Citii Document.-No. 27. (OCT'S O Hi<» COMMUNICATION FROM THE CONSULTING PHYSICIANS RESPECTING QUARANTINE REGULATIONS. In Board of Mayor and Aidermen, July 29,1850. Laid on the table and ordered to be printed. Attest, S. F. McCleary, City Clerk. 2 QUARANTINE REGULATIONS. [July, Boston, July 25, 1850, Dear Sir, I have the honor to inclose herewith the proceed- ings of the Consulting Board of Physicians of the City, on the subject of Quarantine, which was referred to them by you last week. Respectfully, yours, JOHN C. WARREN, Chairman. Hon. John P. Bigelow. QUARANTINE REGULATIONS. Boston, July 25, 1850. To the Mayor and Aidermen of the City of Boston. Gentlemen : The Consulting Physicians of the City of Boston, in reply to a communication from the Mayor and Aider- men, requiring their opinion on the subject of Quaran- tine Regulations, respectfully REPORT: That more than nine years since, a similar require- ment for the opinion of the Consulting Physicians, on the subject of Quarantine, was made by the City Au- thorities. In consequence of this application, a full report was at that time prepared and submitted by this Board, stating at some length their reasons for believ- ing that Quarantine Regulations are neither useful nor effectual in preventing the introduction of epidemic diseases. Since that period, quarantine laws in this place have been relaxed and nearly abrogated, without detriment, it is believed, to the City or its Inhabitants. The Board of Consulting Physicians do not perceive any sufficient reason for changing or greatly modifying the opinions expressed by them at that time. The re- lations of Boston with other parts of the world, are the same, in proportion to its population as formerly. The only difference worthy of notice on this occasion, con- sists in the multiplication of railroads, in consequence 4 QUARANTINE REGULATIONS. [July, of which, a much greater number of strangers are be- lieved to enter the City, every day, by land than by water. Against these, no protection of the nature of a quarantine is practicable. In regard to merchandize on board vessels, it is believed that no thorough or effectual examination can be made without overhaul- ing or discharging the whole cargoes, a burden to which the mercantile part of the community could hardly be expected to submit,-and if a nominal and superficial examination merely is made, it only subjects the vessels to a useless detention and tax, without affording any advantage to the community. The Board of Physicians take the liberty to refer to their former report, above alluded to, and herewith an- nexed, for a detail of facts and reasons, which at that time governed the conclusions at which they arrived. They now respectfully recommend the discontinuance of all quarantine restrictions, with the exception of the following, which they herewith submit. That every vessel which shall hereafter arrive in the harbor of Boston, having emigrant passengers on board, shall be taken to the quarantine ground near Deer Isl- and ; and it shall be the duty of the Resident Physi- cian forthwith to examine the same, and to order any emigrant passengers who may be sick with malignant contagious disease, together with their effects, to be re- moved before said vessel shall be permitted to leave the said quarantine ground. Signed, JOHN C. WARREN, GEORGE HAYWARD, JACOB BIGELOW, GEORGE C. SHATTUCK, ZABDIEL B. ADAMS. To the Committee of the Board of Aidermen on Internal Health. Gentlemen : The Consulting Physicians of the City have received from your Board a request that, agreeably to a vote of the Board of Aidermen, they would state their opinion " of the necessity or utility of any quarantine regula- tion or a quarantine establishment, as a means of pre- venting or arresting the progress of contagious or infec- tious diseases." The importance of this subject has induced the Board of Consulting Physicians not to return an immediate answer to the application, and to take time sufficient for a most deliberate and cautious survey of the facts on which their opinion is to be based. Quarantine establishments were created at a remote period, when the laws which regulate the diffusion of malignant epidemics were less understood than they now are. A dread of the wide sweeping mortality which these diseases sometimes bring with them, natu- rally led to the introduction of every practicable meas- ure supposed to be adapted to prevent their dissemi- nation. The spirit which of late years has been applied to the investigation of facts connected with this subject, has wrought a great change of opinion in the minds of medical men and even of the whole community. In consequence of very careful researches, some of the formidable diseases, reputed to be contagious, have been ascertained to be scarcely if at all so; such as the 6 QUARANTINE REGULATIONS. [July, yellow -fever, cholera, leprosy, &c., others, whose non- contagious character is not established, have been found to be contagious only in particular localities among persons where an epidemic predisposition existed; such as one of the forms of typhus fever. The facts, from which the conclusions alluded to, have been derived, are too numerous to be cited here. Fur- thermore, we might notice that the diseases generally believed to be communicable by contact, such as small pox, measles, &c., are more frequently introduced into this City by land than by sea; and that, to oppose an effectual barrier to these diseases, we must establish a cordon around the City, and wholly cut off communica- tion with the places where they exist. Whether even these means would be effectual we consider to be most doubtful. Contagious or infectious disease, in order to be propa- gated, requires the concurrence of two circumstances. 1. A disposition to disease, usually called a predisposi- tion, in the subject. 2. The existence of a contagious or infectious principle. This principle is supposed to exist in the atmosphere or in some unknown medium, and is either generated in the infected spot, or conveyed to it from a distance through such medium. Now it is pretty obvious that' sanitary cordons and quarantines can have no efficacy in resisting the transmission of a noxious principle through the atmospheric air, or through an unknown medium. The statements briefly made above are not founded on vague suspicions and popular opinions, they are de- rived from the careful and laborious observation of the diffusion of disease and the result of experiments. We believe, therefore, they will authorize the following con- clusions. 1850.] CITY DOCUMENT.-No. 27. 7 1. That the great epidemics against which quaran- tines and sanitary cordons have been established, the plague, yellow fever and cholera, are not the necessary nor proper subjects for such precautionary regulations. 2. That typhus fever is not commonly contagious out of its proper or epidemic atmosphere. 3. That the diseases generally believed to be conta- gious, such as the small pox, measles, &c., are transmit- ted through the atmosphere from an infectious living body and received, apparently, through the lungs, by the infected person. The considerations stated above are, we conceive, conclusive against " the necessity or utility of a quaran- tine establishment as a means of preventing or arresting the progress of contagious or infectious diseases." The total abolition of the present system of quaran- tine regulations seems to us therefore to be imperiously demanded by the public good. At the same time we would ask leave to state as our opinion, that it would be necessary to have proper hos- pitals, or separate accommodations of some sort, for the reception of the poor affected with the small pox and imported typhus fever, and a City Physician to attend these hospitals, to vaccinate the poor, and to keep a watchful eye on such sources of impurity in the atmos- phere as are continually arising in a large city.