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 42
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such infected persons to be removed to the cholera, small-pox, or other hos- pitals, or such other safe and proper place as he may think proper, or as shall be directed by the said president, not exceeding four miles from said district, and cause them to be provided with suitable nurses and medical attendance, at their own expense, if they are able to pay for the same, but, if not, then at the expense of the county, as provided in sections 1729 and 1730 of the Code of Tennessee." This act also declares that no other officer or board within the said distriet, except the Board of Health and its proper officers, shall sign, grant, or deliver any certificate or bill of health. It also confers upon the Board of Health a direct oversight over medicines or poisons, construction of buildings, ventilation ; over boarding-honses, public halls, assembly rooms, theaters, jails or prisons, water-closets, sinks, privies. vaults, cisterns, and wells; also over sidewalks, streets and gutters, sewers, drains and pipes, plumbing, food, unwholesome fruits or vegetables, milk, cheese and butter, hydrants and the water supply, cattle and horses, slaughtering and slaughter-houses ; also over dogs, pounds, stables, offensive odors, places, and liquids, and over public vehicles and street-cars -- every thing, in fact, that can nearly or remotely affect the public health. This ordinance, so all-embracing, can be enforced by pen- alties, the penal clause providing, " that every person who knowingly omits or refuses to comply with, or who resists or willfully violates any of the pro- visions of this ordinance, or any of the rules, orders, sanitary regulations, or ordinances established or declared by the Board of Health in carrying out the provisions of this ordinance, or the execution of any order or special regulation of the Board of Health, made for that purpose, is hereby declared to be guilty of a misdemeanor, and, on arrest and conviction before the president of the Board of Fire and Police Commissioners, he shall be fined for each offense in any sum not less than one nor more than fifty dollars, to be collected as other fines are collected." In addition to this, by Article V of the ordinances it is made a nuisance-
1. To do, or cause to be done, any of the following acts, and any per- son convicted thereof shall be fined not less than five nor more than fifty dol- lars:
2. To build, construct, or keep a slaughter-pen or house within the taxing- district, or within one-half mile thereof.
3. To construct a vault or privy less than fifteen feet deep, or less than four feet distant from the line of any street or public place, or from the property of others, without the consent of the owner.
4. To have a vault or privy on the land owned or occupied by one's self, the contents of which escape therefrom or overflow.
5. To cause. create, or permit within the taxing-district, or within one inile thereof, any nuisance on one's premises; and each day such nuisance is permitted to remain shall constitute a separate offense.
6. To throw or put into any street or public place any dead animal, or fail to remove and bury without the taxing-district limits the carcass of any dead animal owned by him. her. or them.
7. To throw into the street or other public place any filth or noxious sub-
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stance, or to permit the same to flow from one's premises into any street or public place, or on the property of others.
8. To haul dirt through the streets in carts without sufficient tail-boards to prevent it from falling out upon the streets.
9. To throw any water or other substance from the windows of any house into the streets of public places, or on the premises of others.
10. To keep any horses, mules, oxen, or cows within the taxing-district, and fail to remove without the taxing-district, at least twice a week, all dung, filth, and litter.
The Forty-Fifth Congress, which adjourned sine die, on the 4th of March of this year (1879), passed an act creating a National Board of Health, which provides :
1. That there shall be established a National Board of Health, to consist of seven members, to be appointed by the President, by and with the advice and consent of the Senate, not more than one of whom shall be appointed from any one State, whose compensation, during the time when actually engaged in the performance of their duties under this act, shall be ten dollars per diem each, and reasonable expenses, and of one medical officer of the Army, one medical officer of the Navy, one medical officer of the Marine Hospital Serv- ice, and one officer from the department of justice, to be detailed by the sec- retaries of the several departments and the attorney-general, respectively, and the officers so detailed shall receive no compensation. Said board shall meet in Washington within thirty days after the passage of this act, and in Washington or elsewhere from time to time, upon notice from the president of the board, who is to be chosen by the members thereof, or upon its own ad- journments, and shall frame all rules and regulations authorized or required by this act, and shall make, or cause to be made, such special examinations and investigations at any place or places within the United States or at foreign ports, as they may deem best, to aid in the execution of this act and the pro- motion of its objects.
