26o 



SCIENCE. 



[Vol. X. No. 251 



In discussing cliolera and its probable appearance in tlie Uniied 

 States, Dr. Sternberg said, — 



" It is perhaps too soon to speak with confidence with reference 

 to the action taken by the sanitary officials of the port of New York 

 upon the recent arrival of two cholera-infected vessels from the 

 Mediterranean ; but we have good reason to hope that the meas- 

 ures taken will prove sufficient, and that this pestilential disease, 

 which has for several years been threatening us from a distance, 

 has not effected a lodgement upon our shores. Whether it would 

 be practicable to put our seaports in ."iuch a state of sanitary defence 

 that it would be safe to open the door and defy the foe, is extremely 

 doubtful. I have never believed that yellow-fever was excluded 

 from New Orleans in 1S62 and 1863 by the sanitary regulations 

 enforced by General Butler, as has been claimed. The exemption 

 from this disease enjoyed by the unacclimated soldiers from the 

 North, who filled the hospitals in that city at the time mentioned, 

 was due, in my opinion, to the absence of commerce during the 

 military occupation of the city, and to the rigid enforcement of 

 quarantine restrictions. 



" But I do believe that this and other cities similarly located can 

 be preserved from such devastating epidemics as have too often oc- 

 curred in the past, and that, by the carrying-out of needed sanitary im- 

 provements and the constant supervision of expert sanitary officials, 

 supported by an enlightened public sentiment and sufficient appro- 

 priations, the ravages of pestilential diseases may be restricted 

 within very narrow limits. 



" As regards cholera, the system of local defence is even simpler 

 than in the case of yellow-fever. Ample evidence demonstrates 

 that the epidemic extension of this disease depends largely, if not 

 exclusively, upon the water-supply. Where this is subject to con- 

 tamination by the discharges of the sick, there cholera is liable to 

 become epidemic. On the other hand, cities like Rome, in Italy, 

 which have an ample supply of pure water, drawn from a source 

 not likely to be contaminated, seem to be cholera-proof, notwith- 

 standing the filth and squalor in which a considerable portion of the 

 population live. The same thing is seen in Naples, which in 1884 

 suffered terribly, but which, since the completion of its new system 

 of water-works in 1885, has enjoyed a comparative immunity, not- 

 withstanding the fact that cholera still prevails in Italy, and that we 

 have evidence of its presence in a malignant form in the city re- 

 ferred to. When I was in Naples, in 1885, the mayor of the city 

 invited a number of the delegates to the sanitary conference to the 

 municipal palace for the purpose of conferring with them with ref- 

 erence to projected sanitary improvements, and especially with 

 reference to the best system of sewerage for the city, which, up to 

 the present time, remains destitute of sewers, and which, I may add, 

 is a noted stronghold of typhoid-fever. In the course of the con- 

 versation, I suggested to the mavor Colonel Waring's American 

 system, which has been tested with such favorable results in this 

 city. iVIy recommendation was sustained by the distinguished 

 German^bacteriologist, Dr. Robert Koch, who was one of the dele- 

 gates present. I may remark that I have recently received a letter 

 from Dr. Koch, asking me to give him full particulars with refer- 

 ence to the details of this system as carried out in the city of Mem- 

 phis." 



In commenting upon quarantine as at present practised in this 

 country, the president said that he considered it a wrong principle 

 that commerce should be taxed for the support of quarantine 

 establishments. In his judgment, the people who are protected 

 should pay the cost of such protection. He was not so much con- 

 cerned with the unjust tax laid upon ship-owners as with the gross 

 injustice to passengers practised at many ports in various parts of 

 the world where they are so unfortunate as to be detained at a 

 quarantine station. He narrates the history of a case of this kind 

 which fell under his own observation. He says, " When I left 

 Brazil, in the month of August last, small-pox was epidemic both 

 in Rio de Janeiro and at Para. Our ship touched at Para, and five 

 days later at Barbadoes. A passenger for this port was not al- 

 lowed to land, because of the prevalence of small-pox in Brazil. 

