Quarantine and Commerce 
AN ADDRESS 
DELIVERED BEFORE THE 
COnriERCIAL CLUB 
OF 
CINCINNATI, 
by 
Dr. Walter Wyman, 
SURGEON-GENERAL OF THE MARINE-HOSPITAL SERVICE, 
OCTOBER 15th, 1898. Quarantine and Commerce 
BEING AN ADDRESS DELIVERED 
BEFORE THE 
COMMERCIAL CLUB, 
OF 
CINCINNATI, 
BY 
DR. WALTER WYMAN, 
Surgeon-General of the Marine-Hospital Service, 
October 15, 1898. Quarantine and Commerce. 
Mr. President and Gentlemen .• 
It was with great pleasure that I accepted your kind invitation 
to be present on this occasion, feeling that in coming to Cincinnati 
I would be but returning to a former home, where my residence of 
three years was one of unalloyed pleasure, and I may say profit, 
and I feel to-night as though 1 were simply returning to visit friends 
in a most delightful manner. Having in mind, too, the great com- 
mercial importance of this Queen City of the West and the char- 
acter of your organization, I feel that the topic named for discus- 
sion this evening is a timely one; I myself having devoted a large 
part of the last few years to the matter of quarantine laws, the 
forming of quarantine regulations, and the execution thereof, 
while you have at heart the great question of commerce, which is 
so seriously affected by quarantine. Quarantine and Commerce : 
without commerce there would be scarcely any necessity for quar- 
antine, and the latter assists or obstructs according as the quar- 
antine restraints are rational or irrational. 
The tremendous growth of commerce during this age of steam 
and electricity has made necessary greater attention to the demands 
of a righteous quarantine ; and the intolerance of expensive delays 
by modern commerce demands that quarantine shall be stripped 
of all unnecessary, burdensome features. 
In modern times he is not a properly qualified quarantine 
officer who does not realize that the detention of those floating 
communities, the merchant ships, laden with the exchange prod- 
ucts of the earth's surface, and the interference with that great 
network of railroads which form our interstate commerce, are 
matters of serious import to trade and to the functions of our 
national domestic life. 
On the other hand, he is not a proper quarantine officer who 
does not realize that generally through commerce are the great 
contagious diseases carried to all sections of the globe and from 4 
one part of a country to another, so that if through mistaken 
judgment or an overweening desire to yield to commercial interests, 
a mistake is made and contagion allowed to spread, proceeding 
hand in hand with commerce in its all pervading ramifications, not 
only is death and disaster brought about, but the very end which 
he sought to avoid, the crippling of commerce, has been brought 
about to an increased degree that simply cannot be estimated. 
1 am glad of this opportunity of calling public attention to the 
critical position in which the well qualified and wise quarantine 
officer is often placed. To him are particularly applicable the 
words of Daniel Webster, when he said: " No one can perform 
his part well unless he comprehends and feels its importance and 
comprehends and justly appreciates all the duties belonging to it." 
Not only must he mean well ; he must do well. Consider the 
position in which he is often placed. A great ship from a foreign 
clime, whose daily expenses may amount to thousands of dollars, 
is held pending the examination of a suspicious case of sickness. 
The agent of the vessel, the assignee of the cargo, the master 
and passengers are all intolerant of delay. Perhaps it is a foreign 
vessel, and, through the Department of State, the representatives 
of the foreign government are bringing pressure to bear. Almost 
alone he faces these conditions in the quarantine anchorage, hold- 
ing the vessel there while he determines in his own mind the 
nature of the sickness. This situation develops a primary require- 
ment of the modern quarantine officer. He must be well versed 
in the science of medicine, with special training with regard to 
those diseases which will become epidemic, and with which many 
physicians, in the course of their lifelong practice, never become 
familiar. 
Stretched along the Atlantic and Gulf and the Pacific Coasts of 
the United States, from Maine to the State of Washington, at 120 
points of entrance to the ports of the United States, are these 
officers. So far are most of them removed from observation, by 
reason of their isolated location, that the public knows but little of 
their self-sacrificing, difficult, and scientific labors. 1 have visited 
a great many of these stations and observed the services of these 
men while being rendered, and I wish to state here that I know 
of no position calling for higher qualities of manhood, physical 
endurance, mental acuteness, judicial temperament, and firmness 5 
of purpose, than is required by the position of a maritime quaran- 
tine officer. 
Now, the consideration of quarantine naturally demands the 
division of the subject into maritime and interstate quarantine. 
