Yellow fever epidemic of 1878 in New Orleans. First recognized case of yellow fever in the Charity hospital, New Orleans, epidemic of 1878. (Continued from February number of New Orleans medical and surgical journal.)

              NEW ORLEANS MEDICAL AND SURGICAL JOURNAL
YELLOW FEVER EPI MIC OF 1878 IN NEW ORLEANS
By
JOSEPH JONES, ll. D.
Professor of Chemistry and Clinical Medicine,
Medical Department, Uriiv.of La., Visiting Physician of
Charity Ho pi tal, New Orleans
NEW ORLEANS
MEDICAL JND Su~GICJL J1DUR~AL.
MARCH, 1879.
ORIGINAL COMMUNICATIONS.
Yellow Fever Epidemic of !878 in New Orleans.
By JOSEPH JONES, M. D.,
Professor of Chemistry an(l Clinical Medicine, Medical Department, University of
Louisi•na, Visiting Physician of Charity Hospital, New Orleans.
(Extmctfrorn Clinical Leolu1·e, delivered in the Amphitheat?·e of the Charity Hos­pital
Jan•ua1-y 8th, 1879. Reported for the New Orleans Medical and Su1·gical
Joumal.)
(Oontinuedjro·m Februa1'1J Number.)
FIRS'l' RECOGNIZED CASE OF YELLOW FEVER IN THE CHARITY
HOSPITAL, NJ;;W ORLEANS, EPIDEMIC OF 1878.
As far as my information extends, the first recognized case of
fellow fever in the Charity Hospital, during the epidemic of
HS78, was as follows :
Frank Walsh, laborer, native of Ireland, age 36; had been
working at the jetties at the mouth of the Mississippi river;
came to New Orleans about the lOth of .:fuly, and entered the
Charity Hospital July 18th, 1878. He appears to have been
attacked with fever on the 15th of July. Was assigned a bed
in Ward 30; in the medical service of Dr. Henry John Francis
Steinau, my chief of clinic.
July 18th, 1878.- Condition on admission, muscular· and
nervous prostration ; cephalalgia, intense pain in back and ex­tremities;
anorexia, nausea, vomiting; tongue coated with
white and yellowish fur in centre, and red at tip and extremi·
ties.
684 Original Communications. (11~arch
A. M., temperature 105°, respiration 40; pulse 108 and
bounding; conjunctiva red and face flushed; capillary conges­tion
of face and extremities. P. M., pulse 126; respiration 36 ;
temperature 1040.75. July 19th.-Conditiun much the same;
thirst excessive; abundant perspiration; delirium; jaundice;
temperature 1030.5; pulse 108; respiration 28. Died· July
19th, 3 o'clock, P. M. After death the body presented an in­tensely
yellow jaundiced hue, with mottling of the integuments
of the lower extremities and dependent portions of the body.
Dr. Steinau brought the viscera to my office, and I subjected
them to careful microscopical and chemical examination with the
following results :
Heart.-Yellow, flabby appearance. Fibres of heart readily
crushed between the fingers. Under the microscope the fibres
of the heart were found to have lost to a great extent their
distinct transverse marks, and were loaded with oil globules
and fibrinous granules. These granules were not micrococci, but
were minute oil globules and particles of altered fibrin, albu- "-<
men and musculin.
Liver.-Of a mottled yellow and brown color ; portal capilla­ries
conjested. Under the microscope the liver presented the
appearance of acute. fatty degeneration. Liver cells loaded
with oil globules. The liver presented the appearance charac­teristic
of yellow fever.
Stomach.-Mucus membrane, intensely congested. This
viscus contained about six ounces of dark altered blood-black
vomit. Under the microscope the black vomit from the stomach
contained numerous bacteria, the spores and thallus of a small
delicate Torula, Rotatoria, altered blood corpuscles, brown
masses of hrematin, .mucus cells, and corpuscles, and broken
capillaries.
In the month of July, 1878 (from 21st to 31st in­clusive),
37 whites were admitted into Charity Hospital with
yellow fever, of which number 20 proved fatal. August, 363
cases and 203 deaths; September, 292 cases and 145 deaths;
from the 1st to the 26th October, 87 cases and 35 deaths; total,
July 21st to October 26, 779 cases, and 403 deaths. The mor­tality
amongst the whites suffering with yellow fever in the
Charity Hospital was therefore over fifty per cent.
1879J JoNEs-Yellow Fever Epidemic of 1878. 685
No blacks suffering with yellow fever, were admitted in
July; in August, 15 cases and 4 deaths; September, 14 cases
and 2 deaths; October, 9 cases and 2 deaths. Total : 38 cases
and 8 deaths.
Therefore, the total number of cases treated in the Charity
Hospital during the period specified was 817, with 411 deaths.
According to the statistics compiled by Messrs. Dunlap and
Parham, resident students of the Charity Hospital, of the total
number of cases, 135 were contracted in the hospital, the
patients being under treatment for other diseases at that time;
57 of these cases were fatal. Included in the above 135, were
the house surgeon, assistant surgeon, 6 Sisters of Charity and
10 resident students :-3 Sisters of Charity and 1 student died
from yellow fever.
These statistics differ from those recorded by the clerk in
the hospital books. Thus, the total monthly deaths from yel-
<-... low fever and all causes, were as follows : July, yellow fever
11, all c~uses 77 ; August, yellow fever 169, all causes 240;
September, yellow fever 176, all csuses 236; October, yellow
fever 54, all causes 97 ; N ovemb~r, yellow fever 15, all causes
65 ; December, yellow fever none, all causes 49. Total deaths
during the preceding six months from yellow fever 425 ; total
deaths from all causes 764. Total cases of yellow ·fever dis­charged
from the hospital as cured 345. According to this
record, the total cases of yellow fever treated were 770; it is
evident, however, that this statement leaves out those cases
occurring in the hospital as supervening diseases. During the
entire year of 1878, there were in the Charity Hospital 1120
deaths and 4615 discharges; remaining from 1877, 600. Total
cases 6335. Yellow fever, therefore, caused in the CharitY.
Hospital less than one-half the total mortality from all causes.
On the 22d of July, 1878, I received the following note from
Dr. J. D. Hunter:
DR. JOSEPH JONES:
Dear Sir-A case of yellow fever on Robinson street, near
Common. Please look at it.
J. D. HUNTER, M. D.
July 22, 1878.
686 Original Oomrnunications. [March
This case died with black vomit and hremorrhage from the
bowels. By my advice, this case was reported to the Board
of Health, as one of yellow fever.
Dr. Hunter furnished me with the following facts with
reference to the history of this case :
James Stanley, age 28, native of Ireland; had been in New
Orleans 10 years. Laborer in Gas Works; residence, Robin­son,
second house from Common.
Had visited a relative on Erato street, about two weeks be­fore
his attack-with this exception, had not been away from
the immediate vicinity of the Gas Works. Died July 22d,
with black vomit and hremorrhage from stomach and bowels.
Died in convulsions on the 5th day of disease. Body very
yellow after death.
The cases which I subsequently attended on Villere street,
in this vicinity, appear to have originated from this case.
On the 24th of July was called to Miss F. Been, age 19, na­tive
of England, resident of New Orleans 9 months, at 12 North
Rampart street. Has been throwing up black vomit since the
23d of July. Threw up large quantities of black vomit in my
presence. Black vomit examined microscopically, exhibited
bacteria, a delicate fungus resembling the Torula cerevrsiae,
and fungi in various stages of development, altered blood cor­puscles
and fragments of hrematin, mucous corpuscles, broken
capillaries, casts of mucous folicles, and patL;hes of mucous
membrane. The urinary secretion had been very scant for
twenty-four hours; obtained however fmm the patient, one
fluid ounce of dark urine, which upon examination was found
to be loaded with albumen, and with granular casts, and
with some altered blood corpuscles. The casts of the tubuli
urinife.ri were impacted with detached cells, yellow granular
matter oil globules, and bodies resembling micrococci; also
the urine contained epithelial cells from the whole track of tile
urinary apparatus, also bacteria and rotatoria.
I pronounced the case on~ of yellow fever, and so reported
it to the Board of Health. The mistress of the house was in­formed
as to the nature of the disease, and I also expressed the
1879] JONEs-Yellow Fever Epidemic of 1878. 687
belief that the patient would die during the following 12 or 24
hours. At the time of this observation the pulse was 96, t~e
temperature 102°, pulse small and feeble. Intense jaundice.
The patient had several spasms and died at~. A.M. July 25th.
Examined the body after death and found it of a brilliant yellow
color, with the more dependent portions of a mottled, purplish,
yellowish appearance. The features were swollen, and black
vomit streamed slowly from the corners of the month.
