Page images
PDF
EPUB

ited sense. Now, it matters not, so far as the necessity of quarantine regulations is concerned, whether yellow fever is contagious in this limited sense, or not. Personal contact with the sick will not engender yellow fever; but this is but one of several methods by which it is contended that the morbific agent that generates the disease may be communicated. If the infecting agent can be imported in the holds of ships, their cargoes, or the baggage of passengers, the propriety of quarantine regulations cannot be doubted. In the sense we have used the term contagious, that is, synonymous with transmissible, yellow fever is a contagious disease. The definition we have given it best accords with medical science, and it is understood in that sense by the best medical writers.

Dr. Hort is the most strenuous opponent of quarantine laws whose views have been made public; and he admits that the cause of yellow fever is transmissible; that it can be imported in vessels and merchandise. In a pamphlet written by Dr. Hort, and published by the committee appointed by the House of Assembly of this State to examine into our quarantine laws, he says, "infectious air from the hold of a ship, or from clothes or goods, or from a trunk," would communicate the fever. This is an admission from one of the ablest opponents of quarantine laws, that the causes of yellow fever may be imported.

It is of no consequence, so far as the necessity of quarantine regulations are concerned, whether yellow fever can or cannot originate in a city, so long as it can be imported. If we grant that local causes can generate the fever in New York-an opinion supported by a majority of medical men or that its origin may be domestic, it is no proof that it cannot be, or has not been, imported. The numerous extracts from the official records of the New York Board of Health, submitted by Dr. Vache, and published by the committee of investigation, seem to be of too positive a character to deny that yellow fever may be imported. Innumerable instances, quoted by Dr. Hort, of persons visiting those sick out of the infected district, prove that yellow fever cannot be communicated by personal contact. Yet this is no proof that merchandise put on board a vessel in a port where the atmosphere is infected with the morbific agent, may not convey the causes of yellow fever to this port. Who knows the nature of this morbific effluvia? You may sleep in the same bed with, handle or wear the clothes of persons who died of yellow fever, out of the district in which the atmosphere is infected with the malaria that generates it, and not be attacked. Yet this is no proof that you may, with equal impunity, handle or wear the clothes of those who died of the fever in the place or country in which the infecting agent pervaded the atmosphere. You may inhale the morbid exhalations emanating from the person of one sick with yellow fever, out of the district in which the atmosphere is contaminated with the morbific miasm that causes the disease, and be wholly exempt from an attack; yet you would not be similarly exempt should you inhale the noxious exhalations emanating from the cargo of a vessel from a yellow fever port, or from the baggage of the seamen or passengers that had been exposed to an atmosphere containing the infecting agent. The subtility of the morbific agent that produces yellow fever, has hitherto eluded all chemical analysis. It is not known whether the atmosphere is merely the medium of conveying the miasm to those attacked, or whether it holds it in chemical solution. To an unphilosophic mind it may appear strange that a malignant fever could be communicated by going on board a vessel from

a yellow fever port, or handling the merchandise put on board there, and that it could not be communicated by wearing the clothes of those who died of the same fever, when out of the infected district. Such a supposition is not, however, at all absurd. A cargo taken in at a yellow fever port, where the atmosphere is infected with the malaria that originates yellow fever, may, on breaking bulk on its arrival at this port, emit a far more deleterious and infecting agent than that which emanates from the persons of those sick with yellow fever, whether residing in or out of the infected district. Who knows the extent of the change produced upon the morbid matter that causes yellow fever, in consequence of its passage through the human system? That effluvia which is eliminated from the bodies of the sick may not possess one particle of the peculiar infecting agent that existed in the atmosphere which originated the fever. The small-pox virus, after its passage through the system of the cow, will no longer produce the small-pox. It has evidently undergone an important change, by which it is deprived of much of its deleterious properties. Well authenticated cases are recorded, where persons have drank the black vomit ejected from the stomachs of those having yellow fever, sleeping in the same bed with them, and wearing their clothes, and yet not take the fever. The inference to be drawn from these cases is, that the peculiar morbific agent that causes yellow fever loses its infecting properties, is totally changed, in passing through the human system. You cannot take yellow fever by visiting the sick who are removed from the place where the atmosphere contains the infecting agent.

Among the medical men who replied to the interrogations of the committee of investigation, appointed by the House of Assembly of this State, we would notice, particularly, Dr. Vache of this city, and Dr. Hort of New Orleans. The former is in favor of, and the latter opposed to quarantine. The former is of the opinion that yellow fever can never originate in this city, that it is exclusively an imported disease. The latter contends that its origin is domestic, that it is not an imported disease. The following is taken from the able letter of Dr. Vache to the committee of examination:

"The domestic or foreign origin of the disease, wherever it has appeared, has occupied the attention of the most distinguished men in the medical profession, and has frequently led to controversies as little profitable to science as to the characters of the contending parties. The subject, at this day, is as doubtful as it was at the commencement of the discussion, and will probably continue so, as long as physicians identify honor with pride of opinion, and partisans suit facts to theories, with predetermination not to be vanquished. Much has been published on both sides of the question worthy of consideration; each party has collected with unwearied labor all the information to be obtained with equal talents and equal learning, and still, the origin of yellow fever out of Africa is a theme on which volumes will, doubtless, be written for years to come, and perhaps until the end of time.

