With Compliments of Henry P. Campbell. ] . 
The Yellow Fever Germ 
ON COAST AND INLAND. 
A DISCUSSION OF 
SHIP AND RAILROAD. QUARANTINE. 
BEFORE THE MEDICAL ASSOCIATION OP GEORGIA, 
ROME, APRIL 18, 1879. 
By HENRY FRASER CAMPBELL, M. D., Augusta, Ga., 
Chairman of the Committee on Endemic, Epidemic and Contagious Diseases, in the 
Board of Health of the State of Georgia. 
[Reprint from the Transactions.] 
Jas. P. Harrison & Co., State Printers, 
Atlanta, Georgia. ERRATA 
Page 15, Bth line,! Dr. W. H. Doster should read W. H. Foster ; page 
17, line 16, 1839 for 1879. The Yellow Fever Germ 
ON COAST AND INLAND. 
A DISCUSSION OF 
SHIP AND RAILROAD QUARANTINE. 
BEFORE THE MEDICAL ASSOCIATION OF GEORGIA, 
ROME, APRIL 18, 1879. 
HENRY FRASER CAMPBELL, M, D., Augusta, Ga., 
Chairman of the Committee on Endemic, Epidemic and Contagious Diseases, in the 
Board of Health of the State of Georgia. THE YELLOW FEVER “ GERM,” ON COAST AND 
INLAND—SHIP AND RAILROAD 
QUARANTINE. 
HENRY F. CAMPBELL. M. D., Augusta. 
Mr. President: I have listened with close attention, and not 
without much interest, to the reading of the two able and elab- 
orate essays just concluded.* It is needless for me to state that 
expression has been given in both of them to views in regard 
to yellow fever, which are, in many important particulars, 
totally at variance with my own. 
I must say, I had scarcely expected, at this enlightened 
period in the history of sanitation, to be called upon to 
argue the portability of the yellow fever germ, or to advocate 
before the Medical Association of Georgia, the importance 
of quarantine measures as the means of preventing the 
entrance of the disease into our ports, and of limiting its 
advance and spread into our interior towns, or to urge se- 
questration as a rational measure for protecting the people 
of our State from epidemic incursions, and for saving them 
from the desolation which has so often followed in their 
wake. 
The arguments we have just heard advocating the doctrine 
of “ the local origin of yellow fever ” as opposed sometimes 
*Yellow Fever—lts Cause and Relation to Other Malarial Fevers. By J, G. West- 
moreland, M.D., Atlanta. Quarantine—lts Sanitary and Political Aspect in Relation to 
the Spread of Epidemic Diseases—By J. C. LeHardy, M.D., Savannah. 4 
Yellow Fewer “ Germ.” 
to the theory of “ contagion,” and at other times to that of 
“foreign importation,” certainly must be recognized by every 
one present as oft repeated and familiar. They are over 
one hundred years old, if not coeval with the existence of 
yellow fever itself upon this continent. They are as often 
repeated (and with a vigor which age has never impaired) as 
the incursions of the disease have offered occasions for their 
revival. They are ever ready-made to our hand, and lie 
broad-east, challenging acceptance. “The filth-produc- 
tion of disease” has been the key-note which has first struck 
upon the ear in the beginning of every epidemic of yellow 
fever since 1766. Before that time no one had ever doubted 
invariable importation. Ido not believe there was ever an 
epidemic of yellow fever anywhere in the country since 
then in which some one did not attribute its origin to a local 
cause, and claim that some greater degree of cleanliness, or 
stricter attention to “ the laws of sanitation,” would have 
prevented the occurrence of the first case and saved the 
community from devastation. 
FILTH CONTAGION—GERM-PROP AGATION. 
There are some principles which, though we ourselves 
do not attach the same specific importance to them that 
some few others may, yet against them we find it difficult 
to bring an unconditional argument. The principle incul- 
cating cleanliness is certainly one of them. Ko sanitarian, 
whatever may be his belief in regard to the true origin of 
any form of disease, is ever found willing to lessen the im- 
portance of strict cleanliness, or to question the advantage 
of the most scrupulous removal of all impurities from the 
earth, the water,, and the air, as, on general grounds, one of Yellow Fever “ Germ” 
5 
the very first principles of preventive medicine, No one 
can go beyond me, for instance, in the importance I am 
willing to accord to this fundamental measure of sanitation. 
Freedom from filth, I am now particularly careful to state, 
is the first, the last, the most indispensable condition for the 
maintenance of the public health. 