The Board of Health caused the disinfection of the house and
surrounding streets and gutters, with carbolic acid.
Upon careful inquiry I found that this patient (Miss J . Been)
had been attacked with yellow fever on the 19th of July,
and that she had been treated by a physician for ordinar.v
bilious fever.
On the 27th of July, I was called to see J. R. Hall (age 35,
native of Pa., resident of New Orleans 10 yean•), at 31 Gas­quet
street, and found that be had been attacked with fever on
the 23d of July. Saw this patient for the first time July 27th,
10, A. M. Pulse 110; temperature of axilla 106°, F.; delirium,
juandice, nausea, great capillary congestion, The high tem­perature,
restlessness and vomiting, with great congestion of
the capilaries continued up to the moment of death, July 30t.h.
A g·lazier by the name of Samuel Cohn, was taken sick with
fever on the 7th of July, at the corner 0f Gasquet and Marais
streets ; was transferred to the Touro Infirmary and was
treated by Dr. Loeber, who prouounced his case to be yellow
fever. About the S<'t•ne time a man named Walter, a compan­ion
of, Cohn, was seized with fever at 48 Gasquet street, just
across from the resideuee of the latter. and about eight doors
furt.l1er down than the house of Hall. These cases coustituted
another foci ot dist>ase. It is worthy of note that tile men,
Cohn and Walter, were in tbe bahit of frequenting gambling
saloons, and th e former informed me that it was his belief that
he and his companion contracted yellow fever at a Keno bouse,
No. 32 Royal street. About three days before their illness,
they '' sat down to play in company with three sailors, one of
whom had a fearful bad s1nell." The child of Walter took the
disease and died.
688 Original Communications. [March
I was called to case8 in rapid succession in various portions
of the city-on Robin, Orange, Rampart, Basin, Villere, Conti,
Magazine, Perdido, Franklin, and other streets.
POLISH EMIGRANTS IN THE COMMERCIAL HOUSE, CORNER OF
GIROD AND PETERS STREETS.
On the 12th of August, 1878, I ins.Pected the Commercial
House (corner of Girod and Peters streets,) and gathered the
following tact!'~ :
The schooner Paul Slavey, Captain Young, arrived at the
port of New Orleans April 26th, 1878, from Laguyra, Venezu­ela,
South America, with 262 German-Polish emigrants. TheEle
Polish emigrants had resided in Venezuela about fifteen
months. From information gathered in the Commercial
Hotel, and also from the agent of the German Society, we
learned that the emigrants arrived in good condition and
health, and without any sickness among them. For several
days after their arrival they were taken care of by the German
Society, and afterwards placed in the hands of the Louisiana
State Immigration Bureau, and were by the officers lodged in
the Commercial Hotel, and supplied with clothes and food. In
this latter work Major Burke was active. At the end of a
week the greater portion of the Polish emigrants were sent by
the Louisiana State Immigration Bureau to three different
plantations in the parish of St. Mary. Seven families, com­posed
of about twenty-eight souls, remained in New Orleans,
quartered in the Commercial Hotel. The adult members ap­pear
to have supported themselves by making and f;elling
baskets through the city. On the 12th of August, at the time
of my inspection, I found only one family remaining in . the
Commercial House. As far as my information extended, Dr.
Cullen was called to see a woman about the 24th of July, who
bad iust been delivered of twins and who was suffering with
fever, black vomit and profuse uterine hemorrhage. Upon in­quiry,
Dr. Cullen ascertained that there was at the time of his
visit, another case of yellow fever in the Commercial House.
The woman delivered of twins, died during the night of the
. I
..
1879] JoNEs-Yellow Fever Epidemic of 1878. 689
24th. She was probably first attacked with yellow fever about
the 20th of July. Oases of yellow fever then followed in rapid
succession iu the Commercial House and in the neighboring
sailor boarding houses, so that on the 12th of August, I found
. only 11 persons alive in the Commercial House ; nine had died
of yellow fever in the hotel, and five in the Charity Hospital,
and three still remained: uuder treatment in the latter institu­tion.
It would appear therefore, that 28 souls were left in the
Commercial Rouse from the main body of the Polish emigrants,
and of this number, one-half, or 14, had perished by yellow
fever up to August 12th. At the time of my inspection the
bedding and old clothes were burning in the court of the hotel;
the smell which pervaded the entire house was disgusting and
produced headache, nausea and loss of appetite. On the 17th
of August, 5 days after the inspection, I was seized with in­tense
pain in the head and back and was prostrated by a
violent fever. My temperature reached 104°.5. Quinine ap­peared
to arrest the progress of this fever; 100 grains were
taken by me in about 48 hours. At the end of nine days I re­sumed
the practice of medicine.
INSPECTION OF SAILORS' BOARDING HOUSE, No. 22 GIROD 8TREET,
IN WHICH ELLIOTT, THE ENGINEER OF THE EMILY B. SOU­DER
LAY_SICK, AND FROM WHICH HE WAS TRANSFERRED
TO THE HOTEL DIEU.
The boarding house No. 22 Girod street, was kept by Mrs.
Celia Eagan, and upon my inspection on the 13th of August,
1878, I gathered the following facts: Tom. Elliott, the engineer
of the Emily B. Souder, was sick in this house about the 22d
of May, with what the attending physician and the boarding
bouse keeper, regarded as intermittent fever, from which the
man is said to have suffered the preceding year. He was sent
in a cab to the Hotel Dieu May 29th. He is said to have been
intemperate.
No other case of fever occurred in this house. No other case
of f'ever occurred in this neighborhood, for more than one month.
1 was most careful in my inquiries on this point, interrogating
river pilots, tugboat men, boarders and boarding house keep-
690 Original Communications. [March
ers in this neighborhood. At the time of my inspection of 22
Girod street, there were present 7 boarders, all in good health,
and none of the boarders bad been affected with yellow fever,
up to august 13th . .
The son of Mrs. Eagan affirmed that he had slept in the same
'room and in the same bed with Elliott during his illness, and had
experienced no ill effects, although he had never had yellow fever.
THE SECOND CASE FROM THE STEAM-TUG CHARLIE B. WOODS.
We have seen that Mr. Caven, the engineer of the steam­tug
Charlie B. Woods, was attacked with yellow fever nineteen
days after the commencement of the illness of his mother-in­law,
five days after that of the Kirtz child in the adjoining·
house, and two days after, that of his son Lee.
No other cases of yellow fever appear to have occured
amongst the crew of this boat (consisting of 30 men, many of
whom had never had yellow fever), until the 8th of August.
This case was as follows :
Forty-four Girod street, Sailors' boarding house; John
Hadley, age 23, in New Orleans 9 years; from crew of tugboat
Charlie B. Woods; attacked with severe pain in head and
back, and high fever; August 8th, 12 M., disease well marked
yellow fever. Recored.
The first case of yellow fever iu this house (44 Girod street),
was that of Maggie Duft, who died with black vomit, on the
6th of August, after an illness of 4 days. This case is said to
have been treated by Dr. Cullen.
In the early part of August, I had cases of yellow fever in
the various sailor boarding houses at the head of Girod street,
as at. 54 and 55, and also in the crowded tenements bordering
on the St. Mary's Market, on St. Joseph, North and South,
Market and Tchoupitoulas streets.
Such facts, therefore, enabled me to trace no connecUon between
the cases on Constance street and the steam-tug C. B. Woods, and
through it to the E. B. Souder, nor between the case of Elliott
and the cases occurring at the head of Girod street.
1879] JONES-Yellow FeJVer Epidemic of 1878. 691
MEXICAN CIRCUS.
It was surmised by some, that the fever bad been introduced
from Mexico, by a circus which arrived about the close of
of June in New Orleans from that country.
Careful inquiries at the City Hall and in other directions,
have established,
l st. The Mexican Circus was organized in a mountainous
region of country, where yellow fever is unknown.
2d. The Mexican Circus reached New Orleans by rail, pass­ing
through regions in which yellow fever was unknown.
3. The Mexican Circus was in good condition and free from
disease at the time of its arrival in New Orleans.
We exclude in like manner, this foreign source of disease.
[ was aided in my inquiries with reference to the Mexican Cir­cus
and Polish emigrants, by Mr. James Zacharie, of the Oity
Hall, as will be seen from the following letter:
NEW ORLEANS, January, 1879.
DEAR DOO'l'OR :
Being unable to obtain the desired information earlier, I have
delayed answering your letter until to-day.
1st. The Mexican Circus of Torrea Rea arrived in this city
from Brazos Santiago, Texas, via Morgan City, per steamship
Harris, about the end of June. Their tent was erected on
the corner of Rocheblave and Canal streets, and their first
permit for a performance was issued by the city on July 3d.
