USA > Tennessee > Shelby County > Memphis > A history of the yellow fever : the yellow fever epidemic of 1878, in Memphis, Tenn., embracing a complete list of the dead, the names of the doctors and nurses employed, names of all who contributed money or means, and the names and history of the Howards, together with other data, and lists of the dead elsewhere > Part 41
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not resumed until 1855, since which time four epidemies have occurred, and it has appeared sporadically every year up to 1872, and since then, epidemically. The triumphant march of cholera in Europe and this country, in 1831-2, when it passed through the most crucial tests of quarantine, first induced a change in the enactments above recited. Confidence in quarantine was every-where shaken. It was found to be no barrier to the spread of the plague to eities whose unsanitary condition invited it, and that it hampered, hindered, and prevented commerec, without affording the equivalent of safety. It was, there- fore, resolved by many French scientists to try and effect a change or modifi- cation of the quarantine enactments that would relieve commerce and yet afford the surveillance necessary to adequate protection. A report upon quar- antines, from the Academy of Medicine, of Paris, concurred in the propriety of a complete reform ; and, on August 18, 1847, a royal ordinance of France declared the first recognition of truths based upon the opinions of medical men, that many of the restrictions of quarantine were unnecessarily burdensome, and therefore abolished. Still other reforms were decreed in France, in 18-49- 50. But the eminent sanitarians of France were not satisfied by the reforms accomplished in their own country. This was only the beginning of the work they had in view. They proposed to show that it was in accordance with science, and for the interests of the commerce of all other nations, to accept the reforms which they had effected in France. Accordingly, Dupeyron suggested to the ministers of commerce the idea of a Sanitary Congress,* which was adopted, and delegates to it from all the principal countries of Europe, by in- vitation of the French government, met in Paris, in 1851. This congress adopted a quarantine code, which was afterward ratified by the nations repre- sented. In 1865, on the approach of the cholera, the French government called an international sanitary conference, to meet at Constantinople, where a further modification of the quarantine restrictions was had. The yellow fever having prevailed epidemically in 1855, in Norfolk, Virginia, and in 1856, in Bay Ridge and at Fort Hamilton, New York, in spite of the most stringent
* The sanitary reform, which began in England about the same time, under the pro- visions of the new poor-law, attacked no less vigorously the ancient fallacies of quaran- tine in that country. The General Board of Ilealth, instituted by act of Parliament, in 1843, persisted in repeated efforts against the quarantine regulations for plague, yellow fever, and cholera ; protesting that protection from pestilential diseases does not consist in quarantine regulations alone, but more in internal sanitary measures-measures which have for their object the suppression and prevention of conditions without which the diseases regarded as quarantinable would not exist. The measures proposed by the Gen- oral Board of Health were the destruction of all the sources of infection in town and country ; sanitary improvement of habitations; a full supply of wholesome food and wholesome water, extending to the persons and materials employed in commerce ; and, finally, if in spite of these precautions, pestilence manifests itself in any place, abandon- ment of the locality, until the cause of the pestilence is found out and eradicated. In its enthusiastic war on the local causes of diseases, it includes among them quarantines, and by resolution declared, in their report of 1849, "that quarantine, instead of guarding against and preventing disease, fosters and concentrates it, and places it under conditions the most favorable that can be desired for it- general extension."
