THE NATIONAL QUARANTINE

It will be recalled that a year ago there was almost a panic in the United States for fear that cholera would get lodgement on the land through the port of New York, and spread over the country. There seems to be very little fear this year on account of the cholera, though there is probably almost as much cholera in Europe as the year before, and it appears to be spread over a wider area. There are two reasons why there should not be a panic this season. One of these is due to the apprehension that fills nearly every mind as to the business outlook. The other is that the same spectre is powerless to frighten the same community twice. If it were generally known, however, that under the provisions of a bill passed by Congress last February the Supervising Surgeon-General of the United States Marine Hospital Service is empowered to overlook the work of all local quarantine authorities, and to take charge of such work whenever in his discretion he thinks that the quarantine is inefficient, the people of the United states would have another reason for feeling tolerably secure against the invasion of cholera. Last year conditions arose in the port of New York as cannot possibly arise under the regulations now enforced. Ship after ship came into port with cholera on board, and the people were filled with apprehension that the disease would get through the quarantine into the crowded tenement-house section of the metropolis. Fortunately these apprehensions were not well founded. But they resulted in the passage of this national quarantine law, which medical men regard as a very wise measure.

Under this law it is not contemplated that the local authorities, when efficient and thorough in their work, shall be either superseded or interfered with. It is made the duty of the Supervising Surgeon-General of the United States Marine Hospital Service to see that the local authorities are efficient and zealous, and to take charge of the work or supplement it in cases where he deems such a course to be necessary.

The law also empowers Dr. Walter Wyman, the Supervising Surgeon- General, to send assistants abroad to all infected ports, who shall examine all immigrants and passengers about to come to this country, and grant each one a bill of health. Without this a passenger cannot pass the quarantine lines into this country. The bill also gives the President the right to prohibit, in whole or in part, the introduction of persons and property from such countries or places as he shall designate, and for such period of time as it is deemed necessary, whenever, by reason of existence of cholera, or any other infectious or contagious disease in a foreign country, there is serious danger of the introduction of the same into the United States, despite the quarantine defences. Under the law the Secretary of the Treasury promulgated regulations last spring. These regulations require that in ports infested with cholera passengers of the cabin class must produce evidence as to abode during the four days immediately preceding embarkation, and, if necessary, they and their baggage may be detained, and the baggage subjected to such disinfection as is necessary. Steerage passengers in a cholera-infected port, or from a cholera-infected place must be detained five days under medical observation, and their personal effects and baggage must be disinfected by steam. The regulations further forbid the shipment of certain articles of bedding and clothing from an infected port, also certain articles of merchandise, such as old rags, old jute, and old gunny, during the prevalence of an epidemic, and for thirty days after it has been officially declared at an end. All rags at all times are to be disinfected before shipment to the United States.

The principal ports of embarkation of immigrants to this country are Southampton, Liverpool, Hamburg, Bremen, Rotterdam, Amsterdam, Antwerp, Havre, Marseilles, Genoa, and Naples. A medical officer of the Marine Hospital Service has been detailed to serve in the office of the consul at each of the ports named. These officers have all had experience with ships, and with but two exceptions, Dr. Wyman says, have had actual quarantine experience. They have been at their respective stations for four months past, and their reports show both the necessity of their presence and the good results of their activity. Speaking of this, Dr. Wyman, in an address before the American Medical Association, said: "This is a new departure in quarantine --- quarantining in foreign lands --- and the ultimate result may be looked for with great interest. Whatever the result may be, certain it is that the presence of these officers in European ports has diminished in a great degree the danger of the introduction of cholera and other diseases from those ports. Their relations in one or two instances with foreign governments were in danger of being strained, but this danger has been averted both by their tact and good judgment, and because of the all-powerful United States law, which practically says to foreign officials that should they object to the official acts of these officers, the alternative is the refusal of the bill of health and the cutting off of all commerce between their ports and the United States."

