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 43
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# The Jamaica report, drawn up by some of the ablest medical men England has pro- duced, and by very able civilians who knew what they were talking about, says: " Epidem- ies of fever in this island are often confined to certain districts, showing that the local causes are then and there in one force. Thus, at this very time severe fevers are prevalent at
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reduction of Vera Cruz, yellow fever appeared, and many invalids and sick persons were sent to New Orleans and other places for treatment, in the trans- ports which carried out the troops, yet they did not propagate the disease any- where. Thus at least fifty thousand experiments made in Tampico, Vera Cruz, and New Orleans, not to name other places, produced no personal or other kind of contagion, though in both the first named places yellow fever prevailed moderately among residents not acclimated. The Board of Health of New Orleans, in an official document, announced for the month beginning with the 26th of November, 1853, that 6,707 passengers from foreign ports, chiefly emigrants, had arrived at our wharves in forty- seven sea-going vessels, by the river route. Now, if we add the num-
St. Thomas in the east and St. Thomas in the vale, places wide apart and unconnected : at other times the canse is more general, and it rages over the whole; months and years sometimes pass without the disease occurring, either in a sporadic or epidemic form, and then suddenly it barsts out with all its force. These fevers are common to all cia -- es : some, however, deny that the black race can suffer from yellow fever; instances, however. do occur, though rarely. The prevalent opinion that one attack of yellow fever defends the person from another is decidedly fallacious." In another part of the report the Board of Health of Jamaica say : " Not one single epidemic witnessed by the health ofi- cers there could be attributed to importation." . . . "Yellow fever patients constantly arrive at Kingston, and for the last twenty-five years have never been put into guaran- tine." At Gibraltar, in 1828, great numbers of the British troops were attacked who could not possibly have come in contact with any infected individual. Of 282 w men and children of the 12th regiment, who were not allowed to enter the fortress. but re- mained in the camp, not one had the fever, though several of them slept in the same beds with their husbands laboring under the epidemic ( which they had caught while on duty in the fortress), and continued, with their children, to use the same bedding after their husbands were removed into the hospital." MI. Amiel says: " Where the wife in the same bed came in contact with the patient, scorched by febrile heat, or bedewed with co- pions perspiration, when she inhaled, under the same tent, the eflluvia of his breath. how could the air sufficiently interpose to prevent the process of contagion and its fatal con- sequences?" In 1804, while yellow fever was devastating Leghorn, 6,000 person> left Leghorn for Pisa. The French army moved at the same time to the same place. taking with them 180 men with the disease; yet there was no propagation of the disease at Pisa. Dr. Blair, one of the latest and one of the ablest writers on yellow fever, says of British Guiana: " There was no difference of opinion to excite discussion here, for there was not a single person, professional or non-professional, in the length and breadth of the colony, who, in 1538, after the first alarm had subsided, had the least suspicion of contagion in our yellow fever. During the epidemic the yellow fever cases, in their worst form. were never separated from other patients in our hospital wards. Such a thing was not deemed necessary and never thought of. They were classified with acute diseases. Our hospital nurses never got infected, although in the closest connection with the sick, and often smeared with their ejections; and these nurses were chiefly German and Portuguese im- migrants." Dr. Bell, of Louisville, a distinguished physician and a recognized authority in all that relates to the yellow fever, reinforces the above evidence by his own experience. ITe says: "I have seen and attended in this city some of the severest forms of yellow fever that have been described in the tropics. I have walked through the quarantine grounds at Staten Island and conversed with the yellow fever patients ; I was in the yel- low fever haunts below Brooklyn Heights in 1856; I was in the yellow fever district of Philadelphia while the fever was prevailing there, and I never had the least fear of catch- ing it."