The older of these divisions is maritime quarantine, which dates 
back in history to the fifteenth century, when, by reason of the 
plague in the Orient, the first quarantine .was established by the 
authorities of Venice. For forty days they confined in their laza- 
rettos those who came from the infected domains From that time 
until the present maritime quarantine has been maintained by 
civilized nations, with degrees of intelligence varying with the 
sanitary and medical intelligence of the age. The growth of 
medical science has brought with it improvements in quarantine 
administration based upon increased scientific knowledge; but, I 
regret to say, the improvements in quarantine administration have 
not always kept up with equal pace. 
At the very best quarantine is a restraint, and as such is irk- 
some, and the day will be hailed with joy, and I believe that its 
breaking may even now be discerned, when our knowledge of 
contagious diseases, our .practices with regard to municipal, mari- 
time, and individual sanitation will be such that quarantine will 
become little more than a name, requiring only the stamp of inspec- 
tion, given to render assurance doubly sure, as to the health of 
vessels and the people and cargo which they carry. But at the 
present time this pleasing contemplation is about on a par with 
the happy thought of universal peace and disarmament of nations, 
greatly to be desired and an ideal state; but as we can no more 
think at the present moment of disbanding our armies and dis- 
mantling our ships of war, no more can we at the present moment 
think of dispensing with quarantine. 
NATIONAL MARITIME QUARANTINE SYSTEM OF THE UNITED STATES. 
With regard to the national quarantine system of the United 
States, I believe it to be in advance, in intelligence and effective- 
ness, of that of any nation. The only nation which, in the matter 
of importance and intelligence, can be compared with it is the 
English nation, and I wish here to call attention to and refute the 
statements which are so frequently made, sometimes by vision- 
aries and theorists and at other times by anglomoniacs, to the 6 
effect that the English do not believe in quarantine at all, and that 
in spite of their lack of quarantine restraints the same or a greater 
degree of safety has been assured as has resulted from the more 
strenuous efforts of other countries. Not to dwell too long upon 
this topic I will simply refer to the discussion thereof in the British 
Medical Association, which, for the first time in its history, met at 
a point outside of England, namely, at Montreal, last fall. By 
special invitation I joined in the discussion there with regard to 
the relative merits of the quarantine systems of England, Canada 
and the United States. It was shown that the quarantine pro- 
cedures of Canada were practically the same as those of this 
country. It was agreed by the English physicians who were 
present that in all essential particulars the practice of quarantine 
in Canada and the United States was that of the English, and that 
the differences in details are due to the different conditions regard- 
ing territory, coast line, and exposure. 
From the paper which I read at that meeting I quote as fol- 
lows, remarking upon certain peculiar conditions attaching to the 
United States: "First, the great number of the ports of entry 
and the great length of coast line, measuring, exclusive of Alaska, 
5,450 statute miles, not counting the intricacies of the shore line. 
Then the great population, numbering in 1890 about 63,000,000, 
while that of the German Empire, without its dependencies, was 
49,000,000; France, 38,000,000; Great Britain and Ireland, 
37,000,000; Italy, 30,000,000 and Spain 17,000,000. The areas 
covered by these populations are as follows: United States, 
2,970,000 square miles; German Empire, 200,000; France, 204,- 
000; Great Britain and Ireland, 121,000; Italy, 114,000; Spain, 
194,000. 
Again, special conditions exist in connection with the great 
crowds of immigrants that daily land upon our shores. In ten 
years (1882-1891) more than five millions of them arrived, and in 
one year alone (1891) more than half a million were received. 
These immigrants are from all countries, from over-populated 
districts; they are mainly of the poor and ignorant class, and 
through their baggage, as well as themselves, subject the United 
States to the importation of infectious disease to a degree far in 
excess of the exposure of any of the nations just mentioned. 7 
Other conditions affecting the quarantine policy of the United 
States, are found in the great variations of climate and in the 
character of the commerce on different portions of our coast, by 
reason of which diseases much dreaded in one section give but 
little concern in another. There are, therefore, three geographical 
sections. First, the Atlantic Coast, north of the southern bound- 
ary of Maryland. Here arrive most of the immigrants, and our 
chief concern is with regard to cholera, smallpox and typhoid 
fever, while yellow fever excites but little apprehension. Second, 
the Atlantic Coast, south of the southern boundary of Maryland 
and the Gulf Coast. Here very few immigrants arrive, but on 
account of proximity to the Spanish Main, with its yellow fever 
infected seaports and because climatic conditions favor the propa- 
gation of yellow fever if introduced, that disease is the chief con- 
cern. Third, the Pacific Coast. Here there is some immigration 
from China, and guard must be kept against yellow fever from 
South America-smallpox, cholera and the plague from the 
Orient." 
THE BANE OF YELLOW FEVER. 