 Proceeding to St. Thomas, less than two days' sail from Barbadoes, 

 our passenger was again refused permission to land, except to go to 

 the quarantine station for a certain number of days. This was all 

 right, but the conditions upon which he would be received seemed 



to me to be all wrong. Either he himself or the ship must guaran- 

 tee the payment of the quarantine fees, which would be three dol- 

 lars a day for his Ijoard, and five dollars a day to the quarantine 

 physician, if he were alone. If others were at the station at the 

 same time, this fee would be divided between them. One can easily 

 imagine what a hardship such a tax would be for a person of lim- 

 ited means, who had only provided himself with funds for the 

 journey he had undertaken. The agent of the ship refused to take 

 any responsibility, and our passenger had no resource but to sub- 

 mit to the imposition, or to come on to New York, paying his pas- 

 sage to that port." 



Another illustration of the evils arising from the present systen> 

 of supporting quarantine establishments was given by Dr. Sternberg, 

 in his address, as being his own experience when he recently arrived 

 at New York quarantine on his return from Brazil. " With the 

 deputy health-officer, who boarded our ship, came a man with a 

 jug. I was informed by one of the officers of the ship that he was 

 to disinfect the vessel. Being somewhat curious to know the 

 method of disinfection employed, I asked the ship's surgeon to go 

 with me to inspect, when, after a detention of less than one hour, 

 we had started from the quarantine station for our wharf. We 

 found that the man with the jug had lowered a bucket by means of 

 a rope through one of the hatches between decks. Upon pulling 

 up this bucket, I found that it contained two or three pounds of 

 some powder which had been wet, probably with acid solution, and 

 which gave off an odor of chlorine. No doubt, when first lowered 

 between decks, there had been a considerable evolution of chlorine ;: 

 but, in the vast space to be disinfected, it was so diluted that at 

 the end of an hour I did not detect the odor of chlorine-gas when I 

 lifted the hatch, and it was only by approaching my nose to the 

 bucket that I was able to ascertain what disinfectant had been used. 

 The most curious part of the story is, that I was informed that the 

 bucket had been lowered between decks to disinfect a quantity of 

 hides which were stored in the hold. What was the object of this 

 ' disinfection ' ? Evidently not to disinfect, for no one at the pres- 

 ent day would think of maintaining that the hides in the hold had 

 been disinfected by the procedure of the man with the jug. The 

 only object that I can conceive of depends upon the fact that there 

 is a fee for disinfecting, which must be paid by the agents of the 

 ship ; at least, I was so informed by one of the officers of the ship." 

 The president referred to the fact that while exotic pestilential 

 diseases, such as yellow-fever and cholera, were the levers which 

 move corporations to make necessary sanitary improvements, these 

 are, as compared with certain indigenous or naturalized infectious 

 diseases, of secondary importance. The chief aim of the American. 

 Public Health Association should be to ascertain what measures 

 are most effectual for the restoration of their endemic maladies, 

 such as typhoid-fever and the malarial fevers, and for the banish- 

 ment of all diseases in which the contagion is given off from the 

 persons of the sick, such as scarlet-fever and small-pox. So 

 far as the diseases of the class last mentioned are concerned, we 

 may safely say that we know how they may be banished from a 

 community ; viz., by isolation of the sick, and disinfection of all 

 infectious material, and, in the case of small-pox, by vaccination. 

 The mam mission of the sanitarian, therefore, is to insist upon the 

 thorough execution of these measures. 



Other topics dealt with in the address were the necessity for 

 instruction of the people in the principles of personal hygiene, in 

 which labor Mr. Henry Lomb of Rochester had borne so noble 

 and generous a part, by giving prizes for essays on the construc- 

 tion of the homes and the composition of the food of the working- 

 man; the erection of laboratories, such as that at Johns Hopkins 

 University, the Hoagland at Brooklyn, and others at New York. 

 Philadelphia, Boston, and Ann Arbor; the infectious diseases of 

 animals, — anthrax, swme-plague, hydrophobia, etc. With refer- 

 ence to the germ of cholera, Dr. Sternberg said, — 



" With reference to cholera, I may say to you that recent re- 

 searches give support to the conclusions of Koch as to the path- 

 ogenic role in this disease, of the spirillum discovered by him in 

 the intestines of cholera patients. Its constant presence in this 

 disease seems to be demonstrated, and it is now generally admitted 

 by bacteriologists that there are definite characters by which it 

 may be distinguished from similar organisms obtained from other 