And yet, the general and unquestioning acceptance we 
all give to this universally acknowledged principle, has, 
I do not hesitate to say, sometimes led us widely astray, and 
blinded onr minds to the recognition, in particular in- 
stances, of other factors, which are in some cases equally, 
and in a few others incomparably more important and influ- 
ential in the origination of diseases. Let me for illustration 
mention a few forms of disease which, in the opinion of 
the entire profession, could not be originated per se by any 
amount, or by any intensity of filth independent of another 
factor:—these are small-pox, measles, whooping-cough, 
scarlatina.* The other factor in these several cases is the 
well recognized specific poison, known by its propagation 
by contagion, and by the uniformity of its effects. 
The conditioning factor, then, as I have just stated in these 
several diseases, is contagion. Though most of us would ad- 
mit that a more virulent form and more active propagation 
of these contagia would probably be promoted by bad sani- 
tary conditions, few would predicate their origin without a 
focus of contagion. Some few—and the number so holding 
may be on the increase—attribute to yellow fever a true con- 
tagion. It is known, at least among those with whom I have 
had occasion to express myself, that I am not of the num- 
"I am aware, that, in the opinion of some few, scarlatina has been attributed to 
some peculiar emanation of slaughter-pens. The hypothesis is scarcely as yet enter 
tained as worthy of credit. 6 
Yellow Fever “ Germ” 
ber who admit, in the ordinary significance of the term, the 
contagiousness of yellow fever. Its general prevalence in 
communities, its onward progress from street to street, from 
ward to ward, and from house to house, of the towns and 
cities where it is raging; and again, its progress along rivers 
and railroads, and its advent with ships—all, to the minds 
of some, invite to the interpretation of contagion. When to 
these that very strong characteristic of contagious diseases is 
added—one generally admitted to be an attribute too of yel- 
low fever, I mean the almost uniform immunity conveyed 
to the subject by having suffered in one genuine attack— 
those who believe least in the contagion of yellow fe- 
ver, admit with candor the plausibility, of the reasons 
of those who believe in it most. But, for all this, I here 
distinctly deny any belief in the personal contagion of 
yellow fever. But the question now is not one of con- 
tagion, but one of “ unsanitary conditions,” as local filth 
and other objectionable states have been called. I have 
stated what I believe to be the opinion of the profession 
generally in regard to such conditions, as being incomp- 
etent to originate small-pox, or measles, or scarlatina, in- 
dependent of their peculiar contagion. Indeed, the nega- 
tive of this question is so strongly and so universally held, 
that on the occurrence of cases of these affections, contagion 
is predicated and assumed, even where contact or infectious 
communication, cannot be traced. It would be an endless 
labor, and one of most certain failure, to develop out of 
any amount of- filth, or any kind of filth, a single case of 
small-pox or measles independent of their respective con- 
tagia. 
Though, as I have stated, I am no believer in.yellow fever Yellow Fever “ Germ ” 
7 
contagion, I have discussed some of the ordinary phenomena 
of contagion so as pertinently to illustrate its less familiar, 
more recently studied, and as yet mysterious analogue and 
simulacrum, the germ-propagation of disease. 
As there is a specificity in contagion producing specific re- 
sults, so it is incontestable that each form of fever, or of 
disease depending upon the inception of germs, must have 
its own specific germ, to which is due the peculiar type of 
its manifestations as notably and as distinctly as the toxic 
effect of one poison will differ from another—as atropia 
from strychnia, or opium from arsenic. 
Under the present circumstances I can give no authority, 
I can bring forward no corroboration of my statements 
from the records of medicine, which, so far as I know, may 
or may not be full of them. I can only relate my belief— 
give you what have been the results of my own observation 
and reflections. To formulate them, would be to present 
you with several propositions relating to yellow fever, which 
will probably be found to differ but little from the creed 
of many others of the profession on the subject. 
My own views may be thus generally expressed : 
Ist. That the origin and propagation of yellow fever is 
dependant upon what may be recognized by its effects as a 
specific germ—at present hypothetical, but not more so 
than other forms of atmospheric poisons, malaria, etc. 
2d. That this germ is an exotic wherever it may be 
found in any of the localities of this country—probably do- 
mesticated in certain localities, as New Orleans, so as to have 
become feebly naturalized, or quasi indigenous, at times. 
3d. That the assemblage of phenomena recognized 
and called by us “ yellow fever,” and which are of a spe- Yellow Fever “ Germ.” 
cific and uniform character, owe their specificity and uni- 
formity to the specific nature and unvarying form of this 
atmospheric germ, in the same manner as do small-pox, 
measles and scarlatina owe their specificity of form, to the 
peculiar contagion which had originated each one of them. 
In the same manner, to be more familiar, as do the narcotism 
of opium and the tetanus of strychnia owe the specificity of 
their manifestations to the varying physiological effects of 
these two toxic agents in the blood of the subject. 