Now, of the diseases mentioned above the three which give 
the most concern and require the greatest activity are cholera, 
smallpox, and yellow fever, and of these three the last, yellow 
fever, is the one disease which exceeds all the others in danger 
and importance because we know the least of its true nature and 
character. 
Through the summer the whole southern coast of the United 
States is on the qui vive lest yellow fever shall gain admittance. 
Ever since the settlement of this country there has been this 
annual dread. Of late years the visitations have been, happily 
less frequent, but not so infrequent as to enable us to forget at any 
time the panic, the mortality, and the interference with commerce 
which are its invariable concomitants. 
During the present century there have been only nine years 
in which the United States has not been visited by yellow fever. 
In some of these years, it is true, the visitation has been slight, 
but in others-notably the epidemic of 1878-the visitation has 
been heavy, causing a suspension of traffic, hindrance to inter- 
course between sections, obstruction to transportation of supplies 
and consequently suffering, and finally death itself. It has been 8 
estimated that the epidemic of 1878 invaded 132 towns, caused a 
mortality of 15,954 persons and that the pecuniary loss to the 
country was not less than $ icxd,ooo,ooo in gold. 
The restrictions upon maritime commerce caused by this dis- 
ease are so great that it seems incredible that they are submitted 
to without more complaint or that greater difficulty is not experi- 
enced in their enforcement. Though formerly yellow fever pre- 
vailed in the north, it is now recognized as menacing only the 
south, and, accordingly, in the quarantine regulations of the United 
States an imaginary line has been drawn along the southern border 
of Maryland and a distinction has been made in regard to vessels 
arriving at ports in the United States north and south of this line 
when they come from ports infected with yellow fever. Thus, a 
vessel arriving from Cuba at one of the southern ports between 
the first of April and the first of November, eventhough there has 
been no yellow fever on board during the voyage, must be disin- 
fected and held from three to five days before being allowed entry; 
exception is made to passenger vessels constructed of iron, with 
immune crews, carrying only immune passengers, the vessel not 
lying over night in a Cuban port. The same vessels arriving at a 
northern port are disinfected only in case disease has actually 
appeared on board. 
Even with these great restrictions upon commerce, safety is 
not absolute, and the question has been frequently asked of late 
years: " How long is this condition of affairs to be allowed to 
persist? " 
CUBA'S UNSANITARY CONDITION. 
In 1896 formal complaint was made to the Spanish Govern- 
ment of the sanitary condition of Havana, which permitted the 
persistence of yellow fever in the city and harbor. I addressed a 
letter to the Secretary of the Treasury, recounting the facts and 
making protest as a sanitary officer charged with the duty of pro- 
tecting the United States. This letter was forwarded to the 
Secretary of State, and in turn transmitted by him to the Spanish 
Minister in Washington, accompanied by a note of warning, for 
presentation to the Spanish Government, and a copy was sent to 
our own Minister in Madrid for presentation to the Spanish Govern- 
ment there. The revolution which was then prevailing in Cuba 
furnished, perhaps, sufficient reason why the Spanish Government 9 
could not at once undertake a regeneration of the city and the 
cleansing of the harbor, yet this, I believe, they never would have 
done, even, if there had been no rebellion, and, had there been no 
other reason for the waging of the war so successfully conducted 
during the past summer, in my opinion it would have been justified 
by reason of these intolerable sanitary conditions, which the 
Spanish Government, through its rapacity, had allowed to exist so 
long at the port of Havana and other ports of Cuba without amelio- 
ration. For it may be said that yellow fever is not a natural in- 
habitant of the United States, and that, while it may when intro- 
duced and under favoring conditions affect communities where 
proper sanitary conditions exist, still its maintenance as a prevail- 
ing disease is due to want of proper sanitation. It may spread 
where there is no filth, but it is none the less a filth disease, and 
one of the most, if not the most, glorious results of the war will be 
the regeneration of the Cuban cities and the gradual extermination 
of this burdensome, horrible pest. 
Whether under Cuban or American rule, attention doubtless 
will be given to the sanitary conditions in Cuban seaports, and 1 
look for a relief in great part, though not altogether, from the 
quarantine restrictions upon commerce which for so long a time 
have been, and are now, in vogue. Let me explain : With Ameri- 
can predominance in the Island of Cuba there will be little or no 
difficulty, even before the ports and cities are placed in better 
sanitary condition, of this Government exercising a surveillance 
over vessels leaving for the coast of the United States proper. 
