APPENDIX TO THE REPORT OF THE CENTRAL BOARD OP HEALTH it OF J A M A I C A. i s i Presented to the Legislature under the provisions of the 14th Vic. chap. 6*0, and printed by order of the Assembly. S P A MIS fl-TOWN: Printed by f, m. wilson, 5, martin-street, FOR THE HONORABLE HOUSE OF ASSEMBLY, 18f)*2, E R RATA. Page 135, line 14, for members read member. 136, last line, for ill-starved read ill-starred. — 137, line 32, after civilized man, add to dwell im — 139, in a note, for as quod read usque ad. — 140, line 16, for metropolis read city. — 141, line 32, for independant read independent!. — 142, line 37, for colapse read colapsed. — 145, line 35, for metropolis read city. — 152, line 15, after attendance add &c. &c. — 152, lines 19 and 20, dele besides. — 152, line 38, for found read seen. — 164, line 30, for wilst read whilst. — 160, lines 3 and 4, for subject read subjects* TABLE OF CONTENTS. Page, Appendix A 1 Appendix B, No. 1 : 7 Appendix B, No. 2 21 Appendix C, No. 1 ., 29 Appendix C, No. 2 30 Appendix D, No, 1 32 No. 2 33 Appendix E, No. 1 40 Appendix E, No. 2... , . 7© Appendix F 118 Appendix G 123 Appendix H, No. 1 128 Appendix H, No. 2 ... 132 Appendix I. 271 Accounts 273 Supplemental Account 278 APPENDIX TO THE REPORT OF THE CENTRAL BOARD OF HEALTH. APPENDIX A. Buies, bye laws, and regulations, drawn up by the Central Board of Health, for the purpose of being submitted to his excellency the governor in council, under the provisions of an act, passed in the four- teenth year of the reign of her present majesty, Vic- toria, chapter sixty, entitled “ An act for the esta- blishing of a Central Board of Health, and for other purposes. 1st. All swine shall be immediately removed from towns and townships, and from close contiguity to dwellings in rural districts, and all pigsties within towns and townships, or near to dwellings in rural districts, shall he demolished. 2nd. All dogs kept in towns or townships, shall be destroyed, unless provided with a chain or collar by the owner or owners, on which his or her name is distinctly marked. 3rd. All goats shall be prohibited from wandering about the streets of towns and townships, and no per- 2 Appendix. son or persons shall be permitted (o keep any num- ber of goats exceeding six, in any one yard in any town or townships. 4th. All rubish, filth, or refuse, of any kind, de- clared to be injurious to health by the Central Board, shall be removed, at frequent periodical intervals, from dwellings and their immediate neighbourhood, to such place, or places as the parochial authorities may, from time to time, appoint. 5th. All rank vegetation close to, or any thing that obstructs the free ventilation of air around dwell- ings, shall be cut down and removed. t>th. All dung and other refuse of stables, shall be removed daily to a place or places appointed by the parochial authorities, and shall there be deposited and got rid of by burning or otherwise. 7th. All foul stagnant ditches, pools, gutters, or drains, shall be covered, and filled up, or drained, and all accumulations of privy soil or other offensive decaying matter, near to human dwellings, and which cannot be easily removed or destroyed, shall be co- vered with a layer of earth or lime. 8th. The proprietor or occupier of any house, or houses, not provided with such conveniences, shall construct and erect suitable privy or privies, for the accommodation of the inhabitants of such house or houses. 9th. All houses which shall be pronounced filthy, or unwholesome by the Central Board of Health, or wherein a case, or cases of cholera or other epidemic disease shall have occurred, and w hich shall not have- been inhabited since, or where no means of cleansing shall have been employed, shall be cleansed and pu- rified by lime-washing, and such other means as the said Board may direct. 30th. That an officer or officers, to be appointed by, and acting under the authorities of any place, or places, w here the cholera or any other epidemic shall threaten, or actually exist, shall enter and inspect ail or any dw ellings or other buildings, aud all or any Appendix. courts or premises around such dwellings or other buildings which sh dl he suspected of being in an unwholesome condition, and shall require the own- er or occupier thereof, or any person having the cus- tody and care of such building, to remove or correct, within a reasonable period of time, to be by the said authorities specified, all existing nuisances as shall be declared by the Central Board of Health to be in- jurious to health, whether by rendering the atmos- phere impure, or by preventing the free access of air. 1 !th. The said Central Board of Health shall have full power, and they are hereby authorized, to de- clare the means necessary for the proper ventilation of any building or buildings used as a dwelling or dwellings, and such means shall he used and adopt- ed in any place or places named by the said Board. 12th. The said Central Board shall have full power, and they are hereby authorized, to pull down and re- move all or any dilapidated building or buildings which shall be uninhabited and in a filthy and un- wholesome condition, unless the same shall be forth- with repaired, and purified as the said Board shall di- rect. 1'Uh. The several local authorities throughout this island, in their respective districts, shall have full power, and they are hereby authorized under the di- rection of the said Central Board, to hire or procure, or, if urgently necessary, to take possession of unoc- cupied houses, buildings, or other tenements suitable for the purpose of being used as places of refuge and retreat for such persons as the said local authorities may see fit to remove out of infected houses or dis- tricts. 14th. The said Central Board of Health shall have full power, and they are hereby authorized, to compel the removal of inmates from houses which shall be declared by any duly qualified medical man. or other person acting under the instructions of the said Board, 4 Appendix. to be unwholesome from overcrowding or otherwise, to buildings or places of greater safety. 15th. The Central Board of Health shall have full power, and they are hereby authorized to engage any suitable building or buildings, or a room in any build- ing for the reception of necessitous persons attacked with cholera or any other epidemic disease. 16th. The said Central Board of Health shall have full power, and they are hereby authorized to require the immediate removal and interment of the dead, and to make and issue all rules and regulations re- specting burial grounds, means for the removal of the dead, and mode of sepulture, and to prohibit wakes, and other idle congregations of persons in infected districts or places. 17th. The said Central Board shall have power, and they are hereby authorized, when and where requisite, to institute and establish a system of house visitation, including a provision for the supply of me- dical and other assistance, and of medicines and ne- cessaries for the sick, as well as for other sanitary purposes. 18th. The said Central Board of Health shall have power, and they are hereby authorized, to require the local Boards of Health of the several parishes in the island to send regularly, and by every post, to the secretary of the said Central Board, a correct state- ment of the number of persons attacked by cholera, or other epidemic disease; of the number of deaths in each town and district over which such local Board presides, and containing such other particulars as may be required by the said Central Board, in order that the information so obtained may be made public in an official form. Persons acting under the authority of the said Central Board of Health, shall not be liable to any prosecution for any alledged injuries to property, arising from the enforcement of any, or either of the above bye-laws, rules, or regulations, and such per- Appendix. 5 sons are authorized to plead such bye-laws, rides, or regulations, as a lull defence to any proceedings instituted against them. The public and parochial authorities of this island are hereby required to execute the above bye-laws, rules, and regulations, or such of them as the said Central Board shall direct, in all cases where the owners or occupiers of houses and tenements shall, from poverty or any other sufficient cause, be unable to carry out the same. The above rules, bye-laws, and regula- tions, were passed at a special meeting of the Central Board of Health, holden at St. Jago de la Vega, on Thursday the nineteenth day of June, in the year of our Lord, one thousand eight hundred and fifty-one. (Signed) J. GAYLEARD, President of the Central Board of Health. Additional regulation drawn up by the Central Hoard of Health, for the purpose of being submitted to his excellency the governor in council, under the provi- sions of an act passed in the fourteenth year of the reign of her present majesty, Victoria, chapter sixty, entitled “ An act for the establishment of a Central Hoard of Health, and for other purposes." The Central Board of Health shall have power, and they are hereby authorized, to issue an order to the authorities of each parish in the island, to carry into effect the existing police and other laws for cleansing and keeping free from nuisances, and to enforce re- gulations enacted for that purpose in all towns, and that the said Central Board of Health shall also have power to employ a proper person to see the laws obeyed in those respects, when, and as occasion may Appendix. require, and to superintend the execution of any fu- ture rides and regulations that may he issued by the said Board. Passed by the Central Board of Health, at a meeting holder) in St. Jago de la Vega, on Tuesday, the fust day of July, one thou- sand eight hundred and fifty-one. (Signed) J. GAYLEARD, President of the Central Hoard of Health. Appendix. 7 APPENDIX B, No. 1. NOTIFICATION OF THE CENTRAL BOARD OF HEALTH, DRAWN UP AND PRESENTED BY THE COMMITTEE ON THE PREVENTION AND SPREAD of EPIDEMIC DISEASES, COMPOSED OF ALL THE MEDICAL MEMBEHS OF THE BOAI5D, AND ORDERED BY THE BOARD TO BE PRINTED. 8 A ppendix. THE CENTRAL BOARD OF HEALTH, CONSTITUTED UNDER THE ACT VIC. XIV. Chap. 60, CONSISTS OF THE FOLLOWING MEMBERS: Hon. JAMES GAYLEARD, President of the Council, and President of the Board. Hon. C. M'LARTY MORALES, M. R Col. Sur, Lond. Speaker of the Honorable House of Assembly. C. MACLEAN, M. D. Deputy Inspector-General, and Principal Medical Officer of the Army in Jamaica. J. WINGATE JOHNSTON, M. D. Deputy Inspector of Naval Hospital and Fleets, and Senior Medical Officer of the Royal Naval Hospital at Port-Royal. Hon. HECTOR MITCHEL, Mayor and Custos of Kingston. Hon. W. D. TURNER, M. D. President of the College of Physicians and Surgeons, Jamaica. PATRICK YULE, Lieut-Colonel, Commanding Royal Engineers. J, MAGRATH, M. R. C. Surg. Lond. And Surgeon to the Public Hospital, Kingston. LEWIS QUIER BOWERBANK, M D, & M,R C.S.E. Appendix. 9 NOTIFICATION OF THE CENTRAL BOARD OF HEALTH. I. The Central Board of Health, taking into consi- deration the circumstances that the Asiatic cholera con- tinues to prevail in several places in the parish of Ha- nover, that it has recently entered the adjoining pa- rish of Westmoreland, and that there has also been an outbreak of the disease, within the last four weeks, at Up-Park camp, in the immediate vicinity of the chief city of the island, where a few cases have again been seen during the last fortnight, have deemed it their duty, in compliance with clause live of the act of the legislature under which the Board is consti- tuted, to prepare and draw up, for the sanction of the governor in council, various rules and regulations to be observed and carried out in all places which shall appear to be threatened or shall be already affected with any epidemic or contagious disease.” II. Before the issuing of these rules and regula- tions, the Central Board of Health think it right to make known their views on the leading points in the history of Asiatic cholera, bearing on the subject of the public health ; more especially in reference to the local and removable causes which favour its deve- lopement and spread, and to the most effectual means of preventing or mitigating its ravages. HI. The general result of the experience of almost all the medical men in this island, who have had large opportunities of witnessing the cholera since it first appeared in the beginning of October of last year, has been, that it may spread, as an epidemic disease, in- dependently of human intercourse or personal com- munication. All endeavours to restrain its progress by quarantine measures have hitherto proved ineffec- tual. On the first irruption of the pestilence into Europe in lbdl-2, each nation attempted to prevent the invasion by rigorous quarantine and other rest ric- five means; but in every instance without avail.— Appendix. Again was the like attempt made in 18(7-8, and again it was found and declared to be utterly ineffec- tual. S V. In Great Britain, the question of the importa- tion of cholera as an epidemic, and of the practicabi- lity of preventing its introduction and spread by pro- hibitory regulations, have been more attentively exa- mined than in perhaps any other country; and the result of all the enquiries has been a very general concurrence of opinion as to their entire inefficiency. Tlie General Board of Health of England expressed their deliberate opinion on the subject in their report on quarantine, and in their first and second notifica- tions issued in the autumn of 1848; and the Royal College of Physicians of London, embracing almost all the distinguished physicians in England, recorded about the same time, their sentiments in the follow ing w ords :—“ Cholera appears to have been very rarely communicated by personal intercourse, and all at- tempts to stay its progress by cordons or quarantine have failed. From these circumstances, the commit- tee, without expressing any positive opinion with re- spect to its contagious or non-contagious nature, agree in drawing this practical conclusion, that in a district where cholera prevails no appreciable in- crease of danger is incurred by ministering to persons affected with it, and no safety afforded to the com- munity by the isolation of the sick.” To the soundness of this conclusion, the Central Board of Health would express their entire assent. V. It is to lie observed that the circumstance of healthy persons from an uninfected district having caught the disease bv going into an infected locality, does not at all invalidate or affect the opinion now expressed; such persons became exposed to and in- haled the atmospheric poison in the place where it existed, and were equally obnoxious to its deleteri- ous agency with the residents in the infected locality UM'lf. if such persons on returning to their uninfect- td district were not only attacked themselves with Appendix. the disease, but became the centres or foci from which it spread around in the neighbourhood and thence to the adjacent district, there would certainly be strong reason to believe that its diffusion was ow- ing to personal communication, or to contagion, as such an occurrence is usually denominated. But no substantiated instance of this kind, with exact de- tails as to the dates of the earliest cases of the dis- ease, the place from which the patients came, and as to whether the locality and district were perfectly healthy at the time of their occurrence, with other par- ticulars necessary to be known, has been brought under the knowledge of the Board. On more than one occasion, alleged instances of the sort have been ascertained, upon examination, to be entirely falla- cious. It is, however, to be remarked that several cases have been related to the Board by medical wit- nesses, where one or two inmates of the house, to which a person had returned from an infected locali- ty with the disease upon him, became soon after- wards affected with it, while the neighbourhood was, at the time, wholly exempt ; but upon no such occa- sion did the disease ever manifest any tendency to spread as an epidemic. Vi. The striking exemption, upon the whole, of nurses in cholera hospitals and of the attendants of the sick in the air) apartments of private dwellings', not to multiply similar facts, affords a most gratifying proof that no danger is incurred by ministering to the sick, even when many are congregated together; provided free ventilation and thorough cleanliness be maintained in the apartment, and all intemperance be avoided. VII. The death of several medical men in differ- ent parts of the island may have suggested the idea that their fatal sickness had been caught from pa- tients whom they had been attending. But it is to be remembered that these gentlemen were residing in the infected atmosphere of their districts, and con- Appendix. stantly visiting the very fori of the pestilence, and this too, under the very unfavourable circumstances of great fatigue, anti of mental as well as bodil y ex- haustion. From enquiries made by the Central .Board, it moreover appears that several of these gen- tlemen had been unable, in consequence of the un- ceasing demands upon their professional assistance, to pay any attention to themselves, while the premo- nitory symptoms of the disease were upon them ; while others fell victims to the pestilence, from the want of that very aid which they had been actively engaged in affording to others at the time of their own seizure. This has been one of the lamentable results of the utter insufficiency of the means of me- dical relief in almost every part of the island, at the present time. VII1. The Central Board of Health deem it almost unnecessary to record their conviction that the deve-4 lopement and spread of Asiatic cholera are power- fully favored by the existence of all local impurities, and of w hatever tends to contaminate the atmosphere with the exhalations from putrescent and decaying- matter. The influence of such causes has been re- cognised not only bv all medical men, but by the in- telligent members of every community where the pes- tilence has appeared ; and credit is due to the local authorities in this island for the promptitude and energy with which, in most places, operations of cleansing and purification were carried out, when their attention was once fairly draw'll to the subject, upon the appearance of the new pestilence on our shores. It is, however, much to be regretted that the necessity for the continued and permanent adoption of such measures has not been duly recognised any- where, and that even already, while the pestilence is still lingering in the land, the former state of neglect has been too generally permitted to return. It is to be hoped that the legislature, upon their next assem- blage, will not fail to pass an enactment by which the Appendix. continuance of so many flagrant abuses may be pro-: vented, and the public health be more effectually pre- served. IX. Instead of specifying' the various sources of local impurity in towns and elsewhere, which pro- mote the spread and ravages of epidemic disease, the Central Board would at present rather direct the at- tention of the public to the best means of getting rid of the rubbish and refuse matter, which are apt to accumulate around human dwellings. IN one of the towns in the island have yet established a system of prompt and effective scavenging, whereby there might he, as there certainly ought to lie, the daily removal from streets, lanes, and courts, of all waste and de- caying matter whatsoever ; and yet the necessity for such a regular system of cleansing is of course much greater in Jamaica than in cooler climates, where not only the amount of decomposing organic matter is less abundant, but the process of decay is much less rapid, it should be universally understood that the existence of dead or excrementitious animal and ve- getable substances near human dwellings is liable to do mischief to health at all times, but more especially during the prevalence not only of cholera, but of every other epidemic disease. The condition of the streets and roads w ithin, and in the immediate neighbourhood of, our towns, is so faulty—and in none so much so as in the chief town of the island—and the means of quick and in- expensive conveyance are so defective, that hitherto much difficulty has been experienced first in collect- ing together the refuse matter, and then in removing it to suitable places at a distance, and there getting- rid of it without detriment to public health. Upon no account, should accumulations or dung-heaps be ever permitted to be made within a considerable dis- tance of any habitations ; and then only when it is intended to make use of their contents for agricultu- ral or other purposes. X. Hitherto the value of the refuse matter of towns, 14 Appendix. ns manure for the land, has not been sufficiently ap- preciated in almost any country; and it has been on- ly of recent years that the attention of the British public has been strongly drawn to this very import- ant subject—important in an economic not les* than ifi a sanitary point of view. The Central Board would entertain the hope that ere long it will engage the t houghts of many persons in this island, interested in the improvement of the land, as well as of the sa- nitary condition of the people. In the meantime, they would suggest that the most ready and effec- tual mode of getting rid of ail dry rubbish is to have it at once burned in those places to which it has been conveyed. The large offensive accumulations which have been allowed to be made in tlie gullies, and oil the roads around Kingston, Spanish-Town, and other towns, might thus he speedily destroyed. Un- der other circumstances, as with night soil and such like deposits which cannot easily lie consumed hv tire, it is a good plan to cover the noxious refuse with a layer of a foot or two of earth ; the injurious effects are thus completely prevented for the time. XI. The keeping of swine in towns, or near to hu- man habitations in any locality, should be strictly prohibited : it is not sufficient that their straying about the streets should be prevented. The condi- tion also of stables within towns requires to be sub- jected to special observation and restrictions. XII. The extreme importance of a free and con- tinual ventilation of dwellings, and more especially of sleeping apartments, has not hitherto been sufficient- ly recognized in the construction of houses for the la- bouring classes in Jamaica. During the night, the atmosphere within becomes contaminated in the very highest degree, in consequence of the ignorant closing up of every orifice, whether door or window. The evil is increased by there being no opening in the roof, such as exists in houses in colder climates. 'There is thus no means of escape for the foul air, nor of admission to the fresh air; and yet the constant Ajrpcndix. renewal of the air that is breathed, is indispensibly necessary for the maintenance of the healthy exist- ence of all living beings. The mere congregation of a number of persons in a confined unventilated space is sufficient, at all times, to produce serious disease. During the prevalence of epidemic sickness, the pernicious results of neglecting the above simple law of life are aggravated tenfold. As interfering with the free play of a pure atmos- phere around dwellings, all rank vegetation in their immediate vicinity, such as is so frequently seen in this country close to negro huts, should be removed, and the surface of the ground kept free from vegeta- ble debris. Upon a future occasion, the Central Board will point out other defects in the houses of the poorer classes requiring correction, and indicate at the same time the means of effecting the desired changes. XIII. Besid es preventing the free access of air, rank vegetation near to dwellings tends to keep up a state of dampness, which is one of the most power- fully predisponent causes of disease. A wholesome dwelling must be dry, as well as clean and airy. XIV. The Central Board have very carefully con- sidered what are the precautionary and preventive sanitary regulations to be recommended for the ap- proval of the executive, and for enforcement in those districts which are threatened or are already affected with any epidemic or contagious disease, and more especially with Asiatic cholera. Besides the regular removal, at short intervals of time, of all nuisances from and near to habitations, and the adoption of suitable means of promoting their free ventilation, the lime-washing of houses has been found to be. ex- tremely useful. This expedient is of such easy appli- cation, and is so inexpensive, that it should never be omitted with all the inferior description of houses in a district which is threatened with the epidemic. It need scarcely to be remarked that the lime-washing of the interior of the house, is of much greater conse- 16 Appendix. quence I linn Unit of the mere exterior. The lime used in t he process should he fresh burnt and fresh mixed, as it is only in its caustic state that lime can be said to possess any disinfectant properties. XV. Personal as well as domestic cleanliness should be recommended and enforced by all who have authority or influence with the labouring- classes. XVI. Whenever the disease threatens to prevail, the Central Board would emphatically declare their opinion of the extreme importance, for the saving of human life, of removing from overcrowded and impure dwellings, in districts where the disease has appeared, as many of their unattached inmates as possible, and of locating them in places of greater purity, until the violence of the epidemic invasion has passed over, and the dwellings which have been, or which-are li- able to become, the seat of the pestilence have been thoroughly purified. The Board consider it to he quite necessary that arrangements for providing such houses or places of refuge and temporary retreat should he made in all towns and large villages where the cholera threatens to prevail; and with respect to estate villages and other scattered habitations in rural districts, the Board would strongly represent, to the proprietors and ma- nagers of the land that any large empty building—- such as a boiling-house, or store or trash-house, or even a mule or cattle-shed, if perfectly clean—might he advantageously used for the purpose. Many in- stances might he quoted where numerous lives have been saved, and great distress and suffering prevent- ed, by the timely removal of the inhabitants of an un- healthy locality to one of greater salubrity, even in the immediate vicinity. XVII. The experience of the last nine months in this island has shewn that the results of establishing cholera hospitals for the treatment of the sick have been, on the whole, unsatisfactory. From the ex- treme rapidity of the disease, when once the malignant Appendix, 17 symptoms have set in, and from the excessive exhaus- tion and tendency to fatal collapse which then ensue, it lias been generally found better to leave a patient undisturbed in his own dwelling, however objection- able this may be, than to incur the risk of aggravat- ing; the symptoms by removing him to another place. As, however, instances will occur of persons hav- ing no abode of their own being attacked, and of others being seized at a distance from their dwellings, and having no means of return, or such return being quite inadmissible, it will be prudent that some ac- commodation should be provided for the reception and treatment of such necessitous individuals. XV] 11. With respect to the interment of persons who die from cholera, the Central Board are of opi- nion that the prevalent notion that a dead body is more liable to retain and give off infectious effluvia than a living one, is not warranted by any authenti- cated facts within their knowledge. Medical men have been engaged, day after day, in handling and examining the bodies of patients who have died from the pestilence, and there is scarcely an instance, as far as the Board are aware, of injurious results to them or their assistants. The apprehension, therefore, of in- fection emanating directly from a dead body should be dismissed from the minds of those who have to be in attendance. In like manner, the Central Board do not deem it necessary that any special or distinct bu- rial grounds should be used for the victims of chole- ra, provided always the place of interment be at a suitable distance from human dwellings, and the graves be dug of a sufficient depth. The great object should be to remove out of the house, where the death has taken place, the dead body, liable as it is to very rapid decomposition in a tropical climate, and to have it buried in a becomingly short time. In numerous instances, the interment has been made with most indecent baste. A period of at least six hours should be allowed to elapse from the time of death. Should it unfortunately happen that great mortality Appendix. occurs in a district where there is difficulty in obtain- ing a supply of coffins, tiie Central Board would re- commend that the corpse should he rolled up in the body or bed clothes, and plastered over with pitch, tar, or lime, and thus conveyed to the place of inter- ment. There is no necessity for burning the bed or bed- ding of a cholera patient; but they should, of course, be washed and freely exposed to the air. The addi- tion to the water of the solution of chloride of zinc, or of other similar chemical salts, has been found serviceable. it is always prudent to employ a vehicle where practicable, and not the labour of bearers, for the conveyance of the dead to the place of interment; great fatigue, from whatever cause, predisposes a per- son to the invasion of epidemic disease. The keeping of wakes at funerals has been so often followed by the sickness and death of the persons at- tending such idle meetings in infected districts, that the Central Board are of opinion that they should be strictly prohibited. Hie Board would take this opportunity of express- ing their opinion that all burials within towns, or very near to human dwellings, should be discontinued throughout the island as speedily as may be prac- ticable. XIX. The subject of the diet of the working class- es in this island, in reference to its influence as a fa- vouring or determining cause of choleraic attacks, de- serves serious attention. Long fasting, followed by excessive eating, ought to be carefully avoided. Fa- tiguing exercise in the morning, before food has been taken, is not without danger. It is much to he desired that the use of fresh animal food was more general and frequent than it is among the labouring popula- tion of our towns and rural districts. The proprietors or managers of estates might do much to improve the dietary of the people, by having a bullock slain once a week, or oftener, and selling it at as low' a price aa. Appendix. possible, so that only no loss should be incurred. A small portion of such meat, with a due proportion of Indian corn, rice, or the better sorts of the ordinary bread kind of the island, w ould form a much more nourishing and wholesome diet than what is almost universally used by the working classes. The sub- stitution of peppers and other warm spices (so freely made use of among the native population of the East) in place of the excessive use of salted provisions, very often rancid at the same time, would be productive of much benefit. XX. That the insufficient clothing of the lower or- ders, and the consequent exposure of thesurface ofthe body to the alternations of heat and cold so frequent in this climate, and to the chilling effects of wet and moisture, predispose to attacks of cholera, cannot be doubted. In all bowel complaints it is very neces- sary that the skin be kept warm, and protected against sudden chills. It would contribute much to the health ofthe working classes if they were accus- tomed to wear a jacket or dress of thin woollen mate- rial, next to the skin, during the day; and at night the use of a similar garment would be, in very many instances, more defensive against the cold damp air, than a mere mat or blanket. In the event of a cha- ritable distribution of warm bed clothing to the poor, when attacked with cholera, it might be more useful, as well as less expensive, to give flannel dresses in the place of blankets. The practice, common among the negroes, of sleeping at night in the same clothes which have been worn during the day, is decidedly unwholesome. The poor should be cautioned against the danger of sleeping on the bare ground. A bed is of such easy construction, that there can be no ex< cuse for any one being without it. XXL In conclusion, the Central Board would ur- gently press upon all classes the extreme importance of immediate attention being paid to the slightest ir- regularity ofthe bowels, or disorder of the general health, on the threatened outbreak and during the Appendix, prevalenceof epidemic cholera. In this as in other countries, much difficulty has been experienced in inducing the lower classes to apply for medical re- lief upon the earliest indication of the premonitory sickness. Upon estates and other places where num- bers of persons assemble together for work, it will be useful, as a precautionary means, to inspect and interrogate each individual before commencing work in the morning, and upon leaving it in the evening.— In towns and large villages where the disease has ap- peared, the only efficient means of arresting its ra- vages is by establishing a system of regular house-to- house visitation, so that all the slighter cases may be promptly discovered, and the more aggravated ones be brought, without loss of time, under medical treat- ment. In order that prompt assistance may be afforded to the sick, it will be prudent that a register of such persons as may be willing to act as nurses or attend- ants, should be kept in each district, and that their remuneration per diem should be fixed by the local authorities. I dissent from all parts of the notification which infer the doctrine of non-contagion, and all matters founded on that opinion ; and more particularly from the opinions that no injurious effects can arise from hand- ling or keeping cholera corpses, and that there is no necessity to have separate places of buriaL W. D. TURNER, M. D. President of the Colleye of Physicians and Surgeons, Jamaica, T. James Brown, Secretary. Spanish- 'Town,* July l 1861. Ti‘ue topv, Joi-iN C. Macfarlane, Secretafp. Appendix. APPENDIX B, No. 2. SECOND NOTIFICATION OF THE CENTRAL BOARD OF HEALTH, DRAWN ISP AND PRESENTED BY THE COMMITTEE ON THE PREVENTION OF THE SPREAtJ OF EPIDEMIC DISEASES, Composed of all the medical members of the board* AND ORDERED BY THE BOARD TO BE PRINTED, Appendix. THE CENTRAL BOARD OF HEALTH, CONSTITUTED UNDER THE ACT VIC. XIV. Chap. 60, CONSISTS OF THE FOLLOWING MBMUKRS : Hon. JAMES GAYLEARD, President of the Council, and President of the Board. Hon. C. M‘LARTY MORALES, M. R Col. Sur Lond. Speaker of the Honorable House of Assembly. C. MACLEAN, M. D. Deputy Inspector-General, and Principal Medical Officer of the Army in Jamaica. J. WINGATE JOHNSTON, M. D. Deputy Inspector of Saval Hospitals and Fleets, and Senior Medical Officer of the Royal Naval Hospital at Fort-Royal. Hon. HECTOR MITCHEL, Mayor and Gustos of Kinyston. Hon. W. D. TURNER, M. D. President of the College of Physicians and Surgeons, Jamaica. PATRICK YULE, Lieut -Colonel, Commanding Royal Engineers, Jamaica. J, MAGRATH, M. R. C. Surg. Lond. And Surgeon to the Public Hospital, Kingston. LEWIS QUIER BOWERBANK, M D. & M.R C.S.E. A ppendix. 