They subsequently performed at the coruer of Orleans and
Bourbon, at the New Lake End, and in several other parts of
the city.
2d. This circus company was organized at Zaccatecas, a city
in the interior of Mexico, which yellow fever never reaches.
Subsequently they performed at Saltillo, Monterey, Matamoras,
and embarked at Brazos Santiago.
3d. They left hPre on a steamboat about August 16th, and
the last beard of them, was at St. Louis.
I could not learn of any one of the troupe having the yellow
fever.
2
•
692 Original Communications. [March
4. In regard to the Polish emigrants, Mrs. Hendrick (now at
No. 104 St. Charles street), formerly in charge of the Commer­cial
Hotel, told me they arrived here from Venezuela in March.
That part of them went to the country, but returned a month
later, sick with swamp fever, and subsequently the yellow
fever broke out among them, ~nd many died. These people
came here ou a small schooner, and were destitute, being the
remnants of a Polish colony in Venezuela, When they arrived,
here, they were starving, and they were cared for by charita·
ble persons. They were sick with swamp fever fully two
months before the yellow fever broke out in the vicinity of the
Commercial Hotel.
I have given you all the information I could obtain, and will
be happy to ue of service to you in getting anything more you
may require on the subject.
Yours truly,
JAMES ZAOHARIE.
Prof. Joseph Jones, 495 St. Charles street.
The yellow fever of 1878, sprang up in the month of July,
simultaneously in widely separated portions of New Orleans.
This has been shown even by my own limited experience, and
will be still further illustrated by the following record of my
private practice during the early period of the epidemic of
1878, giving the localities and dates of the caseR treated:
•
.....
1879) JoNEs-Yellow Fever Epidemic of 1878. 693
Datil and Location of the first 60 Cases of Yellow Fever treated by Joseph Jones, M.D., In
New Orleans during the Epidemic of 1878. 'l'he D•athA were rclati VI' Iy more numerous
during th• earlier periods of the Epidem ic. The total Unscs treated up to the 6th of Octo­ber
2.i6; total Deaths, 18 1 Deatl• in 1 ~ 2 Cases 7 0 per cent Mortality
No of Time in Date of
Cases Age. Sex. Race. Nativity. N. 0 . Place of Residence. Results. Attack.
1
2
3
4
5
6
7
8
9
10
11
12
1:3
14
15
16
17
16
19
20
. 21
2:!
23
24
25
26
27
28
29
3(1
31
32
33
34
35
36
37
38
39
40
41
4'l
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
63 F .
2l M.
6 M.
30 ]<',
46 M.
9 M.
22 F.
19 F.
35M.
16 F.
16 M.
19M.
21 F.
30 M.
36M.
20 M.
20 M.
25M.
5 M.
25 F.
54 M.
44 M.
19M.
50 F.
30 1<'.
22 F.
60 M.
8 F.
16M.
11 F.
8 M.
6 M.
8 F.
30 F .
5 M.
28M.
23M.
25M.
25M.
1il M.
25 ]<',
30 M.
20 ]<',
9 M.
18 ]<',
3 F .
33 M.
48 F.
3 F.
15 F.
10M.
20 ]<'.
1 F.
30 M.
6 M.
1::! ]<' .
11 F.
!:! F.
6 F.
11 F.
W. Ky. 17 days 122 Constance Recov'd Juse 30
W. N. 0. Birth 124 Constance Died July 13
W. Penn. 3 years 122 Constance Recov'd July 16
W. Ky. 3 year~ 122 Constance Recov'd July 18
W. Penn. 23 years 122 Constance R• cov'd July 18
W. Tenn. 3 years 122 Constance Recov'd July 21
W. Penn· 3 years 1:<0 Conbtance Recov'd July 17
W. Eng. 9 Ju o's 12 N. Rampart Died July 19
W. Penn. 10 years :ll Gasquet Died July 23
W. Italy. 14 years Common & Cl'b'ne Recov'd July 26
W. Mis~. 10 years 167 Orange Recov'J July 27
W. Ala. 5 years 1ti:3 }{o!Jin Recov'd July 25
W. Tenn. 6 mo's J1 N. Basin Died July 28
W. Canada. 6 mo's 16ti St. Charles Recov'dJuly 31
W. Ky. 15 years~58 tit. Andrew Recov'dJuly 31
W. N. 0. Birth 46 S. Villiere Recov'd July 31
W. N. 0. .Birth .BaronnenCommonRecov'dJuly 28
W. La. 10years51Camp Recov'dJuly30
W. N. 0. Birth. 47 Rubinson Recuv'dAug. l
W. Ala. 4 years 163 Rubin Hecov'd Aug. 3
W. N. Y. 20 years 204 Lillerty Recov'd Aug. 8
W. Miss. 11 years 44 S. Villere Recov'dAug. 4
W. N. 0. Birth :3\JO Common Recov'd Aug. 2
W. N. 0. Birth 10f> Howard Recov'dAug. 1
W. N. 0 . Birth 140 Felicity Recov'd Aug. 2
W. Ala. 4 years 163 Robin Recov'd Aug. 6
W. N. 0. Btrth 46 S. Villero Recov'dAug. 4
W. N. 0. Birth 46 S. Villere Recov.d Aug. 6
W. N. 0. Birth 46 S. Villere Recov'd Aug 10
W. N. 0. .Birth 46 S. Villere Recov'dAug.12
W. N. 0. Btrth 36:3 Magazine Died lAng. 8
W. N. 0. Birth St. Mary & Car'nd't Recov'd'Aug. 6
W. N. 0. Btrth 214 Conti Recov'dAng. 6
C. Ga. 3 years 8t. Charles & J'ks'n Recov'd Aug. 2
C. N. 0. Birth 98 Perdido Recov'd Aug. 7
W. N. Y. 10 mo's 9tl Pe1:dido Died Aug. 7
W. Eng. 9 years l'ugboat C. WoodsRecov'd Ang. 8
W. !roland. W years 55 Girod Recov'u Aug. 8
W. Ind. J'er. 10 years 363 Magazine Recov'd Aug. 10
W. N. 0 . Btrth oB Annnncia~ion Dt,-d Aug. 10
W. Ireland. 11 years 5l Girod Recov'd Aug. 11
W. W.- Va. 6 mo's J63 M·.~gazine Died Aug. 12
W. Miss. 2 mo's :36:3 Magazine Died Aug. 12
W. N. 0. Birth 149 Terpsichore Recov'd Aug. 12
W. Mo. 7 years t:i2 St. Joseph Recov'd Aug. 13
W. N. 0. Birth 8-.l tit. Joseph Recov'd Aug. 1.>
W. Ireland. 12 years 57 Girod Recov'd An g. 14
W. S. C. 9 years 16:3 Robin Recov'•J Aug. 16
W. N. 0. Birth 88 Annunciation Recov'd Aug. 16
W. N. 0. Birth 88 Annunciation Recov'd Aug. 16
W. Ala. 4 years 16J Hollin Recov', Aug. 10
W. N. 0. Bin h. 424 Magazine Recuv'd Aug. 16
W. N. 0. Birth 424 Magazine Recov'd Aug. 16
W. Italy. 9 years 265 Chartres Recov'd Aug. 16
W. N. 0. Birth 167 Orange Recuv'd Aug. 31
W. N. 0. Birth 167 Orange Recuv'd Aug. 31
W. N. 0. birth 212 Conti Recov'd Aug. 24
W. N. 0. Birth 212 Conti Recov'd Aug. 2ti
W. N. 0 . Bii:th 212 Conti Becov'd Aug. 28
W. N. 0 . Birth 212 Conti Recov'dAug. 29
l
=
694 Original Oommunications. [March
In the preceding table, 60 cases first treated, aro recorded,
of these, 9 proved fatal. As the epidemic progressed, it became
less fatal. Thus, of 196 cases treated chiefly during the
month of September, and up to the 6th of October, when I was
disabled by severe and painful illness from continuing my
labors, only 9 (nine) proved fatal. The mortality, therefore,
amongst these 206 cases treated by me during thf) epidemic of
1878, was 18, or 1 death in 14,2 cases or a mortality of 7.0 per cent.
From the preceding statistics, I have excluded those cases
which were undoubtedly of malarial o-rigin, and presented dil:l­tinct
intermil:lsions and remissfons, and universally recovered.
From the preceding investigations, no light was thrown up­on
the foreign importation of the disease; on the contrary,
the facts developed appear to favor the view of the domes­tic
origin of the disease; at all eveuts no connection can be
traced between the various local outbreaks, occupying a belt
at least, two miles in length, and the two cases said to have
been engendered on board the steamship Emily B. Souder. ·"""
The connection of these cases wit.h the subsequent and simul­taneous
explosions in difl'erent portions of New Orleans, can
be connected neither in space, nor in time.