There is in contemplation already the locating of disinfecting 
plants in a number of Cuban ports by which vessels may be made 
absolutely safe before leaving these ports, and after vessels have 
been placed in proper sanitary condition at the port of departure 
the time occupied in their voyage to our coast, provided they 
arrive with no manifestations of disease, will be counted'as the 
time which is now passed by the vessels while held in quarantine 
from three to five days on this side. But more than this, I feel 
confident that soon the sanitary ideas of the United States will 
prevail in Cuba and that sanitary engineering, sanitary plumbing, 
good drainage, good sewerage, and good water supply, will all, 
under American influence, replace the sad conditions which prevail 
in all Cuban cities at present. 10 
With these improved conditions there is no question in my 
mind that yellow fever will diminish in intensity and frequency 
and may be made in due time to disappear almost entirely. These 
results have been attained in Jamaica despite its proximity to 
Cuba as a source of infection, and with " Cuba Libre " liberated 
from the dominion of the Spaniard, whether independent or 
attached to the United States, it is not too much to expect that the 
yellow scourge will be made to almost entirely disappear; and with 
its disappearance from Cuba almost nine-tenths of the danger of 
its introduction into the United States will be removed. 
One writer has said with regard to Cuba, that, as its prosper- 
ity and commerce has increased it has become the greatest nursery 
and camping ground of one of man's most ruthless destroyers. 
" Itself most seriously afflicted, it annually disseminates to other 
lands, as from a central Hell, disease and death." The picture is 
a strong one, but no stronger than the truth. 
We may confidently expect that President McKinley, your 
greatest citizen, our greatest citizen, with that warm sympathy 
with the wishes of the people and that earnest regard for our true 
welfare which has so notably characterized his administration, will, 
in the formative conditions that now prevail in that beautiful 
island, see that this most important subject receives the considera- 
tion which it deserves. The blessings that will result can. hardly 
be estimated, for with such a central Hell of dissemination of this 
disease, no matter how great the care to escape it on the part of 
other tropical ports, or to eliminate it if infected, they are con- 
stantly subject to infection and again to reinfection from this same 
pestilential center. 
INTERNATIONAL SENTIMENT NECESSARY. 
But with this great source removed there will be hope for 
other tropical ports and it is not too much to expect that the influ- 
ence of example and the beneficent results obtained will cause the 
Governments of other centers, more remote but still dangerous, 
to take radical measures to the end that this disease, which is so 
peculiarly a disease of the Western Continent, shall no more 
exercise its ruinous sway, but become practically blotted out, 
leaving only to history to record the times when neglect of sanita- 
tion went hand in hand with oppression and robbery, and commerce 
was afflicted with a burdensome parasite. It is not pure optimism 11 
to suppose that an international sentiment may be awakened, 
which will cause Yellow Fever in a given port and the faulty sani- 
tation which it implies to be an opprobrium upon the Government 
in possession of the offending port so great as not to be borne. 
Every nation should be held responsible for any conditions within 
its borders or within its dependencies which tend to propagate epi- 
demic diseases that may be carried to other nations with which it 
expects to maintain a friendly commerce. 
Two years ago, in Mexico, at a meeting of the Pan-American 
Medical Association, I called attention to this subject in an address 
on international responsibility with regard to infectious diseases, 
and from the report of the International Committee upon Inter- 
national Quarantine, submitted and adopted by that association, 
1 quote the closing paragraph, as follows : 
" Sentiment does not enter into the the ordinary consideration 
of quarantine, yet your committee cannot refrain from expressing 
the hope that an international sentiment will be awakened with 
regard to sanitation of seaport cities and their harbors so that a 
perpetually infected seaport will be regarded as an unnecessary 
menace to other countries and an intolerable obstruction to com- 
merce ; and that, yielding to this sentiment, the various Govern- 
ments will remove conditions which subject them to international 
opprobrium, that trade may go on unfettered and friendly inter- 
course be maintained without danger to human life." 
NATIONAL MARITIME QUARANTINE. 
Now, further with regard to Maritime Quarantine, I suppose 
many of you are more or less familiar with the discussion which 
has been particularly active in the last few years as to whether it 
is properly a national or a state function, and a few words upon 
this subject 1 believe will not be out of place. 
THE DEVELOPMENT OF NATIONAL QUARANTINE. 
Until [893 there was, properly speaking, no national system 
of quarantine. The Colonies had their own Quarantine regula- 
tions before the formation of the Union, and from that event to 
1893 quarantine was left to the care of the State Governments, 
and by the latter to county governments or to municipalities, as 
the case might be. There was, indeed, national legislation, but 
all the Acts of Congress up to 1893, relating to quarantine, spe- 
cifically provided that the said national measures were in aid of the 12 
state and local authorities. Whatever opinions may have been 
held by members of the National Legislature, quarantine was 
permitted to be exercised by the States as a police function, and 
even in the present law, which gives national supremacy, it is 
provided that assistance shall be given the States or municipalities 
by the government authorities, the supremacy of the latter being 
asserted only when the State or local authorities fail or refuse to 
enforce the uniform national regulations. 
