A Reply to a Letter entitled “ Dr. Joseph Holt and Steam as a Disinfectant.” Reprinted from the November number of the N. O. Medical and Suhgicai. Journal Commercial Relations with Brazil as affected by Quarantine Regulations. Extracted from N. O. Press, of Oct. 20th, 1SS5. A Reply to the Letter “Dr. Joseph Holt and Steam as a Disinfectant.” Reprint from November number New Orleans Medical and Surgical Journal. New Orleans, October 5th, 1885. Editors N. O. Med. and Surg. Journal: Gentlemen:—Under the title “ Dr. Joseph Holt and steam as a disinfectant,” I have just read in the last num- ber of your Journal a letter from Dr. A. N. Bell, Editor of The Sanitarian. The character of the headline and tone of the letter are forcibly suggestive of the fact that a discussion on a purely scientific question has drifted into that unfortunate whirl- pool of acrimonious controversy which has invariably made shipwreck of every affair, however worthy, drawn within the range of its fatal influence. So easily and delightfully seductive is the downward course to this maelstrom of the medical profession and its collateral sciences, that it requires the most decisive and energetic exhibition of a true moral courage to resist the sweet satisfaction to the soul afforded by giving the “ last-lick.” Of all other pugnacious creatures, doctors are proverbi- ally the weakest on this point: The temptation, in the first place to get angry, and, in the next place to hit back, sorely presses upon those who are by nature of a peppery disposition. There are some sinners in this world, and of these I am the chief, who just glory in a row. The excitement of a 4 heated and even offensive controversy is exhilarating; and, unfortunately for the higher interests of our profes- sion and of all science, is too often rushed into and pur- sued, regardless of mischevious consequences to the cause we profess to honor and support, and contrary to the guid- ance of a cool and prudent judgment. I will frankly acknowledge that my remarks, calling forth a reply from Dr. l3ell, were stimulated by a feeling of resentment occasioned by his editorial in the June num- ber of The Sanitarian, which, by some unfortunate kink in my interpretation, I construed as animadverting with ridicule upon the Editors of this Journal and myself, exposing jeeringly our ignorance in not being possessed of certain information familiar to himself and assumed to be generally known. While wrong in allowing myself to become irritated, there is some paliation in the universal frailty whereby we all, children and old folks alike, repel with indignation any instruction or correction of an error offered through the medium of contemptuous ridicule. Nothing so quickly arouses a spirit of resentment, even in the meek and lowly, (neither of which we are) or makes a school master more thoroughly despised. No incentive lends such zest in a fight. This method of imparting knowledge when adopted by one to whom we have looked up as a high priest in the inner sanctuary of the temple of science ; as a specialist whom we know to be erudite in all that appertains to pre- ventive medicine, and from whom we have expected infor- mation and guidance bestowed in the tender spirit of a grand philanthropy; by one for whom we have long enter- tained a feeling of the highest personal regard ; this method, I say, did take me aback with a shock of aston- ishment reacting in a flush of anger which threw me off my guard and committed me to a harshness of expression, un- warrantable in the light of facts revealed by a recent per- usal of the July number of The Sanitarian. It matters not what others may think or say, I am deter- 5 mined no trivial pique shall place me in a permanent atti- tude of hostility towards Dr. Bell, disrupting ties strength- ened by years of pleasant acquaintance and several acts of kindly consideration on his part. Moreover, when I wage war I wish to fight my enemies and not those who are engaged in the ranks with myself ; above all, I intend to avoid anything that could wound the feelings or enkindle the enmity of one whose life of service in the cause of humanity should command in his age the respect and affection of all true men. Let us now talk “Maritime Sanitation,” a little, I will lead off by reiterating my conviction that: “Steam cannot be applied as an effectual disinfecting agent in ships, and steam has not been the method of disinfection in any port since 184.8." Let it be remembered we are talking of Quarantine and of what is practicable, on the one hand protecting against the introduction of pestilence while, on the other, avoiding obstructions injurious to commerce. It was never my intention to include the idea of what is possible to be accomplished. It is possible to lift a steamship over the Brooklyn Bridge, but to propose it as a practicable route up