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ber which had previously arrived to the number which has since ar- rived from sea, the aggregate will scarcely fall below 10,000, while by other routes, chiefly by the river, the emigrants, absentees, and other unacclimated persons (as the steamboat population coming to the city in September, October, November, and December), 40,000 may be added, making 50,000 living ex- periments against possible contagion-50,000 exposures to all the possibile sources of contagion-the houses, goods, etc., of persons recently dead, in- eluding emanations from the sick and dying, during the decline of the epidemic, and during the whole of this period, all proving harmless. If the yellow fever be contagious or transportable, why has it not been carried beyond the tropic of Capricorn during centuries of active intercommunication ? Why did it appear only north of the equator, with two or three exceptions, always near the line, until 1850. when it traveled for the first time to Rio Janeiro, which, however, is within the tropie? Such vast, yet significant, experiments quite overthrow those few cases where the opening of a box or a bale of goods is followed by yellow fever-mere coincidents, not causes. There is not the least reason to think that the world, combined for the purpose, could create an epi- demic yellow fever, or even a single case, in any city, street, or house upon the globe. The enlightened governments of Europe, whose intertropical pos- sessions enable them to judge from large experimental intercourse, have not only gradually lost confidence in quarantine as a preventive of yellow fever, but they oppose it as altogether mischievous-at least such is the case in Great Britain. Quarantine in our own country is nominal, illusory, and i.ver comes up to the theory of real quarantinists. The deception is, therefore, less mis- chievous than an honest enforcement would be. The provisional assumptions of contagion, seclusion, and quarantine in yellow fever, once altogether proper and wise, anterior to experimental tests, are now no longer such. In the hour of despair and ignorance, the theory that the building of a large city in a country where earthquakes and volcanoes prevailed, would prevent them, might be tolerated until after a fair trial. But, if experience prove that earthquakes continue as before, the building of cities for this purpose should not continue. If faith is but proved by works, the contagiousness of yellow fever in New Orleans falls to the ground, because, in practice, it is disregarded both by the acelimated and the unacclimated, inasmuch as doctors, nurses, and neighbors visit the sick in the freest and most fearless way, and with equal impunity with those who keep at a distance from the sick .* Experience shows, both in
# A New Orleans correspondent of the New York Times, who wrote intelligently, and like a man of experience, in one of his letters asked: "Is there any danger in visiting the sick-room?" And he answers, "I do not believe there is, other than that the close air of the room is prejudicial, and may derange the system, in slight degree. This is my own view, based upon the fact that there are hundreds of unacclimated persons in this city who are attendant npon the sick, and who exhibit no more tendency to contract the disease than do those who avoid even the passing of an infected house when practicable. In fact, yellow fever seems to be caused by a morbid principle entirely different in its characteristics than any which excite or produce other epidemie diseases. Every day ex- perience here shows that it can not be communicated from person to person, but that it is
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hospital and private practice, that proximity to the sick does not enhance the danger to one living in the " infected district." In the rural districts, and in the towns where tear was great and experimental knowledge of the fever little, the people adopted a different line of conduct-the principle of seclusion and non-intercourse. The traveler, denied the hospitalities of the house be- cause he had merely passed through an "infected district " or village, wan- dered along the road. seeking shelter in vain for the night. Towns suffered for want of provisions, because their rural neighbors feared to approach the siek. Sometimes depots were established near these self-beleaguered towns, where the sick and their attendants and families went for supplies, and thereby escaped starvation. The artillery placed at the landings and wharves, threatened to send grape and cannister shot into boats and vessels that dared to approach from infected districts .* Individuals as well as towns carried out the principle of seclusion, and were alike unsuccessful. Although the quarantine party is, to a great extent, composed of men of the highest integrity, talent, patriotism, and disinterestedness, yet it is feared that some who profess quarantine loudest are, at heart, infidels; if they are sincere they are not consistent. By what code of morality can they justify them- selves in dispensing with quarantine in any case like the following example, taken from the Daily D.Ity, of September 13th, 1853? Captain Baxter's state- ment. as given by the editor : " Captain Baxter left here (New Orleans) with the Cherokee, on the 12th of August last, when the epidemic was at its height, with 169 Passengers, the majority of whom were unacclimated, and liable to the yellow fever. During the voyage, there were ten of the crew down with the fever, and on the arrival of the Cherokee in New York, there being two still sick, they were ordered into the hospital, where one of them died ; the other recovered." Were the crew and passengers (without mentioning the ship and cargo) kept forty days in the lazaretto undergoing fumigation ? Not at all. Captain Baxter adds: "They were all permitted to land in New York, after eighteen hours, and the sick members of the crew were alone compelled