As a result of the old system, prior to 1893, each State had its 
own quarantine requirements. Different cities in the same States 
had different requirements. One city, in order to divert trade 
from its neighboring rival, would be less exacting than the latter 
in the inspection and treatment of infected vessels. Some cities 
found quarantine to be a means of considerable revenue, laying 
heavy charges for unnecessary inspection and perfunctory disin- 
fection of vessels. The position of quarantine officer became 
extremely lucrative, and one of the principal offices to be used as 
a reward for political service, and as a source from which could 
be derived contributions for partisan purposes. No wonder, then, 
that this system was faulty, a burden upon commerce, and did 
not protect. 
The great demand for uniformity of maritime quarantine pro- 
cedures was formerly the chief cry of the sanitarians of the United 
States, both before and subsequent to the civil war. Conventions 
were held for the purpose of bringing about an agreement of the 
different states as to quarantine matters and regulations one at 
Philadelphia in 1857, another at Baltimore in 1858, New York in 
1859, and Boston in i860. These conventions were then inter 
rupted by the war. The first held after the war was at Jackson- 
ville in 1878, the next at Philadelphia in 1885, and one was held at 
Montgomery, Alabama, in 1889. These conventions utterly failed 
to effect their purpose, and it was not until Congress passed the 
law of 1893 that anything like uniformity of quarantine regulations 
was provided for the United States. But while Congress did allow, 
as it were, by sufferance, the state to execute quarantine meas- 
ures, it never by any act abandoned or disclaimed its right to 
maintain quarantine under the clause of the Constitution which 
gives it the right to regulate commerce, and in 1893 it passed an 
act entitled " An Act Granting Additional Quarantine Powers and 13 
Imposing Additional Duties Upon the Marine Hospital Service," 
empowering the Surgeon General of the marine hospital service 
to examine all the quarantine regulations of the various states and 
municipalities, and if any were found to be insufficient authorizing 
the Secretary of the Treasury to formulate such additional regu- 
lations as should be necessary; these regulations to be enforced 
by the state or municipal authorities if they will undertake to do 
so, but if they fail or refuse the President is authorized to execute 
them and to appoint or detail officers for this purpose. 
THE PRESENT LAW- 
This act was a great advance in the matter of national quaran- 
tine, and under its provisions regulations have been promulgated, 
and in several instances, where state or municipal authorities have 
failed to execute them, the compulsory right mentioned in the law 
has been enforced and the National Government has taken control. 
But the law still fails to provide for a strictly national quaran- 
tine, and is faulty in a number of respects. First, the provision 
which requires a demonstration of inefficiency before the National 
Government shall take control has a fatal effect, because a demon- 
stration of deficiency involves too much danger. Ordinarily the 
failure to enforce the national regulations is only demonstrated by 
some marked occurrence, which is dangerous in the extreme. For 
example, at one quarantine station, where the President has taken 
action under the law of 1893, the first demonstration ot inefficient 
administration was the permitting of the landing of a large number 
of immigrants who had been exposed to cholera, and had actually 
conveyed cholera to a port on the way to the United States. 
Aside from this it requires too much time, and offers opportu- 
nity for too much dispute as to whether the regulations have failed 
of enforcement, before under the law the President can be called 
upon to act. Another unfortunate feature of the present law is 
that the Government is obliged to aid in the execution and enforce- 
ment of such quarantine regulations as may be promulgated by 
the states and municipalities. Occasionally some very foolish and 
useless regulations are thus promulgated which it would be obvious 
folly to assist in executing. The law should read that if there is 
any assistance to be rendered it should be by the states and munici- 
palities to the National Government, and should not compel the 
National Government to assist the states. The present law does 14 
not provide for the establishment of national quarantine stations at 
such points as may be necessary, either on the sea coast or on the 
Mexican and Canadian borders. It does not provide that when a 
vessel has been inspected by a national quarantine officer that that 
inspection shall be final. It does provide that if the vessel has 
been disinfected it may be admitted to enter any port named in the 
quarantine certificate, but the number of vessels thus disinfected 
is comparatively few compared with those simply inspected. 
At or near one of the principal seaports of the United States 
the National Government, acting on request of several state and 
municipal authorities, has established a most complete quarantine 
establishment at large expense, conducted by regularly commis- 
sioned officers of the Marine Hospital service. The municipality 
thus protected has established another quarantine station nearer to 
the city, where it goes through the form of reinspecting, and charg- 
ing for, vessels which have already been passed upon by the 
national officers, and there is no law to prevent this. The law is 
lacking also in not providing for the apprehension of vessels from 
Cuba, which, under the guise of fishing, are engaged in smuggling 
upon our southern coasts, and while thus engaged may land infected 
material. And, worst of all, the National Maritime Quarantine 
law of 1893 provides no penalties for breaking the quarantine rules 
other than the penalty imposed upon a vessel if it sails from a for- 
eign port without a bill of health. 