23 SECOND NOTIFICATION OF THE CENTRAL BOARD OF HEALTH. Suggestions for the 'Treatment of Malignant Cholera. It cannot be too forcibly impressed on the mind of the public, that the earlier the patient is attended to in this disease, the greater will be his chance of safety ; and that the delay of even a very short time may prove fatal. A few doses of medicine, judiciously given at the onset, will very frequently arrest its pro- gress, whereas if it is permitted to go on uncontrolled for even a very few hours, a fatal termination is likely to be the result. During the existence of cholera in a district, not the slightest disorder of the bowels should be neg- lected. It is the more necessary to caution all per- sons upon this point, as the looseness of the bowels, which, in a large majority of cases, is present for se- veral hours, and sometimes for days, before malig- nant symptoms set in, is frequently not attended with pain or any other inconvenience to alarm the patient. The disease may he said to have four stages, viz. : the premonitory diarrhoea, in which (with or without vomiting,) the stools are frequent, liquid, and of a yellow or feculent colour. The second, in which (with or without vomiting, or cramps,) the stools are destitute of bile, shreddy or like rice water. The third, (or state of collapse,) where (with or without vomiting or purging,) the heat of the body is diminished until often an icy coldness ensues, the pulse being feeble, and sometimes totally impercepti- ble; and The fourth, (or state of re action,) characterized by fever and congestion of some of the viscera, the brain being generally implicated. Appendix. These stages are not observed in every case, aa sometimes the first evacuations resemble rice water ; but it rarely happens that collapse takes place with- out some premonitory symptoms preceding it. The stage of re action has been comparatively rare in the present epidemic. , In this disease, the poison produces in the first stage, irritation of the mucous lining of the alimentary canal and torpor of the skin ; in the second stage, ar- rest of secretion, and transudation of serous fluid into the alimentary canal ; and in the third, a marked change in the blood, which has been gradually taking place from the commencement of the attack. it is on this view of the disease that the treatment is based. In the first stage, the moderate use of opium, com- bined with aromatics is indicated, and when assisted by external warmth, it will very frequently prove suc- cessful in arresting the disease. The addition of a fewr grains of calomel to the opium has been frequent- ly found serviceable. But it is only at this period that opium should be given, as when the secretion of bile is arrested, it augments the torpor, and has in very many instances, as is now almost universallv ac- knowledged, done irremediable mischief. Should the opiate remedies fail to a fiord speedy relief, the treat- ment for the second stage should be had recourse to, even should the secretion of bile be not yet entirely suppressed. When the patient is first seen, he should be confin- ed to bed, and for the relief of the gastric and abdo- minal symptoms, have a sinapism and flannels moist- ened with spirit of turpentine applied externally. The cramps will be assuaged by dry rubbing or the use of stimulating liniment, and by a hotair bath,* if it can be easily procured. * A hot air bash can readily be prepared by placing: on a hospital bedstead, with sacking: bottom, a sufficient number of blankets to ccver it so as to reach to the floor, and by placing under the bedstead two, or more saucers containing strong rum, set on -fire. Appendix. When opium has failed to arrest the disease, or the patient is seen for the first time in the second stage, the mercurial treatment should be had recourse to, and persevered in until its effects are discernible by the stools assuming a green color, when its use may be suspended. A scruple of calomel is to be given as a dose in the first instance, and afterwards a grain every quarter of an hour until the desired effect is produced. Should the temperature become lowered, or other symptoms of decrease of power appear before the mercurial ac- tion is perceptible, the saline medicines, viz.: a com- bination of chlorate of potass, carbonate of soda, and chloride of sodium, should be given every half hour, continuing the mercury until the stools have assumed the character above mentioned, or the stage of col- lapse sets in, when the use of this mineral, if it has already been freely administered, may be discon- tinued. At this stage, if it has not already been done, the patient should be wrapped in blankets, the frictions be continued, and a hot air bath, if practicable, be given. If the patient is seen for the first time in a state of collapse, and has not already taken mercury, it would be advisable to give a scruple of calomel immediately, and to administer saline medicines every quarter or half hour, according to the exigency of the case, and in extreme instances, saline enemata. Turpentine enemata have also been found serviceable. The wrap • ping up in blankets, the use of the hotair bath, the ap- plication of bags filled with hot sand, or bottles of hot water along the limbs, frictions with mustard flour, stimulating liniment, &c. and in fact every means ca- pable of preserving the animal heat and safely excit- ing the circulation, should be had recourse to, and the saline medicines should be continued until bile appears in the stools, when the intervals between the doses are to be gradually increased until eventually they are discontinued altogether. Appendix. If, instead of receding, the disease appears to ad* vance, a little brandy may be cautiously given ; but large quantities of it have been found not only useless but prejudicial. When the prostration becomes considerable, small doses of camphor, capsicum and carbonate of ammo- nia made into pills, may be taken in conjunction with the saline medicines. As many persons have died suddenly in getting out of bed to go to the night chair, in this stage of the complaint, the patients should invariably use a bed pan, without getting into an upright position. If the discharges from the bowels, from their fre- quency and copiousness appear to be rapidly exhaust- ing thepatient, a stringent and stimulatingenematamay be given every hour, until relief is obtained. Acetate of lead, turpentine, &c. have been used for this purpose. Should the irritation of the stomach continue after mercurial action is established, or after the stools have become yellow under the saline treatment, two drops of creosote may be given in some mucilagi- nous fluid every hour, for a few doses. Nitrate of silver, oxide of bismuth or hydrocyanic acid will generally check vomiting, but these medicines should only be used under the immediate direction of a me- dical man. The application of stimulants externally, and occasionally of a blister over the epigastrium, will be required. When the patient complains of a pain and uneasi - ness in the bowels, warm fomentations or a poultice will afford relief. Purgative or aperient medicines should be used with great caution. An enema of warm water, when deemed advisable, may be given, and should this not relieve the constipation, a dose of rhubarb and magnesia with an aromatic, or of castor oil and spirit of turpentine, will best answer the pur- pose. When during convalescence diarrhoea becomes tron biesome, the rhubarb draught may be given, and afa terwards, a small quantity of laudanum, either by the mouth or anus as deemed most advisable. Appendix, Great attention should be paid to the diet of the patient not only during the existence of the disease but for some time afterwards. In the early stage the patient should not be compelled to take nourishment, as doing so would increase the mutation of the sto- mach. After some time, when he thinks he can re- tain it, small quantities of arrowroot may be given, and when the dejections lose their choleraic charac- ter, chicken broth or beef tea, with a little barley or vermicelli boiled in it (but allowed to subside) may be carefully ventured on. Solid meat should not be taken for at least live or oix days from the commence- ment of convalescence. For drink the patient generally prefers iced water to every thing eise; but toast water, barley water, lemon grass tea, weak mint tea, or an infusion of adm root are unobjectionable, if desired. Soda water, or the ordinary effervescing draughts, are often most grateful to the patient, and may be freely given. Milk and water will also be an excellent beverage if it does not disagree with the stomach, as besides quenching* thirst it affords no inconsiderable nourishment. During convalescence, nothing more in general will be required than appropriate food, but occasionally a few grains of quinine combined with carbonate of so- da or a mild bitter, may be necessary to restore the tone of the alimentary canal. The Central Board of Health, in their first Notifi- cation, have explained at length their views regarding the sanitary arrangements to be adopted in localities affected or threatened with malignant cholera, with out attention to which, little benefit can he expected from any mode of treatment. As fear and ail other depressing emotions of the mind predispose to attacks of the disease, it is import- ant to resist, as far as possible, their influence. Nutritious diet, and, when circumstances will allow, the moderate use of sound wine or malt liquor, will prove useful ; but all approach to excess in the use of alcoholic liquors should be carefully avoided, as r\ 28 Appendix. intemperance creates a susceptibility to the disease, and when drunkards are attacked it generally proves fatal, T. James Brown, Secretary. Spanish- Town, July 17/4, 1851, True copy, John C. MacfarlanE, Secretary. Appendix 29 APPENDIX C, No. 1. Island Secretary's Office, 28th July, 1851. Sir, I am directed, by his excellency the governor, and honorable board of privy council, to transmit, for the information of the Central Board of Health, (four- teenth Victoria, chapter sixty,) a copy of an order in council, which will be promulgated in the Jamaica Gazette by Authority, during the present week, 1 have the honor to be, Sir, Your obedient servant, (Signed,) ■ SAML. RENNALLS, Clerk to the Council. T. J. Brown, Esquire, Secretary to the Central Board of Health, A ppendix APPENDIX C, No. 2. Jamaica, In Privy Council, 26th July, 1851. Whereas the governor and council have been cer- tainly informed that the disease of cholera is prevail- ing throughout the parish of Westmoreland, the cus- tos and justices of the peace of the said parish are hereby directed and enjoined to enforce, by all l&wful means, the strict observance of the existing sanitary laws of the island : And whereas the Central Board of Health, under the provisions of the fourteenth Vic- toria, chapter sixty, entitled “An actio establish, for a limited period, a Central Board of Health, and for other purposes,” has submitted to the governor in council a rule or regulation for authorizirg and em- powering the said Board to employ a competent per- son to see to the execution of the said laws in the said parish of Westmoreland, the said Central Board of Health is hereby accordingly authorized and em- powered by his excellency the governor, with the ad- vice of the privy council, to depute, and send some competent and prudent person as a health officer to reside during the prevalence of the said disease in the said parish of Westmoreland, and to collect and convey to the proper authorities all information respecting the non-observance of the said sanitary laws in the said parish oi Westmoreland, and to bring to the notice of the magistrates all parties neglecting, or offending against the said laws, disorder that the same may be proceeded against according to law ; and also to give effect to, and enforce by all lawful means, such rules, regulations, and bye-laws, as hereafter, upon the re- commendation of the said Central Board of Health, may be issued and established by the governor in Appendix. 31 council, for the said parish of Westmoreland, during the prevalence of the said disease. Ordered, That the clerk of the council do cause the foregoing order of his excellency the governor in council, to be published in the Jamaica Gazette by Authority, and to communicate the same to the Cen- tral Board of Health. (Signed,) SA ML. REN NALLS, Clerk to the Council. 32 A ppendix. APPENDIX D, No. 1. Island Secretary's Office, 15th August, 1851 Sir, I have been directed by his excellency the gover- nor, and the honorable board of privy .council, to transmit, for the information of the Central Board of Health, (fourteenth Victoria, chapter sixty,) the en- closed copies of proceedings at a privy council held on the 13th instant, in connection with the rules, bye-laws, and regulations submitted by that board for the approval of the governor in council. I have the honor to be, Sir, Your obedient servant, (Signed,) SAML. RENNALLS, Clerk to the Council. T. J. Brown, Esquire, Secretary to tke Central Board of Health, Kingston. Appendix- APPENDIX D, No. 2. Jamaica, In Privy Council, 1.3th August, 1851. May it please your excellency, The committee to whom were referred the rules, bye-laws, and regulations, drawn up by the “Central Board of Health,” under the provisions of the act of this island, fourteenth Victoria, chapter sixty, and submitted for the approval of your excellency in council, Report—That they have accordingly considered to what extent, and in what form these rules and regu- lations could be best carried out, by omitting those that, in the opinion of the committee, are unnecessary or altogether objectionable, or by adding to or alter- ing them in such a shape that they should be, as much as possible, conformable to the provisions of the law under which they are to be promulgated. In the first instance, your committee have to ob- serve that these rules, bye-laws, and regulations, if sanctioned in their present state, would extend be- yond the meaning and scope of the fifth section of the said act, fourteenth Victoria, chapter sixty, un- der which they are professedly drawn up, as they, ge- nerally speaking, are not limited in their operation to “ the case of any of the districts of this island which shall appear to be threatened, or shall already be threatened, with any epidemic or contagious dis- ease,” but they are offered for your excellency's ap- proval in council as rules and regulations to be adopted for the island, whether cholera or any other epidemic disease may prevail in a particular district, or in such and every parish of the island, or not. In the second place your committee perceive that Appendix. some of these bye-laws are already provided for un- der existing laws of this island, more particularly un- der the seventh Victoria, chapter fourteen, for the maintenance of good order in towns and communities; therefore, in the opinion of the committee, those laws, if vigorously carried out by the proper authorities, would be more effective than any repetition of such ■enactments in the rules, bye-laws, and regulations, under present consideration. The rule providing “ that persons acting under the authority of the said Central Board shall not be liable to any prosecution for any alleged injuries to pro- perty, arising from the enforcement of any or either of the above bye-laws, rules, and regulations, &c.” your committee have thought proper to strike out entirely; and they have annexed to this report, the rules submitted by the Central Board of Health, and those that they are of opinion should be issued wholly, as drawn up by that Board, or with such alterations as the committee deemed it advisable to make to them ; and the committee recommend that in the promulgation of them, it should be distinctly stated that they are to be in force in those districts now visited or threatened with epidemic disease. The committee, in recommending the rules thus drawn up to the consideration of your excellency and the Board, must observe, that however desirable it may be that most, if not all of these rules, should, at an early period, receive the sanction oflegislative en- actment, there at present exists no law under which these rules can be enforced, except in districts already tainted by contagious disease, or threatened there- with ; they can therefore be only recommended for general adoption, under the expectation that expe- rience of their practical utility may induce the legis- lature to make them subject matter of a precise law to be enforced by penalties for disobedience of them, and proper to be more generally extended. (Signed,) DOWELL O’REILLY. (Signed,) EDWARD PAIS TON. Appendix. Mules and regulations approved of by the governor and privy council for districts of the island threatened or injected with epidemic or contagious disease. 1. All rubbish, filth, or refuse of any kind, likely to be injurious to public health, shall be immediately removed, by the parties depositing the same from dwellings, and their immediate neighbourhood, to such place or places as the justices of the peace, in quarter or special sessions assembled, may, from time to time, appoint for such purpose. 2. All rank vegetation close to, or any thing that obstructs the free ventilation of air around dwellings, shall be cut down and removed ; due consideration being had for trees planted for ornament and shade. 3. All dung and other refuse of stables shall be re- moved daily to a place or places appointed by the said justices of the peace, and shall be there deposited and got rid of by burning or otherwise. 4. All foul stagnant ditches, pools, gutters, or drains, shall be covered and filled up, or shall be drained, and all accumulations of privy soil, or other offensive decaying matter near to human dwellings, and which cannot be easily removed or destroyed, shall be co- vered with a layer of earth or lime. 5. The proprietor or occupier of any house or houses, not provided with such conveniences, shall construct and provide suitable privy or privies for the accommodation of the inhabitants of such house or houses, due regard being had to the health and com- fort of the neighbourhood. 6. All houses which shall be pronounced filthy or unwholesome by any officer or officers acting under the instructions of the Central Board of Health, or wherein a case or cases of cholera, or other epidemic disease shall have occurred, and which shall not have been inhabited since, or where no means of cleansing shall have been employed, shall be cleansed and pu- rified by lime-washing, and such other means as the said Board may direct. 36 Appendix. 7. That an officer or officers, to be appointed by the justices of the peace in special sessions assembled, and acting under their authority in any place or places where the cholera, or any other epidemic shall threat- en, or shall actually exist, shall have power to enter and inspect all or any dwellings or other buildings, and all or any courts or premises around such dwell- ings or other buildings which shall be suspected of being in an unwholesome condition, and shall require the owner or occupier thereof, or any person having the custody and care of such building, to remove or correct, within a reasonable period of time to be by the said justices specified, all existing nuisances as shall be declared by the Central Board of Health to be injurious to health, whether by rendering the at- mosphere impure, or by preventing the free access of air. 8. The said Central Board of Health shall have full power, and they are hereby authorized, to declare the means necessary for the proper ventilation'of any building or buildings used as a dwelling or dwell- ings, and such means shall be used and adopted in any place or places named by the said Board, so that such means of ventilation do not interfere with the rights of persons occupying lands or premises in the immediate neighbourhood of such buildings. 0. The said Central Board shall have full power, and they are hereby authorized, to cause to be pulled down and removed ;T or any dilapidated building or buildings which shall be uninhabited and in a fil- thy and unwholesome condition, unless the same shall be forthwith repaired and purified, as the said Board, or any officer acting under the instructions of the said Board, shall direct. 10. The justices of the peace throughout this is- land, in their respective districts, shall have full pow- er, and they are hereby authorized, when directed by the said Central Board, to hire or procure houses, buildings, or oilier tenements suitable for the pur- pose of being used as places of refuge and retreat for Appendix. 37 such persons as the said local authorities may see fit to remove out of infected houses or districts. II. The said Central Board of Health shall have full power, and they are hereby authorized, to require and enforce the removal of inmates from houses which shall be declared by any duly qualified medi- cal men, or other person acting under the instructions of the said Board, to be unwholesome from over- crowding, or otherwise, to buildings or place of great- er safety. 1*2. The said Central Board of Health shall have full power, and they are hereby authorized, to en- gage any suitable building or buildings, or a room or rooms in any building, for the reception of necessi- tous persons attacked with cholera, or any epidemic disease. 13. The said Central Board of Health shall have full power, and they are hereby authorized, to require the immediate removal and interment of the dead, and to make and issue all rules and regulations for remo- val and mode of sepulture, and to prohibit wakes and other idle congregations of persons in infected districts or places. 14. The said Central Board of Health shall have power, and they are hereby authorized, to institute and establish a system of house visitation in houses or districts threatened or already affected with cho- lera, or other epidemic disease, including a provision for the supply of medical and other assistance, and of medicines and necessaries for the sick, as well as for other sanitary purposes. 15. The said Central Board of Health shall have power, and they are hereby authorized, to require the local boards of health of the several parishes in the island wherein cholera or other epidemic contagious disease exists, to send regularly, and by every post, to the secretary of the said Central Board, a correct statement of the number of persons attacked with cholera or other epidemic disease ; of the number of deaths in each town and district over which such lo- Appendix. cal hoard presides, and containing such other parti- culars as may he required by the said Central Board, in order that the information so obtained may be made public in an official form. Ifi. The public and parochial authorities of this is- land are hereby required to execute the above bye- laws, rules, and regulations, or such of them as the said Central Board shall direct, in all cases where the owners or occupiers of houses and tenements shall, from poverty or other sufficient cause, be unable to carry out the same. 17. The Central Board of Health are hereby au- thorized to call upon the authorities of any parish in the island which shall appear to be threatened, or shall be already affected with any epidenic or conta- gious disease, to carry into effect the existing police and other laws for cleansing and keeping tree from nuisances, and to enforce regulations enacted for that purpose in all towns, and that the said Central Board of Health shall also have power to employ proper persons to see the laws obeyed in those re- spects, when and as occasion may require, and to superintend the execution of any further rules and regulations that may be issued by the said Board under the sanction of his excellency the governor in council. Resolved, That the council, in agreeing to the re- port from the committee to whom were referred the rules, bye-laws, and regulations drawn up by the Central Board of Health, and submitted for the ap- proval of his excellency the governor in council, can- not advise his excellency the governor, in the absence of legislative enactment, to issue rules and regulations for the island generally; the provisions of the four- teenth Victoria, chapter sixty, under which they would be issued, declaring that such rules and regu- lations are to have the force and effect of law in dis- tricts of the island which appear to be threatened or are already affected with any epidemic or other contagious disease. Appendix. 39 Resolved, That the council hereby signify their ap- probation of the rules and regulations submitted by the Central Board of Health, as amended by the committee, as lit to be proclaimed in such districts of the island, as may be declared by the governor, with the advice of the council, to be threatened or infected with any epidemic or contagious disease. It was then Resolved, That it be a recommendation from the privy council to his excellency the governor, to com- municate, by message to the legislature at its meet- ing, a copy of the resolutions passed in council this day, and of the report of the committee now agreed to, and also a copy of the rules and regulations as amended and approved of by the governor and the board this day. Ordered, That the clerk of the council do trans- mit to the Central Board of Health a copy of the re- port of the committee, and of the rules and regula- tions as amended and approved of, and also a copy of the several resolutions passed in council this day. (Signed,) SAML. RENNALLS* Clerk to the Council, Appendix. APPENDIX E, No. 1. QUARANTINE COMMITTEE OF THE CENTRAL BOARD OF HEALTH. The first meeting was held on Thursday, the 5th day of June, 1851, at eleven o’clock, a. m. at the house of Dr. Magrath, Kingston. Present—Dr. Magrath, Dr. Maclean, Dr. Johnston, and Dr. Bowerbank. Dr. Milroy was also present. Dr. Maclean acted as chairman. Dr. Chamberlane attended to give evidence. Examination of Dr. Chamberlane. Question 1. How long have you been health officer of Kingston? Answer. Twenty-four years. Q. 2. Can you state how many vessels have been put into quarantine during the last live years ; or what may be the average number per annum ? A. 1 have not kept any register of the number, but that may be found out by applying to the board of health in Kingston, or to the governor’s secretary, with whom I always communicate on such occasions. Q. 3. Against what diseases is quarantine imposed in the port of Kingston ? A. Small pox, measles, scarlatina, and cholera. Q. 4. At what distance is the quarantine ground or station from the port? A. It is at Green Bay, two miles distant from Port- Royal, and seven miles from Kingston. Q. 5. Is it a safe anchorage ? Is it easily accessi- ble for the conveyance of supplies of food, &c. &c. to the ships ? A. It is a safe anchorage, and easily accessible. Q. 6. When a vessel is in quarantine how does she receive fresh provisions ? A. The captain is directed to keep a boat astern, Appendix. 41 so that supplies may be put into it when they are sent »ff from shore, and water is generally furnished to the essel, when required, by the naval tank. Q. 7, Have you ever known any accident from dorm or other causes to vessels lying in quarantine n Green Bay ? A. Never. Q. 8. Describe the usual mode of procedure with a vessel when quarantine is imposed. May letters be sent on shore at once? May the clothes of those on board be sent on shore to be washed ? A. On the arrival of a vessel at Port--Royal, the health officer goes alongside in his boat, and puts questions to the captain, (or surgeon, if there be one,) and if quarantine is to be imposed, she is directed to proceed at once to Green Bay, and hoist a yellow dag. If it is wished to send letters on shore, they are directed by the health officer to be fumigated with sulphur or sprinkled with vinegar, and to be then put into the ship’s boat astern, from which they may be taken by the people in the bum-boat, when provi- sions are sent off. Letters are not generally landed in the health officer’s boat; occasionally a few single letters are landed by him, but never any packages of letters. The mail bags, after being fumigated, are re- moved at once in the boat of the superintendant of steamers. No clothes, or body linen of any op board are ever permitted, under any circumstances, to be landed from a vessel in quarantine. Q. 9. In the absence of the health officer, may bis duties be performed by another person $ A. Yes, if he is sick or temporarily absent, the officer of the customs may act as his substitute, ac- cording to the quarantine act; but the duty is gene,, rally performed by a medical man in such cases. Q. 10. Is there any rule of quarantine instructions or regulations ? Did you receive any upon your appointment as health officer ? A. I am not aware of any such code, I never re, peiyed any. I make my reports to the board of 42 Appendix. health in Kingston, and receive directions from them or from the governor. Q. 11. Is there any fixed or defined period of de- tention for particular diseases ? By whom is this period determined ? A. The period of detention is named by the board of health in Kingston, in each particular instance. The board of health communicates with the gover- nor and council, with whom rest the decision and responsibility. Q. 12. Are yon aware whether the recommenda- tions of the hoard of health, have always been fol- lowed by the governor and council ? A. Not upon all occasions, 1 believe. Q. 13. Are you aware whether any regular record of the proceedings of the board of health has been kept A. Of late I am not aware. 1 have always address- ed my communications to the board. Formerly a re- cord was kept—when Dr. Bancroft was president. Q. 14. Please to state the periods of detention which have generally been imposed for particular diseases ? (a) Small Pox.—Nineteen to twenty-one days, counted from the date of the last death, or of the con- valescence of the last case. (b) Measles.—From sixteen to twenty-one days, to be counted in the like manner. On the last occa- sion which occurred nine days only were imposed. (c) Scarlatina.—I do not recollect any instance of a vessel being put into quarantine for this disease. (d) Cholera.—An order was issued by the governor and council last October, requiring that ail vessels from a port suspected to have cholera should not receive pratique until five clear days had elapsed since leaving the suspected port, and provided no case or the disease had occurred on board ; under the latter circumstance the vessel was to be detained un- til the governor’s pleasure was ascertained. Q. 15, Has the duration of quarantine, imposed for Appendix. 43 particular diseases, as was mentioned by you, been always the same during your acting as health officer? A. No; during the last three or four years there has been a curtailment of the quarantine formerly im- posed. 1 have known, in former years, vessels com- ing from America, or parts suspected to have cholera, to be detained for fourteen days in quarantine. Q. 16. If any person or persons be sick on board a vessel on her arrival, and there be no surgeon on board, how is medical attendance obtained while the vessel is in quarantine d A. No arrangement has ever been made for such attendance. From motives of humanity 1 have sent medicines off to the ship without however going on board to see the sick persons, but it is no point of mv duty to do so. All my assistants have done so 111 vewise, and looked at the parties on board. Q. 17. Has there ever been a lazaretto or any place provided where the sick or the healthy may be landed while quarantine continues d A. Never. On one occasion, about six years ago, the bishop of Jamaica, and the other passengers on board the same vessel, performed their quarantine at “ Apostles’ Battery.'1 A case of small pox had occur- red on the voyage from Nassau, N. P. but there was no sickness on arrival. Q. 18. Have you ever known an instance where the health officer, or any one acting in his stead, has gone on board a vessel and then returned on shore while tiie vessel was put into quarantined A. No; but 1 heard that a mistake of that kind did occur on one occasion at Port-Royal. Q. 19. Have you known instances where persons have died on board vessels in quarantine without having been seen by any medical man, or received medical assistance ? A. Yes, l have; the death occurred from confluent small pox. The schooner came into harbour with the disease on board from the opposite coast. 1 secured the parties and placed the vessel in quarantine. 44 Appendix, Q. *20. What penalties are attached to the violation of quarantine 1 A. The quarantine act determines the amount of the penalties ; they are very heavy. Q. 21. Have they ever, to your knowledge, been imposed ? A. 1 do not recollect an instance. Q. 22. Have you known instances of persons going on board vessels before the visit of the health offi- cer ? A. Yes, and I reported them to the authorities ; and measures were adopted to prevent a recurrence of such conduct, particularly by the naval authorities on the station. Q. 23. Was there any penalty or punishment in that case ? A. 1 believe not. In one instance they escaped off the island, Q. 24. Are any measures taken, or are there any means provided, to prevent ships in quarantine hav- ing communication with the shore ? A. Not any ; but the commanders or masters are held responsible for the due performance of qua- lantine. Droghers trading. O CD Q. 25. Are all vessels entering the harbour requir- ed, without exception, to be visited by the health officer 1 A. Some are exempt.; all coasting vessels (drogh- ers) bearing the island flag are not subject to the visitation of the health officer; they are exempt by law* Q. 26. Do these vessels (droghers) ever trade to any other port except those of the island ? A. i have heard that they sometimes go to Cuba and St. Domingo ; I do not know it as a fact—they never apply fora certificate, as other vessels, to en- ter at the customs. JSo vessels can enter at the Customs without produ- Appendix. cing the health office!3s certificate ofe-i lieving that the disease was imported on that eion ? A ppeudi.v. A. No, there were not; at least it was not trace- able. Q. 52. Were the cases of scarlatina which you have seen in other years, and which were sporadic, ever traceable to importation ? A. No, they were not, as far as 1 could discover ox learn. Q. 53. You have already said that you never saw an instance of scarlet fever on board a vessel ar- riving in this harbour? A. I never have, to the best of my recollection. Q. 54. During your residence in Jamaica have you often met with measles ? A. Y es ; frequently. Q. 55. Has it ever prevailed as an epidemic ? If so, in what year? A. it occurred as an epidemic in 1821, and then proved very fatal. I mention this year from memory, Q. 56. Had you reason to believe that upon all or any occasions in which you have seen cases of mea - sles the disease was imported ? A. I do not know that the epidemic of I82i was imported, but I may mention that a few years ago a good many cases of measles occurred at Up-Park Camp among the children and soldiers of one of the black regiments which had recently arrived from Nassau, N. P. where the disease was prevailing at the time of their departure. The disease, upon that oc- casion, did not spread to the town, preventive mea- sures having been taken by the medical officers at the time, and with whom i held a conference o/i the subject. U- 57. Have you known instances of measles on board a vessel when she arrived here 1 A. A few ; a recent instance occurred with II. I, S. “ Alban.5' Q,. 58. What length of quarantine was imposed on the “ Alban ?” A. 1 think it was ten or twelve days from thp dm a nf the convalescence of the last case. ua 50 A ppendix. Q. 59. During your residence in Jamaica have yott seen many cases of small pox ! A. Yes, a good many ; it was, during slavery, a common and fatal disease here. Q. 60. Has it ever prevailed as an epidemic during that time ? A. Yes, there was a severe epidemic in 1831 ; it proved very fatal to children as well as adults. Q. 61. Can you state where the first case in that epidemic occurred, and whether the case was, in any measure, traceable to importation ? A. The first case occurred in Water lane, in King- ston. I am not aware that it could be traced to im- portation by any vessel. Q. 62. Is there any published account of that epi- demic 1 A. Yes; a paper by Dr. Paul appeared in the Ja- maica Physical Journal. Q. 63. What does Dr. Paul state respecting the history of the appearance of the epidemic ? A. The following is an extract from his paper :— “This island is, perhaps, as free from epidemics as any other part of the world, still they do steal amongst us, and notwithstanding all the guardianship of health officers appointed to the different ports and harbours, the transmission of disease escapes their penetration, and the worst species, at various times, rage throughout our population.” “ About the 20th March, 1831, it was discovered that a child in Water lane had a quantity of pustules over its body, face, and limbs, which, after examination by several medical gentlemen, was pronounced to be small pox ; unfortunately, however, two or three chil- dren had already caught the infection, and although orders were given to admit no one into the house where the child was, yet, anxiety to see a disease that had not appeared since, I believe, 1812 or 1816, caused many imprudent persons to visit, and a little time only elapsed ere cases were observed in all parts of the town.” Appendix. 51 “ I shall not here enter into the speculations ad- vanced as to how or in what manner the disease came into Kingston; suffice it to say that it had been rag- ing for some months before at Nassau, N. P. be- tween which place and this city were frequent com- munications, and 1 do not think the authorities, on the occasion, were at all so careful as they ought to have been.” Q. 64. What is your own opinion as to the deve- lopement of the epidemic in 1831 ; could it be traced to importation? A. 1 took all possible pains to discover the origin of the disease, but my enquiries upon that occasion proved fruitless. It might, however, have been im- ported ; Dr. Paul insinuates it was. Q. do. Do you remember whether any vessel or ves- sels were put into quarantine upon that occasion in the harbour here, upon suspicion that they had brought the disease \f A. I do not think that any vessels were then put into quarantine. I may mention that it has been known that persons have sometimes been landed from vessels outside upon the palisades, and have made their way to Kingston with small pox on them. A case of this sort occurred about twenty-four years ago, the vessel was the schooner Montague, from Li- verpool. The man was apprehended, and the spread of the disease prevented, Q. dd. Have you seen or heard of cases of small pox in Kingston since the epidemic in 1831 ? A. Yes ; several occurred in the town in 1840. Q. 67. Were these cases in 1840 traceable to im- portation “? A. I do not recollect that they were. Q. 68. Did the disease spread much in Kingston on that occasion ? A. It did not; prompt measures were adopted by the mayor to segregate and to seclude the infected, and to prevent all communication with them. Q. 6.0, Have you known many instances of vessels Appendix. arriving with cases of small pox on board at the time* or in which cases have occurred during the voyage ? A. Very many on board vessels from all parts, as England, America, the Spanish Main, and theWind- ward islands. They have all, in turn, been subjected to quarantine. Q. 70. What is the greatest number of cases which you have ever known to occur on board any one vessel % A. Three or four. Q. 71. INot more than three or four on board any emigrant ship ? A. The number of cases certainly never exceeded six or eight, if there were ever so many. Q. 72. Is the occurrence of single cases of small pox on board of ships not unfrequent, the rest of the crew and passengers remaining unaffected ? A. It is by no means unfrequent. I may here mention the “ Brandon,” with emigrants, which ar- rived here a few days ago, as an instance, Q.. 73. Are you aware whether, in some of the in- stances of emigration vessels having two or three cases of small pox on board, there were several per- sons on board unvaccinated % A. I am not quite prepared to give a definite an- swer. In the recent case of the “ Brandon,” there were a good many emigrants onboard unvaccinated who did not catch the disease. There were two hun- dred and forty-nine African emigrants and twenty* eight of a crew. These cases of small pox occurred during the voyage from Sierra Leone, two were fatal, One recovered. The two fatal cases occurred in un- Vaccinated persons ; the patient who recovered, had been vaccinated. Q 74. What length of quarantine was imposed on the ship “ Brandon V A. As seven days had elapsed from the date of the 'death of the last case upon her arrival ; she was kept in quarantine twelve days before she was allowed to have aii.v 'communication with the shore* Appendix. Q. 75. Did all on board remain healthy? A. Yes, up to the 31st ultimo, when she sailed for the northside of the island. Q. 76. Are you aware of the practice at the island of .St. Thomas, when a vessel arrives which has had a case of small pox on board during the voyage, but which is healthy on arrival? A 1 am not aware. Q. 77. Do you know whether St. Thomas ever suf- fered from epidemic small pox ? A. 1 do not know. Q. 78. is varicella of frequent occurrence in Ja- maica A. Yes, it is. Q. 79. Do you regard it to be communicable? A. Yes ; i think it is. Q. 80. Does it, do you think, occur spontaneously, or has it been ever traceable to importation ? A. it certainly occurs quite spontaneously, and like small pox, seems to depend upon a specific con- tagion. Q. 81. In your opinion, is there any affinity or al- liance between varicella and variola % A. I do not know of any ; but authors seem to think so. Q. 82. Can you alledge any reason why small pox should not appear spontaneously, i. e. independently of communication with persons already infected, as well as chicken pox ? A. I see none whatever; but like varicella, mea- sles, &c. seems to depend upon a specific contagion. Q. 88. Does hooping cough ever occur in Jamaica? A. Very rarely. Q. 84. You regard it as infectious ? A. It is considered to be by some. Q. 85. Would you impose quarantine for it1? A. Certainly not; I never heard of its prevailing at sea. Q. 86. Are you of opinion that erysipelas is ever infectious ? 54 Appendix. A. Yes ; f am disposed to think it is under certain circumstances, or condition of insalubrity. Q. 87. Is dysentery also liable to become infec- tious '? A. Yes, dysentery also. Q, 88. Would you recommend that quarantine be imposed in cases of infectious erysipelas and dy- sentery ? A. Y es, if there were numerous cases of the dis- ease on board a vessel, but not otherwise, and ij it did not put on that character. Q. 89. During your service as health officer, has quarantine ever been imposed for yellow fever ? A. No, l do not recollect such an occcurrence. I never did. Q. 90. Have many vessels with yellow fever on board arrived during that time 1 A. Yes, a great many. Q. 91. You therefore permit yellow fever patients to be landed at once, and the rest on board to be ad- mitted to pratique without any delay ( A. Yes ; 1 have always done so ; yellow fever pa- tients are continually being landed at Kingston, and likewise dysentery cases, particularly out of the steamers from Cbagres and the United States. Q. 92. Have you ever, during your residence in Ja- maica, seen an instance that yellow fever appeared to be communicated from the sick to the healthy ?■ A. Yes ; 1 think that I once have; the occasion was a great many years ago, (1807,) before l was health officer. 