FEVER, YELLOW. 



321 



* First 31 day?, 

 t No further official notice was taken of the fever in 

 VOL. xviii. 21 A 



1853. 



4. The weight of testimony is very pronounced 

 against the further use of disinfectants. Physicians 

 in infected towns, almost without exception, state 

 that they are useless agents to arrest the spread of 

 yellow fever, while some of them affirm that their 

 vapors are seriously prejudicial to the sick. 



5. Personal prophylaxis by means of drugs, or 

 other therapeutic means, has proved a constant fail- 

 ure. A respectable number of physicians think the 

 use of small doses of quinine of some avail in pre- 

 vention. 



6. Quarantines, established with such a degree of 

 surveillance and rigor that absolute non-intercourse 

 is the result, have eifectually and without exception 

 protected those quarantines from attacks of yellow 

 fever. 



^ The sanitary engineer explained to the Asso- 

 ciation the peculiar topography of New Or- 

 leans. The city requires protection by levees 

 against the lake and the river. During Feb- 

 ruary, March, April, and May, it lies below the 

 level of the Mississippi. About one tenth of 

 its streets is paved. There is no underground 

 drainage. The drainage is wholly insufficient. 

 Water lies two feet below the soil, which is 

 thoroughly contaminated by uncemented and 

 unfloored vaults. Garbage is dumped into low 

 places. Cistern water is drunk. The supply 

 of water is wholly insufficient. It is in gen- 

 eral in bad sanitary condition. Whatever the 

 views of this Commission and each of them 

 in turn is denied by men of equal reputation 

 one thing is certain: the only factor in yellow 

 fever which is fully proved, and also in human 

 power to remove, is tilth. If the Commission, 

 in estimating the causes of epidemics, fail to 

 regard sanitary conditions, their labors are 

 futile. It is a well-known fact that epidemics 

 run their course in a period varying from 90 to 

 120 days ; that after hibernating they frequent- 

 ly resume their march at the exact line where 

 the disease ceased, and with the succeeding 

 season they go on relentlessly conquering and 

 to conquer. The most energetic sanitary re- 

 forms are a primary duty. The prevention of 

 a return of this scourge may depend as much 

 upon sanitary regulations as upon the establish- 

 ment of a rigorous yet evadable national quar- 

 antine. 



Mrs. Thompson, a lady of New York City, 

 was the first publicly to suggest a commission 

 to investigate the character of the disease in 

 New Orleans. She accompanied her sugges- 

 tion with an offer of five hundred dollars to- 

 ward defraying its expenses. Other sums were 

 afterward given. From the investigations of 

 the Commission thus originated came the above- 

 mentioned report to the Public Health Asso- 

 ciation at Richmond. Subsequently Congress 

 authorized a board of experts, who submitted 

 their report at the end of January, 1 879. They 

 hold that yellow fever is a specific disease, and 

 is produced by the introduction into the human 

 organism of a specific poison. This poison has 

 never been chemically or microscopically de- 

 monstrated, yet it is safe to assume that it is 

 material and particulate, and endowed with 

 the ordinary properties and subject to the or- 

 dinary laws of material substances. It is not 



