AS TO YELLOW EEVER. 
BY JOHN P. WALL M. D. 
(Reprinted from the Florida Times-Union.) AS TO YELLOW FEVER. 
By JOHN P. WALL. M. D. 
(Reprinted from the Florida Times-Union.) 
Sime the appearance of the yellow fever in 
Tampa, I have noticed much in the Times- 
Union, more or less reflecting upon me, 
for having advised the people of Tampa to 
get away from the place and thus escape the 
fever. The authors of these criticisms have 
shown themselves such ignoramuses-and 
among them are some of your editorial staff- 
that I would hardly deign to notice them 
but for the hope that it may prove of some 
benefit in the future. 
Yellow fever is one of the few diseases of 
which little is positively and definitely 
known as to its cause, nature (in a patha- 
logical sense) and exact mode of propagation. 
For at least a century, all these points have 
been discussed; and whether we know much 
more about them now than did our progeni- 
tors of the last century is extremely prob- 
lematical, as the literature of the disease 
abundantly proves. Medical opinion has 
been divided as to its origin, transmissibil- 
ity and contagiousness from its first inva- 
sion of the shores of North America. 
It is generally conceded now, however, 
that it is a zymotic disease, and that if it 
does not have its origin on our shores in 
filth, at least the latter is an essential factor to 
the generation and propagation of its infect- 
ing germs, or morbific agent-the poison 
that produces the disease. Why it should 
take on a comparatively mild type in certain 
seasons and manifest no marked disposition 
to spread at times is another of its problems 
for which we cannot account at the present 
day. 
The few facts that we do know about yel- 
low fever are that it is a disease attended 
with a considerable mortality, ranging from 
10 to 75 per cent.; and that the atmosphere 
of the city where it is prevailing sooner or 
later becomes infected-poisoned with its 
morbific agent; and that those susceptible 
to the disease, i. e., not being acclimated, or 
protected by a previous attack, will in all 
probability take the disease. Experience has 
taught us this much, at least. 
Yellow fever, then, being a zymotic dis- 
ease-having its origin probably in the filth 
of the slave-ship-the necessity and impor- 
tance of sanitation-to keep air, water and 
soil clean and pure, become too obvious to 
the ordinary mind to require any arguments 
to demonstrate. 
The Technical Commission of the Inter- 
national Conference of Rome (1885) says: 
"The measures recommended against 
cholera are, in general, applicable to yellow 
fever and to other diseases which prevail in 
epidemic form under the influence of bad 
sanitary conditions, and which are trans- 
mitted by human intercourse. The most 
effective measures for preventing the propa- 
gation of diseases of this class are: the sani- 
tary improvement of cities and of vessels 
sailing from infected ports, isolation of the 
sick, and disinfection of infected or suspect- 
ed articles and localities." 
If, then, the same sanitary prophylaxis 
for cholera is good for yellow fever, why is 
not the doctrine and practice of England in 
regard to cholera applicable here to yellow 
fever? Instead of a quarantine of detention, 
except as to the sick, the English pursue the 
following enlightened and common sense 
plan, as set forth in an editorial in the 
London Lancet of the 20th of last August: 
"All sick of cholera or diarrhoea are dealt 
with and isolated at our ports; but the 
healthy are not herded with the sick, as is 
done under quarantine. They (the healthy) 
are allowed to go where they will, provided 
they submit to proper supervision, bjr giving 
the address of the destination to which they 
are traveling. These precautions form, 
however, only the fringe of our system of 
prevention. Our ponulation, knowing that 
the Government will no longer pretend to 
guarantee any measure of safety by drawing 
a quarantine around the country, have of 
their own free will set themselves to remove 
from their midst those conditions under 
which imported cholera can alone spread; 
and, according to Dr. Thorne, they have, 
apart from all Government dictation, spent 
during the past ten years, by way of loan 01 
in current expenditure, over eighty millions 
sterling for purposes mainly of a sanitary 
character. When quarantining countries 
can give evidence of their alternative sys- 
tem by submitting to any such expenditure, 
then it will be time enough for them to urge 4 
that their system merits further considera- 
tion at our hands. Up to the present time, 
and this even in the Ped Sea, which is looked j 
upon as the gateway by which cholera may 
at any time enter Europe, the quarantine 
stations are not even provided with the 
common decencies of lire. 
