scourged of 
 American cities — and ship fever had lost much of its significance 
 through the substitution of steamships for sailing vessels, and the en- 
 actment and enforcement, both by this country and by foreign countries, 
 
mM 
 
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 6 
 
 of laws for tlio provcmtion of ovc'rcrowdinp; and for the protection of the 
 health of hnniij^rantH. With the decline of ship fever, Hn)all-])ox af,'(iiii 
 hej^an to increaHc in conHefinence of a nef^dect of vaccination or its im- 
 perfect performance, and tliiH diseaHe aj,'ain affected tlie puhHc health 
 more or less severely as the tide of innni^rution swelled or ehhed. 
 
 Within the past (piarter of a century small-pox has mor«' than once 
 assumed epidemic proporticms, as in the period from IHCiHto lh75i and 
 from 1H7*J to 1HH8 ; yellow fever has prevailed locally from time to 
 time, and as an e])iden!ic in the ^rississi])pi VjiUey in 187?}, 187H and 
 1879 ; cholera spread throughout the country in 18()r»-()7, and invaded 
 nineteen states west of the Alle<,du'.nies in 187M ; and these three dis- 
 eases with their varyin<,' manifestations — occasional lon<f intermissions, 
 followed hy violent and disastrous epidemic outhreaks — have domi- 
 nated the (luarantine question during this e])och. 
 
 In the few years immediately i)recedin<j; this period some progress was 
 made in an organized attempt to reform the ahuses of quarantine, and 
 to frame a system in accord Avith the increasing knowledge of epidemic 
 diseases — one whi(di should he freed from the r.miecessary hardships 
 and rigors of quarantines, revived or imjjrovised in the face of existing 
 danger, and too often inspired and enforced by an unreasoning dread 
 and terror — similar to those witnessed in soutliern Europe during the 
 past two years. This attempt was inaugurated by Pr. Wilson Jewell, 
 of Phihidelphia, one of the foremost sanitarians of his day, and who, 
 in 185(5, proposed the estal)lishpient of "a uniform (!ode of regulations, 
 "operating alike in all respects, and offering the least resistance to an 
 "active commerce, and with a humane regard for the health of the 
 "passengers and crews, and the comfort of the sick on board of all ves- 
 "sels detained at quarantine stations." A "Quarantine Sanitary Con- 
 "vention" was held in 1857 for the purpose indicated, and some progress 
 was made during its subse(|uent sessions when the outbreak of the 
 Civil War put an end to the movement. 
 
 It may be here remarked, in passing, that these few quoted lines 
 indicate the essential features of the quarantine of those days. They 
 were primarily quarantines of detention or exclusion, inconsistent 
 with an "active commerce ;" the "health of the passengers and crews. 
 "and the comfort of the sick," were matters of secondary importance 
 and the enforcement of sanitary measures confined to proceedings of a 
 most primitive character where such measures were attempted at all. 
 Little attention was paid to disinfection, purification, isolation of the 
 sick, and the other measures which now receive most attention. The 
 regulations entailed great personal sufferings and hardships, and vex- 
 atious delays and losses to travel and traffic, while they generally 
 failed to protect the country from the introduction of these exotic dis- 
 eases. It is not to be wondered at that "quarantine" has received so 
 much condemnation. 
 
 COAST depensp:;s should be under national control. 
 
 During all this time, from the earliest date to the present, the con- 
 trol of quarantine has remained entirely under the jurisdiction of 
 State and local authorities, except during the brief period in which 
 the National Board of Health exercised its limited quarantine powers 
 under the act of 1878 and which expired in 1882. It is this absence of 
 
!i(l('(|uate Niitioiial health authority and le«,M8hitioii, uiul the fact that, 
 ill such al)Ht'nce the maritinu' (luarantincH are controlh'd ami admin- 
 istered by State inid loeal autlioritieH — resulting in diverse, and fre- 
 (|iiently contlieting, rejjtulations and requirementH and of necessity, 
 ill a tendency to limit i)reeautionH to their own individual interests, 
 (•(iinmercial as well as sanitary — wliicdi throw upon interior States 
 flic responsibility of fully informinj^ themselves of the strength or 
 weakness of these outposts, in ortler to know where to antieii)ate dan- 
 1,'er and how to make their own preparations to meet it. 
 
 At its Inst session. Congress appointed a commission to examine and 
 report upon the measures necessary for the defense of our seacoast 
 at,'ainst a -foreign armed enemy, and a distinguished ]tul)li('ist and 
 statesman, Mr. Tilden, has recently urged this as a paramount duty of 
 the Govenmient. Millions of dollars have already been expended 
 peuded for such defense, and millions UKU'e wdl probably be forth- 
 coining to meet this possible contingency. But the assaults of 
 foreign contagion are not a contingency. They are actual events, 
 and during tlie past twenty years they have cost the country, an 
 afrgfegate loss of life only less than that of the great war imme- 
 diately preceding. Every sanitarian and many of our leading 
 statesmen know tliat this actual and ever-recurring loss is vliolly and 
 entirely preventable by the expenditure of a sum which sinks into 
 utter insignificance before the millions which will be appropriated for 
 the protection of our coasts against a possible futcure danger. 
 
 But thus far neither sanitarian nor statesman has been able to over- 
 come the petty jealousies of individuals, communities, and of States 
 themselves, so as to secure the legislation necessary to remedy even 
 the present confusion. Such sanitary measures as are now enforced 
 l)y the National Government are based upon authority derived from 
 the act of April 29, 1878, to prevent the introduction of contagious or 
 infectious diseases into the United States. But the late Secretary of 
 State, Mr. Frelinghuysen, and the late Secretary of the Treasury, Mr. 
 Folger, both decided that the act in question, having been repealed by 
 the act of June 2, 1879. could not be revived by the expiration of this 
 latter act. The point would have less practical importance if the au- 
 thority which assumes to act under it can and will furnish the country 
 the necessary protection' in the present emergency. Practical sanitary 
 executives are less concerned, just now, as to who exercises the au- 
 thority and by what right, than in the questions : Is the authority 
 wisely exercised ? Is it sufiticient ? May we rely upon it implicity '? 
 If not, to what extent, and how can we remedy its deficiencies ? 
 
 It is by no means meant by this that it would not be better that 
 there should be a properly organized National health department, act- 
 ing under clear and undisputed legal authority, and supplied with 
 funds adequate to its legitimate necessities. The present status of 
 National sanitary legislation and of the National sanitary executive 
 is admittedly defective and unsatisfactory. The history of the recent 
 attempts to control the disinfection of rags ; the complications at the 
 port of New York concerning consular bills of health ; the strictures 
 upon the inspection service maintained along the coast, and in the 
 matter of inspections on the Canadian frontier during the recent small- 
 pox epidemic ; the complaints of various boards of health that they 
 are directed to look to the associated press for information and warn- 
 ing concerning threatened danger from abroad, to their ports and 
 
 II; 
 
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 tonitory* -imd many otlior siiniliir iimttorH point to tlm ncccsHity U) 
 a W(*ll-('()nHi(K'it'(l iind nuliciil roviHion of o\istiii{^ Niitional Hunitaiy 
 loKiHlation. 
 
 Consular billH ol' licaltli. which nw now an a vnh aliiioHt worthless, 
 inif,'ht ln) made of tlio greatest viihic; and thi'sc. toK^'tlicr with tlu- 
 prompt ptd)licati()n of (liroct and ollicial information concc^rnin},' the 
 Hanitary wtatuH of foreifjtn ports — hucIi information to ho Hocurcd hy 
 compi't«'nt porHons — are tfHHcntial to the to the pn-vention of the intro- 
 duction of foreign conta^'ion. Ohviously Huck meaHureH can he wan- 
 lated, controlled and jjrovidtrd only l)y the National government. 
 
 
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 rOHHIItllilTIKH OF I'tlMSKNT COAST OEKKNSEH. 
 
 NevertheleHH, I am more than ever convinced, since comphiting this 
 inspection, that Asiatic cholera, as well as snuill-pox and yellow fever, 
 may 1)»' etfectually ex(duded from the llnited States hy an intellif^ent 
 use of tiie a<j;encies still at our command. This is not a matter of 
 speculation or theory. A ^raat advance; has heen made since 1878. A 
 quarantine of exclusion of these three diseases is now a matter of cer- 
 tainty, depending upon ])romi)t notification of threatened dan<?er; vig- 
 ilant supervision over connnercial intor(H)urse with infected localities : 
 inspection of all immi<i[rants and the enforcement of their vaccinal 
 j)rotection; sanitation and purification of infected vessels and cargoes; 
 isolation of those sick with these diseases ; the surveillance of suspects 
 (luring the periods of incuhation ; and the employment of other well- 
 defined preventive and i)recautionary measures which now con- 
 stitute the hest modern sanitary practice as applied to maritime 
 quarantine. 
 
 Cholera has never yet heen kept out of this country after hecoming 
 epidemic in Europe, and I admit that ipiarantines, as conducted in 
 that country, have proved inelTectual to control the spread of the dis- 
 ease. But the conditions vhich ol)taiii here are radically different 
 from those in Europe. In that country, as I have said elsewhere,' ii 
 narrow strait or sea, a river, a mountain chain, or merely a territorial 
 houndary line, with its custom-houses and pnssport system, defines the 
 limits to he guarded, and forms the only ])hysical harrier hetween the 
 quarantiner and the (piarantined. Here, the whole width of the At- 
 lantic intervenes hetween us and the infected country. There, cordons 
 and (inarantiiies mean privation, misery and suifenng, and, ultimate- 
 ly, starvation. Here, the Nation could exist unaffected in all her ma- 
 terial interests hy a quaranthie whose period of detention is limited to 
 the time necessary to destroy contagitm through the rapid processes 
 of modern disinfection and sanitation. There, it may be true, as 
 alleged, that a (piarantine of exclusion is impossible of execution, and 
 
 ♦Both for tlu* TrjiiNois State Hoaud of Health as its Sccrctury, and for tlid Sanilaiv 
 Council of tli(> Mississippi Valley as its i-xccutivo i)(ll('or, I liav(.' attcnipttMl to secure siicii 
 Infornuition— asking for copi(>s of consular report s, or tl.e essential facts contained tliorciii, 
 as to the existence of epidemic contii^jious diseases at ports in eomnuTcial relation with 
 this country and with especial reference to Asiatic iduilera: also for the addresses of nicdi- 
 eal inspoi'tors stationed at foreign ports, etc. 'I'he Sei'retary of Slat(^in acknowledKinh'llic 
 receipt of my requf^sts, stated tliat they had heen referred to the Treasury IJepartniciit, 
 iuformiiiK nie in (^ffei't, that charge of all nuitters pertaining to the public health w:is 
 assuMUMi by that brunch of tlie National government. No reply has yet been received 
 from the Treasury Department nor from any of its bureaus. 
 
 tPractieal Ueeommcndations for the Exclusion and Prev(^ntion of Asiatic Cholera in 
 North America. An Address d(>li.'ered at the opening of the National Conference of Stfite 
 Boards of Health, 8t. Louis, Mo„ October i;{-]5, IHS4. 
 
9 
 
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 mplotiiif,' tliis 
 
 yellow fever, 
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 a matter of 
 ince 1878. A 
 latter of cer- 
 
 (laiiser; vig- 
 ed localitios ; 
 heir vaccinal 
 
 and cargoes; 
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 to maritime 
 
 ter hecominR 
 (conducted in 
 a\ of tho dis- 
 ally different 
 elHewhere,' a 
 r a territorial 
 n, defines the 
 between the 
 h of the At- 
 lere, cordons 
 id, nltiniate- 
 1 all her ma- 
 is limited to 
 )id processes 
 be true, as 
 ecution, and 
 
 for tli(< Siinitary 
 I to socun' siii'li 
 iitaiiuMl thorriii, 
 iul relation with 
 ilrcsHcH (if nicili- 
 knii\vliHlf,'inK(li'' 
 try ncpartnii'iil. 
 iltlni hoiiltli was 
 )t been received 
 
 iatie Cholcni in 
 rt'i'cnct! of iStato 
 
 tli;ii the attempt to maintain it does mon* harm than ^ood, in leading 
 til immlterless contraltand i)racticeH Ijy whieli the diHease may he in- 
 truihiccil in nnsnspected ways. None of this is true wlien applied to 
 till' exclusion of Asiatic cholera from this country; while to accejjt 
 the stateUK^ntH un(|uestioned would cause \i^'ilance to he relaxed, 
 would invite conta}j;ion to our shores unimpeded, and would finally 
 tlirow upon individual conununities the burden and the responsibility 
 (if li^ditiufjj the disease at an imnu'use disadvantajjie that is, of lif»ht- 
 iiii; it at Ikuuc ami from numy (luarters, instead of on the outer lines 
 and from only (me direction. 
 
 Those outer lines, even with some defects and weak places, T Ixdieve 
 to be even now sutViciently strong,' to keep out the disease if i)ro))er 
 viiidance and thorouf,'hness be ex»'rcised, if all the facilities be utilized, 
 and if timely notification of threatened danj^er be f,'iven by the National 
 ^'overnment. 
 
 The next year or two, however, will furnish a tolerably conclusive 
 test of the erticiency of cpuirantine to exclude the pestilence from this 
 country. 
 
 lMMi;niATK RESULTS OK THE INHl'ECTION. 
 
 During the progress of the inspection it was observed that the com- 
 piuisons institut(!d and the information furnished prompted (|uarantine 
 otlicers and health authorities to avail themselves of facilities pre- 
 viously overlooked or neglected, and to put themselves in communica- 
 tion with each other for purposes of mutual cooperation and sup- 
 port. At many of the statitms those in charge invited criticism and 
 Kiif,'j,festions, while others would not rest satisfied until their facilities 
 and a])])liances were made more complete. Suggested improvements 
 have already been made in many instances and others will doubtless 
 1)1' secured. 
 
 Not the least among tho good results which are already perceptible 
 is the recognition of tho fact that tlu^ administration of quarantine at 
 a ^'iven port is not a purely local measure ; but that tho country back 
 of it. and communities distant in space but in close proximity in point 
 of time, are also interosted. Since States and communities continue 
 to control maritime quarantine, and in many instances are jealous even 
 ofii suggestion of Federal interference, it is right that they should recog- 
 nize the full import of their obligations. Nor should they overlook the 
 fiict that these distant communities have the power to both help and 
 punish. Illinois, for example, by recently refusing entrance to immi- 
 1,'nints coming through ports which were lax in enforcing vaccinal 
 l)votecti(m, furnished a powerful argument to the quarantine officers 
 iit such ports whereby they secured compliance with their requirements 
 liy the steamship companies. This retiex action may bo carried still 
 further. If a port or locality should notoriously disregard the pre- 
 oautions necessary to prevent the access of cholera it would be an 
 obvious duty of self-protection not only to exclude immigrants but to 
 cut oft' all intercourse with such port or locality. With the danger 
 of such a contingency clearly recognized the authorities would not 
 only be apt to exercise proper vigilance, but all transportion and com- 
 mercial agencies — railroads and steamships — would become quaran- 
 tine aids. Captains and officers would have an additional incentive 
 
 ■i" 
 
 I ■ ; 
 
 -~^' 
 
 •S'*! it 
 
10 
 
 VWi 
 
 for keeping their vessels in good sanitary condition and for promptly 
 reporting cases of suspicious sickness during the voyage if it came 
 to be understood tliat faihire in these respects would he followed by 
 loss of trade and employment. 
 
