July 10, 1885.] 



SCIENCE, 



23 



QUARANTINES AND THEIR SCIENTIFIC 

 VALUE. 



The outbreak of cholera in Europe during 

 the past summer has naturally awakened a 

 lively interest in precautionary measures to 

 prevent its access to this countr3\ The ex- 

 perience of all epidemics shows that among the 

 chief and first obstructions suggested is that 

 of quarantines. From their early application 

 against the progress of plague in Italy, to their 

 latest use during the past summer to prevent 

 the introduction of cholera in Spain and Italy, 

 this institution has met with indifferent success 

 in preventing the spread of an epidemic ; so 

 that to-daj' the practical question of its efficacy 

 remains still unsettled in the minds of manj^ 

 Indeed, there is a large and influential number 

 who inveigh against all quarantine measures 

 as useless in a sanitar}" point of view, and as 

 causing needless obstructions to the free inter- 

 course of persons and commerce. It will be 

 the object of this paper briefly to review the 

 position, and establish, if possible, a reliable 

 stand-point from which the work of sanitari- 

 ans ma}' be rationally carried on. 



To approach the subject properly, we must 

 first disabuse our minds of many European 

 prejudices and ideas. So much of our medi- 

 cal literature comes from these sources, that 

 we insensibly adopt conclusions drawn from 

 these writings, without considering the diflfer- 

 ences of geographical position, and the facility 

 which this gives us of employing measures 

 which ma}' be impracticable in most of the 

 European countries. While this would emi- 

 nently be the case, even were the conclusions 

 reached by European governments founded on 

 the recognized natural history of epidemics, 

 another element of distrust is presented when 

 we know that other factors enter into and bias 

 their writings. 



Governmental jealousies, geographical posi- 

 tions, impeded commercial relations, the diffi- 

 culty of demonstrating an intangible element, 

 with the consequent contrariety of opinions, 

 have each and all tended to perpetuate the di- 

 versity of measures taken by different govern- 

 ments to obstruct the progress of a scourge. 

 The several international sanitary congresses 

 which have from time to time been held since 

 the outbreak of the first cholera epidemic in 

 1831, have rareh' been harmonious in action, 

 adopting their conclusions mostly by a majority 

 vote, or, if harmonious, the governments the}^ 

 represented have often failed through interested 

 motives to give them cordial force and effi- 

 ciency. Particularly is this notable with the 

 EngUsh. Cholera is endemic upon a large 



area of her richest possessions. Her commer- 

 cial relations with these countries are constant 

 and immense. Any action taken to repress 

 the spread of cholera must contravene more or 

 less these relations, and is met either b}' eva- 

 sion, or distinct refusal to adopt such action. 



Her medical men insensibl}' imbibe the same 

 spirit ; and we find her medical literature teem- 

 ing with articles on ' epidemic influence,' ' non- 

 contagiousness of cholera,' the ' non-efficienc}' 

 of quarantine,' ' cholera purely a filth disease,' 

 etc. 



While there is much in these writings which 

 should command respect and attention, partic- 

 ularly in all that pertains to local sanitation, 

 we should notice that their principal value lies 

 in restricting and jugulating a scourge once 

 admitted, rather than preventing in the first 

 instance its ingress to the country. The geo- 

 graphical position of the different nationalities 

 of Europe with respect to one another pre- 

 cludes the application of the principles of 

 quarantine as understood in this countr}'. 

 Land quarantines have always proved ineffect- 

 ual : and there is but one spot where quaran- 

 tine applied to vessels can hope to be effectual 

 against the incursion of cholera ; that is the 

 one established within the past few years at 

 the island of Camaran, at the entrance of the 

 Eed Sea. In a paper recently published, I 

 have detailed the principles and purposes which 

 actuated the European international sanitary 

 commission in its establishment.^ If the regu- 

 lations established at this point are faithfully 

 carried out, the danger from cholera, so far as 

 its transportation by Mohammedan pilgrims is 

 concerned, should be effectually prevented. 



Before making our estimate of the efficiency 

 of quarantine measures to prevent the incur- 

 sion of an epidemic, wx must consider for a 

 moment the position of this countrj- with ref- 

 erence to the two great scourges which it is 

 desired to contravene. In no part of this 

 country are cholera or j'ellow-fever endemic : 

 neither can reach our shores except through 

 the intervention of shipping. The time of 

 transit from Europe is longer than the incuba- 

 tive period of cholera ; to all northern ports, 

 from Havana, it is nearly equal to the incu- 

 bative stage of yellow-fever : disease, there- 

 fore, contracted before going on the ship, 

 would be developed before arrival at our ports. 

 We shall see, when we speak of the detail of 

 measures for repression, that a vessel, so far 

 from being unfavorable, is reallj' an efficient 

 spot to jugulate cholera. The same rule does 

 not apply to yellow-fever. 



1 New- York Medical record, April 18, 1885. 