"Since our system of medical inspection 
came into operation it has gone hand-in- 
hand with a steady sanitary progress far ex- 
ceeding anything to be met with in those 
European countries where the inhabitants 
are led to believe that quarantine restric- 
tions will be imposed for their protection in 
times of danger; it has been accom- 
panied by a great diminution of mor- 
tality, and it has spared the inhabitants 
of this country from an untold amount of 
misery and destitution, which 'is the more 
burdensome because it follows in the track 
of preventable disease and death.' That our 
system is complete we do not for a moment 
pretend, and we would make no boast of 
the fact that imported cholera has on each 
occasion, for many years past, been at once 
checked in this country; but we do hold 
that the experience of the past few years has 
once again indicated the uselessness of 
quarantine and the great advantages of the 
system we have substituted for it. Quaran- 
tine has a blighting effect on sanitary pro- 
gress ; it leaves the people unprepared to 
face a disease which disregards the antiquat- 
ed barriers which nations have opposed to 
its extension, and so it prepares the way for 
panic. On the other hand, the steady pro- 
gress of true measures of prevention ten s 
to impart that feeling of confidence which is 
of such value in the face of an impending 
epidemic, and at the same time it promotes 
the healthiness and well-being of the popu- 
lation." 
In the same article the editor points out 
that Spain, France, Italy and Algeria, rely- 
ing on quarantine for protection, have suf- 
fered from the ravages of cholera during the 
European epidemic of 1884-87. 
In the New York Medical Record of the 29th 
ult. we find the following editorial article: 
"England's commercial interests have al- 
ways led her to doubt the need and distrust 
the efficacy of quarantine. She has held 
what she is pleased to consider the ' common 
sense view,' viz: that, though theoretically 
quarantine may succeed in keeping out 
disease, practically, in any large coun- 
try, it amounts simply to an irrational 
derangement of commerce. England 
has long since, says the British Medical 
Journal, discarded quarantine as a means of 
preventing cholera, and now places her 
trust in the security afforded by purity of 
local surroundings-of soil, air and water 
on land; and a system of watchful medical 
inspection at her seaports, 't'he success of 
this policy, continues our contemporary, has 
been complete, and there are not wanting 
indications that this success is exercising a 
beneficial effect on public opinion abroad. 
It is added that at the recent International 
Hygienic Congress,at Vienna, opinion seemed 
to be turning against quarantine. Italy and 
Austria, in particular, are wavering in their 
allegiance to the older methods." 
If, then, a quarantine of detention for 
cholera has proven to be useless, it is cer- 
tainly much more senseless for the preven- 
tion of yellow fever. And on this point- 
the detention of persons-let us quote some 
of our latest text books on the practice of 
medicine. 
Flint, in his edition of 1884, page 1026, 
says: 
" Measures for the prevention of yellow 
fever relate, 1st, to the removal of local con- 
ditions which favor the multiplication of 
the disease-germs, 2d, to quarantine regula- 
tions, and 3d, to disinfection. The first of 
these three divisions embrace all that per- 
tains to public and private hygiene. The 
local conditions especially important as 
auxiliary causes are unknown, and, there- 
fore it can only be hoped that they will be 
reached by rendering sanitary measures as 
complete as practicable. But, be these 
measures never so complete, they do not 
make superfluous those of quarantine and 
disinfection. The object of quarantine reg- 
ulations is that the disease-germs shall not 
be imported. To effect this object, either 
there must be non-intercourse with places in 
which the disease prevails, or all articles of 
merchandise, clothing, etc., brought there- 
from must be thoroughly disinfected. To 
be efficient, quarantine regulations must in- 
clude, not only vessels from infected ports, 
but inland transportation by railroads and 
other conveyances. There is no danger of 
the disease being carried by the living body 
after disinfection of the wearing apparal, 
nor by the bodies of the dead. Detention of 
the well or the sick is, therefore, a needless pre- 
caution, except to prevent groundless pvpu- 
lar apprehension. (Italics mine.) If impor- 
tation of germs have taken place, the houses 
with their surroundings in which cases 
occur, should be instantly and completely 
disinfected. The object now is to "stamp 
out' the disease. There is ground for the 
belief that this object may be effected if 
measures of disinfection be promptly and 
thoroughly carried out. 
"During the prevalence of an epidemic, 
unacclimated persons should avoid going 
within the infected area, except under a 
sense of duty, and they who are already with- 
in the area should leave it. unless there are 
motives for remaining which render the 
risk of life justifiable and praiseworthy." 