1 have seen no such case of more re- cent years. On that occasion I allude to, it assumed a typhoid type and was very fatal to the crew. Q. 93. Was it not once the practice here, and in some of the other West India islands, to impose qua- rantine for yellow fever? A. Yes, it was, 1 believe. I believe it was done so here also; not in my time as health officer. Q. 94. Have you ever heard of a British ship of War being refused pratique in consequence of having Appendix* 55 yellow fever on board in one of the British West In- dia islands and receiving it at once in a foreign one 1 A. Yes, I have ; the case occurred, I believe, with the ship ; the island where she received pra- tique was St. Thomas’, but I have no personal know- ledge of the facts. Q. 95. Did you consider the epidemic disease, known by the name of the dandy fever, which pre- vailed here and in other West India islands, as infec- tions 1 A. I did not, but many medical men did, as they do cholera, &c. Q. 98. Have you seen any other epidemic diseases in Jamaica besides those already mentioned ? A, Yes ; I have seen influenza, and also epidemic dysentery, and erysipelas. Q. 97. Was either of these diseases, in your opi- nion, ever introduced by shipping ? A. No ; I could not discover that they were, but others thought that they Were; particularly small pox and cholera. It has generally produced a difficult and futile task to trace these diseases to importa- tion ; in some instances I did succeed, and they are related in this examination. Q. 98. It appears, therefore, from your evidence, Dr. Chamberlane, that three great and fatal epide- mics, viz.:—small pox, in 1831; scarlatina, in 1841 ; and cholera, in 1850; not to mention any of yellow fever, for the prevention of which quarantine has not been imposed, had occurred in Jamaica while you have been health officer, and that upon none of these occasions could the disease be traced to importation, notwithstanding every pains were taken to discover the origin of the epidemic. Is such your opinion 1 A. Yes; it is most certainly, to the best of my judg- ment and enquiry; small pox might have been. I have my doubts with reference to cholera and scarla- tina. Nevertheless, it is supposed that cholera was introduced bv vessels from Chagres, Appendix. Q. 99. Have you ever witnessed a ease where you were satisfied that any disease was conveyed from a vessel to the shore by letters, or by any description of Jomiles, under w hich term the cargoes of vessels, as w ell as body clothes, are included ? A. JNo, I never have ; but the introduction of cho- lera, at Port-Poyal, was falsely ascribed to the latter cause. 1 mean foul linen. Q. 100. Clause three of the existing quarantine act intimates that some merchandize and goods are more liable to retain and carry infection than others ; w hat is your opinion ? A. My last answer is a reply to this question ; some think otherwise, that cotton and woollen stuffs possess such properties. Q. 101. In your opinion, is the dead body more, or is it less liable to convey and diffuse an infectious disease, than the living one ? A. Yes ; 1 am inclined to think that it is less so ; such fears never operated with me during the recent visitation, but this is adverse to the general opinion. Q. 102. Do you consider the medical attendant of a patient, labouring under an infectious disease, apt to convey the malady to his other patients % A. Yes ; under some circumstances l think he may do so, as in small pox, for instance, or scarlatina. Q. 103. Have you met with such instances in your own practice? A. 1 have. Q. 104. Frequently, or occasionally l A. Occasionally, and that rarely. Q. 105. Would you, under any circumstances, deem it necessary that any sort of restriction be imposed on a medical man on shore, while he attends cases of infectious diseases, with the view of preventing its spread ? A. Certainly not; I never heard of such a course being pursued, but nevertheless, I am of opinion be may become the medium of infection, as 1 have stated under certain circumstances. Q. 106. What measures should you adopt to pre- vent the spread of an infectious disease on shore i A. I should advise that the sick be separated from the healthy, and that all sanitary precautions, in the way of cleanliness and free ventilation, be enforced. Q. 107. Would you advise that any of the healthy or unattached inmates of the house, where the dis- ease occurred, be put in quarantine or under any re- striction ? A. No, I should not. Segregation and temporary isolation, and the strict observance of sanitary mea- sures, would preclude such a necessity, but much depends upon the nature of the disease, and the num- ber of persons infected, &c. Q. 108. Are you aware that single or sporadic cases of the plague are continually occurring every year in coherent parts of Egypt, just as in the case with cholera in the East Indies, and yellow fever in the West Indies, but that epidemics of the disease occur only occasionally and after the interval of seve- ral years ? A. Yes, i am. Cholera never appeared nor travel- led to these shores till last year; an extraordinary year it was in reference to atmospheric phenomena ; some great epidemic was anticipated by many, and preparations made accordingly. Yellow fever is ab- sent sometimes for several years, except a sporadic case or two. Nine or ten years ago it made awful ra- vages amongst the military and naval forces here. U. 109. How do you account for such phenomena, in reference to plague, yellow fever, and cholera ? A. By the peculiarities of season, and the exist- ence of certain atmospheric influences. This is the ordinary occurrence in all parts of the world. Q. 110. Then these diseases shew no tendency to spread or become epidemic in some years, although no restrictive measures are adopted, while they do in others. A. Yres ; it is so. Q. ill. Do you consider that the atmospheric pe- Appendix. 57 58 Appendix. culiarities to which you have just alluded, are neces- sary accompaniments or precursor to the spreading of all diseases w hich are every now and then liable to prevail epidemically—small pox and the other ex- anthemata, as well as the plague, yellow fever, and cholera '? A. Yes, I do ; and I would give the late awful vi- sitation as an instance worthy of record. Previous to the outbreak, numerous cases of intermittent fever, dysentery, and diarrhoea prevailed in the district of Kingston, under my charge. Jt is an unhealthy dis- trict, surrounded by grave yards, &c. &c and is in- habited chiefly by paupers of the lower orders. Q. 112. Do you consider that, quarantine, as it is at present pra< ticed in Jamaica, is a safeguard, or affords much protection to the public health ? A. No ; it is not now a sufficient safeguard as it is carried out, but it might be rendered otherwise, very easily too, and the public health better protected. Q. 113. Is it a source of much inconvenience and distress, as well as of expence to the shipping ? .. A. Yes; it is, I believe. No class of persons are disposed to submit, under any circumstances, to re- strictions on their liberty. Q,. 114. What changes or modifications in the ex- isting practice of quarantine here would you recom- mend ? A. In the first place I should recommend that the health officer should go on board instead of merely going alongside of each vessel, and fully ascertain the actual condition of those on board, and also of the vessel itself, preparatory to the adoption of such pre- cautionary measures as he may require to be carried into effect. Q . 115. In the event of any person or persons be- ing confined to bed by sickness in the between decks, would you recommend that the health officer should go below and see them, if there was no medical man on board A. Yes, 1 would ; I have done so in some instances Appendix. with American steamers when dysentery and inter- mittent fevers prevailed, and I have caused the dead to be removed from them and buried on shore. Q. 116. Do you consider it necessary that letters should be fumigated before being landed ? A. 1 do not; the present practice might be discon- tinued with perfect safety, under certain restrictions. Q. 1 17. Would you permit the body clothes of those on board a vessel in quarantine to be sent ashore to be washed? A. 1 see no objections, provided they were first immersed in boiling or in sea water. Q. l 16. Against what diseases do you consider that quarantine is necessary ? A. Against small pox, measles, and scarlatina ; also whenever there were very many cases of yellow fever, erysipelas, and dysentery on board, if these diseases appeared to have assumed an infectious cha- racter, as 1 have known them to do. Q. ! 19. What measures should, in your opinion, he adopted in the event of a vessel having any of the diseases now enumerated on board? A. 1 would recommend that all on board, the sick as well as the healthy, be removed out of the ship and landed in a lazaretto, or place of security, keeping the sick and healthy apart from each other, while the vessel should he fumigated and cleansed. We have no lazaretto, but Fort Augusta was recently convert- ed into one for the service of the emigrant ship. Q. 120. Do you think that the healthy and unat- tacked should be kept in quarantine as well as the sick ? A. In some cases 1 am of opinion that they should, for some days at least Q. 121. Supposing that a vessel arrived, having had, during the voyage, one or two cases of small pox on hoard, but that ail, upon arrival, were quite healthy, what duration of quarantine, or segregation, in a place of detention, would you recommend ? A. i should require fourteen days to have elapsed 60 Appendix. since the date of the last death, or the convalescence of the last case, before I would permit any on board to have “ pratique.” L think this the minimum re- striction in such cases. I speak from facts. Q. 122. If one or two cases of measles, or scarla- tina had occurred under the like circumstances, what detention would you impose? A. As in the case of small pox, but for a shorter period, viz.: a week or ten days ; measles and scarla- tina are highly infectious, and fatal diseases. Q. 123. In the case of numerous cases of yellow fe- ver, erysipelas, and dysentery being on board a ves- sel on her arrival, what measures should be taken ? A. I should only detain the sick, but I should im- pose no restraint on the unattacked ; segregation would answer all purposes in preventing any mis- chief in such cases, especially if they had not assumed an infectious tendency. Q. 124. If all the crew and others on board a ves- sel to be put into quarantine, were removed out other, do yon think that the cargo might he landed at once without any danger to the public health ? A. As I have never seen or known of an authentic case of any infectious disease being conveyed by any description of merchandize or goods, (excepting per- haps foul vapor lino :, in certain in actions diseases,) I do not see any good reason why the cargo might not be landed at once. Q. 123. Do you consider that vessels might, with safety, be allowed to come up at once to the port of Kingston and be boarded by the health officer there in place of being detained at Port-Royal for that pur- pose ? A. Yes, f do ; at the wharf or wharves at the west end of Kingston, I think Rat a better and more rigid mode of examination could be carried on, and the public more effectually secured against the introduc- tion of all, or any contagious or infectious diseases, than the course now adopted. I can see no danger from such a course being pursued. I have sent a Appendix. 61 vessel from that direction or station into quarantine, having a case of small pox on board while lying in the stream, just as it broke out, and prevented the spread of the disease. Q. 126. Might ships of war, on their arrival at Port- Royal, be permitted, do you think, to carry out pre- cautionary measures against the introduction of dis- ease under the direction of the principal medical officer of the royal naval hospital ? A. I am of opinion that quarantine regulations may be safely carried out by such authorities in their own department. I may mention that prior to 1830, ships of war were not subject to supervision of the health officer, or to the quarantine regulations affect- ing other vessels, but the legislature deemed it ne- cessary to include them afterwards. Q. 127. Are you aware, whether before 1830, when ships of war were first brought under the operation of the quarantine laws, they were ever suspected of having introduced an epidemic infectious disease into Jamaica . A. I am not aware that they ever were. I have no instances to relate. They were in 1840 included and placed under the supervision of the health officer, like other craft, perhaps upon suspicion. 1 may state that after the appearance of chol-ta in England, in 1831 and 1832, the board of health established here, by Lord Bel more and his council, directed all ves- sels to be visited by the health officer. Q. 128. Have you read the report of the French academy of medicine on quarantine, and the plague in 1846 ? A. No ; I have seen extracts from it. Q, 129 Have you read the report of the general board of health on quarantine ? A. Yes ; I have read portions of it. Q. 130. Do you concur with the general conclu- sions of that report ? A. Answer above. No. 62 Appendix. Q. 131. Are you aware that formal quarantine is virtually abolished in England ? A. I have heard so, under the free trade laws and regulations, and l look upon it as rather unsafe, and a dangerous experiment in some cases. I mean the substitution oi" sanitary measures alone for quarantine restrictions, as recommended by the general board of health of England. Additional Queries. Q. 1. What restrictions would you recommend on the sending of letters ashore ? A. In case small pox or oilier infectious disease appeared on board at or near the end of the voyage, the mail bags ought to be I reely exposed to the air for sometime before being landed or fumigated. Q. *2. How would you determine on, from what ex- act period of a case would you date convalescence from small pox, measles, and scarlatina i? A. In reference to measles and scarlatina I should date from two to three days after the completion of the desquamation of the cuticle ; in case of small pox perhaps later. Q. 3. At what period of an exanthematous fever do you regard the activity of the morbific poison, or the risk of infection to be greatest? A. In measles, after the eruption has appeared, or is fully established, but particularly during the pro- cess of desquamation. In scarlatina, at the commencement of the process of desquamation in particular, and perhaps shortly after the commencement of the efflorescence. In small pox, soon after the maturation of the pus- tules has commenced, and during the process of des- quamation also. I allude to the ordinary forms of these. Q. 4. Would you require the same period of deten- tion in quarantine for vaccinated, as for unvacci- Appendix. 63 nated persons who happened to he on board a ves- sel in which one or two cases of small pox had oc- curred during a voyage, but which was free from dis- ease upon her arrival 1 A. Mo ; 1 consider that one half the period would be sufficient for vaccinated persons under such cir- cumstances, and therefore that only seven days should be required in their case to have elapsed since the death or convalescence of the last case. Q. 5. Do you consider that if ail on board of a ship which was put into quarantine in consequence of a case or two of small pox having been on board were vaccinated immediately upon arrival, the period of detention might, with safety, be abridged l A. Yes, i think it might; nevertheless it must not be forgotten that one vaccinated emigrant on board the “ Brandon” took the disease, but recovered. Q. 0. Have you ever heard that cases of small pox have occurred on board any of the royal mail steamers during the voyage from England to Jamaica ? If so, were they put into quarantine ? ' A. 1 have been quite recently informed by Dr. Maclean, the chairman, that a single case of small pox occurred in the “ Medway,” in November, 1849.— The man, one of the crew, sickened after leaving Ma- deira. When they reached Barbadoes lie was conva- lescing. The vessel was put and kept in quarantine during the three days she remained there, and the patient was put on board a schooner for the purpose of completing his quarantine. A sort of sentry box on the deck, in which lie had been kept apart from the rest of the crew, was thrown overboard. The “ Med- way” proceeded on to St. Thomas, where she was at once admitted to pratique. As she was leaving Barbadoes, they saw some fishermen hauling the sen- try box ashore and landing it. The “ Medway” ar- rived at Jamaica six days after leaving Barbadoes, and was at once admitted to pratique, having a dean bill of health from St. Thomas, and all on board having Appendix. continued quite healthy. Dr.Milroy has also inform- ed me that a single case of small pox occurred on board the “Severn,” during his voyage out in Ja- nuary last. The man, one of the crew, was conva- lescent when they reached St. Thomas, and the ves- sel was, in consequence of this, and of no other case having occurred on board, admitted to pratique at once. Dr. Milroy and the other passengers for Ja- maica were transferred to another steamer, the “ Great Western,” which brought a clean bill of health from St. Thomas, and consequently received “ pratique” on arrival at PortRoyal. I had not heard of these cases until the other day. (Signed,) 11. CHAMBERLANE, M.D. Examination of Dr. Walslie, R.A. before the quaran- tine committee of the Central Hoard of Health, 5t/i June, 1851. Question 1. How long have you acted as deputy health officer at Port-Royal'? Answer, Two years and a half. Q. 2. In your absence the health officer’s visit may be performed by an officer of the customs ? A. Yes, it may ; it is permitted by the quarantine act. Q. 3. Have you ever heard that vessels have had communication with the shore before the visit of the health officer, or after quarantine had been imposed ? A. I have known instances of persons going on board vessels before I had visited. They were re- ported upon. Q. 4. Was any penalty inflicted on the offenders ? A. I believe not. Q. 5. Are there any means of preventing communi- cation between vessels in quarantine and the shore at night 1 A. None whatever. Q. 6. In your opinion does the existing system or Appendix. practice of quarantine afford a safe guard or protec- tion against the introduction of infectious or conta- gious diseases ? A. 1 think not, in its present state. Q. 7. Is it the source of much inconvenience and distress, as well as of great expence to the shipping*? A. Y es, decidedly. Q. 8. What changes or modifications should you recommend in the present system or practice of qua- rantine ? A. There should he a lazaretto for the reception of suspected as well as of sick persons; they should he separated one from the other. Q. f). Do you consider that the public health would he endangered if the health officer were to go on hoard and inspect a vessel on her arrival, and also those on hoard, instead of merely going alongside as at present ? A. Yes, I do, if there were any infectious disease on board. Q. 10. You were at Port-Royal when the earliest cases cf Asiatic cholera occurred there; had you any reason to believe that the disease was introduced by any vessel ? A. No, I have no,. Q. 11. Supposing a vessel arriving, having recent- ly had one or two cases of small pox on board during the voyage, but with all quite healthy after arrival, do you consider that the vessel should he put into quarantine ; and, if so, for what length of time ? A. i am not prepared to give a decided opinion upon this question. Q. 12. Have you ever known of persons dying on hoard of vessels in quarantine, and without any me- dical attendance ? A. Yes, 1 have; and of small pox. Q. 13. Y ou are acquainted with the circumstances, of H. M. S. Alban being put into quarantine for ten days, a few months ago, in consequence of two cases iif measles having occurred on board during the 66 Appendix. voyage from— to Jamaica, although the children were declared to be convalescent upon ar- rival, and all others on board had been and were perfectly healthy ; do you consider that such de- tention was necessary. A. Yes, 1 do. Q. 14. Is quarantine ever imposed at Port-Royal for cases of any sort of fever, continued or periodic, having occurred during the voyage, or being on board at the time of arrival V A. No, 1 believe never. Q. 15. Have you known of any instance of a ves- sel arriving with the corpse of a patient who had died on board from fever; if so, was quarantine im- posed ? A. Yes, 1 have; no quarantine was imposed. Q. 16. “The order of the governor, dated 28th October, 1850, contains the following instructions That if there be any “ body on board who is ill of ma- lignant cholera, or of any other disease which either yourself or other medical men regard as infectious or contagious, or if any person has died on the passage of any such disease, or if the clothes of any person who lias so died are on board, or if the vessel has ar- rived after a passage of less than five days from any part where you ascertain that any such disease pre- vailed at the time of the departure of the vessel, then, and in every such case, you insist upon the vessels stopping and casting anchor if necessary, and re- fraining from all communication with the shore, until you shall have reported the case and circumstances to the actual president of the board of health, at Kingston, and to the governor or officer administer- ing the government of the island, and until further directions .are given by competent authority.” The order then proceeds to state, “ you may consider these instructions for the present, as applicable indis- criminately to all vessels of any description, except her majesty s ships of rear, or other vessels of the royal navy” Do you consider that these instructions au- Appendix. 67 thorized you not to detain or put into quarantine ships of war, if they had had a case or cases of cho- lera or other infectious disease on board, or if cases of such diseases had occurred during the voyage? A. Yes, I do. Q. 17. Do you consider that the public health would be endangered if ships of war, at Fort-Royal, were left to carry out precautionary and preventive measures under the direction of the medical officers of the royal naval hospital ? A. In my opinion, all vessels of war should be subjected to the same regulations and restrictions which are imposed on merchant vessels. Please to add any remarks illustrative of the ope- ration and psactice of quarantine in this port, or sug- gestive of any modification which you would recom- mend to be adopted and which you think it right that the Central Board of Health should be made ac- quainted with. Examination of captain Cooper, II. N. harbour master of the port of Kingston, before the quarantine com- mittee, bth June, 1851. Question. 1. How long have you been harbour master of the port of Kingston '? Answer. Six years. Q. 2. Has your attention been drawn to the opera- tion of the quarantine laws on the vessels arriving in the port? A. Yes; on various occasions. Q. 3. Do you consider that the existing system of quarantine, as carried out here, affords a security and safeguard against the introduction of infectious dis- eases by vessels arriving ? A. No ; 1 do not. Q. 4. Can you inform the committee whether any vessels from Havanna, or other port in Cuba, were Appendix. put into quarantine here during the first nine months of last year A. Not to my knowledge, although there was a monthly communication with Havanna by the royal mail steamers. Q. 5. Are you aware whether vessels from Kingston during.the prevalence of cholera here, were put into quarantine in Cuba, where tiie disease was % A. Yes. Q. 0. Can you inform the committee of the aver- age usual expences to which a vessel is subjected in the ports of Cuba, when she is detained there in quarantine ? A. The following is a list of the charges which ■were imposed on a cutter, the “ Hero,” during qua- rantine for seven days, in the harbour of St. Jago de Cuba :— Interpreter of visits, at 4s. per visit £1 8 0 Doctor, seven visits, at 12s. 4 4 0 One voyage aboard 0 4 0 £5 10 0 The daily expences, at 30s. per day £10 10 0 Q. 7. If it was deemed advisable that vessels should, instead of being visited by the health officer at Port- Royal, be permitted to come up the harbour and be then boarded from the shore, is there convenient an- chorage ground in the stream and within a short dis- fance from the shore where vessels might come to ; and what place would you recommend ? A. There is perfectly good anchorage ground, and vessels might, be anchored three quarters of a mile from the shore, south of the town ; they would then be perfectly clear of all vessels lying in the port of Kingston, by placing a buoy there, and instructions being given to the pilots, to anchor all vessels there until boarded. Appendix. 69 Q. 8. Are there any disadvantages or inconveni- ences attending the present practice of the vessels being visited by the health officer off Port-Royal % A. None; but I do not consider that sufficient time is given to the health officer to make the necessary enquiries and examination, the vessel being under weigh at the time, and frequently two or three vessels entering at the same time. Q. 9. Would it he, in your opinion, a convenience or any saving of expence to the shipping, if such a place were adopted in place of the present practice! A. It would not be a saving, but if it be necessary that quarantine regulations should be strictly carried out, it would be far better than the present plan, and to the best of my judgment, without any additional risk to the public health. Please to add any remarks or observations illustra- tive of the operation of the quarantine laws, with which you think that the Central Board of Health should be acquainted. (Signed,) W. S. COOPER, Harbour Master. 70 Appendix. APPENDIX E, No. 2. Answers of Dr. John McFarlane, to the questions is- sued by the quarantine committee of the Central Hoard of Health. Question I. How long have you acted as health of- ficer at the port of Montego-Bay ? Answer, Since the 15th April last. Q. *2. Do you act as health officer for more than one port; if so, how far distant are they from each other, and from your residence? A. 1 act as health officer for the port of Montego- Bay, and reside in the town. Q. 3. What is the average number of vessels per annum, put into quarantine in the port of Montego- Bay, while you have been health officer ? A. There has been no vessel put into quarantine, since 1 have been health officer. Q. 4. Inmost of the instances where quarantine has been imposed during your service, has it been owing merely to the vessels having arrived from an infected or suspected port, or to their having actual disease on board at the time of arrival ? A. See answer to query No. 3. Q. 5. State as nearly as you can, the number of vessels which have been put into quarantine in your port, during your tenure of office in consequence of actual disease on hoard, and please specify the disease or diseases for which the detention was imposed *? A. See answer to query No. 3. Q. 6. Is any medical attendance given to the sick on board a vessel in quarantine. Have you ever known of a case proving fatal on board ? A. See answer to query No. 3. Q. 7. Please to describe the mode of procedure in ascertaining whether a vessel outside the port is to Appendix. receive pratique, or to be put into quarantine ; does the pilot ascertain this before the visit of the health officer; do you know of an instance or instances where the pilot, boarding a vessel at sea, has taken the crew of his boat on board, and that the crew af- terwards left the vessel and returned on shore leaving the pilot on board to take the vessel into port! A. In general the pilot boards the vessel at sea, but the pilot crew do not board ; they proceed, when within a reasonable distance of the anchorage, for the health officer, who immediately goes alongside and ascertains the state of the health of the vessel, admitting her to pratique or otherwise, according to circumstances. 1 am not aware of any instance where the crew of the pilot boat have boarded a ves- sel and returned on shore, leaving the pilot on board. Q. 8. At what distance from the port is the qua- rantine ground or station; is it a safe anchorage; have yon ever known of accidents from vessels lying there ; are there any means of preventing communi- cation with the shore 1 A. The quarantine ground, (Great River,) is dis- tant about three miles by sea, from Montego-Bay, and seven miles by land, it is considered, by the most competent judges, an anchorage of the best and safest description. I have never known any acci- dents happen to any vessel lying there ; but there are no means of preventing communication with the shore. Q. 9. Have you heard of instances where any vio- lation of the existing quarantine regulations, in your port, have taken place, either in the way of an incor- rect statement, having been given on arrival as to the health of those on hoard during the voyage, or by any communication with the shore during quaran- tine ? A. I am not aware of any violation of the existing quarantine regulations, in either of the ways mention- ed in the query. Q. 10. During your residence at or near to the Appendix. port of Montego-Bay, what epidemic diseases have prevailed in rhe town or surrounding district? Were they distinctly traceable to introduction by ship- ping? A. During my residence in Montego-Bay, yellow fever has thrice prevailed as an epidemic, once in 1842, and the second time in 1848; scarlet fever, once in 1844, and the late visitation of cholera in 1850 and 1851. They have never been traceable to introduction by shipping. Q. 11. In your opinion docs the system of quaran- tine, as it exists at present and is carried out, afford protection to public health ; and is it, do you con- sider, a safeguard against the importation of epi- demic infectious diseases. A. In my opinion the system of quarantine as at present existing, affords a tolerable efficient protec- tion to public health. It is not a perfect safeguard to the importation of epidemic diseases, unless the pilots were prevented from hoarding before ascertaining the existence or non-existence of disease on board, and also having some efficient means of preventing any communication with the shore, m the event of a vessel being put into quarantine. Q. 12. Are there any changes or modification in the present system, which would render it in your opinion, more efficient as a safeguard, or make it less vexatious to shipping, without compromising the public health ! A. The two suggestions made in mv last answer, are the only ones, I at present can make, and these being carried out, would not be at all vexatious to the shipping. Q. 13, Do you consider that the public health would be endangered, if the health officer went on board instead of merely alongside, as at present, eve- ry vessel upon arrival, and ascertained by personal inspection and examination the condition of those on board, and also the state of the vessel itself? A. I do not think it would be prudent, (keeping in view the public health,) for the health officer to board immediately, without first making tiie necessa- ry enquiries as to the state of the ship ; but X think it would be advantageous, after being satisfied as to the state of the vessel, for the health officer to board and examine the passengers, crew, and ship, more especially ; I consider the above necessary as regards emigrant ships. Q. 14. Is there any convenient place on shore to which the sick might be sent for medical attendance, if you deemed it advisable that they should be re- moved out of the ship ? A. None. Q. 15. In the event of a vessel being found to be exceedingly foul, and therefore liable to produce, or to keep up and aggravate sickness, is there any place on shore where the healthy on board the vessel might be conveniently located during the process of cleansing and purifying her ? A. None. Q. 16. Please to add any observations respecting the subject of quarantine, or in any measure illustra- tive of its operation in the island, either for good or evil, which you think it may be useful that the Cen- tral Board of Health should be acquainted with ? A. I have no suggestions or observations further than what 1 have already embodied in the previous answers. Appendix. Answers of Dr. A. C. Stevens to the questions issued by the quarantine committee of the Central Board of Health. Question I. How long have you acted as health of- ficer at the port of Falmouth 1 Answer. Appointed in December, 1848. Q. 2. Do you act as health officer for more than one port; if so, how far distant are they from each Other and from your residence l 74 Appendix,' A. For the port of Falmouth only. Q. 3. What is the average number of vessels, per annum, put into quarantine in the port of Falmouth, while you have been health officer? A. One American brigantine last year put into quarantine, having small pox on board ; and during the existence of cholera several coasting vessels, hav- ing the disease on board, were placed under observa- tion in the harbour. Q. 4. In most of the instances where quarantine has been imposed during your service, has it been owing to the vessels having merely arrived from an infected or suspected port, or to their having actual disease on board at the time of arrival ? A. In consequence of the actual existence of dis- ease on board at the time of arrival. Q. 5. State, as nearly as you can, the number of ves- sels which have been put into quarantine, in your port, during your tenure of office, in consequence of actual disease on board ; and please to specify the disease or diseases for which the detention was im- posed ? A. One American brigantine, and four droghers. The brigantine had one case of small pox on board, and the coasting vessels had cases of cholera, Q. 6. Is any medical attendance given to the sick on board a vessel in quarantine ; have you ever known of a case proving fatal on board ? A. Large vessels are sent to Great River, to lee- ward of Montego-Bay, and are under the observation of the health officer of that port; I knowr of no fatal cases occurring on hoard while in quarantine. Q. 7. Please to describe the mode of procedure in ascertaining whether a vessel outside the port is to receive pratique, or to be put into quarantine. Does the pilot ascertain this before the visit of the health officer ; do you know of an instance or in- stances where the pilot boarding a vessel at sea, has taken the crew of his boat on board, and that the Appendix. crew afterwards left the vessel and returned on shore, leaving the pilot on board to take the vessel into port ? A. Vessels are boarded by the pilot at a distance- from the harbour, who, before he boards, ascertains that no sickness exists, or has existed during the voyage. The vessel, if the replies are satisfactory, is then brought into port, when she is boarded by the health officer and examined. The pilot and his crew are not permitted to leave a vessel till she has been so examined. Q. 8. At what distance from the port is the qua- rantine ground or station ; is it a safe anchorage ; have you ever known of accidents from vessels lying there; are there any means of preventing communi- cation with the shore ? A. Vessels are sent from this port, (Falmouth,') to Great River to perform quarantine, which is about six miles below Montego-Bay. I arn not acquainted with the locality. Q. 9. Have you heard of instances where any vio- lation of the existing quarantine regulations, in your port, has taken place either in the way of an incor- rect statement having been given on arrival, as to the health of those on board during the voyage, or by any communication with the shore during quaran- tine *? A. In the case occurred last year, the captain en- deavoured to conceal the sickness he had on board, and did deceive the pilot, who was sent with the vessel to quarantine, when, inspected by the health officer, the case was discovered. Q. tO. During your residence at or near the port of Falmouth, what epidemic diseases have prevailed in the town or surrounding district; were they dis- tinctly traceable to introduction by shipping? A. I am not aware of any case of disease being in- troduced by the shipping. Q. 11. in your opinion does the system of quaran- tine., as it exists .at present and is carried, out, afford. Appendix. protection to public health; and is it, do you consi- der, a safeguard against the importation of epidemic infectious diseases 1 A. If the present system is carried out properly, I consider it a safeguard to public health ; the dis- ease, the introduction of which we have most to dread, is smallpox, and a proper inspection of the crew of vessels is the only safeguard, as little reliance is to be placed on the master’s reports, Q. 1*2. Are there any changes or modifications in the present system, which would render it, in your opinion, more efficient as a safeguard, or make it less vexations to shipping, without compromising the pub- lic health ? A. 1 am afraid that in some of the small ports of the island, the quarantine regulations are not strictly carried out. I am not aware of any vexatious opera- tion of the quarantine, in regard to the shipping, ex- cept when disease actually exists on board Q. 13. Do you consider that the public health would be endangered, if the health officer went on board, instead of merely alongside, as at present, every ves- sel upon arrival, and ascertained by personal inspec- tion and examination, tiie condition of those on board, and also the state of the vessel itself? A. The plan ! follow is to have the crew mustered at the side of the vessel, and see that all is right, then go on board, and make a more minute inspection. I do not think that the public health would be en- dangered by the officer going on board. Q. 14. Is there any convenient place on shore, to which the sick might be sent for medical attendance, if you deemed it advisable that they should be re- moved out of the ship 1 A; There is no fit place for persons having conta- gious diseases. Q. 15. In the event of a vessel being found to be exceedingly foul, and therefore liable to produce, or to keep up and aggravate sickness, is there any place t>n shore where the healthy on board the vessel could Appendix. be conveniently located during the process of cleans- ing and purifying her \ A. There is, on shore, an excellent hospital where seamen only are admitted, and where all not labour- ing under, contagious disease may be sent; J would not recommend patients having small pox to be taken there, the hospital being near other institu- tions. Q. 10. Please to add any observations respecting the subject of quarantine, or in any measure illustra- tive of its operation in this island, either for good or evil, which you think it may be useful that the Cen- ral Board of Health should be made acquainted with. A. I am of opinion that the quarantine laws, as they exist, are, if properly carried out, a sufficient safeguard against the introduction of contagious dis- eases, but I fear that the duties of health officer, at some of the small ports of the island, are carelessly performed in consequence of the officer living at a dis- tance from the port, and that communication has been had with the shore before his inspection of the vessel. I consider that it is highly necessary that the health officer should be empowered to enforce sanitary measures on shore, as this important point is greatly neglected. (Signed,) A. C. STEVENS, Health Officer, Port of Falmouth. Answers of Dr. Jelly, to the questions issued by the quarantine committee oj’ the Central Board of Health. Question I. How long have you acted as health officer at the Port of Savanna-la-Mar. Answer. From the 21st of February, 1848. Q. 2. Do you act as health officer for more than one port; if so, how far distant are they from each 'other and from your residence £ A, I act as health officer for the port of Savanna* la-Alar only, and the duty is performed by my part-* ner, Dr. it. S. Harvey,' who practices on the bay, and whose residence is within ten minutes ride of it. Q. .3. What is the average number of vessels, per annum, put into quarantine in the port of Savanna-la- Mar while you have been health officer? A. Prior to the outbreak of cholera in this island, no necessity has occurred for putting vessels into quarantine since l have held the appointment of health officer. Q. 4. in most of the instances when quarantine has been imposed during your service, has it been owing to the vessels having merely arrived from an infected or suspected port, or to their having actual disease on hoard at the time of arrival ? A. With the exception of one instance, (a drogher arriving here with a case of cholera on hoard from Green Island,) the whole of the vessels which have been placed in quarantine, have been so placed sim- ply from the fact of their having come from some