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quarantine restrictions, and as many, with good reason believed, in conse- quence of them, Dr. A. N. Bell, in Hunt's Merchants' Magazine, advocated free pratique to all well persons, under whatever circumstances, and asserted that " things and not persons cause and propagate disease."* Dr. Wilson Jewell, of the Philadelphia Board of Health, in November, 1856, secured the passage of a resolution by that body, providing for a quarantine and sanitary convention -- the first ever held in America. It met on the 13th of May, 1857, was in session three days, nine States being represented. It aulopted resolu- tions favoring quarantine of persons sick of small-pox, and, under certain eir- cumstances, typhus fever, cholera, and yellow fever; and of infected vessels and cargoes. At the second annual meeting of the convention, in Baltimore, in April, 1858, committees were appointed on external hygiene, or quarantine. and internal hygiene, or the sanitary arrangements of cities. These reported at the third annual meeting, held in New York, in April, 1859. The subject most discussed at this meeting was the contagious or non-contagious nature of yellow fever. This followed upon the introduction, by Dr. W. H. Stevens, of a resolution declaring " that in the absence of any evidence establishing the con- clusion that yellow fever has ever been conveyed by one person to another, it is the opinion of this convention that personal quarantine of cases of vellow fever may be safely abolished." This was adopted by a vote of eighty-five to six. "In the summer of 1858," says Dr. A. N. Bell, " there being a fleet of vessels detained in New York quarantine, and a number of cases of yellow fever in the hospitals, excitement ran so high that, on the night of September Ist, a mob, estimated at a thousand strong, removed the sick from the hospi- tals and burned the buildings. Subsequent to this act, and until the law of 1863 was carried into effect, the quarantine in New York was extemporized. In 1862 the writer was physician-in-chief of the floating hospital in the lower bay, for the special care of yellow fever. On the conclusion of that service, in his report to the Commissioners of Quarantine, he especially recom- mended the shoals of West Bank in the lower bay as the most suitable place for robuilding the establishment. Shortly thereafter, at the instance of Hon. H. C. Murphy, of the State Senate, he drew the law known as the law of 1863 (which is still in force), deducing its main provisions from the report submitted at the Fourth Annual Quarantine Convention, and designated West Bank as the situation for the structures." Many members of the Legislature, however,
* So it proved in the great epidemic at Norfolk, Virginia, in 1853. A large number of refugees to Baltimore and Wilmington, N. C., sickened and died in those cities, but none of the inhabitants contracted the disease. Again, cases of yellow fever were introduced in New Orleans in 1870, '71,'72. 73, and '76, but no epidemic ensued. The conditions were not favorable to the propagation of the special cause. The epidemic in Shreveport, of 1873. was occasioned by persons going from New Orleans, who had been exposed to cases brought there on board the brig Valparaiso, and not less than 250 cases appeared in the vicinity of where the vessel was moored, but no epidemie took place. The atmosphere of New Orleans was not in the condition favorable to the propagation of the organisms to the extent of an epidemic; but that of Shreveport was pre-eminently so, the fever proving peculiarly fatal.
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deeming the crection of suitable structures on West Bank impracticable, that clause was stricken out for the time, and the bill passed, excluding all other places. It took three years more, the arrival of cholera in 1865, and the effectual resistance of various devices and attempts to possess other localities, to convince those who conducted quarantine for the time, and the Legislature, of the propriety of reinstating the provision for West Bank. Dr. John Swin- burne, health officer at that time, on careful investigation of the subject, secured the needful amendment of the law in 1866, which has resulted in the erection of the most effectnal and the least oppressive quarantine establishment in the world .* In the same year of this enabling act for the completion of the New York quarantine, owing to the prevalence of cholera, a second European conference convened at Constantinople, and, in 1874, an International Sanitary Convention at Vienna. These were attended by representatives of the highest standing from the various governments of Europe, from Egypt, and Persia. The latter of these conventions, after a thorough review of the former, and an animated discussion of a programme comprehending twenty-six stated questions on the nature of cholera, adopted the following rules, as the sense of the con- ference :
1. Vessels from infected ports must undergo observations which, according
