Omaha Daily Bee Newspaper, March 5, 1893, Page 10

PLAGUES AND PUBLIC HEALTH The Questions of Cholera, Quarantine and Immigration Analyzed, THEORIES CONTROVERTED BY EXPERIENCE Al Exclusion an Annoying and Useless ditions s Spread rtant Data, fient Foster Epidemies, Air € Th Loeal Ca T bruary contains W. Chan- Bos subjects of The Sanitarian for an important paper by Dr, C. etary of the Maryland kindred and cellar, sec of Health chole on th quaranting immigr sin and spread of the dr of rigid qua wue of tho individual onsidercd value care in det preventives rvant and from the standpoint of an obsc experienced physician, As these sub- jects ave of vital and timely interest major portion of ths paper is appended: In the whole range of polities, even that of science itself, there is no subject on which such ue notions have prevailed: none respecting which men's minds -have been so completely and so generally ey and spread of and the possibility of exc quarantine regulation certainly opposes to its peculiar difficulty; but one enormous assumption, and by ing to distinguish between one ¢ 1 ascertained facts, which it is essen- tial to discriminate, the extent to which both medical and unprofessional men of the greatest intelligence haue allowed their understanding to be abused is per- fectly astonishing. b For many ycars t ing cholera and communities and countries intercourse measur more restrictive, has scemingly effect of priving the the sanitarian, and the of the power of applying to tion the commonest and men have ar Asiatic chol luding it The investigation no by the ai by subject diseases from by non- or had the shysician Losn its investi rules of reason- od on this topic, apparently to their o stion and to that of in a manner which would have ed them with shame and overwhelmed them with confusion had they so done with reference to any other subject of human inquiry. And yet it is a subject on which it is of the greatest importance that the ideas should be elear and the judgment sound The incidence and spread of cholera have heretofore been governed almost invar found ready made to its taste —that is to say, the number of ill-fed people living in'filthy. erowded houses, and breathin a polinted atmosphere. N York fought the cho mmer by every effort und that could suggest execute, but in spite of energy di played by and munic ipal authorities ater was ther per fell vie ong Wwas proc et or malorum was seve ips chored in the lower quaran- tine surveillan rigid any that could well be devised. The disease en- tered the city, but it was not communi- cated from the steerage to the cabin pas- songers on the infected ships: and on this it is that we are asked to rest owr faith in the tremendous efficacy of quar- antines. 1t would have been reasonable suppose, o priori. that a disease arising from spe causes inhering in the indi- vidual and his personal effects would ob- serve peculiar laws, and spread from person to person us readily on hoard ship as in the city: but it was not found to do 80 in the case of the Normannia at the port of New York recently, anda knowl- edge of this fact is essential to an under- standing of this subject. It has been established by a multitude of evidence perfectly overwhelming that cholera will not spread by contagion from person to person, but only through infected food or drink, or an infective principle in the atmosphere defendent upon local conditions. Prof. von Petten- kofer of Munich, the great modern authority upon such subjects, in an_ ad dr published in the Munchener Medi- cinische Wochenschrift wember, 1892, said that “‘the etiology of cholera is an equation with three unknown quanti ties, namely, x, a specific germ dissem nated by human inter: stor dependent on place and time, which he calls ‘local disposition,” and z, the individual predisposition.” While not denying that x, the specific gorm, has some etiological im- portance, Prof. von Pettenkofer says he cunnot think that the comma Dbacillus, without the assistance of loeal disposition, can cause epidemics of chol- Practically he believes that local physical, and sanitary conditions mu: be attended to in order to make a cholera-p ‘0of. To show his utter disbelief in tl cholera being transmitted by germs the disease, except where the “local dis- position” exists, Prof. obtained some cholera bacilli from Ham- burg, which he carefully cultivated in bouillon, and after neutralizing the small amonnt of acid in his stor h to produce a good medium for the develop- other n sati \ors, cove Now science energy the at national, state the r and a dozen or ims to the di At med that t fons 1 infected bay, under more as a dranght of the fresh ing numberless comma L which he experienced no inconvenien except colicky pains and amoderate diagrhoa two ys after, The nined bucteriologically by Dr Pleiffor and 1 ohre du tion of the diarrhcea, and were be swarming with comma beeilli, there were no symptoms of Asiatic cholera. I'vof, Emmerich made an ex- uetly similar experiment on himself, with much the same result A specific virus or germ entering the human system cannot enjoy more than a temporary interval of calm—a period of incubation-after which it must work its work of destruction or cease to be a fac- b in the causation of the dises “Piaces as well pevsons,” says von Pettenkofer, “‘often enjoy immunity, and places which 1 at one often rewain i at another, when the ‘specific germ' and ‘individual predispositic But the nature and the local condition; streets, bad drainage, impure water, ili- ventilated and over wded houses, Imllm d_soil with & certain iydration, and the state of the exercise an important influenc the causation and dissemination of chol- ora, and thus the seat of the disea: be considered essentially local. From the date of the earliest histori- cal records, the opinions of men have divided on the subject of the causes igin of pestilential siclans and scientists, unable to aceount for the spread of pe on the prineiple sons, wnd al bouillon contain- found to us degree of the weather tilence of éxtraordinary sea. laining to admit that discancs can avise de novo from y of the air or pollution of the ¢ resorted to invisible ani- wonled in clothing or bales | the Mississippi valley at the time od from fore trie “ at cortain lods to weigo mankingd. The great Sydenham ik pestilencs W ocoult qualities of fgn coun y subject of exclud- | place ! ly mystified as that of the | not wbly by the proportion of materiul | von Pettenkofer | fected with chole: m fo) | lazavetto ment of the cholera spirilli,he swallowed | 1849, ne cilli, from | ported in the c stools | ng the dura- | yot | | | time | landed even | and the | Thero wer 1" are present.” | such as narrow, filthy | further extension of the e of | there both in | posed to the may | does the cholera spread from person diseases: and | | arfivals of 1 no THE OMAHA the air, and explained the peculiar l and connected with the h symptoms of diseases by the influence of an epidemic constitution of the air, His occult qualities” have been ridiculed by later physicians; but so far as his theory in this respect has been neg lected the e of medicine has de generated, and the ecause of humani has suffered. One of the most impor ant as well as most difi branches of medical science is to ascertain the effect of the reigning constitution of the air on pre- vailing ai and to apply that knowledge to the arrest and cure of those diseases, In opposition to the theory cholera s never propagated in America, but al- ways imported from abroad, it is very probable that the disease may, and gen- y does, originate in the count it exists as an epider The common opinion of the propagation of pestilential diseases solely thro 1 the deadly m diffusing itself in the air has most calamitous ef m human happiness, piec researches of ent have boer dili i of the subje ence to its real causes, to suggest the true means of avoiding the terrible scourge of Asiatic choler vithout denying to trade and travel any of facilities which consistently with every prudential r d for con- ions of protection and safety it may be permitted to enjoy The quarantine the ing the exclusion of the germ of thedis- cuse at the expense of neglecting all other nitary precautions. Such ve- strictive measures, when carried beyond the point of mere inspection and disin- fection, are utterly useless and always injurious, not only to comme but to communities as 1, indue! i tion of the public mind whic vesults in a disgraceful panic such ns was witnessed at re Island last fall. Cholery (1t with on the same 1 principle as all other di i and t that every sanitary defect be sought out and, as far remedied., hin facts, it 1t ases, ud a licine and nted the ts who might nt and ¢ to trace and those s 10 demand- possi- the definite limit of is to be noted that (quarantine h with exceptions, if invariably, proved an utter failu in excluding infectious diseases from community or country, nor does it f that the entrance of an infected ship at any port will necessarily spread the dis- rase in that port. There are no recorded s to show that restricted me ve suceeeded in keepin, cholera out of any country, or ev staying its progress, whe the conditions ure favorable to its spr established VY the <€ SHALL WAVE DOMINION ALSO FROM SEA TO SEA,AND FROM THE RIVER UNTO THE ENDS O THE EARTH!' ' P8.72: 8./ W ment of the city with the onset of minute inquiry he w tain that the by the remote from th any intercour who had come nor could dire traced betwe idly and parts of the eit other During the and January, 187 Orleans a total ants from ch of the ¢ unable m hanic of front with other first disense —a lived and worked in a river whatever from t personal ' any two of dozen cases which were developed simultancously , without any month of there arrived at New nearly ~infe 10 ascer pers me part in attacked the had pe Decemt 2,000 DAILY BEE: SUNDAY, MARCH 5. th dopart and Is entirely familiar After eity had SONS place: intercourse bo the first half Ap- different the sick hav- ing had any intercourse one with an- 1872 immi- ted districts in ype, but it was not until May or June, 187 ocenrred in provailed Ttaly, the v and d notwith imunicat countries and the antin 5 the that city n try. Fu, s fr lon died at other thwn: G tacked exc with them authority, that Marseilles and ing the throu nee, land, Belgium, and but no authenticated curr v point north of It may be said tha cases, however striking, impose on the t oned as that no events but such as a neral concelus proofs of the n be de ated to be re scale can warrant any scalo n be shown the ments that laws, enforced authority of d tic initial case epidemically feature of th wdline ding and general urt e Ma noble in southern I epidemic was not kind these places, nor were any gover In in epide the of the Dot the in that n_at