2. The duties of the National Board of Health shall be to obtain informa- tion upon all matters affecting the public health, to advise the several depart- ments of the government, the executives of the several States, and the Com- missioners of the District of Columbia, on all questions submitted by them, or whenever, in the opinion of the board, such advice may tend to the preserva- tion and improvement of the public health.
3. That the Board of Health, with the assistance of the Academy of Sci- ence, which is hereby requested and directed to co-operate with them for that purpose, shall report to Congress, at its next session, a full statement of its trans- actions, together with a plan for a national public health organization, which pian shall be prepared after consultation with the principal sanitary organiza- tions and the sanitarians of the several states of the United States, special atten- tion being given to the subject of quarantine, both maritime and inland, and especially as to regulations which should be established between State or local systems of quarantine and a national quarantine system.
4. The sum of fifty thousand dollars, or so much thereof as may be neces-
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sary, is hereby appropriated to pay the salaries and expenses of said board to carry out the purposes of this act.
Congress has now (May, 1879) under consideration, at the called session of the Forty-Sixth Congress, a bill introduced by Hon. Casey Young, of the Tenth District of Tennessee, and which, by the efforts of Senator Harris, of Tennessee, passed the Senate before the close of the second session of the Forty-Fifth Congress. It is entitled an act " to prevent the introduction of infectious or contagious diseases into the United States, and to establish a Board of Health." It provides:
1. That it shall be unlawful for any vessel engaged in the transportation of goods or persons from any foreign port to and into the United States, to enter any port of the United States, except in accordance with the provisions of this act, and all rules and regulations made in pursuance thereof; and any such vessel which shall enter, or attempt to enter, a port of the United States in violation thereof, shall forfeit to the United States a sum, to be awarded in the discretion of the court, not exceeding five thousand dollars, which shall be a lien upon said ves-el, to be recovered by proceedings in admiralty in the proper district court of the United States.
2. That all such vessels shall be required to obtain from the consul, vice-consul, or other consular officer of the United States at the port of departure, or from the medical officer, where such officer has been detailed by the President for that purpose, a certificate, in duplicate, setting forth the sanitary history of said vessel, and that it has in all respects complied with the rules and regula- tions in such case, prescribed, and herein authorized, for securing the best pos- sible sanitary condition of the said vessel, its eargo, passengers, and crew; and said consular officer is required, before grauting such certificate, to be satisfied that the matters and things therein stated are true; and for his services in that behalf shall be entitled to demand and receive such fee> as shall by law- ful regulation be allowed, to be accounted for as is required in other cases. That upon the request of the National Board of Health, the President is au- thorized to detail a medical officer to serve in the office of the consul at a for- eign port for the purpose of making the inspection and giving the certificates hereinbefore mentioned : Provided, That the number of officers so detailed shall not exceed, at any one time, six : Provided further, That any vessel sailing from any such port without such certificate of said medical officer, entering any port of the United States, shall forfeit to the United States the sum of five hundred dollars, which shall be a lien on the same, to be recovered by proceedings in admiralty in the proper district court of the United States.
3. That the National Board of Health shall make all needful rules and regula- tions authorized by the laws of the United States for the prevention of the introduction and spread within the United States of contagious or infectious diseases, which shall be uniform and subject to approval by the President, and shall be charged with the execution of the same, and of the provisions of this act and all other laws of the United States for the prevention of the introdue- tion and spread of contagious or infectious diseases, and all quarantine regula- tions established under the authority of said laws in respect to all vessels and
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vehicles engaged in commerce with foreign nations and among the respective States, whether by land or water.