So as to give these consuls and medical officers at the seaports selected for embarkation full information, the United States consuls in the interior have been instructed by the State Department to notify consuls at ports of the prevalence of any contagious diseases in these interior places, and also when merchandise or passengers are about to leave or have left any section within their respective consulates. At the port of embarkation each immigrant is furnished with an instruction card giving his name, last residence, name of ship, port and date of departure, and a reference number relating to the manifest, which is required by the immigration regulations, and in which is contained further information regarding each immigrant. This card must also bear the stamp of the consulate, and also be stamped or punched at the quarantine at the port of arrival, and again at the immigration depot, and it is to be held b the immigrant until he reaches his final point of destination. These inspection tickets and labels upon the baggage furnish the health officers of the interior States valuable information in regard to immigrants coming within their borders. This provision also ensures care and accuracy on the part of medical officers, and particularly on the part of United States consuls at ports where immigrants do not usually embark for the United States, but which may be sought by them in the hope of avoiding the enforcement of the stringent rules at ports where medical officers have been stationed.

The very great majority of foreign immigrants come through the port of New York, and as the quarantine is particularly efficient at this port the danger from cholera is very much lessened. But there are now twenty-three ports in the United States with steam- disinfecting chambers. Besides New York, these ports are Portland, Boston, Sandy Hook, Delaware Breakwater, Reed Island in the Delaware River, Cape Charles, Baltimore, Wilmington, North Carolina, Savannah, Back Beard Island, Georgia, Charleston, Dry Tortugas, Key West, Mullet Keys, Pensacola, Mobile, Chandler Island, New Orleans, Galveston, San Diego, San Francisco, and Port Townsend. Ten of these ports are national quarantine stations, and there is a provision in the law that if a State wishes to surrender the use of its quarantine buildings and disinfecting apparatus to the United States, the Secretary of the Treasury is authorized to receive them, and pay a reasonable compensation to the State for their use. The precautions in the ports are almost as thorough as it is possible to make them.

There seemed to be a danger, however, by reason of immigration through Canada. The Canadian laws do not provide for the inspection and sanitation of ships and passengers at foreign ports, and it was feared on this account there would be a large deflection of immigration to Canada. But this danger has been reduced to a minimum by the regulations of the Canadian government. Forty miles below Quebec, in the St. Lawrence River, is the Grosse Isle quarantine station, with perfect apparatus for scientific disinfection and accommodations for the sick and those suspected of infection. This station is reserved for infected vessels. Farther up the river, at Quebec, is the Luise Embankment, where there is a complete disinfecting plant; while at Port Levis, directly opposite, is located another. All immigrants, whether from infected or non-infected countries and though coming on non- infected vessels, are obliged to undergo inspection at one of these points, and all their baggage is disinfected. Further than this, through the courtesy of the Canadian authorities, there are representatives of the United States Marine Hospital Service stationed at Quebec for the purpose of inspecting and disinfecting and labelling the baggage, and giving certificates to immigrants bound for the United States. Thus it would seem that protection against the introduction of cholera through Canada is as complete as it can be made.

The officer charged with the enforcement of the national quarantine keeps a hydrographic map upon which he traces the progress of any contagious disease in any part of the world, taking his facts from reports of consuls and the telegrams in the public press. In this way, bearing in mind the degree of efficiency in dealing with such diseases in the various countries, he is able to anticipate the course of such a disease in any part of the world. It is interesting to know that last summer, when the presence of cholera in Hamburg was still denied by the authorities at that city, Dr. Jenkins, from the quarantine station in New York, compelled the acknowledgement by the authorities that cholera had reached Hamburg. His map showed the course of cholera directly toward that city, and by insisting upon a report from there, through the State Department, the facts were at last given to the public. Dr. Wyman, from his office in Washington, takes careful cognizance of the health of the people all over the world, and is therefore prepared to act with intelligence whenever there is likelihood that any contagious or infectious disease may be imported into this country. American security depends upon the vigilant application of scientific precautions, and there is every reason to believe that such are now being taken.