Bartholov in his work on practice, says: 
"A germ or germs are introduced. Ac- 
cumulated filth, decomposing animal or 
vegetable matters, bad or no drainage, 
crowding and other hygienic evils are in- 
dispensable to impart the necessary vitality. 
Lodging thus in a suitable soil and with the 
appropriate atmospherical conditions present 
the disease germs grow and infect those in 
the proper personal state to receive the 
poison. ************ 
It is not by personal contact that the dis- 
ease is communicated-in other words, it is 
not a contagious, but an infectious disease, 
and it is not against individuals that 
quarantine restrictions should be enforced, 
but against articles of clothing, bedding or 
the like or against allfomites." 
Again, in the Lamb Prize Essay, for the 5 
American Public Health Association, 1886, 
on disinfection and individual prophylaxis 
against infectious diseases, by Dr. Sternberg, 
Surgeon United States Army, we find the 
following on yellow fever: 
"This disease, like cholera, is contracted 
in infected localities, rather than by contact 
with the sick. Indeed, it is rarely, if ever, 
communicated directly by a sick person to 
his attendants. In infected places the poison 
seems to be given off from the soil, or from 
collections of decomposing organic matter, 
and we have no definite evidence that it is 
communicated through the medium of food 
or drinking water (as is the case with chol- 
era.-W.) The history of epidemics of this 
disease shows that when it obtains a lodg- 
ment in a city or town which is in an unsani- 
tary condition, in Southern latitudes and 
during the summer months, it extends its 
area and invades new localities similarly sit- 
uated, until frost occurs, or at least until the 
weather becomes comparatively cool in the 
autumn. Those who remain in an infected 
area, unless protected by a previous attack, 
are almost certain to contract the disease, 
and much less can be done in the way of in- 
dividual prophylaxis than in cholera. We 
therefore advise all who can get out of the 
way of this fatal disease to do so. * * * * 
* * * * This being the case, we repeat 
our advice to all those whose duty does not 
require them to stay on the field of battle, 
to make an orderly retre at to some place of 
safety." 
If such is the teaching of science, will 
medical men on county boards of health 
please tell the public how much sense there 
is in their fifteen days' quarantine of indi- 
viduals ? Are they mere puppets of panic- 
stricken communities, and by being thus, 
prostitute science and professional propriety 
to magnify their importance in the popular 
estimation? Do they think it a light and 
trivial thing to interrupt and prostrate all 
business and bankrupt common carriers be- 
cause these foolish measures of quarantine 
are applauded by some scared editor who 
has aroused, by his ill-timed effusions on a 
subject of which he knows hut little, if any- 
thing, a groundless popular apprehension? 
Does it not occur to them that they are ex- 
hibiting themselves to their professional 
brethren who read and think, as being either 
ignorant or dishonorable? Has it never oc- 
curred to them that they are playing the role 
of quacks and charlatans? Much would I 
prefer to be shunned by the ignorant than 
thus to sacrifice truth and science to the 
clamor of a senseless scare, and forfeit my 
own self-respect. 
If. as is pretty well established, yellow 
fever is not a contagious disease, and there 
is no danger from the well, sick or dead, 
from the infected locality-barring the 
clothing and other effects-how is this thing 
of confining a people to an infected locality 
to be justified? Do they expect them to 
remain and die like dumb brutes? If they 
do, they are fools as well as inhuman mon- 
sters. I told the people of Tampa that we 
had yellow fever here, and advised them to 
get out. I did this deliberately, and to pre- 
vent reports being spread, I got the tele- 
graph operators to refuse to receive any mes- 
sages that would give the alarm to the out- 
side world until I could give the people a 
chance to get away. I know. Mr. Editor, 
that I was not endangering the lives of 250,- 
000 people of the State as you charged, be- 
cause I knew that the infection was only 
here, and did not extend all over the State. 
I was guided by the teachings of science, 
and actuated by humanity and common 
sense in my proceedings. The result has 
vindicated my course and prevented an in- 
crease of calamity that would, in all proba- 
bility, have amounted to a holocaust in the 
sacrifice of life, to say nothing of the in- 
creased suffering that would have naturally 
resulted. I have nothing but the profound- 
est contempt for the nincompoop M. Ds. and 
pseudonymous liars of the "Viator" stripe 
who write about fifteen days' incubation and 
a State Board of Health, and took occasion 
to maliciously misrepresent me at a time 
when I had neither time nor opportunity to 
defend myself. The charge made by the 
Times-Union and "Viator" that I said I 
would guarantee that ' 'no yellow fever got 
into Tampa," is false in toto. When that 
"M. D." quoted Flint about the fifteen days' 
incubation, why did he not quote him cor- 
rectly? and why did he leave out what I have 
quoted from the same author on quarantine? 