VALUE OF DISINFECTION AS PRACTICED IN NEW ORLEANS FOR
THE ARREST OF YELLOW FEVER.
All credit should be given to the patriotic motives of the
presidents and officers of the Board of Health, who have en­deavored
to arrest, and even to "stamp out n yellow fever in
New Orleans, and a very brief review of disinfection, and
especially of ''carbolic acid" disinfection in New Orleans, may
prove at once of interest and profit to you as medical students.
Carbolic acid appears to have been first used for the arrest
of yellow fever and as a disinfectant during the epidemic of
1867, under the direction of Dr. S. E. Smith, President of the
Board of Health. He is dead. He once held a high position
in the medical service of Lhe Confederate army, and after his
residence in New Orleans, died in Texas.
In order to demonstrate the effect of disinfection I will give
you a short outline of the record of the yellow fever in this
city since 1866 :
1879J JONES-Yellow Fever Epidemic of 1878. 695
1866-The mortality was 185 and almost entirely confined to
persons unacclimated and recently from unacclimated coun­tries.
In 1867 the yellow fever appeared in June. The first case
died on the lOth of tbat month at the Charity Hospital. The
Board of HP.alth was unable to connect the origin of the dis­ease
to infection from without the city. The fever did not
acquire epidemic proportions until about the middle of August.
In his official report Dr. S. E. Smith states every house where
a death occurred was, under the direction of the health offi­cers,
cleaned and fumigated with sulphurous acid gas, and dis­infected
with carbolic acid. The premises were also purified
and the vaults disinfected with sulphate of iron. Notwith­standing
thP.se measurP.s the disease became epidemic, an im­mense
number of cases occurred, and 3107 deaths were reported
as directly caused by yellow fever, in addition to 990 deaths
caused by the various paroxysmal and continued fevers.
Very few persons liable to the disease, escaped an attack,
but the mortality, relative to the number of inhabitants, was
very small. The number of subjects for yellow fever was
large, from the fact that there had been no epidemic since
1858, and all the children unuer nine years of age were suscep­tible.
The low rate of mortality in that epidemic was attrib­uted
by Dr. Smith to the cessation of emigration from Europe
and the increase of the negro population, in whom the ten­dency
of the disease is to recovery.
1869-0nly 3 deaths from yellow fever were reported, 1 in
July and 2 in October.
1870-During the summer and autumn the deaths from yel­low
fever reported to the Board of Health numbered 587. It
is worthy of note that other fevers caused 594 deaths; so that
the total number of deaths from fevers recorded was 1178, and
of the:~e 241 were ascribed to pernicious and congestive fevers.
A marked peculiarity of the disease was the rapidity with
which it increased in the first five weeks, showing its tendency
to become epidemic; after reaching the climax the change was
gradual. The weather for a month prior to the appearance of
fever in 1870 had been very warm and sultry, and the nights
particularly close and oppressive. After the disease had made
some progress the atmosphere became exceeuiugly dry, and
at the time when the mortality had reached the ma,ximum,
cold winds prevaileu from the north, while the sun was hot,
and the dryness increased. There was no rain for six weeks.
It has been urged that the singular course of the fever was
due mainly to these climatic causes. According to the pub­lished
report of Dr. W bite, President of the Board of Health,
all such disinfectants as chlorine gas, carbolic acid, sulphurous
acid gas and lime were freely used. Dr. Albers, Sanitary In­spector
of the Second District, where 399 deaths occurred out
of 587 in the entire city, was especially active in the applica­tion
of the carbolic acid. He was a strong advocate of its
696 Original Communications. [March
efficiency in checking yellow fever. Notwithstanding the
copious use of carbolic acid, the monthly mortality from yAllow
fever was as follows: August, 3; St>ptember, 231; October,
242; November, 106 ;December, 5; tot:-~1, 587.
Tllus, in spite of the employment of disinfectants, the yellow
fever seems to have followed its usual course, with a certain
period of increase, succeeded by a certain period of decrease.
1871- The first case of yellow fever reported died in the
Charity Hospital August 4th ; the second August 20th, after 5
days' illness; the third September 5th, after 6 days' illness.
In July, 1 case, 1 death; in August, 2 cases, 2 death~>; in Sep­tember,
37 cases, 9 deaths; in October, 53 cases, 22 deaths; in
November, 33 cases, 19 deaths; December, 2 cases, 2 deaths.
The total number of cases was 114; total deaths 54. The
large mortality wa.s reached among these sporadic and disin­fected
cases of 47.3 per cent., or 1 death in 21 cases. The dis­ease
was confined chiefly to the Fourth District. It has been
claimed that the limited spread was mainly due to the use of
carbolic acid. The fever manifested no tendency to spread
either in this city or in other places where no disinfectants
were employed.
1872-0nly 83 cases and 39 deaths were officially reported.
The deaths occurred as follows : In August, 1 : September, 5;
October, 24; November, 7; December, 2.
On the other hand the so-called congestive fevers caused 165
deaths. The disease was widely spread over the city, but
appeared late in the season and showed no tendency to become
epidemic. 17 cases were reported in the First District, 4 in
the Second District, 1 in the Third District, 59 in the Fourth
District.
1873- The first case was traced to the bark Valparaiso,
which had been disinfected at Quarantine Station and reached
New Orleans June 26th. Of the 226 deaths from yellow fever
only 68 were of Americans. There were out of 3:J8 cases
reported 226 deaths, as follows: July, 8 cases, 3 deaths; Au­gust,
40 cases, 19 deaths; October, 135 cases, 79 deaths; No­vember,
22 cases, 17 deaths.
The president of the board states that fully 50 per cent. of
the recoveries were not reported ; many physicians did not
report their cases. If this is true, why did not the yellow
fever spread in those quarters where its existence was not
brought to the notice of the board, and where no disinfection
was practiced, assuming that the disinfection was efficacious,
and that the disease was limited in its ranges¥ It is worthy
of note that in 1873 the various forms of fever, exclusive of
yellow fever, caused 763 deaths. of which 246 were from con­gestive
and 109 from malarial fevers.
1874- 11 deaths were reported as cansed by yellow fever-2
in September, 6 in Octo her, 2 in November, and 1 in December.
1875-Yellow fever caused 61 deaths; 5 in August, 24 in
September, 20 in October, 9 in November, and 3 in December.
-
18791 JoNEs-Yellow Fever Epidemic of 1878. 697
In that year the following resolutions were passed by the
Chamber of Commerce:
Resolved, by the Chamber of Commerce of New Orleans, That
the system of disinfection to prevent the propagation and
spread uf infectious diseases in our city practiced with so much
apparent success since 1870, should be continued and encour­aged
by the ~:)tate and city authorities; also that the efforts of
the Board of Health to prevent epidemics are approved and
commended.
Be it further resolved, That this Chamber recommends to the
present Legislature to grant authority to the Board of Health
to permit, at its discretion, the passage of vessels from infected
ports to the city after the same have been satisfactorily and
thoroughly fumigated and disinfected, in lieu of the prescribed
time-detention called for by the existing quarantine law.
1876-42 deaths were caused by yellow fever, as follows :
In August, 1; in September, 19; in October, 17; in Novem­ber,
4; in December, 1. I was informed by the late Dr. Gau.
det, President of the Board of Health, that in 1876, the dis­ease
was of local origin and could not be traced to foreign im­portation,
In that year I was a member of a commission com­posed
of Dr. Joseph Scott and Mr. Rickey, appointed by the
Chamber of Commerce, to visit Memphis, Galveston and
Shreveport, for the purpose of raising the quarantine against
New Orleam~. It was held by the commission that the disease
was sporadic in its nature that year and would not spread, and
that there was no necessity for the establishment of q uaran­tine.
Both Memphis and Shreveport raised the quarantine,
but Galveston declined to do so. Neither of the former cities
suffered any detriment that season on account of their acqui­esence
in the views of tile com mission.
1877- But one death from yellow fever was reported, which
occurred in November. This man passed the Quarantine
Station.
The following table shows the mortality from yellow
fever and the aggregate mortality from other fevers :
Years. Yellow fever.