"I am aware it is alleged that yellow fever has spontaneously appeared on different occasions in several interior portions of our country, and I am also aware it is said to have exhibited itself in the cities and towns of seaports, when not traceable to any vessels connected with it; but I dispose of the one with the opinion, that the disease arose from local miasm of so fatal a character as to lead to the conclusion of its identity with yellow fever, especially as it is well known to practical physicians that the general symptoms of acute malignant fevers are very similar, and frequently require the nicest judgment of the most experienced practitioner to decide one type from the other. Of the other, I say, it is but negative testimony when the contrary has been so frequently established, and of

doubtful accuracy, where the desire of health-officers, to avoid censure, and the interests of owners and officers of suspected vessels, are taken in consideration. In New York, yellow fever has always appeared in the vicinity of shipping; while in other portions of the city, where human beings are piled on each other, in the most degraded and miserable condition, amidst heaps of accumulated filth, and loads of animal and vegetable putrefaction; where hunger and nakedness stalk abroad at noonday, exposed to the fiercest rays of a summer's sun, and where the unfortunate inhabitants are driven to their damp, ill-ventilated and loathsome rooms, for partial shelter, and temporary protection, during the pitiless storm, it has never been known.

[blocks in formation]

"Its very exception to all other forms of fever, in being arrested by frost, seems to me conclusive, at least of its tropical origin. But, admit it can be endemic, or local, and will prevail whenever the combination of causes essential to its development exists, does it establish that the disease cannot be conveyed from other portions of the globe, and disseminated wherever the pestilence is transmitted, distributing devastation and death to those within its fatal influence? Of this, however, enough.

"To enter into the argument in extenso, would lead to a lengthened analysis of the subject, too voluminous, perhaps, for the occasion. Be it, therefore, as it may, the object of the committee, I apprehend, is not to enter into the controversies of medical men, or to know whether yellow fever can be of domestic origin in this state, but to ascertain if the quarantine laws are in accordance with progressive science, and whether they can be repealed, or so modified with safety to the health of the community, as to be less oppressive to the commercial interests of the country.

"That yellow fever can be brought to the city from abroad, or, in other words, that vessels arriving at this port from places where yellow fever prevails at the time of their sailing, may give the disease by the liberation of the specific poison, on opening the hatches, and especially, on breaking out the cargoes or ballast, to persons communicating with them, or extend it to those on shore, whether the crew be in health or not, few persons acquainted with the history of our quarantine, would be willing to deny. The instances are too positive, and too numerous to be disputed."

Though Dr. Vache is no believer in the domestic origin of the disease, yet so far as quarantine is concerned, he deems this fact of very little importance. It is an established fact, that its origin is not exclusively domestic. It can be, and has been imported, though it may originate here. Therefore it is not important, so far as the necessity of quarantine is concerned, whether it can originate in this port or not. The important question is, are our quarantine laws in accordance with medical science, commercial experience, or can they be made less oppressive to the interests of commerce, without endangering the public health? All laws that are necessary to the security of the public health, are not burdensome to commerce. A malignant epidemic raging in this city for thirty days, would prove more burdensome to commerce than all the necessary quarantine regulations for ten years. It is certainly beneficial to the interests of commerce that the health of the city should be properly guarded. In the language of Dr. Vache-"The pecuniary loss of a hundred years by a proper quarantine establishment, cannot equal that occasioned by the ruin and desolation occasioned by a single season of the pestilence." Yet all unnecessary burdens upon commerce, all quarantine regulations obstructing the commerce of this city, not necessary to protect the health of the city, are unjust, and ought not to be tolerated.

We must now give a short extract from the pamphlet of Dr. Hort, published in the report of the committee. The principal object of Dr. Hort,

is to prove that yellow fever is not a contagious disease; and, therefore, he concludes there can be no necessity for quarantine laws. Afer a few preliminary observations, he says:

"My remarks will be confined to the questions of contagiousness and importation of yellow fever, on which the expediency and necessity of quarantine laws in Louisiana alone depends. Of the origin of diseases called endemic, or those of local origin, and confined to a certain section of country, (as the plague in the Grecian camp, so beautifully described by Homer,) and of epidemics, which travel from country to country, and from continent to continent, and from one hemisphere to the other hemisphere, apparently controlled by no fixed laws, we know nothing more, strictly speaking, than what was known in the time of Hippocrates.

[blocks in formation]

"If it is maintained that a disease originates in a certain country, and causes or circumstances are pointed out which are supposed to produce it, then, whereever we find in other places and parts of the world the same causes or circumstances, we cannot see why the same disease should not be produced in the one, as well as in the other place. If such causes, however, do not exist, the disease cannot exist, unless the doctrine of contagion be admitted.