# Under and by virtue of this act, the quarantine establishment for the port of New York consists of warehouses, docks and wharves, anchorage for vessels, a Hoating hospital, boarding-station, burying-ground, and residences for officers and men. Mier- chants are afforded facilities for overhauling and refitting vessels while in quarantine. Connected with the warehouses are apartments with appliances for special disinfection by forced ventilation, refrigeration, high steam, dry heat, and chemical disinfection. The boarding-stations for suspected vessels, arriving between the Ist day of April and the 1st day of November, is in the lower bay, below the Narrows. Vessels are boarded as soon as practicable after their arrival-between snurise and sunset. The anchorage for vessels under quarantine iz in the lower bay, two miles from shore, and within an area designated by buoys. Quarantine applies against yellow fever, cholera, typhus or ship fever, and small-pox, and any new disease of a contagions, infections, or pestilential nature. The floating hospital, with a capacity sufficient to accommodate 100 patients, is anchored in the lower bay from the Ist of May to the Ist of November; at other times it is anchored in some more secure place. The hospital at West Bank, when so required, is used exclu- sively for yellow fever and cholera patients. The buildings on Hoffman Island are used as a place of reception and temporary detention of persons who have been exposed to contagious or infectious diseases, but who are not actually sick. The health officer ix the custodian of the quarantine establishment; his jurisdiction extends within the limits of the city and county of New York. In ascertaining the sanitary condition of a vessel, he is anthorized to examine. under oath, the captain, crew, and passengers, and to inspect the bill of health, manifest, log-book, cargo, etc. Vessels liable to quarantine are required to discharge in quarantine, and be detained long enough thereafter for disinfec- tion and aeration, such detention not to exceed ten days, unless the disease occurs or re-appears during that interval, in which event the time is extended ten days. But no vessel or cargo, which has been in quarantine, is allowed to proceed to New York or Brooklyn without the approval of the mayor or Board of Health of those cities respect- ively. Filthy or unhealthy vessels are subject to quarantine for purification, not exceed- ing ten days. On infected or suspected vessels, all clothing, personal baggage, cotton, ha.np, rags, paper, hides, skins, feathers, hair, woolens, and other articles of animal origin,
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to circumstances, may last from one to seven days. In the eastern parts of Europe and elsewhere, though ouly in certain exceptional cases. the surveil- lance may be prolonged to ten days.
2. When the Board of Health have sufficient proof that during the voyage no case of cholera, or of any other suspected disease, has occurred on board, the observation is to last three to seven days, reckoned from the medical in- spection. If, under these circumstances, the voyage has lasted at least seven days, the surveillance is to be limited to twenty-four hours, to give time for the examination and disinfection considered as neces ary. In cases under this category the observation may be held on board, as long as no case of cholera or suspicious circumstance occurs, and when the hygienic condition of the ship allows. In these cases the unloading of the ship for disinfection is not necessary.
3. When, during the passage, or after the ship's arrival, cases of cholera or other suspected diseases occur, the surveillance for those who are not ill is to last seven full days, beginning from their isolation in a hospital, or whatever place is assigned to them. The sick will be disembarked and properly at- tended to in a place separated from the persons under surveillance. The ship and all objects belonging to it are to undergo a thorough disinfection, after which persons obliged to remain on board will be subjected to surveillance for seven days.
4. Vessels from suspected ports-that is, such as lie near places or ports where cholera prevails, and are in intercourse with them-may be subjected to observation lasting, at most, five days, provided that no suspicious cases of disease have occurred on board.
5. The quarantine of emigrant and pilgrim ships, and, in general, all vessels whose condition is deemed especially dangerous to the public health, shall be carried out under particular regulations, which the Board of Health shall decide.
6. When the conditions of a place do not allow the presented regulations to
are subjected to an obligatory quarantine and purification. Molasses, sugar, and live and healthy cattle are subjected to quarantine at the option of the health officer. All other merchandise is exempted from quarantine and admitted without delay. The effect- of persons who die in quarantine are taken in charge by the health officer, and if not claimed by the rightful heir in three months, are delivered to the public administrator of the city of New York. All persons who have died are interred, without delay, in the quarantine burying-ground, at Seguin's Point. A vessel has the right to put to sea before breaking bulk, in preference to going into quarantine; but the health officer in such case in- dorses on her bill of health the circumstances under which she leaves port, the length of her detention, and her actual condition, and sends to the quarantine hospital such sick as may desire to remain. All passengers on board of vessels under quarantine are provided for by the master of the vessel. Any person violating the quarantine regulations, or who shall oppose or ob-truet the health officer, or any of his employés, in the performance of their duties, is guilty of misdemeanor, and punishable by a fine of not less than $100. or by imprisonment not less than three nor more than six months, or by both such fine and imprisonment. Any person aggrieved by any decision of the health officer may appeal therefrom to the commissioners of quarantine, who constitute a board of appeal.