d in in of the 1884 France cither por ptsuchas brought the disease It was ostimated, 100,000 diseas: lera Nimes on 18 and nie being time un and but the of at- m ulon, dur- distributed Switze Aust the ase of chi »d among this army of fugitives at wble. these that in this argument howeve by ol as nothir s or A« etherlands, are isolated individual imagination, and large m ne al docu- nments, of no avail in 1831 in warding off ¢ Astrachan, M Berlin, B aris, Cairo an cholera in 1 from 1d town of ing the amounting most almost Cow, sslau, 1 Alexandri fir: in Sunderland, notw vigilant ¢ St. an w lera 7id quarantine ower Vienna, appeared Ham- in the thstand- rantir nonintercourse SIZE OF THE UNITED STATES (EXCLUSIVE OF ALASKA) 1893—SIXTEI PAGES barous rigor recallod th but even Corsica s not escaped Colonel Mason, further states (roport to State department, Washington, Juty a1, 184 Ar¥s’ which is an old densely built, and. badly drained and ventilated city, has been most severely stricken, and the 'pinic there has been 80 extreme that thie wurths of the en- tire population have fled. At Nimes, however, less thdn twenty miles distant a number of refugees from Marseilles and Toulon havedied of cholera, but the eity is so clean and the sanitary manage- ment so good that the contagion has not been kindled there In this connection it is worthy of note that England, Belgium, Germany and Austria, that took no precaution agal ra during the outbreak in France, remained almost entively free from infection, only a few cases having 00 among the refugees who had takenshelter in Switzerland and Austria, while Italy, with the most i coast and frontier quaranting able to keep off the disease. of the Italian government such restrictive m criticised by the v middle rous not action imposing rely in eminent [talian au- thority Tommaso Crudeli, who had mad sfal study of cholera, and de- clared his belief “that such precautions are lessi that they lull the p into a false security, besides or ling a and unne y Injury upon 15 le trad Unquestionably the first law is that of self-pre vation, but the need of a law stringent as that contemplated in the several bills before ¢ to protect the people of this country from an inva- sion of the cholera has yet to be satis- yrily determined. There is u dis- position on the part of many to make the condition of affairs in this country worse than it really is, in order to secure the doubtful advan of a national quaran- tiny The most trustworthy and scien- titic authorities of Europe, some of whom have been quoted above, do not coneur in the opinion, so generally expressed by the medical men of this country, that the only, or even the best way to ex- clude that of hermetically sealing our ports against ships from all infected places. In fact, such rigorous exclusion is denounced by the savants of rope as an unfit survival of a custom commonly observed in the dark cholera is [t has been stated that the closest intercommunication was maintained all through the epidemic in Hamburg 1 summer between that city and ot Buropean cities. The communication by sea and by land between Hambur, » chief continental seat of cholers Liverpool and London, or Berlin Vienna, is said to have of MEXICO of disease oce urs inport; this obli detained ship, although she may had no communication whatever the s, to sail with a foul bill their arrival at New York, or any other port in the United States, one ship is immediately veleased: the other is obliged to perform quarantine, under the president’s proclamation, for twenty days. Again, two ships lond with foul eargoes during an epidemic. One sails thirty days after the poestilonce coased; under the forty days quarantine system she must_carry a foul bill; the other waits ten days more, when she is entitled to a clean bill T ship with a foul bill will be obliged to undergo quarantine for twenty days, that with a clean bill will discha her cargo in three or four days: but it is ohtious that the danger in each case is equs ‘e the danger real, the ship with an bill must of necessity convey mty m to the market in which her s are sold, Once m ship with a foul cargo pos: sho waits forty tormination and bill Anothe ship loads neargo during these forty is d fow hours puted to have porti she has no comm shore, yet she is obli foul bill. In this od is n bill, and a clean accom 1 with a foul bill tain, therefore, that were capable of being conveyed by g cargoes of ships with foul bills often be without the slightest while the cargoes of ships bills would frequently be extremely pe ilous. From these the system of quarantine as practic this country cannot be supported by bills of health, the last prop on which it stands, The experience have with duri days its with- a cloan with a ¢ days; she case of ehole pened in the cation with the to sail with a also, a contagic with a cl cont s the would danger, with cle; of every people and y nation, since all created animal was quarantined on N > 1 tlation period of forty tests the inutility, nay, more, of attempting to exclide cases by m quarantine regulations, A theoretically perfoct quarantine which it would be impossible to break at any point, and which must, of course include the full period of incubation of the particular disease quarantined would doubtless, if practicable, afford a in higher degre of security against the introducti of discase cer been constant, | exist in imagination, and