EPIDEMIC DISEASES IN" 1883. 



319 



Government in 1873 for the purpose of inves- 

 tigating the causes of cholera, and their report 

 was made early in 1883. Prof. Hirsch, of the 

 commission, announced his adherence to the 

 doctrine that "from the cholera-patient an in- 

 fectious substance is actually thrown off, which, 

 however, is not yet capable of acting directly 

 as a cholera-poison, but only obtains its spe- 

 cific infecting influence after it has undergone 

 a certain change, outside the system of the 

 patient himself, and under the afore-men- 

 tioned external circumstances, either upon or 

 in the soil or a succedaneum of the soil." 



Prof. Pettenkofer announced as his opinion, 

 that "the reproduction of the cholera-poison 

 takes place quite independently of the cholera- 

 stricken individual (as such), seeing that it 

 may attach itself to persons, sick or well, or to 

 other objects, through the instrumentality of 

 which it may be carried from place to place, 

 and wherever it finds appropriate conditions 

 for its reproduction it may light up an epi- 

 demic." The recommendations of this com- 

 mission for the prevention of the disease are 

 as follow : 



Of all the measures which may be applied to the 

 prevention and combating of cholera, those take the 

 first place which have for their aim the improvement 

 of general sanitary conditions ; all specific measures 

 against cholera will prove unavailing unless we pay 

 the strictest attention in inhabited places to the puri- 

 fying of the soil from organic and easily putrefying 

 refuse, to the drainage of the soil, to the constant 

 flushing of the sewers, to the frequent emptying of 

 cess-pits, to the careful inspection of dwellings and 

 closing those that are really hurtful, the provision of 

 pure water both for drinking and other domestic pur- 

 poses, and the like. 



Yellow fever prevailed during the year in 

 its native home on the island of Cuba; on 

 the Mexican shores of the Gulf; in a less 

 degree in Brazil, and to a very serious extent 

 on the western shores of Mexico. There is 

 always danger to the Gulf-ports of the United 

 States from" the admission of yellow fever from 

 Havana, Cuba, and from Rio de Janeiro, but 

 this year it was threatened from a city where 

 the shipping has hitherto been measurably ex- 

 empt Vera Cruz, Mexico. No other city on 

 the Gulf-coast of Mexico suffered severely from 

 yellow fever, but on the west coast the disease 

 appeared with unusual virulence. 



Vera Cruz, like Havana, has cases of yellow 

 fever the year round. The following table of 

 mortality from yellow fever, at the Hospital de 

 Sebastian, was compiled by Assistant Surgeon 

 Guit6ras, of the Marine-Hospital Service : 



Speaking of the endemic character of the 

 yellow fever at Vera Cruz, a local tradition has 

 it (Padre Alegre) that yellow fever was in- 

 troduced there in 1699, by an English ship, 

 which arrived with a cargo of negro slaves 

 from the west coast of Africa ; but there does 

 not appear to be much contemporaneous his- 

 torical evidence to support the tradition. Yel- 

 low fever appeared on the west coast of Mex- 

 ico, principally in the cities on the coast bor- 

 dering on the Gulf of California. The disease 

 appeared at Mazatlan early in September, and 

 is now believed to have been introduced by a 

 vessel from Panama. It spread rapidly to 

 Guaymas, Hermosillo, and Manzanillo. The city 

 of Acapulco inaugurated a rigid quarantine 

 against vessels from the other western coast 

 ports, and escaped the infection. La Paz, in 

 Lower California, Mexico, was also infected 

 with the fever, which reached the highest pitch 

 of malignancy in September, and deaths in that 

 town reached 114. The acting United States 

 consul at La Paz, Mr. Viosca, was himself af- 

 fected with the disease, as was also Mr. Willard, 

 United States consul at Guaymas. Mr. Wil- 

 lard estimates that only about 200 persons died 

 at Guaymas of yellow fever, out of 3,500 at- 

 tacked. He estimated that in the capital of 

 the State (Hermosillo), over 2,000 persons were 

 sick from the disease at one time. The effect 

 of this scourge on those towns was to paralyze 

 all business and create a general panic in the 

 interior. As usual, on its first appearance, 

 there was much discrepancy of opinion as to 

 whether the disease vvas really yellow fever, 

 or simply the ordinary coast bilious fever; 

 but as the epidemic progressed, it became im- 

 possible either to conceal the fact that yellow 

 fever was present, or to deny it so effectually 

 as to prevent adjacent towns from quaran- 

 tining against them. The American steamer 

 Newbern, which left Guaymas on the 19th of 

 September, arrived in San Francisco on the 

 29th, with five of her crew sick with yellow 

 fever. Fortunately, the disease was not com- 

 municated to the city. The United States 

 Government took early precautions against the 

 admission of yellow fever by keeping inspect- 

 ors at Havana and Vera Cruz to report by tele- 

 graph the departure of infected ships. In- 

 spectors were stationed in Arizona at Fort 

 Yuma and Benson, to prevent the entrance of 

 persons sick with yellow fever, or of infected 

 baggage from the Mexican cities. An inspector 

 was also stationed at Brownsville, Texas, for the 

 same purpose. The Government maintained a 

 quarantine at Ship Island, in the Gulf of Mexi- 

 co; a quarantine at Pensacola; Sapelo Sound, 

 on the Atlantic coast, and near Cape Charles 

 in Chesapeake Bay. The Icrcal authorities of 

 the United States ports maintained their quar- 

 antines as usual. The Revenue Cutter Service 

 was instructed to patrol the Gulf-coast for the 

 purpose of inspecting vessels, and to forbid the 

 entrance into any port of persons infected, or 

 of vessels having infected cargoes, and to order 