in- fected place. Q. 5 State, as nearly as you can, the number of vessels which have been put into quarantine in your port, during your tenure of office, in consequence of actual disease on board ; and please to specify the disease or diseases for which the detention was im- posed ? A. Only one. The disease having been cholera. Q. 6. Is any medical attendance given to the sick on board a ve:>sel in quarantine; have you ever known of a case proving fatal on board ? A. Medical attendance is given to the sick on board ; and no case, to my knowledge, lias proved fatal on board. Q. 7. Please to describe the mode of procedure in ascertaining whether a vessel outside the port is to receive pratique, or to be put into quarantine. Does the pilot ascertain this before the visit of the health officer; do you know of an instance or instances where the pilot, boarding a vessel at sea, has taken Appendix. Appendix. the crew of his boat on board, and that the crew af- terwards left the vessel and returned on shore, leav- ing the pilot on board to take the vessel into port ? A. The usual practice at this port is to go along- side vessels as soon after their appearance as possi- ble, within a reasonable distance, and to ascertain the state of the health of those on board, by putting the usual questions as prescribed by quarantine regula- tions, and subsequently corroborating, by personal inspection, the correctness of the replies. In all cases where, during the prevalence of cholera, ves- sels have been ordered into quarantine, the pilot ca- noes have merely placed the pilot on board, and the crew have returned on shore; the pilot performing quarantine with the ship, and in no case has it come to my knowledge that the crew have gone on board and subsequently returned on shore. Q. 8. At what distance from the port is the qua- rantine ground or station; is it a safe anchorage; have you ever known ofaccidents from vessels lying there ; are there means of preventing communica- tion with the shore? A. The distance of the quarantine ground from the port is about one and a half mile. The anchorage is good, though somew hat exposed. No accidents, how- ever, have been know n to have happened from ships lying there. There are no means whatever of pre- venting communication wiih the shore. Q. I). Have you heard of instances where any vio- lation of the existing quarantine regulations in your port has taken place, either in the way of an incorrect statement having been given, on arrival, as to the health of those on board during the voyage, or by any com- munication with the shore during quarantine ? A. The only case that has come under my know- ledge of the nature alluded to, was in the instance of a drogher from Kingston, when the cholera was raging at the time of her departure, landing a pas- senger at Paradise during the evening, a distance of four miles from the bay, without haying been visited Appendix. by the health officer, for which offence the master was brought up before the magistrates and lined £3 ; no evil, however, resulted from it. Q. JO. During.your residence, at or near the port of Savanna-la-Mar, what epidemic diseases have pre- vailed in the town or surrounding districts ; were they distinctly traceable to introduction by ship- ping ? A. Influenzas, fevers, dysenteries. In the year 182*2, we had a malignant fever which proved fatal to many seamen and masters of ships, as well as to those residing on shore, both in the town and coun- try. In no instance were epidemic diseases traceable to the shipping. Q. 11. In your opinion, does the system of quaran- tine, as it exists at present and is carried out, afford protection to public health ; and is it, do you con- sider, a safeguard against the importation of epide- mic infectious diseases? A. In my opinion the system of quarantine at this port is defective, from the absence of more ample means to ensure protection to public health. But I consider it, to a limited extent, a safeguard against the importation of epidemic infectious diseases. Q. 12. Are there anj changes or modifications in the present system which would render it, in your opinion, more efficient as a safeguard, or make it less vexatious to shipping, without compromising the public health ? A. I know of no changes in the present system which, to be beneficial, would not involve a consider- able outlay ; and the more stringent the pow ers of inquisition, the more vexatious would those powers be to the shipping. Q. 13. Do you consider that tiie public health would be endangered if the health officer went on board, instead of merely alongside, as at present, every vessel upon arrival, and ascertain, by personal inspection and examination, the condition of pr board, and also the state of the vessel itself I Appendix. A. 1 consider by subjecting a medical officer to board an infected vessel and examine the state of the crew and ship, you are either bound to place that of- ficer in the same quarantine as the crew, or to repu- diate entirely all ideas of contagion. Q. 14. Is there any convenient place onshore to which the sick might be sent for medical attendance, if you deemed it advisable that they should be remov- ed,out of the ship ? A. There is no convenient place within some miles from the port, where, if it were deemed ad visable, the sick could be removed to with safety. Q. 15. In the event of a vessel being found to be exceedingly foul, and therefore liable to produce or to keep up and aggravate sickness, is there any place on shore where the healthy on board the vessel could be conveniently located during the process of cleans- ing and purifying her ? A. As in the preceding case, there is no conveni- ent place out of the town where the healthy on board of a foul vessel could be placed during the protess of cleansing and fumigating. Q. 16. Please to add any observations respecting the subject of quarantine, or in any measure illustra- tive of its operation in this island, either for good or evil, which you think it may be useful that the Cen- tral Board of Health should be made acquainted with % A. I am not prepared with any observations of sufficient weight or utility to entitle them to the con- sideration of the Board, Answers of Dr. Potts to the questions issued by the quarantine committee of the Board of Health. Question 1. How long have you acted as health of- ficer at the port of Lucea Answer. About nine years. Q, 2. Do you act as health officer for more than n Appendix one port; if so, how far distant are they from each other and from your residence \ A. For Lucea alone ; about a mile from my resi- dence, from which i have a view of vessels passing into the port. Q. 3. What is the average number of vessels, per annum, put into quarantine in the port of Lucea, while you have been health officer ? A. Only one since my appointment, the Glen Hunt- ley, about six years ago. Q. 4. In most of the instances where quarantine has been imposed during your service, has it been owing to the vessels having merely arrived from an infected or suspected port, or to their having actual disease on board at the time of arrival “? A. The Glen Huntley had small pox on board, on her arrival at the port of Lucea. Q. 5. State, as nearly as you can, the number of vessels which have been put into quarantine in your pert, during your tenure of office, in consequence of actual disease on board, and please to specify the diseases for which the detention was imposed'? A. The above reply answers this query. Q. 6. Is any medical attendance given to the sick on board a vessel in quarantine ? A. The Glen Huntley had a medical man on board. Q. 7. Have you ever known a case proving fatal on hoard 1 A. Several African emigrants died on board the Gien Huntley, and many after they were landed. Q. 8. Please to describe the mode of procedure in ascertaining whether a vessel outside the port is to receive pratique, or to be put into quarantine ? A. In case of disease on board, the yellow flag is expected to be hoisted ; in all cases I run to wind- ward of the vessel and examine the master. Q. 9. Does the pilot ascertain this before the visit of the health officer ? A, If the pilot ascertains it before the health offi- Appendix. cep he gives information to the latter, and does not board the vessel. Q. 10. Do you know of an instance or instances where the pilot, boarding a vessel at sea, lias taken the crew of his boat on board, and that the crew af- terwards left the vessel and returned on shore, leav- ing the pilot on board to take the vessel into port? A. The pilot of the Glen Huntley boarded that vessel off the port of Montego-Bav, and on his arrival at the port of Lucea, was sent into quarantine with the vessel. Q. 11. At what distance from the port is the qua- rantine ground or station; is it a safe anchorage *? A. About seventeen miles from Lucea, but the Glen Huntley rode out her quarantine at the east end of the port of Lucea; I believe so. Q. 12. Have you ever known of accidents from ves- sels lying there ? A. Never. Q. 13. Are there any changes or modifications in the present system which would render it, in your opinion, more efficient as a safeguard, or make it less vexations to shipping, without compromising the public health ? A. 1 have considered of none. Q. 14. Do you consider that the public health would be endangered if the health officer went on board, instead of merely alongside, as at present, every vessel upon arrival, and ascertained by per- sonal inspection and examination, the condition of those on board, also the state of the vessel itself? A. When the health officer has ascertained that there is disease on board a vessel, there is no neces- sity for him to board her; but if he is doubtful he would board the vessel and examine her crew, as he is as likely to convey the disease on shore as any of the crew. Q. 15. Is there any convenient place on shore to which the sick might be sent for medical attendance, Appendix. if you deemed it advisable that they should be re- moved out of the ship ? A. A temporary hospital can always be procured. Q. 16. Are there any means of preventing commu- nication with the shore ? A. The integrity of the master and a coast guard. Q. 17. Have you heard of instances where any vio- lation of the existing quarantine regulations in your port has taken place, either in the way of an incor- rect statement having been given, on arrival, as to the health of those on board during the voyage, or by any communication with the shore during quarantine ? A. None. Q. 18. During your residence at or near the port of Lucea, what epidemic diseases have prevailed in the town or surrounding district ! A. The present c hole ra- ti. 19. Were they distinctly traceable to introduc- tion by shipping ? A. The cholera was introduced into Lucea both by passengers by land and droghers. Q. 20. In your opinion does the system of quaran- tine, as it exists at present and is carried out, afford protection to public health; and is it, do you consi- der, a safeguard against the importation of epidemic infectious diseases'? A. I think it does. In the case of the Glen Hunt- ley the measures employed prevented the spread of the small pox among the inhabitants. Q. 21. In the event of a vessel being found to be exceedingly foul, and therefore liable to produce or to keep up and aggravate sickness, is there any place ©n shore where the healthy on board the vessel might be conveniently located during the process of cleans- ing and purifying her? • A. In the case of the Glen Huntley the emigrants were landed up the river and marched to a depot, rented for the occasion. Q. 22 Please to add any observationsresp erit i ng the Appendix. 85 subject of quarantine, or in any measure illustrative of its operation in this island, either for good or evil, which you think it may be useful that tiie Central Board of Health should be made acquainted with? A. I have not sufficiently considered the subject to venture an opinion. JOHN D. POTTS, Health Officer, Lucea. Answers of Dr. Che vers, to the questions issued by the quarantine committee of the Board of Health, Question 1. How long have yon acted as health of- ficer at the port of Alligator Pond ? Answer. Since November, 1847. Q. 2. Do you act as health officer for more than one port; if so, how far distant are they from each other and from your residence? A. I only act for the port of “ Alligator Pond,” about eighteen miles from my residence. Q, 3. What is the average number of vessels, per annum, put into quarantine in the port of Alligator Pond while you have been health officer. A. None have been put in quarantine since my ap- pointment, except droghing vessels from Kingston, during the months of November and December, 1850. Q. 4. In most of the instances where quarantine has been imposed during your service, has it been owing to the vessels having merely arrived from an infected or suspected port, or to their having actual disease on board at the time of arrival ? A. Q. 5. State, as nearly as you can, the number of vessels which have been put into quarantine in your port, during your tenure of office, in consequence of actual disease or diseases on board, and please to specify the disease or diseases for which the deten- tion was imposed. A, None. Appendix. Q. 6. Is any medical attendance given to the sick on board a vessel in quarantine ; have you ever known of a case proving fatal on board. A. Q. 7. Please to describe the mode of procedure in ascertaining whether a vessel outside the port is to receive pratique, or to be put into quarantine; does the pilot ascertain this before the visit of the health officer; do 5 on know of an instance or instances where the pilot, hoarding a vessel at sea, has taken the crew of his boat on board, and that the crew af- terwards left the vessel and returned on shore, leav- ing the pilot on hoard to take the vessel into port? A. Most of the vessels visiting “Alligator Pond” are from Kingston, one or two from England direct; no pilot lives at the port. Q. 8. At what distance from the port is the quaran- tine ground or station ; is it a safe anchorage ; have you ever known of accidents from vessels lying there ; are there any means of preventing communication with the shore ? A. If necessary to put vessels in quarantine, there is a fine bay two miles from the port, hue no means af preventing communication with the shore. Q. 9. Have you heard of instances where any vio- lation of the existing quarantine regulations in your port has taken place, either in the way of an incorrect statement having been given, on arrival, as to the health of those on hoard during the voyage, or by any communication with the shore during quarantine? A. None. Q. 10. During your residence at or near to the port of Alligator Pond, what epidemic diseases have pre-< vailed in the town or surrounding district; were they distinctly traceable to introduction by shipping ? A. I have attended the sick at this port, for nineteen years, also the shipping ; it is a very unhealthy place; •we once had small pox here, brought over land from “ Kingston.” A vast number of people live on true beach ; no town ; sailors suffer less at this place per- Appendix. haps than most other seaports in the island, from my advice to the captains not to allow any one to land except the boat's crew. Q. 11. In your opinion does the system of quaran- tine, as it exists at present and is carried out, afford protection to public health ; and is it, do you consi- der, a safeguard against the importation of epidemic infectious diseases 1 A. I consider this port being- free from the cho- lera, in consequence of all “ coasting vessels” from Kingston, according to bis excellency’s judicious or- ders, “ that all vessels, either from Kingston or any other infected port, should be put under quarantine, or be a certain number of days from said port. Q. 12. Are there any changes or modifications in the present system which would render it, in your opinion, more efficient as a safeguard, or make it less vexations to shipping, without compromising the pub- lic health ? A. Q 13. Do you consider that the public health would be endangered if the health officer went on board, instead of merely alongside, as at present, eve- ry vessel upon arrival, and ascertained by personal in- spection and examination, the condition of those on board, and also the state of the vessel itself*? A. I consider the health officer ought to have the crew mustered at the gang way; if the least doubt be on his mind, he ought to go on board ; the public health must and ought to be the first and only consideration. 1 have visited vessels with bad cases of “ yellow fever,” remained hours on board with the sick, with no ill effects to myself or those that I came in contact with on shore. Q. 14. Is there any convenient place on shore to which the sick might be sent for medical attendance, if you deemed it advisable that they should be re- moved out of the ship ? A. Several places, where the sick could be landed and taken care of. 88 Appendix Q. 15. In the event of a vessel being found to be exceedingly foul, and therefore liable to produce or to keep up and aggravate sickness, is there any place on shore where the healthy on board the vessel might be conveniently located during the process of cleans- ing and purifying her 1 A. The same places, where the sick could be taken. Q. 16. Please to add any observations respecting the subject of quarantine, or in any measure illustra- tive of its operation in this island, either for good or evil, which you think it may be useful that the Central Board of Health should be made acquainted with '! A. Although few vessels call at this port, neverthe- less 1 consider a boat and two men ought to be placed at the command of the “ health officer a small sum per annum for the men. 1 had great trouble to get the fishermen to take me off to the “ coasting ves- sels” during the months of November and December, 1850, and part of January, 1851. In both ports to windward and leeward of “ Alligator Pond” cholera was very bad. Evidence of W. CHEVERS, Health Officer at Alligator Pond,. Answers of Dr. Clachar to the questions issued by the quarantine committee of the Board of Health. Question 1. How long have you acted as health of- ficer at the port of Fort Antonio ? Answer. For upwards of three years. Q. *2. Do you act as health officer for more than one port; if so, how far distant are they from each other and from your residence '? A. I act for one port only. Q. 3. What is the average number of vessels, per innum, put into quarantine in the port of Fort An- tonio, while you have been health officer ? Appendix. Av I have put no vessels into quarantine, except coasting vessels, during the prevalence of cholera. Q. 4. In most of the instances where quarantine has been imposed during your service, has it been owing to the vessels having merely arrived from an infected and suspected port, or to their having actual disease on board at the time of arrival ?••-'- A. With reference to the vessels last mentioned, quarantine was imposed because they arrived from infected ports, except one, where actual disease was on board. Q. 5. State, as nearly as you can, the number of vessels which have been put into quarantine in your port, during your tenure of office, in consequence of actual disease on board, and please to specify the dis- ease or diseases for which the detention was im- posed *? A. One vessel only was put into quarantine in consequence of actual disease on board, and that was cholera maligna. Q. 6 is any medical attendance given to the sick on board a vessel in quarantine; have you ever- known of a case proving fatal on board ? A. I always give medical attendance to the sick on board. The case last mentioned proved fatal after the vessel was placed in quarantine. Q. 7. Please to describe the mode of procedure in ascertaining whether a vessel outside the port is to receive pratique, or to be put into quarantine ; does the pilot ascertain this before the visit of the health officer ; do you know of an instance or instances where the pilot, boarding a vessel at sea, has taken the crew of Ids boat on board, and that the crew af- terwards left, the vessel and returned on shore, leaving the pilot on board to take the vessel into port! A. The pilot is the first to ascertain if there be sickness on board of vessels outside the port; if brought into port, the health officer would, if neces- sary, plane her in quarantine, and report to the exe- cutive or Central Board of Health. I never kneiy Appendix. of an instance of that described in the last part of this query. Q. 8. At what distance from the port is the qua- rantine ground or station ; is it a safe anchorage ; have you ever known of accidents from vessels lying there ; are there any means of preventing communi- cation with the shore 1 A. About half a mile to the leeward of the port; the anchorange is perfectly safe. Never knew of any accidents. There are no means of preventing com- munication with the shore except the fear of penal- ties under quarantine law. Q. 9. Have you heard of instances where any vio- lation of the existing quarantine regulations, in your port, has taken place, either in the way of an incor- rect statement having been given, on arrival, as to the health of those on board during the voyage, or by any communication with the shore during quaran- tine ? A. 1 have known of one instance of each. Q. 10. During your residence at or near the port of Port Antonio, what epidemic diseases have pre- vailed in the town or surrounding district; were they distinctly traceable to introduction by shipping ? A. Measles and hooping cough have prevailed as epidemics many years ago at Port Antonio and the surrounding district. The malignant cholera prevail- ed as an epidemic at the end of last year and the beginning of this. In no instance were they distinct* ly traceable to introduction by shipping. Q. 11. In your opinion does the system of quaran- tine, as it exists at present and is carried out, afford protection to public health ; and is it, do you con- sider, a safeguard against the importation of epi- demic infectious diseases ? A, The present system of quarantine cannot, in my opinion, afford adequate protection to the public health, nor be a security against the importation of epidemic diseases, so long as the means of enforcing quarantine regulations are so inefficient. Appendix. Q„ 12. Are there any changes or modifications in the present system which would render it, in your opinion, more efficient as a safeguard, or make it less vexatious to the shipping, without compromising the public health l A. Iam of opinion that if the penalties could he summarily enforced by a bench of justices of the peace, instead of a prosecution in the supreme court* infringements of the law would rarely occur, especially if means were given to health officers to detect or prevent infractions of the law. Q. 13. Do you consider that the public health would be endangered, if the health officer went on board, instead of merely alongside, as at present, eve- ry vessel upon arrival, and ascertained, by personal inspection and examination, the condition of those on board, and also the state of the vessel itself? A. I consider the personal visits of health officers on board of vessels, instead of alongside, would not endanger the public health, and might be advantage? ous to the shipping by enabling health officers to form more correct judgments of the condition of the sick, and the state of the vessel itself. Q, 14. Is there any convenient place on shore to which the sick might be sent for medical attendance, if you deemed it advisable that they should be re- moved out of the ship f A. Navy Island, in the immediate vicinity of the quarantine ground, presents a most convenient place for the removal of the sick, if proper buildings were erected for their reception. It has been used on se- veral occasions for this purpose, when captured Afri- cans have been brought into port with small pox on board, and not a single case was ever communicated to persons on shore. Q. 15. In the event of a vessel being found to be exceedingly foul, and therefore liable to produce, or to keep up and aggravate sickness, is there any place on shof-e where the healthy on board the vessel Appendix. could be conveniently located during the process of cleansing and purifying her ? A. A more eligible spot than Navy Island cannot possibly be found. Q. 16*. Please to add any observations respecting the subject of quarantine, or in any measure illustra- tive of its operation in the island, either for good or evil, which you think it may be useful that the Cen- tral Board of Health should be acquainted with ? A. I am disposed to think that instead of quaran- tine grounds being arbitrarily chosen by health officers at almost all the ports of this island, as at present, it would be more conducive to the public security, and less vexatious and oppressive to shipping, if a few approved places were permanently fixed for vessels with infectious diseases on board, immediately to re- pair to on their arrival, where adequate means should be provided for an efficient performance of quarantine and the due attendance of the sick. The places most eligible for this purpose, appear to me to be somewhere near Port-Royal and Port Antonio, and at the latter place, Navy Island, as being the best ports on the south and north of the east part of the island, where vessels usually make the land. (Signed,) JOHN S. CLACHAR, M.D. Health Officer, Port-Antonio. 2±th June, 1851. . Answers of Dr. Maitland to the. questions issued by the quarantine committee of the Central Board of Health. Question 1. How long have you acted as health of- ficer at the port of Black lliver? A. For ten years. Q. 2. Do you act as health officer for more than one port ; if so, how far distant are they from each Other and from your residence ? A. For die port of Black River alone. Appendix. Q. 3. What is the average number of vessels, per annum, put into quarantine in the port of Black Hi ver while you have been health officer ? A. Fourteen vessels, under the order in council of October, 1850. Q. 4. In most of the instances where quarantine has been imposed during your service, has it been owing to the vessels having merely arrived from an infected or suspected port, or to their having actual disease on board at the time of arrival % A. From the vessels arriving from an infected port. Q. 5. State, as nearly as you can, the number of ves- sels which have been put into quarantine, in your port, during your tenure of office, in consequence of actual disease on board ; and please to specify the diseases for which the detention, was imposed 1 A. Two vessels, a Spanish schooner with typhus fever on hoard, and the schooner Rosa, with cholera, as reported to the Board on the 3d instant. Q. 6. Is any medical attendance given to the sick on hoard a vessel in quarantine 1 A. Not in this harbour. Q. 7. Have you ever known a case proving fatal on board ? • A. One case, that of Mrs. Bucknor, on hoard the Rosa schooner, John Innis, master, as reported on the 3d instant. Q. 8. Please to describe the mode of procedure in ascertaining whether a vessel outside the port is to receive pratique, or to be put into quarantine ? A. A vessel entering the port is approached within speaking distance, and her condition ascertained by questioning the master. Q. 9. Does the pilot ascertain this before the visit of the health officer ? A. The pilots have the power of ascertaining the sanitary condition of the vessel before the health of- ficer visits. Q. 10. Do you know of an instance or instances where the pilot hoarding a vessel at sea, has taken Appendix the crew of his boat on board, and that the crew af- terwards left the vessel and returned on shore, leaving the pilot on board to take the vessel into port ? A. 1 know of no such occurrence. Q. 1 L At what distance from the port is the qua- rantine ground or station ; is it a safe anchorage ? A. The distance stated by the harbour master is two miles and a half. Yes. Q. i *2. Have you ever known of accidents from ves- sels lying there % A. None. Q. 1.3. Are there any means of preventing commu- nication with the shore A- 1 know of none, except through the interfer- ence of the magistrates and police. Q,. 14. Have you heard of instances where any vio- lation of the existing quarantine regulations, in your port, has taken place either in the way of an incor- rect statement having been given, on arrival, as to the health of those on board during the voyage, or by any communication with the shore during quaran- tine ? A. I know of none. Q. 15. During your residence at or near the port of Black River, what epidemic diseases have prevail* ed in the town or surrounding district? A. Measles, hooping cough, and cholera. Q- 16. Were they distinctly traceable to introduc- tion by shipping ? A. They were not. Q. 17. In your opinion does the system of quaran- tine, as it exists at present and is carried out, afford protection to public health ; and is it, do you consi- der, a safeguard against the importation of epide- mic infectious diseases ? A. I consider a system of quarantine indispensa- ble. Q. 18. Are there any changes or modifications in the present system, which would render it, in your opinion, more efficient as a safeguard, or make it less Appendix’. 95 'vexatious to shipping, without compromising the pub- lic health ? A. I am unable to suggest any alterations. Q, 19. JDo you consider that the public health would be endangered, if the health officer went on board* instead of merely alongside, as at present, every ves- sel upon arrival, and ascertained, by personal inspec- tion and examination, the condition of those on board, also the state of the vessel itself? A. 1 Consider the practice of boarding infected vessels would be attended with risk. The precise state of the vessel and crew could no doubt be as- certained with greater correctness by actual examina- tion. Q. 20. Is there any convenient place on shore to which the sick might be sent for medical attendance, if you deemed it advisable that they should be re- moved out of the ship ? A. I am not acquainted with any suitable place. There is no public hospital at this port. Q. 21. In the event of a vessel being found to be exceedingly foul, and therefore liable to produce, or to keep up and aggravate sickness, is there any place on shore where the healthy on board the vessel might be conveniently located during the process of cleans- ing and purifying her 1 A. I am not acquainted with any suitable place for such purpose. Q. 22. Please to add any observations respecting the subject of quarantine, or in any measure illustra- tive of its operation in this island, either for good or evil, which you think it may be useful that the Cen- ral Board of Health should be made acquainted with. A. — 96 Appendix. Answers of Dr. Lemouious to the questions issued hff the quarantine committee of the Centred Board oj. Health. IIio Bueno, 25th June, 1851. Sir, I herewith return the queries which you directed tome, by order of the quarantine committee of the Central Board of Health, with my answers. 1 have the honor to be. Sir, Your must obedient servant, '(Signed,) W. LEMONIOUS, Health Officer, Ilia Bueno. T. J. Brown, Esquire, Secretary to the Central Hoard of Health. Question 1. Ilow long have you acted as health officer at the port of Rio Bueno ? A. Since the year 1838. Q. 2. Do you act as health officer for more than one port; if so, how far distant are they from each other and from your residence ? A. For Rio Bueno only. Distance from my resi- dence four miles. Q. 3. What is the average number of vessels, per annum, put into quarantine in the port of Rio Bueno while you have been health officer? A. Four, Q. 4. In most of the instances when quarantine has been imposed during your service, has it been owing to the vessels having merely arrived from an infected or suspected port, or to their having actual disease on board at the time of arrival ? A. No quarantine has been necessary to be im- posed on any vessel during my service. Q. 5. State, as nearly as you can, the number of vessels which have been put into quarantine in your port, during your tenure of office, in consequence of Appendix. 97 actual disease on board ; and please to specify the diseases for which the detention was imposed? A. None. Q. 6*. is any medical attendance given to the sick on board a vessel in have yoii ever known of a case proving fatal on board ? A. Answered above. Q. 7. Please to describe the mode of procedure in ascertaining whether a vessel outside the port is to receive pratique, or to be put into quarantine. Does the pilot ascertain this before the visit of the health officer; do you know of an instance or instances where the pilot, boarding a vessel at sea, has taken the crew of his boat on board, and that the crew af- terwards left the vessel and returned on shore, leav- ing the pilot on board to take the vessel into port? A. The pilot boards every vessel, hoisting a signal for him, outside the port, and i visit her as early as possible after she is anchored ; the master sends a boat for me, no boat being furnished to me for that purpose. I believe that the pilot only goes on board any vessel, and sends his canoe on shore. Q. 8. At what distance from the port is the qua- rantine ground or station; is it a safe anchorage * have you ever known of accidents from vessels lying there ; are there any means of preventing communica- tion with the shore ? A. The last instructions 1 received directed me to send any vessel I might find it necessary to put into quarantine to Ocho Rios, about twenty two miles to windward of Rio Bueno. I am not sufficiently ac- quainted with the roadstead at Ocho Rios to afford any information. Q. 9. Have you heard of instances where any vio- lation of the existing quarantine regulations in your port has taken place, either in the way of an incorrect statement having been given, on arrival, as to the health of those on board during the voyage, or by any corns fmmication with the shore during quarantine f Appendix> A. I know of no such case, nor have I ever heard of one. Q. JO. During your residence, at or near the port of Rio Bueno, what epidemic diseases have pre- vailed in the town or surrounding districts ; were they distinctly traceable to introduction by ship- pin»? A. No epidemic disease has ever prevailed at Rio Bueno during my residence there, or near it. Asi- atic cholera visited it in December and January last past, which certainly was not introduced by ship- ping. Q. 11. In your opinion, does the system of quaran- tine, as it exists at present and is carried out, afford protection to public health ; and is it, do you con- sider, a safeguard against the importation of epide- mic infectious diseases ? A. I am not possessed of the quarantine laws, and therefore cannot give my opinion on it; but I consi- der that when epidemic or infectious disease is im- ported in any vessel, her being put into quarantine, must, in a great degree, prevent such disease from spreading among the inhabitants on shore. Q. 1‘2. Are there any changes or modifications in the present system which would render it, in your opinion, more efficient as a safeguard, or make it less vexatious to shipping, without compromising the public health 1 A. I cannot say. Q. 13. Do you consider that the public health would be endangered if the health officer went on board, instead of merely alongside, as at present, every vessel upon arrival, and ascertained by personal inspection and examination, the condition of those on board, also the state of the vessel itself? A. I consider that when the master or pilot, de- clares that there is epidemic or infectious disease on board, it would endanger the public health if the liealth officer went on board, and would be useless Appendix. fey running risk, as it is the duty of that officer to or- der her immediately to sea, to proceed to the quaran- tine ground. Q. 14. Is there any convenient place on shore to which the sick might be sent for medical attendance, if you deemed it advisable that they should be remov- ed out of the ship ? A. Whenever I have thought it advisable to order sick seamen on shore, the master of the vessel to which they belonged has made some arrangement with an inhabitant, and paid for their lodging and attendance. In other cases I have sent sick seamen to the marine hospital, at Falmouth. Q,. 15. In the event of a vessel being found to be exceedingly foul, and therefore liable to produce or to keep up and aggravate sickness, is there any place on shore where the healthy on board the vessel might be conveniently located during the process of cleans- ing and purifying her ? A. There is no other way of locating the crew of any vessel on shore during the process of cleansing and purifying her, except the one mentioned in the foregoing answer. Q. 16. Please to add any observations respecting the subject of quarantine, or in any measure illustra- tive of its operation in this island, either for good or evil, which you think it may be useful that the Cen- tral Board of Health should be made acquainted with 1 A. I have already stated my belief that the quaran- tine law, (as far as 1 know it,) must, in a great degree, afford protection to public health, and 1 think, that is more the case in ports where no marine or other public hospital exists. But in Jkingston, Falmouth, Montego-Bay, and the other ports, having such hos- pital, 1 consider it a cruel infliction on both sick and well on board of any foul ship, in my humble opi- nion it would be better to send the sick to the hos- pital, where they would be more comfortable am? Appendix. better attended to, and to lodge the well on shore? whilst the vessel was being cleansed and purified. (Signed,) " W. LEMONlOUS, F. C. P. & S. Jamaica. Health Officer, Rio*Bueno. Answers of Dr. 