Do you think that was either gentlemanly or 
honest? 
It is just such nincompoops as he who 
impose false ideas upon the people, and ex- 
cite groundless apprehensions of danger. 
As for railroad quarantine, it is an absurd- 
ity, and the disinfection practiced with sul- 
phur at the quarantine station, was about as 
efficient as so much ordinary smoke. Yet it 
met the approval, according to their report, 
of two or three of your Jacksonville physi- 
cians, who reported that the fumigation at 
Dr. Caldwell's camp was satisfactory, and 
was of two or four hours' duration, I am not 
certain which. Now, in the article on Dis- 
infection, in Vol. 2, Reference Handbook of 
the Medical Sciences, by Dr. Sternberg (pre- 
viously quoted), page 480, can be found 
this: 
"Fumigation with sulphur dioxide has 
been largely relied on for the disinfection of 
clothing" To be effectual, the articles to be 
disinfected must be freely exposed to its ac- 
tion, in a well closed chamber, for a period 
of at least twelve hours. Burn three pounds 
of sulphur for each thousand cubic feet of 
air space in the room." 
And, besides, it is only efficient for micro- 
organisms in the absence of spores, being 
quite impotent for the destruction of these 
reproductive elements. Now, do they know 
anything about the micro-organisms and 
spores of yellow fever? and whether or not 
these spores-the reproductive elements- 
pertain to the yellow fever poison? And as 
for the closeness of the fumigating chamber, 
if it was the one I saw, it was wholly lacking, 
and failed to confine the fumes of the sul- 
phur, which were escaping in a manner to 
remind one very much of a country smoke- 
house in the bacon-curing season. And yet 
this was satisfactory to the sanitarians and 
hygienists of Duval county! 
In the North Carolina Medical Journal of 
November, 1878, Dr.R. A,Kinloch, of Charles- 6 
ton, S. C., published an able article on "In- 
land Quarantine," from which I make the 
following extracts: 
"Can it be claimed that any 'cordon sani- 
taire' has ever kept out cholera or yellow 
fever when these diseases appear in an epi- 
demic form? Has it ever prevented the ex- 
tension of yellow fever from our seaport 
towns in)o the interior? In years gone by, 
and before we were as proud as we are now 
of our scientific knowledge, we never enter- 
tained the hope of land quarantine prevent- 
ing the spread of the disease. And its dif- 
fusion. or march into the interior, with rare 
exceptions, never took place. In recent 
times the boasted sanitarians have so im- 
pressed the people with their importance 
that much is now expected. Hence incon- 
veniences, privations and sufferings have 
followed, in a most alarming degree, the 
futile attempt to carry out a supposed prin- 
ciple in hygienic law. Upon a mere as- 
sumption of the knowledge of the laws of a 
disease (a knowledge possessed, as we said 
above, no more now than it was a hundred 
years ago), the most arbitrary regulations 
have been attempted. People flying from a 
stricken city have been driven back to die. 
Refugees from a pestilence have been hunt- 
ed down, and, upon the possibility of their 
introducing disease (after they had already 
been the carriers of the poison, if such thing 
were possible,) have been shipped to the 
nearest sister city, who in turn was expected 
to protect herself. This selfish, arbitrary 
and unreasonable action was practiced by 
cities hundreds of miles away from the in- 
fected regions, and in Northern as well as 
Southern latitudes. The law of self-preser- 
vation, as interpreted in other times, con- 
tained no provision for a brother's welfare. 
We regret to say that in but few instances 
has even a protest against this rule of con- 
duct gone forth from the profession. The 
people naturally cling to their superstitions. 
They possessed but small capability of dis- 
tinguishing between areal and an imaginary 
danger. They were without that enlighten- 
ment which should have reached them 
through the profession, and they were ready 
to reject the lesson of facts. Thus it was 
that the futile scheme most generally con- 
sisted in the attempted exclusion of persons. 
While this action for the most part pertained 
to municipalities, or improperly constituted 
health boards, it at times received the sanc- 
tion and support of regular health officers in 
good repute." 
The late Dr. J. M. Woodworth, Supervis- 
ing Surgeon-General of the Marine Hospital | 
Bureau, expressed the belief that absolute 
quarantine by land is impracticable. 