 One obvious advantage which may be expected to follow the publi- 
 cation of this report, will be the notification to all interested of the 
 weak places in our line of coast defenses, and this will naturally ensure 
 greater care and vigilance at such places and greater watchfulness of 
 them by others. 
 
 dii 
 
 To some places which I was unable, from want of time and pressure 
 of other duties, to personally visit and inspect, the following series of 
 questions was addressed, and subsequent correspondence elicited the 
 necessary information in such cases : 
 
 1 What are the quarantine facilities at your port '? Please furnish 
 copy of laws or ordinance^, and of rules and regulations. 
 
 2. How far from the city is the quarantine station? 
 
 Is the station out of the track df commerce or travel ? 
 
 How far from the city are vessels inspected ? 
 
 How are vessels, cargoes and persons disinfected and purified ? 
 fi. What are the periods of detention and seasons ? 
 
 7. How would a cholera- infected vessel be treated? 
 
 8. Under what circumstrnces would vessels be sent to the nearest 
 refuge station ? 
 
 3. 
 4. 
 
 5. 
 
 m 
 
11 
 
 ATLANTIC AND GULF COAST QUAEANTINES, 
 
 1,0( ATioN OF Stations, Equipment, Poweus and Authouity, Huleh and IIegui.ations, 
 
 Methods, etc., etc,, fuom Canada to Texas, inclusive. 
 
 Akbanoed CIkogkaphically. 
 
 Pleas( furnish 
 
 ;o the nearest 
 
 Canada : 
 
 On the !)th and 10th of October, I made an inspection of the Grossc Isle (luarantine 
 estalilishment, on the 8t. Lawrence river, about 3 miles below (^uob(>c. Dr. F. Montizam- 
 bei't, Chief Quarantine Officer of the Dominion, telegraphed me on the !tth that he would 
 send his yacht to meet me at St. Thomas, a station on the Inter-Oolonial railway, about 
 ;!ii inilos from Quebec. We left the wharf at this place about 4:30 p. m., but owing to head 
 winds wore unable to use the sails, and the men had a weary pull of two hours and a 'lalf 
 to make the five miles to the station against the strong current and ebb tide. \s this boat 
 i< the sole means which the station possesses for boarding a vessel foe inspection pur- 
 liosus, I became (luite convinced that a steam yacht or launch is a necessity in such a 
 swift current and with such high tides as obiain in this stream, the channel being fully two 
 and one-half miles from the station. The Orosse Isle auar.antine station is an island about 
 one and one-half miles long, divided into Sick, Central and Healthy Divisions. In the Sick 
 Division ai-e the hospitals with the necessary adjuncts. There is a two-story brick hospi- 
 tal, with 100 beds, including some in private wards for cabin passengers ship's officers, 
 eto.; and a one-story wooden shed with about seventy beds. There are also ample facilities 
 for disinfection, and for the purification of clothing, etc. In the Central Division are the 
 iiuanintine officer's and chaplain's residences, and iiuarters for the employes, eight in 
 number, embracing a hospital stmvard, a sergeant of police (who speaks four languages), a 
 baker and the boat's crew. From this point ships tliat stop opposite the station for inspec- 
 tion arc gone out to. In the Healthy Division, (a mile and a (luarter from the hospital), are 
 the houses of detention with aecommodatioi^s for about 2,000 persons: a large wash-house: 
 a bakery: a furnace for hot-air disinfection; rooms specially arranged for fumigation; 
 I'haix'ls, police barracks, etc. There is telephonic communication between the diff'eront 
 divisions of the station, and telegraphic to Quebec. The disinfectants employed are (ddor- 
 idcoflinie, corrosive sublinnite and sulphurous-acid gas. Labarraciue's solution is also 
 used for the sponging and washing of patients and attendants, and permanganate of pot- 
 ass for coloring dangerous solutions; chloride of lime in solution, four ounces to the 
 gallon, is used in the vessels which receive the discharges of the sick. Infected clothing 
 and bedding are steeped at once, in the wards, in a weaker solution of clilorido of lime or ol 
 ocrrosivo sublimate, and t;ien boiled befoi-e being sent to the wash. The dry-heat oven is 
 rarciy used: what can not he steeped for at least two hours, and then boiled for at least 
 half an hour is generallv burned, in the absence of a steam disinfcctor. For fumigation, 
 sulphurous-acid gas is used in closed apartments either from burning the crude sulphur, 
 or from the copiier reservoirs in which it lias been stored under pressure, and which arc 
 olitaiiicd from New York. 
 
 Siiould a vessel arrive here with cholera. Dr. Monti/ambcrt purposes to treat her as 
 follows: Land the sick and their attendants directly at the Sick Division, with every 
 thing suspected connccti-d with them. Land all the steerage passengers and their effects, 
 and iilace them in the detention houses at the Healthy Division. Open all windsails, hatches' 
 !>ortliolos, etc., on the vessel; have the bilgc-water repeatedly pumped out or changed; 
 Hupplv umiucstionable drinking water to jill. All the luggage of the cabin passengers and 
 111!' clVi'cts of the crew to be opened out on boanl; all body and lied linen to be steeped in 
 
 
12 
 
 h-^n ; 
 
 1 « I fC 
 
 1 1 
 
 f 1', 
 
 
 solution of coiTOHive sublimate; and other ellVcts, witli tlie oponed trunks, etc., to be n: 
 peatodly fumieftted with sulphurous-ueid gas in closed aiiartmcnts. The vessel in all 
 attainable parts, and notably the cabins, steerage and forecastle, to be scrubbed with solu- 
 tion of corrosive sublimate and fiiniigatiKl. The cargo to bo opened up in as many places 
 as possible, and then, the hatches, etc., being closed, the compressed sulphur dioxide to 
 be poured In amongst it from the reservoirs. Should it seem necessary, the cargo would 
 be landed to allow of its more detailed disinfection, and the more satisfactory treatment 
 by washing, rinsing with corrosive-sublimate solution and fumigation of the empty vessel. 
 
 Whilst the vessel and those on bonrd are thus being attended to the steenige passen- 
 gers and their effects are washed and disinfected on shore at the Healthy Division. The 
 attendants being always amongst them, would report by telephone at once any slightest 
 appearance of illness, and in addition a regular medical '.'ispection is made twice daily 
 of all those under detention, viz: At it a. m. and 4 p. m. each day. Any one showing even 
 doubtfid symptoms is at once removed from amongst the others, placed in a ward of ob- 
 servation and <^hence returned to the Healthy Division or taken to hospital as may be re- 
 quired. Subso(iuent to completed process of disinfection, the vessel, passengers and crew 
 would be detained for eight clear days after the occurrence of the last cholera case before 
 being admitted to prati(iue. 
 
 The process thus described is carried out with any vessel that arrives with an infect- 
 ious disease difl'ust^d amongst its passengers, except that the vessel is allowed to proceed 
 after disinfection without further detenci';n. With a cholera ship, however, application 
 would be made by telegraph for authority to detain the vessel and all on board, and it 
 would probably be aiicorded. 
 
 Grosse Isle was for a K ng while one of the most important (luarantine stations on this 
 continent. Over 15, 000 victims of cholera and ship fever are buried on the island. It was 
 established during the sailing-vessel period wlien,— as the result of the long voyage, 
 crowded steerage and ignorance or disregard of all sanitary and hygienic observances 
 —almost every arrival was more or less infected. For the requirements of tbe period, it 
 was probably as well adapted and as completely e(iuipped as any establishment in the 
 ■world. The vessels then in use could easily approach its wliarf and receive such 
 treatment as was at that time considered necessary. 
 
 But with the advent of the huge ocean steamships— with their great draueht, short 
 passages, improved accomni':^dations, and imperative demand for "(luick dispatch"— the 
 station has lost Much of its importance. One set of conditions has largely obviated its 
 necessity as a barrier against the introduction of epidemic contagion, while another set 
 has created a necessity for improvements and modifications which have not been made. 
 As a eonse(iuence, there is loss attention paid to the maintenance of the station and to the 
 enforcement of the regulations. During the season up to the 9tli of October, tlio date of 
 my inspection, only 32 vessels out of a total of 420 arrivals had stopped at the station lor 
 examinaticn. 
 
 My observations and study of the jnactmonts suggest the following as among the more 
 important nuitt(>rs reiiuiring attention, if this station is to be relied upon, to prevent an 
 invasion of cholera or otlit r grave epidemic contagious disease via the Kt. Lawrence livcr* 
 —having ri'gard on the one 'land to the efilciency of service, and on the other to the inter 
 ests of coninierci': 
 
 1. The hoarding at lUmouski and inspection of the mail steamers is an absoiute nccos 
 sity, and all foreign vessels bound up should be inspected at or below Gross' Isle, so that 
 it the vessel netuls to be detained at (luaraiitine the fact can be promptly ascei lained, and 
 if healthy and free from danger of conveying infection or contagion, she may proceed 
 without unnecessary delay. 
 
 2. The revision of the regulations so as to secure the compulsory sending back to 
 «iuarantine of any vessel that passes up to Quebec without having been inspected, no ves- 
 sel to be allowed to enter the custom house at Quebec or Montreal without first exhiliitinc 
 the cortillcato of the inspecting medical onic(3r. 
 
 3. Better facilities for boarding vessels at the (juarantine station are re(iuired as 
 already suggi^sti^d. 
 
 ♦ Cholei a was introduced into this counti y by this route in 181(2. 
 
13 
 
 4. The adoption of some of the jnore modern appliances for disinfection, as for exam- 
 lili', a stonm disinfector for rags, textile fabrics, etc., or the methods employed at the Mis- 
 sissippi (luarantine of the Louisiana State Board of Health. 
 
 t"). The vaccinal protection of the immigrants should be enforced. 
 
 (!. The. addition of another medical ofttcor to the stalT of the station. ! 
 
 7. Should it be impracticable to thoroughly disinfect a vessel or cargo, wharfage facil- 
 ities, in addition to those oxis-ting at present, should be provided for vessels of the heaviest 
 draft t),.it n.'ivigate the 8t. Lawrence. 
 
 The modiflcatlQ-s herein briefly indicated, with the facilities already possessed and the 
 natural advantages fully utilized, would, to a great extent, remove the apprehension of 
 iholeraflndingits wny>into the country through the St. Lawrence, and would materially 
 obviate the necossit> of restrictions over traffic and travel between the Dominion and the 
 United States. Sweeping and onerous requirements, entailing unnecessary expense and 
 delay— especially if such expense and delay be due to inadeiiuate equipment and appli- 
 ances— defeat the very object of quarantine and provoke avoidable hostility and opposi- 
 tion, or lead to neglect and indifference. In order to make a quarantine effective as a 
 safeguard of the public health, nothing should be required which is not clearly necessary; 
 the facilities and regulations should be such as to insure a minimum of interference and 
 inconvenience consistent with the end; and every necessary requirement should be rigidly 
 continuously and Impartially enforced. 
 
 The only diseases requiring attention at the present time are cholera and small-pox. 
 Up to the time of my visit the vaccinal protection of immigrants was not enforced, and 
 small-pox had repeatedly been introduced into Illinois and the Northwest by unvaccinated 
 immigrants coming through the Dominion. Since my inspection, no unprotected immi- 
 grant is allowed to land, and under the present regulations the risk of imported small-pox 
 pontagion, via the St. Lawrence, is very materially reduced. A steam yacht has also been 
 ordered to take the place of the yacht for boarding vessels at Grosse Isle. Upon this will 
 b<j placed the modern appliances for disinfection above indicated. 
 
 During my inspection I was urged to make my criticisms and suggestions direct to tho 
 quarantine olffcer, and subsequently the Dominion government invited me to communi- 
 cate the same to them. 
 
 In addition to the quarantine on the St. Lawrence there are two other quarantine 
 stations maintained by the Dominion government— one on Partridge island, for the port 
 of St. Johns, N. B., and one on Lawlor's island, for tho port of Halifax. These are subject 
 to the same enactments as apply to the Dominion generally. 
 
 Dr. W. W. Wickwire, Inspecting Physician for the port of Halifax, writes mo, under 
 date November 20th, "tho quarantine station is on an island in the harbor of Halifax, about 
 three and a half miles from tho city. This island is owned by the Dominion govnrnment, 
 and is used entirely as a quarantine station— the only persons living there permanently 
 are tho steward and his family. The island (Lawlor's) has an area of about 150 acres. 
 There are now hospital buildings affording accommodations for about 100 persons, but 
 additional Ijuiklings could easily and rapidly be constructed. 
 
 The quarantine anchorage, whore inspection takes place, is about tlu-fjo-quartcrs of 
 a mile Irom the city. Pilots are required to bring all vessels iftto this anchorage ground 
 if there bo any disease whatever on board, and there remain until inspected." 
 
 are re(iulred as 
 
 Maine: 
 
 The Navy Department has been in the habit of sending yellow-fever infected vessels 
 to tho Navy Yard at Portsmouth,- Now Hampshire, but owing to protests by tho citizens, 
 of that city, against such action, Dr. F. M. Gunnell. Surgeon-General, under authority of 
 tliu Secretary of the Navy, in 1884, established a refuge station on Widow's Island, in 
 Ponobscott Bay. 
 
 A tempo -ary hospital and quarters for offlcors have been built, and an artesian well 
 bored, from vvhich an abundant supply of good water has been obtained at the depth of 
 sixty feet. "The island is (ionvenient of access from the sea, has excellent anchorage pro- 
 tected from storm winds, and affords a safe and desirable refuge for infected vessels com- 
 ing north from the West Indies or Gulf of Mexico." The Surgeon-General recommends 
 
 "If 
 
vr 
 
 t'T .«. 
 
 MA 
 
 -) , 
 
 H>, 
 
 
 I? r i ■, 
 
 14 
 
 In his report bonriiiB date Ootob(>r 1. 1SH5, tlmt pornianent buildings bd erected at this pluno; 
 and a stronKly i^onstriu^ted wharf, to facilltato tiio landing of heavy Htores from vesHnls 
 in or<i('r to acconvpUsh thoroiigli fumigation and disinfeetion. Witli the exception of this 
 station there are no (luarantinefacilitieH along the eoant of Maine, an<l this is under the .'oii. 
 ir>): of the Navy Department. Why should it not bo utilized as a refuge station, incase 
 cholera is found on vessels in this neighborlioodV 
 
 I visited Portland in August last, on account of the importance it possesses in thia 
 connection, owing to its being the winter port of the Grand Trunk railway, and thus re- 
 ceiving a considcHiible immigrant travel during tlie winter montlis. I found that inspec- 
 tions were made only upon the arrival of vessels at the wharf, wlion they are boarded by 
 the city physician. If contagious disease, such as small-pox, be found on a vessel, it 
 would be ordered to the quarantine groun<ls about two miles from the city: those on board 
 would be vai'cinatcd, and sucii disinfection enforced as might be practicable under the 
 circumstances. 
 