4th. As without the specific virus, we could never origin- 
ate a case of small pox, so do I believe, without the specific 
germ, no condition however unsanitary—even did we accu- 
mulate filth, piling it up from the pavement to the sills of 
the second story windows—would enable us to manufacture a 
single case of genuine yellow fever. We might poison and 
kill the entire community with indigenous germs, some forms 
of which are even more promptly and surely fatal than the 
terrible and mysterious exotic itself; but without the yellow 
fever germ, hibernated or recently imported, we can have 
no yellow fever in its genuine and indubitable individ- 
uality. 
sth. Comparing, then, that which is minute, intangible, 
and as yet hypothetical, with that which is gross, common and 
cognizable to the senses, I would as hopefully look for spon- 
taneous origin to be given to a banana, a pineapple, or a 
plantain, by some particular preparation of our soil, as I 
would expect a case of yellow fever to originate in any of 
our ports or inland towns without the previously imported 
germ as the source of its inception. The exotic germ is no 
more naturalizable than the exotic fruits—even less so. 
6th. Though I regard the germ as indispensable to the 
origination of the disease, I would, by no means, be under- Yellow Fever “ Germ.” 
9 
stood as abating, in the slightest degree, the imperative ne- 
cessity for the strictest purity, otherwise, of air and water. 
I can conceive of such purity in the surroundings of • a 
locality into which these germs might be introduced as 
would fail in giving them the support necessary to their 
propagation, and it is true that propagation is less active and 
their decline more rapid in localities where sanitation has 
been untiringly enforced than in neglected and unwholesome 
places. 
Yo single induction of modern and advanced science has 
been more established or more constantly and effectually 
acted upon than that which affirms the existence of morbific 
atmospheric germs. The entire complement of antiseptic 
surgery, with its reliable results and brilliant achievements, 
depends upon this rational assumption, and upon the devis- 
ing of methods for preventing germ ingress and for secur- 
ing germ destruction. From this direction it is clear the 
“germ theory” of yellow fever receives a remai'kable 
corroboration. 
When I speak then of a specific imported germ, I profess 
no more and no less accuracy of statement than those do who 
speak of the “ malaria” and of the “ foul airs” by which 
they account for the local origin of yellow fever, and of in- 
termittent fever. The very term they use to designate these 
latter fevers refers to a cause as hypothetical as the “ germ ” 
But little has been done as yet for defining the essential ele- 
mentsof either malarial or yellow fever, as we all know. Dr. 
Salisbury,* and more recently, T)r. Eklund,f of Stockholm, 
* American Journal of Medical Sciences, vol. LI., p. 51,1866. 
t Note on Marsh Miasm—{Limnophysalts Hyalina.) By Abr. Fkedrik Eklxjnd, M. 
D., Stockholm, Sweden, Physician of the First Class in the Swedish Eoyal Navy. 
Translated from the Archives de la Medecine fiavale, vol. xsx, No. 7, July, 1878. By A- 
Siblet Campbell, M. D., Augusta, Ga., President of the Augusta Medical Society.— 
Bichmond and Louisville Medical Journal, vol. xxvi., No. 4, October, 1878. 10 
Yellow Fevdr “ Germ” 
have each had some success with the vegetable poison of mala- 
rial fever. Dr, Joseph Jones, Dr. Richardson, Dr. White and 
others, have given attention to yellow fever germs and the 
ultimate elements of its poison. It has not, as yet, been 
satisfactorily demonstrated, though some of these researches 
have been highly encouraging and enlightening. Like all 
other atmospheric blood poisons, we know it, as yet, prin- 
cipally, by the phenomena attendant upon it and resultant 
from its inception within the system. 
It has, for a long time, appeared to me that a study of 
the physical characters of the yellow fever poison, whether 
it be germ or some other kind of particle, should be con- 
ducted, not in the blood of the yellow fever subject nor in his 
secretions nor in his tissues. The atmosphere itself is the true 
and most hopeful field to hunt for the intimate and ulti- 
mate nature of the morbific cause of yellow fever. Until 
our means and appliances for atmospheric analysis and in- 
vestigation become more perfect, it is not probable that the 
physical characteristics of the cause of yellow fever will be de- 
monstrated. We have every reason to believe that after any 
portion of this atmospheric poison has once entered the 
system and produced its results, its physical characters and 
capabilities are changed, that it becomes innocuous, and is 
not capable of producing a second time the phenomena 
characteristic of its manifestation—even did the healthy 
individual drink the blood, or were he inoculated with the 
secretions of a fatal case. Should this surmise prove to be 
correct, it will account for the absence of personal contagion 
in the yellow fever subject at present so largely believed. 
Filthy local conditions are admitted on all hands to exag- 
gerate the effects of yellow fever poison, and to promote its Yellow Fever “ Ggrm.” 