"It may be argued," continues Dr. Kin- 
loch, "that it is necessary to calm thepublic 
mind, and that upon this ground quarantine i 
serves a useful purpose. We question if : 
public quietude is not thus often obtained j 
at too high a cost, and if the reaction, that J 
sooner or later must follow with the realiza- I 
tion of the truth, is not the evil the more to 
be dreaded? We cannot, however, now dis- 
cuss this point, but will parenthetically ex- 
press our earnest conviction that truth is ! 
ever the best policy, and should be diffused j 
everywhere under an enlightened and pro- 
gressive medicine. 
"With the vulgar, the question of exclud- 
ing disease from communities is a simple 
one, and their faith in the potency of human 
power and scientific application of means is 
stronger than it can be with our enlightened 
profession. Quarantine and sanitation are 
now, with the people, veritable supersti- 
tions. They are worshipped and implicitly 
relied upon. There are many, too, in the 
profession equally credulous in this regard, 
and some, though sufficiently informed, 
culpable enough to encourage the vulgar 
delusion, with the view, perhaps, of magni- 
fying their own office." 
Much more might be adduced to show the 
absurdity of inland quarantine if time and 
space permitted, but I shall wait till after 
frost to prove its futility in the present epi- 
demic, when probably some more M. Ds. 
will feel as cheap as they may be surprised. 
This is the first season that I have had any 
experience with a County Health Board, and 
I am so disgusted with its workings that it 
will be my last. I have no hesitancy in de- 
nouncing them as a curse to the State, and 
trust that amono the first acts of the next 
Legislature will be the repeal of the statute 
creating them. For funds they are made de- 
pendent on the County Commissioners, and 
are expacted, without remuneration, except 
in the way of abuse, to protect the public 
health. Nor do I have any faith in a State 
Board of health being able to accomplish 
any more in preventing the introduction and 
spread of epidemic diseases: and am fully 
convinced that, as a member of the Constitu- 
tional Convention of 1865, I made a mistake 
in using my efforts to get a provision in the 
Constitution providing for a State Board of 
Health. Capable medical men cannot be 
expected to use their knowledge and give 
their time to the public for nothing, while 
incapable men would prove a blight and curse 
to the commercial and industrial prosperity 
of the State. So the best thing for the State 
is to let her population know that they must 
protect themselves after the English fashion 
by removing from their midst those causes 
which would give epidemic diseases a foot- 
hold if introduced. Provision for medical 
inspection at seaports, and the detention 
and isolation of the sick with infectious and 
contagious diseases, is all the quarantine 
that a State law should provide for or per- 
mit on the part of any seaoort city or town. 
Of course this should include disinfection 
where necessary. Beyond this neither 
State, county nor municipal law should ex- 
tend; for, as already pointed out, reliance 
on quarantine has a blighting effect on sani- 
tary progress, which is our only hope for 
the future health and prosperity of the 
State. 
In conclusion I may say that the fever did 
not get in here through the Plant Line of 
steamers, but was evidently smuggled in by 
a small boat engaged in contraband trade, 
which, it seems, eluded the Custom House 
officials as well as the quarantine authori- 
ties. The ."first cases occurred during my 
absence from the State, and were among 
Italians and fruit dealers, who were 7 
doubtless the confederates of the smugglers 
and receivers of the goods. This was evi- 
dently the avenue by which the fever was 
introduced in the character of fomites, as I 
expect to be able to conclusively prove at 
the proper time. The sanitary condition of 
the city afforded a suitable soil for the lodge- 
ment and propagation of the infectious 
poison, and the result the world knows. It 
is true that the city authorities disregarded 
my warnings as to the neglected sanitary 
condition of the city, and seemed to be in- 
spired with a spirit of antagonism to me per- 
sonally. Why this was so I leave to them to 
explain if they can; and if the result has 
been pleasing to them and the people of 
Tampa, they are welcome to all the enjoy- 
ment it affords. 
I was absent from Tampa from the 2d to 
the 25th of September, and, from what has 
since come to my knowledge, I presume 
the first cases must have made their appear- 
ance about the middle of September-in res- 
idents and not in persons who had come 
from either Key West or Havana. How- 
ever, I was home but a few days before my 
suspicions were aroused as to the presence of 
yellow fever in the city, but these were not 
confirmed till the first of the following 
week, October 3d and 4th. On the 22d of 
September a case was reported, but the 
physicians who saw it denied its being yel- 
low fever. This was three days before my 
return. I know now that if I had seen cer- 
tain cases to which my attention was called 
on the day that I announced its presence to 
the public, I should have been able to de- 
clare its presence at least six days earlier 
than I did. 