'Thomas Johnstone to the questions is- sued by the quarantine committee of the Central Hoard of Health. Question 1. How long have you acted as health of- ficer at the port of Dry Harbour? A. From the 20th March, 1840. Q. 2. Do you act as health officer for more than one port * if so, how far distant are they from each other and from your residence l A. I do not act for any other port. I reside five miles from Dry Harbour, and within sight of the port. Q. 3. What is the average number of vessels, per annum, put into quarantine in the port of Dry Har- bour, while you have been health officer ? A. I have never had occasion to place any vessel in quarantine. Q. 4. In most of the instances where quarantine has been imposed during your service, has it been owing to the vessels having merely arrived from an infected or suspected port, or to their having actual disease on board at the time of arrival ? A. See answer, query No. 3. From four to five vessels annually arrive at Dry Harbour, and those di- rect from London or Liverpool, being at sea from five to six weeks, and have seldom found that sickness prevailed during the passage. Several other vessels call in during the year from other ports in the island for fresh cargo. Q. 5. State* as nearly as yon can, the number of Vessels which have been put into quarantine in your port, during your tenure of office, in consequence 6f actual disease on board, and please to specify the Appendix. disease or diseases for which the detention was inw posed? A. See answer, query No. 3. Q. (j. is any medical attendance given to the sick on board a vessel in quarantine; have you ever known of a case proving fatal on board ? A. Were it necessary medical attendance would be given, sickness arising after entry, I generally attend. Q. 7. Please to describe the mode of procedure in ascertaining whether a vessel outside the port is to receive pratique, or to be put into quarantine ; does the pilot ascertain this before the visit of the health officer ; do you know of an instance or instances where the pilot, boarding a vessel at sea, has taken the crew of his boat on board, and that the crew af- terwards left the vessel and returned on shore, leav- ing the pilot on board to take the vessel into port? A. There is no anchorage or quarantine ground outside the harbour ; the pilot generally boards some distance from the port, and his crew mostly go on board with him, towing the canoe with a line. I board immediately on her coming to anchor, and if necessary to place the vessel in quarantine, my in- structions are to place her in, and to leeward of the other vessels in port; the pilot never leaves the ves- sel until boarded. Q. 8. At what distance from the port is the qua- rantine ground or station; is it a safe anchorage; have you ever known of accidents from vessels lying there; are there any means of preventing communi- cation with the shore ? A. See answer, query No. 7, The anchorage with- in the harbour is safe; there are no means of prevent- ing communication with the shore that 1 am aware of further than the strict orders of the master on board to the contrary. Q. 9. Have you heard of instances where any vio- lation of the existing quarantine regulations in your port has taken place, either in the way of an incor- rect statement having been given, on arrival, as to the Appendix. health of those on board during tlie voyage, or by any communication with the shore during quarantine ? A. i have never known of the existing quarantine regulations violated in this port. Q. 10. During your residence at or near to the port t>f Dry Harbour, what epidemic diseases have pre- vailed in the town or surrounding district; were they distinctly traceable to introduction by shipping? A. The only disease that has prevailed in Dry- Harbour is from no epidemic disease ever introduced by the shipping to my knowledge; cholera prevailed to some extent in St. Ann’s Bay, to windward, and Rio Bueno to leeward. Dry Harbour escaped. Q. 11. In your opinion does the system of quaran- tine, as it exists at present and is carried out, afford protection to public health; and is it, do you consi- der, a safeguard against the importation of epidemic infectious diseases k? A. I do consider it affords protection to public health, and if the duties are strictly attended to, it is a safeguard against the introduction of epidemic infections diseases. Q. 1*2. Are there any changes or modifications in the present system which would render it, in your opinion, more efficient as a safeguard, or make it less vexatious to shipping, without compromising the public health ? A. My experience does not warrant me in offering any suggestions. Q. 13. Do you consider that the public health would he endangered if the health officer went on board, instead of merely alongside, as at present, every vessel upon arrival, and ascertained, by per* sonal inspection and examination, the condition of those on board, and also the state of the vessel itself? A. I do not consider the public health endangered by the health officer going on board. I consider the 'duties inefficiently performed unless the health officer personally inspected the men and the state of the ves- sel. ■Appendix. Q. 14. Is there any convenient place on shore to which the sick might he sent for medical attendance* if you deemed it advisable that they should be re- moved out of the ship t A. There is no place at present; if required, a place could be procured. Q. 15. In the event of a vessel being found to be exceedingly foul, and therefore liable to produce or to keep up and aggravate sickness, is there any place on shore where the healthy on board the vessel might be conveniently located during the process of cleans- ing and purifying her ? A. Accommodations might be procured for the healthy in the town. Q. 16. Please to add any observations respecting the subject of quarantine, or in any measure illustrative of its operation in this island, either for good or evil, which you think it may be useful that the Central Board of Health should he made acquainted with l A. See answer, query No. 12. THOMAS JOHNSTONE, Health Officer. Dry Harbour. Answers of Dr. Day ley to the questions issued by the quarantine committee of the Centi at JBoard of Health. Question 1. How long have you acted as health of- ficer at the port of St. Ann s Bay ? A. The date of my appointment as health officer at the port of St. Anns Bay, is the 26th November, 1838, since which time I have acted as such. Q. 2. Do you act as health officer for more than one port; if so, how far distant are they from each other and from your residence ? A. Only for St. Ann’s Bay. Q. 3. What is the average number of vessels, per annum, put into quarantine in the port of St. Ann’s Bay, while you have been health officer. 104 Appendix. A. Since 1 have resided in St Ann’s Bay, now twenty-three years, I have never known a vessel put in quarantine. Q. 4. In most of the instances where quarantine has been imposed during your service, has it been owing to the vessels having merely arrived from an infected or suspected port, or to their having actual disease on board at the time of arrival'? See answer to query No. 3. Q. 5. State, as nearly as yon can, the number of vessels which have been put into quarantine in your port, during your tenure of oftice, in consequence of actual disease on board, and please to specify the disease or diseases for which the detention was im- posed. A. Vide answer, No. 3. Q. 6. Is any medical attendance given to the sick on board a vessel in quarantine ; have you ever known of a case proving fatal on board? A. I cannot give an answer to this question, as the quarantine ground is twenty miles from St. Ann's Bay, and as l have never had occasion to order a ves- sel in quarantine, I am not in a position to say what practice is observed. Q. 7. Please to describe the mode of procedure in ascertaining whether a vessel outside the port is to receive pratique, or to be put into quarantine; does the pilot ascertain this before the visit of the health officer; do you know of an instance or instances where the pilot, boarding a vessel at sea, has taken the crew of his boat on board, and that the crew af- terwards left the vessel and returned on shore, leav- ing the pilot on board to take the vessel into port ? A. The pilot has instructions, if a vessel has any epidemic disease on board, not to bring her into port. The health officer boards a vessel when she comes into harbour, but no communication is permitted with the town until the health officer visits the vessel. It is a common practice for the crew of £be pilot host Appendix. 105 to go on hoard the vessel, at sea, with the pilot, and the boat is towed into harbour ; the crew of the pilot boat seldom return on shore before the pilot. Q. 8. At what distance from the port is the quaran- tine ground or station ; is it a safe anchorage; have you ever known of accidents from vessels lying there ; are there any means of preventing communication with the shore ? A. Oracabessa, (about twenty miles from St. Ann’s Bay,) is the quarantine ground, and it is said to have safe anchorage. I have never heard of any accidents from vessels lying there ; there are no means, to my knowledge, to prevent communication with the shore. Q. 9. IIav e you heard of instances where any vio- lation of the existing quarantine regulations in your port has taken place, either in the way of an incorrect statement having been given, on arrival, as to the health of those on board during the voyage, or by any communication with the shore during quarantine ? A. I have never heard of any instance. Q. 10. During your residence at or near to the port of St. Ann’s Bay, what epidemic diseases have pre- vailed in the town or surrounding district; were they distinctly traceable to introduction by shipping? A. The only epidemic diseases I have known in the port of St. Ann’s Bay are small pox and cholera, neither of which were traceable to introduction by shipping. Q. 11. In your opinion does the system of quaran- tine, as it exists at present and is carried out, afford protection to public health ; and is it, do you consi- der, a safeguard against the importation of epidemic infectious diseases 1 A. It does not; there are ports adjacent to St. Ann’s Bay where vessels might go in, and no health officer present to board them. I may mention Ocho li ios especially; this port is to the windward of St. Ann’s Bay ; there is no health officer there. Q. 12. Are there any changes or modifications in the present system which would render it, in your Appendix. opinion, more efficient as a safeguard, or make it ieso vexatious to shipping, without compromising the pub- lic health ? A. The only modification I would suggest is, that the health officer should be required to board each vessel, and not to trust simply to the captain’s report of the health of the crew. Q. 13. Do you consider that the public health would be endangered if the health officer went on board, instead of merely alongside, as at present, eve- ry vessel upon arrival, and ascertained by personal in- spection and examination, the condition of those on .board, and also the state of the vessel itself ? A. It has been my practice to board the vessels and personally inspect the crew, &c. Q. 14. Is there any convenient place on shore to which the sick might be sent for medical attendance* if you deemed it advisable that they should be re- irtoved out of the ship % A. When it is necessary to order a sick patient on shore, the captain procures lodgings and pays the ex- pence ; in most cases the medical man is employed by the ship to attend the crew. Q. i-5. in the event of a vessel being found to be exceedingly foul, and therefore liable to produce or to keep up and aggravate sickness, is there any place on shore where the healthy on board the vessel might be conveniently located during the process of cleans- ing and purifying her? A. Yes; no difficulty in getting lodgings. Q,. 16. Please to add any observations respecting the-subject of quarantine, or in any measure illustra- tive of its operation in this island, either for good or evil, which you think it may be useful that the Central Board of Health should be made acquainted with ? A. I have no observations to add. (Signed,) T. JY. B AY LEY* Surgevn, Appendix. 107 Answers oj Dr, Clarke to the questions issued by the quarantine committee of the Central Board of Health. Question 1. How long have you acted as health of- ficer at the port of Aimotto Bay ? A. Since April, 1850; 1 acted as deputy also some years back under Dr. Maxwell. Q. 2. Do you act as health officer for more than one port; if so, how far distant are they from each other and from your residence *? A. For the port of Annotto Bay only. Q. 3. What is the average number of vessels, per annum, put into quarantine in the port of Annotto Bay, while you have been health officer ? A. None have been put into quarantine since l have held the office, Q. 4. in most of the instances where quarantine has been imposed during your service, has it been owing to the vessels having merely arrived from an infected or suspected port, or to their having actual disease on board at the time of arrival ? A. * Q. 5. State, as nearly as you can, the number of vessels which have been put into quarantine in your port, during your tenure of office, in consequence of actual disease ou board, and please to specify the dis- ease or diseases for which the detention was im- posed *? A. Q. 6. Is any medical attendance given to the sick on board a vessel in quarantine; have you ever known of a case proving fatal on board % A. - Q. 7. Please to describe the mode of procedure in ascertaining whether a vessel outside the port is to receive pratique, or to be put into quarantine ; does the pilot ascertain this before the visit of the health officer ? ,, 108 Appendix, A This is seldom or never ascertained (ill (he vessel comes into port, the harbour being' large and an open roadstead ; the pilot is not looked to in the matter at all, the question being settled when suspicion arises by the decision of the health officer. Q. 8. Do you know of an instance or instances where the pilot, boarding a vessel at sea, has taken the crew of his boat on board, and that the crew af- terwards left the vessel and returned on shore, leaving the pilot on board to take the vessel into port? A. Q. 9. At what distance from the port is the qua- rantine ground or station ; is it a safe anchorage ; have you ever known of accidents from vessels lying there ; are there any means of preventing communi- cation with the shore ? A. At Oracabessa about eighteen miles distant. I am told by competent judges that the anchorage is safe. 1 do not know that there are any particular means of preventing communication with the shore. Q. 10. Have you heard of instances where any vio- lation of the existing quarantine regulations, in your port, has taken place, either in the way of an incor- rect statement having been given, on arrival, as to the health of those on board during the voyage, or by any communication with the shore during quarantine? A. I have not. Q. 11. During your residence at or near the port of Annotto Bay, what epidemic diseases have pre- vailed in the town or surrounding district; were they distinctly traceable to introduction by shipping? A. Measles in 1837 ; scarlatina in 1842 and 1843 ; hooping cough in 1843; dysentery in 1844 and 1845; and cholera in 1850. 1 am not prepared to say in what way they were introduced. Q. 12. In your opinion does the system of quaran- tine, as it exists at present and is carried out, afford protection to public health ; and is it, do you con- sider, a safeguard against the importation of epi- demic infectious diseases ? Appendix. 109 A. 1 believe that it is calculated to afford consider- able protection, but I will not say a complete safe- guard against it. Q. 13. Are there any changes or modifications in the present system which would render it, in your opinion, more efficient as a safeguard, or make it less vexatious to the shipping, without compromising the public health ( A. I am not prepared to offer any. The destruc- tion of fomites and proper cleansing and ventilating of the vessel are obvious suggestions, and might be enforced by penalties. Q. 14. Do you consider that the public health would be endangered, if the health officer went on board, instead of merely alongside, as at present, eve- ry vessel upon arrival, and ascertained by personal inspection and examination, the condition of those on board, and also the state of the vessel itself? A. The individual risk to the officer would, of course, be increased “ pro tanto” by the increased exposure to noxious emanation ; the channel, and consequently the chance of propagation, would be li- mited in the case suggested, and the latter capable of being still further diminished by the use for the oc- casion of personal precautions ; perhaps therefore,, the degree of danger to the public health from such, a course wmuld be inconsiderable. Q. 15. Is there any convenient place on shore to which the sick might be sent for medical attendance, if you deemed it advisable that they should be re- moved out of the ship ? A. I know of no place on shore to which they could be carried with safety to the inhabitants. Q. lb. In the event of a vessel being found to be exceedingly foul, and therefore liable to produce, or to keep up and aggravate sickness, is there any place on shore where the healthy on board the vessel might be conveniently located during the process of cleansing and purifying her ? A. The same answer applies to this question ; po» Appendix* sibly the cleansing and purifying might be carried on without disembarking the crew. Q. 17. Please to add any observations respecting the subject of quarantine, or in any measure illustra- tive of its operation in the island, either for good or evil, which you think it may be useful that the Cen- tral Board of Health should be acquainted with ? A. I have no special information to give on the subject, hut as illustrative of the beneficial operation of quarantine in this island, ! may be allowed to point to the entire absence of small pox from it for a period of nineteen years, although infected vessels have ar- rived at its shores during that time. (Signed,) THOMAS CLARKE, M.D. Health Officer, Annotto Hay. Answers of Dr, W. />. Cooke to the questions issued by the quarantine committee of the Central Board of Health. Question 1. Ho w long have you acted as health of- ficer at the port of Morant Bay 1 A. From the 22nd March, 1845, Q.-2. Do you act as health officer for more than one port; if so, how far distant are they from each other and from your residence 7 A. For Fort Morant also, the distance being se- ven miles by the post road. Q. 3. What is the average number of vessels, per annum, put into quarantine in the port of Morant Bay, while you have been health officer? A. None. Q. 4. In most of the instances where quarantine has been imposed during your service, has it been owing to the vessels having merely arrived from an infected or suspected port, or to their having actual disease on board at the time of arrival ? A. None. Q. 5. State, as nearly as you can, the number of ves- sels which have been put into quarantine, in your Appfh'duf. port, during your tenure of office, in consequence of actual disease on board ; and please to specify the disease or diseases for which the detention was im- posed ? A. None. Q. 0. Is any medical attendance given to the sick on board a vessel in quarantine * have you ever known a case proving fatal on board ? A. None. Q. 7. Please to describe the mode of procedure m ascertaining whether a vessel outside the port is to receive pratique, or to be put into quarantine ? A. It is not usual to board a vessel outside the roadstead at Morant Bay, it not being always prac- ticable, but as soon as the reef is cleared the health officer goes alongside and makes the usual enquiries. Q. 8. Does the pilot ascertain this before the visit of the health officer ; do you know of an instance or instances where the pilot boarding a vessel at sea, has taken the crew of Ids boat on board, and that the crew afterwards left the vessel and returned on shore, leaving the pilot on board to take the vessel into port ? A. No-. It is their constant habit. Q. 0. At what distance from the port is the qua- rantine ground or station ; is it a safe anchorage ; have you ever known of accidents from vessels lying there ; are there any means of preventing communi- cation with the shore % A. I do not know of any quarantine ground either at this port or at Port Morant. The crew can always be prevented, but not the crew of the pilot boat, as they may board and come on shore before the vessel is in sight. Q,. 10. Have you heard of instances where any vio- lation of the existing quarantine regulations, in your port, has taken place either in the w7ay of an incor- rect statement having been given, on arrival, as to the health of those on board during the voyage, or 112 Appendix. by any communication with the shore during quaran- tine ? A. None. Q. II. During your residence at or near the port of Morant Bay, what epidemic diseases have prevail- ed in the town or surrounding district; were they distinctly traceable to introduction by shipping? A. Cholera. Not at all. Q. 12. In your opinion does the system of quaran- tine, as it exists at present and is carried out, afford protection to public health; and is it, do you consi- der, a safeguard against the importation of epide- mic infectious diseases ? A. 1 do, with the exceptions already stated in re- gard to pilots leaving the vessel before the visit of the health officer. Q. 13. Are there any changes or modifications in the present system, which would render it, in your opinion, more efficient as a safeguard, or make it less vexatious to shipping, without compromising the pub- lic health ? A. I am of opinion that if vessels were compelled to hoist a yellow flag at the mast head in all cases where there had been a death on board, or where there had been any infectious disease within sixteen days of her arrival, it would answer well, and do away with the necessity of lying to in a dangerous situation, such as outside the reef at this port. Q. 14. Do you consider that the public health would be endangered, if the health officer went on board, instead of merely alongside, as at present, every ves- sel upon arrival, and ascertained, by personal inspec- tion and examination, the condition of those on board, also the state of the vessel itself? A. This involves the question of contagion or non- contagion ; a subject which cannot be entered into in so brief a space. I am of opinion, however,, that the public health would not suffer except in cases where the disease is known to be contageous, i. e. Appendix* 113 small pox, croup, &c. &c. I am convinced that nei- ther cholera nor yellow fever are at all contagious, ex- cept in the former after death. I am confirmed in this opinion by a lengthened and extended expe- rience. Q. 15. Is there any convenient place on shore to which the sick might be sent for medical attendance, if you deemed it advisable that they should be re- moved out of the ship ? A. There is no place whatever. Q. 18. in the event of a vessel being found to be exceedingly foul, and therefore liable to produce, or to keep up and aggravate sickness, is there any place on shore where the healthy on board the vessel might be conveniently located during the process of cleans- ing and purifying her X A. There is no public place. A house might be procured for the health v. Q. 17. Please to add any observations respecting the subject of quarantine, or in any measure illustra- tive of its operation in this island, either for good or evil, which you think it may be useful that the Ceil- ral Board of Health should be made acquainted with. A. The existing quarantine laws are perfectly ade- quate to the prevention of the importation of epide- mic diseases, if faithfully and rigorously carried into execution, but the remuneration afforded, in many in- stances to the health officers, renders their services al- most altogether inefficient, and in some cases entails a loss to the holders of the office. At this port of road- stead the sum of sixty pounds is paid by the receiver- general ; out of this small sum the health officer has to provide a boat and crew which absorbs nearly one half of the income; now should it so happen that a vessel arrives with an infectious disease, the health officer is expected to give his whole attention to the sanitary condition not only of the crew but of the vessel ; should such an unfortunate contingency arise, he must take his choice of either starving or Appendix. doing his duty. I would suggest that either the sala- ry be increased, or a sum allowed for a boat and crew. 1 am no advocate for doing away with quarantine re- gulations, as I conscientiously believe them to be a safeguard to the public health. Answers of Dr. Tarrant to the questions issued by the quarantine committee of the Hoard of Health. Question l. How long have you acted as health officer at the ports of Old-Harbour and Salt River? Answer. Acting two years ; confirmed two years. See below. Q. 2. How far distant are they from each other and from your residence ? A. Old Harbour, by land, nine miles ; Salt River, by land, one mile; and Carlisle Bay, by land, twelve miles. Q. 3. What is the average number of vessels, per annum, put into the ports of Old-Harbour and Salt River while you have been health officer ? A. In 1848, two; in 1849, eighteen; in 1850; eigh- teen; and in 1851, sixteen. Q. 4. In most of the instances when quarantine has been imposed during your service, has it been owing to the vessels having merely arrived from an infected or suspected port, or to their having actual disease on board at the time of arrival ? A. Quarantine has never been imposed during the period I have been health officer. Q. 5*. State, as nearly as you can, the number of vessels which have been put into quarantine in your ports, during your tenure of office, in consequence of actual disease on board, and please to specify the dis* ease or diseases for which the detention was im- posed. A None. Q. (>. Is any medical attendance given to the sick on board a vessel in quarantine ; have you ever known of a case proving fatal on board ? Appendix. A. As health officer I should consider it my duty to give professional advice when needed. None. Q. 7. Please to describe the mode of procedure in ascertaining whether a vessel outside the port is to receive pratique, or to be put into quarantine ; does the pilot ascertain this before the visit of the health officer; do you know of an instance or instances where the pilot, boarding a vessel at sea, has taken the crew of his boat on board, and that the crew af- terwards left the vessel and returned on shore, leav- ing the pilot on board, to take the vessel into port ? A. By calling alongside. Never; no. Q. 8. At what distance from the ports is the qua- rantine ground or station ; have you ever known of accidents from vessels lying there ; are there any means of preventing communication with the shore ? A. At each place from two to three miles ; the an- chorage in each place is good; I am not aware of any. Q. 9. Have you heard of instances where any vio- lation of the existing quarantine regulations, in your port, has taken place, either in the way of an incor- rect statement having been given, on arrival, as to the health of those on board during the voyage, or by any communication with the shore during quaran- tine ? A. No. Q. 10. During your residence at or near to the ports of Old Harbour and Salt River, what epidemic diseases have prevailed in the town or surrounding district ; were they distinctly traceable to introduc- tion by shipping ? A. The usual epidemics of the country, and none of them attributable to the shipping in port. Q. 11. In your opinion does the system of quaran* tine, as it exists at present and is carried out, afford protection to public health ; and is it, do you consi- der, a safeguard against the importation of epidemic infectious diseases f 116 Appendix. A. Certainly so when properly carried out. Yes, in a great measure. Q. 12. Are there any changes or modifications in the present system which would render it, in your opinion, more efficient as a safeguard, or make it less ■vexatious to shipping without compromising the pub- lic health ? A. I am not aware of any. Q. 13. Do you consider that the public health would be endangered if the health officer went on board, instead of merely alongside, as at present, every vessel upon arrival, and ascertained by personal inspection and examination, the condition of those on board, also the state of the vessel itself? A. I do not think so. Q. 14. Is there any convenient place on shore to which the sick might be sent for medical attendance, if you deemed it advisable that they should be remov- ed out of the ship ? A. At Old Harbour Bay, lodgings could be ob- tained, and probably at Salt River, if needed ; but I am not aware of any at Carlisle Bay. Q. 15. In the event of a vessel being found to be exceedingly foul, and therefore liable to produce or to keep up and aggravate sickness, is there any place on shore where the healthy on board the vessel might be conveniently located during the process of cleans- ing and purifying her ? A. As above. Q. 16. Please to add any observations respecting the subject of quarantine, or in any measure illustra- tive of its operation in this island, either for good or evil, which you think it may be useful that the Central Board of Health should be made acquainted with ? A, I think penalties should be imposed on persons boarding vessels, and on masters of vessels leaving their ships before the visit of the health officer, both of which frequently occur to my knowledge. * W. TAB RANT. J'ere, 2Qth August. 1851. A ppendi.r. 117 N.B.—To the ports of Old Harbour and Salt River, that of Carlisle Bay is attached, the duties of which 1 have to perform, although not named in my com- mission, and for which 1 receive no extra pay. W. TARRANT. 118 Appendix. APPENDIX F. The following are copies of the circular and ques- tions on small pox :— Central Board of Health, 4/Zt August, 1851, Sir, I have the honor to enclose, by order of the com - mittee of the Central Board of Health, on the preven- tion of the spread of epidemic diseases, certain que- ries on the subject of the reported outbreak of small pox in the parish of Trelawny, to which the Board request your answers will be as prompt and explicit as the nature of a written examination will admit. I have the honor, &c. T. J. BROWN, Secretary. Have you met with any cases of small pox in your district within the last two months ? If so, how many such cases have come under your notice ? When and where did the first case occur; please describe particulars? Did the cases occur in vaccinated or unvacci- nated persons ? Could the disease be traced to introduction ; or did it occur spontaneously ? Over what extent of district does the disease ex- tend ? What is the existing state of vaccination in your parish ? Please to add any observations which you think may be of importance? Appendix. Falmouth, 8th August, 1851. Sir, I have the honor to state, for the information of the Central Board of Health, in reply to certain que- ries forwarded to me, that no cases of small pox have occurred in my district. Very few persons have been vaccinated, the negro population being generally very careless about it, and the only means to ensure its general performance, will be making it, if possible, compulsatory among them. I have the honor to be, Sir, Your obedient servant, A. C. STEVENS. Have you met with any cases of small pox in your district within the last two months *? If so, how many such cases have come under your notice ? AVhen and where did the first case occur; please describe particulars. Did the cases occur in vaccinated or uiivaccinated persons ? Could the disease be traced to introduction, or did it occur spontaneously ? Over what extent of district does the disease extend ? No case of small pox has occurred in my district. WILLIAM SCOTT, M.D. Falmouth, 1th August, 1851. Please to add any observations which you think may be of importance. I believe that a very small proportion of the native population is now vaccinated. From lymph, lately obtained from England, some fifty or sixty persons were vaccinated a few months since. Appendix. It would be desirable that a periodical supply should be forwarded to tins place from the Royal Naval In- stitution, per packet. The lymph obtained from Kingston generally fail- ing, that on the other hand in hermetically sealed glass tubes being always found efficacious. w. s. Have you met with any cases of small pox in your district w ithin the last two months ? ]\o. If so, how many such cases have come under year notice ? When and where did the first case occur; please describe particulars t Did the case occur in vaccinated or unvaccinated persons ? Could the disease be traced to introduction, or did it occur spontaneously Over what extent of district does the disease ex- tend *? What is the existing state of vaccination in your parish ? Please to add any observations which you think may be of importance. i believe that the population of Trelawny are but very partially vaccinated, particularly in the rural dis- trict;. The negroes, generally speaking, seem indif- ferent". to vaccination, and it is only when impelled by dread of the disease, that is to say, when they believe it to be in their immediate neighbourhood, that they apply fo r the insertion of the vaccine matter. LEWIS ASHEN HEIM* Appendix. Duncan's, P.O. August 15th, 1851. Your letter of the 4th instant, has only reached me pi time to reply by this day’s post. 1 am Sir, your obedient servant, W. UALRYMPLE. T. J. Brown, Esquire, Secretary to the Board of Health, Kingston. Sir, Swanswick District. No, 1. Several cases of small pox have lately oc- purred. 2. About thirty.. 3. A month ago, at Hyde estate, the first two eases were those of two lately imported Africans by the ship “ Branclon,” of a yery mild type, which did not attract much notice. In a few days after, the disease spread amongst the creole negroes, and in a more ag- gravated form. 4. Unable to answer this question. 5. Answered in question No. 3. 6. About five or six miles round on the adjoining estates tp Hyde, Swanswich, Gibraltar, and a village called Haddington. 7. There has been no regular vaccination sjtncp freedom, (1834.) 8. A few days after the appearance of the disease in the two Africans, three creoles, man, wife, and child, (living under the same roof,) were attacked ; the man died, and the nurse who attended him has since died pf the disease. I have to notice two more deaths of Africans im- ported in 1849, and there are s.eyeral more cases in a dangerous state. The last supply pf vaccine lymph has taken. (Signed,) W. I)ALFjtVM1TE, 122 Appendix. Swausivick District, Whitehall, Trelawny, September 16th, 1851. Sir, I have to acknowledge the receipt of your commu- nication of the 6th instant, enclosing certain resolu- tions passed that day, by the Central Board of Health, regarding vaccination in this parish ; and I have to request the favour of your laying before the members of the Board, my anxious desire to carry out their suggestions, that I have already vaccinated some three or four hundred, and distributed lymph in various directions, and to all and every one who made application. I find it impossible to obtain a medical vaccinator, and in order fully to carry out the wishes of the Board, will have to employ one or two intelligent in- dividuals in this the principally infected and wind- ward part of the parish, and shall have, at a future time, to bring under the favorable consideration of the Board, remuneration for their services. The small pox continues to spread, and my report to the several sessions of the peace, held in Falmouth last Saturday, shewed one hundred and fifty cases which had come under my knowledge up to that date, with fourteen deaths; bull have to add two more fatal cases since, making in all, up to this date, sixteen deaths ; still, however strong, I think that the disease has not as yet assumed any, or in fact its usual ma- lignant character; and I am glad to find that the re- port about Stewart Town was much exaggerated ; for up to last week only two cases had taken place, and they have now the means of vaccination. I remain, Your very obedient servant, W. DALRYMPLE. T. J. Brown, Esquire, Secretary to the Central Board of Health, Kingston. Appendix* APPENDIX G. September 1st, 1851. IN PRIVY COUNCIL. Whereas his excellency the governor and council have received certain informal n that the parish of Trelawny, in this island, is threatened with the dis- ease called small pox, which has actually appeared in several places in the said parish : And whereas “ the Central Board of Health,” under the provisions of an act of the legislature of this island, fourteenth Victoria, chapter sixty, have drawn up rules, bye- laws, and regulations, for preventing the spread, and mitigating the violence of epidemic or contagious dis- eases, which rules, bye-laws, and regulations have been submitted for the approval of the governor and council, and certain of them have been confirmed and sanctioned by the governor in council: It is therefore ordered by his excellency the governor, with the ad- vice of the privy council, that until the further order of the governor and council, the following rules and regulations, submitted by the said Central Board of Health, shall be enforced and carried into effect within and throughout the said parish of Trelawny:—- 1. All rubbish, filth, or refuse of any kind, likely to be injurious to the public health, shall be immediate- ly removed by the parties depositing the same from dwellings and their immediate neighbourhood, to such place or places as the justices of the peace, in quarter or special sessions assembled, may, from time to time, appoint for such purpose. 2. All rank vegetation close to, or any thing that obstructs the free ventilation of air around dwellings shall be cut down and removed, due consideration be- ing had for trees planted for ornament and shade. Appendix, 3. All dung and other refuse of stables shall be re- moved daily to a place or places appointed by the said justices of the peace, and shall be there deposit- ed and got rid of by burning or otherwise. 4. All foul stagnant ditches, pools, glitters, or drains shall be covered and filled up, or shall be drained, and all accumulations of privy soil or other offensive decaying matter near to human dwellings, and which cannot be easily removed or destroyed, shall be covered with a layer of earth or lime. 5. The proprietor or Occupier of any house or houses, not provided with such conveniences, shall construct and provide suitable privy or privies for the accommodation of the inhabitants of sUch house or houses, due regard being had to the health and com- forts of the neighbourhood. & All houses which shall be pronounced filthy or unwholesome by any officer or officers acting under the instruction of the Central Board of Heallh, or wherein a case or cases of cholera or any epidemic or contagidiis disease shall have occurred, and which shall not have been inhabited since, or where no means of cleansing shall have been employed, shall be cleansed and purified by lime-Washing and such other means, as the Said Board may direct. 7. That an officef, or Officers, to be appointed by the justices of the peace in special sessions assem- bled, and acting under their authority in any place or places where the cholera or any epidemic or contagi- ous disease shall threaten to appear, or shall actually exist, shall have power to enter find inspect all or any dwelling or Other buildings, and all or any Court's or premises around such dwellings or other buildings which shall he suspected of being in an un- wholesome condition, and shall require the owner or occupier thereof, or any person having the custody and care of such building, to remove Or correct; withih a reasonable period of time, to be by the said justices Specified, all existing nuisances as shall be declared by the Central Board of Health to be injh* Appendix. Hous to health, whether by rendering the atmosphere impure, or by preventing the free access of air. 8. The said Central Board of Health shall have full power, and they are hereby authorized, to declare the means necessary for the proper ventilation of any building or buildings used as a dwelling or dwellings ; and such means shall be used and adopted in any place or places named by the said Board, so that such means of ventilation do not interfere with the rights of persons occupying lands or premises in the imme- diate neighbourhood of such buildings. 9. The said Central Board shall have full power, and they are hereby authorized, to cause to be pulled down and removed all or any other dilapidated build- ing or buildings which shall be uninhabited and in a filthy and unwholesome condition, unless the same shall be forthwith repaired and purified as the said Board, or any officer acting under the instructions of the said Board shall direct. 10. The justices of the peace throughout this is- land, in their respective districts, shall have full pow- er, and they are hereby authorized, when directed by the said Central Board, to hire or to procure houses* buildings, or other tenements, suitable for the pur- pose of being used as places of refuge and retreat for such persons as the said local authorities may see fit to remove out of infected houses or districts. 11. The said Central Board of Health shall have full power, and they are hereby authorized, to require and enforce the removal of inmates from houses which shall be declared by any duly qualified medical man, or other person acting under the instructions of the said Board, to be unwholesome, from overcrowding or otherwise, to buildings or places of greater safety. 12. The said Central Board of Health shall have full power, and they are hereby authorized, to engage any suitable building or buildings, ora room or rooms in any building, for the reception of necessitous per- sons attacked with cholera or any epidemic or com Vagious disease*. Appendix, 13. rhe said Central Board of Health shall have? full power, and they are hereby authorized, to re- quire the immediate removal and interment of the dead, and to make and issue all rules and regulations for removal of the dead and mode of sepulture, and to prohibit wakes and other idle congregations of per- sons in infected districts or places. 