INTEREST OF INTERIOR STATES IN MARITIME QUARANTINE. 
The interest of the interior states in maritime quarantine is 
greater than may at first appear. Immigrants and other passen- 
gers, merchandise, etc, arriving at a port of entry are not alto- 
gether destined for that port. The interior states, it may be 
stated are principally their destination. Why then should not the 
whole country share the expense of quarantine and relieve the 
vessels of the onerous quarantine charges ; and why should the 
safety of the interior of the United States be dependant upon the 
conscientiousness and care of a local appointee, whose responsi- 
bility is limited to the confines of his town or his state, and who 
moreover is not a unit in the general system arranged for protec- 
tion. but as too often happens is appointed for some political or 
local reason and subject to change with the changes of local politics. 
In justice to the state and local quarantine administrations I do not 15 
wish to imply that this is the universal rule, and I wish here to 
give testimony to the ability and care of many of these state and 
local officers, but the fact remains that the principle is faulty and 
the argument just mentioned has had a number of verifications in 
actual experience. 1 have been informed on very good authority 
that at one point of entry into the United States from a foreign 
country, if cases of suspected smallpox are destined through the 
state to other states, no attention is paid to them, they are allowed 
to go on. They are only taken up and held under surveillance.if 
intending to stop in the state which is upon the border. 
In illustration of the interest which the interior States have in 
maritime quarantine and their desire for a strictly national system 
and as demonstrating that the expenses of quarantine should be 
met by the whole people rather than by vessels entering the 
several ports, I insert here the following communication from the 
board of health of Michigan addressed to the Senators and Congress- 
men from Michigan. 
State Board of Health, Office of the Secretary. 
Lansing, March 18, 1896. 
Gentlemen: We, the officers of the Michigan State Board of Health, 
having in mind especially the protection of the citizens of Michigan from 
danger of contracting communicable diseases from immigrants and immi- 
grants' baggage passing through the port at Portland, Me., to which port 
many immigrants bound for Michigan and beyond sometimes come, es- 
pecially in winter, when the St. Lawrence River is not navigable, and under- 
standing that it is the desire of the local and of the state health authorities 
of Maine that a national quarantine station be established at the port of 
Portland, Me., do most respectfully urge the honorable the Senators and 
Representatives in Congress from Michigan to use their influence to bring 
about this desired improvement. 
We believe that a frequently changing municipal government, with its 
varying ideas of the expediency of making expenditures which are more 
largely for the protection of ci izens of other parts of this country than of 
the citizens of Maine, is not equal to the task of the continuous maintenance 
of a quarantine station which shall meet the requirements for safety to the 
health of our people. 
We believe that the interests of the whole country would be much better 
served if there was at Portland, Me., a quarantine station under the control 
of the National Government. 
Again expressing a desire that you use your influence in bringing about 
this desired change, we remain, very respectfully, 
FRANK WELLS, President. 
HENRY B. BAKER, Secretary. 16 
QUARANTINE A FUNCTION OF THE TREASURY DEPARTMENT. 
For these reasons I have held, and still maintain, that all 
quarantine, particularly maritime quarantine, should be National. 
It is a concomitant of commerce, over which, under the Constitu- 
tion, the National Government has absolute control, and it naturally 
belongs to that Department of the Government invested with the 
power of regulating commerce in other respects. In other words, 
it is, properly speaking, the function of the Treasury Department. 
This Department registers, licenses, and enrolls all merchant ves- 
sels of the United States; it inspects the hulls, boilers, and 
machinery; it determines upon the number of passengers which 
may be carried, and provides for the housing and the rations of 
the crews; it carefully examines all the pilots upon the American 
vessels and determines upon granting them a license ; it supervises 
the bringing of immigrants by these vessels from abroad; it 
enforces the navigation laws and aids vessels in distress by an 
efficient revenue-cutter service; it provides the lighthouses and 
the buoys which mark the channels for these vessels to enter ; it 
makes the soundings and furnishes the charts of our coast in fur- 
ther aid of these vessels; it provides for the care of the sick of 
our merchant marine: why then should it relegate to a state 
authority or the health officer of some small port the one remain- 
ing act of surveillance over these vessels, namely the determina- 
tion of whether they may be admitted to enter from a sanitary 
standpoint. Why should it leave to a local appointee, responsible 
only to a mayor or a governor, the power to determine whether 
all the people and the merchandise in these vessels, destined for 
all portions of the United States, shall be permitted to enter with- 
out detention, and why should it give this local officer the puwer 
to detain these vessels in quarantine ? 