11 
spread and propagation in communities after the importation 
of the specific germ. But there are too many instances on 
record—too many in my own observation and experience, 
(and to these last, only, I can now appeal,) in which simple 
importation without any concomitant local impurity, in the 
cleanest and healthiest pine land situations, was fully com- 
petent to produce, in the most healthy and robust, the best 
marked cases of yellow fever ending in “ the haemigastric 
death.” 
THE RAILROAD TRANSPORTATION OF DISEASE-GERMS. 
Mr. President, it is but too recently that I have had to 
argue this question for me to forget all the horrors I then 
fell upon, and which plainly placed beyond all doubt, the 
transportation of disease-germs. My theme was not then 
the question of the trans-oceanic importation of this dreaded 
exotic—this I had long ago regarded as a question settled 
by all good observers and all logical thinkers. My duty was 
to consider a problem in which coast-importation was held 
as one of the assured predicates. I do not know that any 
one before had made the railroad transportation of disease- 
germs, as accounting for the spread of yellow fever from the 
coast to the interior towns of the South, the subject of 
special and distinct research. Taking the history of epidem- 
ics in Augusta as an illustration, “we would call attention 
to the fact,” as I state in that paper, “ that though from 
1768 to 1838 there had been about twenty-seven visitations 
of yellow fever in Charleston, (136 miles distant) ; and seven 
visitations in Savannah (135 miles distant,) from 1807 to 
1851 (J. M. Toner) the disease had never found its way to 
* Report No. 2 State Board of Health 1876. The Railroad Transportation of Disease- 
germa—Yellow fever and dengue fever in Augusta in the years 1839-1850-1854 and 1876 12 
Yellow Fever “ Germ.” 
Augusta till 1839,” after establishment in 1836 of railroad 
communication with Charleston, “ and that its more wide- 
spread outbreak (of initial cases) was in 1854, after the 
establishment of discharging depots on both sides of the city, 
communicating also with Savannah, at which place in that 
year raged a most desolating epidemic for some month or 
more before its appearance in Augusta. 
The several apparitions of the ghastly visitant in Ma- 
con, I have no doubt, could the facts be considered in the 
same connection, would present a like suspicious history in 
regard to railroad transportation of yellow fever germs. 
Indeed, who can estimate the terrible agency that the rail- 
roads, not less than the rivers, have exercised in the stricken 
west during 1878! 
Though the origin of epidemics in a city, or in many 
cities, might furnish evidence on a grander scale, yet there 
are among my records individual instances which well 
illustrate the railroad transportation of yellow fever germs, 
and the genuineness of the resultant disease—under circum- 
stances, too, which positively contradict the influence of any 
reasonable local cause adequate to its production. 
To adduce one specific case will sometimes testify more 
pointedly than to appeal to a multitude. I read from the 
paper referred to above : “ These ‘germs,’ or hypothetical 
elements of disease, many observations have convinced us, 
are transported in the cars arriving from infected ports, re- 
taining their virulence through hundreds of miles of pure 
country air.” In substantiation of this, I now give the cases, 
by many still well remembered, of Mr. and Mrs. Lampkin, 
at Union Point. Mr. Lampkin, in 1854, was transportation 
agent at this station, and went daily into the freight car Yellow Fever “ Germ” 
13 
arriving from Augusta, where a devastating epidemic was 
prevailing. Mrs. Lampkin also went daily for several weeks 
into the passenger cars to superintend refreshments. Both 
became infected and both died of yellow fever with black 
vomit within a short period of each other. At Union Point, 
quite elevated and in the pine region, seventy-six miles from 
Augusta, no one would pretend to say there was any local 
cause adequate to account for these deaths by yellow fever. 
I ask to read one more striking instance: “ The following 
statement was given us by Dr. A. B. Lanier, of Oliver, at 
the time 1 was preparing my report in 1876 : ‘ This place 
is located on the Central Railroad, forty-five miles (station 
No. 4|) from Savannah. All the railroad employes at Oliver 
who slept in the cars had yellow fever. Those who did 
not sleep about the cars, though all other circumstances per- 
taining to the two classes were identical, did not take the 
disease, A young man named Lufborough, a farmer of the 
neighborhood, twenty-one years of age, perfectly healthy, 
had not been near Savannah during the entire season. On 
the night of the 13th of September (1876), Mr. Lufborough 
went on board the accommodation passenger car that 
remained over night at Oliver. He slept on the car that 
night. He was taken with yellow fever on the night of the 
16th, and died with black vomit on the night of the 21st. 
What greater proof could we have of the portability of 
yellow fever infection, and of its virulence, independent of 
all conditions, sanitary and unsanitary, than we find in these 
cases. 