4. That the Board of Health shall also be charged with the duty of obtaining information of the sanitary condition of foreign ports and places from which contagious or infectious diseases are or may be imported into the United States; and to this end the consular officers of the United States, at all ports and places, shall make to the National Board of Health weekly reports of the sanitary condition of the ports and places at which they are respectively sta- tioned, according to such forms as said Board of Health may prescribe; and the Board of Health shall also obtain, through all sources accessible, includ- ing State and municipal health authorities throughout the United States; weekly reports of the sanitary condition of ports and places within the United States ; and the Board of Health shall prepare, publish, and transmit to the medical officers of the marine hospital service, to collectors of customs, and to State and municipal health officers and authorities, weekly abstracts of the consular sanitary reports, and other pertinent information received by said board; and said Board of Health shall also, as far as it may be able, by means of voluntary co-operation of State and municipal authorities, of public associations and private persons, procure information relating to the climatic and other conditions affecting the public health ; and the Board of Health shall make, to the Secretary of the Treasury, an annual report of its opera- tions, for transmission to Congress, with such recommendations as it may deem important to the publie interests; and said report, if ordered to be pub- lished by Congress, shall be published under the direction of the board.
5. That the National Board of Health shall, from time to time, issue to the consular officers of the United States, and to the medical officers serving at foreign ports, and otherwise make publicly known, the rules and regulations made by it and approved by the President, to be used and complied with by vessels in foreign ports, for securing the best possible sanitary condition of such vessels, their cargoes, passengers, and crew, before their departure for any port in the United States, and in the course of the voyage; and also such other rules and regulations as shall be observed in the inspection of the same on the arrival thereof at any quarantine station at the port of destination, and for the disinfection and isolation of the same, and the treatment of cargo and persons on board, so as to prevent the spread of cholera, yellow fever, or other contagious or infectious diseases; and it shall not be lawful for any vessel to enter said port to discharge its cargo or land its passengers, except upon a permit from the health officer at such quarantine station, certifying that said rules and regulations have in all respects been observed and complied with, as well on his part as on the part of the said vessel and its master, in respect to the same, and to its cargo, passengers, and crew ; and the master of every such vessel shall produce and deliver to the collector of customs at said port of entry, together with the other papers of the vessel, the said certificates re- quired to be obtained at the port of departure and the permit and certificate herein required to be obtained from the health officer at the port of entry.
6. That rules and regulations made and approved as herein authorized shall 19
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be promulgated, so that when cholera, yellow fever, and other contagious or in- fections diseases shall be ascertained by the Board of Health to exist in any port or place within the United States in such form as threatens its spread, the communication of the same to other ports and places within other States by means of vessels and vehicles engaged in the transportation of goods or passengers between two or more States shall, as far as practicable, be pre- vented; and in that case the Board of Health shall select suitable localities for establishing stations on rivers and other lines of inter-State commerce and travel by railroads, and may cause to be erected necessary temporary buildings for the disinfection of passengers, baggage, cargoes, vessels, and vehicles, and 'may enforce such rules and regulations relating thereto as may have been prescribed therefor. .
7. That it shall be the duty of the National Board of Health, so far as it law- fully may, in the execution of the powers conferred upon it by law, to invite the co-operation of, and to correspond and co-operate with, local sanitary offi- cers, boards, and authorities acting under the laws of the States in sanitary measures, to prevent the introduction and spread of contagious and infectious diseases from foreign countries into the United States, and from one State into any other State, by means of commercial intercourse, upon and along the lines of inter-State trade and travel; and to that end it shall be lawful for said Board of Health to confer upon any such local officer or board within or near the locality where his or its authority is exercised power also to enforce the provisions of this act, and all rules and regulations made in pursuance thereof. And in case such local officer or board shall refuse to execute and enforce the laws of the United States, and the rules and regulations of the National Board of Health, made in pursuance thereof, for the inspection, disinfection, and treatment of vehicles and vessels, their cargoes, passengers, and crews, or, in the opinion of the National Board of Health, shall neglect or fail to do so, it shall be the duty of the President, upon the application of the National Board of Health, to detail from the medical staff of the Army or Navy or the ma- rine hospital service a suitable officer to execute or enforce said laws, rules, and regulations, or to appoint some suitable person for that purpose. (And it shall be the duty of the National Board of Health to report the facts to the governor of such State, with such sanitary advice as the board may think proper in the premises.)
8. That to pay the necessary expenses of placing vessels in proper sanitary condition under the provisions of this act, the Secretary of the Treasury be, and he hereby is, authorized and required to make the necessary rules and regulations, fixing the amount of fees to be paid by vessels for such service, and the manner of collecting the same.