 The iittention of the mayor, and subsiMiuontly of the State Board of Health, was culled 
 to the possibility of cholera being introduced by immigrants during the winter monllis. 
 
 Ne^v Hampshire : 
 
 Dr, Irving A, Watson, Secretary of the New Hamps^hire State Board of Health, writes, 
 under date of October !!, 1885: "Except under unusual liability to infection, no (luaranline 
 is maintained at Portsmouth. The only vessels that come into the harbor of Portsmouth 
 are coasters from American ports, and a few vessels now and ihen from the Pritisli 
 Provinces (New Brunswick and Nova Scotia.) During the present luontli but one vessel 
 lias entered the port outside of coasters from American ports, untl that was a vessel from 
 New Brunswick loaded with railroad ties. Tlie very small amount of shipping that conies 
 into Portsinoutli outside of our own coast trade which is very small, consists of now iiinl 
 then a vessel loaded with railroad ties from the Provinces, ami salt from Turk's island. Their 
 is no passenger tralllc whatever. The ciuarantine laws of the State, as well ns the city 
 ordinances of Portsmouth, are auito strict, and in the v(>ry few instances of contagious 
 diseases that have been found on board of vessels coming into the harbor of Portsmouth, 
 the niaslersof such vessels have notided the pilots and a medical olTleer has been sen.; 
 to them and suitable (luaruntine established, 
 
 "Formerly there was a (juarantine station about a mile down the harbor, whi(ih was 
 established and used exclusively by the government: it now exists unoccupied. There has 
 been no occasion for the disinfection of cargoes, for many yeai's, I tliink. The govovn- 
 ment li.is sent one or two vessels, among which was the Plymouth, up to this port to 
 freeze out the yellow fever. 
 
 "I ilo not know of a single instance In which disinfection of vessels, crews and cargoes 
 lias been rcciuired. I have recently investigated the condition of alTairs at this port, and 
 do not II lid it necessary at the present time to establish a Quarantine station. There is not 
 the least probability of small-pox being brought to Portsmouth from Montreal and vicinity, 
 or from the Provin(>es by water. On the other hand we have no infected cities to fear along 
 our own coast, and as no v(>ssels arrive from foreign ports, other than those mentioned 
 above, there seems to be no demand whatever for a amirantine service. Should any cir- 
 cumstance arise that would make it necssary to establish such a service at Portsmoutli, wo 
 would do so." 
 
 Massachusetts: 
 
 In company with Dr. S. H. Durgiii, Chairman, and Mr. George F. Babbitt, a member of 
 the Boston Board of Health, I made a visit of inspection to the Boston (luarantino cslal)- 
 lishmcMt on the i;Jtli of August last. This is situated on Gallop's island, about .seven miles 
 from "iiM'ity, a.vi comprises abundant hospital accommodations for contagious discuses 
 in two buildings: a largi; storehouse for infected cargoes, connected with deep watm- by a 
 suitubh- wharf and tramways; and upon another wharf is a building for disinfecting I'lolli- 
 ing, baggage, (>tc. TJic island is about twelve acres in extent, and vessels may lie at its 
 wharves entirely out of the track of commerce. The arrangement of the buildings, etc., is 
 compact and workmanlike, and everything was found.ingood order. 
 
15 
 
 . '■•<■. 
 
 rooted atthisplufo; 
 itoros from vessols 
 le exception of thi^ 
 lis is iirulorthe .'on- 
 ige station, incase 
 
 t possossea in this 
 ilwtiy, and tlnw ro- 
 found that inspoc- 
 lioy are boarded hy 
 ind on a vessel, it 
 ity; tiiose on board 
 icticable under tlio 
 
 Healtli, was called 
 10 winter montlis. 
 
 . of Health, writes, 
 tion, no (iiiarantine 
 rbor of Portsmouth 
 II from the IVi'itish 
 nth but one vessel 
 ,t was a vessel from 
 hipping that conios 
 onsists of now and 
 'urk's island. There 
 as well as the city 
 nces of contaf;i()us 
 )or of Portsmouth, 
 ficer lias been sen.; 
 
 harbor, whi(!li was 
 cupicd. Tliere has 
 hink. The govern- 
 up to this port to 
 
 crews and (iargoos 
 rs at this port, and 
 ition. There is not 
 itreal and vicinity, 
 itles to fear along 
 n those mentioned 
 Should any cir- 
 at Portsmouth, we 
 
 bbitt, a member of 
 Iiiarantine cstab- 
 iihotit seven miles 
 uitagious diseases 
 111 deep wati'r by a 
 isinfectiiig ''lolh- 
 sels may lie at ils 
 3 buildings, etc., is 
 
 boarding station is at Deer island, about a mile and a half from quarantine, and 
 till' port physician resides at this station during tl;o entire year. The (luarontine steamer, 
 Siiinuel Little, is also kept at the Doer island station ready for boarding vessels, conveying 
 the sick from vessels to the hospitals, etc. Since my inspection this ve8.sel, built for the 
 (luarantino service thirteen years ago, has been ordered to b(i rei.laeod bv a new one with 
 important improvements and better facilities for disinfection. The regulations require the 
 purl physician in (luarantine to visit and inspect all vessels arriving in the harbor between 
 .Tune and November from any foreign port, except Canada and the Provineos, and from 
 any domestic port south of Virginia. No vessel which has had on board, during her last 
 vdyage, any sickness of a contagious or doubtful character, shall i)ass <tuarantin(< without 
 inspection and consent »of the port physician. It is also provided by n^gulation that no 
 vessel shall bo allowed to bring any sickness of a doubtful or contagious character past 
 iiiianintine during any season of the year. Every facility is provided for the speedy and 
 Cdiiifortablo transfer and the subse(iuent care of such persons as nicy arrive by vessels 
 siilTering from contagious or infectious diseases. The itersonnel of the (iiiarantine estab- 
 lislmicnt consists of two physicians and the necessary employes. The physicians are em- 
 ployed during the whole year. When (iiiarantine duties do not demand their attention they 
 are occupied in the city institutions on Deer island. 
 
 In the large storehouse there is an apartment for disinfecting rags and other articles by 
 the snliihurouK-acid process, and there" is also a larg(^ amount of storage eapaidty. Tho 
 (lisiiifcN'tlon of clothing, pi^rsonal baggage, etc., is effected by the steam process. The 
 superhi^ated steam is supplied by the quarantine steamer. For my observation tlie steam 
 was discharged into the apartment provided for this purposes, and in a few minutes tho 
 iiiuperatui'M was raised to 2:20= 1'., at which point it was evident it could be maintained as 
 loug as desired. 
 
 All immigrants are examined on arrival, and are vaccinated or reviiccinatedif notpro- 
 ti ctcd by decid(Hlly recent vaccination or revaccination. • Careful scrutiny is bestowed on 
 all iiersons and goods arriving by vessel, untl such cargoes, vessels and personal baggage 
 as seem to retpiire it are thoroughly disinfected as above indicated. 
 
 The adminhtration of quarantine at Boston has received for the last nineteen years the 
 direct supervision of tho present Chairman of the City Boai-d of Hea'tli, and tho access of 
 cholera through this port is hardly likely to occur. Curing this period I have been able to 
 trace small-pox cases to Boston very rarely, and none for several years recently. Tho 
 inclhods pursued at this port demonstrate that the disease may be excluded. 
 
 Rhode Island : 
 
 The (luarantine regulations of the port of Providence are under control of the board of 
 iililermeii, who appoint annually a health ofTlcer of quarantine, to execute such orders as 
 s:ii(l board may, from time to time, prescribe relating to (iiiarantine. Dr. Charles V. Cha- 
 liiii. Superintendent of the Health Department of Providence, writes ' 'that all vessels sub- 
 ject t(> (Iiiarantine are stopped about one mile below the city. Vessels are inspected by the 
 health olTlcer before they are allowed to come to the wharf, or have any communication 
 with the shore. 
 
 "Our foreign commerce is very small, mostly with St. .lohn, N. B. and with the W<39t 
 Iiiilies. The only European arrivals wo have are a few Italian ves^sels with suli)liur. 
 
 "If any vessel was found to be infected, I would have her thoroughly cleansed and dis- 
 iiileeted with sulpliur or chlorine or both. Baggage and clothing of crew could be treated 
 on shore at the small-pox hospital grounds, which are situated near (luarantine. Our 
 eliannel is so narrow that it is impossible for vessels to anchor very far from the line of 
 travel." 
 
 Connecticut f 
 
 The iiuaraiitlne facilities of New Haven, the most important Connecticut port, aro 
 ileseribed by Dr. Liiulsloy, Secretary of the State Board of Health, as "not entirely satis- 
 factory. No special preimrat ion exists for the proper management of vessels subject to 
 miiirautine, exceiiting that th;' Board of Health of Now Haven Is clothed with full authori- 
 ty. t(i subject any s-ch vessel to such regulations for the protection of New Haven, as said 
 lii'Mfd may deem uoeossary. 
 
 
16 
 
 
 \'k^\ ■ I' 
 
 > \y 
 
 )i : i' 
 
 .:.^S-t 
 
 ■;^':'^ (■'!',•' 
 
 "The veflHol (and cargo, if noocfSHiiry.) would bo dislnffcted by tho funics of burning sul- 
 phur and Hiibs('(iiiont ventilation, and waHhiiiKwith Holutioii of corrosive Hii))liinate orsoini' 
 of tho iireparatlniis of chlorino. The elothiiiK of tho (S'uw and their perwonal elToctH would 
 ijo also dihinfectod, and tlxiy would bo kopt undor suporvlsion until danger of comnninicii- 
 tion of the disease had passed. 
 
 "Vessels on whieli thfjre has been uo malignant or eontagious disoaso during the voy. 
 a;,'e, and on which then! is at i)resi)nt no siokniiss may come to any |)ul)li(^ wharf in N(!\v 
 Haven harbor, and signal for tho health ofllct>r; but no person is allowed to leave the vi'ssol 
 beforethe arrival of tho health ofTl(!er. In ease of any 8i(;kness on board, the vessel hIiuII 
 come to ani'hor within (luarantine limits and signal for tho lioaUh olTlcer from there. Tiii> 
 nuarantino station, as you will see'by tho enclosed map, is oiUy one and one-halt niiii's 
 from the centre of tho city, and in Now Haven harbor directly in tho line of travel. 
 
 "In case of tho arrival of a cholera vessel, it would be det.iiimd in iiuarantine. Tln'ic 
 is no hospital provided for the reception of cholera. Th(> patient would bo kei)t on bounl 
 under siK^h care as was pra(^tlcal)le, rospocting isolation ami disinfection, until a temiior- 
 ary provision could bo made, (by tents, probably,) on the shore for his or their reception, 
 after which the vessel would bo disinfected. If the cargo was such as to reiiuire si>ecinl 
 apparatus for disinfecting it, we '.have none, and shculd have to send the vessel to Now 
 York or elsewhere for that purpose." 
 
 .New York: 
 
 About two-thirds of the total immigration and more than two-thirds of the total foreign 
 imports into the United States pass through iiuarantine at the port of New York. Witliout 
 assuming that these proportions may bo taken as a nieasure of the relative importance of 
 tho Now York (luarantine compared with the (luarantines of the rest of the country, itt 
 absolute importance cannot be overestimated. The individuwls and their elTocts ami the 
 cargoes with which it deals, are distributed to every part of the continent, and while fidni 
 climatic and other (conditions, the port itself might be protected by given (luarantfne 
 methods, it would by no means follow that measures adequate for such protection would 
 ensure the safety of remote sections of the country from the disastrous etTeets of the im- 
 portation of foridgn contagion or infection through and beyond tho port. Many improve- 
 ments in tlu! Now York (luarantine system have been made during tho past twelve or 
 lltteon years, and to a great extent in direct recognition of those considerations. Duiinn 
 this period the interest of tho int(>rior in the administration of the system has come to be 
 acknowledged and is allowed to i^xort some influence. 
 
 Tho statutes relating to (iiuirantine at the port of Now Y'ork are very voluminous, Imt 
 the most imi>ortant are to bo found in Chapter 358 of tho Laws of 18(i;{, entitled, "An n<-t 
 establishing a (luarantine and dollning the (lualillcations, duties and powers of tho health 
 ofificer for tho harbor and port of Now York, " and in Cliapter 592 of the Laws of 18(i5, amend- 
 atory thereof. Although there is a board of iiuarantine commissioners consisting of tlinc 
 members, tho powers and duties prescribed by tho law are practically exerted and dis- 
 charged by the health olTlcer aforesaid. In 1880, upon the establishment of a State Uoard 
 of Health, this olllccr, together with th(> attorney-general and the superintendent of the 
 State survey, were made i^.r-officio members of the State Board, but no control or autluu-ily 
 over maritime iiuarantine is confei-red upon or exercised by the Board, except indirectly 
 through the cx-offirio connection of the h(>altli oniecr, who is chairman of a standing coni- 
 miltoc of that body ui>on the sul)ject of (luarantino. 
 
 On tho 10th, nth and 12th of August, in company with Di. William M. Smith, Health 
 Onicer of tho Port, I made a personal inspection of the iiuarantine establishment and of the 
 methods enforced thereat. TluMiuarantine anchoragii is in the Lower Bay, a trlanguliu' 
 area of about two and one-half miles along its sides, its northern apex being about ek'ven 
 miles from the city and Ave miles f" ni tho health officer's station, near Clifton, on the left 
 shore of " the Narrows." At the upper apex of the anchorofi^o, and about four miles in- 
 side of Sandy Hook, is moored the quarantine ship, "Illinois," in charge of a dcpiity 
 inspector. 
 
 After the first day of May and until the first of the ensuing November, all vessels 
 from the West Indies, tho Windward Isles, tho oast coast of South America, and the west 
 
 I? 
 