14. The said Central Board shall have power, and (hey are hereby authorized, to institute and establish a system of house visitation in towns or districts threatened or already affected with cholera or any epidemic or contagious disease, including a provision for the supply of medical and other assistance, and of medicines and necessaries, for the sick as well as for other sanitary purposes. 15. The said Central Board of Health shall have power, and they are hereby authorized, to require the local boards of health of the several parishes in the island wherein cholera or any epidemic or contagious disease exists, to send regularly, and by every post, to the secretary of the Central Board, a correct state- ment of the number of persons attacked by cholera or any epidemic or contagious disease, of the number of deaths in each town and district over which such local board presides, and containing such other par- ticulars as may be required by the said Central Board, in order that the information so obtained may be made public in an official form. Iff. The public authorities of this island are hereby required to execute the above bye-laws, rules, and re- gulations, or such of them as the said Central Board shall direct, in all cases where the owners or occu- piers of houses and tenements shall, from poverty or any other sufficient cause, be unable to carry out the same. 17. The Central Board of Health are hereby autho- rised to call upon the authorities of any parish in the island which shall appear to be threatened, or shall be already affected with any epidemic or contagious disease, to carry into effect the existing police and Appendix. other laws for cleansing and keeping free from nui- sances, and to enforce regulations enacted for that purpose in all towns, and that the said Central Board of Health shall also have power to employ a proper person to see the laws obeyed in those respects, when and as occasion may require, and to superintend the execution of any future rules and regulations that may be issued by the said Board under the sanction of his excellency the governor in council. Ordered, That the clerk of the council do cause the foregoing order of his excellency the governor in council to be published in “The Jamaica Gazette by Authority,” and to be communicated to the Central Board of Health. SAML. RENNALLS, Clerk to the Council. 128 Appendix, APPENDIX II, INo. 1, Central JJoard of Health, Kingston, September 1851. Sir, I am desired by the committee of the Central Board of Health, on the subject of medical relief, to address to you, as one of the medical gentlemen of the parish of the accompanying questions, and to request that you will afford the committee, which has been appointed to consider the best means of providing medical relief for the poor of this island, answers to the same, with such addi- tional information as may aid the committee in their- labours. 1 am also desired by the committee of the Central Board of Health, appointed to consider the sanitary state and wants of the different parishes of the island, to request that you will, previous to answering the above mentioned queries, favour the committee with a statement of the present sanitary condition and re- quirements of your parish or district. As the time is limited by which the reports of the two committees must be prepared, and the general re- port of the Central Board of Health be laid before the legislature, the Board desire me to request that your answers will be as prompt and full as the nature pf a written examination will admit. I have the honor to be, Sir, Your most obedient servant, T. JAMES BROWN, Secretary' True copy, John C. Macfarcane, Secretary, i. What is the area or extent in square miles your parish ; is it scattered, or congregated ?n towns pr villages is the land chiefly mountainous Appendix. 129 plains; are all the inhabited localities accessible by good, bad, or what description of roads ? 2. What was the estimated population of your pa- rish before the late hejyvy visitation of cholera ; and. what is the estimated reduction by the pestilence; are the adult survivors principally male or female ; what is their occupation, trade, or calling ; is it prin- cipally agricultural, or otherwise ? 8. What is the number of sugar or other estates in cultivation in your parish ; is the demand for labour in the cultivation of these equal to, or greater than, the labouring population can supply ? 4. What is tiie average amount of wages paid to an -estate’s labourer, per diem, in your parish ; how is it in general paid, regularly or otherwise ; and in money nr in kind ; are the people willing to work in the cul- tivation of estates; and if not, what cause contri- butes to their unwillingness ? 5. Please state, as nearly as you can, the amount of pauperism in your parish, and w hat is the number of persons who, from sickness, age, or other disability, are unable to contribute anything for providing them- selves with medicine and medical attendance. (j. What is the number of qualified medical practi- tioners in your parish; and please state their places of residence ; do you consider the number adequate to the requirements of the population? 7. Is there any public dispensary or hospital in your parish ; if so, please state how it is supported ; whe- ther by voluntary contributions or by the legislature, or by both ; and if by voluntary contributions, do the negro population contribute their quota towards the same; is there any medical practitioner resident in, or employed to visit such dispensary or hospital; and if not resident, at what distance from the same does he live; what amount of remuneration is paid to a medical attendant for his services ? 8. Are the negro population in general willing, w hen sick, to apply for medicines at such dispensary, or to submit to the discipline and medical treatment 130 Appendix. provided for sick persons in such hospital; if not, to what do you attribute their reluctance ? 9. Are you aware if the dispensary act of the ninth Victoria, chapter forty three, worked well in your parish, and throughout the island ; and if not, to what cause may its failure be attributed t 10. Who is the coroner of your parish ; please state his name, occupation, and place of residence, how he is remunerated, whether by a fixed salary, or by fees, or by both ; please also state the proba- ble income of the coroner in your parish, the average number of inquests held yearly, within the last ten years, the number of post mortem examinations aris- ing out of these, and the preponderating cause or causes of mortality. 11. Do you consider that any advantage would arise from the office of coroner being fdled by a duly qualified medical practitioner; if so, please state on what grounds. 12. Is there any register kept in your parish of births, marriages, and deaths ; and how far back does such register extend perfect and uninterrupted ? 13. What diseases are shewn by such register to have been most common and fatal during the last ten years % 14. Is the of marriage generally observed by the peasantry of your parish, or is their offspring ge- nerally the result of the illicit intercourse of the sexes 15. Is the practice of obeahism or myalism common in your parish ? lb. Are there in your parish any uneducated black men who practice on the sick as “ quack doctors ;,J and can you state what payment they receive for their 'visits or medicines! 17. Do you know of any instances where deleteri- ous drugs or noxious mixtures have been administer- ed by such persons, or have you reason to believe that such cases have occurred ? 18. Do you think that recourse would be had to V Appendix. 131 such “quacks” if the professional services of a suffi- cient number of duly qualified medical men could be obtained at a fair remuneration ; and do you consider that a preference would be given to such last named persons? 19. Do the negro women generally apply for the assistance of such “ quacks” during the season of child-bearing ; have you known of instances where unskilful treatment has resulted in injury to the child or mother ? 20. Have you any reason to believe that the crime of infanticide is ever committed in your parish, either by the mal-practices of such “ quacks,” or by the mo- thers themselves ; and what, in your opinion, would be the effect of more extended medical relief towards the suppression of such crime ? 21. Do you think that a legislative provision, hav- ing for its object the encouragement of medical gen- tlemen to visit and reside in this island from England, Ireland, or Scotland, would be acceptable to the la- bouring classes of this country; and would the gen- tlemen so coming here be likely to meet with a fair share of employment, producing a competent living? *22. If the legislature should impose a tax for the purpose of providing medicines and medical aid throughout the different parishes of the island, under the denomination of a “ Medical Relief Tax,” how do you consider such an impost would be paid—wil- lingly or not; and what method would you advise for laying it, on the person, or on the property, and on what description of property ? 2d. Is a proper and adequate supply of medicines provided and kept in your parish in the event of any epidemic disease appearing therein ? 15c pleased to state anything that may occur to you as useful to be known to the Central Board of Health, on the subject of medical relief generally, and parti- cularly in Jamaica. True copy, John C. Macfarlane, Secretary. 132 Appendix,, APPENDIX II, No. 2. Answers of the honorable Hector Milchel, cuslos of Kingston, to the questions appended to circular of 8th September y 1851. 1st. It extends along the sea shore about five miles and a half, and may be said to be one mile in breadth north to south, lying on an inclined plain and partly on the long mountain, and all accessible. The soil is clay, and may be cultivated into gardens. The roads require frequent repairs. It has never been sur- veyed. 2nd. The population was never correctly ascer- tained, but was variously estimated from forty to thirty-five thousand. The loss by cholera may be considered three thousand five hundred. It has not been possible to ascertain the proportion of ages and occupations. A very small proportion of agricultu- ral occupation may be mixed with the inhabitants. 3rd. There are no sugar estates. 4th. There is no rule of wages for estates labour. 5th. The number of paupers on the list is ninety- one males, and three hundred and sixty females, and the cost for the last twelve months £‘4340. At the present moment half the number of the inhabitants do not know how to provide themselves with subsist- ence, and they shift among themselves from morning to night as they best can, therefore unable to provide themselves with medicines and medical attendance. Oth. There are ten doctors in this parish. It would be difficult to calculate the requirements of a poor population. The number of medical gentlemen in practice appears to be sufficient for the ordinary calls of payment* Complaint exists among the pau- pers. 7th. There is no public dispensary, but there is a Appendix. public hospital. It is supported entirely by the legis- lature. There is a private dispensary supported by individuals who contribute a small sum each. The remuneration for medical attendance is, I am told, small. The fifth Victoria, chapter eighth, provided that each parish should have a parochial asylum, and authorized the establishing of dispensaries throughout the island, but it is repealed. 8th. The negro population in general are willing to take medicines from a dispensary or submit to medical treatment if they get it for nothing, but in many cases would rather die than pay for it. 9th. 1 am aware of the ninth Victoria, chapter forty-three, and it was never attempted to be carried into effect in this parish. I cannot answer for the other parishes. 10th. The coroner’s name is Benjamin Naar, a to- bacconist, and lives in Harbour and Hanover streets, and is remunerated by fees. 11th. A medical practitioner filling the office of coroner would, as a man of education, be more com- petent. 12th. There is a register of births and deaths, and it has been opened for registering since the year one thousand eight hundred and forty-four, but it is very little used in consequence of no penalty to enforce it. 13th. The diseases have not been attended to. 14th. The rite of marriage is comparatively little attended to, and I fear is generally the result of illicit intercourse of the sexes. J5th. The practice of obeahism and myalism occa- sionally shews itself. 16th. There are persons uneducated among the black and coloured inhabitants, who assume to them- selves a knowledge of quackery, and no doubt do mischief, but are not easily detected. They take any thing they can get as remuneration, but they do not shew it. 17th. I have no doubt that deleterious drugs and 134 Appendix. noxious mixtures have been administered by such persons. 18th. Ignorance predominates so much among the lower classes, that they do not pretend to judge for themselves, and I think compulsion would be neces- sary for the preservation of society. 19th. Negro women are very commonly used as midwives in child-bearing. It would be ditiicult to bring their unskilful treatment to the child, or the mother to a legal conviction. *20th. The crime of infanticide is occasionally oc- curring, but is of very difficult detection. Society must be more generally refined, and morality more generally diffused before that crime can entirely dis- appear. 21st. The welfare of the island depends upon a le- gislative enactment to provide the island with the ne- cessary medical assistance, to enforce the rules ne- cessary among an ignorant population, for the preser- vation of life. 22nd. The experience the island has already had by the cholera shews that medicines and medical aid should be provided for by the legislature, whether it would be willingly acceded to or not. If the same ruin should continue to the island, no person or pro- perty could bear such an impost. If prosperity should follow cultivation, the legislature could have no difficulty in aportioning the measure of taxation. 23rd. I believe a proper and adequate supply of medicines is not provided and kept in this parish to meet the wants of an epidemic disease appearing therein. I was much surprised, on the late visitation of cholera, to find a deficiency of medicines in the whole island, and as Kingston was considered the capital and the principal place of commercial inter- course, every part of the island looked to it for a sup- ply. Medicines are of no great value, and, in future, it would be culpable negligence to be without a rea- sonable supply. Appendix*. 135 .Answers of Dr. Chamberlaine to circular 8th Septem- ber, 1851. A statement of the present sanitary condi- tion and requirements of the city and parish of Kingston, by R. Chamberlaine, M.D., M.R.C, S. London. The committee of the Central Board of Health in their circular of the 8th ultimo, desire “ inter cilia” to have a statement of the present sanitary condition and requirements of this parish. One of these “ circulars' is addressed to me, and I hope I shall be found readily disposed, when any re- quisition is put forth, and couched in the language of courtesy, as this “ circular” undoubtedly is, to meet the wishes and desires therein expressed, and particu- larly on a subject of such primary, of such paramount interest and consideration. A subject indeed that in- volves life itself. A subject in which our very exist- ence, one and all, is intimately connected and mainly depends ; and who and what members of our profes- sion would be backward or indifferent in responding to, or complying with, an application so complaisant- lyinade? None surely. But let one ask, in sober seriousness, is it not a work of supererogation ? I think it such. Have not reports of a similar nature been repeatedly made ? Have I not often individu- ally called the attention of the authorities, aye, in print likewise to the state of such things ? Have I not for special reasons conducted the queen’s com- missioner in person, overall those sections of the city in which abominations were most frequently preva- lent, and most commonly to be seen, and which I conceived should be brought under the notice and cognizance of such a functionary I Verily 1 have! And what utility, what benefit have these labours brought forth? What indeed? What attention or care has, at any time, or in any season, been bestowed upon Appendix. this most important, most absorbing subject? Has it ever met with the due consideration its neglect in- volves, or the dangers with which it is always preg- nant, and by which it is still surrounded, and may again entail upon this suffering, pauperized commu- nity, another overwhelming calamity, sooner or later? I say what are the results of all this trouble and exertion and cost of time? Aye, what? Nil ! We only w rite and talk, nothing more! In obeying the requisition of the 1 have only to toil “« tale of leu told;" that almost all, or most of our streets, lanes, and thoroughfares, continue to be, and are in the same condition as they were antecedently to the frightful and destructive visitation of last year. They were then, as all men know, a blot and a reproach upon our system of municipal government, and a disgrace, a curse, an eye-sore, and an affliction of no ordinary character to a civilized and enlightened community. With their foul, fetid pestiferous emanations, and ac- cumulated filth, their deep pits and rugged excava- tions, more like ravines and water courses, danger- ous alike to man and beast, and consequently unlit for travelling night or day, and in many instances so uneven and irregular as to resemble the undulations or hearings of a troubled sea after a storm, (e. g. Ox- ford, Bond, and Charles streets,) so intersected by ruts and hollows, as to endanger the safety of every vehicle that attempts to pass over them; such as they are, they have not, I assert, their parallel on the face of the earth. The neglect in which the city of King- ston is left in all such matters, is strikingly apparent at all times. It has ever attracted the notice of Europeans and foreigners, w ho have had the misfortune to land on these shores, to he disgusted with its filthy condi- tion. Its sanitary condition has been generally sta- tionary, always bad, but certainly the evil has in- creased, and become worse annually, particularly since negro emancipation, (premature, hasty, injudi- cious, reckless emancipation,) was thrust “ nolens miens' upon these ill-starved, doomed colonies. Appendix, 137 From tills source, and the inflexible perseverance in n stubborn, perverse, dogged policy, conspicuously baneful and destructive, almost all the calamities and disasters that have befallen this once flourishing and prosperous island, (and still continue to afflict it,) may be solely traced or mainly ascribed. Surely clean, smooth, orderly and level streets, lanes, and thoroughfares are closely, nay, intimately connected and blended with the comfort, with the wholesome, healthy, prosperous condition and circumstances of its denizens. Then, let me ask, how can the sanir tarv state of a city be improving as long as its tho- roughfares are suffered and continue to be the depo- sitory of variform carcases, under various degrees of decomposition, or putrefaction, or filthy, offensive, poisonous fluids proceeding from, and running out of all the the yards and horse stables into the streets and lanes, and there forming pools for swine to per- form their daily ablutions and bask in f As long, in fact, as dirt, carrion, ordure, offal, broken glass-bot- tles and tin kettles, cocoanut shells, dead dogs, cats, and pigs, rats and fowls, are cast into the public a It leys and thoroughfares, and allowed to remain there unremoved and undisturbed,* so long will the atmos- phere become more polluted, more unwholesome, and consequently unsuited for the purposes of life, causing sickness and mortality, particularly amongst those most exposed to its influence in confined, damp, low, narrow nnventiiated hovels and decayed houses—-surely where such horrors prevail that town or village is no longer a fit place, a meet habitation for civilized man, and so long must the sanitary con- dition of such be at its ebb. It is a sad tale to tell, but these are not the only nuisances and wrongs the gnoral, sober, and virtuous portion of the inhabitants * Daring the prevalence of cholera in this town, it was not uncom? wscm ito see foul beds. Linen, pillows, blanket.?, lying in the public streets, thoroughfares, and dunghills, unnoticed or untouched until th.,e jCWie* pounced upon the prizes and sacked them, quite regardless of tany consequences connected jvith the infectious or cpnfagiom #&iuf*s #1' "■foiftittt,* ' * 138 Appendix. have to encounter and endure day after day, year af- ter year, apparently without reform, without remedy ;• other abominations exist, are seen, felt, and borne, equally disgusting, equally dangerous to life, and equally expose us to disease and death. “ We live under an enlightened government,” people tell us, and some prate about it in the public prints. I do not think that the absence of sound regulations or con- tempt for, ora wilful neglect of the laws, are proofs of this assertion ? Some have began to manifest a dispo- sition to resist and put them at defiance ; perhaps this is the new mode of shedding light upon an idle, slothful, semi-barbarous race. The new code, per- haps to promote order, peace and industry, or “ to teach the young idea how to shoot,” or to regenerate the worthless, indolent, thievish, self-willed “ independ- ent paupers” that infest in myriads the town and its vicinity. I record the fact with sorrow and regret, that in this city almost all the laws and ordinances that enjoin, or contain, or have for their object any wholesome regulations and rules, for the promotion and preservation of the public health, or for keeping the town in a clean, orderly, and sound condition, and for repressing and correcting all such nuisances as render it foul, filthy, and uninhabitable, are allow - ed to remain in abeyance. They seem as if made to be violated, or to be thrown aside unnoticed and unheeded, and there they lie neglected and unen- forced. These are well known facts, so that none can have the temerity to gainsay such statements.— INow then what are the sad consequences to which all classes become obnoxious under such circum- stances, under such an accursed system ? Why, countless numbers of meagre, hungry hogs, and starveling curs belonging to the lower orders are suf- fered to spread themselves over the town, to peram- bulate the streets, and to roam undisturbed in all di- rections. There is scarcely a street, or a lane, or a dung hill, ora dirt heap, or a foul recess of any de- scription where these animals are not seen congre- Appendix, gated together, or found alone, revelling unmolested in filth, or taking their customary repast upon offal, or ordure, or the putrid carcasses of their own, or other species of animals found in abundance (and readily found) in these localities at all times, it would seem for their accommodation and for which purpose their owners set them loose. There is no call upon their purse for this systerr\, of dieting their pets ! It may be contended that hogs and dogs are scaven- gers, be it so, but they are both nevertheless a migh- ty nuisance,* inasmuch as they add to the collected filth, and are besides a source of great inconveni- ence and danger to travellers. This is not all, the hogs form with their snouts, in most of the public avenues and thoroughfares, large excavations, thereby adding to the danger and unsafety of life and limb, exposing, as well, all kinds of vehicles and the quad- rupeds in common use, to the same contingencies.— in a sanitary point of view, I shall notice other mat- ters connected with their being at large, hereafter.— How these pests to our community are disposed of, after they get into good condition, 1 shall not at- tempt to sicken the Board with a detail of the process, suffice it to say, that those who are fond of sausages, or swine flesh, or as it is termed in common parlance, “ country pork,” may hear of the recherchce dishes that are occasionally prepared for the gratification of their gastronomic propensities, and it is worthy of record, that the keeping and rearing of this species of animal, and that too at the cheap rate of feeding which has been adopted in common, and brought under notice in the preceding lines, forms no incon- siderable source of revenue to this class of our popu- lation, hence the feeling of resistance to the laws ma- nifested when any attempt is made to mitigate such * Surely nothing can be more glaringly indecent, wore preeminently- calculated to produce disgust and loathing as quoad nauseam, or to taint the morals of youth than the filthy scenes that are too frequently exhi- bited in the public streets and lanes daily, when hogs, dogs, and goati are permitted to be at large at all hours iy, them. 140 Appendix; a crying evil. The sanitary condition of the city is more seriously affected and more permanently dam • nified by other causes than any yet brought under notice in the foregoing pages, of which I shall shortly speak more at length. 1 have, in a cursory manner, hinted at the pits and cavaties discoverable in all di- rections, by the sides, and often in the middie, of the most populous streets after heavy showers. These are quickly filled with water, in which swine are ac- customed to wallow and bask. They soon become stagnant pools, emitting foetid exhalations. These pools are found also in the yards of the miserable ho- vels in which the masses are chiefly domiciliated, and this at once brings me to the immediate considera- tion of other sources by which the sanitary state of the metropolis is more seriously damaged than any yet recorded, such sources of contamination as de- mand immediate attention. The wretched hovels, tenanted and occupied by the masses, ] maintain, present to our view the worst receptacles of filth and miasmata it is possible to con- ceive, and such as nobody can contemplate without the most thorough disgust and alarm. These loath- some habitations are in the worst condition one can imagine. They are not confined to any particular quarter4 of the town, but are found, now a days, in all directions, and are nothing more or less than “ pest- housesThe walls and floors are saturated with rain water, that percolates through the decayed roofs.— They keep them generally closed and unventilated both night and day. In very many instances there are no floors, so that their inmates repose upon the damp earth. Such is the condition and state of their dormitories. Now, in what circumstances do we find the yards of these wretched dwellings ? Soon after the town became supplied with water by the compa- ny. the washerwomen discontinued and left off the washing of clothes out of the city, as they were wont to do at Rock Spring and elsewhere, but now a days they carry on this operation in their yards. There Appendix. 141 innumerable tubs, set in rows, will be found, all con- taining stale soap-suds, or putrid soap-water, become so from keeping and allowed to remain in that state for days, they are then upset or cast into the public streets and lanes, where, amalgamating with mud and other offensive materials, it forms a most noisome and poisonous compound, generating in their neighbour- hood intractable fevers and other distempers, which spread and infect all who have the had luck to be within the range of their baneful influence. There also will be seen lean hogs, starved dogs, and fa- mished goats, (all like their owners and their family huddled together,) the excreta of which, scattered in all directions, emit a most intolerable stench. The recent pestilence afforded me ample opportunities of entering all such places, and during my visits 1 was compelled to keep my pocket handkerchief applied to my nose. To these may be added the putrid ex- halations from their hogsties, (generally erected next to, and seldom far from, their narrow sleeping rooms or cabins,) and also from their scanty confined shal- low privies, never purified, never cleansed, never emp- tied. The occupants of these low and filthy hovels live poorly and nastily. (As the foundation of ano- ther source of malaria, I shall have occasion to speak of the quality of their food soon.) They generally appear attired in rags, and their persons are ever fil- thy and offensive. They are chiefly daily labourers, washerwomen, house cleaners, coalers, fishermen, coblers, eanoemen, grave-diggers, &c.; such are their occupations when they choose to exercise They belong to the class of independant paupers.—• The next abomination to which I shall call the atten- tion of the Board is the converting of some of the public streets into a market or mart, for the expo- sure and sale of putrid salted fishes, (cod, salmon, mackerel, herrings,) pork, beef, hams, and rotten cheese ; all these articles of human food are found laid out in stalls or tables at the west end of King- ston, and elsewhere, One third of Princess street i* 142 Appendix. thus disposed of, on both sides. Bourden street, from the intersection at Princess street, to West street, is similarly appropriated. The stench emanating, at all times, from these unsound provisions is absolutely suffocating, increased, as it frequently is after show- ers, by the filthy pools of muddy water, or putrid mire, immediately in front of these disgusting booths. Are such likely to damage the sanitary condition of the town ? Are they calculated to engender disease ? Is the health of the people likely to suffer from such a loathsome accumulation of malaria ?—I mean those that are in proximity to the effluvium. The havoc made by the recent pestilence, in these districts, is a suffi- cient response. It is impossible to look at the in- mates of these shops and dwellings, where such arti- cles are kept and sold, without feeling a deep com- miseration ; their countenance is pale, sallow, blood- less ; their bodies are lean, asthenic, and withered, their limbs refuse apparently to perform the functions for which they were destined ; in fact, a better sub- stitute could not be found for the “ anatomie vivante.” They are painful specimens of the baneful effects of inhaling an impure atmosphere. The articles enu- merated, and thus put forth for sale, constitute the principal food of the independent paupers. Imme- diately after cholera travelled to these shores, the in- mates of such foul, filthy habitations, in all quarters of the town, became the first, and almost, with few exceptions, the principal victims of this desolating and extraordinary malady. In a Oygeian point of view, this was to be expected, and consequently the ravages of this direful pestilence, in such localities, were most frightful and formidable. The virulence with which its victims was assailed had no parallel, except at Kurrachee, when it fell upon the military, where, in little more than five minutes, the hale and hearthy were cramped, colapse, and dead ! They were speedily decimated in all such quarters. In very many instances they severally became corses in two hours! The absence of cleanliness and ventilation Appendix. 143 was conspicious all around their dwellings ; in tact, the sanitary condition of the town could not be worse when the destroying fiend alighted amongst us. The whole country was quite unprepared in every re- spect’, and the results of the dreadful visitation are now well known and most severely felt. In this colony alone, at the lowest calculation, not less than thirty-six thousand persons (chiefly the agricultural classes) perished. In this city, the deaths could not be less than five thousand ; and in fourteen years, from 1817 to 1831, Macaulay states, that fifty mil- lions of the human race have been swept off by this scourge alone ; and since 1832 to 1850, Gunn adds ninety millions more, making a total of one hundred and forty millions destroyed by cholera in all parts of the globe. Great Britain supplies its quota at above one hundred and twenty thousand victims in 1832 and 1849. It is incumbent, as it is useful, to relate that in certain quarters of this city, where the streets happened to be free from most of the abominations (set forth and described in this summary) and where sanitary processes and free ventilation were put in force and strictly maintained, not only in the dwellings, but in the yards and out-offices, there the scourge seldom paid its visits, and when it did, their inmates were more commonly attacked singly, generally es- caping the fate of their less fortunate fellow-citizens. Cholera then, malignant cholera, would appear to be the disease of filth and malaria, never controlled or confined within bounds by any guards, police, sanita- ry cordons, or restrictions of any description. Hav- ing endeavoured to place before the Board most of the noticeable points that have reference to the sani- tary condition of this town, (once the abode of wealth, and rank, and grandeur,) I proceed to consider the last demand of the committee of the Central Board of Health, viz.:— “ a statement of the requirements of your parish or district;” and in the circular trans- mitted to me, the Board desire “ that your answers will be as prompt and full as the nature ©f a written, 144 Appendix. examination will admit.” 1 hope 1 have in this in- stance met their request; and 1 hope the answers in both documents are as full as the nature of a w ritten communication will admit, and as prompt as the li- mited time prescribed by the Board for the conside- ration of subjects so truly momentous, and of such deep interest to all classes will allow. And now I be- lieve ! should stop ' I do not desire to throw any obsta- cles or impediments in the path of improvement, nor do T feel indifference or supineness for the reformat tion of abuses ; on the contrary, every honest man, every good eiiizen, who has made these beautiful is- lands his chosen abode, or Ids adopted country, or who is forced to spend his days in them, hopes to see those laws faithfully carried out, that have for their object, the preservation of his health, the pro- curement of his comforts, the providing for his safety, by the exclusion of destructive or pestilential mala- dies ; in fact, all such as throw around him protec- tion for life and property, and the certain correction of all evils, moral, social, and physical. It is easier to find fault than to apply a remedy. The remedies sought after and loudly called for in the present emer- gency, (the vestHence has not as yet departed our shores,) are surrounded by difficulties of no ordinary stamp, fn the exhausted and embarrassed state of the public finances, one is really at a loss what to recommend—■ what answer to make to a question of such vast im- portance—-one in which all human interests are more or less concerned or interwoven—or to describe or to suggest “ what are the requirements of your parish ?” But 1 am digressing. 3 humbly submit that the rigid enforcement of the laws, (even such as they now stand on the statute books,) is one of the first require- ments. This is imperatively demanded if the ques- tion of sanitation is to be seriously entertained. In a community so peculiarly constituted as this is, it may turn out a more difficult task than is imagined ; ** fflw labor, hoc opus.** Liberty of the subject is a great privilege, but not to be tolerated wfxen if Appendix. 145 tlie public weal.’’ By a faithful and strict observance of the laws a vast amount of existing evils might be overcome. As soon as these are put into actual ope- ration, others may be devised, having for their object general internal sanitary arrangements, and other reme- dial measures. 2d. A continuous and plentiful supply of water for the irrigation of the streets, and for all pur * poses of internal cleanliness. 3d. Sewers and ces- pools, to carry off, to the remotest distance, all the noxious fetid fluids now collected and retained in most yards, a large portion of which afterwards run into the streets and lanes. 4th. The prohibition of washing clothes in the town. 5th. The destruction of all old decayed and filthy hovels. 6‘th. The tax on dogs, to be imposed and enforced without distinction, so that the town may be rid of the superfluity of these pests by night and day. 7th. The immediate aboli- tion or removal of that pre-eminent grievance, preg- nant at all times with danger, “ The market of abo- minations” kept at the west end of Kingston.— 8th. And, second to none, an amended and stringent enactment to rid the town of all hogs and goats ; at all events to exclude or keep them confined out of the town, as is done in Barbados. 9th. And last, though not least, a special sanitary police, appointed and paid to carry out the ordinances and laws in all such matters which have been hitherto neglected and al- lowed to moulder on their shelves. The late police and the present constabulary force are ineligible for vsuch a service; and if reasons were required to be ad- duced for such assertion, they shall be furnished, even as plentiful as black-berries. I have refrained from touching as yet, except in a partial manner, upon a source of malaria I consider as pestiferous as any—• I allude to the privies of the whole metropolis. It is supposed that their numbers are not much below three thousand. 1 believe I can assert, without fear of contradiction, that none have been emptied (an act of cleanliness—-a duty seldom neglected in former days) since emancipation. Night-men are no longer Appendix. to be found, they have been converted into gentlemen. Are these depositories, daily accumulating, to remain thus ? Are they not concerned in tainting the atmos- phere and disturbing the sanitary condition of the town? Undoubtedly they are. It must be kept in rememberance that atmospheric impurity is not al- ways confined to the domiciles of the wretched. When the north or the west winds prevail, the atmos- phere, in the dwelling now occupied by me in Hast street, becomes so painfully disagreeable and offen- sive, in consequence of the effluvia being wafted into its chambers or apartments from the neighbouring privies, (never emptied, never purified,) that it com- pels the closing of doors and windows for its exclu- sion. How to deal with this mammoth nuisance, (such a pestiferous accumulation of putridity,) I do not offer, at present, any opinion. I must leave it to the superior wisdom of the learned Board, as well also as the following sink-holes of corruption :— Jst. The barrack privy nuisance. 2nd. The railway putrid mud nuisance. 3rd. Idle public hospital privy nuisance. 4th. The intramural interments nuisance. 5th. The intramural slaughter house nuisance. 6th. The Solas market nuisance. 7th. The carbonic gas nuisance.