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be carried out, the inspected ship is to be dispatched to the nearest hospital, after it has received all the assistance that its condition may require.
7. Ships coming from infected ports, which have touched at a port en route, and have left it without undergoing quarantine, will be treated as ships coming from an infected harbor.
8. In cases of mere suspicion the sanitary board may order special disinfec- tion regulations.
9. In ports where cholera is epidemic full quarantine is not to be kept, but means of disinfection are to be strictly applied.
In 1874, also, the minister of agriculture of France appointed a commission, to report upon the sanitary laws in force at the various ports and other mari- time towns of France, and to suggest the changes which the development of international communications by the introduction of steam seemed to render necessary. The result of their labors, as decreed by the President of the Republie, was: For the future, cholera, yellow fever, and the plague will be the only foreign epidemics to guard against. A permanent embargo will be plaeed upon all vessels arriving from countries where they prevail. Typhus fever and small-pox will be made merely the object of exceptional precautions, and even in these cases the measures taken will apply solely to vessels upon which there is some sign of disease. Vessels which are entirely free from dis- ease will be exempt from quarantine after inspection by the officers of health. The presentation of a bill of health, upon arriving in a French port, will only be compulsory for vessels coming from the eastern shores of Turkey in Europe, from the Black Sea, and from all countries beyond Europe . . The merchandise arriving by any vessels which can show that there have been
no deaths or contagious diseases on board will be exempt from all detention, and be allowed on shore at once, with the exception of leather, hair, and other animal debris. The coast line has been divided into eleven circumserip tions, each to be provided with a sanitary officer, whose duty it will be to see that the regulations are carried out in his own district.
The United States laws on quarantine make those of each State supreme, and United States vessels, in common with all others, are obliged to submit, The national quarantine law which was enacted by Congress last year [1878] provides : That whenever any infectious or contagious disease shall appear in any foreign port or country, and whenever any vessel shall leave any infected foreign port, or having on board goods or passengers coming from any place or district infected with cholera or yellow fever, shall leave any foreign port, bound for any port in the United States, the consular officer. or other repre- sentative of the United States, at or near such port, shall immediately give in- formation thereof to the supervising surgeon-general of the marine hospital service, and shall report to him the name, the date of departure, and the port of destination of such vessel ; and shall also make the same report to the health officer of the port of destination in the United States ; and the consular officers of the United States shall make weekly reports to him of the sanitary condition of the ports at which they are respectively stationed ; and the said surgeon-general of the marine hospital service shall, under the direction of the
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secretary of the treasury, be charged with the execution of the provisions of this act, and shall frame all needful rules and regulations for that purpose, which rules and regulations shall be subject to the approval of the president; but such rules and regulations shall not conflict with or impair any sanitary or quarantine laws or regulations of any State or municipal authorities How existing, or which may hereafter be enacted. That it shall be the duty of the medical officers of the marine hospital service, and of custom officers, to aid in the enforcement of the national quarantine rules and regulations estab- lished under the preceding section; but no additional compensation shall be allowed said officers by reason of such services as they may be required to per- form under this act, except actual and necessary traveling expenses. That the surgeon-general of the marine hospital service shall, upon receipt of information of the departure of any vessel, goods, or passengers from in- fected places to any port in the United States, immediately notify the proper State or municipal and United States officer or officers at the threatened port of destination of the vessel, and shall prepare and transmit to the medical officers of the marine hospital service, to collectors of customs, and to the State and municipal health authorities in the United States, weekly abstracts of the consular sanitary reports and other pertinent information received by him. That wherever, at any port of the United States, any State or municipal quarantine system may now or may hereafter exist, the officers or agents of such system shall, upon the application of the respective State or municipal authorities, be authorized and empowered to act as officers of the national quarantine system, and shall be clothed with all the powers of the United States officers for quarantine purposes, but shall receive no pay or emoluments from the United States. At all other ports where, in the opinion of the sec- retary of the treasury, it shall be deemed necessary to establish quarantine, the medical officers or other agents of the marine hospital service shall perform such duties in the enforcement of the quarantine rules and regulations as may be assigned them by the surgeon-general of that service, under this act : Provided, that there shall be no interference in any manner with any quarantine laws or regulations as they now exist, or may hereafter be adopted, under State laws.