These are some of the defects in the National Quarantine 
Law as it at present stands, which it is the aim of the Caffery 
Bill to rectify. This bill is now before the Senate and the House, 
reported on favorably by both committees, but not yet acted on 
by either body. 
INTERSTATE QUARANTINE AND YELLOW FEVER. 
With regard to interstate quarantine, the law authorizes, 
when it is satisfactorily shown that yellow fever prevails to such 
an extent in any state as to endanger other states and territories, 17 
national rules and regulations may be made, and another law re- 
quires cooperation with state and local authorities. The truth is, 
however, with regard to some of the epidemic diseases, particu- 
larly yellow fever, that, by the time the disease has become so 
extensive as to seriously threaten another state, the measures 
which might have been successful in suppressing it are apt to be 
futile. In other words, yellow fever is somewhat like a conflagra- 
tion ; if the first sparks are discovered the fire may be prevented 
from spreading and in fact be put out, but if too much headway is 
gained there is sure to be some destruction and almost certain to 
be some spread. Yellow fever is a disease which is so disastrous 
to commerce and so entirely disrupts the business of a town or 
city, that in most places it is an act of temerity, almost, to proclaim 
it. I know that in one city at least it prevailed in the late fall 
and has been kept secret until the local medical officer declared 
that if the good Lord did not send a frost soon he could keep the 
knowledge of it back no longer. The temptation to hide the first 
case is very great, and it is extremely difficult to believe that a 
few cases of mild fever with recovery, no more severe than an 
ordinary case of malarial fever, are as dangerous as a spark in a 
bundle of shavings. It is natural to look upon the hopeful side of 
affairs and there is frequently enough of doubt as to the nature of 
a case to furnish an excuse to the attending physician to give the 
benefit of the doubt to the harmless disease and call it malaria; 
yet there is no doubt that occasionally well defined cases where 
they are actually known are hidden, and the sooner an educated 
public opinion demands that every case be promptly announced 
and prompt action taken, the sooner will we be able to obviate an 
epidemic. 
THE MC HENRY EPIDEMIC. 
What can be done when prompt notification is given 
can be illustrated by last summer's experience in McHenry, Missis- 
sippi. The yellow fever prevailed in that town in the fall of '97 
and during the following winter a most thorough disinfection of all 
the houses known to have been infected was conducted, great care 
being exercised. However, an icehouse, supposed to be such but 
really filled with sawdust, which had been used during the epi- 
demic of '97 by people from an infected house as a latrine, escaped 
disinfection. In cleaning it out last summer two workman were 
simultaneously stricken with yellow fever. There had been a 18 
number of cases before the disease was made known and one or two 
persons who had been exposed to infection had gone to neighboring 
localities where they, themselves, developed the disease. They 
were traced, however, and placed under treatment and when 
recovering ordinary precautions were taken and it did not spread 
from these cases. All who had been exposed to infection in 
McHenry were isolated, the sick were treated in tent hospitals by 
themselves, and thus all trace of the disease was wiped out. 
There were all told twenty-five cases. How the disease originated 
later in Louisiana and Mississippi is a matter not yet to be passed 
upon. It would be improper to give a decision upon this point 
until full official inquiry has been completed, but it is a short- 
sighted policy that contemplates the secretion of all knowledge of 
the presence of yellow fever; it is not only shortsighted, it is a 
cruel policy, cruel to those in the immediate neighborhood, and, 
on the part of state and local physicians, unjust and cruel to the 
people of neighboring states and localities. If there were some 
means by which there could be a compulsory notification and the 
general Government could immediately take charge of the infected 
locality it would give increased confidence, would prevent the lay- 
ing of senseless quarantines, and in time people might come to 
regard a case of yellow fever as they do at present a case of 
small-pox-something to be avoided, but to be taken care of offi- 
cially. Deception is practiced because it is known that if the 
disease is announced the neighboring states and localities will 
quarantine against, and ruin the business of the locality infected. 
On the contrary the neighboring states and localities take this 
action because experience has taught them that deception is prac- 
ticed until the truth can no longer be withheld. The announce- 
ment of one case of yellow fever is generally proof positive that 
there have been a number of cases before the announcement was 
made, and that the announcement is only made because the truth 
can be no longer withheld. 
MEASURES TO PREVENT SPREAD OF YELLOW FEVER. 