a quarantine than is to be attained in any oth : but where are the - conditions of a perfeet quarantine to be found, and at what cost woule the experiment be car- ried on? A perfect quarantine can only ) Under such circumstances there can be | parallel to the folly of attributing | every outbreak of cholera to in- fected persons or infected merchandise, and of ablishing quarantine reswric- tions inessential to their object and de- structive to commeree. The following recorded facts have been selected from | many of a similar character to show that ' cholera does not spread from immigra- tion, nor from the importation of me chandise in places where the “local d position™ necessary for its propagation is absent, ior to May 1, 1832, 30,000 immigrants 1 arrived in the St. Lawrence river from infected ports in Kurope, and yot not a single case of cholera developed in Canada or the United States until the middle of June, 1832, when the first case oceurred in Montreal, and from this cen- ter of infection it spread throughout the United States. On_ December 1848, a steamer in- a landed in New York. Of the immigrants by this steamer, fifty died at the quarantine, which at that time was merely nominal, and yet not case of the disease occurred outside the until the 1lth day of May, ly six months after the deaths 1tine, when two deaths were re- y ot w York. In November, 1853, no less than twenty vessels, on which 1,141 persons had died of cholera, arrvived at the port of New York, but the disease did not obtain a foothold in the country until January, 1854, at which time it broke out in th city of St. Louis. From this center it passed to Chicago in April, to Detroit in May, and in June it became epidemic in w York. In 1865 three steamers ari York from Havr been deaths from the voy but no cases in the city. In the spring cholera was carried into Halifax by the steamer gland, of the National line, which v afterwards proceeded to New York, where, on April 20, she 895 pas s and 116 office men, having lost 316 by cholera. eight cases and five deaths those who had to do with the at Halifax, but there was no ase, and not 1 in New York from this importation. Subsequently, however we 3,000 arrivals in New Yor of individuals who had been dir otly ex- infection at Liverpool, on quarantine, but so slowly at quai ed in New on which the cholera among vesse a case ship and at to person (except where un epidemic constitution of that there w there is the air) e only twenty-one deaths o in New York up to Jul h there were freque the cholerainfected ships during all the time. The epidemic of cholera which deci- mated Memphis, Tenn., in 1866, made its appes about the middle of July of thut year. The pestilential constitution of the air which ‘pervaded the whole of was powerfully aided in Meraphis by local vitiations, and not by an importéd con- | tagion. The writer'of this was at the time 4 praticing physician i Memphis, | | epidemic of with the world; it also sprang up sud- denly | and Scotland, when restrict In 1832 Bre the in other towns, both in which was considered to ha perfect system of quarantine, both on the frontie; gland most vigorous ve measures had been practiced. lau, the capital of Silesia, the most rs and on the river Oder, was suddenly alarmed by cholera appearing in one of its suburbs. The first case was a female who had never quitted the city, any person suspected of being infected, nor In nor been in engag a few days after communication » attacked with chole ty remote one with another. from with lin any traffic of any kind. er death many pe in parts of S0ns e city cach other, and without having had any communication About the same time Berlin, despite a sanitary cordon, com- posed of the choice troops of the king- dom, under himself, be ages of cholera. The inhabit year, lookin, the ey m and the country to th enlisting all the means in cordons and qua by sanita prevent the discase of the their antines, from approaching nts of Hamburg, the with anxiety toward St \ soverel ame u theater for the n me Ber- vd, and power, to from any quarter, found it suddenly ap- pear in the city, risin the ground and atta the city and all ¢ as it King all se s of the community we from tions of simultaneously, without the sick havini had int diseass ur could not be tion from any sour bad. Similar restri posed by the were attender ess, and V rtificial barrier; escaped entirel a great impr sion governments of but conditions of the city we stive Austrian with the § nna bec the disease, while many | upon urope, me and same one with another. d to the imp they released vessels from the ne of performing a rigorous quar that is to sa rej their quarantin In the Cunnin am, the subject, he says, page 12 ence of fairs and other country [India] has ag fied to the truth of the conciusion th y, many of the g :aled the most obnoxious > law. ighteenth annual report of Dr imper Th i itary notoriousl measure: government want the scat of aces where no had” been interposed These facts produced most of the the im of vernments tures of A ial sanits commissioner of India, bearing upon this The expe atherings in this in and again testi- at cholera is not carried by persons from to cause one locality to anothe themselves influence [t} Pettenkofer] to be- ted by the disease 'ting to the United States gov- persons not necessary I culiarities come affe In repc of von 50 as xposed to the al pe- ernment the