East River is to my mind on a par with steam adopted in quar- antine for general service on account of its “ easy mode of application for the disinfection of vessels.” That a ship can be disinfected by steam I have not questioned. In his letter, Dr. Bell has cited the instances of four steamships in the U. S. Navy, infected with yellow-fever. Two of them in 1848 ; one in 1862 and one in 1868. The cases are new to me and highly interesting. Let us examine the accounts critically: They were all steamships in the Navy, hence, carrying no cargo and empty of any thing likely to be injured by steam at a high temperature. After fruitless attempts to get rid of the infection the use of steam, which happened to be ready at hand, was finally suggested as a disinfectant. In no one of these cases was it resorted to as an adopted 6 method, but in the exigencies of repeated failure was hit upon, almost by chance, as the first step in cleaning up the ship ; followed by a careful scraping, scrubbing, painting and whitewashing, together with particular attention to cleansing thejbilge. The use of steam, therefore, was only a part in a very elaborate and tedious process of ship sani- tation and was used through apparatus improvised hap- hazard. While I believe the high temperature of the steam did have much to do with ridding these vessels of infection, I am by no means disposed to accord it that entire credit which seems to have omitted the other agents used. Not only did these four instances of steam used as the agent in disinfecting a ship extend over a period of nine- teen years, but occurred in localities a thousand miles apart. In one of the accounts it is very clearly stated that paint •was blistered and “ a few articles of furniture that were glued together had fallen a fart."' This brings us down to the consideration of reasons why I do not think steam can be applied as an effectual disin- fecting agent in ships. If a system of quarantine in ports such as New York, Liverpool or New Orleans, requires as the prerequisite to the application of its adopted disinfecting agent that every vessel from a quarantineable port shall be unloaded, this settles the question. Such a quarantine is a failure because it puts an embargo upon commerce. Not only must it en- tail an enormous expenditure of money which must be met by an exorbitant, a ruinous tax on tonnage, but the delay would completely block the current of trade. Shipping could not and would not stand it. But suppose it did? Very well, you have emptied the ship and have steamed, scraped, scrubbed and painted her, but how about the cargo? That must be treated also, for surely you do not mean to say you intend to disinfect the hold of a vessel and neglect, it may be, thirty thousand packages of freight, every one of them possible fomites ! Of course not. 7 There stands a quarantine warehouse, one compartment full of rice ; another of coffee ; another of sugar ; one is filled with furniture ; one with potatoes ; another with codfish. It it were not for the miserable prejudice of our mer- chants, I can see good sense and economy in steaming these several cargoes. Our rice and our coffee would come to us already boiled ; nicely steamed. In fact, it would save a deal of bother with cooks now-a-days. The only trouble is, some of us like a little change in diet once-in-a-while, and not boiled things all the time. Cod-fish balls fried and baked beans forever ! We do not always prefer hard-boiled eggs. Here are dietary prejudices to the steam some cranky people would be almost sure to interpose as an objection. As for the merchants, do not tell me anything about the bull-headed set! They are as obstinate in their notions about the “ condi- tion of goods on arrivalas anybody who is determined not to be convinced ; and will continue to sell raw food to the people in spite of any demonstration steam might afford. A great trouble with the plan is that it is too far in advance of the present spirit of public intelligence and gratitude. Here comes a 2000 ton sailing vessel loaded to the plim- soll or, perhaps, the plimsoll below the water line, a mis- cellaneous cargo, and a captain of exceeding profanity What is to be done? Are you going to unload that ship and then put her through the tedious process of parboiling, blistering the faint, scrubbing her up and reloading, with that captain standing around expressing himself, and any hope left for your immortal soul? Man is by nature sinful, and you only add to the enor- mity of your own moral depravity and corruption of your whole nature, which is commonly called original sin, when you say that you would not answer back and give as good as he sends. 