24 



SCIENCE. 



[Vol. VI., No. 127. 



But what, then, is quarantine as understood 

 in this country? Is it mere blind repression, 

 established through the instinct of fear, and 

 calculated to obstruct all intercourse among 

 nations, both personal and commercial ? Deal- 

 ing with intangible agencies, is it equally vague 

 in its principles of repression? The term is 

 an unfortunate one ; for it naturally carries us 

 back to the derivation of the word, with all its 

 inconveniences and sufferings of detention, its 

 useless and blind precautions, its superstitions 

 and silly forms as practised for centuries in 

 the south of Europe, and as enforced in Spain 

 and Ital}^ even during the past j^ear. It has 

 no such meaning to-day, but comprises the 

 whole series of measures, h3'gienic as well as 

 restrictive, emploj^ed to contravene the incur- 

 sion of an epidemic. These are not limited to 

 those taken at the port of arrival of a vessel, 

 but include those which in my judgment are 

 far more important, — the inspection of pas- 

 sengers and luggage before embarkation, the 

 S3'Stematic inspection of passengers in transit, 

 and, finall}^ their observation and inspection 

 on arrival at port. The underlying principles 

 upon which its workings are based, are the 

 modes of transmission, and the period of in- 

 cubation of the disease to be contravened. In- 

 telligent quarantine, while working on these 

 principles, will var}' the details according to 

 the localit}^ to be protected, and the particular 

 disease to be excluded. The series of measures 

 necessary to repress cholera would in no wa}^ be 

 applicable to the exclusion of 3^ellow-fever, for 

 they are transmitted by wholl}^ different agen- 

 cies. Cholera, while the most pandemic of all 

 epidemics, is also among the most contagious, 

 or, rather, secondar}^ influences enlarge widel}' 

 the sphere of the contagious influence ; while 

 3'ellow-fever, limited to certain zones and al- 

 titudes, is non-contagious, its transmission 

 depending wholly upon the surroundings of 

 man. Strange as may seem the assertion, a 

 ship should be one of the best places to jugulate 

 cholera ; for if due precautions of cleanliness, 

 and disinfection of discharges, are promptly 

 made, we avoid the secondary sources which 

 arise from soil and contaminated water. On 

 the other hand, 3^ellow-fever, appearing on ship- 

 board, can have no ending, so long as there is 

 fresh material upon which to feed, short of 

 seeking a zone where it loses its virulence, or 

 discharging the vessel, and subjecting it to the 

 most minute cleansing and purification. 



In an article of this kind, it is unnecessary 

 to recite the details of measures of repression 

 of the two diseases, based on the above prin- 

 ciples. I have alread}" done so in the article 



' Quarantine,' in Buck's ' Hygiene,' and the 

 paper referred to, lately published in the 

 Medical record. There are, however, two or 

 three points to which it is well to refer, and the 

 discussion of which may correct popular mis- 

 apprehensions. I have stated that the time of 

 transit from European countries to our shores 

 is longer than the incubative period of chol- 

 era. If, therefore, by careful inspection of 

 all soiled clothing at the point of departure, 

 this factor for conve3'ing the disease is elim- 

 inated, we have only to watch the develop- 

 ment on shipboard of such cases as may 

 have acquired the disease before coming on 

 the vessel. The moment a case is recog- 

 nized, or even suspected from any diarrhoeal 

 discharge, it should be promptly isolated, at- 

 tendants quarantined, discharges at once dis- 

 infected, all soiled clothing promptl3^ destroyed, 

 attendants' hands washed for the slightest stain, 

 and it would be promptl3'^ suppressed. There is 

 here but the primary factor with which we have 

 to deal. The secondary ones, of contaminated 

 water, floating germs, and conditions of the 

 soil, are absent. If efficient measures are 

 taken, a ship should be a favorable place to 

 repress the disease. It would remain, then, 

 for the land quarantine to maintain the vessel 

 under observation for the requisite time to 

 determine that no new cases occur. A series 

 of measures which would suggest themselves 

 promptl3^ to any health-officer should be taken ; 

 such as the removal of all from the vessel 

 to a spot of absolute isolation, the thorough 

 cleansing and disinfection of all the cabins, 

 linen, etc. 



While 3^ellow-fever ma3^ be transmitted by 

 an3^ of the surroundings of an individual, its 

 favorite habitat is in the filth which accumulates 

 in the bilge of a vessel. Nothing short of 

 reaching this filth, and removing it with the 

 most scrupulous care, can insure a protective 

 influence. Disinfectants, fumigations, great 

 heat in its various applications, are but secon- 

 dary adjuvants, to be emplo3'ed onl3^ after most 

 scrupulous cleanliness has been effected. I 

 believe in the efficiency of quarantine, if the 

 measures recited cursority above are rigidly 

 carried out. The3^ are measures to which the 

 most minute attention must be given in ever3^ 

 detail. The neglect to carry out an3^ single 

 provision will cause failure, and throw discredit 

 upon the S3'stem. 



It is a subject of interest to consider the in- 

 fluence of steam-navigation upon the dissemi- 

 nation of cholera and yellow-fever. As neither 

 disease travels faster than man himself (for 

 I discard the theor3' of ' epidemic influence '), 