It is the policy of the Marine-Hospital Service while attempt- 
ing to suppress an epidemic to prevent so far as possible unneces- 
sary restrictions upon commerce. Therefore, a classification of 
freight has been made. Some classes require no disinfection 
whatever, other classes, under certain conditions, require partial 19 
disinfection of exterior etc , and other classes require absolute 
disinfection. With regard to passenger traffic, train inspectors are 
placed upon all trains running from the infected districts, with 
a view to preventing people leaving unless possessing a certificate 
to the effect that they have been in a non-infected place for the 
ten days immediately preceding and a certificate for the disinfec- 
tion of their baggage if from an infected locality. When a town 
or locality is of a size which will permit of it, a cordon of guards 
is thrown around it and none are allowed to leave it without pass- 
ing through a camp of detention, which is made as comfortable as 
possible, where people may pass ten days and then be given a 
certificate which permits them to pass into non-infected states and 
localities. Experience has proven that an epidemic of yellow fever 
which begins early in the summer is a much more serious affair 
than one which begins in the fall or late summer. The worst epi- 
demic of yellow fever known in modern times was that of 1878, 
when it is estimated there were over 15 000 deaths. This epi- 
demic began in the early summer; the one of last year began in 
the early fall, as also did the one which is now prevailing. It will 
dimmish with the appearance of cooler weather and be brought 
to an end by the first killing frost. In explanation of the seeming 
spread of the disease it should be stated that in many of the places 
announced as being newly infected it is found that the disease has 
been prevalent in a mild form 20 to 30 days, thus showing that it 
has not spread from place to place as is popularly supposed but 
that the disease may have come to a number of places at about the 
same time from a common origin. Thus when A is infected and 
after a while B is found to be infected and later on C, it does not 
follow that C has taken infection from B but rather from A. This 
again emphasizes the disaster involved in the authorities of A 
keeping the existence of the disease a secret. 
Now gentlemen it is time I should bring my remarks to a 
close. 1 must not forget that these matters, so absorbing to my- 
self, may not be of equal interest to you. Yet I should like had I 
had time to prepare and had you the time and patience to listen, 
to touch upon many topics growing out of the subject presented. 
1 should like to speak more fully concerning the quarantine law, to 
describe the quarantine service of the United States, National as 
well as State, to describe how the former has grown to twelve 20 
large stations with their equipments of piers, warehouses, barracks, 
boarding steamers, hospitals, and disinfecting apparatus. 1 should 
like to describe the work of the Marine Hospital Service, whose 
officers control these stations and to tell what the corps does and 
how it has grown from the limited relief to the sailor when it was 
established in 1798 to its present proportions in this the 100th year 
of its existence when it treats 53,000 sailors annually, con- 
ducts twenty hospitals and 120 relief stations, examines pilots 
examines men for the revenue cutter Service, examines crews 
for life saving stations, conducts a hygienic laboratory, inspects 
the immigrants, and issues public health reports each week, em- 
bodying sanitary and statistical news from all parts of the world. 
I might interest you with a plain narrative of its operations during 
the past summer and fall, when so many causes have contributed 
to unusual responsibility and to extension of its scope. But all 
this would take undue time. So in conclusion 1 will simply give 
expression to one thought which occurred to me while reflecting on 
the topic of the evening, and while visiting, as 1 often do, as it is 
but a block from my office in Washington, that beautiful building, 
the Congressional Library on Capitol Hill. All Americans who 
visit that building are impressed with the grandeur of its architec- 
ture, its ornate exterior, and the beauty of its interior structure 
and decoration. The appreciation is by no means diminished by 
the sense of proprietorship, which all may feel; and as from one of 
its upper balconies one takes in the views spread out before him, 
these emotions can not but be enhanced. There is the Capitol, 
unsurpassed by any in the world, and from its base the broad 
clean avenues, fringed with trees, extend to the Potomac ; and 
toward their further end rise the White House, the Treasury, the 
State, War and Navy building, the Naval Observatory, and that 
grand monumental shaft to Washington. All this is ours, and as 
the eye rests upon the Virginia hills beyond, it is not difficult* for 
the mind to go still further South across the blue waters of the 
Gulf to the Gem of the Antilles, freed at last, and to Porto Rico, in 
three more days to be under the American flag. Then we think 
of Hawaii and the Philippines, and how with all this expansion of 
our territory, there must be expansion of our commerce. Our 
exultation, however, is tempered by responsibility; the commercial 
world has much to do to profit to the utmost by our new conditions, 21 
and as each agent of Government service seems striving to lend 
all possible aid to secure the full fruition of our victories, let me 
say to you, on behalf of the National Quarantine Service, that 
no effort will be spared to prevent our commerce being hampered 
by disease, for this is modern quarantine,-to strip commerce of 
disease, both for its own good and for public safety.