8 The religious question, therefore, enters into this thing with its awful solemnity and imposes not only an additional liability to all the miseries of this life, to death itself, but a certainty of the pains of hell forever. Only a few days ago the captain of a British steamship witnessed the process of simply wetting his favorite blue- flannel shirt in our method of treatment. I will present the exact report from the Times-Democrat of the 3d inst. : “It appears on the arrival of an English steamer at the station it was necessary to put her through the course of fumigation and sprinkling of all wearing apparel with the bi-chloride of mercury solution. Accordingly, all the cap- tain’s clothing was brought on deck and the sprinkling nozzle turned on them. The spray permeated even into vest-pockets, and soon each article was well wetted. The captain looked on silently for some time, but when he saw a favorite blue-flannel shirt of fine fabric soused, he could not contain himself, and turning to Dr. Aby, exclaimed : “Ah, doctor, it’s to bad to ruin that! Look at it, now,” and he held up the limp and dripping garment by the sleeves. “ It’s ruined, sir, it’s ruined, and I’ll pay you for it. You have outraged the British flag and a British sailor. You’ll get that shirt back, sir, from the mouth of a cannon.” The doctor explained, but the captain assumed intense anger. The vessel came to the city, discharged its cargo and loaded with cotton. The other afternoon Dr. Aby was seated on the wharf at Quarantine with a few friends, enjoying the pleasant breezes that came over the water, when a steamship was noticed approaching from up the river. She was a long, low English craft, heavily laden, and was making good speed. As she neared Quarantine it was remarked that she was steering unusually near the shore. It was not long before she was abreast of the wharf, and Dr. Aby recog- nized that she was the vessel commanded by his irate captain Just as he noticed the name on her bow there was a deep boom of a cannon and a puff of smoke shot out from her topgallant forecastle. The firing of a gun at this point was so unusual the doctor was taken aback by the report, and more so by a black object that came flying to- ward him through the air. As it rose overhead the breeze inflated it, and it stood out in silhouette against the clear sky—the captain’s blue-flannel shirt, with arms outspread' and tail flying. He had kept his word.” 9 If simply wetting the captain's wardrobe threatened so seriously to strain the cordial relations existing between Great Britain and the United States, what would nave been the result had his shirts been steamed and shrunk about four sizes too small? There is nothing problematical about it. A personal outrage upon a British subject is an outrage upon his flag, and the inevitable consequences speedily follow. Diplo- matic relations broken off and the country unprepared, without a navy, and every sea-port exposed finds itself precipitated into all the horrors of a gigantic war with the first maritime power of the world. Dr. Bell, a man of intellectual force, full of patriotism and human sympathy, is too astute not to have forseen these things, and yet in the very moment of a fearful warn- ing ; while the apalling roar of the British lion (wet) has hardly ceased its reverberation, here comes the gentleman from New York, crying “ Steam ! Steam ! ! ;’ How the gentleman can reconcile this as consistent with bis ideas of patriotism and humanity is a conundrum too much for me, and I give it up ! There are some curious people in this world. As an offset to the dangers of invoking the calamity of war, while warding off that of pestilence, the high tariff under the steam system levied on vessels passing quaran- tine is the only thing that could save our ports from an invading fleet. While the enemy would smile at our guns they could not stand the quarantine ; so the system is not one of unmixed evil after all, but is compensatory in time of war. In reasserting my convictions of the impracticability of steam as an available disinfectant for general service in quarantine, it is not done with the intention of advocating or defending any other system. Any plan, it matters not who suggests and puts it into operation, is successful in direct proportion to the recon- ciliation accomplished between the conservation of the public health on the one hand, and commercial freedom on the other. 