17 
 
 <f. 
 
 imcs of biirniiiK-iil- 
 
 sublimate or sonn' 
 •Honal ofTocts Wdiiki 
 iiBcr of ('oiniiiiiiiicii- 
 
 ii8o (UiriiiK tlie voy- 
 iil)lii' wharf in N(;\v 
 li toloiivc tlie vcHsel 
 rd, tlid vossi'l Himll 
 n- from tlioro. The 
 unci onc-luilf niiii', 
 10 of travel, 
 (luarantino. Tiicre 
 
 1 be kept on boui'ii 
 
 on, until a tcniiior- 
 
 or their reception, 
 
 to require spccinl 
 
 i tlie vessel to New 
 
 I of the total foroinn 
 few York. VVitlioiit 
 itive iniportanoo of 
 
 of the country, itt 
 lieir effects and tlic 
 out, and while from 
 y given (luarantfno 
 ih protection would 
 IS effects of the ira- 
 rt. Many iniprovi'- 
 
 the past twelve or 
 idorations, Diirinj,' 
 em has come to be 
 
 ry voluminous, Imi 
 i, entitled, "An art 
 )wers of the ln'alth 
 iws of 18(15, anii'iiil- 
 consistins of tlirci' 
 exerted and dis- 
 t of a State liojiid 
 )erintendent of the 
 ontrol or authority 
 , except indiri'i'tly 
 )f a standing i-om- 
 
 M. Smith, Hcaltli 
 ishniont and of tin' 
 ■ Hay, atrianf:iilar 
 beiuK about elevi'ii 
 Clifton, on the left 
 out four miles iii- 
 large of a di'inity 
 
 jmber, all vessels 
 rica, and the west 
 
 cuiist of Africa, as also those from infected ports of the United States, are brought to an 
 anchor ntMir tlds veHS<>l and board(>d t)y an inspector from an ordinary row boat. The 
 ollli'or aHcertains--lKt. The present condition of the passengers and crew. Ud. Tlie his- 
 tory of tiio vessel during the passage in reference to sicknes.n, etc., and the sanitary his- 
 tory of the viissel whih^ in the port of departure. The bill of health is tlien (\\andn;od, and 
 till' sworn statement of the (tnptain and medical odlcor of the vessel is next required, each 
 l)('lng duly sworn, that the port or ports from widch they sailed were, to the best of their 
 kimwlcdge and belief, perfiictly iiiwilthy, being fret! from all malignant contagious and 
 iiil'ritious disease; that no such disease existed among tlie shi|)ping in said port or ports 
 at tic time of their departure, and that no case ol sickness or deatli from small-pox, ciiol- 
 (M'a, yellow fever, ship fever, or any contagious or Infectious disease! has occurred on 
 lioard thii^r vessel while in any port or on the passage. 
 
 A .arofiil examination is made in every instance of the 8tt!erage, and if objectionable 
 from filth, it is ordered to be immediately cleansed and then fumigated. If the vessel has 
 been absent from the fiort of departure for a time, etiual to or exceeding the usual period 
 of im-iibation of the disease prevailing at su<di port, the passengers are inspected by the 
 iiuaraiitine officer and the vessel is discharged under a per... it. 
 
 If there is any sickness of a suspicious character resembling yellow fever, cholera or 
 typhus, the sick are removed to the (|uarantine hospital on Dix island. If the ship is less 
 than ilve days from a port infected with yellow-fever, passengers and vessel are held until 
 that period has fully elapsed. In the meantime^ the hatches are opened, the cargo and 
 steerage are fumigated twice, at various intervals of several hours, with chlorine or 
 sulphurous-acid gas. 
 
 All baggage, mails, and whatever articles liable to have become infected are put in a 
 I'losc apartment and submitted to disinfection by the agents mentioned. This done, the 
 master of the vtissel is given a ' 'permit" and directed to the discharging anchorage in the 
 upper l)ay, distant three miles from the city. Hero (in the language of Dr. Smith's report,) 
 under the constant supervision of the <iuarantine police, and the fretiuent visitation of the 
 licaltli officer, the most perfect system of cleanliness is enforced. In the meantime the 
 i.UKo is discharged upon open lighters. The exposure of the cargo to idr in lis transit 
 toliicdock, serves still further to reniovo the danger of infection. There is no inst-vnce 
 of the propagation of disease from that source in the history of (luarantino at the port 
 of New York. The (sargo being removed, the hold is thoroughly washed, and in tlie case 
 of sailing ve8S(!ls the limber-streaks alon^ the keelson are taken up, accumulations 
 of llltli removed, and the air-spaces washed down, until the water returns clear ( f any 
 eyidence of impurity. A solution of sulphate of iron, or of bichloride of mercury is then 
 used, with wiiiidi to scrub and rins(! the entire hold, inclusive of the air-spaces and limber 
 streaks. Finally, from fifty to one luindr(!d pounds of sulphur, according to the size of 
 ilie|vesscl, are burned under tlie hatches, which are closely cover(!d. Th(! ship's crew 
 is tlien mustered, and examined as they pass before the health officer. If all are well the 
 vesselis allowed to proceed to her dock .without further delay. In vessels suspeeted of 
 yellow-fever inlection, tlie crew are not allowed to discharge cargo, or if they do, are 
 submitted to a quarantine of observation for live or six days. 
 
 All foreign vessels not suDject to visitation in the lower bay afe boarded by the health 
 oflleer or his deputy at the Ijoarding station on Staten Island, a short distani.'e al)Ove the 
 Niirro\ys, and opposite the health ofTlcer's residence. From May until November follow- 
 ing, all vessels from ports "south of Capo Henlopen, " are visited at this point, unless 
 some of the ports south of this, become infected with yellow-fever, in which case vos-sels 
 from such i)orts are examined at the (luarantine station in the lower bay. 
 
 The ipuirantine hospital for yellow fever and other contagious diseases, except small- 
 fiox, is upon Dix Island, an artificial cunstruotion about two miles above! the quarantine 
 an.liorngc towards the Staten Island shore, out of the track of commerce. The hospital 
 is built on the fiavllion plan, has five wards connected by covered passage-ways, and has 
 eomfortable accommodations for 300 patients. There are also on the island suitable (luar- 
 ters fur officers and attendants, a disinfecting room and all the modern sanitary appli- 
 ances. Bmull-pox cases are not treated here, but are taken to one ot the city institutions 
 on Blackwell's Island in the East River. 
 
 —2 
 
 IIP- 
 
 
 r 
 
 ■■•I' 
 
18 
 
 r/.i 
 
 m ■ 
 
 ' 4 > - 
 
 ■'ii;''' 'I'Tri ■ 
 
 
 ■ k ■ 
 
 One mill- iibovo Dlx IsUiiid is Hoffiniiii Islund, alno iirfiflclal. iind u|)oii thiH are tho 
 buildings and applianetw ni'COHsary for a tiuiirautini; of observation. ' 'duspocta" from j-iij. 
 low-fiivcr, (du)l(M'a, typliUH or yidlow-fever i)x|)osuro, am Imro dotainod during tliu ruspuc. 
 tivc periods of intubation. Two imracMi.so structures furnisli acconmiodations for iibout 
 2,000 persouH, and in aiiotlior building an) tho (piarlors for olTliiers and employiis, an I for 
 administration purposos. Abundont batliing and laundry facllitios and disinfecting appll- 
 hnccs aid provided, and hero as well as on Dlx Island, are immense reservoirs iiiul a 
 number of clHterns for the storage of fresh water. 
 
 Tho health odicer's station, or main auarantine station is near Clifton, and at tliib 
 place is the residence of the health ofllc(>r, quarters for two deputies, and a good wharf. 
 Vessels are here boarded from a commodious steam yacht, by which, also, conimiinimi- 
 tion with the olher divisions of tlic (juarantine establishment is miiintained. The islandH 
 and stations are connected by telegraph, ami the liealth olllcer's (luarters are also con- 
 nected by wire with the city. 
 
 The personnel of tlie establishment Viiries with the exigencies of the season. In addi- 
 tion to the health ofiioer, I found oidy two deputies emi'loyed, one upon tho iiiiiUMnline 
 ship and one at the (luurantine station. Dr. Smith himself attends to tho siclt in hospital, 
 and was treating a yellow-fever case (convalesctuitj during my visit. 
 
 Bumming up, Willi reference to the exclusion of chohu-a iind small-pox,* the iiuiirin- 
 tino plant and facilities of the port of New York art! unrivalleil. the printed regulntlons 
 judicious, und with proper vigilance, the service should sulllce to prevent either of tlieso 
 diseases from (obtaining access to the country through this avenue. JJuttlni entire sys- 
 tem is liampered by a vicious lliiaiu'ial policy which is, in elTect, a farming-out of the ser- 
 vice. At tho other important ports the fees go directly to the municipality or State, findthf 
 chief executive olllcers are paid Ilxed salaries, and are provided with such employs n;* 
 may be noi'essary to the proper and etHcient conduct of tht' (luarniitine. 
 
 New Yorlv may exclude cholera liuder her present system, Imt more conlldenco would br 
 reposed in tho result if loss wore demanded of professional ability, personal integrity ami 
 executive firmness in he health ofllcer, and if the system were freed from in(luenc(^s whidi 
 are most deprecated liy those who, without prejudice, best understand thorn. 
 
 Pennsylvania: 
 
 The maritime quarantine of tho port of Pliiladelphia, and practically of tho State of 
 Pennsylvania, is enforced at the ' 'Lazaretto", situated on the left bank of tho Delawan.' 
 river, about eleven miles bolow Philadelphia In company with Dr. R. A. Cleemnnn, of 
 the City Board of Health, and Dr. Benjamin Lee, Secretary of the State Board of Health, 
 I made a visit of inspection to this station on the (iih of August last. The quarantim' 
 grounds are about ten acres in extent, surrounded by cultivated farms and separated from 
 the main channel by Little Tinicum island, between which island and the station there 
 was formerly a navigable channel which was used as the quarantine anchorage, but is now 
 too shallow for that purpose for largo vessels. Quarantine was established at this point 
 in the early part of the century, and .sections of a law enacted in 1802 are still in force. 
 There has boon practically littlo change in tlio equipments or methods since 1818, exeept 
 that a steamboat has replaced tho many-oared barge used formerly in visiting, and that 
 by this means vessels are inspected en route, not being obliged to come to anclior unless 
 detention for sickness is necessary. The structures, comprising a largo hospital (sixty 
 bods), administration building, government warehouses, etc., arc well built and spacious, ' 
 but anti(iiiatod. For more than half a century the establishment was tho best e(iuipped 
 on the continent. All vessels from foreign ports and such American ports as maybe 
 designated by tho Board of Health of Philadelphia, bound for the iiort of Philadclpliiii, 
 and arriving between tlio lirst of June and the first of October, are required to come fn 
 anchor as near the Lazaretto as the draft of water will permit, and there await the 
 visit of the (luarantino olllcers,— the Lazaretto physician and tho quarantiniMiiastor, 
 The former administers the oath or anirmation to the caiitain, ami examines persdiiallv 
 
 * Cholera found its way through ihN port to the eastern portion of this ooiititry in 1^1". 
 and to tlie country generally in ISti.j. No attention is paid to tlie vaccinal status of immi- 
 grants unless the d.sease is actually on vessels. As a natural consequence small-pox has 
 repeatedly been introduced into tho interior through this port. 
 
19 
 
 1(1 111)011 this are tho 
 "Suspocta" from ycl- 
 3d during tliu rospiic- 
 iiiodiUions for about 
 111 employes, mi I for 
 nd disiiifoc'tinK iippll- 
 OHO reservoirs juul a 
 
 Clirton, and iit tliib 
 B, and a, good wiiarf. 
 di, iiiso, conimiiiiii'ii- 
 It (lined. Tlie ishiiidH 
 unrtors are also coii- 
 
 tlio season. In iiddi- 
 upon tlio iiuiir.intini' 
 I the bielc in hospital, 
 
 ill-pox,* the iiiiJH'in- 
 printed roHuliitions 
 ■event either of these 
 liiit tlie entire sys- 
 rniing-out of tlie ser- 
 iility or State, aiul the 
 ith onch employs a« 
 I no. 
 
 <j conlhleneo would lie 
 lersonal integrity iiiul 
 !rom induenceswhicli 
 id them. 
 
 tically of tlie State of 
 
 janli of the Delaware 
 
 R. A. Cloemann, of 
 
 tato Board of Health, 
 
 last. Tlio quarantine 
 
 IS and separated from 
 
 md the station there 
 
 imoliorage, hut is now 
 
 [ibiished at tliis point 
 
 802 are still in force, 
 
 xls since 181S, exeept 
 
 in visiting, and that 
 
 :)nio to anchor unloFS 
 
 largo hospital (sixty 
 
 1 Ijtiilt and spacious, ' 
 
 IS the best e(iuipped 
 
 in ports as may be 
 
 ort of Philadelpliiii, 
 
 reiiuired to come to 
 
 and there await the 
 
 10 (luarantine master, 
 
 examines persunallv 
 
 f this country in I'il". 
 ciiial status of immi- 
 uonco small-pox has 
 
 into tli(» state of health of all on board, and, in eonjunetion with the iiuarantine master, 
 jisecrtalns the sanitary history of tlie voyage, liondition of port of departure, character of 
 eari:e. etc The latter ofTlcer e.xamlnes Into the eondltion. with regard to cleanlinijss, 
 .,f the hold, cabin and foreeastlo, c lines the bilge to bo pumped out and purified by fresh 
 water, and ascertains wln^ther any part of the cargo Is in a damaged or lnfi;etlous ctmdl- 
 lion. It the vessel Is satisfactory In all these resiiects, a certilleate to that effect, signed* 
 liy both olTl.v^rs, Is furnished and she is allowed to proceed to the port. This certificate is 
 aihlie-sed to the health (jflleer of the port, to whom It must be delivered within 'Jl hours 
 alter the vessel lands at her wharf. 
 
 If any contagious or Infectious disease (measles excepted) bo found on board, or If the 
 vi,s-r| he from nn infected port, or If her cargo be considered dangerous as to contagion 
 orinfi'CtioiKor the veFsol's sanitary condition be unsatisfactory, die certilleate is withheld 
 iiiiil tlie necessary measures are Instituted to ren'ler her safe from conveying contagion or 
 infi'dion. These measures are entirely within the discretion of the I.azare''/> physician* 
 (of eourse under the control of the Board of Health of the City) and are eniorced under 
 his supervision by the quarantine-master. So far as they are prescribed they consist of 
 rmrineation "by ventilation, scrubbing and whitewashing." Fumigation is efTectod by 
 -ulihiir combustion in iron iiots. There are none of the modern appliances for disinfec- 
 tiouof vessels or cargo. \o attention Is paid to the vaccinal status of Immigrants unless 
 ?niall-pox is discovered on a vessel; and as a natural consequence the disease has fre- 
 quently been Introduced into the interior through this port. Telegraphic communication 
 hasreeiMitly been established with Philadelphia. 
 
 Owing to the filling up of the channel in front of this Lazaretto, large vessels detained 
 in iptarantine could not be kept out of the track of commerce as completely as Is desir- 
 iilili'. In examining the surroundings of the station we proceeded on the quarantine 
 steamer as far south as Chester, at which place we found the revenue cutter troni which 
 inspections of vessels arriving in tho Delaware Bay are made. In connection with these 
 inspections I took ocea-^ion to repeat tho suggestion made at Baltimore, to-wit: That tho 
 Government inspection service should be utilized as fully as possible, and to this end 
 should receive the cooperation and recognition not only of Pennsylvania, but of the Dela- 
 ware and Now Jersey health authorities. Stale and local. This sugirostion was subse- 
 'luently acted upon by the adoption of a resolution by the Philadelphia board of health 
 reipiiring all vessels from infected ports to report for tho removal of sick sailors at the 
 U. S. (,)uarai.tlne Station at tho Delaware breakwater before proceeding up the river. 
 
