The camps for the north and south crews should be at a considerable distance from each other, and the run of trains should be arranged so as to have the crews in camp as little as possible. For passenger trains there need be no delay; for freight trains generally there must be, and their crews go in camp. There is no necessity of doubling these stations if suitable ones be chosen and they be well conducted, but conditions may be such, as on the Illinois Central and Yazoo Valley Railroad this year, where it is advisable.

These stations must be frequently and carefully inspected, and the same is true of the train inspection work.

Occasions may arise where it is necessary to guard the southern relay camp by a number of guards, as if it were a camp of detention. It must never be allowed to become infected.

A PRÉCIS OF DETENTION CAMP MANAGEMENT.

By P. A. Surg. J. H. WHITE.

Although instructed to prepare this syllabus of detention camp management simply with a view to yellow fever, the writer has presumed to so arrange it that with slight changes it may also meet the requirements of other diseases.

Of course it would be possible to go more deeply into details in many directions, but it has been shown by the past experience of this service that competent officers do better work when furnished with outline rules rather than minute instructions. The smaller details will suggest themselves when the outline is given. The mind is able to take a comprehensive glance of the whole general plan given in outline, while if it be padded with minutiæ this desirable result is in a measure prevented.

DETENTION CAMPS.

To avoid any confusion as to meaning, it may not be amiss to state that this whole article will, in the body thereof, refer entirely to camps for yellow-fever purposes, and that the necessary deviations to meet the requirements of other diseases will be treated in a final chapter.

LOCATION OF CAMPS.

In the selection of a site for a camp of detention, the general points to be considered are:

First. A healthful location, as free from malaria as may be available and a situation which has good natural drainage. The avoidance of any possibility of standing water after heavy rains is essential, because such camps are frequently to be occupied by delicate women and children, whose health and comfort are both to be watched over.

Second. A site so situated as to be easy of access by rail or steamboat and very preferably the former.

Third. One to which good water supply and a good base of food supply is easily accessible.

The camp should consist of two distinct portions: (1) main camp and (2) hospital camp. The whole establishment should be, if possible, at a distance of a mile or more from any settlement. The adjunct camp for yellow fever and intermediate hospital purposes should be at least

one-fourth mile to leeward or one-half mile to windward of this main camp.

The location should be as close to the infected place as clean territory, suitable for the purpose, can be found. It should preferably be upon a line of railway, whose distributing or dividing point outside is a small place rather than a large city. While this matter of small distributing point is not absolutely essential, it is advantageous, as enabling the easy and careful observation of the distributing point, which point is the one most likely to be attacked in the event of any accidental escape of infection from the camp.

Camp Perry, located by P. A. Surg. John Guiteras, United States Marine-Hospital Service, in 1888, on St. Marys River, where it is crossed by the Savannah, Florida and Western Railroad, about halfway between Jacksonville, Fla., and Waycross, Ga., on a slightly rolling sandy plain, which drained itself rapidly into the river, was an ideal location. It also fulfilled the above-mentioned requirement, Waycross, the distributing point, being only a village of about 3,000 inhabitants.

EQUIPMENT.

The site having been selected, the ground should be prepared by such slight ditching as may be necessary to prevent any standing water in case of heavy rains. Much ditching should be avoided on account of malaria. It is always advisable to provide the hospital camp complete before any other work is done, as it often occurs that the very first admissions bring suspected cases to light.

Experience has shown that the general outline of establishment used at Camp Perry, subsequently modified by a board of officers (Surgeon Carter and P. A. Surg. Kinyoun), is the most convenient form.

It consists of a hollow square, of which the buildings form one side and tents three. Subjoined are ground plans, which are believed to embody all the needed changes from the plans of Drs. Carter and KinAn alternative, ground plans of which are also submitted,

presents itself here, viz:

A double camp, its two parts independent, except for a common executive office and kitchen (although not always feasible), presents the advantage that seldom or never will there be any suspicion attached to Camp No. 2, because, as a rule, nearly all sickness has, in our experience, developed within the first four days, and hence would be developed in the Camp No. 1. This plan of a double camp would naturally inspire in the people outside more confidence in the safety of camps, and, although not at all a sanitary necessity, may be expedient, for its moral effect alone. Such double camps should be divided, not only by guards, but by a double fence of barbed wire as well. The whole of both camps should be surrounded by a double barbed wire fence, at least 6 feet in height, each fence to have wires 6 inches apart, from top

to bottom, and the two fences set 18 inches apart, so as to render egress in haste a matter of physical impossibility. All refugees in the main camp should be housed in tents, in order that disinfection may be easy after any suspicious case has occurred. Kitchen and dining rooms should be arranged so as to involve a minimum of time and labor in serving meals, and with capacity in the latter for seating the whole number of refugees at one time. For purposes of good discipline, there should be provided separate tables for subaltern officers. such as commissary, quartermaster, clerks, et al., in order that they may the better preserve their proper authority over attendants; officers of the guard may be included in the list of such officers, or the whole guard messed together, according to circumstances. It is not at all advisable that the guard, however, should mess with the lower grade of attendants, as the responsible nature of guard duty is prima facie evidence of the necessity for a better class of men for these important posts, and they should therefore be separated when possible.

In addition to the privies located on the plans there may be necessity for providing a few, more convenient of access, for delicate women, and these should by all means be dry earth closets located in a tent, and daily emptied. The locations indicated in the plan should not be considered as essential, but should be varied to avoid contamination of the water supply or for other sanitary reasons.

If not already existent, a sufficient amount of railroad siding should be provided to hold the necessary cars for disinfection and commissary purposes. At a point most convenient for this purpose on this siding there should be built a waiting and dressing pavilion, containing from four to six rooms, to be used for the purpose herein before mentioned, and from four to six tents, end to end, for examination, reception, and registration of applicants for admission.

In case it be deemed advisable to use the double camp heretofore recommended, the only necessary change in the plan submitted, and labeled "Exhibit A" will be the placing of the buildings laid down on said plan exactly in the center of the quadrangular open space and the running of a barbed wire fence through the middle of the camp from side to side, in such manner that the line occupied by said fence shall bisect the site of the surgeon's office, the telegraph office, the kitchen, and the commissary.

It will also be necessary to provide in this case an additional quar termaster's storeroom unless the existing storeroom is also placed upon the middle line, which can in fact be done by making one building serve for quartermaster's and commissary's work.

It is believed that there will be no necessity for changing the entrance to camp in the substitution of a double for a single camp. Should such change, however, be considered necessary, it may be readily accomplished by leaving out a sufficient number of tents from the camp on the side next to the surgeon's office to provide a 50-foot avenue from the

surgeon's office to the outside and running the wire fence in this case, so far as it concerns that portion fronting the surgeon's office, as two fences, one being on either side of the aforesaid avenue.

FOOD AND WATER SUPPLIES.

If pure water can be obtained by pumping or carrying from a neighboring stream, such supply is preferred, and only when this is unavail able should resort to driven wells be had. In case neither of the above supplies are available, water should be brought in railroad water cars from some reliable source; and in very porous soils, where water is near the surface, the driven-well supply should be a dernier resort, as it is manifest that in a small territory the dejecta from 1,000 persons, no matter how carefully removed, must to some extent poison such water.

The food supply should come by preference from a noninfected city or town, but in some cases, as at Camp Fontainbleau, in 1897, it is absolutely impossible to do otherwise than obtain supplies from an infected center. In such cases all containers must be either at once burned or disinfected, preferably burned. Sawdust, paper, cloth, etc., so used should be burned at once.

PERSONNEL.

In addition to the commanding officer, the medical staff, and the hospital steward, the necessary personnel of a detention camp should be: (A) Guards, who should be placed at intervals, long or short, according to the topography of the site, and be under officers to be named hereafter.

(B) Disinfecting force.

(C) Quartermaster, commissary, clerks, bugler, telegraph operator. (D) Cooks, waiters, laundresses, scavengers, teamsters.

ROUTINE, DISCIPLINE, ETC.

The commandant should make frequent day inspections of camp and guard lines, and occasional night visits to the latter; visit at frequent intervals all parts of the camp, and in general so inform himself as to be capable of deciding, in large measure from his own knowledge, the complaints brought before him. He should see without exception all cases of sickness, however trivial, reported by the inspectors, and himself decide whether suspicious or not. He should not confine himself, however, to routine inspections, but leave such to his assistants. He should keep careful watch against possible bad food or polluted water as tending to create sickness which may simulate yellow fever and confuse diagnosis. The assistant medical staff, consisting of one or more inspectors, in proportion to the size of camp, one resident physician for the hospital, and one doctor or chemist as chief disinfector, should each and all report directly to the commanding officer. A double daily