1867 . .. ... . . .... .. . . . .. . ... . .. .. .. 3,107
1868.. .. ............ . . . . . . . . . . . . . . 0
1869 . . . . . . . . . . . . . . . . -. .. . . -..... 3
1870 - . . . . . . . . . . . -..... -. . . . . . . . . . . 587
1871 . . . - .. ... .. - . . . . . . . . . . . . . . . . 54
1872 ... . . .. ........ .. . . . . - . . . . . . 36
1873 .... . ... . . ... ..... . . . . - . . . . . . . 226
1874 . . ... . .. . .. .. .... . ·····-· ·· ··· 11
1875 .... . ... . .. . -. . . . . . . . . . . . . . . . . 61
1876.... . .. . ........ . . . . . . . . . . . . . 42
1877... ... . . . .. .. . . . .. . . . . . . . . . . . . 1
Totals. . . . . . . . . . . .... , • . . . . . • • . 4:,131
Other fevers.
990
415
412
591
349
325
763
610
614
643
495
6,307
698 . Original Oommunication8. [March
In 1878, the yellow fever bid defiance to all the measures of
disinfection, as is well shown by the following monthly
tableau of deaths: May, 2; June, none; July, 50; August, 974;
September, 1893; October, 1044; November, 90; December, 3:
Total, 4056.
These numbers are below rather than above the actual
deaths caused by the pestilence of 1878, for without doubt,
many deaths from yellow fever have been entered upon the
mortuary record as due to pernicious, remittent, malarial fevers.
Such discrepancies are inseparably connected with the differ­ences
of views as to the nature, origin, pathology and symp­toms
of the various forms of tropical and sub· tropical fevers.
The disease does not seem to have assumed epidemic pro­portions
until about the middle of July. Immediately after
the appearance of the disease, the Board of Health introduced
as thorough a system of disinfection as was practicable. Large
quantities of carbolic acid were used, whole area.s of the city were
disinfected, etc. The city was in bad sanitary condition, the
weather intensely warm, the barometric pressure low, and the
atmosphere loaded with moisture. The conditions were all
favorable to the rapid spread of the disease. Oases occurred on
Robertson, Villere, Constance, Girod and other streets. The
spots were all thoroughly disinfected and surrounded with a
cordon of carbolic acid. I am informed by Dr. Taylor, Secre­tary
of the Board of Health, that during the month of July,
1470 gallons of pure carbolic acid, in addition to a considerable
amount of Page's crude carbolic acid, were distributed in and
around the infected localities.
It is my belief that the most strenuous efforts were made,
under the direction of the President of the Board of Health, to
arrest the propagation of the poison and prevent an epidemic;
and that the Sanitary Inspectors performed their duties as
faithfully as ever before in the history of the city.
It is also my belief that the quarantine was as rigid as ever
before in the history of New Orleans. It seems possible, from
the above facts, that the disease may have been importerl and
also of local origin. It appeared to be uninfluenced by disin-
1879] JoNEs-Yellow F(fl}er Epidemic of 1878. 699
fection, and advanced from house to house, and block to block,
from the different foci of infection.
In considering the value of disinfectants for the arrest of
yellow fever, it must be borne in mind that the disease has
been absent for varying periods, and in many years it has pre­vailed
only to a limited extent, in New Orleans.
Thus many writers have held that the disease was unknown
in this city from its foundation, in 1717, to 1796, a period of
79 years, during which there was no quarantine, while at the
same time there was unrestricted and frequent intercourse
with the West Indies. We propose to examine this question
at some future time, as its discussion would be out of the ques­tion
in the limits assigned to this clinical lecture.
The following table has been constructed from the records
preserved by Dr. Bennet Dowler, Dr. Edward H. Barton, Dr.
Erasmus Fenner and others, and by the various Boards of
Health. We will not now discuss the different estimates. in
certain years by difterent writers, the data being sufficient to
show the absence and limited spread of yellow fever when no
disinfection was practiced .
Year. Deaths from
yellow fever
1817 .. .. ... . . 800
1818 . .. . . . ... 115
1819 .... . ... 425
1820 .. ...... 400
1822 ..... . . 808
1823 .... . ... .
1824 . - . .. . . 108
1825 . . . . . . . . 49
1826.... 5
1827 . ........ 109
1.828 ......... 130
1829 ..... .. .. 900
1830 ... .. .... 117
1831 2
1832 ... . .... 400
1833 ...... . 1000
1834 ......... 95
1835 ... .
1836 . . . . . . . . . 5
1837 . . . . - ... 1300
1838 ....
3
Year. Deaths from
yellow fever
1.839 ...... 800
1840 . . .. . . . 3
1841 ... .. . 1800
1842 . . .. -. 211
1843 . ... .. . 692
1844 .. ... . . 148
1845 . . : . . 2
1846 . ...... 160
1847 .. .. . . 2600
1848 . . . . . . . 872
1849 . .. . . . . 769
1850 . .. . . .. 107
L851 . . . . . . . 17
1852 .... .. 456
1853 . ... . . 7849
1854 . .. .. . 2316
1855 ..... . 2615
1856 . .. . . . 74
1857 . . .... . 200
1858 ..... . 4855
Year. Deaths from
yellow fever
1859.... . .. 9~
1860 . . . . .. 15
1861.. . . . . . .
1862. .. .... 2
1863.. .. . . . 2
1864 . . . . . . 6
1865.. . . . .. 1
1866 ........ 185
1867 . . . ... 3107
1868... . . .. 3
1869 3
1870 .. . 587
1871 . ..... 54
1872 . ...... 39
1873 .. . . . .. 226
1874 . . .... 11
1875 . . ..... 61
1876 . . ..... 42
1877....... 1
1878 . ...... 4056
700 Original Communications. [March
PRESENT SITUATION OF NEW ORLEANS AND OF THE MISSISSIPPI
VALLEY WITH REFERENCE TO YELLOW FEVER.
In view of the horrible plague of 1878, which swept from New
Orleans, up the valley, into the very heart of the continent it
inay well be asked if in the present condition of affairs, the
Mississippi valley throughout its entire length bas any protec­tion
against a recurrence of a similar calamity under similar
climatic conditions?
Whilst the hope may be indulged that many years will
elapse before such a combination of climatic causes, and espe­cially
the prevalence of a tropical summer over the greater
portion of this immense valley shall occur; and whilst it
may be held that the remarkable spread of the disease along·
the water courses, railroads, aud other lines of travel, and the
rapidity of propagation, have followed from the long continued
heat and moisture of the Summer and Fall of 1878; at the
same time it is manifestly fhe duty of the State of Louisiana, in
virtue of the control which her situation gives to her of the
navigation of the Mississippi and the relations of the valley to
foreign• and domestic ports, to investigate through her Legisla­ture
and municipal and sanitary officers, the entire subject,
and to perfect a system of quarantine and sanitation in the
shipping and within the port of New Orleans which shall in
all respect correspond with the advancement of modern hy­giene.
The sympathy and the beneficent generosity of her
sister States during her days of pestilence, as well as ~ tbe fu·
tnre welfare of millions living along the banks of the Missis·
sippi and its tributaries,·demand that those charged with the
conduct of the affairs of Louisiana should institute every known
measure for the removal of the causes of domestic or foreign
pestilence.
If it be found upon careful investigation that the State is
unable to meet all the emergencies and expenditures required,
then an appeal should be made to sister States and in the last
resort to the General Government. Much may be accomplished
by an improvement and enlargement of the quarantine facil­ities
now possessed by the State. Thus by the first section of
an Act of Congress entitled ''An 'Act making appropriation
for certain civil expenses of the government for the year end-
,,.
18791 JoNEs-Yellow Fever Epidemic of 1878. 701
ing the thirtieth of June, 1858," approved March, 1857, the
sum of fifty thousand dollars was appropriated ;for the con­struction
of warehouses at Quarantine Station on the Missis­sippi
river below New Orleans, provided, that no part of said
sum shall be expended until the State of Louisiana shall {lass
a law ceding jurisdiction over the site of said warehouses to the
United States, and shall grant to the United States the use of
so much land as may be necessary for the construction of such
warehouses, with water front, and P.rivilege of the wharf now
built or hereafter to be built in said station; therefore, in order
to comply with said provision, and to carry the said law into
full force and efl:ect :
It was enacted by the Senate and House of Representatives
of the State of Louisiana in General Assembly convened, and
approved February 8th, 1858, by Wm. W. Pugh, Speaker of the
House of Representatives, Wm. F. Griffin, President pro tern.
of the Sert'a,te, and Robert C. Wickliffe, Governor of the State
of Louisiana, "That the State of Louisiana does .hereby cede to
the United States jurisdietion over the site of such warehouses
as shall be constructed under the Acts of Congress, approved
the third of Mal'ch, 1857, aforesaid, as Quarantine Station, on
the Mississippi river, below New Orleans, and do hereby further
grant to the United States the .use of so much land as may be
necessary for the construction of such warehouses ; with water
front, and privilege of the wharf, now built or hereafter to be
built, on said station."
