NORFOLK, VIRGINIA

-QUARANTINE DISTRICT OF THE ELIZABETH river.

This board is composed of seven members, three of whom are appointed by the councils of Norfolk, three by the councils of Portsmouth, and one by the judge of Norfolk county.

It must contain two physicians,—one a resident of Norfolk and one of Portsmouth. Their term of service is four years, and they may be reappointed.

The city of Norfolk pays three sevenths of the expenses of the station, the city of Portsmouth three sevenths, and the county of Norfolk the remaining seventh.

The quarantine commissioners have all the powers of the councils of the two cities.

The only boat at the command of the medical officer is a small rowboat, and the water at the anchorage is often extremely rough. While visiting a vessel during a storm last spring, the boat foundered, and Dr. Thom, the health officer, was obliged to swim ashore, narrowly escaping with his life. Vessels enter this port from two directions,—by the mouth of the river from Hampton Roads, and via the Albemarle and Chesapeake Canal, those coming in the latter way being principally small coasters. The boarding station for the former is about four miles from the city, in the light of Craney island, off Lambert's or Sewell's Point. This is also the anchorage for coaling-vessels, being directly opposite the terminus of an important railroad, which, though now used principally for coal, will at no distant day bring other merchandise, and eventually passengers as well. It may therefore properly be said to be directly in the track of commerce.

There is no landing or boarding station and no hospital. The floating hospital, which once existed here, went to pieces three years ago. An infected ship could only be treated with the passengers, crew, and cargo aboard. One requiring any more thorough treatment would be sent to the United States quarantine station at Fisherman's island, Cape Charles. What ample provision for her reception at that point this great republic has made will be seen further on. Vessels arriving from the southward by the canals are ordered to await inspection at or near Johnston's mill, about a mile and a half above the Navy Yard, in what is known as the Southern branch. In point of fact, not needing pilots, they often slip by.

Infected clothing and bedding are burned. The disinfectants used in the vessel are sulphurous acid fumes, and chlorine evolved by the action of sulphuric acid on chloride of sodium. Quarantine is in force all the year round for European vessels, and from May 1st to November 1st for vessels hailing from southward of the latitude of Cape Lookout.

Clean vessels from infected ports are detained ten days, and then fumigated, the process occupying from twenty-four to seventy-two hours. Vessels with contagious diseases on board are detained until the period of incubation has elapsed, after the recovery of the last case. This is

rated at about fourteen days for small-pox and cholera, and twenty-one for yellow-fever. Yellow-fever suspects would on no account be allowed to land or to go elsewhere. Immigrants never arrive here.

THE UNITED STATES CAPE CHARLES QUARANTINE STATION ON FISHERMAN'S ISLAND,

is at the mouth of the bay, off Cape Charles. The "Woodworth" is at present the only boat at the station. It is too small for the heavy seas it is obliged to encounter, old, and slow, so that many vessels run by, unexamined. The boarding station is an anchorage in the open bay, off Trimble Light, about sixteen miles from Norfolk. Vessels are examined here from April 29th to November 1st. The quarantine does not exist in winter. "Fisherman's island" is about thirty-five miles from Norfolk. There is no landing station. The tug anchors about a third of a mile off shore, and passengers are carried ashore on the shoulders of the crew.

The island is a long, barren reach of sand, perhaps a mile in length and a quarter of a mile broad, much of the surface below the level of the ocean. The hospital, now four years old, is rapidly becoming untenantable. The sky can be seen through the roof of the wards, and the foundations are in danger of giving way, as the ocean breaks in during heavy storms, and has washed a deep trench along one side of the building. The keeper, Captain William Walker, who resides all the year round on the island with his wife and assistant, has been compelled, by the encroachments of the ocean, to vacate his own house, and appropriate a part of the hospital as his residence. There is a more elevated plateau farther south on the island, whither the buildings will evidently have to be transferred if the station is continued. A pump, which was depended on for water, is now entirely submerged at high tide. A tank, containing three hundred gallons of rain-water, is the sole water-supply. The dimensions of the building are seventy-five by thirty-eight feet. Ten patients might be very imperfectly cared for here, there being two wards with ten beds. There are, as said, no wharves or piers, no barracks for observation, no warehouses for cargoes. An empty vessel might be disinfected here, but the infected cargo of an infected vessel would have to be removed on lighters hired for the occasion. There is no apparatus of any kind for disinfection. The station is well out of the track of commerce, and has ample anchorage; and the rapid spread of population in the direction of the old station at Willoughby's Sandspit, a few miles below Norfolk, seems to make this the most available point for the protection of all the cities lying above.

The new line of railroad for Fortress Monroe and Old Point Comfort has its terminus on Cape Charles only a few miles distant, and would form a ready means of transportation for supplies. When it is remembered that this station constitutes the sole defence for the cities of Richmond, Yorktown, Annapolis with its hundreds of naval cadets, Alexandria, and the capital of the nation itself, the folly of leaving it thus unequipped is manifest.