10 The principles of preventive medicine reduced to the terms of a pure science furnish the only possible medium of reconciliation. A failure to enforce these principles from ignorance or any other cause, must always result in alienation and vio- lent conflict of health and commercial interests, throwing open the gateway to pestilence or barring it against trade by non-intercourse. We have endeavored to build upon these principles, de novo, applying our methods to the direct and speedy ac- complishment of the indications without the slightest ref- erence to or assistance from any who may have labored in the same line of thought. We have had no feeling of am- bition or other motive than to render the State some ser- vice, and to account for our stewardship as trustworthy servants. We claim nothing more than to have done what lay directly before us in the line of duty. We have chosen sulphurous acid gas to displace the en- tire atmosphere within a ship and as the disinfectant of cargo because of its justly accredited germicidal power, its innocence as affecting ship and cargo, the speed and abso- lute thoroughness with which it is applied, and economy. We have adopted the solution of bichloride of mercury because it stands preeminently above all others as a germi- cide ; is colorless and odorless in solution ; is not injurious to textile fabrics by stain or corrosion ; can be applied to all surfaces that may be reached with water, bilge, hold, decks, saloons, births, bunks, forecastle ; is absolutely free from injurious effect when handled in the solution, one to one thousand, for months at a time ; and is vastly more eco- nomical than any other agent. It must not be allowed to touch brass or ornamental metal. We are not committed totheuseof any particular agents. When Dr. Bell or any other sanitarian shall come for- ward with agents demonstrated to be of a higher disinfect- ing power ; one wherewith to displace mephitic atmosphere and another to apply to surfaces, baggage, etc. ; freer from injurious effect upon ship cargo and textiles; safer to 11 handle and less expensive, we will discontinue the sulphur- ous acid gas and bichloride of mercury at once and adopt the new. But all of these qualities must be proven. And finally, gentlemen, begging your pardon for so tres-. passing upon your valuable space, if Dr. Holt is such a ter- ror to pestilence and death as to be invoked as a disinfectant, while thanking Dr. Bell for this extraordinary tribute to his medical ability, and accepting the office, he prefers to “^0 .it alone” He has no prejudices but please shut off the steam ! Yours very truly, Joseph Holt, M. D. Commercial Relations with Brazil, as affected by Quarantine Regulations' The following was a reply to a recent letter from the Bra- zilian Consul-General at New York, complimentary to the improvements in Maritime Sanitation introduced during the present season by the Board of Health of the State of Louisiana : Office Board of Health, } New Orleans, Oct. 17? 1885. \ Dom Salvador Mendonca, Consul-General of Brazil, New York City, N. Y. : Sir— Through the courtesy of your Vice Consul, Mr. Allain Eustis, I have been presented a copy of a recent letter in which you have graciously mentioned my name in connection with the effort being made at this port to devel- op commercial relations with the vast fields of trade south of us, and particularly with the Empire of Brazil. The reciprocal importance of these trade relations far exceeds any comprehension entertained by persons not especially informed by a careful study of the subject. 12 Accepting the axiomatic truth that the currents of trade seek the shortest course, it follows that the coffee importa- tion into the Valley of the Mississippi, including the States on the Mexican Gulf, about twenty-four States and Terri- tories in all, if allowed to pursue its natural and unobstructed way, would be by the shortest and most direct route from Brazilian ports, through tthe Carribian Sea and Gulf of Mexico, into the Mississippi to New Orleans, the great distributing point to the interior of the continent, both by water and by rail. Not only coffee, but valuable furniture woods and other exports of the tropics naturally tend to follow this direct line to the areas of consumption, while the commodities of exchange, such as Western Produce, manufactured goods, agricultural and other machinery, coal, iron, timber, etc., would follow the return course in ships regularly plying. As for the Mexican trade we can hardly imagine a wider departure from the apparent natural laws of commerce than the shipment of coffee from Vera Cruz through the dangerous straits and around the peninsula of Florida into the Atlantic and to New York, besides the risks, many times the distance simply across the Gulf to New Orleans. Deflections such as this seem almost like “ tricks in trade,” and are unaccountable upon any hypothesis except that of some obstruction in the natural channel too formi- dable to be overcome by the inherent power of the current itself. A proclamation of non-intercourse, a forty or ten days detention in quarantine, is sufficient to turn the tide of com- merce from any port in the world. The instant a seaport plants itself behind such an obstruc- tion its own importance ceases as absolutely as though it had wiped itself from the face of the earth The coffee trade furnishes an exposition of the whole question in a manner