On personal inspection of the Mississippi Quarantine Station,
I find that the warehouse constructed by the United States, in
accordance with the Act of Congress approved third uf March,
1857, is in need of certain repairs; and that the wharf has been
rendered, by the action of the waters of the Mississippi river,
and by the decay incident to all such structures near the mouth
of this great river, wholly unfit for the discharge and proper
disinfection of the cargoes of vessels infected with yellow fever,
typhus fever, small pox, cholera, and other infectious and con­tagious
diseases.
An expenditure of a sum not exceeding $30,000 (thirty
thousand dollars) by the general Government, or by the State
of Louisiana, would be sufficient to construct the necessary
•
702 Original Oommunications. [March
wharves at the Mississippi Quarantine Station for the speedy
discharge and disinfection of the cargoes of infected vessels.
An expenditure of a sum not -exceeding $20,000 (twenty
thousand dollars) would place the quarantine stations at the
Rigolets and Morgan City in effective condition. _
An expenditure of $100,000 (one hundred thousand dollars)
either by the State of Louisiana or by the General Government,
would not only be sufficient for the construction of the necessary
wharves, docks, warehouses and hospitals at the Quarantine
Stations but it would also be ample for the purchase of the best
disinfecting apparatus. The apparatus should consist chiefly
of-
1st. Apparatus for the rapid removal of the bilge water and
its replacement by water containing from 2 to 5 per cent. of
carbolic acid.
2d. Apparatus for the rapid and thorough removal of the air
within the ship.
3d. Apparatus for the rapid generation and injection of anti­septic
gases, such as sulphurous acid and chlorine.
4th. Apparatus for the production of heat and cold within
ships.
I have already in the pages of the New Orleans Medical and
Surgical J ourual discussed the value and mode of action of the
various disinfectants which may be used for the arrest of con­tagious
diseases and it will be unneccessary to dwell longer on
the subject.
Not only should the cargo of the ship and the clothing and
baggage of the crew and passengers receive careful attention
and thorough disinfection at the quarantine stations, but as the
danger of the importation of foreign pestilence may be les­sened
by the institution of efficient sanitary measures under
the direction of competent officers on board the ships trading
with New Orleans, it is important that a code of sanitary regu­lations
should be promulgated to the officers of all ships and
vessels holding commercial relations with this port.
Dr. Reid, of Edinburgh, during the debates of the Third Na­tional
Sanitary Convention in the city of New York, 1859, held
that it is desirable that a ship should be v~ntilated, that pas­sengers
should be detained, and also that vessels s~ould not
.I
1879J JONES-Yellow Fever .Epidemic of 1878. 703
be crowded ; that such things should be looked to at the port
of embarkation, and the proper precautions should be made at
the port of arrival. It appeared to Dr. Reid, twenty years
ago, that th6 subject of quarantine might be generalized very
much and put upon a kind of international or cosmopolitan
footing, because it is an object of very great importance not
only that individual States should concur with what was desir­able,
but that quarantine regulations should be adopted to the
commerce of the whole globe. If possible the questions relat­ing
to quarantine should be so agitated that such arrange­ments
should be made as would promote the general public
health at any and every port.
Dr. Reid said: ''If you look to Boston on the one hand, and
New Orleans on the other, and determine upon such regula­tions
as can be applied and entorced at these ports, they might
be sufficient also for all general cosmopolitan purposes, and then
you would be enabled to obtain the assistance (if such assist­ance
could be obtained) that foreign governments could give,
and that such governments would also expect from this coun­try.
You will observe that this question is not a local one; it
is a string, which, like other strings, has two ends, and you
must pull at the ports of embarkation, as well as at the ports of
arrival! in order to know what is necessary at the one and
what is to be excluded at the other. If the diseases treated at
quarantine were like a disease of a peculiar character that
arose somewhere, no one knew where, presenting itself at the
ports, and were to be judged and determined by quarantine
arrangements at the port of arrival, then quarantine at the
port of arrival would be the only subject of consideration; but
if you are to be guided in what. you do by the extent to which
you are supported by hygienic measures and proper precau­tion
at the port of embarkation, it is quite clear that anything
that interests States, that point which unites the several mem­bers
of this Convention from different parts of the Union, must
als~ equally apply to and interest those who see the connec­tion
and relation of foreign governments to this question.''•
•Proceedings and Debates of the Third National Quarantine a.nd Sanitary ConTention,
held in the oilly of New York, ls:.l, pp. 62; 63.
704 Original Communications. [March
By the various quarantine conventions in Europe, as that of
Paris in 1850, and that of Constantinople some fifteen years
later, an energetic impulse has been given not merely to the
study of restrictive measures, but also to the still more im.
portant subject, the application of public hygiene to the pre­vention
of epidemics at their source, in their homes and exotic
cradles. For many years past hygienic measures for the pre­vention
of the disease in ships trading with ports in which
yellow fever prevails, have been proposed and instituted by
the health officers ( 1
) of the port of New York. Hygienic
rules for the government of ships on their way from tropical
ports, were issued in New Orleans by Dr. C. B. White C) in
1875, by the late Dr. Felix B. Gaudet, in 1876, and by the
the late Dr. George W. Peete of Galveston, Texas.
And while we are speaking, at this very moment, views sim­ilar
to those of Dr. Reid of Edinburgh, ate urged by the Yellow
Fever Commission now holding its sessions in our city, and
the project of the establishment of a National Quarantine is
clearly outlined in their modes of inquiry, and conduct of the
examination of witnesses,
Notwithstanding that we hold that Lo1:1isiana is competent
to deal with the subject of quarantine, and that her medical
men are more competent to deal with yellow fever than men
foreign to her soil, institutions and interests ; at the same time,
in the event that the State of Louisiana fails to investigate the
entire subject, and to perfect a system of quarantine and civic
hygiene, in accordance with the requirements of the commerce
of the Mississippi valley, we believe that the general govern­ment
should perfect a system of national quarantine which
shall be under the control and direction of competent medical
men whose duties and compensation shall be such as to pre­vent
even the suspicion of fraud or favoritism; and which
should be alike in its regulations and operations for all parts
of the country, from Maine to Texas.
If act.ion should be taken neither by the State nor by the
general government, and the belief become fixed that quaran­tine
(as it now exists) ~s incapable of excluding foreign pes-
(1) PubUo Health Reports and Papero, 1873, p. 416.
(II) DiaiDi'eation iD Yellow Ji'8VIIr, p, T.
1879] JoNEs-Yellow Fever Epidemic of 1878. 705
tilence from the port of New Orleans, then upon the first note
ef alarm, we may expect the repetition of the local quarantines
of the past summer; the city will be cnt off from intercourse
with the surrounding country, and will resemble more nearly
a plague-stricken .ship anchored at quarantine. Under such
circumstances, New Orleans should make every effort to build
up the trade which legitimately belongs to her, with South
America; Mexico and the West Indies. Commerce should be
conducted by acclimated persons, and all necessary sanitary
regulations for t~e prevention of infectious or contagious dis­eases
should be instituted upon ships trading with this port.
All unnecessary taxes on commerce should be removed, and
the city made as far as possible a free port open to the com­merce
of the world. Of course, all persons who live perma­nently
in New Orleans, should expect to become acclimated,
and by their acclimation they would present a barrier to the
spread of yellow fever.
Quarantine may be viewed both as a national and interna­tional
question, and its perfection will depend upon the careful
study of the peculiar climatic, geological and topographical
relations and indigenous diseases of each country. Thus Eng­land,
by her insular situation, by the peculiarities of her
climate and soil, and more especially by her energetic hygienic
measures, is exempt from many dangers which threaten cer­tain
portions of the United States, and can with immunity
maintain the free pratique of her ports. Dr. S. Oakley Van­derpoel,*
the accomplished and efficient Health Officer of the
port of New York, has well said that the question of quaran­tines
is one of the most complex of hygiene and medicine. If
you bear in mind the obscurity which still hangs over the con­ditions
of the development of epidemics; if you recall that,
upon the globe, there is not a continent; that on such ~ conti­nent,
there is not a country which does not possess different
conditions of predisposition, or immunity, with reference to
these scourges; if further, it is remembered that every quar·
antine system, while it confers advantages upon those it pro­tects,
involves grave prejudices for those it contravenes, you
will understand how difficult it is to express, in determinate
*Public Health Reports and Papere, 1873, p. 405.
706 Original Communications. [March
administrative formulas, regulations applicable to every place
To be scientific and practical they should necessarily arrive at
conclusions variable according to the locality or part to which
the regulations are to be applied ; variable also according to
the nature and the diseases they purpose to contravene. These
regulations will then, by their diversity, recall how varied are
the dangers they should prevent, and also how different is the
morbid receptivity of the different populations which they are
to protect. It is not difficult, then, to comprehend how essen­tial
it.is that the great question of sanitary measures should
become more and inore the privilege of competent men-of
men who understand the mode of the propagation of epidemics,
the local and geographical conditions of their development,
and the special prophylactic measures applicable to each.