The legislature of Tennessee, at the session which closed on the 1st of April, 1879, adopted amendments to the act of the preceding legislature, providing for a State Board of Health, as follows :
1. That the State Board of Health be, and they are hereby, empowered to declare quarantine, whenever in their judgment the welfare of the publie re- quire it, and to prescribe such rules and regulations as they may deem proper for the prevention of the introduction of yellow fever, cholera, and other epi- demic diseases into the State of Tennessee ; and whenever the yellow fever, cholera, small-pox, or other epidemie diseases appear in any locality within the State, and information thereof is brought to the knowledge of said State Board of Health, they shall prepare and carry into effect such rules and regu- lations as in their judgment will, with the least inconvenience to commercial travel, prevent the spread of the disease ; they shall select suitable localities for establishing quarantine stations, and may erect necessary temporary build-
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ings for the disinfection of passengers, baggage, cargoes, and other matters believed to convey the contagious principle of yellow fever, cholera, small-pox, and other epidemic diseases, and may enforce such transhipment of passengers as they may deem necessary, and shall assign to the charge of each station a competent physician and necessary assistants, who shall receive such compen- sation as the said Board of Health may deem reasonable and just ; and the members of said board shall be allowed a per diem compensation of not more than ten dollars, with traveling and other necessary expenses, for each and every day while actively employed in the business of said board.
2. That any person or persons who shall willfully disregard or evade such quarantine as said Board of Health may declare, or violate any rule or regula- tion they shall make in attempting to prevent the spread of any epidemic dis- case, shall be guilty of a misdemeanor, and, upon conviction, shall be fined not less than fifty dollars nor more than five hundred, or imprisoned in the county jail for a period of three months, or both, at the discretion of the court.
3. That for the purpose of enabling the State Board of Health to accomplish the end for which it was created, the sum of three thousand dollars per annum is hereby appropriated, which amount the comptroller of the treasury is hereby directed to issue his warrant for, or any part thereof, first having the sum duly certified by said board.
1. That the governor shall have power, and it is hereby made his duty, to appoint two additional members of said board connected with the commerce and transportation of the country.
In addition to the above enactment, Memphis, under the act repealing her city charter and creating the Taxing-district government, will also enjoy all the benefits likely to flow from the enforcement of an ordinance providing for a local Board of Health, and declaring the law of quarantine. This ordinance, which is almost identical with that in force in New York city, confers upon the health officer almost absolute powers. It is made his duty to " carry out all the orders of the Board of Health and the laws of the State and ordinances of the distriet in relation to the sanitary regulations of the district ; to proceed, from time to time, to make a thorough and systematic examination of the district, and cause all nuisances to be abated with all reasonable promptness. And for the purpose of carrying out the foregoing requirements, he shall be permitted, at all times, from the rising to the setting of the sun, to enter into any house, store, stable, or other building, and to cause the floors to be raised, if he shall deem necessary, in order to a thorough examination of cellars, vaults, sinks, or drains ; to enter upon all lots or grounds, and to cause all stagnant waters to be drained off, the pools, sinks, vaults, drains, or low grounds to be cleansed. filled up, or otherwise improved or amended ; to cause all privies to be cleansed and kept in good condition, and to cause all dead animals or other nauscous or enwhole-ome things or substances to be buried or removed beyond the limits of the district." It is also made his duty "to visit and examine all sick persons who shall be reported to him as laboring, or supposed to be laboring, under any yellow or ship fever, small-pox, cholera, or any infectious or pestilential dis- case, and, under the advice of the president of the Board of Health, cause all
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