178 PHARMACEUTICAL BACTERIOLOGY. 



ment of the quarantine regulations is under the direction of the Public 

 Health- and Marine Hospital Service. The most important quarantine 

 stations in the United States are at San Francisco, New Orleans, New York 

 and Boston, ranking in importance in the order named. The Station at 

 San Francisco is of special irriportance because upon its ef&ciency depends 

 very largely the exclusion of plague, cholera and small-pox, the three highly 

 communicable diseases so prevalent in the Orient. Of course a national 

 quarantine to be effective must be complete, covering every port of entry, 

 whether large or small, maritime or inland. This is very often not the case 

 and as a result an epidemic may enter via a minor port where the service is 

 inadequate due to incompetent or insufficient inspection. 



The quarantine officers are kept informed as to the occurrence of epi- 

 demics or sporadic cases of quarantinable diseases in foreign countries 

 and port cities thus putting them on their guard as to the need of special 

 vigilance regarding imports and immigration from such places or cities. 

 However every ship from a foreign port on arriving within the quarantine 

 zone of the station is visited by the boarding officer who immediately proceeds 

 to get data regarding the sanitary conditions on board, as to deaths, sick- 

 ness of any kind, etc. All passengers, including the ship's crew, are lined 

 up and inspected by the boarding officer. If nothing untoward is reported 

 or detected the captain of the ship is given a clean bill of health and the 

 vessel is permitted to dock and discharge passengers and cargo. 



If however the boarding officer finds a case of small-pox or other quaran- 

 tinable disease on board, the ship is anchored near the station; the passengers 

 and crew are landed at the quarantine station and, with the aid of the ship's 

 officers, the quarantine officer proceeds to disinfect all persons and their 

 personal effects, the same class distinction (first cabin, second cabin, steerage, 

 ship's crew) being maintained as on ship. Each day, as long as the quar- 

 antine lasts, all persons are examined by the chief officer of the station, to 

 note, if possible the first manifestations of new cases. Jugt as soon as a 

 new case is found the patient is at once taken care of in an isolated hospital. 

 Suspects are kept under observation in an isolated camp. 



All personal effects, including every bit of clothing worn, is disinfected 

 in enormous double walled cylinders, by means of hot formalin laden steam 

 under pressure. Sterilization is made absolutely complete without any 

 injury to the clothing. 



The ship with its cargo is next disinfected with sulphur dioxide gas 

 generated in iron pots or paUs placed upon sheets of tin. A little alcohol 

 is poured over the sulphur, ignited, the exits closed down and kept closed 

 for twelve hours. If the cargo contains combustible material as alcohol, oil, 

 of health: Scarlet fever (including scarletina and scarlet rash), diphtheria (including 

 membranous croup), small-pox, epidemic cerebro-spinal meningitis, anterior poliomyelitis, 

 leprosy, and bubonic plague. 