WILMINGTON, N. C.

This station is located at Southport (formerly Smithville) near the mouth of Cape Fear river, twenty-five miles from Wilmington.

The organization of the State Board of Health of North Carolina is unique. The nine members are elected by the state medical society, and, with the exception of the civil engineer and the chemist, must all be physicians. This plan gives a guaranty of exceptionally good appointments, and entirely removes the board from the sphere of political influences. The quarantine commissioners are three in number,—a medical quarantine officer under the title of quarantine physician, and two physicians selected by the president of the state board of health. All hold their appointments virtually for life.

Two miles above Southport is passed the quarantine property, about two acres in extent, on which are the ruins of a hospital burned some five years ago. The means of communication with vessels is a row-boat with a crew of four. The anchorage opposite Deepwater Point has ample depth of water, but is exposed to heavy seas, being almost directly open to the sea. A much safer point would be on the opposite side of the river, where the United States government already has a good wharf.

There being no buildings of any kind, it would be necessary to treat the sick on board. The cargo would be lightered, but in the absence or a wharf a light vessel would run the danger of capsizing in the heavy gales which prevail here. Pumping the bilge, sulphur fumigation, and washing with bi-chloride solution constitute the sole means of disinfection. The safety of the port consists in the fact that no immigrant or other passenger ships enter it.

The period of detention of a vessel from an infected port is rarely over nine days. Each case is treated on its merits. The refuge at Sapelo is so distant as to make it practically valueless for this port. The state legislature turns a deaf ear to all importunities for an appropriation for rebuilding the hospital and furnishing the necessary modern appliances. It is evident to the most superficial observer that the commerce of Wilmington, and with it the necessity for increased quarantine facilities, must increase rapidly in the near future. This port is in fact nearer at once to the great North-west, and to the West Indies and South America, than any other harbor on the coast. The connecting link, the Cape Fear & Yadkin Valley Railroad, will soon be completed.

The Atlantic coast line puts it in close connection with all the great cities of the North and South, while the Carolina Central brings the interior of the state to its very doors. Add to this the fact that the Cape Fear river is navigable for ships of the largest size, and it must be granted that it is destined to be one of the most important commercial points on the South Atlantic coast. But with the present arrangements, efficient quarantine would necessarily amount almost to an embargo.

The evils resulting from the present disjointed system of quarantine may be thus summed up, in view of the facts just rehearsed:

1. Want of uniformity in quarantine regulations, placing one port at a disadvantage as compared with another.

2. Conflict of authority, owing to the methods of appointing officials. 3. The entire lack of appreciation on the part of local legislatures, whether state or municipal, of the importance of the expenditure of considerable amounts of money in order to render quarantines at once efficient and inoppressive.

4. The tendency on the part of local civic sanitary authorities to limit their responsibility to the protection of their own city, reckless of the consequences which may ensue to inland communities, if they permit infection, which circumstances render harmless to themselves, to pass unchallenged to the latter.

XIII.

THE LOUISIANA QUARANTINE SYSTEM AND ITS CONTEMPLATED IMPROVEMENT.

By LUCIEN F. SALOMON, M. D., SECRETARY LOUSIANA STATE BOARD OF HEALTH.

In treating of this subject it is not necessary to enter into a description of the quarantine system of Louisiana as it now exists, as this is all embraced in the admirable descriptive paper read by Dr. Joseph Holt at the last meeting of this Association. With the new plan of cleansing and fumigating ships and the disinfection of baggage and ships' effects by moist heat, you are all, therefore, sufficiently familiar; but before entering into a description of the needed improvements which are now in course of construction, I desire to call your attention to the results of the present methods, as a guaranty that the opening of the next quarantine season will find the Louisiana health authorities in a position to assure the utmost degree of protection against the importation of disease into the country by way of the Mississippi river and New Orleans. That New Orleans has escaped a visitation of yellow-fever, when the disease has been widespread in the south-eastern corner of the country, has, in my opinion, been largely due to our quarantine, even with its defects, which will be pointed out.

In his last report to the general assembly of Louisiana, Dr. Joseph Holt, as president of the state board of health, wrote as follows:

"Notwithstanding the frequent arrival in quarantine of vessels infected with yellow-fever, and deaths of patients there during the three years of operation of the new system opening the Mississippi to trade, no vessel with its passengers and crew has yet developed a sign of infection after the disinfectant treatment, accomplished immediately upon arrival."

The same can be said of the working of the system during the present year, thus making four years of successful operation. During the years 1885, 1886, 1887, and up to November 1, 1888, of over four thousand vessels arriving at the Mississippi quarantine, there were nine hundred and sixty-six from known infected and suspected ports, distributed as follows:

of which sixteen were infected with yellow-fever.