strictly individual in its attack." And Dr. Westmoreland, of Atlanta, Georgia, scouts the idea of contagion, and sustains his position by his own personal experience in 1878. He says: " I nursed the case of young Brand, in Atlanta. I felt that if yellow fever was contagious, after all I had said-if I had actually been deceiving the people-that I de- served to catch it, and ought to die. I therefore determined to give it a full trial. I staid in the room with my patient all day. I even slept in the room with him all night, with the black vomit all around me, and the room thoroughly impregnated. I unpacked his clothes, and handled them freely: I tonched the patient, nursed him, and waited on him, till he was dead. I had two nurses who went through the same ordeal with me, and they both came ont unscathed. Dr. Johnson went through even worse than that. He was with us all the time. and hold the patient's head while he was vomiting. He is now in perfect health. If there is any thing that is absolutely demonstrated, it is that yellow fever is not contagious."
# Exactly as in 1878, when panic prevailed from New Orleans to Chicago, by river and railroad, and from the Mississippi as far as Knoxville, in the mountains. And many, indeed most of the towns co- quarantining escaped the fever, the people being thus confirmed in their faith in quarantine as their only safeguard against the pest.
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to go into hospital detention. Such a quarantine is but a kaleidoscopic illu- sion. If the New York authorities entertained the belief that yellow fever is contagious, they would not, in this strongest possible case of importation, have willfully exposed the lives of half a million of people, unless they are worse than pirates themselves .* Their acts, more than their words, show that they have no belief in quarantine as a preventive of yellow fever. The same infi- de lity is obvious in the actions of the few contagionists in New Orleans. They no more avoid yellow fever patients than they do rheumatic patients, or char- ity. They are better than their doctrine." Continuing his logical disquisition on the cruelty to persons, the cost to commerce, and the injury quarantine infliets upon those who are the prey of it, Dr. Dowler says: "If New Orleans contagionists succeed in getting the city and State governments to establish the contagiousness of yellow fever, by a special act, let the same act forbid the ex- portation of cotton, even to our enemies in time. of war. In time of peace, it would be more unjust to send infected cotton to the subjects of her Britannic Majesty, or to the subjects of the Emperor of the French .. It would be still more criminal to export cotton and contagion to Philadelphia. New York, Bos- . ton, and other cities, as a return for their opulent donations to yellow fever - uf- ferer- during the Jate epidemic. " It may be said that a contagionist, how sin- cere soever he may be, is not bound to care for his neighbors' interests and health, but hone-ty requires him to care for both. It is doubtful whether the English Minister was strictly moral when he declared that he . cared for Eng- land and English interests alone.' The same dubiety hangs over Commodore Bainbridge's toast, . My country, if right, but my country, right or wrong.' If yellow fever be contagious and transportable, quarantine ought to be en- forced by grape and cannister, gibbets, and fines, though commerce should per- ish altogether. If quarantine is to reign in New Orleans, let it be as rigid as in the Levant, for no Eastern mummery can be more absurd than that prae- ticed at the quarantine stations of the United States at the present time. The strictness of the East has both consistency and reason in its favor (admitting the doctrine of contagion), which can not be urged in favor of the West. 1 doctor of some Atlantic city of the Union goes on board of a ship from New Orleans-the plague-stricken eity-he looks at the cotton bales, and the pas- sengers, and he straightway ignores his own theory, his oath, and the law : for in a few minutes or hours after the vessel is admitted, no one being able to-
The authorities of New York now enforce a rigid quarantine. In 1878, every case of yellow fever that found its way to that city was at once sent to the quarantine hos- pital for treatment; and that is the declared policy for the future, not only of New York, but of every other city in the Union.