That this infection, whether we call it “ germs ” or give 
some other name to the poison, will lurk about in houses 
and remain virulent long after the subsidance of an epidemic 14 
Yellow Fever “ Germ” 
we had in 1854 some striking instances; “ after this epi- 
demic there were numerous cases which occurred after sev- 
eral 4 black frosts.’ ” These originated in persons who, on 
their return to the city—generally ladies—set about over- 
hauling and “ putting to rights” their wardrobes and 
trunks, book cases and bureaux, that had been closed on 
leaving the city at the time of the outbreak of fever. One 
such case, most marked in the circumstances of its origin) 
occurred under my own observation.” 
INCUBATION OF YELLOW FEVER GERMS. 
Facts illustrative of incubation, whether of “germs” or of 
“ contagious principle,” are more advantageously studied in 
localities far removed from that of a prevailing epidemic. 
I am aware that the facts I am about to relate will be inter- 
preted as incubation of germs, or as the incubation of conta- 
gion, entirely in accordance with the tenets of those who 
may discuss them. 
In the year 1877, yellow fever prevailed as an epidemic 
at Fernandina, Florida. A gentleman having relatives in 
Augusta, Ga., moved with a portion of his family to that 
city to escape the disease. The situation of the house of 
his relatives was at the upper end of Greene street, the 
house being somewhat isolated and the locality being con- 
sidered generally healthy. The man himself was in a few 
days attacked with yellow fever, contracted in Fernandina, 
and died shortly after with black vomit. Two large Sara- 
toga trunks, containing the clothing of the father and 
daughter, were opened in the house shortly after his arrival 
and just before the death of the former. Neither the 
daughter nor any member of the resident family were Yellow Fever “ Germ.” 
15 
attacked with anj disease for six weeks. At the end of 
this time the daughter, who opened the trunks, was attacked 
violently with yellow fever, and in rapid succession all the 
other members of the family developed well marked but mild 
cases of the disease—which did not extend beyond the 
household of this family. 
The cases just referred to were under the care of Dr. W. 
H. Doster, Drs. H. H. Steiner and John S. Coleman being 
iu consultation. It is from these latter gentlemen that I 
have obtained information relating to the circumstances. 
These, in my opinion, bear most plainly not only upon 
the transportation of yellow fever germs in the trunks and 
ordinary apparel of refugees, but also give us some valuable 
enlightenment on the subject of incubation, a subject of 
deep interest and most difficult of determination. 
RAILROAD QUARANTINE. 
Mr. President, I must still further tax your patience, that 
you may know by my record that my disbelief in the “ local 
origin of yellow fever” is not a thing of to-day, and that the 
lessons of my observation and experience have not been 
unheeded, but have left their precept. Please allow me 
here to read : “From the above series of facts relating to 
the initial cases of the three visitations of yellow fever in 
Augusta, though without further investigation, we perhaps, 
should not venture to affirm their origin to be solely the re- 
sult of railroad communication with infected ports ; we would 
still strongly urge that particular and more careful inves- 
tigation be directed to such connections as the most probable 
means of transportation of infected air, or of air conveying 
“ disease-germs,” from infected ports to inland towns and Yellow Fever “ Germ” 
cities. And further, that a strict quarantine—as strict as 
that which could possibly he applied to boats, ships and 
other means of water transportation in ports—be made to 
control the incoming of trains from infected ports and cities 
during the prevalence of yellow fever. Never let a single 
car come to a healthy town that is freighted or takes passen- 
gers in an infected port—let them be met at least twenty 
miles from the city by fresh cars for both the passengers and 
the freight.” 
My non-belief, as I have heretofore stated in personal con- 
tagion, is here also vindicated, and, as far as I can do it, 
explained. “In these recommendations we here distinctly 
state that by ‘ quarantine we do not refer to the exclusion of 
persons,’ either well or sick, arriving from the infected 
regions. This element of quarantine would comprehend 
that which we do not hold as a tenet of our faith in regard 
to yellow fever—the doctrine of contagion. Give hospitable 
refuge to all those who are well; to those who have been 
infected and are about to be attacked ; to those already 
overtaken in their flight from the dread pestilence ; but ex- 
clude the cars which have borne them away from their in- 
fected homes, and ventilate and purify the trunks that con- 
tain their infected clothing. * * The yellow fever subject 
is laboring under the dire effects of a poison, and thousands 
of observations and centuries of experience have demon- 
strated that he can no more communicate his disease by 
any emanation from his own body or secretions than can the 
subject poisoned with strychnine communicate his frightful 
tetanus to his friend or to his nurse. As in the one in- 
stance, the strychnine itself is required to produce another 
case; so in yellow fever a fresh supply of atmospheric 
disease-germs is required to produce the phenomena.” Yellow Fever “ Germ.” 