* The atmospheric pollution which such a hoarded conglomeration-must necessarily produce, can hard- ly be less fatal than the destructive epidemics by which we have repeatedly suffered, tending, at the same time, to increase their virulence. And however ignorant we may stiil continue to remain of the real causes of zymotic and epidemic distempers, we know * It rqay be asked what is this nnisap.ce? It is the gas evolved iq lime kilns and wafted into our dwellings by the sea breezes, or north winds—the respiration of which is very oppressive, and interferes with sleep ; and consequently is unsuited to the delicate structure of our lungs? Man carries a pair of them beneath his ribs, fitted only to in- spire oxygen and nitrogen in the;r purity—a physiological fact most people seem to forget, and very few care about; nevertheless it is upon this important consideration that our enjoyment of health mainly hinges. Appenaix, 147 that filth, uncleanlmess, and an impure atmosphere, ate positively favourable to their outbreak and to the virulence of their ravages. In these pages sufficient proof, I hope, has been adduced of the irresistible truth, of the damning fact, as it had reference to one of the causes, and also to the awful consequences of the dismal pestilence by which this unfortunate colony was afflicted last year. It therefore behoves the authorities, when put in pos- session of such testimony, to adopt at once, afrd urge upon the legislature the carrying out, without delay, such a scale of general and effective remedial measures as will ensure and fix upon an immovable basis the pro- motion of the public health : the maintenance of order, cleanliness, and decency, (public and private,) as well as the abatement or the annihilation of every nuisance wherever found, moral, social, and physical, by which this Community has long been, and is, up to the present moment, afflicted, degraded, and disgraced V In these colonies the science of sanitation is in its in- fancy, but it is hoped that the “ circular” is ini- tiatory to a sanitary movement, in this city at least, the ultimate effect, whether so intended or not, lies beyond the pecuniary advantage, pounds, shil- lings, and pence. I must draw this hasty sketch of the sanitary con- dition and requirements of the parish to an end, begg- ing the committee to keep in mind, that “ we have outlived the notion that the calamitous results of hu- man error and social ignorance are the direct and in- evitable inflictions of Providence, to be submitted to with Mahommedan fatality. The philosophy of cause and effect has cleared the question of most of its difficulties, and we can but trust that far-reaching- views will he combined in its solution with soundness of judgment and promptitude of action, and that a li- beral spirit will animate all parties in the furtherance of so grand and benevolent a work.” Appendix; 148 Answers of Dr. Chamherlaine to the questions append* ed to circular 8th September, 1851. No. 1, 2, 3, and 4. These questions appear to have reference chiefly to agricultural districts, 1 may saj al- most exclusively so. I therefore, as an inhabitant of Kingston, the principal city of the British West In- dies, leave them to be answered by the medical gen- tlemen and others residing in such. No. 5. An able writer says, “ the pauperism of England is to be attributed, in a great measure, to the reckless and improvident habits of its labouring poor.” Now, if the habits of the English labouring poor be in reality such as to elicit such an opinion, a fortiori, with how much more force, and truth, and correctness, may we apply the remark to the lazy, indolent, emancipated population of these unfortu- nate decaying colonies, who have none of the numer- ous evils with which their European brothers have to contend. The same writer continues to inform us, “that th e greatest prudence, united with the greatest industry on the part of the poorer classes, will not always save them from want. “This is frequently thecasein England, where wages nreloiv, compared with the expencesof living, so that an ordinary labourer often cannot, in the period of his life, when he can do the greatest amount of la- bor, save any thing against the time of decrepitude or sickness, and the children of suffering parents must suffer witii them. The question in regard to such is, by what means shall their present distress be relieved 1 The economists of the new school (as it is sometimes called) say, that they are to be abandoned to starvation. But a doctrine so abhorrent to our nature, is only a hideous theory which cannot enter into the laws or habits of any people, until human na- ture shall be sunk into brutal hard-heartedness. The dictates of religion, conscience, and compassion en- join us to give relief, and the only questions practically Appendix. discussed, relate to the mode and degree of Ihe as- sistance to be afforded, and the measures which ought to be adopted for reclaiming such as bring their misery upon themselves, by vice and idleness.. The two great objections are, remedy of present suffering, and prevention of future ; and these two objects are very much blended, for it is a great rule so to administer succour as not to encourage idleness or vice. In the case of young subjects of relief, the greatest charity is that which is directed to the forming of good ha- bits and giving them instruction in useful arts. With older subjects there is very little hope of any great amelioration of character. But even with these, a re- gard to the influence upon their habits is constantly to be kept in view in administering to their present wants. “ One essential condition is, that they should he made to labour, and thus contribute as far as is possible to their own support. As to the sick and infirm, the rest of the community are bound to support them by a just assessment of the expences.” These observations strictly apply to the “pauper- ism” of Kingston as well, but it may be useful to se- parate pauperism from vagrancy, before the answer is made to the question in reference to “ the amount of pauperism in your parish?” Dalton gives three classes of poor, or pauper. We have them all! Of the first two, the numbers are not very great and they are provided for, as will be seen hereafter. It is to the third class I shall direct my observations chiefly, “ the poor by prodigality and debauchery, also called thriftless poor ; as idle, slothful persons, pilfer- ers, vagabonds, strumpets,* fyc.” It is upon this over- * M. Duchatclet, after tracing the first causes of prostitution to an irregular life, says, in his elaborate statistical work “ on the Prostitu- tion in the city of Paris,” “ This is a general cause, and acts upon all indiscriminately, but there are secondary causes which he thus notices in detail. Laziness may be placed in the first rank; it is the desire of procuring enjoyment, without working, that causes many young wo- men to leave their places, or to refrain from seeking others when oat of service. The laziness, carelessness, and cowardice of prostitutes have 150 Appendix. whelming' community of vagrants that my answer shall hinge—“ those who produce nothing, and who contribute nothing, either for their own support, or become almost proverbial. Misery, proceeding to frightful extremes, is also one of the most active causes of this evil. Vanity, and the desire of being finely dressed, is another active cause of prostitution, particu- larly in Paris, where simplicity in dress is actually a subject ofre- pioach, and shabbiness is still more condemned. * * * * * * * * * Those who know the ex- tent to which love of dress and finery exists in some women, will easily judge of the activity ol such a cause of prostitution in Paris.” State of education among these women.—On registering the prosti- tutes it is customary to make them sign an engagement that they will conform to all the measures of sanity and safety which are prescribed by the police “ It appeared to me,” says the author, “ that these sig- natures might make known, to a certain extent, the education which the signers had received. T therefore considered that all those who had declared that they would not sign their names, and merely made a cross, or some other mark, were entirely ignorant and uncultivated ; that those who could sign should he divided again into two classes, viz : into those who wrote well, and those who wrote badly ; of the four thousand four hundred and seventy prostitutes born and brought up iu Paris, two thousand three hundred and thirty-two could not sign ; one thousand seven hundred and eighty could sign, but badly ; one hundred and ten signed well ; many of them indeed particularly so. Of two hundred and forty eight, 1 had no information. Of those who were born in the departments the proportion entirely without educa- tion, was still greater—of seven thousand six hundred, four thousand three hundred and fifty-two were unable to sign: two thousand seven hundred signed badly; ninety-five signed weli; four hundred and fifty- three penmanship not known. Of the five hundred and one foreigners, two hundred and forty-five could not sign; twro hundred and seventeen signed badly ; seventeen signed well ; twenty-two, their writing not known.” Now, I would ask do these observations in any wise embrace a class, or do they apply to the habits an t customs of the swarms of ladies found in Pink, Chesnut, Hose, Bread. Matthew's, and Peters' lanes, of this delectable town? Many in addition may be expected from the rural districts to swell their numbers, it being more than possible that “ Othello’s occupation's gone.” Poor Jamaica ! Under the sway of one of the most urbane, hospita- ble and witty of her rulers, long lingering in the hopelessness of dis- pair, is doomed to abandonment and irretrievable desolation! But what can Sir Charles Grey do to save the gem of the x\ntilles ? The beautiful land of springs! whose peaceful green hills, and fertile plains and cultivated valleys, will soon resemble those of the sister isle! whose sable sons, retrograding in the scale of human beings, must speedily return to lawless life and unmitigated barbarism. A land where civili- sation and the arts once flourished—but alas! “in the vicissitudes of thingsis consigned to destruction—to ruin—to utter annihilation 1 a desert! a wilderness ! another Hayti! a land “ Where savage monsters roar, Where love ne’er deigns to dwell,” And must it he so ? Such will be the effects of emancipation, free trado; fend cheap sugar! Appendix. 151 the support and enjoyment of others, are, in every community, a public nuisance ! ’ And such is the third class, as defined by Mr. Dalton, in its strictest sense. The amount then of “ such pauperism” in King- ston is very great indeed, it is becoming more pre- valent, more rampant daily, and how can it be other- wise ? The laws and ordinances are frequently in abeyance. They are, such as they are, in many in- stances, a dead letter; and the negro population are consequently more prone and disposed to vice and idleness, and crime, since premature emancipation was forced upon these colonies than before. They very frequently refuse all kind of honest employment, and when engaged for any kind of labour, their con- duct is always marked by dogged disobedience, in- dolence, and sluggishness. They go where they list, and in fact, do as they please, thus producing utter disgust in the employer. The domestics partake of the same characteristics. They take or refuse work as they please, and often prefer wandering and roaming about in all directions, night and day, like their hogs, committing petty thefts upon all lands, open, or otherwise, or they are engaged at nights in plundering stores, wharves, or dwelling houses, and thus we find when struck down by sickness, or acci- dents, or maimed by their fellow-man in squables and fights, (I allude to the young' and robust of both sexes,) they seek for pauper medical and other aid ; they have no means, no pecuniary resources in reserve, for pro- curing sustenance in such cases, and under such cir- cumstances, but should they, at any time, possess themselves of coin b v honest, or dishonest callings, the men squander and exhaust their stock on cigars, rum, dress, and concubines. The women on finery, silk pa- rasols, polkas, muslin gowns, and white kid gloves, with which they decorate the persons of themselves and children, in imitation of, and often vying with, their superiors. The emancipated negro of these co- lonies is in fact, an “ independent pauper,” (particu- larly those resident in towns,) and some of our legis- Appendix. iative acts render him hold, insolent, and however anomalous it may seem, idle, tending at the same time to confirm him in his assumed independence. Neit her sex work continuously now a days. When the insolent and refractory conduct of the men exclude them from employment, the labour is then performed by women. They, in turn, work irregularly, and when not occu- pied in any honest vocation, pursue and indulge, at the same time, in a dissolute and profligate course of life. Adultery and fornication are almost exclusively confined to this class. It is proper to state in answer to the question propounded, that those “ who, Jrom sickness, age, or other disability, are unable to con - tribute any thing for providing■ themselves medicines and medical attendance,” receive such at the ex- pense of the public, at an outlay of £5000 per an- num. On the “ pauper list,' the names of four hun- dred and fifty persons, termed out-pensioners, will be seen, on whom eleemosynary assistance is, be- sides, bestowed weekly, at the rate of £50 sterling. Independently of, and apart from, this number on the pauper list, the quarterly returns of the medical officers will exhibit an average, annually, of above six hundred others, visited and prescribed for at their homes ; for all these services a paltry reduced salary of £1*20 is awarded to each. The numbers are increasing. In the year 1810 the numbers did not, altogether, exceed ninety, including the then ci- ty guard, for which the surgeon received £300 per annum as salary ! Compare the numbers and the sala- ry then and now—and ask, if the perseverance in such a policy is honest and correct, and who has rea- son to complain ? In this abominable city, eighteen thousand seven hundred and thirty-seven persons, (this computation was made previous to the recent visitation,) it is said, are to be found without any oc- cupation; a portion of these, males and females, are to be found collected at the rails in the police office, and around the court-house, wasting their time from morning till evening, daily. Ought these to be Appendix, Included in the amount of “ pauperism V' As they, too, apply for parish medical aid when sick, as the city poor,'' i think they must he. Much of the crime and “ pauperism” that now exist in the land, must he attributed to the want of education. No. 6. In the city of Kingston they are now re- duced to ten or eleven, and they reside in various parts of the town ; this number, I conceive, is more than adequate in the present stage of our colonial po- licy, marked as it is in its consequences, by deca- dence, ruin, and abandonment, xo the requirements of such a population. No, 7, Yes ; a public hospital, a vast and expen- sive pile—and that noble institution the ■“ Metcalfe /dispensary," falling rapidly into decay for a want of support by those for whose benefit it was specially erected and endowed. The legislature has been im- pelled, by petition, to make annual grants to keep and sustain it. It has worked badly since it was founded, because the negro population generally will not subseihe to it, although medicines and medical aid can be readily obtained at ail times, and at all hours for themselves and their families, at the very lowest cost, viz, : 3d. per week. Two professional gentlemen are employed, or attached to this institu- tion, viz.: Doctors Altman and Jobert, at salaries of £50 each, per annual. The voluntary subscriptions for 1050 amount to, £44 6s. The subscriptions from contributing members for 1850 amount to, £201. Grants from .the legislature £t00 per annum, aunu-: ally. No. 3, No ; they grudge all money expenditure for such purpose, and will not part with a qua tee in •the employment of medical men in town and country, and their reluctance may be ascribed to tire notion they entertain “ that it is useless to employ doctors, as people must die" as well as a mercenary, covetous, venal, and parsimonious disposition, peculiar to the race in general, in such cases particularly. J$ the purchase of luxuries there is 119 jack 9/ 154 Appendix. coin. The same remark applies with redoubled force to the pageantry observed and maintained in the costly obsequies of their dead. The procession, in such cases, often reminds the spectator of the tail of a comet! And 1 cannot help noting the fact, that the negro population generally, seem to have an unac- countable propensity to law and lawyers. This pre- dilection may be ascribed to their invincible love of feuds. They are the most litigious, wrangling, quar- relsome, jabbering people upon earth ; and, however inconsistent it may appear, they can always find mo- ney for law expenses ; physic, under any circum- stances, they “ throw to the dogs." The sentences of the police justices, involving pecuniary fines, are no sooner pronounced by them, than they are paid to the clerk. No. 9. A question, I apprehend, for medical men residing in rural districts. To my knowledge it worked badly, and the failure is attributable, perhaps, to the causes recorded in answer eight. No. 10. Benjamin Naar, esquire, tobacconist, Ha- nover street; some times fees, other times salary ; now fees again, by the disallowance of the act to fix the salary, at the colonial office; fees average now nearly £400 per annum. Average number of inquests, per annum, after the late visitation, ninety ; before, one hundred ; average number of post mortem, examina- tions about twenty-eight; preponderating cause or causes of mortality, I would say “ intemperance,” (apoplexy and pectoral disorders maybe so recorded, but are not these very often superinduced by intem- perance?) prevailing alike in palaces and in hovels.* * Hence wc have, in this island, a considerable amount of intemper- ance, and as the consequence, a considerable amount of disease, mental derangement, pauperism, crime, and misery. This must be obvious to the most casual observer. Mr. Neisoxi read a paper before the Statisti- cal Society of London, in June, in»t year, “ on the rate of mortality among persons of intemperate habits,” which shows that the lives of beer- dt'inkers average twenty-one years; spirit- drinkers, sixteen; and those who drank both beer and spirit indiscriminately, sixteen. The average duration of life after the commencement of intemperate habits among mechanics, working and labouring men, was eighteen years : traders,. Appendix. Irrespective of* the mortality consequent upon the vi- sitations of contagious and destructive epidemics, I retain this opinion.* No. 11. 1 do ; every advantage. The office of co- roner is one of the most ancient and responsible under the crown, and has been so from time immemorial.— I look upon this question as a most important one, and will deal with it as such to the best of my judg- ment and information ; in answer, I say important, because legislative measures are quickly required that will at once strike at the root of a mighty evil. I am of opinion that it ought to he filled in these colonies by no other class of persons but “ a duly qualified medical practitioner,” especially when we know that the duty of this official, in the present day, is almost solely confined to enquire “ when any person comes to a violent, or a sudden death, or dies in prison, by what manner he comes to his end.” And because, according to Sir Edward Coke, “a coroner should have five qualities—he should be (1) probus homo, (2) legalis homo, (3) of sufficient knowledge and under- standing, (4) of good ability and pow er to execute bis duties according to his knowledge, (5) of diligence and attendance for the due execution of his office,” and then when vacancies occur, ignorant and illiterate aspirants folloioing mean occupations, as tailors* cob- lers, carpenters, shoemakers, bricklayers, tinkers, Sfc. will be excluded and rendered ineligible. As the law now stands, anybody may be pitch-forked into the dealers, and merchants, seventeen; professional men and gentlemen, fifteen, and Females, fourteen years only! The number of paupers in Massachusetts, in 1849, was twenty-four thousand eight hundred and ninety-two, of whom ten thousand two hundred and fifty-three were foreigners, more than nine-tenths of the whole number were made so by intemperance 1 * Mr. Porter, of the Board of Trade, in his treatise called “ Self Imposed Taxation?' shews that the working classes of Great Britain spend annually on beer, spirits, and tobacco, (these three articles alone,) no less than £50,000,000 sterling ! And lord Shaftesbury, better known as lord Ashley, tells us in his speech on “ public amusements,” that fully six-tenth3 of all cases of insanity to be found in these realms (Great Britain) and America, arise from no other cause than the habits of in- temperance in which the "people have indulged. Appeiidix. Office irrespective of his fitness or qualifications, by the most open and barefaced practice of bribery and corruption. That candidate has the best chance of securing the Vacancy, ** of being returned and duly elected” by the voice of the people, forsooth, who can make arrangements with the electors themselves, or through the instrumentality of their friends to give the highest amount of bribes. Now, this is the cer- tain, the infallible passport to office, and however monstrous and indefensible such a state of things, such a vicious system, may appear, nevertheless it commonly prevails in onr community. Hence mean hovels, ycieped “freeholdsrise up in all direc- tions, as if at the wand of the magician, (and chief!)7' by dishonest means,) so that the principal traffic, now a days, in such cases, is established and derived from the wages of bribery and corruption, demanded and openly accepted with impunity by those who are n®w permitted to exercise the elective franchise for their services at all elections ! The present coroner is a most, intelligent, pains- taking officer, perhaps one of the best that, ever filled that post in this island ; in his court, he is, however, boisterous and undignified, and there is a lamentable absence of urbanity and kindness to those placed above or below him in society. No* 12. There are three registers, one of births, 6ne of deaths, and one of marriages, now kept at the registrar's office in Spanish-To wn, but “ when and how Jar back either of them extends perf ect and uninter- rupted1 am riot prepared to state, at present. The rectors of the several parishes may furnish* perhaps, more full and satisfactory details of these. 1 consider them imperfect. The law to enforce the registration of births and deaths, enacted in 1842, was objection- able and inutile, because penaltylesSi It was conse- quently soon repealed and another substituted* but i lie home government put. its veto upon the amended enactment. Seriousevils have transpired, arising out Of the careless and negligent manner in which the re5 AppcndiX. gisters of births, marriages, and deaths were formerly kept. Omissions have occurred by which persons have failed to establish, in such cases, their just claims ; and if proof were wanting, 1 adduce the case of the late Mr. Hannaford, as a striking exemplifica- tion of the fact of the omission in recording a mar- nage ; others are not wanting, still more distressing and painful, by the omission of deaths. No. 13. 1 have already stated that there are three registers—the question therefore applies, i presume, to the “ register of births and deaths,” kept in the office of the common council of Kingston, and by the clerks of the vestries of other parishes also, and not those records now made in obedience to a clause in the clergy act of 1847. The latter is simply a regis- ter of births, marriages, and deaths, and are bona fide the registration of names and dales of such made by the rectors in their respective parishes. Upon the face of these no diseases whatever, or mortality in consequence, are or were ever exhibited in their co- lumns,* But by the former “ the diseases shown to be most common and fatal during the last seven years,” (there was no registration made antecedently to that period,) are consumption,f fevers, dysentery, apo- 157 * In this category, wc must except Spanish-Town, where, for seve- ral years at the beginning of this century, the causes of death were re- corded in the rector’s register. f Pulmonary consumption is very rife in this island of recent years, and may be looked upon as one of the chief preponderating1 causes of mortality. The statistical reports issued by the registrar-general show that fifty-nine thousand and twenty five of the inhabitants of England and " ales are cut olf by pulmonary consumption in one year, and, as the mean duration of the disease is about two years, it follows that the num- ber of consumptive patients constantly living, and destined eventually to sink under the ravages of the disease, is no less than one hundred and eighteen thousand and fifty ! In other words, eighteen and a half per cent, or about one fifth of the total mortality. England and Wales ac- knowledges pulmonary consumption as its cause. And by this malady alone, society is constantly deprived of the services of one hundred and thirtieth part of its members!! Had our “ register of births and deaths” been kept “perfect and Uninterrupted” a statistical report of the mor- tality consequent upon this insidious disease would have proved useful and interesting, but alas! there are no records made since 1850—-and ‘Sbese extend to only three months in that year ! 158 Appendix. plexy, and lastly, the recent pestilence of cholera.— As the registers now stand, 1 place little or no value upon either or any of them, because faulty. “The register of births and deaths,” kept in the office of the clerk of the common council, has become obsolete. The reasons are assigned in answer twelve. Tso. 14. This question applies chiefly to rural dis- tricts ; one of the greatest pecuniary encumbrances to some, perhaps to all parishes, is the desertion and abandonment by the male of his offspring—I mean those that are the result of the illicit intercourse of the sexes. Ps o. 15. Certainly not; but a little is to be found, now and then, in lore affairs, as the records of our police office and the court of quarter sessions occa- sionally disclose ; nevertheless it is my conviction that both still continue to be practised in most of the agricultural districts, (1 speak advisedly,) and that the negro population generally, but particularly the peasantry, are unchanged in their feelings as to the power and influence of this species of magic, or witch- craft. Ail the efforts of their pastors to eradicate, by moral and religious instruction, and discourses, the belief in, and the dread of, this remnant of African bar- barism, have failed. The female natives of Hay ti arc adepts in the art. And woe be unto that unfortunate wight who happens to be the object of their jealousy or revenge, the consequences are most distressing— often fatal. Their “ macandals" are generally com- posed of the teeth of various animals, of hair, feathers, cowries, or jeggays, bits of glass, &c. &c. “ Eye of newt and toe of frog, Wool of bat and tongue of dog, Adders’s fork and blind worms’ sting, Lizzard’s leg and owlet’s wing.” These are sometimes introduced into a glove and placed in the bed of the victim ; atotliers, someof these articles is administered by mixing them with the soup or other aliment, condiments for a “ hell broth,"—* Appendix. “ B ruler la chandelle voir' is a part and parcel of this infernal machinery, the ground work of which is poison, and hundreds of both sexes, in town and country, have fallen victims to these diabolical prac- tices. The “ shadow box' belongs to this demonia- cal art. No. 16. Yes; there are two or three “clever” black doctors—their charges are very low indeed, nevertheless they are seldom paid, and they cannot re- cover in our courts, for reasons that are self-evident. No. 17. No; 1 do not ; but 1 have heard of a re- cent case which was published “pro bono publico f I suppose. No. 18. Yes; I do. The black population ap- pear to prefer their own people. They seem always to entertain a marked sympathy for their own colour in most things, and they, in turn, pander to their wants and desires, and particularly so, in the exercise of the “ healing art,” and if any or a little obeaism is inter- mingled, the prepossession is unchangeable and insur- mountable. i am constrained to think that a pre- ference would not be given to the last named persons ; nor do l think they could be obtained for the fair remuneration that is provided generally for such pur- poses, in Jamaica. No. 19. There can he no doubt that cases of un- skilful treatment, attended with loss of life to mo- ther or child, have occurred by the employment of sue!) persons, but as I made no record of names and numbers at the time, 1 am not prepared to say much more on the subject. During the season of child- bearing, they apply to old black midwives generally for assistance, most of whom are ignorant, coarse, and devoid of skill. No, 20. I have heard of, and read paragraphs on, such occurrences, but no cases have come under my Own immediate observation and notice. I cannot see how “ extended medical relief'’ could tend to the sup~ pression of such a crime on the part of the mother. No. 21. I fear not; it is another important 160 Appendix. tion and well worth the experiment The agricultu- ral classes appear to have no great predilection lor white doctors. They, in my opinion, would meet with little or no encouragement from this portion of our community, unless it be carried out lay stringent compulsory enactments; even then, l have my doubts. The negro will not consider this provision a boon con- ferred upon him. We Jind medical gentlemen leaving the island, when they can, for leant of such responsi- ble employment, under any citcumslances, and the scur- vy treatment that the profession encounter generally, from other classes also, on most occasions, is a signi- ficant hint enough for them to keep away and seek employment in other and more genial climes. No. 22. This is another serious question and a dif- ficult one to be dealt with. I really do not desire to speak disparagingly in answer, on a subject of such •vast, such vital importance, but knowing as I do the disinclination, and in innumerable instances, the un- alterable fixed resolution of the negro labourers not to part with their money for such purposes (even ivhen life itself teas involved! ) I fear such an impost would be met “ unwillinglyI see no utility in laying it on the “person,*' An impost, in the shape of a “ ca- pitation tax was laid not long since, and whilst one class paid it, another put the law at defiance. “ Ex uno disce omnesd An impost laid on house and land may answer, and in default, levy must be made on chattels. The negro population have little dread at the de- privation of personal liberty. Yes! if you deny him his cigars and rum at the same time, it then becomes in reality, an insupportable infliction,, not otherwise, Onr penitentiary and prisons present the strongest proof we can desire of this fact. Do they not look sleek and joyous in their marine palace, at Rae town ? The diet and sea air are great inducements to linger here in inglorious ease! And when the law is satis- fied, and they are at large again, do they not return quickly to their happy abode l Corporal Appendix. 161 is quite another consideration. The dread is mani- fested upon all occasions when this mode of punish- ment is only spoken of. I would ask again, is this class inspired bv the fear of imprisonment in our gaols for the violation of any law ? No! They tell you exultingiy, “they are quite ready to god Educa- tion will change all tiiese things No. 23, and last question. The druggists, in ex- pectation of another visitation from cholera, have made provision accordingly ; l speak advisedly. ** Be pleased to state anything' that may occur to you as useful to be known to the Central Board of Health, on the subject oi" medical relief generally, and particularly in Jamaica.” 'The requisition is made, and the Board will pardon me if f prove a little .diffuse, in answer. J have, in the proceeding pages, directed their notice to the working of the “ Metcalfe Dispensary” which was established about ten years, since, for the benefit of the labouring classes of this city, but those for whom it was exclu- sively erected, will not subscribe to it, or if they do, and fall into arrears, refuse to ratify, or fulfil their engage- ments, or pay up their subscriptions, especially when they meet with no difficulty in procuring orders for medical and surgical aid noon the medical officers ap- pointed to attend the destitute poor, exclusively. Now, in tiiis category, I find the following trades and occupations, viz. :—cooks, grooms, nurses, house cleaners, tailors, coblers, carpenters, fishermen, ped- lers, bricklayers, boot and shoe makers, bookmakers, seamstresses, cabinet makers, storemen, plumbers, coopers, basket makers, higlers, cigar and straw hat makers, coalers, and general labourers, all of whom do not receive as wages less than six, and most, more than twelve shillings per week. Some of the tradesmen viz. : plumbers, carpenters and others, often refuse to work at four shillings per diem, and eooly tell you “ they are doing nothing, and cant 162 Appendix. get work.'' These facts I think it right to record in this place, in order to prove the “ unwillingness ' of this class to pay for medical assistance even when it can be obtained at the lowest possible figure. In many instances both men and women apply to me for recommendations to the chairman of the outpension- ers committee, for what do you imagine, gentle read- er V To obtain pecuniary aid, forsooth! The parties in such cases are most frequently adolescent, or they are in the prime of life. The men fell you “ they are too weak, or too old, or they are sick, and can’t work.” The women, that “ they can’t go to work, for they have children to look after, and the fathers are gone to sea, or dead, or live in the mountains,” and will give them no assistment ! Such are the characteristics—such the matchless profligacy and idleness by winch the present generation is dis* tinguished ! And what renders them more odious and less worthy of protection and assistance from any quarter, is the rude carriage and independent deportment usually manifested, when offered work of any kind in the town ; out of it, as it refers to the services of domestics, is, on most occasions, beside the question. Squaiidity, indigence, want, rags, and all their concomitants, prove no induce- ment to accept proffered employment in such cases ! The town is infested with myriads of the young and healthy of both sexes, who come under this reproach, and they are domiciliated chiefly in the lanes—east, ward, north, and south. “ On the subject of medical relief generally, and par- ticularly in Jamaica f l think it relevant, perhaps imperative, to direct the notice of the Board to ano- ther fact, and as senior magistrate, it falls within my province to do so without trenching upon the duty or privileges of others. The town of Port-Royal is now, and has been, for some time past, left without a duly qualified resident medical practitioner, and the destitute poor, and indeed all classes of the civil inhabitants, are thus unprovided an4 totally unfur- Appendix. nished with medicines, or medical and enirurgical as- sistance for themselves, or their families, at all times and at all hours ; nor is there any hospital, or public dispensary to be found in the town, and although re- peated offers were made by myself to reside there and afford the required help, for a reasonable salary, (£100 per annum,*) they were never accepted by the authorities, but objections always raised on the score of poverty.” “ The parish ivas too poor to provide medicines and medical attendance for its paupers !” Such oilers it was presumable, would never have met with a dissentient voice; so might opposition and objections be started on the same grounds against the employment of a rector, an organist, a parish clerk, a beadle, a solicitor of the parish, a clerk of the peace, a clerk of the vestry, a collector of petty debts, a clerk of the market, or any other parish officer, but the parish is provided with all these public servants ; and surely a medical officer is as necessary and as useful to a body of civilized people, equally indis- pensable to the helpless poor writhing under pain, disease, and affliction, as either or any of these func- tionaries, all of whom are annually elected, and most paid, by the Vestry. There is 7to lack of funds for these ! But the professors of the “ healing art’ are of no consequence ; “ they are at a discount /” Their services, it would seem, can be dispensed with, until fell disease and death are found stalking over the land. “ Sufficient is the day—say they,for the evil thereof!” And if this is not a proof of a falling, lost, demoralized country, then I know not what is ! Ought we to be surprised to find our black fellow- subjects chime in with such sentiments and chase the doctors” from their doors ? Certainly not! The cholera made its invasion, it is said, first in this ancient town in October last, and the people were compelled, (and gladly too,) to accept medical aid at the hands of the medical officers attached to the * An army medical officer made a tender to perform the dutie* for tkalf this amount, It was aiso rejected by the Vestry! 164 Appendix. navy and army. There was no other class from whom aid in such unparalielled distress could be sought on such an extraordinary emergency, and the numbers proving insufficient for the arduous and harrassing task, another was ferretted out and brought from an extensive, distant agricultural parish, w here he had little or nothing to do since free- dom dawned upon these now' almost useless colonies, in order to render additional help to those attacked by the pestilence in this wretched, unfortunate, de- serted town, and he and four others received remu- neration in a sum much below £400 sterling for three months services, night and clay !* “ On the subject of medical relief generally, and particularly in Jamaicaf there is, 1 venture to assert, a vast field for speculation and improvement well worth the attention and consideration of the Board. But I warn the Board that their labours will he of very little or no value to the public if they are not supported, maintained, and enforced by stringent le- gislative enactments. We live in fearful, in very extra- ordinary times. This beautiful island is suffering in various forms. i he present state of things in gene- ral is most deplorable. In the recent awful visitation hundreds, aye, thousands, that were prostrated by the fell disease, lost their lives, in fact, were swept away in rapid succession for want of ike services and care of those whom bad treatment, emanating in the adop- tion of a niggardly parsimonious coarse, in most mea- sures, (evincing a rotten system of the most despicable policy,) had driven out of the country to seek their f or- tunes in other and distant lands, denied as d was to them during their sojourn amongst us, and that loo on the soil in which they first drew their breath, and which was endeared to them by every He, human and divine, wilst others in their almost irremediable help- lessness and despair are left to pine and waste their cloys in neglect, obscurity and want ! * Dr. Stennett. alone, had a vote of £330 for six weeks professional services during the prevalence of cholera ialiis parish Appendix, In concluding these answers to the 11 circular.'' I beg the Board to keep in rememberance this simple, hut painful truth, that no class of her majesty's sub- ject in these distant and health-destroying dependen- cies experience more illiberally, meet with more in- gratitude, that are more frequently imposed upon and worse rewarded for their services than the mem- bers of the noble profession to which 1 have the ho- nor to belong ! We may make laws, holding forth encouragement and tempting, with rewards the Faculty to migrate and reside amongst us: We may expatiate upon the beauty and salubrity of our mountain homes : We may also entertain them by discussing the liberal grants of money that have been bestowed in consideration of professional ser- vices during tlie awful visitation of last year. “ And ice may call spirits from the vasty deepf hut will they come ? No ! Your reputation is fixed, it is esta- blished upon an adamantine basis ! Ingratitude and neglect have done their work, and premature eman- cipation has clenched it ! U. CHAMBERLAINE, M.D. M.R.C.S. England. 