supposed cause and trans- mission of cholera in Europe during the seilles says year [1881] has witness ure of the quarantine | first signal of Marseilles, Italy established a land dar quarantine, both by sainst read te Turin to quarantine from every the Mediter France Naples, ( ancan, 1884, Consul M *1t is to be noted that this utter fail- At v n and and against mainland 2d the system from yet wsica all which and yet chol arly the wholo of Italy, from imposed Toul v by Mar- the rous it has arvivals port for of ba voluminous and direct, but there were not more cases of the pestilence in either of those four cities than in the city of New York, which maintained the strictest quarantine, supplemented by action of the United States marine hos- pital service in rigidly enforcing hun- dreds of passengers to remain in in- fected ships, among the dead and the dying during the time—an act of cruelty which coming generations will regard with the same horror that we now do the persecutions of the witches in the seventeenth century or the cruel- ties of the black hole of Calcutta. Pro- gressing on. this line, our next step toward the practices of the barbaric s and institutions of the world will to draw lines of circumvallation ind the town or district to be pro- tected, and to station, heyond these lines, cordons of marines, armed with cutlass and mitrailleuse, a: ing the entrance of germs in the atmospheric currents which conv such germs unseen X untry to coun- be pathogen fore! tw require vessels coming from ports to perform quarantine for whether any cases of disc curred during the voyage or not. The reason why twenty days has been fixed on as the period necessary and suflicient to exterminate infection in all its known and unknown states no one has ever pri tended to assign. Let us look at the system in relation to merchandise. The argument nst a national quarantine, as applicable to ‘merchandise, is short and unanswerable. ,As the germ cholera is, according to Prof. Koch, killed by drying, and as it cannot be conveyed by curreats of air except when dry, but little importdnce is attached b scientists to the ipfluence of the atmo: )here in contagilnating merchandisc The only . thevefore, in which goods :an be contagionéd is'by being handled, or by coming in eimtact, by some means or other, with those affected with the disease. But pedfle sick with cholera cannot labor in the flelds to gather the raw mate 1 they cannot labor in the various pt By which the raw ma- terial is manufactured: they cannot labor in the waretouses, at the docks, or on board ship in,gvler to pack and the s, It is not, then, par- ticularly easy to see how merchandis can become impregnated with the in- fectious matter, or germs of the disease. But granting that merchandise may be infected, what immunity is afforded a community by quarantine from contami- nation by pestilential contagion con- veyed in such goods? Bills of health are documents from consuls to ships sailing from cos subject to their con- sular jurisdiction, certifying the state of health of these places nee to pestilentisl time of the departur A foul bill declares and a clean bill the ab: contagious or infectious dis seaport from which a vessel s at the period of her sailing, Now supp two ships to load with clean cargoes in a period of health. One sails a day before 1 the other; in the meautime a single case of the nee of in the ,COMPARED WITH OTHER COUNTRIES! weans of prevent- | | about | than 1,250,000,000 people. | up of | which is not perfect is simply an irra- tional derangement of commerce with- out any benefit to public health. What we need, and all that we need in_ this respect, is ‘“a system of medical inspections” as prac- ticed by the English government, which differs from “‘quarantine” in the follow- ing essential respect 1. Tt affects only such ships as have been ascertained to be, or as there reasonable ground to suspect of bein, infected with pestilential diseas ship is deemed infected unless the been actual occurrence of the dised board in the course of the voyage. 2. It provides for the detention of the has | , and, | after | s ark for | days, at- | the' folly, | infectious dis- | vessel only s0 long as is necessary for the roquirements of a medical inspec- tion, for dealing with the sick, if any, in the manner it prescribes, and for carry- ing out the process of disinfection. 3. Tt subjects the healthy on board to detention only for such length of time as admits of their stato of health being de- termined by medical examination, | In rd to the question of immi tion, it may be stated that we h people in the United States, while we have unoceupicd terri- tory that will comfortably accommodate at least 300,000,000 inhabitants and, if settled as thickly as Belgium and some other European countrics, the surface area would contain a population not less | If, therefore, we can secure a desivable class of immi- grants, the r of cholera should not induce our government turn them away. They will not only serve to fill the desol wilds of America and “make two *blades of grass grow where one now grows,” but they will supply much needed labor to the plantations of the south and the farm lands of the west Unlike the Dutch Process No Alkalies —OR— ~Other Chemicals are used in the preparation of bl /9 W. BAKER & C0.’S BreakfastCocoa which is absolutely pure and soluble. 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