"As To Yellow Fever"

Transcript

Page 4/Column 1

That their system merits further considera-

tion at our hands. Up to this present time,

and this even in the Red Sea, which is looked

upon as the gateway by which cholera may

at any time enter Europe, the quarantine

stations are not even provided with the

common decencies of life.

“Since our system of medical inspection

came into operation it has gone hand-in-

hand with a steady sanitary progress far ex-

ceeding anything to be met with in those

European countries where the inhabitants

are led to believe that quarantine restric-

tions will be imposed for their protection in

times of danger; it has been accom-

panied by a great diminution of mor-

tality, and it has spared the inhabitants

of this country from an untold amount of

misery and destitution, which ‘is the more

burdensome because it follows in the track

of preventable disease and death.’ That our

system is complete we do not for a moment

pretend, and we would make no boast of

the fact that imported cholera has on each

occasion, for many years past, been at once

checked in this country; but we do hold

that the experience of the past few years has

once again indicated the uselessness of

quarantine and the great advantages of the

system we have substitute for it. Quaran-

tine has a blighting effect on sanitary pro-

gress; it leaves the people unprepared to

face a disease which disregards the antiquat-

ed barriers which nations have opposed to

its extension, and so it prepares the way for

panic. On the other hand, the steady pro-

gress of true measures of prevention tell us

to impart that feeling of confidence which is

of such value in the face of an impending

epidemic, and at the same time it promotes

the healthiness and well-being of the popu-

lation.”

In the same article the editor points out

that Spain, France, Italy and Algeria, rely-

ing on quarantine for protection, have suf-

fered from the ravages of cholera during the

European epidemic of 1884-87.

In the New York medical Record of the 29 th

ult. we find the following editorial article:

“ England’s commercial interests have al-

ways led her to doubt the need and distrust

the efficacy of quarantine. She has held

what she is pleased to consider the ‘common

sense view,’ viz: that , though theoretically

quarantine may succeed in keeping out

disease, practically, in any large count-

try, it amounts simply to an irrational

derangement of commerce. England

has long since, says the British Medical

Journal, discarded quarantine as a means of

preventing cholera, and now places her

trust in the security afforded by purity of

local surroundings – of soil, air and water

on land’ and a system of watchful medical

inspection at her seaports. The success of

this policy, continues our contemporary, has

been complete, and there are not wanting

indications that this success is exercising a

beneficial effect on public opinion abroad.

It is added that at the recent International

Hygienic Congress, at Vienna, opinion seemed

to be turning against quarantine. Italy and

Austria, in particular, are wavering in their

allegiance to the older methods.”

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If, then, a quarantine of detention for

Cholera has proven to be useless, it is cer-

tainly much more senseless for the preven-

tion of yellow fever. And on this point –

the detention of persons – let us quote some

of our latest text books on the practice of

medicine.

Flint, in his edition of 1884, page 1026,

says:

“Measures for the prevention of yellow

fever relate, 1 st, to the removal of local con-

ditions which favor the multiplication of

the disease-germs, 2d, to quarantine regula-

tions, and 3d, to disinfection. The first of

these three divisions embrace all that per-

tains to public and private hygiene. The

local conditions especially important as

auxiliary causes are unknown, and, there-

fore it can only be hoped that they will be

reached by rendering sanitary measures as

complete as practicable. But, be these

measures never so complete, they do not

make superfluous those of quarantine and

disinfection. The object of quarantine reg-

ulations is that the disease-germs shall not

be imported. To effect this object, either

there must be non-intercourse with places in

which the disease prevails, or all articles of

merchandise, clothing, etc., brought there-

from must be thoroughly disinfected. To

be efficient, quarantine regulations must in-

clued, not only vessels from infected ports,

but inland transportation by railroads and

other conveyances. There is no danger of

the disease being carried by the living body

after disinfection of the wearing apparel,

nor by the bodies of the dead. Detention of

the well or the sick is, therefore, a needless pre-

caution, except to prevent groundless popu-

lar apprehension. (Italics mine.) If impor-

tation of germs have taken place, the houses

with their surroundings in which cases

occur, should be instantly and completely

disinfected. The object now is to ‘stamp

out’ the disease. There is ground for the

belief that this object may be effected if

measures of disinfection be promptly and

thoroughly carried out.

“During the prevalence of an epidemic,

unacclimated persons should avoid going

within the infected areas, except under a

sense of duty, and they who are already with-

in the areas should leave it, unless there are

motives fro remaining which render the

risk of life justifiable and praiseworthy.”

Bartholow in his work on practice, says:
“A germ or germs are introduced. Ac-

cumulated filth, decomposing animal or

vegetable matters, bad or no drainage,

crowding and other hygienic evils are in-

dispensable to impart the necessary vitality.

Lodging thus in a suitable soil and with the

appropriate atmospherical conditions present

the disease grow and infect those in

the proper personal state to receive the

poison. * * * * * * * * * * * * * * * *

It is not by personal contact that the dis-

ease is communicated – in other words, it is

not a contagious, but an infectious disease,

and it is not against individuals that

quarantine restrictions should be enforced,

but against articles of clothing, bedding or

the like or against all fomites.”

Again, in the Lamb Prize Essay, for the

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