t During and after the epidemic of 1873, persons residing in cities competing with Memphis for trade in Arkansas, Mississippi, as well as West Tennessee. made no scruple of declaring their belief in the contagion theory, so far as the dry goods, woollen goods, furniture, and even certain kinds of groceries, that Memphis offered for sale, were con- cerned, but when it came to their receiving either bales of cotton or wool from, or pass- ing through, Memphis or other infected points, they closed their cars to the contagion theory, and not only willingly became the agents for the sale of such cotton or wool, but eagerly solicited the sale of it.
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know how he could possibly have ascertained, by a look, whether contagion was or was not in the vessel. If yellow fever quarantine be well founded, such conduct is murder by the thousand. If the laws of the land and of nature have established the fact of the importability of yellow fever, by means of persons and merchandise, and if quarantine be necessary to prevent this im- portation. then quarantine can never be dispensed with by a look or a whim; that is, the laws of nature can not be changed in this way. If importation be the antecedent of yellow fever in New Orleans, let quarantine against it be not only strict, but eternal. If the act of the Legislature of Louisiana, in the winter of 1817, establishing a code of quarantine laws was wise, the re- peal of those laws in 1818 was foolish. But it may be said that these laws had failed to prevent an epidemic during the summer of 1817. True, but why has the same course been pursued since, and why pursue it again, as is intended now ? The experiment has been often repeated in various countries, and with like results-results mischievous, demoralizing, repulsive to humanity, and tending to increase the mortality of yellow fever during an epidemic. If the people of New Orleans could be brought to believe in the contagiousness% of this disease, benevolent as they are known to be, the rich would be secluded ; intercourse would be so restricted that many would perish from neglect." This testimony against yellow fever quarantine by Dr. Dowler, fortifies Dr. Dupuy De Chambrey, of New Orleans, who, in his historical sketch of yellow fever, as it appeared in that city in 1819, says:
*"Contagion in its most literal and restricted sense" is defined by Dowler to " im- ply the actual contact of a well person with a dead, or sick person, or his apparel, by which a specific poison is transmitted from one to the other, reproducing a similar dis- ease, as in small-pox, cow-pox, itch, etc. In a more enlarged sense this term includes invisible emanations from the siek, consisting of specific poison, doubtless dissolved or suspended in the air, and capable of reproducing a similar disease in any indefinite number of persons who come near the patient, of which small-pox again affords the most complete typical illustration. Here the fundamental idea of contact is, perhaps, real, though unseen. Another type or criterion of contagion is this: it can not act except within a very circumscribed space, in any season, Intitude or climate; it may be limited by isolation from, or non-intercourse with, the healthy; its extension probably might reach from pole to pole, if all could be brought in proximity with a single siek individ- ual, although the emanations from his body, at a few feet from the same, mixing with the atmospheric ocean, become harmless, not epidemic. The word INFECTION, generally used as synonymous with the word contagion, has too often played a conspicuous, if not a satisfactory, role in the vague and inconclusive disputations of yellow fever quarantin- ists. If the word infection means an emanation of a specific acrial poison from the sick, giving rise to a similar malady in the well, it must be precisely the same as contagion ; but if it means an impure air arising from an animal or vegetable source, or from both combined, then it is but another word for miasma, malaria, or bad air. The labored at- tempts to explain this word -- the bad faith in which it has been used-at one time for contagion, at another for the bad air of a sick room, a sick city, a vile scent, or palndian exhalation, go to show that it is a most perfidious word, the shiboleth of dialecticians- a word pregnant with mental reservations. It is the limbo of countless pamphlets, books, and laws upon yellow fever quarantine, the lumber of the last and present centu- ries. If infection be used to denote the contamination of the atmosphere of a room, or