However, the diagnosis of yellow fever is 
not the easy thing that some suppose, nor 
does a post mortem always demonstrate the 
true character of the disease, as some doc- 
tors believe. In 1870 the disease prevailed 
on Governor's Island a month before it was 
recognized even by the Health Board of 
New York who stated that "post mortem 
examinations upon the bodies gave satisfac- 
tory evidence that the disease was not yellow 
fever." But it was proved to be yellow fever 
when seen by a medical man familiar with the 
disease. There were 159 cases with 52 deaths. 
But yet a whole month passed before the 
true character of the disease was recognized 
on an island in New York Harbor within 
rifle shot of Castle Garden. Strange to say 
there were a few cases in the city, but the 
epidemic on the island did not extend to the 
city. (W. Y. Medical Record for 1870 and 
1871.) "The late Dr. Warren Stone, of New 
Orleans, very justly remarked that when he 
had seen one epidemic of yellow fever he 
thought he knew all about it, but after see- 
ing twenty epidemics he discovered that he 
knew nothing about it." Such was the lan- 
guage of the late Dr. J. C. Nott, who gave it 
as an illustration of how little really was 
known of this disease by those who had had a 
life-time opportunity, as it were, to study it. 
The mortality here has been about 17 per 
cent, among the whites, and hardly one per 
cent, among the blacks. There have been 
up to date, 26th of November, 72 deaths from 
the fever, only 2 of which were colored- 
one mulatto and one full blooded African. 
The exact number of cases in Tampa and 
vicinity is not known, as all were not re- 
ported, and some were so mild as not to re- 
quire the services of a physician; but I 
should estimate the number at about 400 
whites and possibly 200 negroes. Among 
the latter the cases were, as a rule, of a mild 
type. Not an old resident who had had the 
fever in previous epidemics in Tampa, had 
it this time; nor did any one suffer from a 
second attack during the epidemic. The 
whole adult Cuban population was acclimat- 
ed and escaped. Nor does this immunity 
conferred by one attack of the disease, de- 
pend on the severity of the attack-a mild 
attack being as protective as a severe one. 
With children it is generally mild-the 
younger the child the milder the fever-so 
that it is a great mistake to remove small 
children beyond the infection if it is expect- 
ed the place where it is epidemic or any oth- 
er Southern city, is to be their homes, i. e., 
provided the parents are acclimated so as to 
run no risk themselves. 
There is another prevalent idea, enter- 
tained, too, by some very competent men, 
the erroneousness of which I desire to point 
out; and that is in case of an epidemic appear- 
ing in a city, all that is necessary is to re- 
move the unacclimated into camps some dis- 
tance in the country. This is impracticable 
in the first place, because of the lack of con- 
veniences in the shape of houses or even 
tents for the protection of the people from 
the inclemencies of the weather, and in the 
second place, even if such camp was estab- 
lished, communication with the infected 
place for some time at least, would from the 
very nature of things, be kept up, so that 
the infection would be sure to invade the 
camp before arrangements for getting sup- 
plies and other necessaries from uninfected 
places could be made. In this way the fever 
was carried out into families several miles 
from here into the country during the pres- 
ent epidemic. According to Dr. J. C. Nott, 
who moved his family from Mobile into the 
piney woods seven miles from the city, in 
1856, even before the fever reached Mobile 
from New Orleans, the fever followed his 
family out of the city and he lost four of his 
children. (A7. Y. Medical Record, 1871.) 
But there are other things which render 
this camp business wholly impracticable: 
1st, getting the people to leave their homes 
when there are so many medical ignora- 
muses and wiseacres who will swear to the 
last that it is not yellow fever; and 2d, the 
impossibility of keeping them there if they 
should feel disposed to have communication 
with the infected area. It is very easy for 
theorists and inexperienced people to say 
what ought or should be done, but carry- 
ing out their suggestions is altogether a very 
different thing, unless one was an autocrat 
with a standing army to execute his orders. 
It is one thing to preach, and another to 
practice. And it is for this reason that a 
State Board of Health would be as literally 
helpless in controlling the spread of an epi- 
demic as any other authority now existing. 
The success of the National Board in 1879 
was not encouraging and proved a failure. 
John P. Wall, M. D. 
November 28th.