 Dr IJeiijamin Lee, of the State Board of Health, wrote me on the l!8th of September that 
 "in company with Drs. Cloemann and Ford and several non-professlonnl members of the 
 city beard, Dr. Wilson the Lazaretto physician, and Dr. Bailhache of the Marino Hospital 
 service and National Board of Health, I visited the U. 8. Quarantine Station at tho Dela- 
 ware breakwater on S(>ptombcr 4.' Dr. Marshall of the Delaware State Board joined us on 
 the way. Dr. Hunt of tho New Jersey Board fully expected to come but was prevented 
 by an outbreak of typhoid somewhere in his bailiwick." After describing the accommo- 
 dations, surroundings, etc., and means of boarding vessels, Dr. Leo adds: "Tl\,e vessels 
 lie about four miles off In very rough water and de( lino to come insido the breakwater on 
 aceount of tho time which It takes. The only boat is a little yawl entirely unfit for heavy 
 weather. There is space enough to put up temporary barracks here in case of emergency, 
 and there is a government pier close by to which vessels could bo brought. There are no 
 anangements for disinfecting cargoes or clothing. 
 
 "It is doubtful whether this would be tho best place for a permanent quarantine station 
 on account of the exposed situation and roughness of tho water. Also because incase 
 of storm so many vessels take refuge hero, often close together. The distance from tho 
 city Is also a possible objection. l?l I think there must be an island higher up the bay 
 fomewhcre, which could be utilized for the purpose." 
 
 
 ' Appointed by the Governor. 
 
20 
 
 m ^ 
 
 
 *i 
 
 ,» r ' 
 
 t- 1 
 
 < , t '' 
 
 'oiiH of tho cDftsting 
 ':\vii,ter. deHi.Tibed 
 
 Delaware : 
 
 Quiinuitiiii! iiloiiK tlu! Doliiwari) (ioiwt in liinitod to tlio lociil roK"' 
 trado. TlKno is II KovDrnnii'iit (iiiarantino Htation at tho Dt^lawaro 
 in oonnootloii with tho I'onnHylvariia <iuurantlno systom. 
 
 Maryland : 
 
 Oil till) Itli of AuKUHt, accomiianiod by Dr. JiiinoH A. Bteimrt, Hoalih (JommisHioiici', [ 
 iniulo an inspuction of tlus (luiinintiiio ostalilishmoiit at the port of Biiitimore. Thin in sit- 
 uatod at Littlo Hawkins or LuadinK Point, about hovon miloH from tho oity.ontho I'alupsco 
 rivor. Tho jjroiindH bolonBing to tlio Htation oinbraco about twonty-flvo aoios, Hurroundoil 
 by improvod farms. Tiiorn is a now and woll arrauKod hospital IxiiidiuK witli iiccoinnio- 
 datlons tor forty patients. Also a rosidonoo for tlio physioian in (!liarji;o, boatmon's \\oum\ 
 stables, ate, all in jjood condition and neatly kept. The station is connoctod by tol(,'piione 
 with tho city. Tlioro is no provision for tho care of those detained for observatifni after 
 exposure upon an infected vessel. Tho hosiiital facilities may be increased by the use of 
 tents in suitable weather, and in case of emerKency the old (luarantino establishment now 
 used as a sinall-pox hospital might bo utilized. 
 
 Tho auarantino soiison extends from May 1 to October 31, and durinsr this period iin 
 assistant resident physician is on duty at tho station. All foroien vessels bringing pusson- 
 gers are roiiuired to stop for examination throughout the year. No attention Is paid to the 
 vaccinal protection of immigrants, unless small-pox is discovorod on a vessel, and owing 
 to this neglect repeated Introductions of tho disease Into tho interior have ucourred 
 through this port. Vessels are boarded in the harbor from a steam tug kept in constant 
 readiness for that purpose. Tho depth of water at tho (luarantine anchorage is about 
 twenty-two feet at low tide, and there is plenty of room to anchor vessels out of tlio track 
 of commerce. There are no facilities as yet provided for the dischnrgo and disinfwction of 
 cargo from an infected vessel, but additional facilities and proper appliances for disinfec- 
 tion are contemplated. 
 
 As a further precaution in the present emergency, I suggested the advisability of n- 
 quiring vessels to submit to inspection by the government service at Capo Charles. 
 
 Virginia : 
 
 Dr. .Tames D. Gait, the Quarantine Medical Officer of the Elizabeth river district, lias 
 furnished the following from Norfolk, under date October 20, 1885: 
 
 "In reply to your in(inirios as made in letter No. 20,519, 1 would brloriy state that the 
 (luarantine facllUie.s of this port are ample. Situated on the Elizabeth rivor, itself an 
 estuary of Hampton Roads, there is all the sea room necessary for an efficient iiuarantine. 
 The 'lua'-antinc station is abreast of Carey Island, five miles below the city, where therivur 
 rapidly widens Into Hampton Roads. Vessels arc invariably examined at the station, and 
 are absolutely prohibited from coming up until inspected by the (luarantine oftlcers. 
 
 "There is nothing special about our method of disinfecting vessels, cargoes and tiie 
 crew. The fumes of burning Siulphur are usually employed. Sometimes, in the case of 
 largo sized vessels, chlorine, generated by the action of sulphuric acid upon common salt 
 is also employed below the wator line. Vessels in quarantine are anchored at u safe dis- 
 tance outside the main ship channel. 
 
 "So far I have hud no cholera-infected vessels to inspect. Should any such arrive,! 
 would treat them on tho same general principles of disinfection as other vessels, giving 
 special attention to tbe tliorough dibinfection, or destruction, if necessary, of all clothing', 
 bedding, rags, or any other materials which might act as fomites for the infection." 
 
 In response to a subseciuent in(iuiry, asking what assistance or protection has been 
 afforded by the quarantine or inspection maintained by the National Government through 
 the Marine Hospital and Revenue Marine services. Dr. Gait writes that "while it does not 
 relieve me from responsibility as the local quarantine officer. It is undoubtedly an addi- 
 tional protection to this city, and I would compare it in military phrase to a second line of 
 entrenchments around us. This service is, as you know, maintained only during the 
 warmer months, and was raised on the luth inst. [Nov.] for the winter, so that I am now 
 without, its assistance." 
 
 
21 
 
 f »f 
 
 'onH of the (Miastinu 
 '•.wii.tor. (lest'ril)«d 
 
 alili ComiuisHioiicr, I 
 altimoro. TliU i^^ !(it- 
 ( city, ontlio I'liliipsco 
 Ivn a<!ro8, Hurr(iun(li;il 
 IdinK with accommo- 
 Ijc, boatmon'M lioii.-ic, 
 iniiMct<!d by toicphune 
 for observation aJter 
 jreasod by tlio uhc of 
 no ostal)liHliment now 
 
 during this period iin 
 ssols bringing iiusHiin- 
 attontion Ispaidtotlie 
 in a VO880I, and owing 
 itorior have occurred 
 III tug kept in constant 
 
 anchorage is about 
 ossela out of the tracli 
 i-go and disinfwction of 
 ppliances for dlsinfec 
 
 the advisability of k- 
 it Capo Charles. 
 
 beth river district, has 
 
 1 brit'ily state that the 
 zabeth rivor, itself an 
 m effleiont iiuarantine. 
 he city, where the rivOT 
 ined at the station, and 
 
 irantine oflloers. 
 ssels, cargoes and the 
 niotimes, in the case of 
 id upon common sail 
 anchored at a safe dis- 
 
 Duld any such arrive, I 
 3 other vessels, !,'lviiig 
 essary, of all clothin*.', 
 jr the infection." 
 )r protection lias been 
 il Government through 
 that "while it does not 
 undoubtedly an addi- 
 rase to a second line of 
 aincd only durlDK the 
 inter, so that I am now 
 
 Huli-'Ciiiientlv. Doc. 31,th<> following information was furnished through Dr. Qnlt 'ly 
 Dr. 1'. M Uniuahart, of the Marine Hospital servlco: "The service has two auivrantine 
 ^team<Ms, the Woodworth and Manhattan, which aro used for inspecting vessels. If any 
 ve'<»t'l is found infecteil it is carried to Fishornuin's Island and Muarantined, and tht) side 
 pittCrtd in hospital on the Island. The hospital was built during the summer ol 1884, and 
 contains about twenty beds. 
 
 "Fi-lierman's Island Is just ofT Cape Charles. A keeper and assistant remain at the 
 ho^pital at all times, and extra help Is employed In case of sickness. Two surgeons of the 
 Marine Hospital service aroidotailed for the summer season (May to December), the one In 
 charu't', tlio other as assistant. Tlio vessels inspected an^ all foreign vessels and vessels 
 from the southern ports of the United States. Every vessel is thoroughly inspected (each 
 man Inspected and cargo examined). If vessel is found Infected, cargo is transferred to 
 lighters and thoroughly disinfected (or thrown overboard), and vessel thoroughly cleansed, 
 (li»lnfe> led and detained In auarantino for a certain length of time." 
 
 North Carolina: 
 
 There are four ports of entry on the North Carolina coast, all having good and spacious 
 harhiirs, namely, Edenton, Beaufort, No wberne and Wilmington. Of these th(^ portijf Wil- 
 iuin«t"ii is the only one of importance for (luarantino purposes. Dr. Thomas F. Wood, 
 Secretary of the North Carolina State Board of Health, writes as follows concerning 
 iin.irantine at this port: 
 
 "111 reply to your letter of inquiry No. 20, 613, 1 would say: Our quarantine facilities aro 
 inadeciuate. The quarantine station is at the mouth of Cape Fear Iliver,20 miles from Wil- 
 mlniitoii. At this station certain vessels aro requlreii to proceed at once to the station for 
 inspection. The quarantine offlcer is appointed by the Governor. He lives at the station 
 and has Immediate charge of all the details of dislntoction, cleansing, unloading and po- 
 lli.'edireetion of the detennos. 
 
 "In all eases of doubt he submits his case to the advisory quarantine board, two gen- 
 tlemen, selected by the President of the State Board of Health, who reside in Wilmington. 
 Ea(h vessel Is treated upon its individual merits, and the rules are made elastic enough to 
 apply tu ear-h case. 
 
 "Our met! lis of disinfection are primitive. The vessel is unloaded, bilge is pumped out 
 iindfnsh water pumped in until it is discharged clear and odorless, and the disinfection 
 is completed by burning sulphur under closed hatches. The vessels are unusually small, 
 iindcomi' in ballast, and as they iire not numerous th(fre is little difflculty in performing 
 satisfactory cleansing. When there is doubt, the vessel is required to load at the station, 
 the cargo lieing carried to it in lighters. 
 
 "Sliould a vessel put in with cholera on board, we would relieve the recessities and 
 haveher towed to Sapelo Station. If her crew was small we would keep her under obser- 
 vation, ami treat the men on board. The quarantine hospital was burned two years ago, 
 and the State has not rebuilt it." 
 
 I)r. Wood encloses a printed copy of the (luarantine regulations, but as these are suf- 
 lloienth summarized in his letter they are omitted from this repo,rt. 
 
 South Carolina: 
 
 The quarantine system of South Carolina is governed by the provisions of a state law, 
 approved December 20, 1881, entitled "An act to render more efTlcient the quarantine aer- 
 vioeotllie several ports of the State." Under this enactment the administration of quar- 
 antine at the port of Charleston is placed in charge of the Board of Health of the city.sub- 
 jectto the advice and supervision of the executive eoncmittee of the State board of health. 
 Atthe other ports of the State quarantine remains under the supervision and control o 
 this latter body, and the stations at Georgetown on South Island, at St. Helena entrance 
 on Buzzard's Island, and at Port Royal on Paris Island, have received special attention 
 since the danger of cholera importation became imminent. Many of the buildings have 
 b'en repaired, and new ones have been erected on the site purchased last year on Buz- 
 zard's Island. 
 
 The following regulations— which are uniform with those in force atthe Georgia quar- 
 antine stations, so far as relates to foreign vessels— govern the quarantines of South Car- 
 olina: 
 
 !/» -ii* 
 
M' 
 
 
 I. On and nftor tho openinK onuli year of tiic National Quarantino Htutlon (Hapelo 
 Boiinil). all vHHsoIrt from tnfootod or HUHpoiUed liiHtiiiloH iirrlvliijf with Blokni'sa on board, 
 or havinK liad Hiitnc diirInK voyage, must b« dlnvtod hy thi- t>ll"t to proceed to huW 
 National Quarantine station. 
 
 II. Any vcsHol arrlviim nt tills port lirarlng thn i-ertlllcato of tlic National (Juanintine 
 onicor, mu-it Im' brouKlit to anchor at tlio iiuarantlne station, and thorr remain until re- 
 leasf'd by the oriler of the board of health. 
 
 III. DiirltiK the closure of said National Ouaranflne station, all vessels suoh as abovi- 
 doHorlbed, must anchor at the port (luarantlne station, under perwonal direction of the 
 auarantine olllcor. 
 
 IV. Vessels from any forel^'n port direct, or via American ports, with or witliout sick- 
 ness on board will, durinK the entire year, be compelled to anchor and remain at the 
 <iuaranline station until released by written permit of tho iiuarantlne ofllcer. 
 
 V. All vessels arriving at this port with sickness on board, or havint; had same durlri; 
 voyage, will, at all stjason-i of the year, no matter from what port, either American or 
 foreign, anchor at the ciuarantlne station, and there remain until released by order of th'' 
 Board of Health. 
 
 VI. Vessels from Infected or suspected latitudes, will, during the entire year, 1)8 re- 
 (luired to discharge any and all biillast at the (luarantlne station, oi' sueh other plai.'i' ns 
 may be designated by tlie liealth authorities, in tlie liarbor undei' water; to have bilges 
 and limbers cleaned and sweetened, and from May 1 to Niivember 1st of each year, be 
 subjecled to at least two fumigations and buch otherdisinfeciion as may be necessary, iinJ 
 be detained at least fifteen days. 
 
 VII. On and after May let, and until November Ist of each year, and longer if the 
 board of health so determine, all coas-twise vespels or steamers from latitudes south of 
 Cap(! Hatteras, other than thos(( liy inland route, musi anchor at the (luaraniine station. 
 Steamers and vessels from non-infected '-'• non-suspectt'd ports, will not be detained 
 longer than necessary for the (luanintine oltleer to satisfy himself of their perfect s^auitiiry 
 condition. Vessels from infected or suspected latitudes will have to comply with section 
 VI, be fumitrated at least twice and detained at ii.'ast llfteon days. 
 
 VIII. Coastwise steamers and vessels arriving at this port by inland route, from iuti- 
 t.udes south of Capo Hatteras, between May Ist and November 1st. and later, if the Board 
 of health so determine, mubt be inspected and trlven perndt by the <iuarantino ofllcer, be- 
 fore thi- landing of oithei- passengers or freight. 
 
 IX. From May 1st to November 1st ot each yeai*. no vessel from an Infected or sus- 
 pected latitude will be allowed to either lighter or bring cargo of fruit up to the city. 
 
 X. Pilots must, in each case, before boarding, make inquiry ns to the sanititry condi- 
 tion of vessels; in no case must they board if the vessel has sickness on board, or has had 
 same during voygae; in such cases tliey must either direct to iSapelo Quarantine station, 
 lead tho vessel in, or have their small boat hoisted alongside, clear ot the water, ami in 
 
 Ms way pilot the vessel in. 
 