It is possible that a national quarantine law might be so
framed as to avoid the charge of centralization on the one
hand, and of political imbecility and fanaticism on the other;
and it is also possible that in its operation it might preserve
the local organizations of cities and villages, and at the same
time combine the double law of international and municipal
prevention of disease. The national quarantine should first
obstruct by restrictive measures, the propagation, from foreign
sources, of morbid germs; and the local sanitary boards should
render, as far as possible, each locality refractory to their de­velopemen
t,
In a properly devised system of quarantine and hygiene, the
general quarantine, so far from opposing the operations of local
sanitary boards, should act in entire harmony with them for
the promotion of the highest degree of health of the entire
people.
Whatever may be the present disposition of the Congress of
the United States as altered and consolidated by the civil war
between the States, it is well known that in past times the
question of the feasibility of establishing a uniform system of
·quarantine laws was discussed by such able lawyers as Web-ster,
Emmett, Wirt, and Chief Justice Marshall. By an Act of
Congress, passed February 25th, 1779, it is provided in the
third section, that " there shall be purchased or erected, under
the orders of the President of the United States, suitable
1879] JONES-Yellow Fever Epidemic of 1878. 707
warehouses, with wharves and inclosures, where goods and
merchandise may be unladen and deposited from any vessel
which shall be subject to a quarantine, or other restraints pur­suant
to the healtH. laws of any State as aforesaid, at such con­venient
place or places therein, as the safety of the public
revenue and the observance of such health laws may require.''
It is evident that this provision has reference to the safety of
the revenue rather than to the enforcement of a quarantine
law: and from the whole tenor of this law we gather that in
1779,, the subject of quarantine was held to be a State, and not
a United States, matter. Thus, the :first section provides that
the quarantine laws of the States shall be observed by the
Federal officers; that their officers shall aid in their execution;
and th~t the Secretary of the Treasury is authorized to extend
the time for making entries, etc., when a conformity to such
health laws shall require it.
Mr. Webster, in the case of Gibbons vs. Ogden,* held that
· quarntine laws were in their general character rather regula­tions
of police than of commerce, in the constitutional under­standing
of the term~
Quarantine laws, for example, may be considered as affect­ing
commerce, yet they are in their nature health laws. In
England we speak of the power of regulating commerce, as in
Parliament, or in the King, as arbiter of commerce, yet the city
of London enacts health laws. Wonld any one infer, from this
circumstance, that the city of London had concurrent power
with Parliament or the Crown to regulate commerce~ or that
it might grant a monopoly to navigate the Thames~ While a
health law is reasonable, it is a health law; but lf under color
of it, enactments should be made for other purposes, such
enactments might be void. Mr. Emmett, although taking a
different view of the character of quarantine laws, yet agreed
with Mr. Webster, that they were not within the competency
of Congress; that whilst they were laws of police they were
also laws of commerce; for such is the nature of that commerce
which we are told must be regulated by Congress, that it en~
ters into and mixes itself with all the concerns of life. This
• Wllarto11'e Reports vol. 9.
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708 Original Oommunications. fMarch
furnishes an argument showing that the States should have
concurrent power over it.
The supposed ratification by Congress of the quarantine laws
did not take place until 1796; whilst many of these laws were
in active operation in the States several years before. For
instance, New Hampshire passed her quarantine laws first
February 3d, 1789, and again September 25th, 1792; Connecti­cut
in May, 1795; the laws of Maryland show the temporary
continuation of these laws in that State from 1784 to 1785,
from 1785 to 1792; from 1792 to 1799, and so on down to 1810.
The State of Virginia passed her first · quarantine law in 1792,
and Georgia in 1792; Delaware 1797. Undoubtedly, these
laws derive their efficacy from the sovereign authority of the
States; and they expressly restrain, and indeed, proaibit the
entry of any infected vessels into parts of the waters and ports
of the States. Attorney General Wirt viewed the quarantine
laws in the same light with Mr. Webster, as police, and not
commercial laws.
Ohief Justice Marshall, in delivering the opinion of the court,
held that the inspection laws and quarantine laws "form a
part of that immense mass of legislation which embraces
everything within the territory of a State, not surrendered to
the general government; all of which can be most advanta­geously
exercised by the States themselves. Inspection laws,
quarantine laws, health laws of every description, as well as
laws for regulating the internal commerce of a State, and those
which rPspect turnpike roads, ferries, etc., are component parts
of this mass. No direct power over these subjects is granted to
Congress; and, consequently, they remain subject to State
legislation."
It is scarcely to be credited that States controlling great
commercial centres, such as Boston, New York and Baltimore,
will surrendet these rights tamely to the dictation of one or
more meu appointed by the President, and stationed in Wash­ington.
If the quarantine laws, the so-called National Quar­antine,
shall be framed alone for the Southern States, they
may be perverted by designing meu into a gigantic system of
commercial oppression. Vague generalizations and shallow
assertious as to the powers aud necessities of the so-called
- I
18791 JONEs-Yellow Fever Epidemic of 1878. 709
AMERICAN NATION, will surely not lead to such hasty and un­~
ise legislation as will override the last vestige of State rights.
It is but just to believe that the wise men of Congress will ex­ercise
the necessary caution, and will frame such laws as will
not only protect in the best manner the health and welfare of
the people, but also preserve all that is valuable in State and
municipal regulations.
SANITARY CONDITION OF NEW ORLEANS DURING THE EPIDEMIC
OF 1S78.
It is impossible for men to alter climatic conditions, except by
long periods of time devoted to systems of agriculture and
drainage. We cannot look for any great change in this respect
in this generation, especially with the depressed finances and
overwhelming taxes of New Orleans. Under the depressing
and disastrous circumstances which cover the l::ltate of Louisiana
like a mantle of night, and which are the legitimate results of
civil war, confiscation, disfranchisement, and so-called recon­struction,
we cannot expect immediately any great changes,
such as the complete paving of the streets of the capital
city, and thorough drainage. It is well known that New Or­leans
has to contend with certain disadvantagl'ls of location and
construction. Her citizens, in common with those of large sec­tions
of Louisiana, have had to reclaim the sites of their homes
from the Father of Waters; they have- been engaged during
the past one hundred and sixty years in an unending conflict
with flood, tempest, pestilence, and political oppression and
misrule. It is not my purpose to unfold to you the infamous
manner in which, in violation of the sanitary ordinances, and in
defiance of the order and remonstrance of the Board of Health,
the municipal authorities, charged with the cleaning of the
streets, actually carted daily into the heart of the city the
accumulated filth and garbage, to raise streets and fill up lots.
Neither shall I attempt to describe the condition of the gutters,
main drains and canals, blocked up with offal, and presenting
a green, seething, putrefying mass of filth, belching forth nox­ious
vapors.
The picture has been too often drawn by able artists to excite
any longer interest or alarm. You need not be told that the city
710 Original Oommunications. [March
of New Orleans is situated in a plain, which lies below the high
water mark of the Mississippi river; that the soil upon which
it is formed is a tenacious clay, saturated with water contami­nated
with the seepage from privies or foul drains; and that
many of tbe houses, especially in the populous portions of the
city, are badly constructed, badly ventilated, and still more
badly drained; and that large numbers of the inhabitants
sleep on the ground :floors.
What remedies can be applied to this condition ~
lst. Thorough drainage. The chief sanitary problem of
New Orleans, is that connected with drainage . . Without doubt
moisture (a high dew point of the atmosphere) forms one of
the most favorable conditions for the rapid and progressive
spread of yellow fever; ano the same agent, in conjunction
with confined, damp, brick houses, favors the origin of phthisis
pulmonalis.
2d. The proper elevation and ventilation of houses, and the
proper drainage of their yards. An ordinance should be enacted
prescribing a proper elevation of all houses to be erected in
future, and proper drainage of all yards and lots.
3d. The proper grading and enclosure of the gutters and
canals. Continuous efforts shop.ld be made to thoroughly drain
the streets and private premises; the sides of the gutters and
canals, and their bottoms, should be walled in by impervious
and indestructible materials, so as to prevent seepage into the
surrounding earth.