9. That the National Board of Health is hereby directed to make, or cause to be made, an investigation into the contagious or infectious diseases of domestic animals in the United States, and especially such as tend to interfere with the supply of wholesome food, and into the best means of controlling or prevent- ing such diseases, and to report the result of its investigations at the next session of Congress.
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10. That the National Board of Health is also directed to cause a thorough inspection to be made of all animals arriving at, or exported from, the different shipping ports of the United States, and to cause the owners or shippers of such cattle to be promptly notified of the results of such inspections, with such recommendations as may be proper in each case. It shall also notify State and local sanitary authorities of the existence of such diseases of domestic animals as it deems proper to bring to their notice, with such recommendations as may be deemed expedient in each case.
11. That the President is authorized, when requested by the National Board of Health, to detail officers from the several departments of the government for temporary duty, to act under the direction of said board, to carry out the provisions of this act; and such officers shall receive no additional compen-a- tion except for actual and necessary expenses incurred in the performance of such duties.
12. That to meet the expenses to be incurred in carrying out the provisions of this act, the sum of six hundred and fifty thousand dollars is hereby appropri- ated, to be disbursed under the direction of the National Board of Health, which shall make to the Secretary of the Treasury a full and accurate report of its operations under this act, and of all expenditures connected therewith, to be by him reported to Congress.
13. That nothing in this act shall be so construed as to supersede or impair any sanitary or quarantine law of any State. [Laid on the table May, 1879.
II.
The question of yellow fever quarantine is a very vexed one. Many of the best physicians, those most searching in their investigations, most studious and scholarly, of the largest experience and most enlightened views, have opposed it. In support of their position they adduce very strong arguments, fortified by undeniable facts. Some of these the reader is already acquainted with. They are to be found in the origin and prevalence of the disease, in epidemic form, at interior points remote from, and having no communication with, sea-ports to which the yellow fever might be brought in ships; its origin in New Orleans and other places, as attested by commissions organized to investigate for the fact of its origin, and by reputable and able physicians who could have no oh- jeet in a purposed misrepresentation, that, in view of possible after results, world be criminally cruel; in the admission by the homeopathic as well as allopathic commissions of 187s, of the possibility of the geris being perpetuated through the winter months, to break forth so soon as the intense heats of summer come to recuperate them, and enable them to breed and multiply; in the general admission that the filth of cities is a necessary factor in its propagation. and that, without a system of thorough sanitation, no city ean claim exemption from it; in the fact that frost has not always killed it, and that cases of fever have
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originated and proven fatal in the coldest months of winter several weeks after ice has formed, and the thermometer has been many degrees below the freezing- print; in the fact that it runs its course within ninety days regardless of con- ditions, whether of weather; sanitation, or population; that its degrees of latitude are as far apart as the European settlements on this continent and that of South America; and that it is no respecter of nationalities, of color, of sex, of age, of acclimated or unacclimated persons,* of high or low lands, mount- ains or swamps; that it is unknown as to its cause; that science has not dis- covered either a preventive or a cure for it, and the best medical skill can only mitigate and not prevent its cruelties, can only assist to arrest its progress short of decimation. No question has been more ably argued, more vehemently opposed or defended. "At the beginning of the present century," says Dowler, "and for some years after, the yellow fever element was so mingled with the great concerns of humanity, that it excited the public mind to an unexampled de- gree; in the cabinet and in the field, in the legislative balls and in the medical schools, both at home and abroad, and in the colonial governments. It had long been the conqueror of armies and navies, and at one time it threatened to desolate the peninsula of Europe. Its contagiousness was a leading topie, on which reports, pamphlets, and books went forth raging like the epidemic itself. Neutrality was scarcely possible in a matter so deeply involving the interests, passions, and transactions of humanity. Opinions founded on mere hypothesis concerning the cause of this malady, which remains to this day unknown, were not for that reason less, but even more, positive and dogmatic. Affidavits and affronts. certificates and satires, logie and direls, personal contagion and per- sonal invective, bad air and worse legislation, divided the professional and non- professional public on this subject. The non-contagionists, however, greatly outnumbered their opponents. They, for the most part, controlled the legisla- tion of the States of the Union by their efforts or their arguments. But no sooner were they off their guard than the contagionists appealed to the fears of the people, and urged the legislature to do something for the protection of the people by making laws against the importation of yellow fever, whereupon new