17 
I am glad to say, that a quarantine upon the very 
principles I have just read has been, year by year, more 
fully organized in the city of Augusta. I regret that the 
feature of personal quarantine and exclusion is still a part of 
it, though in every other particular, on the first note of 
warning that yellow fever has appeared on the coast, the most 
careful surveillance is established over the trains, and none 
allowed to come to the city that have, from any direction, 
come out of an infected atmosphere. 
PERSONAL CONTAGION IMPROBABLE. 
In years past the most hospitable refuge and tender care 
were ever given to those flying from yellow fever, and to 
those affected with it, and in no single instance do we re- 
member the infection spreading from personal infection. 
Within the record of my own experience, I could relate 
many striking instances pertaining to the epidemic of 
as well as of 1851, apparently illustrative of the non-con- 
tagiousness of yellow fever I shall give but one: 
On the 16th of September, 1854, yellow fever was an- 
nounced as epidemic in Augusta, Georgia, by the Board of 
Health. Among those who, with almost the entire white 
population, fled to the sand-hills, and other safe vicinities, 
was the family of Mrs. C. S. This lady, on her arrival, com- 
plained of extreme lassitude and headache. These symptoms 
were attributed to fatigue, and not regarded with suspicion. 
She went to bed, and her young daughter, a girl of some 
eight years, slept with her in the same bed, the accommo- 
dations being scant. The case rapidly developed undoubted 
symptoms of yellow fever, with black vomit at the proper 
stage. This lady passed regularly through the disease, had 18 
Yellow Fever “ Germ” 
a retarded convalescence but complete recovery. During 
the entire period of her attack, and throughout all the stages 
of access, culmination and decline, the child slept* in the 
same bed each night with her mother, enjoying unexcep- 
tionable health, both mother and daughter returning to the 
city after frost perfectly well. 
The question may be asked, why this cruel exposure of a 
healthy child ? “The tyranny of circumstances” must be the 
answer. If yellow fever were contagious, by the time it 
was fully recognized in the mother, the child was already 
infected, and what other member of the family should she 
sleep with in availing herself of the little chance she might 
have of non-inception after two days contact. Then again, 
the entire family, crowded in the same small house, and in 
constant attendance on the mother, had been little less ex- 
posed to “contagion ” than had been this child, No second 
case occurred. 
I have thus hastily—certainly without time for research, 
and surely not enough for that careful consideration the 
important subject is entitled to—presented the views I have 
held for years on the question of the local origin of yellow 
fever in most of the localities in which it has occasionally 
appeared within the borders of the United States. In the 
West India Islands, in the Gulf of Mexico, we may consider 
that the disease has been at least for a long time quasi in- 
digenous. While in New Orleans “specific yellow fever 
germs,” as we have chosen to call the hypothetical but un- 
doubted specific poison, though originally exotic, have 
become, perhaps, to a certain extent, domesticated, so as to 
produce sporadic cases, but never an epidemic without fresh 
importation. That partial outbreaks may occur at New Yellow Fever “ Germ” 
19 
Orleans wherein recent importation cannot be traced, can 
throw no doubt upon the specificity of the germ or poison 
necessary to the production of the disease, nor from these 
outbreaks, in this locality, can any one argue the identity of 
the yellow fever germ or poison, if you please, with that 
which produces any of the multitudinous varieties of malarial 
fever. 
THE HIBERNATION OF GERMS. 
A few moments ago I referred to cases in which the poi- 
son seemed to be taken in by certain individuals returning 
to the city after a killing frost, when the general freedom 
of the locality from yellow fever infection was undoubted. 
In these instances, the atmosphere of closed apartments, 
wardrobes, closets and book-cases, retained the infection and 
gave rise to cases of yellow fever after the close of the 
epidemic. A sort of hot-house protection had been afforded 
to the exotic, which secured its vitality and preserved its 
virulence. 
There is a potentiality claimed by some as one of the attri- 
butes of the yellow fever germ, in which is recognized a much 
more prolonged retention of its vitality and capacity to pro- 
duce yellow fever phenomena. This is when it is supposed 
that in mild climates, as Kew Orleans and perhaps even in 
Charleston, the germs of a previous season’s importation may 
“lay over” and retain their vitality for the succeeding season. 
This has been termed by some the “ laying over,” by oth- 
ers the “ hibernation of the germs.” There can be little 
doubt that many of the claims of “ spontaneous local origin” 
are based upon sporadic cases which have been due to 
hibernated germs. My own belief accords with that of 20 
Yellow Fever “ Germ.” 
several experienced observers, that such germs are not capa- 
ble of vigorous multiplication, and of such general infection 
of the atmosphere, as to give rise to an extended epidemic 
In the case of an epidemic of yellow fever, whether it can be 
traced or not, it is more philosophical to predicate the fresh 
importation of germs than to lay stress upon the negative 
testimony and claim of spontaneous origin, or that paludal 
poison has given rise to the incursion. 
