In one case I did about the same thing near Memphis, by stationing a caboose at a way siding and designating a point some half mile away as the transfer point. A switch engine preceded the train and took siding at the transfer point. When the train came in sight, the "outside" crew walked down to the transfer point and boarded the train, while the inside crew boarded the switch engine and returned to the city.

A QUARTERS TRAIN IS ADVANTAGEOUS.

If there is sufficient siding room a "quarters train" offers some advantages over a camp, especially in that if it gets infected, or is suspected, we can move it bodily to uninfectible territory and get rid of watching a fresh focus, and can then replace it with a clean train and crew and continue business at the old stand.

TRANSFERENCE OF FOMITES A GRAVE DANGER.

The greatest care must be taken to prevent the transference of possible fomites from the infected place to the relay station, and all transfers of passengers and crews should be under the personal supervision of the inspector.

HOSPITAL CAR OR ISOLATION TENT.

At all relay camps either a hospital car or an isolated tent should be provided for the care of any sick suspects that may turn up. A box car is the best; and another car should be at hand with an autoclave and supply of formaline for disinfecting purposes; this latter car should be without end windows, should be provided with racks of wire netting, have one door sealed and the other fitted with a canvas or rubber gasket, and have connections fitted through door so as to admit of the use of either formaldehyde or steam from a locomotive.

III. MANAGEMENT OF INSPECTIONS.

ORGANIZATION AT INSIDE END.

Necessarily the inner end of any system of inspection from infected to clean territory must be in different hands from the outer end and the organization of it is embraced in the management of the local work, and as such need not be especially described here beyond what has already been said. How far the jurisdiction of the inside man should extend depends on how far the relay is from the infected place, and more especially on how it is operated.

If a "shuttle train" is used the care of the relay should be in the hands of the outside man. If an exchange of trains is made this should also be the case, but if the crews both lay over it is best for the inside man to have charge. If there are two camps the line may be drawn midway between the camps.

ORGANIZATION ON THE OUTSIDE.

This much being settled, we come to the organization of the outside territory. As the country in which we are to operate is practically confined to the extreme Southern States, with the addition of western Tennessee and Arkansas, it is possible to study it in advance and get a clear idea of the routes of travel, junction points, and the like.

The scope of this article does not admit of going into the question of train connections, meeting points, etc. Everyone in charge of such work must work out the details for himself, and he will be apt to find it a troublesome job, but the main points of the work may be glanced at, as they play a considerable part in shaping the plan of organization.

STRATEGIC DIVISION OF TERRITORY.

Looking at the map, then, it will be seen that the roads in the "infectible territory" naturally arrange themselves into three groups. This is exclusive of the roads west of the Mississippi, especially of those in Texas. One group radiates from Memphis and Fulton, Ky., and may be called the western group, another occupies the center of the field with Nashville as a base, and the remaining group is made up of the lines converging on Atlanta and Chattanooga.

PROPER DIVISIONS FACILITATE THE WORK.

This arrangement facilitates the division of the work, but I am strongly of the opinion that the whole territory should be under one man. In no other way can the unity of control be maintained. We have to start off by dividing authority to some extent with the inside man, and further division increases the chance of confusion in a geometrical progression. It is a large territory of course, but I managed to cover about three-fourths of it fairly well last fall, and if a sufficient number of regular officers were supplied to take the subor dinate divisions of the territory it would be much easier.

TERRITORY WEST OF THE MISSISSIPPI.

The territory west of the Mississippi should be divided. Arkansas naturally falls into the Memphis district for the most part, but Louisiana and Texas should be separate jurisdictions. The headquarters for the former should be at Shreveport and for the latter at Houston and Texarkana.

TERRITORY EAST OF MISSISSIPPI RIVER.

Assuming then that the work east of the Mississippi is to be under one head, he should have an officer to assign to the charge of each of the main divisions, with as many regular officers as possible under them and a sufficient corps of acting assistants and inspectors

The Memphis section being the most important, the general headquarters should be there. Of course these remarks are based on the supposition that it is the Southwest that is infected. If it is in some other section that the work is to be done the geographical remarks just made will not apply, but the general plan of organization will be applicable anywhere.

The headquarters should be adequately provided with clerical and other assistance.

It is idle to try to run a large inspection service without adequate office force. I tried to do so on the ground of economy, but it cost more than it came to. Whoever takes charge of such work will find that the impression in the minds of the general public is that "all knowledge and all power" have been intrusted to the "marine doctor," and that as a consequence he will be approached by hundreds of people with whose business he has no direct concern, yet whom he must either see or have someone see for him, and whose numberless letters of inquiry most be answered.

ARRANGE WITH HEADS OF RAILROADS AT FIRST.