[blocks in formation]

*

*

*

*

*

"Infectious air from the hold of a ship, or from clothes or goods, or from a trunk, might destroy a few individuals exposed to its influence, but it could not go far; it would soon be diluted so as to become innocuous; or should it become modified in some way in an impure atmosphere, then it would no longer be the same disease. One fact is here introduced to illustrate this position. In 1817, a barge left this city with goods for a store-keeper at Bayou Sara; during the passage up the river, and shortly after the arrival of the barge, every one of the crew and passengers died of yellow fever. The goods were landed and conveyed to the store; and the store-keeper who opened the packages, although he was warned not to do so, sickened and died of yellow fever; but no other person in the neighborhood contracted the disease. The whole subject is then narrowed down to the question of contagion. It is asked, why do we hear nothing of the yellow fever having prevailed on this continent, and in the West India islands, before they were discovered and inhabited by Europeans? Why, then, would we ask, do we hear nothing of bilious and congestive and typhus fevers, and divers other diseases, unknown to this continent anterior to that period? Will any one say that bilious and congestive and typhus fevers are imported? Yet there was a time when they were not more known on this continent than yellow fever.

"Disease follows in the track of civilization, not carried by the people from one country to another, but developed by the great physical changes brought about by industry and agricultural pursuits. The surface of the earth, once sheltered from the sun's rays by luxuriant vegetation, is laid bare to the action of those rays; the surface of the earth is turned up by the plough; exhalation and evaporation follow; vegetable matter is decaying in large quantities, or large cities are built, and people become crowded together within a very limited space, and filth and offal accumulate; the marshes are exposed, and great changes must be going on in the atmosphere near the surface of the earth; and is it at all strange that, under such circumstances, new diseases should be developed ?"

Dr. Hort is an able writer, and asserts that it is now more than twentytwo years since his attention was first directed to the subject of yellow fever. Yet there is not in the whole range of medical history, a stronger case to prove the necessity of quarantine regulations, than that we have quoted above from his pamphlet. He gives an instance where the yellow fever was communicated by opening a package of goods from a yellow fever port. He quotes the case to prove that yellow fever is not contagious; not contagious, because, he says, "no other person in that neighborhood contracted the disease." It appears that no one who attended upon the

man who died of the fever was attacked. Now, every one must admit that if a cargo of merchandise was to arrive at this port from a yellow fever port, and all who handled that merchandise would be exposed to yellow fever miasm, the necessity of quarantine regulations would be obvious. All medical men of experience agree with Dr. Hort that yellow fever is not contagious in the sense in which he uses the term; but personal contact with the sick is but one of the methods of conveying contagious matter. We have already stated that yellow fever is never communicated by visiting the sick out of the infected district.

The ability with which Dr. Hort has treated the subject, induces us to give a summary of his whole argument, as it appears at the conclusion of his pamphlet. It is as follows:

[ocr errors][merged small]

"1st. That yellow fever, like the other malignant diseases of the south, is of local origin.

"2d. That it is not an imported disease.

"3d. That it is not contagious.

"4th. That civilization has developed diseases, which a higher grade of civilization, aided by changes of climate, may modify or abolish.

"5th. That there is a yellow fever region, in any part of which the fever may at any time originate.

"6th. That on this continent, the yellow fever region has receded greatly.

"7th. That the yellow fever has been abating in New Orleans in a ratio with the improvement going on in the city.

"8th. That there is no occasion for quarantine laws. That experience has shown them to be useless here: while they would be very expensive, highly injurious to our commercial interests, and onerous to passengers.

The remark that "yellow fever is not an imported disease," and "that it is not contagious," as stated by Dr. Hort, will be understood in its proper sense by the reader. The doctor is unfortunate in stating the summary of his arguments. He proves, conclusively, in his pamphlet, that yellow fever is both an imported and a contagious disease. He admits that it can be imported in the holds of vessels, their cargoes, in the clothes and baggage of seamen and passengers; and he admits that the contagious matter can be communicated by handling the clothes or baggage containing the miasm, or by visiting the vessel from a yellow fever port. These admissions prove the necessity of quarantine regulations, with a view to guard the public health.

As the necessity of quarantine regulations are obvious to most men, it might be asked, what is the cause of so much diversity of opinion on the subject? It is simply a difference of opinion as to the extent to which those regulations should exist. Quarantine laws have been, at times, in nearly the entire commercial world, very oppressive, unnecessarily burdensome to commerce, greatly affecting the interests of merchants and others, by diverting trade from places where it naturally belonged, to places less convenient. Enlightened governments have seen the folly of these too restrictive regulations, and they have been, from time to time, modified, giving greater freedom to commerce, and that without the least endangering the public health. We should not be behind in this spirit of enlightened progress, but should make such changes in our quarantine laws as are demanded by the progressive state of medical science, and commercial experience.

As we have stated, the late quarantine law is less restrictive, except in

« ՆախորդըՇարունակել »