 Dr. H. B. Horlbeck, (Uty Itegistrar and Secretary of the Charleston Board of Heiiltli, 
 furnishes tlia following Information concerning the station at the port of Charle-.ton: 
 
 The station at Fort Johu'^on, on Jam(!s Island, is about two miles east from Cli.iHcstoii 
 in the harbor. Tlie buildings comprise a fever-hospital and pest-house, offices, etc. Tlier<' 
 is a fine and conimodious wharf, also boats for boarding purposes, under care of a iimu- 
 antine olTlcer, andaguard boat. Service is maintained from May 1st to Noverabcr Ist 
 every year, to prevent uiuiuthorized communication w ith the Station. Tills service is also 
 continued from November to May when necessary. Vessels are inspected at tlie station 
 jn tho stream. They are fumigated with sutphurou^-aeid gas, and disinfected witli tlie bi- 
 chloride-of-mercury solution. Cargoes of fruit from infected ports are not permitted to go 
 to the city from May 1st to November 1st, and certainly no other cargo until it lias 
 been taken out of the ship at tho station and fumigated (see quarantine regulations,) 
 Vessels arriving pass within a few hundred yards of vessels detained at quarantine. No 
 vessel from a cholera port is allowed to come in, but is ordered to Sapelo. Should a vessel 
 have either cholera or yellow f(!ver break out at quarantine it would be sent to Sapuloiu- 
 stanter, or on the next tide -that is, certainly within twelve liours." 
 
28 
 
 Georgia : 
 
 In .(. 'r. McFarhinil, H^ftltliOnioer of Siiviinnnli. fmnlHliBH the follovvlny !n resroiiBeto 
 
 my l.'ttor: 
 
 "Tlif iiiiaranllne Htatlop Ih locatod seawanl of the olty, iliHtant l)»«twi'Pn fonrttxdi ami 
 ilftt'i'ii mlltiH, upon an oyntor-betl 8lioal; this nlioal in ontlrely Hiirroiinded by water and Ih 
 covi'ii'il alioiit four foot In overy Hood lido. ()n« nhort angh' of tlio rlv«'r clianncl riiUH 
 wiiliin about throe huiidrf'd yardH of tlin Hiatloii. All voshuIs fi'oni Infected or HU^*ptH:ted 
 parts and latifudeti are reiiulred to dlMfharge ballast all lh<' year round at fhi-< (luarantlne 
 (ttatinii. No t)allaHt from tifc Went Indies, or HUMr>"''ted ioijalltloH north of ltl(> de Janelio, 
 liiis lit'cn allowd to be liroiiBlit to tli" (dly of HavanniiliHlncn 187i;. 'I'lilsrumilatlon wanln- 
 i*titiifi'(l a.s a Kiiard aKiiiiist yellow-fover introduction. 
 
 "Tlio fai-illtieH of the ntation ai'o not as Kreat an are reiiulri'd; an Increase of wharfiitre 
 iind the erection of a storoliouHe are needed. 
 
 "All vcshcIh are Inspected at lht> (luarantlne station by tlm resident pliyHlcian. VoHsi.>l8 
 liii'iiiK'), from loreiirn portw, seldom como to this port between May 1 and November 1. I 
 IwIIhvb this Is the case at the other Soulli Atlantic ports. Durlnuthis season but one vesse 
 In caiK" (Kiiano) )ias arrived here. CoiYee vessels liave been in the liabit of comiisK to 1ld« 
 [idit, and hav(^ been reiiuired toundfrgo sulphur fuuilgation with cargo in i>laco; the 
 funii'-i of tlie gas do not lejure tlie quality of the bean In the sliglitest degree. The cargo 
 istlu'ii allowed to betaken by llglilers to the city, while tlio vessel is dotauKHl ar the sta- 
 tion; lier bilges and timbers are cleansiul and disinfected witli solution of sulphate of iron 
 or liii'lil<jrlde of mercury, and. along with all clothing and bedding, she is then subjected 
 to a si'i'ond fumigation. The requirements Having been carried out. and no sickness hav- 
 Ini; occurred on board during detention time, permit Is granted by the health ofllcor for 
 vessi'l to come to the city. The clothing on board aiiy sucli vessel is subjected daily, dur- 
 intrcictention, to the action of fresh air, all bedding and clothing being exposed on deck 
 of vessel and in some cases these iire subjected to boiling. Fumigation with chlorine gas 
 i.s friMiuently resorted to— always when there Is any suspicion of smull-pox Infection. 
 
 "So soon as cholera became epidemic in Spain this past summer, orders were issued 
 to the pilots of this i)ort, not to board, but to direct to the Sapelo Quarantine station, any 
 and till vei^sels arriving from ports infected with cholera. This National Quarantine sta- 
 tion is distant only about sixty miles from the mouth of the Savannah river. It^cently 
 orders have been issued allowing pilots to lead to the port quarantine station any vessel 
 from the Mediterranean coast, when sue li vessel has not had deatli or acknowledged infec- 
 tions diseasi! aboard during her voyr.ge. This change of order was made in conwequence 
 of the decrease of cholera in Europe. These vessels were ordered to the National Quar- 
 antine station because they were all deemed entitled to thorough cleansing, and tlio health 
 authorities of Savannah decided that It cholera did make its appearance on board any of 
 them while having the clothing, bedding, etc.. attended to, it would be decidcMlly prefer- 
 able to have them away from this port. Vessels arriving at this port from yellow-fover 
 latitudes are not boarded by the pilots. Such vessels are led into quarantine grounds if 
 they have not had sickness on board during voyage. If they have had sickness on board 
 during voyage, wliich the captain acknowledges to have been susr^icious, he is directed to 
 the Siipclo station. If any vessel arrives at the port quarantine station and it is deter- 
 mined after investigation that she has liad infectious or contagious disease on board, she 
 is imiiied lately ordered to leave the port, and is directed to th(! National Quarantine sta- 
 tion. This refuge is umiuestionably a very great safeguard and help to this portion of the 
 .\tlantie coast, and in helping and protecting us it protects the country at large. 
 
 "Should a vessel o'-ivc at this port with cholera on board, and the National Quarantine 
 stati'.n be closed, the .-:iip would bo placed at the greatest distance from line of trav(!l (say 
 three-fourths of a mile) and guard boats, with most reliable crows, would prevent any 
 eommuiiication with or from her, excepting the quarantine physician, who would have to 
 remain and look after the sick. Tolographic communication would be opened at once 
 with the authorities at Washington, asking the immediate opening of the National Quar- 
 antin ■ station. If such station was opened the vessel would bo sent there. If it was not 
 opened the health authorities of Savannah would have to assume the responsibility and do 
 the best in their power to prevent the apracd of the disease. 
 
( 
 
 24 
 
 rm^ ■ ,:. 
 
 il^- -SaiiBiiitii/tatm 
 
 "In closinK I iMQnot rofraln from an expression of contli<mnation and pi'otost ajjiiinst 
 the unre'ilnbility of tho ordinary bills of health Issiii'd by somo consuls of the United Htatos. 
 They are worse than usuless,— tliDy are daagerous. It is a froauont occurrence that clean 
 bflis of health are Issued by Ihem at ports whore deadly epidemic diseases are prevailing. 
 'I'here should he some remedy for such pernicious and ciuostlonable conduct. Ayaln, I 
 know positively that steamship-*, from districts of Spain affected terribly with cholera, 
 have been admitted into one of thn largest ports of the United ataten, during this season, 
 without the slightest attempt at fumlgitionof the clothing of seamen, or cleansing of 
 vessels, tho statement being made to me in official correspondence, tliat as no sickness 
 had occurred during the voyage it. was doomed unnecessary to use any precautions, i.nd 
 that this would be the line of action pursued in the future at that port." 
 
 Dr. Jas. 8. Blain, Health Officer of Brunswick, answers: 
 
 1. The (luaruntlne facilities of Brunswick are not so perfect as I would like to have 
 them; but they have proven sufficient to protect this city from all epidemic infectious and 
 contagious diseases since tho yellow-fever epidemic of 1870. 
 
 2. I Inspect all vessels at a distance of from four to ten miles from the city. All vessels 
 are Inspected befon; permission is granted to proceed to the city. 
 
 :>. Vessels are purided and disinfected, first by the dlschaigo of all bulla!:.! or cargo; 
 secondly, the jilanklng along the keelson is taken up. all filth eolloctod in the limbers of 
 the vessel taken out, and the vesiol thoroughly washed and pumped out, salt water being 
 used until tho vessel is perfectly clean; thirdly, a strong solution of carbolic acid and 
 sulphate of Iron is applied to the whole interior, and the vessel Is then fumigated by burn- 
 ing from 100 to aon lbs. of sulphur in the cabin, forecastle and hold of the vessel. All bed- 
 ding and clothing of the crow is subjected to cleans; ••:? and disinfection. All infected or 
 suspected vessels are detained ten days after cleansing, then if no case of disease appears 
 tho vessel receives a permit to proceed to the city. 
 
 4. The quarantine station is four miles from the city; it is not out of the line of travel, 
 but no intercourse v»dth vessels In (luarantlno Is permitted. 
 
 5. All vessels with sickness on board, and all vessels from cnolera infected or sus- 
 pected ports whether or not having sickness m board, arc sent to Sapelo Sound. All 
 pilots and steam tugs on this bar have permanent instructions to order all vessels witli 
 si' kness on board or from cholera-infeeted ports to Sapolo Sound. Pilots are not per- 
 mitted to board such a vessel, but are instructed to direct or conduct them to Sapelo 
 Sound. Afier discharge from the National Quarantine sta'ion, all vessels are again in- 
 t looted at this Quarantine station before receiving a permit to proceed to the city. 
 
 Florida ; 
 
 Notwithstanding its extended eoast of nearly 1,2(fl) mili's, Florida has few harbors in- 
 viting foreign commeieo, and except Fernaudli;a and Pensucola, the relations of Its seven 
 ports of entry to the interior are limited. A State onactm(mt approved February iti, ISSS, 
 provides for the appointment of county boards of health which are clothed with full power 
 to act In rogiird to all matters pertaining to auarantlne, to appoint a port im^pector and 
 other officers, to declare and establish uuaranline and provide rules and regulations for 
 its enforcement, and "after the establishment of any (luarantlne against any port or plaee 
 any person violating the same shall be dtiemod guilty of a felony, and upon conviction 
 thereof, shall b ' punished by a line of not more than live hundred dollars, or by imprison- 
 ment in the state penitentiary not more than one year." 
 
 Under this law the (luarnntine of the port of Ponsaeola is now administered bv the 
 Escambia county board of health. The station is on Santa Kosa Island about nine miles 
 from the port, and is described by the (niarantlne physician. Dr. White, in reply to my in- 
 quiries addressed to Dr. II. IJ. S. Hargls,as being supplied with "all the buildings necessary 
 for fiuarantino purposes. Vessels are inspected at the station. Vessels detained arc re- 
 quired to discharge all ballast, and after discharge of ballast, tho vessel is thoroughly 
 cleansed and waslied in all its parts, then fumigated, using 12 pound.° of sulphur to evi'ry 
 lOO tons registered, the fumigation lasting 12 hours. After fumigation, a saturated solution 
 of copperas Is poured through the air-streaks, betwei-n each timber, running down to 
 
 >?S6.:> 
 
25 
 
 ' ,7 
 
 tmd protest ajcaliist 
 )t the United 8t,atos. 
 currence that oleiin 
 [vscs are prevailing. 
 I conduct. Again, I 
 •ribly with choleni, 
 during tiiis season, 
 on. or cleansing of 
 tliat as no sickness 
 ay precautions, i.nd 
 
 I would like to have 
 omic infectious and 
 
 ;heclty. All vess(!ls 
 
 ill ballat.t or cargo; 
 id in the limbers of 
 lilt, salt water being 
 Df carbolic acid and 
 fumigated by burn- 
 he vessel. All bed- 
 ion. All infected or 
 3 of disease appears 
 
 )f the line of travel, 
 
 3ra infected or sus- 
 Sapelo Sound. \\\ 
 
 dcr all ve.isels with 
 Pilots are not por- 
 
 ict them to Sapelo 
 
 ^sels are ayainin- 
 
 d to the city. 
 
 as few liarbor.s in- 
 lations of its seven 
 1 February Iti, IHi5, 
 bed with full power 
 port ini^peetor and 
 nd reguiatidus for 
 t any port or place 
 id upon conviction 
 rs, or by imprison- 
 
 Iministered by the 
 d about nine miles 
 n reply t'J niy in- 
 •uildinKs necessary 
 Is detaiiioJ arcu'e- 
 )ssel is thoroughly 
 )f sulphur to I'vcry 
 saturated sukition 
 , running down to 
 
 bilge; lime water (wliltewash) used in name manner. The entire hold Isthen whitewashed, 
 lime put In bilge to the forecastle, with bedding, clothing, etc., under the same process of 
 ilcansing, fumij^atlon, etc., the cabin receiving same attention. 
 
 "It is not probable that a vessel with cholera on board will arrive at this station, as all 
 vessels arriving outside the entrance of the port upon which any contagious, infectious 
 or pestilential disease ueeurrcd during the voyage are sent to Ship Island, the pilot co- 
 operating with the local authorities in directing them to that station. Should, however, 
 a vessel get to this station with cholera on board, and in such a condition that she could 
 not bo sent to Ship Island, the sick would, if possible, be cared for In hospital, and the vessel 
 put in bi'st sanitary condition, and such bedding, clothing, etc., as could not be disinfected 
 would be destroyed." 
 
 Dr. Alexander, Port Physician at St. Augustin-J, writes that the (luarnntine flag for 
 that port "stands about one and tliree-fourth.'-' miles from the city, where all vessels 
 from a distance are Inspected, Coasting vessels, or those plying between this and near 
 ports, are allowed to come to the wharf for Inspection, provided there is no sickness 
 on Ijoard; if there Is, then they share th(> auarantine ground as all others. Even upon 
 coming to the wharf, no communication is allowed until inspected. Our pilots are re- 
 nnired to learn from the captain, before boarding a vessel, whether she is from a sus- 
 pected port, or has on board a suspected case. In the first case, she is brought with 
 as little contact as possible inside the harbor, there anchored and report made to port 
 physicnin and board of health. If sickness is on board, she Is directed to pioceed 
 directly to Sapelo Sound refuge station without boarding or entering harbor here. 
 
 "Should necessity demand the treatment of a vessel, we would use the disinfectants 
 reeomniended by the National Board of Health and adopted generally, viz: sulphur, 
 sulphate of Iron, carbolic acid, etc., subjecting cargo, clothing, bed-clothes, etc., to the 
 same, and burn what might endanger after-dlslnfectloh. 
 
 "A vessel entering with contagious disease would not be allowed to remain one 
 hour, as the condition of our harbor would subject the whole city to immediate In- 
 fection; even should a vessel coming from foreign ports be In perfect health and con- 
 dition, she must stop at quarantine ground, and all circumstances connected with her 
 trip be well considered by the board of health before allowing her to come up. 
 