QUARANTINE. 
The natural and inevitable result of a faith in the local origin 
of yellow fever—whether, as stated by one of our distin- 
guished essayists—Dr. Westmoreland—on the ground that 
ordinary marsh miasm, modified or intensified, furnishes 
the morbific agent; or, as by the other—Dr LeHardy— 
that the indigenous production of germs may give rise 
to epidemics the inevitable result of such etiological 
principles, I repeat, is at least an indifference, if not a decided 
opposition, to all quarantine measures for the exclusion of 
the disease. On the other hand, those who recognize the 
cause of yellow fever incursions, in the several localities in 
which it has appeared in this country, as due to the impor- 
tation of an exotic germ, must ever consistently advocate, 
notwithstanding all its imperfections and its repeated failures, 
persistent efforts at improving, perfecting and rendering 
finally efficient, some system of quarantine, or quarantine 
with disinfection, as the only rational hope of our protec- 
tion. To this latter class, it is scarcely necessary for me 
to state, I most conscientiously belong. I can give out 
no uncertain sound on coast quarantine after advocating 
for years the principles I have just rehearsed, and have long Yellow Fever “ Germ” 
21 
since published, in regard to railroad and inland quarantine. 
xSro one can estimate more seriously than Ido the inconven- 
ience and the disastrous interruptions attending all kinds and 
degrees of quarantine. The more extended and the more 
prolonged, certainly the more injurious do they become to 
our financial and commercial interests and to the prosperity 
of the region in which they are maintained. But when we 
estimate the calamities that quarantine measures are intended 
to prevent; what utter desolation a single epidemic will 
produce ; how, once gaining entrance, the devastation is not 
confined to the coast nor to cities of the coast, but spreading 
inland it goes up the rivers, along the railroads and common 
highways of travel to our interior towns and cities—to our 
very health-resorts and places of refuge, to the villages, the 
hamlets, the plantations and the isolated dwellings, till every- 
where the groans of the dying and the wail of the disconsolate 
living are stifled and smothered with putridity and pesti- 
lence,—who thinks now of business or of commerce ! What 
is there worth considering but the saving of human life ! 
I repeat, when we estimate all these horrors for which the 
quarantine offers a hope, say even a theoretical hope of 
evading, I cannot allow the history of its many acknowledged 
failures in the past, nor yet the discouraging predictions of its 
failures in the future, to deter me from giving what support 
I can to continued efforts, under the enlightenment of a 
more advanced science than has ever guided us heretofore, in 
excluding, hy quarantine, the dreaded pestilence. 
As to the desirableness of the national quarantine pro- 
posed to Congress, and the enactment of laws to the end of 
its establishment, I cannot at this time attempt a discussion 
so deeply involving political considerations. The decision Yellow Fever “ Germ” 
by the government, whether for or against such an estab- 
lishment, cannot be otherwise than of the most momentous 
import. The constitutionality and the authority admitting 
of such legislation seem obvious, as seen by the argument 
of Hon. Mr. McGowan, of Michigan. As I have said, 
neither time nor my familiarity with the bearing of such 
questions, will allow me to enter upon such a discussion. 
Many, if not the majority, of our citizens will candidly ad- 
mit that there is much force in the arguments against sub- 
mitting the control of our coast-trade and shipping to any 
other than the municipal government of the ports, or, at 
most, to our own State government. Our representatives, 
with those of other southern States in Congress, will cer- 
tainly look carefully into the bearing of this question, and 
to them we must delegate the responsibility of guarding 
our interests in the important matter. 
THE STATE BOARD OF HEALTH. 