Arrangements must be made with all the roads in the territory to furnish transportation for all officers and inspectors, and to issue orders to all employees that the train inspectors are in absolute control of all sanitary matters on trains and that their orders must be obeyed to the letter.

Provided one goes to the head officers to make arrangements he will find it a pretty general rule that the larger the corporation the more intelligent will be its cooperation in his work.

A clear understanding must be promptly reached with the express companies and with the superintendent of the Railway Mail Service and with the Pullman Company as to just what you want them to do. In all such cases treat only with the man at the top; it will save some trouble and a great deal of time.

TIME IS OF PRICELESS VALUE AT BEGINNING.

Time is of priceless value at the beginning. If it is a question of losing time or having misunderstandings with local authorities and railroads, act first and straighten things out afterwards; it is surprising how much you can do without any real authority if you insist on having your own way.

A competent steward should be in charge of the central office, and, if the territory is a large one, a stenographer and typewriter.

DIVISION CHIEFS.

The officer in charge should be free to go and come unfettered by office work, vouchers, and correspondence.

The chief in each district should have charge of all matters in that territory; receive the reports of inspectors, run over the lines himself pretty frequently, and at the same time cooperate, under the direction of his chief, with those in charge of the other districts. He should report direct to the man in charge of all the work, and take orders from him as far as concerns his immediate sphere of action.

OFFICER IN GENERAL CHARGE.

The officer in general charge should outline the work for each district chief, leaving the details very largely to them, but holding them to a strict accountability. He should visit all parts of his territory from time to time, investigate all rumors of the presence of disease, and transmit frequent reports of the work to the Surgeon-General, provided he can find the time. He should keep in close and cordial touch with the local health authorities everywhere, and with the heads of the transportation companies. The former are often a trifle suspicious at first, but tact and judgment usually overcome this very readily. It is often best to request as a favor what one could demand as a right. The people in the smaller Southern towns can usually be reasoned withthey are rather hard to force. The railroad people are generally eager to give every assistance, and their earnest cooperation is most essential. The discipline of a good road is of the greatest help when enlisted on our side. Generally speaking, the larger the corporation and the higher the rank of the official approached the more intelligent will be the assistance secured.

CHIEF OFFICER SHOULD KEEP INFORMED OF ALL WORK.

While the details of the work in each district may be left to the man in charge there, the chief should keep himself intimately informed of everything concerning the work in hand. In this work success depends on the execution of details; attention to details is really of rather more importance than excellence of general plan.

TRAIN INSPECTORS AND WHAT THEY SHOULD BE.

The inspectors should always be physicians. They should be furnished with plainly written instructions as to their duties, with formal credentials and badges, and if possible should be sworn in as deputy United States marshals.

MUCH AUTHORITY NEEDED BY INSPECTORS.

It will greatly facilitate the control of the train crews if each inspector is furnished with a letter from the general superintendent of the road, addressed to all employees of the road, and stating that the inspector is in absolute control of the train. A similar letter from the Pullman authorities should be furnished them, and they should have

keys to all cars. They must be instructed that in case they find a case of suspicious illness on their train they will be expected to stay by it and to accompany it to one of the observation camps, mentioned in Section V, Chapter II.

CAMPS OF OBSERVATION.

These camps should be small, consisting of a couple of tents properly equipped with cots, etc., and in charge of two reliable men, and established at several points, the location of which can only be determined on the ground. These camps are for the care of cases of suspicious sickness that may be found on the trains.

IMMUNITY DESIRABLE IN INSPECTORS.

The first tier of inspectors-those under the jurisdiction of the officer inside the infected place-should be immunes. Immunity is desirable but not essential in the others.

SCHEDULES OF INSPECTOR'S DUTIES.

A schedule must be prepared showing what each man's duties are, what train he takes, where he transfers, etc. At the central office it should be possible, by consulting this table, to tell just where each man is at a given time, as the train dispatcher locates his trains from his "train sheet."

Such a schedule may prove a more difficult job than it looks, for suitable inspectors can not always be found in sufficient numbers, and those found must sometimes sleep and eat; and, moreover, stations, sidings, State lines, etc., can not be moved at pleasure, so it may be rather a puzzle to fit the men to the runs.

As an illustration of such difficulties and how they are to be met, I give the schedule on the Nashville, Chattanooga and St. Louis Railroad last fall.

The trains were worked out of Nashville into the quarantined territory west of the Tennessee River. Some trains ran all the way into Memphis, some part of the way, and some, after entering the quarantined territory, merged their identity in trains on other roads that entered that territory from other points.

On some of the return runs the men could sleep in the Pullmans; on others they had to work both ways.

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