singularly clear. In 1859 the import into New York was : Pounds, 95*- 674,437: and into New Orleans, 66,484,541. In 1882, into New York 342,840,541 pounds, and into 13 New Orleans only 29,862,272 pounds ; while the consump- tion in the country at large has gone up from 235,865,263 pounds in T859 t0 459,922,763 Pounds m 1882. Thus, while the. consumption throughout the country has enormously advanced, the importation through New Or- leans has enormously receded. The exhibit here of coffee is precisely the same in re- gard to every other article of export and import between this city and inter-tropical regions. The civil war was a temporary derangement that cannot account for a steady decline to the year 1885. If the quarantine of detention had kept out any kind of pestilence, small-pox, yellow fever or cholera, we might call it a reasonable offset to this destruction of commerce, but when contemplated along with the fact that we have been invaded by pestilence whenever these infections were disposed to spread, we are not quite so complacent and by no means contented with a system of superstition endeared to us by long associations and hallowed with the musty odor of antiquity. In the exchange of commodities between the North and South, New Orleans, at the gateway of the Valley of the Mississippi, can justly claim a natural prerogative, being in the most direct line of longitudinal commerce. The main channel of trad£ between the United States and the tropics would follow this route if left to the unobstructed operation of natural forces. This cannot be, unfortunately, for a conflict is waged by the immensely wealthy corporations which own the vast latitudinal or transcontinental railroads centering in Eastern cities and which find it to their inter- est to compel import tropical trade to move over their rail- roads and coastwise steamship lines. They regard with jealous enmity the Mississippi river as the very embodiment of a hostile longitudinal trade across their latitudinal lines. These transportation monopolies are cold-blooded and are without sympathy and consideration of any kind. In their avaricious zeal to establish an absolute control in which 14 they can command freight charges ruinous to shippers and consumers, they do not hesitate to resort to any measures that will cripple and drive out men of smaller means, who endeavor to follow the business of maritime trade along natural lines of movement, co-incident with those of longi- tude, because it interferes with their own schemes of ag- grandizement. Anyone who interferes with the current of trade, whether capitalist or pirate, inflicts a general injury, and is to be regarded as a public enemy, whose motives in either in- stance are the same. A violation of the principles of right, moral and commer- cial, must result in injury. Not only do those powerful corporations seek to central- ize all commerce in their own lines, but their success enables them to dictate terms oppressive to producers and consumers alike. Could there be a violation of what may be called a natu- ral law of commerce more flagrant than the shipment of Rio coffee, at discriminating rates, from New York to Texas, via New Orleans, the discrimination being against the New Orleans buyer? Every incentive of justice and hatred of tryanny urge to resistance of such a perinicious use of power not granted by any law of the land. The constitution je'alously provides against invidious discrimination as a matter of privilege. Having no law, therefore, to back them, the only pretext and shield of these grasping corporations has been the pop- ular fear of yellow fever, and the consequent quarantine of long detention. With these they have needed no law nor other backing, but have been masters of the entire North American trop- ical trade. To have opened the port of New Orleans the year round has disturbed the equilibrium of these scare-crow calcula- tions, while it has given an impulse of renewed hope to all who have an interest in the substantial welfare of this city and Valley. 15 These know that our future prosperity is in the broad fields south of us, and that pestilence and long quarantine detention are the only obstacles which may keep it away. As a slight promise of hope we have already imported this summer since the establishment of “maritime sanita- tion,” June io, the one item of 13,293,787 pounds of cof- fee, against almost nothing during a corresponding period several years previous. Finding that I have extended this letter unduly I will offer my apology with the hope that a future of the high- est prosperity has opened to our people conjointly. For its encouragement to our public I took the liberty of hav- ing published the copy of your letter sent to me. I remain, sir, with great respect, yours truly, Joseph Holt, M. D., President Board of Health State of Louisiana.