By the inexplicable indifference—nay, actual opposition— 
of a controlling majority in our Legislature, the proud old 
State of Georgia, glorying in the distinction and honorable 
title of Empire State of the South, has been placed in a 
position the most mortifying and degrading as regards her 
relations to public health. From being, more than thirty 
years ago, one of the foremost States in the Union—almost 
abreast with Massachusetts herself—in devising and in ad- 
vocating measures of public sanitation and preventive medi- 
cine*—she has, through the deficient statesmanship and ig- 
*At the first meeting of the American Medical Association at Baltimore, May, 1848, 
Massachusetts and New York were the only States having Boards of Registration. Of 
the other States, Georgia and New Jersey were the earliest to destinguish themselves 
as “ having taken steps to give effect to the recommendation of the Association to establish 
State Boards of Registration See Transactions of American Medical Association- 
Volume I. 1848. Yellow Fever “ Germ” 
23 
norance of a majority in the House, fallen to a status far 
below some of the youngest of the States. The State Board 
of Health which, under a wise and enlightened as well as 
benevolent policy of the Legislature, was established in 
1875, has been virtually, as we all know, abolished on ac- 
count of the expense. The meagre appropriation of fifteen 
hundred dollars has been withdrawn as too valuable a sum 
to expend upon such an object! In the eyes of all enlight- 
ened sanitarians, everywhere, we all know, Mr. President 
and gentlemen of this Association, that the State of Georgia 
and her Legislature is a by-word and a reproach! How 
mortifying to all—except perhaps to our majority in the 
Legislature—must be the kindly recommendation of the Na- 
tional Board of Health, that Congress appropriate money 
out of which to pay half the expenses of a State Board 
for Georgia! / Is it any wonder that our General Gov- 
ernment finds it necessary to take charge of our coast in a 
national quarantine ? Will they not in time have to pay half 
the expenses of our Geological Bureau, and probably our 
Agricultural Bureau too ? We are very nearly ripe to be 
taken charge of, like the freedmen and the untutored In- 
dians, as “ the wards of the nation.” 
It is mortifying to look into the depths of our stultifica- 
tion. In a State whose mineral resources are boundless, but 
which require investigation and development, the office of 
State Geologist, established by a more statesmanly and wiser 
legislature, is now scarcely allowed the meagre support 
necessary for the crippled performance of its functions. 
In a State whose chief reliance for the general subsistence 
and wealth of her people, as well as for the productions of 
export, is her agricultural resources, an Agricultural Bureau Yellow Fever ” Germ 
established by wise predecessors, is every day threatened with 
abolishment on account of the miserable pittance that is now 
grudgingly allowed to sustain it. And, I had almost said, 
worst of all in a State whose coast is yearly liable to de- 
vastation by destructive epidemics—epidemics that in the 
recent past have destroyed millions of commerce and sub- 
stantial wealth; that have carried desolation into the homes 
of thousands of her citizens, and extorted a wide-spread 
wail of woe from bereaved hearts everywhere within our 
borders; I say, just on the retreating footsteps of such an 
epidemic, this “ controlling majority” in our State Legisla- 
ture—this majority which no argument, no effort on the 
part of their noble, enlightened and benevolent compeers to 
instruct them, can improve—which no warning, no calamity, 
no destruction of property or of citizens can move—to 
which no braying in the mortar can teach wisdom—se- 
cured the virtual abolishment of the Georgia State Board 
of Health in the very midst of their labors—while actually 
engaged in preparing the report of their investigations of 
the epidemics of 1876, since published in their second an- 
nual report! 
Is it any wonder that thus invited, thus compelled, the 
National Government should deem it necessary, for the com- 
mon good, to take charge of sanitary affairs in Georgia ? 
That in the present enlightened state of public sanitation, 
she should see the importance of a State Board to overlook 
the sanitary affairs of a State so important as Georgia, and 
that she should fear to leave to the charge of such a State 
government a portion of the southern coast, in which all the 
States are, as by a common and inextricable destiny, so Yellow Fever “ Germ” 
25 
vitally interested! ? Should there be inconvenience, or evil, 
or calamity, to the interests of our State in the national 
quarantine, the course of our own Legislature has certainly 
been calculated to invite and to compel them all. 
Mr. President, I suppose it was to be expected that I 
would have had much more to say in regard to the State 
Board of Health. I must reply, that I have already perhaps 
said too much on the subject. Every one in this assembly 
understands, as well as I do, the importance of public sani- 
tation, and the importance, as witnessed by the action of a 
majority of the States, of committing such interests to an 
organized State Board of Health. To our Legislature ap- 
peal after appeal has been made, by noble philanthropists 
and wise statesmen in their own body. Our only hope is, 
that we, the members of this Association, as a widely rami- 
fying influence throughout every community in our State, 
may be able to give our earnest efforts to the enlightenment 
of the people on matters of preventive medicine and public 
health. They are already, I believe, far in advance, in their 
intelligence on these subjects, of many of their representa- 
tives. 
Enlighten the people then, and by so doing we will 
rapidly improve the character of their representatives in 
the halls of our Legislature. We will no longer have to 
hang our heads in shame and confusion at the offer, which 
we have thankfully to accept, “ to pay half the expenses of 
our State Board of Health ; ” we will have no longer to 
dread “ the Central Quarantine” on our coast. With wise, 
judicious and liberal legislation, we will again enjoy the 
respect and confidence, as well as the kindly good-will, of Yellow Fever “ Germ 
“the more enlightened Stateswe will no longer require 
to be taken charge of by the general government; no 
longer have to be cared for as the helpless and benighted 
“ wards of the nation,”