It has been proposed to :flush out the gutters by continuous
streams of Mississippi river water; but this would be of doubt­ful
utility in the present condition of the gutters; with their
mud sides and bottoms, furnishing a surface for the absorption
of decaying matter and the exhalation of foul gases, and the
generation of clouds of insects. The currents of water, to pro­duce
sanitary benefits, should :flow regularly and continuously,
over smooth, well-graded and impervious surfaces, and the
draining machines should be sufficiently powerful and numerous
to remove the surplus water accumulating in the rear or
swamp side of the city. Open drains will accomplish the result
of drainage more effectually than closed gutters, or canals or
sewers. The fall from the river front to the Lake, in which
-
1879J JONEs-Yellow Fever Epidemic of 1878. 711
direction the drainage necessarily flows, is too small to admit
of any system of underground sewage in New Orleans. The
grand obj~ction to such a system, is the want of sufficient fall
to force obstructions and prevent, especially after hard rains,
the filling and stoppage and regurgitation of the contents of the
sewers.
4th. The abolition of the system of making streets with the
foul deposits of the gutters, garbage, aml refuse organic mat­ter
from the yards.
5th. The systematic cleansing and disinfecting of privies.
6th. The systematic disinfection of the gutters and canals
with such agents as quick-lime, copperas and carbolic acid.
7. The progressive elevation and paving of all streets. The
square block pavement, properly laid, is without doubt the
best form of pavement for the peculiar soil of New Orleans,
but much may be aceomplished by the systematic dsitribution
of gravel, shells and ballast of vessels.
8th. The subordination of the street cleaning and scavenger
departments to the orders and direction of -the Board of
Health.
With proper sanitary regulations, and the proper drainage
of the city by skilled engineers, it may be possible to render the
soil and climate of New Orleans comparatively dry, and
salubrious.
INVESTIGATION DESIGNED TO DETERMINE THE CHEMICAL AND
MICROSCOPICAL CONSTITUTION OF THE AIR DURING THE
PREVALENCE OF THE YELLOW FEVER.
I shall close this lecture with a very brief outline of the re­sults
of a portion of my investigations, which were comllfenced
in 1856 and were continued up to the early days of last October,
when they were temporarily suspended by sudden and violent
illness.
At the present moment I will allude chiefly to my observa­tions
upon the air of rooms in which yellow fever patients were
placed.
Seizing upon the fact that cold arrests yellow fever, I sought
to condense and render palpable to the eye and touch the poi·
son, by passing large volumes uf the yellow fever atmosphere
712 Original Communications. [March
through ice~nd ice cold water, by means of carefully construc­ted
bellows. In this manner I threw from 100,000 to 600,000
cubic centimetres of the yellow fever air through ice and icE~
cold water. The products of the condensation thus obtained
were examned both chemically and microscopically: In this man­ner
I have subjected the air of localities and rooms wh~ch ap­peared
to be infected with the yellow fever poison to microsco­pical
and chemical examination, and l have discovered num­bers
of minute organic living particles, which might properly,
be termed sporules, having a diameter ranging from one-ten­thousandth
to one-twenty-thousandth of an inch; and also nu­merous
llving animalculre, together with minute particles of
fatty bodies, scales from the human body and :fibres from the
bedding and clothing. The sporules resembled most nearly
the micrococci and criptococci of Hallier. I have observe<! sim­ilar
particles in the blood of yellow fever patients, and have
found bacteria in the air and in the blood. The blood was ex­amined
immediately after extraction, under the microscope. I
have endeavored to ascertain whether these particles, or the
matters obtained from the air where yellow fever was prevail­ing,
would have any effect upon living animals. Numerous
experiments were made. These substances injected, subcuta­neously,
into animals produced irritant effects, but not death,
so far as the experiments have been carried.
The blood of yellow fever patients under the microscope
differs essentially fro1p that of malarial fever patients; in the
former disease the blood corpuseles rapidly assume a crenated
form, with minute trausudations upon the surfaces. In a se­vere
case of yellow fever the blood often contains small par­ticles
possessing a vibratory motion. I have also observed
bacteria and a singular delicate fungus in the blood of yellow
fever patients. Blood has been allowed to stand and the devel­opment
of the fungus has been watched. If fresh blood from
yellow fever patients be injected into au animal it will produce
fever, but no animal has yet died from it, as before stated. If,
however, the blood be allowed to stand for a short time-say
several hours-it will undergo chemical change or putrefaction ·
and then will prove rapidly fatai to animals, even when in­jected
in minute quantities under the skin.
1879] JONEs-Yellow Fever :Epidemic of 1878. 713
Fresh black vomit introduced subcutaneouslv, acts as a local
irritant, and also produces fever. If black vomit be taken
from the stomach of a dead man, or if that from a living person
be allowed to undergo putrefactive change, it destroys in a few
hours the life of an animal to which it may be administered
under the skin.
The black vomit, iu many cases, a short time after ejection
becomes filled· with low forms of vegetable and animal life,
such as the spores and thalli of torulae, the organized bodies in
yeast, and bacteria. I have noticed as characteristic of the
secretions and excretions in yellow fever an exceedingly deli­cate
fungus which is evidently a species of the plant which
produ<;leS fermentation in beer and yeast.
AGENCY OF THESE ORGANISMS AND THEORIES OF YELLOW
FEVER.
We may take two views as to the agency of these organisms
in the spread of yellow fever, and also two views as to the
nature of the disease :
1. As to the nature of the disease. Yellow fever may be re­garded
as a disease depending solely upou changes of heat,
moisture and other climatic conditions, acting upon the human
constitution in a certain state ; or to the absence of ozone or
electricity from the atmosphere. But, if this theory were true,
the disease would appear in all quarters of the city simultane­ously,
and not ramify, as it does, from a focus, and along- lines
of travel.
2. A modification of this theory might be this: that heat
and moisture, and surrounding climatic conditions, affect­ing
the constitution, when in a certain state, caused the devel­opment
of a certain poison ii' the system thus acted upon and
in this pe~uliar state, which is capable after being developed
of propagating itself, such propagation being due to two
causes : 1. The direct emission of some poison from the person
infected, either from the breath or the secretions. 2. Such
poison may be conveyed by minute forms of plant or animal
life, the plant or animal finding a nidus for its growth in secre­tions,
as black vomit and the· dejecta from the intestines, and
when excreted, conveying the poison by being wafted about
by currents of air .
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714 Original Communications. [March
3. Yellow fever may be due to special germs indigenous to
a limited portion of the world. It inay be supposed that this
germ exis.ts independent of the human organism and may be
transported in ships, etc.; that it thrives in its native locality,
and whilst it propagates outside of that locality, it will not
exist for any great length of time, frost killing it. With this
theory may be coupled the hypothesis that these germs have
potency only whfln in contact with diseased matter.
The fact that the putrid blood and black vomit destroy
animal life would explain why so many deaths have been
traced to the exposure of putrid corpses. It is possible that
this .putrefection is produced by the presence of the lower
forms of organism, without supposing that there was any con­tagious
matter issuing out of the body itself.
How would you explain the fact that when a family is stricken
by yellow fever some members have light and others severe
attacks~
And how do you account for the fact that, as a general rule,
the disease is more malignant among persons recently arrived
from other latituqes than among natives?
In my judgment, this phenomenon is not due to any differ­ence
in the amount of the poison absorbed by different indi­viduals,
but is entirely due to the state of the system of the
person at the time of the reception of the poison. To illustrate:
during the recent civil war, in the early days of the conflict,
gunshot wounds healed readily, and the destructive form of
disease called hospital gangrene, was almost unknown. This
disease commits the most terrible ravages on the body, and the
slightest wound might result in the exposure of important ar­teries,
muscles, etc. As the war progressed the disease be­came
more and more common.
Thus, after the lm1g campaigns in Virginia, Tennessee, Mis­sissippi
and Georgia, where the men were exposed in the
trenches to all kinds of weather, by day and by night, and to
all manner of hardships, wounds healed with great difficulty,
and hospital gangrene frequently supervened, causing great
loss of life. The difference in this case was that the constitu­tions
of the men had been altered by unfavorable conditions
of existence.
.,
,
1879] JONES-Yellow Fever Epidemic of 1878. 715
In yellow fever it is a remarkable fact that as a general rule,
the natives of cold climates suffer most from the poison, This
can be explained on the hypothesis that the poison partakes of
the nature of a ferment, and a healthy individval ,has a large
amount of matter in his blood capable of undergoing chemical
change. Hence the high temperature and rapid structural al­terations
produced by the poison in such cases.
Persons residing in a tropical or semi-tropical climate for
many years, and natives, have the fever in a milder form as a
general rule. It would appear tha.t the effect of the climate
• was to alter the blood so as to prevent the violent changes
which take place iu the blood of totally unacclimated persons.
This whole subject is one of the most complex charactM, in­volving
considerations of the relations of vital forces, to other
forms of force; the effects of heat and moisture and of malaria
in reducing the stauda.rcl of health.
•