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"I formerly believed the yellow fever to be contagious, but since I have been in the midst of it, my numerous practical observations have never been able to furnish me with a proof of this much dreaded attribute. Indeed the result has been quite the reverse ; and I am now convinced that the disease is per- manently fixed to the spot, and within the limits of the place which has created it. Not one case occurred beyond the limits of the city, during its prevalence in the years 1817 and 1819, that could be traced to the innumera- ble patients. although daily intercourse was kept up between the people of the neighboring estates and plantations. A great number of our inhabitants who carried the seeds of the disorder abroad, seeking refuge from the danger at a distance, suffered an attack of the fever and died, but in no instance was it communicated to their friends. Fifty times have I had my hands and face besmeared with the putrid blood, black vomit, or foetid, slimy matter of por- spiration. Fifty times have I been immersed in the effluvia issuing from a dead or living subject, and never been infected by the disease .* From exten- sive observations, I infer that the yellow fever of this place is a discase sui generis, the product of local causes, and neither contagious nor exportable. Flight from the infected spot is the only preservative." Governor Villere, of Louisiana, in 1820, in his message to the legislature, a firm advocate of con- tagion and for quarantine, says : " All the medical faculty appear definitely to have adopted the opinion that the yellow fever which, during the last year (1819), has plunged us once more into mourning and desolation, is not contagious." But he argues : " During the months of August, September, and October, there has been almost constantly in the prison of this distressed city a great number of prison- ers, and not a single one among them has been affected with the disorder."t Quoting this, Dowler asks: " If the yellow fever were natural to our elimate, how has it happened that among such a number of persons heaped together in so small a space as the prison of the city, not a single one should have been attacked ?" Dr. T. H. Bache, of Philadelphia, writing in 1820, also furnished Dowler with non-contagion evidence of a valuable character. He stated that " the number of cases of yellow fever admitted into the Pennsylvania Hospital had been twenty-three ; of these fourteen had died, seven recovered, and two still remain [October 6th]. These cases were placed in the common wards, without any attempt to separate them from, or prevent intercourse between
of an urban district or focus, with or without offensive scent, an emanation from vegeto- animal decomposition, not an emanation of a specific nature from a sick man, which in any climate, season, and latitude produces similar malady in the well, then the word becomes intelligible. Such contamination however, does not originate a strictly con- tagious disease, though it may, and often does, aggravate the latter. Seclusion from sick persons does not insure exemption, while the individual lives in the infected district. The locality, not the person, is dangerous.
# The young man, Lonis Daltroof, employed in 1878 by the Memphis Howard Associ- ation to bury their members and employes, faithfully performed that duty, and escaped the fever, though he had as offensive an experience as De Chambrey.
f The same was true as to the prisoners confined in the Memphis jail in 1873; but in 1978 it proved the reverse. The prisoners were attacked; some died, and the rest had to be removed to a place of safety.
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them and the other patients, but in no instance had the disease been com- municated to the latter !" Dr. Reese, in 1820, in his Medical Gazette, affords Dowier additional evidence. He said: " How strange that the antiquated fable of contagion* should still haunt the popular ereed, and be made the hobby-horse on which so many flippant political doctors ride into places of profit, nuder that silly relic of barbarism known as the 'quarantine regulations.' which are as powerless in keeping out yellow fever from the cities in which it is generated by local sources of etfluvia, as they would be in imposing restric- tions against the waves of Old Ocean rising in her wrath. Even here, in Phila- delphia, where a few score of cases have occurred in a district infected by an old and filthy common sewer, we find certain medical savants hunting for its cause in an old ship, guiltless of all but bilge-water; and this with an obvious source of yellow fever under their noses. When will this ghost of contagion and importation be exorcised ?" Dr. Brickell, a practitioner of high repute in New Orleans, sustains Dowler, and, in a recently written letter to Senator Lamar, a member of the congressional committee to investigate the origin. causes, and means of prevention of yellow fever, states that he believes that the fever has become naturalized in New Orleans, and originates there. He concludes:
1. I have seen and treated the disease-yellow fever-from the epidemic of 1848 to that of 1978, inclusive, and in city and country.
2. I believe that the disease ean be, and has been, imported.
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