"As To Yellow Fever"

Transcript

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doubtless the confederates of the smugglers

and receivers of the goods. This was evi-

dently the avenue by which the fever was

introduced in the character of fomites, as I

expect to be able to conclusively prove at

the proper time. The sanitary condition of

the city afforded a suitable soil for the lodge-

ment and propagation of the infectious

poison, and the result the world knows. It

is true that the city authorities disregarded

my warnings as to the neglected sanitary

condition of the city, and seemed to be in-

spired with a spirit of antagonism to me per-

sonally. Why this was so I leave to them to

explain if they can; and if the result has

been pleasing to them and the people of

Tampa, they are welcome to all the enjoy-

ment it affords.

I was absent from Tampa from the 2d to

the 25 th of September, and, from what has

since come to my knowledge. I presume

the first cases must have made their appear-

ance about the middle of September – in res-

idents and not in persons who had come

from either Key West or Havana. How-

ever, I was home but a few days before my

suspicions were aroused as to the presence of

yellow fever in the city, but these were not

confirmed till the first of the following

week, October 3d and 4 th. On the 22 nd of

September a case was reported, but the

physicians who saw it denied its being yel-

low fever. This was three days before my

return. I know now that if I had seen cer-

tain cases to which my attention was called

on the day I announced its presence to

the public, I should have been able to de-

clare its presence at least six days earlier

than I did.

However, the diagnosis of yellow fever is

not the easy thing that some suppose, nor

does a post mortem always demonstrate

the true character of the disease, as some doc-

tors believe. In 1870 the disease prevailed

on Governor’s Island a month before it was

recognized even by the Health Board of
New York who stated that “post mortem

examinations upon the bodies gave satisfac-

tory evidence that the disease was not yellow

fever.” But it was proved to be yellow fever

when seen by a medical man familiar with the

disease. There were 159 cases with 52 deaths.

But yet a whole month passed before the

true character of the disease was recognized

on an island in New York Harbor within

rifle shot of Castle Garden. Strange to say

there were a few cases in the city, but the

epidemic on the island did not extend to the

city. (N.Y. Medical Record for 1870 and

1871.) “The late Dr. Warren Stone, of New

Orleans, very justly remarked that when he

had seen one epidemic of yellow fever he

thought he knew all about it, but after see-

ing twenty epidemics he discovered that he

knew nothing about it.” Such was the lan-

guage of the late Dr. J.C. Nott, who gave it

as an illustration of how little really was

known of the disease by those who had had a

life-time opportunity, as it were, to study it.

The mortality here has been about 17 per

cent , among the whites, and hardly one per

cent, amount the blacks. There have been

up to date, 26 th of November, 72 deaths from

the fever, only 2 o which were colored –

one mulatto and one full blooded African.

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The exact number of cases in Tampa and

vicinity is not known, as all were not re-

ported, and some were so mild as not to re-

quire the services of a physician; but I

should estimate the number at about 400

whites and possibly 200 negroes. Among

the latter the cases were, as a rule, of mild

type. Not an old resident who had had the

fever in previous epidemic in Tampa, had

it this time; nor did any one suffer from a

second attack during the epidemic. The

whole adult Cuban population was acclimate-

ed and escaped. Nor does this immunity

conferred by one attack of the disease, de-

pend on the severity of the attack – a mild

attack being as protective as a severe one.

With children it is generally mild – the

younger the child the milder the fever – so

that is a great mistake to remove small

children beyond the infection if it is expect-

ed the place where it is epidemic or any oth-

er Southern city, is to be their homes, i.e.,

provided the parents are acclimated so as to

run no risk themselves.

There is another prevalent idea, enter-

tained, too, by some very competent men,

the erroneousness of which I desire to point

out; and that is in case of an epidemic appear-

ing in a city, all that is necessary is to re-

move the unacclimated into camps some dis-

tance in the country. This is impracticable

in the first place, because of the lack of con-

veniences in the shape of houses or even

tents for the protection of the people from

the inclemencies of the weather, and in the

second place, even if such camp was estab-

lished, communication with the infected

place for some time at least, would from the

very nature of things, be kept up, so that

the infection would be sure to invade the

camp before arrangements for getting sup-

plies and other necessaries from uninfected

places could be made. In this way the fever

was carried out into families several miles

from here into the country during the pres-

ent epidemic. According to Dr. J. C. Nott,

who moved his family from Mobile into the

piney woods seven miles from the city, in

1856, even before the fever reached Mobile

from New Orleans, the fever followed his

family out of the city and he lost four of his

children. (N. Y. Medical Record, 1871.)

But there are other things which render

this camp business wholly impractical:

1 st, getting the people to leave their homes

when there are so many medical ignora-

muses and wiseacres who will sear to the

last that it is not yellow fever; and 2d, the

impossibility of keeping hem there if they

should feel disposed to have communication

with the infected area. It is very easy for

theorists and inexperienced people to say

what ought or should be done, but carry-

ing out their suggestions is altogether a very

different thing, unless one was an autocrat

with a standing army toe execute his orders.

It is one thing to preach, and another to

practice. And it is for this reason that a

State Board of Health would be as literally

helpless in controlling the spread of an epi-

demic as any other authority now existing.

The success of the National Board in 1879

was not encouraging and proved a failure.

John P. Wall, M.D.

November 28th.

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