#Dr. Francis, of New York, on the contrary, upon the authority of Judge Andrews, Mr. Delespine, and Colonel Forbes, says that the yellow fever which devastated St. Augustine. in Florida, chienly during the month of October, 1821, "did not affect a single individual from the West Indies, nor a native of the country, nor any one who had previously suf- fered from yellow fever." Forty or fifty deaths occurred among newly arrived immigrants before the alarm became general. Eleven deaths happened in one day. About 200 were exposed to the influence of the disease. Of this aggregate 140 were attacked, of which 182 died, including three blacks. Forty deaths took place in the garrison, in a body of 120 s ]- diers." The official army report asseris that this epidemic was " entirely confined to stran- gers, that is, all persons not inured to the atmosphere of the city by nativity or a residence of a long series of years. Spaniards or natives resident in the country, who had the temerity to venture into the city during its prevalence, were liable to its attack, though in a milder degree than immigrants."
*All which has been disproved by subsequent experiences, notably those in Memphis in 1873 and 15%, when the fever proved itself no respecter of fra ms. sparing neither age, sex, color, the acclimated, the nnacclimated, the sober, the drankard, the chaste or the unchaste, the sinner or the saint.
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laws were often enacted with no effect in this behalf. The anti-contagionists, like Sicyphus, must roll the stones perpetually-then, now, evermore. Con- tagionists have, during this, as well as during all former epidemics, collected fatets to prove their theory. A peddler, from an infected district, arrives in a town, his pack is opened, he, the family, and many of the villagers die of yellow fever. Exactly the same occurrence (a mere coincidence) takes place a hundred times, where there has been no peddler, no box of goods opened, no travelers from an infected district. In one town, a erate of crocks, from New Orleans, is said to have been the means of transmitting contagion to the village, but at the very time nearly all the other towns, for 500 miles around, were falling under the malign influence of the epidemic. It would be most extraordinary if crates, boxes, passenger-, and pestilence should never happen to get together-not a> causes and effect, but as coincidence, necessary in the ordinary course of business. If the pestilence got into town before the arrival of a bale of goods. the former did not cause the arrival of the latter. If the man who opens the goods dies of black vomit, together with all his family, a hundred other families take the disease without any such apparent exposure, and die in like manner. A planter fences up his ground and se- eludes himself, family, and slaves, and all escape ; another does the same thing and all are attacked. The great majority of the learned, in Europe, attribute the black plague to the conjunction of Saturn, Jupiter, and Mars, on the 24th of March, 1345; just as many now attribute the late epidemic (1853) to events that happen to coincide in time and place. Those not irrevocably wedded to contagion, might find it useful to study the events which have passed before their eyes within the last seven years. The last Mexican war furnishes the most complete refutation of the contagiousness of yellow fever, in the absence of quarantine, so far as negative evidence can go. If the United States gor- ermoent had tried to devise an experiment, on a vast scale, to ascertain whether the yellow fever could be propagated by ships and armies, it could not have achieved its purpose more effectually. In 1846, 1847, and 1848, this malady existed in Tampico and Vera Cruz, and was very severe in New Orleans in 1847. The troops and material of the army, leaving New Orleans for Vera Cruz, and Vera Cruz for the interior of Mexico, did not suffer themselves from yellow fever, nor spread contagion through the towns and country. In 1848, thousands of the returning soldiers passed through Vera Cruz. in June, where yellow fever existed, and, on reaching New Orleans, in July and August. a few died, out of 15,000 who remained in the city and its environs some time, with- out communicating any disease to the city, by means of their goods, army ma- terials, aud selves. Thousands thus, without having been quarantined, re- mained in the city for a time, and quitted it for their homes, in other towns and places, without having communicated the disease to any one .* After the
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