 "The coast map will show our unfortunate i)osition as far as receiving or entertain- 
 ing a vessel with disease on board. Our proximity to the high seas, the short and ex- 
 tremely narrow Inlet, could but endanger us under the most favorable circumstances, 
 as the small craft or pleasure boat would pass less than one hundred yards from the 
 anchorage." 
 
 No responses have been received to repeated reuuests for information from Key 
 West and elsewhere. 
 
 Alabama : , 
 
 The coast quarantine of Alabama Is limited to one port of entry— Mobile, and con- 
 cerning this. Dr. Jerome Cochran, the State Health Officer, has kindly furnished. In 
 response to my imestions, the following succinct replies, which fully cover all the im- 
 portant points: 
 
 1. The Mobile (luarantine station is chiefly an Inspection station, but has the ordi- 
 nary appliances of dlsinfeetloii. 
 
 L'. The entrance from the Gulf of Mexico into the Bay of Mobile is thirty (30) miles 
 from the city, and vessels are boarded for inspection at this entrance. 
 
 :?. Vessels from infected ports with no sickness on board are disinfected anyhow 
 before they are allowed to api)roach the wharfs. 
 
 4. Vessels with any infectious sickness on board, cr having had any cases during 
 the voyage, are sent at once to Shiii Island. Such vessels are not allowed to enter the 
 Bay at all until released from (luarantine by the Ship Island olflcials. 
 
 5. Moblh* is thoroughly in earnest about her quarantines, and no infectious disease 
 lias been introduced througli the imarantine into the city since the war. Such outbreaks 
 as we have had have been the result of infection brought overland from New Orleans. 
 

 '.t:-'!:;-}. 
 
 26 
 
 6. Any vessel having on board a the time of its arrival, or haviiiji had on board 
 at any time during the voyage, yellow fever or cholera, would bo sent to Ship Island 
 at once, and not allowed to entur the bay at all until diseharKed from the station, and 
 even then, if tliore was any suspicion that she stili remained danyerous, she would be 
 disinfected anew at our own station," 
 
 Mississippi : 
 
 Tlic county boards of health of Hancock, Harrison and Jackson counties eimtrol the 
 maritime quarantities of Mississippi. There is no direct foreign commerce, but Bay St. 
 Louis has a larKC coasting trade with Mobile and Now Orleans, and acquires some quaran- 
 tine importance in conso(iuence. 
 
 Louisiana : 
 
 The quarantine system of Louisiana- is under the control of the State Uoard of Health, 
 which is authorized by various acts of the State LeRislaturo to ilx the duration of quaran- 
 tine and to make and enforce all necessary reyula'ions, to contract for building, employ 
 persons, etc. At ts discretion the Board may atany time cause the detention at the quar- 
 antine stations f( r disinfection, fumigation and pwrlilcation, of any or all vessels from 
 ports in which yellow fi'ver usually prevails or from ports where other contagious or in- 
 fectious disease is reported to exist. Quarantine stations are ostatlishod by law on the 
 Mississippi river not less than 70 miles below New Orleans, at the Rigolettos— the entrance 
 to Lake I'ontchartrain— and below Morgan City on the AtchafaUiya. But the State Board 
 is also empowered to establish additional stations upon any of the approaches to the city 
 of New Orleans in its discretion. 
 
 Under this latter authority the present Board has recently established a refuge station 
 in Pas a L'Outre. some 28 miles below the original station, which latter is on the right bank 
 of the Mississippi 75 miles below New Orleans. A boarding station is also maintained at 
 EadsDort at the head of the jetties. 
 
 Accompanied by Dr. Joseph Holt, President of the State Board, and to whoso indefati- 
 gable energy the recent practical improvt-ments are mainly due, I made a personal 
 inspection of the Mississippi river stations on the l.'ith. Kith and 17th of July last, and wit- 
 nessed the inspection of vessels, the disinfection and treatment of an arrival from an in- 
 fected port— a 2000-ton iron steamer: Inspected another which had been treated two days 
 before'my arrival and was not yet released; examined the appliances for disinfection, etc., 
 and the buildings, hosnitals, warehouse and other items of the quarantine plant. I am, 
 therefore, enabled to endorse from personal observation the claim made that this is the 
 most thorough and vigorous system of sanitary quarantine which has ever been enforced 
 for the protection of a port from the introduction of foreign contagion into this country— 
 if not In the world. 
 
 Beginninj:; with the arrival of a vessel in soundings she is met by the pilot, who co- 
 operates with tlie (luarantine authorities and is freiiuently accompanied by the medical 
 officer from the boarding and inspection station at Eadsport. This officer examines the 
 ship's log and receives a sworn statement from the captain as to the sanitary history of 
 his vessel and her vi>yage, beginning at the port of departure. All on board are mus- 
 tered and carefully examined for cases of suspicious sickness. If the vessel be found 
 in good sanitary condition and free from infection slie is allowed to proceed up the 
 river, but reports at the upper (luarantine station for a second inspection. If from a 
 non-infected port, she is now given free pratique and proceeds to the city. If from an in- 
 fected or scheduled port, or if any suspicious development has occurred in the interim 
 after first inspection, she is either subjected to treatment at the upper station or sent 
 below to the refuge station, as thi^ circumstancics demand. For example: A shmt time 
 before my visit a Mexican steamer had arrived; she was inspected at the boarding sta- 
 tion and all hands mustered and examined as usual, without detecting any suspicious ill- 
 ness. After she had been allowed to depart Ihe pilot reported that a sick man had been 
 roused from his berth to be mustered with the crew. The fact was at once telegraphed to 
 the upper station, and on the arrival of the vessel the man was founu to be suffering with 
 what proved to be yellow fever. The vessel with the sick man on board was at once sent 
 down to the refuge station for necessary treatment, entirely out of the track of commerce. 
 
 
27 
 
 had on board 
 to Ship Island 
 he station, and 
 i, she would he 
 
 tio3 control the 
 ae, but Bay St. 
 s some quaran- 
 
 loard (if Health, 
 itioii of quf.ran- 
 iiilding, employ 
 ion at the iiuar- 
 11 vessels from 
 jntaglous or In- 
 )d by law on the 
 13— the entrance 
 the State Board 
 ches to the city 
 
 a refuge station 
 n the right bank 
 > maintained at 
 
 whoso indefati- 
 
 i.de a personal 
 y last, and wit- 
 vnl from an in- 
 eated two days 
 sinfection.etc, 
 e i)lant. I am, 
 that this is the 
 been enforced 
 this country— 
 
 e pilot, who co- 
 by the medical 
 examines the 
 Itary history of 
 )oard are mus- 
 essel be found 
 roceed up the 
 on. If from a 
 If from an in- 
 in the interim 
 station or sent 
 A short time 
 boarding sta- 
 suspicious ill- 
 man had been 
 Iflegraphed to 
 sulTering with 
 as at cnce sent 
 : of commerce. 
 
 If a vessel on first inspection be found infected she is not allowed to proceed up the 
 river, but is at onci; sent to the n;fiiKe station, the sick are removed to the hospital, and the 
 vessel is treated as hereafter described. Afterbeingthoroughly cleansed and disinfected, 
 she is then sent to the upper station, where the compromised passengers and crew are 
 subjected to a auarantine of observation duiinj^ the usual period of incubation— (h:'pendlng 
 upon the character of the disease. For the acconimodatiou of ihese the huge government 
 warehouse is utilized. IVIeanwhile, the vessel may be allowed to proceed to the city In 
 charge of an acclimated crew, or her cargo may be sent up on lighti'rs— at the discretion of 
 the (luarantiiie authorities. 
 
 There is one medic. il offleer on duty at the boarding station, one at the refuge station, 
 and two at the upper (luarantine— together with thi? ncjcessary guards, boatmc^n, .steve- 
 dores, nurses and other employes. All the stations are in telegraphic communication with 
 each other and with the offlcis of the State Board in New Orleans. 
 
 The following extracts from recent h.'tters of Dr. Holt, written me since my visit, suf- 
 ficiently explain the otlier details of the pre--ent quarantine administration for the protec- 
 tion of tlie (iulf gateway to the Mississippi valley. Improvements in minor points have 
 since been made, and others will undoubtedly follow as experience demands their neces- 
 sity. Under date of September 8th Dr. Holt writes: 
 
 Tlie system coinpreluuids two stations. Tlie Lower Station, for the reception of in- 
 fected vessels only, is situated at I'as a L'Outre, an unused outlet of the Mississipiii. The 
 isolation of this place is complete, while affording anclioi'age to vessels of any tonnage. 
 As soon as a vessel arrives in this station the side are removed to the hosplial, where every 
 provision is now made, for their proper entertainment anil treatment. I'reparati v to the 
 disinfection of a vessel, persons are removed ashore and detained there until tin-- process 
 is thoroughly accomplished. 
 
 Pending th(> construction of a receiving wharf and' warehouse, the freight, when the 
 requirements of disinfection make it necessary, is discliarged into barge.'", and (>very part 
 of the vessel is then subjected to thorough treatment. This nonsists in cleansing of the 
 bilge, and flooding it with bichloride of mercury in solution, (me part to one thousand of 
 wat(>r. All surfaces within the holder below decks are freely wetted with the same solution 
 arplieJ as a spray from a large watering rose, similar to those used in garden watering- 
 pot-, supplied through a two- inch hose, from an elevated tank on the wharf, or from a tank 
 by means of a powerful hand-puinp aboard the quarantine tug-boat. The freight in the 
 liai-fje or after its return aboard ship, is subjected to the protracted action of concentrated 
 sulphurous-acid gas. 
 
 This is applied in the following manner: Aboard the tug there is a compact battery of 
 twelve furnaces for the rapid combustion of sulphur in large (luantity. The lui'naces 
 measure each 3 feet 6 inches in length by 12 inches broad and 7 incln^s in height, and (con- 
 tain, each, a cast-iron pan 3 feet long, 1 foot wide and 2 inches deep. Tliese furnaces open 
 into a large res(.'rvoir, to wluch is connected a driving or exhaust fan capable of displacing 
 about six thousand cubic feet of air per minute. It is driven by an engine wliicli derives 
 its steam from tlie tug boilers. The sulphurous fumes are conveyed to the close barge or 
 into the liold of a ship through a tube of galvanized Iron, jointed in tlie manner of a stove 
 pipe, twelve inches in diameter, end of a length necessary to reach any part of the ship 
 roii'iired. We liav(! now substituttdfor this a hose of asbestos cloth. The V(!ssel is detained 
 at this station until there is every i.ssurance of her being no longer infected. 
 
 Th(^ Upper Quarantine Station, situated on tiie left bank of the Mississippi, thirty 
 miles above itti outlets, is the regular station at which all v(!ssels en route t(j the city are 
 required to stop and undcj'go inspe3ti(m. Tliose hailing from inter-tropical, American and 
 ^"cst Indian ports, and from all the ports of France, and from the Mediterranean, are 
 subjected to the process of disinfection with the mercuric solution and the sulphurous 
 fumes described. Evu-y article of ship's bedding, etc., sailor's luggage, clothing and bag- 
 gage of ollieers and passengers is taken asliore, where, on the wharf, it is wetted with the 
 disinfectant solution. 
 
 Not having as yet satisfactorily completed our drying chambers this part of the pro- 
 cess is still inconvenient. It is desirable that all of these articles should be dried out and 
 
•28 
 
 .■:-^. 
 
 ''j'\'? ■:■■ 
 
 rotiirned abonrd ship (13 early as posslblo. In tli<^ meantime the vosscl has been troatod 
 by the tli?infe<-tant AvettinK in every rmt iird every particle of the atnipsphere heretofore 
 contained in her has been displu-ed by the sulphurous acid nas. 
 
 Vessels, to^Jtethor with thtiir cargoes, ofTleers, passengers and crew, coming from ports 
 infected with yellow fever, are compelled to remain in (iiuirantine a period of live days 
 from moment of arrival, for ol)servation, in order to ylve a reasonable assurance against 
 the presence of the disease In its incubatory stages. 
 
 "The entire treatment of a vessel to prevent the introduction of cholera, yellow fever 
 or small-pox is so exacting and so rigorous as to occasion no little grumbling on the part 
 of those who must undisrgo it. This is particularly the case with officers and others 
 aboard Mexican, Spanish and Italian vessels. Th >se persons resent any effort at sanitary 
 treatment a^ a personal affront whilo, In fact, they most require it. They are utterly with- 
 out feeling and imlifferent as to whether they convey to our port cliolera, yellow fever or 
 the plague. The Americans, English, French and Germans are reasonable in this matter. 
 I mentidu this as a simple matter of experience in regard to nationalities, as wo have to 
 deal with them in auarantine. 
 
 "Our quarantine methods represent the introduction of a system of maritime sanita- 
 tion which has already suggested many particulars of improvement and has opened to 
 our view a broad field of sanitary enterprise far wider in its possibilities of good— first in 
 giving the highest attainable quarantine against the introduction of pestilential diseases, 
 and. Secondly, in removing foolish and untrustworthy restriction, destructive of inter- 
 national commerce and travel. We have demonstrated by practical experience that tho 
 entire plan of treating ships in (inanintine. or maritime sanitation, can be operated at a 
 vary moderate cost in ports doing a small business in shipping." 
 
 Tho following passages from the letter referred to are of special interest: 
 
 In using the bi-chlorlde of mercury, wei know that %ve have one of the most powerful 
 of all tho germicidal agents. Practical test in municipal disiniection and in quarantine has 
 demonstrated its absolute freedom from injury to those having to do with it. In the opera- 
 tion of maritime sanitation, our employes have been wet with the solution from head to 
 heels and for hours at a time, without having as yet shown the slightest evidence of mer- 
 eurlalization. Tlie clothing and other baggage of passengers and crew have been soaked 
 in it witliout the slightest injury to persons or fabrics. Injury to the latter has always 
 been due to the water and not to tho chemical. The tlecks, calkins, bunks and every avail- 
 able part of the vessels have been freely drenched with the solution without injury. 
 
 Tlie sulphurous-acid gas, used as the displacing agent of the atmosphere below deck, 
 has long sim-e proved itself the most i-eliable gaseous disinfectant and the least injurious 
 to cargo of any yet tried. As applied in our (luarantine, it is like turning loose a volcano 
 Into the hold of a ship. 'J'he amount of sulphur used on any one vessel varies from one 
 hundred and fifty to nearly three hundred pounds, so applied as to displace with immense 
 force every particle of air contained in the bilge, betwei^n the planking, or skin, and ceil- 
 ing, in all parts of the cargo and dunnage. So searching are these fumes under the 
 operation ot the law of the diffusion ;of gases, favored by high pressure and rapid motion 
 of currents, that a bowl of rain water, buried in the heart of a cargo of colTee, seventy-five 
 feet distant from thi' conveying hose, was found distinctly impregnated with sulphurous 
 acid. 'I'lie effect upon tht- coffee itself, w'len dry and in good condition, was not obser' 
 vable. By getting the hose well into the duiuuige, we can now treat a cargo of coffee with 
 a thorcngliness never before contemphited, and without the extra expense to shippers or 
 consignees of a dollar, as against from five hundred to eighteen hundred dollars in times 
 past, when iiuarantine treatment involved discharging and reloading cargo, and the em- 
 ployment of a great gang of stevedores, barges, tugs, etc., and even then the disinfection 
 was utterly worthless, as proven by the suljsequent appearance of yellow feveron the ship 
 in port. If recent observations on the destructive influenci! of mineral acids, even greatly 
 diluted, on the cholera virus arc true, then we have in this agent the most efficient adjunct 
 to the mercuric solution. 
 
 As an Instance of unexpected difficulties met with in practice, the amalgamating 
 powers of the mercury salt on pumps, llttiuKs of hose, nozzles, spray roses, etc., presented 
 
29 
 
 1 been troatod 
 ere heretofore 
 
 iig from ports 
 (1 of five dnys 
 irance HBtiinst 
 
 I, yellow fevt'r 
 i«on tlie part 
 rs and others 
 art at sanitary 
 3 utterly with- 
 ellow fever or 
 a this matter, 
 as we have to 
 
 'itimo sanita- 
 las opened to 
 good— first in 
 itial diseases, 
 jtivc of inter- 
 lence that the 
 operat('d at a 
 
 nost powerful 
 uarantine has 
 In the opor'i- 
 from liead to 
 denco of mer- 
 > been soaked 
 !r has always 
 d every avail- 
 injury, 
 below deck, 
 east injurious 
 )se a volcano 
 ries from one 
 vith immense 
 kin, and ceil- 
 cs under the 
 rapid motion 
 seventy-five 
 h sulphurous 
 as not obser" 
 of coffee with 
 shipp(M-s or 
 iirs in times 
 and the em- 
 (lisjnfection 
 noQ the ship 
 even yreatly 
 cient adjunct 
 
 malgamatlntr 
 tc, presented 
 
 for awhile a most formidable difficulty, finally overcome in a simple and economical way. 
 The rapidly destructive effect of the hcMited sulphurous-acid gas upon all flexible hose of 
 organic composition, «;ompellod us to adopt the galvanized iron tubing, heavy and exces- 
 sively awkward in use. This I have completely ovtTCome by having had manufactured a 
 closo-wovon, twilled or corduroyed asbestos cloth. While a perfect noni-conductor of 
 heat, this material is abundantly light, and is proof against acids or heat. 
 
 Under date of November 11, 1885, Dr. Holt writes: "In reply to your letter No. W,i I 
 have the honor to state that we are maintaining a careful guard in the inspection of all 
 vessels from Mediterranean ports. The process of bichloride disinfection is enforced, 
 however perfect the health record and clean the bill of health, including a careful attention 
 to bilge. The only modification in the full force of treatment is the omission of the atmos- 
 pheric displacement by the sulphurous blast. This feature of our system was discontinued 
 November 1, the end of our regular (luarautine season. 
 
 "We are rapidly.constructing an Immense heating chamber, supplied with a double 
 steam coil from a twenty horse-power boiler. The builders (Chicago) insure the easy and 
 speedy attainment of 250° F. This will bo used in addition to the bi-chloride mercury 
 wetting. Any vessel not giving proof of continued good health or, in other words, show- 
 ing any ground for suspicion, will be remanded to the lower station, where she will be 
 subjected to prolonged and vigorous treatment. 
 
 "The new system has paid out of itself every dollar of running expenses. We will open 
 it in perfect working order as lo every detail early.ln May next. We are fully Impressed 
 with the necessity of maintaining vigilance in regard to.eholera."* 
 
 Texas: 
 
 Tue quarantine system of Texas covers a coast line of some 500 miles, extending from 
 the mouth of the Sabine at the Louisiana boundary to the mouth of the Rio Grande. Upon 
 the recommendation of Dr. B. M. Swearingen, the State Health Officer, the law has 
 recently been changed so as to relieve local boards of health of the responsibilities of this 
 coast quarantine, and the Governor is authorized to appoint State quarantine officers, and 
 has sole control of them in the enforcement of the quaiantine laws. This change was in- 
 augurated in the spring of 1883, and stations have since been established and equipped at 
 the six ports of entry, as follows: 
 
 At Brazos de Santiago, near the mouth of the Rio Grande, and covering the port of 
 Brownsville, the commercial gateway to the lower valley. 
 
 At Aransas Pass, covering the gulf entrance to Corpus Christi bay. 
 
 At Pass Cavallo, the entrance to Indianola. 
 
 At Velasco, at the mouth of the Brazos river. 
 
 On the east end of Galveston island, for the port of Galveston. 
 
 At Sabine Pass, the terminus of the Texas Trunk railway. 
 
 Of these stations, that at Galveston is by far the most important, and its quarantine 
 equipment is described by Dr. Swearingen as consisting of a steam tug fitted up with hot-air 
 chambers and modern appliances for the disinfection of a vessel and cargo; a disinfecting 
 war-'iouse with a capacity for treating 4,U00 sacks of coffee at one time; and a station 
 house-the whole plant representing an outlay of about $55,000. 
 
 The station is on the east end of the island, about two miles from the city. Vessels 
 from suspected ports are inspected beyond the bar, ten or twelve miles soutliea&t of the 
 station, and are detained there, If considered dangerous, until the exact facta are deter- 
 mined. If actually infected, they are not permitted to cross the bar, but are ordered to the 
 Ship Island refuge station. If from an infected or interdicted port, a quarantine of deten- 
 tion of twenty days is rigorously enforced, during wliich period the cargo may be removed 
 by lighters to the disinfecting warehouse, and the vessel be suitably treated. From May 1 
 to the close of the quarantine season in November, 1884, 939 vessels were Inspected at this 
 station, and 17 of these were subjected to the 20 days' detention. All vessels are Inspected 
 coming from south of 25° north latitude, and the enforcement of the regulations results In 
 a practical exclusion of vessels from Mexican, Cuban and Brazilian ports during the sum- 
 mer and fall. 
 
 * Cholera was Introduced into this country through this port In December, 1848, and 
 Jn February, 1873. 
 
m> '■■ ^i ■■■ ■ 
 
 iili: 
 mm- 
 
 
 •f* 
 
 IB^ 
 
 
 pP' 
 
 > "■ ■. 
 
 ''n;^-'' J 
 
 ■■■ ' 
 
 30 
 
 Yellow fever in the disease most dreaded, and the quarantine system has been framed 
 Hnd heretofore admlnlstored with reference to Its exclusion. The Mexican authorities 
 have cooperated by establishing a auariintino at Bagdad in aid of the station at Bruzos 
 Santiago covonng the lower mouth of tlie Bio Grande, and have adopted the same rules 
 and rogulations as those enforced at the Texas ports. 
 
 An in^poction of transatlantic steamers with reference to cholera Is now maintained 
 at the six Texas stations and will be continued throuuhoutthe winter. As late as November 
 lOlh of this year there were several steamers from chol'era-infected ports on the Mediter- 
 ranean detained in (lUrtrautlno oil' Galveston. The vessels are not allowed to come to the 
 wharf, but; are unloaded and loaded again by lighters. 
 
 A communication from State Health Officer Bwearingen to the Governor ot the State, 
 <'ommenting upon the efforts to e.Uablish an international quarantine, incidentally but 
 fully sets forth the principles upon which the Texas (luarantlne system is based. 
 
 "Another very material variance between the autliorities of the State and those of 
 Mexico, is the length of time thought to be necessary for \ nssels from infected places, or 
 places liable to infection, to remain in quarantine before granting them free pruticiue. 
 The Mexican Congress of Hygiene limits the period tdtendays, for what they are pleased 
 to designate 'the rigorous quarantine,' while in Texas twenty diiv-* is the universal rule. 
 
 "If wo had disinfecting wareliouses at every port of entry, and stoam tugs supplied 
 with powerful exhaust fans that could drive out the impure air from the holds of ships, 
 anti immediately after forpe into every noolc and crevlco germicidal gases, the ton days' 
 period ot detention would probably be sufll'^lent: but without these appliances of purih- 
 cation, a longer time nnqucstior.:ii)ly gives greater security. 
 
 "In making the above declaration, I do not lose 'ght of the fact that an infected ves- 
 sel, without treatment of any kind, at the end of twenty, thirty or even sixty days qimr- 
 antine, is possibly more dangerous than on the ilrst day of arrival. Tiie history of yellow 
 fever gives abimdant evidence that thei poison does not retain its infectious quality for a 
 long period when exposed to pure air, and that its proliferous properties are lost. The 
 reverse is equally true. In warm, moist, impure air, its 4nfectious quality seems to have no 
 limitation, and of course such condition must favor its multiplication. With these facts 
 conceded, the corollary is unavoidable, that the number of germs will Increase when 
 left undisturbed in the hold of a vessel, where all these favorable conditions are found. 
 Without a warehouse for transferring goods, we cannot, in ten days, by opening every 
 aperture for ventilation, by shifting cargo, pumping out bilge water, and the free use of 
 germicidal gases, so disturb the condition of things as to pronounce the ship, crew and 
 cargo innocuous. 
 
 "Again, all persons are not equally susceptible to the poison of yellow fever, and the 
 period of incubation does not usually commence the first day of exposure. If such was 
 not the case every unacclimated person in an infected city would be down about the same 
 time, and epidemics would be confined to a few days, instead of a few weoka. Assum- 
 ing, then, that the cargo of a ship is infected, and that it will take ten days for the crew 
 to discharge it, the probabilities are that with the majority of them the period of incuba- 
 tion would commence on the eighth, ninth or tenth day, instead of the first, second or 
 third day, after the work of discharging had exposed them to infection. It follows, then, 
 that a ten days' quarantine, when each day brings additional exposure to those who must 
 handle the infected goods, offers every opportunity for the germs of yellow fever to be 
 inoculated before the period ot detention expires, and for the denouement to be made 
 afterwards. ♦ * * 
 
 "Twouty days quarantine for ships from interdicted places, ten for handling cargoes 
 and ton more to give time for incubation, h.is been the rule so long governing the ports o 
 Texas that it might be properly classed among the rinwritten laws of the State. It is a 
 conservative period, a kind of half way chronological station between the opponents of 
 quarantine on the one side, and the advocates of total non-intercourse on tho other. 
 Under that rule we have had no epidemic, nor have our commercial relations bison 
 seriously impaired by it. The guarantee given of freedom from infectious diseases more 
 lian compensates for tho losses sustained by a policy that must necessarily divert certain 
 currents of trade into other channels. 
 
 
31 
 
 1 has been framed 
 (lean niithorltles 
 station at Bruzos 
 5(1 the same ruloH 
 
 now maintained 
 
 late as November 
 
 ts on the Medlter- 
 
 ?ed to come to the 
 
 irnor ot the State, 
 , Incidentally but 
 is based. 
 
 3tato and those of 
 infected placoH, or 
 em free pratique, 
 it they are pleased 
 ho universal rule, 
 am tuRS supplied 
 he holds of ships, 
 ases, the ton days' 
 )pliauces of purih- 
 
 it an infected ves- 
 \ sixty days quar- 
 e history of yellow 
 itious riuallty for a 
 ties are lost. The 
 y seems to have no 
 
 With these facts 
 vlll increase when 
 
 tlons are found. 
 by opening every 
 
 d the free use of 
 he ship, crew and 
 
 low fever, and tho 
 
 sure. If such was 
 
 n about the same 
 
 w weeks. Assum- 
 
 days for the crew 
 
 period of Inouba- 
 
 he first, second or 
 
 It follows, then. 
 
 ;o those who must 
 
 ellow fever to be 
 
 iment to be made 
 
 "The people of T-xas. satisfied with tho systemunderwhichthey have prospered for so 
 
 niiiiiy years, will bo unwilling to take now d(^parturoH. until tho etioloKy of. yellow fever Is 
 more thoroughly comprohcnded, and science discovt-rs mort^Jpowerful agents for its de- 
 ^ti action than wo now possess. With duo deforoneo to the distinguNhod sanitarians who 
 .(inipos'e the (Jongress of Hygleno in our sister republic, we could not accept the ton days' 
 liiiiod of detention 'as a basi! for any agreement that might bo entered into."* * ♦ ♦ 
 
 Since the date of the letter from which the foregoing extracts are made (September, 
 iscl) the "applianci^s for puiillcatlon" have boon furnished at tho Galveston station. But 
 Dr. Swonrlng(!n romnrks in a recent letter to mc, "although wo have; (at Galveston) every 
 finiiity for inaugurating a quarantine more in hnrniony with th(! views of sanitarians, our 
 lirdple are not yet prepar<Hl for experiments." 
 
 .\.s to land qunrantlnos, Dr. Swoaiingen says: "Railways in Mexico make It possible 
 for persons, froiglit, etc.. to bo. transported from Vera Cruz to any city in Texas within five 
 (lays, via El Paso or Laredo. Quarantine stations for the first time wcire this year estab- 
 lislied nt thost! points. I have not attempted even an Inspection service against sniall-pox 
 ill Mexicf). It would be pui'ely ornamental it I did so. The Rio Grande is a shallow stream, 
 111(1 Iroin El Paso to Brownsville, by the river bed, is probably two thousand miles. 
 Siiiiij,'Kling is Ciirrled on extensively, and the United States Govorimient cannot prevent 
 it. A (luarantine ofllcer at any point, would only be a notice to these organized bands and 
 to ilie travelers of both republics, tliat they would hav(^ to cross the river higher up or 
 idwer down, 'only this imd nothing more.' 
 
 "lean enforce with some reason an embargo against persons from Vera Cruz when 
 yilidw fever prevails there, for that city is the only nidus of infection, but when small-pox 
 is all over the country, the extreme folly of such a thing as an inspection at railway cross- 
 ing's, is too apparent to lie discussed." * 
 
 Should cholera be introduced into Mexico and becomes (U)idemic there, the same condi- 
 tions woidd then obtain with reference to the oxelusion of that contagion. Dr. Swoarlngen. 
 ailils, however, that Texas "will cooperate with the authorities of, other Stat(!s, in any dc- 
 finsivo action against cholera Importation that may be indicated by tlie American Public 
 Ilialth As.soclation." 
 
 National Refuge Stations: 
 
 Theie still remains to notice th(! Refuge Stations in Sapelo Sound— off the coast of 
 (leorgla— and on Ship Island in Mississippi sound. These were originally projected by 
 tliu National Board of Health as part of a system intended for the protection of the minor 
 ports, by providing fully-equipped establishments for the care and treatment of infected 
 vessels. Only the Ship Island t-tation was completed on an adequate scale, and its chief 
 importance as a safeguard to the Mississippi river and the port of New Orleans has been 
 IniKely superseded by the estp,bhshment of a refuge station in Pas nL'Outre by the Louis- 
 iiuia State Board of Health. , 
 
 Thesi^'.stallons, Sapelo Sound and Ship Island, are now In charge of the Marine Hospital 
 s iivico, together with those in Hampton Roads and at the Delaware Breakwater, already 
 dosi'ribcd. . 
 
 
 handling cargoes 
 rnlng the ports o 
 the State. It Is a 
 
 the opponents of 
 irse on the other, 
 al relations been 
 JUS diseases more 
 rily divert certain