16th October, 1851. Answers of Dr. Downer to questions appended to cir- cular of Slh September, 1851. No. E The parish of St. Andrew contains an area of about two hundred and forty square miles. It has neither town nor villages. There are probably a dozen houses scattered round about the parish church and courthouse, at Halfway-Tree, and there are two grog and salt provision shops there also, which I think barely sufficient to entitle the place even to he called a village, and this is by far the most important congregation of houses in this parish. Part of the parish is a gently inclined plain, which constitutes about one fifth or one sixth of the whole extent; the residue of the parish is mountainous, and a large part Appendix. of that is difficult of access, the mountains being high and steep. Some of the main roads in the lowlands are passably good, but those in the uplands are in very had order, some of them nearly impassable. No. ti. The population of St. Andrew’s, before the visitation of cholera, was estimated at near twenty thousand. The ascertained deaths from cholera X have understood to be about one tenth. The chole- ra principally affected the lower orders of society, and the occupation of that part of the community in this parish is agriculture. I am unable to state which of the sexes suffered most from the pestilence, my impression is that they suffered equally. No. 3. The sugar estates in existence in this pa- rish, twenty years ago. were Constant Spring; Little Spring; Norbrook; Cherry Garden ; Somerset; liar- bican ; Hope; Mona; Papine; Molynes ; Maverly ; Chancery Hall ; White Hall; Pembroke Hall; Wa- terhouse; Temple Hall; Golden Spring; Hall’s De- light. All of these have been thrown up but Con- stant Spring ; Cherry Carden ; Molynes ; Golden Spring; Norbrook; Mona; and Temple Hall. In order to cultivate these and the few coffee planta- tions still continued in cultivation, the agricultural population is fully adequate, but then that popula- tion is, for the most part, scattered about. Some of the labourers cultivate their own little freeholds, and some occupy the lands of the proprietary as tenants, cultivating the esculent roots of the country, &c. to maintain themselves. With some very rare excep- tions they are a worthless class of persons, idle, im- provident, and sadly debauched. No. 4. 1 am unable to reply confidently to this question. Before the occurrence of cholera, day la- bour was reduced to nine-pence, but 1 have reason to think that labour cannot now be procured readily at that rate, especially in the lowland part of this pa- rish. In the upland eastern district, where the cli- mate and soil are peculiarly adapted to the growth and cultivation of coffee, I believe labour is still pro- Appendix. 167 cared at nine-pence, per day. In paying wages, 1 believe the rent for house and ground is deducted, and I rather think settlements are usually made weekly. The main cause which draws labour from the estates and plantation, is the petty freehold and money culti- vation, of which I spoke in my last answer to ques- tion three. No. 5. The out*door paupers cost this parish, at this present time, rather more than £650 per annum, the number of persons on the out door-pauper list, is one hundred and forty seven. The parish asylum cost about ,£200 more. The expence of graves and cotfins exceeds £50 per annum, making a total of £000 per annum. I do not think any part of the agricultural population able to pay for medical assistance indivi- dually. The only way they could procure it would be by each paying a small sum yearly or half yearly, so as to raise a fund, out of which, when a call was made, the medical attendant might be remunerated. This almost all have the ability to do, but the incli- nation is wanting. No. 6. Three. Dr. Pine, at Golden Spring; Dr. Falconer, at Retreat Cottage, near the foot of Stoney Hill; and Dr. Downer, at Bran’s Delight, near Half- way Tree. The number is not adequate. There is no medical practitioner in the east district, and none in the Red Hill district. These two districts would not be attended by the three practitioners alluded to, The medical gentlemen who practiced in this parish, under the old regime, were Hawkins, Stamp, Gray, senior, Gray, junior, Downer, M‘Fadyen, Dallas, and another, whose name 1 forget; all these had full em- ployment. But independent of three being inade- quate to attend in all parts of so large an area as St. Andrew’s comprises, two out of the three are engaged in other avocations, and decline active practice, per haps, however, it might be otherwise was the remu- neration made equal to the labour involved. No. 7. There is no dispensary, there is* however, an asylum, or poor house, into which sick or decre- Appendix. pit poor persons are received, if they procure and present to the matron an order signed by a justice, churchwarden, or vestryman. Sometimes such per- sons are sent in from distant parts of the parish in a cart. This institution is supported entirely by the parish, and a sum is raised for the support of it annually in the ways and means of the parish, under the [lead of “Poor Asylum.” A medical attendant is provid- ed for this institution, who visits daily. His resi- dence is barely one mile from the asylum. There is also a matron and nurse, who reside in the institu- tion. The salary of the medical attendant is £50. That of the matron £20, and the nurse £ 12, per annum. To supervise this institution a committee is annual- ly appointed, who, with the churchwardens, are ex- pected to visit it occasionally, and see that the de- tails of it are properly carried out. The persons re- ceived into this institution are ordinarily of the very poorest description, and are furnished, during their stay in it, with coarse clothing, marked Asylum on it. Any person who presents an order from a jus- tice, churchwarden, or vestryman, is entitled to pre- scription and medicines, if not directed to be receiv- ed as an in-door patient. The buildings are parish property, and the annual cost of this institution va- ries from £200 to £240. No. 8. The negroes are glad to get medicines, or to be received into the institution spoken of, in an- swer to query No. 7, and submit quietly to such treatment, as may be directed. No. 9. The dispensary act worked but indifferent- ly in St. Andrew’s ; the failure of the act was the natural consequence of the very nature of the act; its provisions were unsuited to carry out the object contemplated. No act, having for its object protec- tion in periods of sickness to the poor, and getting for them constant and efficient medical assistance can succeed, unless the medical assistant is adequately Appendix. remunerated, and a fund raised adequate to remune-* rate him. These two objects, duly attended to, the detail could easily be worked out. Every day, how- ever, that is suffered to pass by unheeded, tends to increase the difficulty in respect to the procuring medical aid for the poor medical men are continual- ly as such diminishing in number, some leave their profession to occupy other stations in society ; some leave the island, and others, (in many cases i fear,) worn down, broken-hearted, and half-starved, pass away from the stage of life. These men’s places, in the present condition of society, can never he tilled up. Already large tracts of land in the rural districts of the island are destitute of medical men, and medi- cal assistance cannot be obtained at any price. This is the case even in St. Andrew’s, which, from its contiguity to Kingston, possesses advantages which are not to he ibund in those parishes which are re- duced to one or two doctors, as the whole medical /staff of the parish. No. 10. The coroner of this parish, is John Ryder Brice. He was formerly the proprietor of a small coffee plantation in St. Thomas in the Vale, he now keeps a ship yard, at the West end of Kingston. He is remunerated for discharging the duties of coroner by fees and mileage. Judging from the proceeds of his office, for the last two quarters, 1 should think his income might be fairly estimated at £300 per annum, or thereabouts; I am unable to furnish the informa- tion required in the last part of this question, To finish this information, reference must he made to the coroner himself who has the inquisitions of the seve* ral inquests he has held since in office. No. II. If the office of coroner were necessarily filled by a medical man, this ad vantage would accrue, the coroner would then be a man of education. The duties, however, of coroner, l look upon to be judi- cial and not medical; under such an arrangement, many post mortem, examinations might doubtlessly he obviated, and the attendance of a medical Appendix. otherwise, might in many case, be dispensed with.— Bat the coroner could not act in the double capacity to hold the inquest and give medical evidence also. No. 12. A register of births, deaths, and marriages, is kept or professed, rather, to be kept in St. An- drew's; but the record is so defective, not from any neglect of the registrar, that the information to be de- sired from it would mislead. I cannot say how far back this registration extends. No. 13. The record of deaths, being stated to be imperfect, if consulted, would notafford useful infor- mation in respect to the most prevalent causes of dcaili within the last ten years. To. 14. Many marriages take place amongst the black *, but illicit intercourse between the sexes pre- vails to a greater extent than marriage. Chastity any way is not much observed. 1 should suspect, bas- tard children to be by far the most numerous. No. id. I cannot speak positively in answer to this question. ? ‘kink the negroes, as a body have retro- on ded in civilization since they were emancipated.— A any of their African habits, and amusements have teen revived, and I suspect their African supersti- tions are practised also, though it is only occasional- ly that the practice of them is brought to light. This is a mere opinion, and will betaken for just as much a3 it appears to be worth. No. 10. There are many persons, black and other- wise, who practice physic, but where no doctor is to be had, the evil naturally springs up ; perhaps in the , first instance benevolence dictates the attempt to af- ,ford relief to the sufferer, and if success follows the attempt, the individual who makes it is pressed into the service and becomes a doctor per force, and ulti- mately gets his ice and rejoices in his new vocation. . J cannot. u!l what are the fees given or received un- der tiit. e circumstances. Some cases of the kind, many years ago, came to my knowledge, in which the fees exacted were considerable. No. V, I am not cognizant of any instances in Appendix. which deleterious drugs have been used by such per- sons ; neither do 1 believe that such eases have oc- curred through ignorance. On the contrary, in such cases as have come to my knowledge, the nostrums used have been very simple, such, as if they did no good, were not likely to do any harm. No. 18. Unquestionably preference would be given to duly qualified professional men, provided the ser- vices of such could be had, irrespective of the pay- ment of fees. The fact is, medical men are unwilling now to give their attendance unless their fees are first paid ; and oftentimes the negroes really have not the money to pay : and even if they have it, they are re- luctant to part with it, and procrastinate under the hope of amendment in the case to save their money, until it becomes too late for medical assistance to avail. It is not in one case out of a hundred, nay, in even a less proportion, that a fee will be paid, how- ever small, for prospective medical aid. The princi- ple of a contract, negroes do not, or cannot under- stand ; in respect of medical assistance, if they pay a dollar they must have a dollar’s worth, and rarely do they evince such moderation as to be satisfied with the mere dollar’s worth. 1 was one of the district practitioners in this parish during the existence of the medical relief bill One day a negro came to my bouse and brought a ticket, not for himself, but for his wire, and having received the ticket and paid the fee, he begged me to come and. see her, as she was ill. I found, cn making the visit, she had been two days in labour, i had an arduous attendance in a miserable negro hut of many hours, and at length I was obliged to resort to the use of instruments to consummate the birth of the infant. No. 19. Negro in id wives and others attend in these cases, and labours are ordinarily happily completed. Formerly, when these mid wives had the advantage of the advice of professional men, I found them ignorant and unskilled, “literally doing the things which they ought not to have done, and leaving undone what they Appendix* ought to have done.” Still nature is so kind that in a natural process, such as parturition, she is not to be thwarted even by officious interference, and the birth is happily consummated in a vast majority of cases in spite of the malpractice of the midwife. At the present time, l suspect the practice of these women to be more defective than it used to be under the old regime, and 1 dare say, death sometimes to the mother, and sometimes to the child, is the result. When I was in active practice, instance of death occurred occasionally from the malpractice of these mid wives, and oftentimes labours which would have terminated kindly, have been rendered untoward by improper early interference on the part of those peo- ple. Under many circumstances, however, they are useful, and indeed their services are indispensable, and if an evil, a necessary ev il; but I looked upon it that the injuries which sometimes result from their ignorance is much more than counterbalanced by the amount of useful service rendered. No. 20. Infanticide is, I should say, as far as ray* experience guides me, an uncommon crime in this is- land* That some children are lost from the false practice of ignorant mid wives, there can he no doubt, and the effect of medical relief effectually carried out, would be to save some lives, mothers and children w hich are occasionally lost during tiie parturient pro- cess. No. 2!. There can be no doubt, but that to esta- blish throughout the rural districts, medical gentlemen w hose province it would be. by legislative enactment, to attend the peasantry professionally, would be ex- ceedingly acceptable to them, but unless they were paid eacli one a stipend for his services, he could not exist, and i think it would he useless to offer less than £‘300 a year. I hardly think competent and Qualified practitioners could be prevailed on to esta- blish themselves in the mountainous districts of the island at a less rate. No. 22, A medical relief tax is the oftly method by Appendix, Which a fund could be raised at all, equal to the ob- ject to be carried out, such a tax on the whole by those interested in its operation, would be paid more willingly, when the peasantry were made to compre- hend i!»e motive of the tax, than any other tax now in existence. But that is not the question. All di- rect taxes are paid unwillingly bv all persons, and the great land-owners who are taxed less heavily in pro- portion than any of the other classes of society, grum- ble most to pay their taxes, nolens volens. If the measure of medical relief is necessary, levy it, and let those whose duty it is to collect it, deal with the question of gathering it in Some questions are most easily settled, not by temporising with the parties, but by boldly walking up to the bull, and taking him at once by the horns. No contribution, how- ever small, if left to the option of the parties to be benefitted, will ever be realized. No system will an- swer to raise a fund but the imposition of a direct tax. This is a subject which once engaged my earn- est attention, and 1 drew out the rough sketch of a bill, and sent it to Mr. Haynes W. Smith, who was the originator of the measure of medical relief. The biii lie drew up was thrown out of the assembly, and another bill was introduced, by some other member and that passed, and ! rather think a second bill, nearly similar to the first. When this first bill had run its course, Mr. Smith applied fora committee to prepare a bill on evidence. 1 was summoned to at* tend that committee, but no committee ever sat, and be requested me to give him my idea on the subject of medical relief, which i did, and if it be not de- stroyed, iie has the paper I wrote still in his posses- sion. 1 have no rough draft of the plan I then sug- gested, and am therefore unable to do more at the present moment than to give a crude and brief out- line of the nature of the enactment I suggested, and 1 am still of opinion that some such method, as 1 then devise, would succeed best. I refer to the appendix which accompanies this document. 174 Appendix. No. 23. A small supply of medicines is kept at the parochial asylum, but insufficient to serve in case of the outbreak of any severe epidemic. The fact is medical relief, os any description, is rendered most unwillingly by the authorities of this parish, and eve- ry account presented to the vestry, by a medical man, for attendance rendered to any member of the poorer orders of the community, is seldom passed without irnpertiiiances and unmerited opposition. Appendix referred to by Dr. Downer, in answer to question No. 22. In order to accumulate a fund to remunerate medi- cal men for rendering professional aid to the labour- ing classes of society in this island, i think a tax on the person, anti not on property, would be the pre- ferable mode of taxation. The persons to he benefited out of the fund are not property persons, many of them possessing none in their own right, therefore these persons should pay a quota in the raising of such fund, far larger in propor- tion than those pay who are to receive no personal benefit from the imposition of the tax. 1st. 1 would therefore suggest a per capita tax, re- gulated by a scale, respective of the number in family of each householder in the parish, whether such householder ire a mere labourer, located on a planta- tion, a tenant, or a freeholder. The scale to decrease in proportion to each, as the number in family in- creases—thus, For 1 in a family, (3s. For (> in a family, IG's. 2 ,, I Os. 7 ,, 17s. 3 ,, i 2s. 8 „ 18s. 4 ,, 14s. 0 ,, 19s. 5 ,, 15s. 10 or more, ‘20s* 2nd. I would suggest at the usual time of giving in a statement of taxable property for the year, every householder, be he rich or poor, should be bound under a penalty, to be recovered summarily, to give Appendix. in, together with his taxable property, (if he possesses any,) a statement of the number of persons of which his family is composed, setting forth the names of each, an .. distinguishing the sexes. But as very few of the lower classes of - society i;i this island are able to write, it should be provider! under such circumstances that the return should be made to the clerk of the vestry, viva voce, and an enrolment made by him in a book, cut in alphabet, adapted for the purpose, and after the time had expired for making such returns, tiie clerk of the vestry should enter in the same book the names of all those persons, and the several mem- bers of their families who had made returns in writ- ing. I really cannot understand why the 28th March should be chosen as the time at which the ordinary tax returns should be made, or within twenty days after. I think the allowance of time insufficient and would therefore suggest that the returns should, for the future, he made on the iOth day of February, or not later than the loth of April, which would be a sufficient allowance of time-. The registration of the several persons with the numerical strength of each family being thus made, the general tax rolls might issue as they do at present. 3rd. Soon after the accounts are made out and is- sued, the collecting constables of the several parish- es should be required to attend at the court house of the parish, or at same certain and convenient loca- tion, a certain number of days every week, and for certain number of hours on those days, both to re- ceive tax accounts which might be offered to be paid, and to issue others not yet delivered, and if tax ac- counts generally were made thus deliverable and pay- able, the general collection of the revenue would be facilitated, and the collections be augmented. 4th. On payment of every tax account, it should be required of the person paying, to make a solemn declaration whether he is, or is not in a condition of life, and in circumstances to avail himself necessarily of the benevolent provisions of the medical relief bill, 176 Appendix. and in sucli declaration being made in the affirmative, bis name should lie entered by the collecting consta- ble, in a register book, cut in alphabet, as a person entitled to medical relief under the bill, and the pro- duction of the receipt of the collecting constables when he shall have duly paid his taxes, should enti- tle such person, and each member of his family, for one year feom the date of each receipt, to all the be- nefits of the bill. 5th. On declaration being made in the negative by any tax payer, his name should also be enrolled in a, similar register, and on payment of his account, one fifth of the medical relief tax should be refunded to him hy the collecting constable of the parish, and bis receipt should be endorsed, “ entitled to medical re- lief.” 6th. Parishes should be divided into districts, con- formably to their localities, and then again into sec- tions, as many as might be requisite. 7th. A medical attendant should be appointed to each district, and a salary appointed to the duties he would have, (or might be supposed) he would have to perform. An allowance should also be provided for a supply of requisite medicines, &c., which should ha kept at the house of such medical attendant, a room therein, or out room being provided by him as a dis- pensary and surgery. 8th. The district surgeon should be required to re- main at home for one or two hours every day, and the time should be fixed and unalterable to prescribe for any persons who might wait on him at that period of the day. And such district surgeon should be bound to prescribe for such persons, furnish them with medi- cines, and administer professionally to them, provid- ed the collecting constables receipt on the first vi- sit produced, shewing they were entitled to the pro- visions of the hilt. 9th. On the production of such receipt, the name of the person so applying for professional assistance should be enrolled, by the district surgeon, in a Appendix. gister book,, cut in alphabet, and a card should be furnished with his name written thereon, and the names of the several numbers of his family should also be staled in the date of enrolment, and date of the collecting constable’s receipt. The production of this card, at any future time, should entitl'e such per- son and such number of Ids family to medical atten- dance, either at the dispensary of the surgeon, cr at the residence of the person enrolled lor the year as herein before stated. 10th. In all cases in which it would not prove in-* jurious to the health of the patient, the, person enti- tled to medical relief, and the several members of his family,'should be bound to seek advice at the dispen- sary, circumstances being otherwise, the surgeon should be bound to visit the patient. 11 til. All cases, should he attended by the surgeon, whether involving the duties of physician, surgeon, or accoucheur, without any extra charge ; ordinary cases in midwifery excepted, which the midwives of the parish are competent to attend to. 12 An. A commissioner should be appointed to each section, who should form a board to superintend the duties of the district, and a justice of the peace should be located in the district, he should inr lute officii be the chairman of such board, and if more than one, the senior justice in such district should be the chairman. lath. It should be the duty of each commissioner to ascertain whether returns have been duly made by each householder in his district, and power should be given him, under the bill, to prosecute and bring to punishment all delinquents who endeavour to evade payment of the medical relief tax. Uth. It should be the duty of the surgeon of the district, evr-ry quarter, to transmit to the chairman of the district, a list of patients enrolled, the names of the several members of their families, being set forth in a seperate column in such list, and the same should 177 178 Appendix. be arranged alphabetically ; diseases treated, and deaths occuring in his practice, being set forth toge- ther, with such other information or suggestions as he might consider it incumbent on him to make to his district board. 15th. The bill should make it imperative on the coroner, to hold an inquest over any person who might die in any district of the parish, of whom he might have information, that death occurred in con- sequence of no medical man having seen or prescribed for the deceased in that his last illness, and rigorous prosecution, under such cases, of wilful neglect or evasion of the medical relief tax, should be provided as consequential and imperative under the bill. 10th. The register should be kept open at the col- lecting constable’s office throughout the whole of the first year, to give every facility for a complete and entire enrolment of all persons liable to the medical relief tax, under the bill, and any person should be entitled to enroll Ids name, at any time, on payment of a surcharge of one-fifth more than the tax as set forth by the scale. 17th. Every person found to evade the tax to he liable to prosecution summarily on information laid before any one justice, and liable to fine, not less than twice the amount of what his medical relief tax would have been, nor more than four times the amount—one half to go to the poor of t he parish, and in augmentation of the medical relief fund, and the whole payable into the hands of the collecting con- stable on conviction, or to stand committed to the penitentiary for any number of days, not exceed- ing days, unless in the mean time fine and costs be fully paid. 18th. The several district surgeons to be liable to fine, not exceeding £ for each case of wilful neg- lect proved against him, or misconduct in the dis- charge of the professional duties of his district, the case to be summarily disposed of in petty sessions. Appendix. 179 and by information on oath before any one justice of the peace ; fine and cost, if not paid in court, to be stopt out of his next accruing quarter’s stipend. 19th. Surgeons of districts to be paid their stipends quarterly, by the parish treasurer, on their account being attested bv the chairman of their districts. 29th. The monies accruing from the medical relief tax, to he paid into one of the banks every quarter, by the several collecting constables, a seperate ac- count thereof being rendered into the quarterly ves- tries, such fund being kept distinct and exclusive of all other taxes. An account also.of all fines accruing under the act, to be added to such fund, a separate and distinct account being kept of them also. 21st. No relief whatever of this tax to be granted, except the case he first examined into by the chair- men of the several districts of the parish, assembled in committee, of which not less than three to be a quorum, of whom one must necessarily be the chair- man of the district to which the applicant seeking re- lief shall belong. On such examination being so made, relief may be recommended by such committee for the whole, or a part, of the tax, on the ground that the applicant is really and truly too poor to pay it. On such recommendation so made, the vestry to be empowered to pass and confirm the relief in ques- tion. 22nd. District surgeons to be bound to afford me- dical aid in all cases of pauperism and actual desti- tution, on certificate furnished by the commissioner of section, and to he authorized to recommend to the churchwardens of the parish for such pecuniary relief, as the destitution of the case may seem to him to warrant. 23rd. The justices and vestry to be empowered, if they deem it necessary, during the first year of the operation of the bill, to borrow from any banking es- tablishment, such additional sum over and above the amount of the taxes as may appear to them requisite* Appendix. to carry into successful effect, the provisions of the bill. 24lh. Justices and vestry to be empowered, after the termination of the first year, to lay such addition* al tax', on such property, as may be taxable in the current year, as may be necessary to increase the medical relief fund, to a sum adequate to meet the exigencies of the bill, in respect of the past year, and the year then current. 25th. 8calc laid down, to be subject to alteration, and modification, and the provisions of the hill, other- wise, to be so subject in the next sessions of the as- sembly, 20t!i. Enactment should not be for a less period than five years. Answers of Dr. Stewart to circular of Oth Septem- ber, 1851. Pedro District, Claremont. P. O. Gentlemen, St. Amts, Seplember 301 h, 1851. I have received your circular requesting informa- tion respecting the sanitary state, kc. of the district ki the circuit of ray practice. I have to inform yor. that the extreme length of this dish ict from my residence is fifteen miles. There is no public dispensary here, and only my own for the compounding and sale of medicines. This district, and the adjoining one, the Moneagnc, have been generally healthy during the five years that I have practiced in them, but sickness has been more prevalent in this year, irrespective of cholera, than in any preceding of mv residence here. Acute disease bears no comparison in frequency here to that of its -occurrence in the lowlands. Yet 1 am aware there is much of a chronic nature, totally neglected and un- provided for, either by attendance or medicines. My dispensary is situated jn the market and post to 1851. I have the honor to acknowledge your letter of 18th September, requiring, on ihe part of the committee of the Central Board of Health, a statement of the pre- sent sanitary condition and requirements of the pa- rish of St. Thomas in the Vale, previously to answer* Sir. Appendix. 182 mg the queries subjoined, by their direction to your letter. In reply thereto, I have to state, that with the ex- ception of inriuenza, which was a few weeks back, generally, and in some localities, severely prevalent, the general health of tire parish has been satisfactory, so far as l know, ever since the disappearance of the cholera. Cases of diarrhoea, dysentery, and cholera, have from time to time appeared, and in some instances have terminated fatally; but this class of disease has probably, and not unnaturally, required an undue share of importance, in consequence of the visitation last year. With respect to the “ requirements” of the parish ; they may be summoned up shortly, as being the ser- vices of an additional number of medical practition- ers ; and the institution of some sort of dispensary, or other means of affording medical and surgical re- lief and medicines, at a reasonable rate, to the labour- ing classes. At present there is nothing of the sort whatever; and for medical practitioners, there are but two, for a district extensive enough to keep in exercise the skill of double the number, and which ought to be able to afford remuneration sufficient for them all. Though, thus in answer to the committee’s enqui- ries, I have staled what the parish wants, I am by no means prepared to point out, or even to suggest, how these requirements are to be supplied. Tims much is certain, the labouring classes will do nothing in'this way to help themselves. 1 have myself offered repeatedly, that is in the au- tumn of 1838, and several times since, to supply all common medicines gratuitously, and to make up in money, what might be required to engage the regular attendance of a medical man, provided the people living on my property, or within reach, would sub- scribe one dollar a year each ; and these offers have Appendix. 183 been as repeatedly rejected or disregarded. And I have reason to believe that mine has not been lbs only proposition which has met the same fate. 1 have the honor to be, Your obedient servant, (Signed,) BRYAN EDYVA RDS, Custos of St. Thomas in the Vale. Montego-Buy, St. James', 13t/i October, 1851. Sir, 1 have the honor to acknowledge the receipt of your letter, of the 18tb ultimo, having queries from the Central Board of Health annexed thereto, and requesting, prior to my answering them, “ a state- ment of the present sanitary condition and require- ments'’ of the parish of St. James. In complying with that wish, I beg to say that there is not, just now, any general sickness within its limits. Some time ago influenza was prevalent, and al- though, commonly mild in its character, it neverthe- less induced in some persons, and especially in the el- derly, bronchial affections which varied, of course in severity ; but tins disease lias nearly altogether disap- peared ; diarrhoea has, I understand, shewn itself in some of tlie rural districts, and so have other forms of intestinal disease, hut it is difficult to arrive at an accurate knowledge of their character in such locali- ties. Cases of cholera have also occurred during the last four weeks. This disease has not assumed that virulence which marked the late .epidemic at its on- set ; but it has, at the same time, been so severe as to be very fatal; and the cases have increased in num- ber within the last few days. In respect to the sanitary requirements of this pa- rish, it appears to me to be necessary, that the direc- tions which are contained in the first seven sections of the regulations issued by the Central Board of Health, in the Jamaica Gazette, of the 11th ultimo,- 184 Appendix. should be regularly carried cut, but on these points there are difficulties. Our constabulary force on which we should look for assistance in the town, at least, until a better ar- rangement could be made, does not as at present constituted, afford any one person possessed of suffi- cient weight of character to fill t lie office required by the seventh section, and thus arises a very great im- pediment. I therefore think il advisable, that some step should be taken to give it effect, and that the person who may hold the office, should perform its duties with unbiassed steadiness of purpose. Connected with this subject is the want of medical practitioners in the rural districts of the parish : and J believe that it is admitted by every intelligent per- son, that if practicable, encouragement should be given to their establishing themselves'therein* i have the honor to he, Sir, Your most obedient servant, (Signed,) G. M. LAWSON, JYJ. D. To the Secretary of the Central Board of Health, El.iyston (.'listen. Si. James. Answers of Dr. Lawson to the questions appended to circular 8th September, 185!. No. 1. There are, I learn, two hundred and twen- ty seven square miles three quarters in the parish of St. James. One town, Montego-Bay, and several villages are in it. The land is chiefly mountainous. The highways leading to the inhabited localities are, for the most part, good ; but the bve-tracts branch- ing off from them to the interior habitations of the negroes very generally had, in fact, dangerous, in many instances, for one on horseback. No. 2. 'Hie census of 1844 gave a population in St. James of twenty-live thousand five hundred and twelve. The number of inhabitants, by births and otherwise, may have increased to between two and, three thousands, after allowing a deduction for deaths, say then it has increased to twenty-cigli-fc Appendix. thousand. The number of deaths from cholera were about two thousand live hundred, as nearly as could, be computed. The population then, may now be said to be, in round numbers, twenty-three thousand. No. 3. There are, in cultivation, in the parish of St. James, fifty-seven sugar estates and four perms for the breeding of stock. The demand for labour on these properties, the sugar estates in particular, is, I am informed, much greater than the supply. No. 4. Hie amount of wages paid to an estates la- bourer is, i understand, one shilling per task, some- times one shilling’ and six pence ; and the task is.fin-; ished in a space of time varying from four to six hours. The wages are generally paid weekly ; but sometimes, every fortnight. There are also rare in- stances in which they are paid monthly. The pay- ments are made i:i coin. The people, according to my information, are not willing to work, and in illus- tration it may bo observed, that notwithstanding the facility with which they do their task, and the early hour at which it is finished, they can scarcely eve:* be got to take a second one in the same day ; but when they have done so, there are instances in which they leave completed it by two o’clock in the afternoon, and by which lime each of them has earned three shillings for that day’s work. The system of task work was established during the apprenticeship, and the negroes were taught to consider the cleaning of a certain number of cane roots a days work ; this they desire to adhere to, and I have information that they prefer taking one shilling for cleaning three hundred cane roots as a day’s work, to working con- tinuously, at the rate of one shilling and six-pence for four hundred roots. The negro is naturally of indolent habits, and his unwillingness to work may be thus accounted for; His wants ate few and having it in bis power to supply them readily by moderate labour, he is enabled also to indulge his disposition. Besides these causes, the cultivation of his provision grounds affords him such ample returns 186: * . as, in numerous instances, to render him independ- ent of his wages as a labourer. During the season of crop, *he labourers work five days in each week ; but at other times of the year only four; and they take many holidays at Easter, in August, and at Christmas. No. 5. There are two hundred and twenty-persons cn the pauper relief list of the parish of St. James, who leceive parochial aid weekly ; but it is impos- sible for me to form an accurate idea of the number •who, from sickness, age, or other disability, are un- able to contribute anything for providing themselves with medicines and medical attendance. I should think however, that the number is large. No. 0. There are seven medical practitioners in the parish oi St. James. Five of them reside in the town of Mon lego-Bay, and the remaining two in the rural districts. The residence of one of the latter, is about six miles from Montego-Bay, in a southwardly direction ; and that of the other at the village of Good-Will, distant from the above named town, about fifteen miles, and to the eastward of it. No. 7. There is a hospital in the parish of St. James, about a mile distant from Montego-Cay, for the reception of seamen and paupers; and a poor house in that town to which the destitute are sent and in which chronic diseases are treated. There is not a dispensary in the parish. Two medical men are appointed to attend at the hospital, at a salary of seventy-five pounds, each per annum, and it is sup- ported by a tax on the vessels trading to the port of Montego-Bay, and on the parish also. There are two medical attendants to the poor house at a salary of twenty-eight pounds each, per annum. A sur- geon is appointed also, to attend the out door poor of the parish at their own residences, at one hundred pounds, per annum. The medical men reside at Mcntego-JBay. No. 8. As there is not a dispensary in the parish 9_f St. James, an answer cannot be given fo the first Appendix. Appendix. part of this query; but as regards the second, de* siring to know if the negro population are willing to submit (o the discipline and medical treatment, pro- vided for the sick in the hospital, I would say that they very generally yield to them. But the number of such admissions has not as yet been large, as there was at one time much reluctance on the part of1 these people to go to the hospital. That feeling, how- ever, is wearing off. No. 9. it did not. The labouring people very ga. nerally were averse to pay for medical attendance, and to induce them to do so, credit, a system not contemplated by the act, was given in many in- stances ; nevertheless, a few cf them only kept their engagements. The act compelled the medical prac- titioners, who accepted appointments under it. to re- ceive, as patients, any efthose people who might pay for their registration, and it sometimes occurred that persons who did not register when in health came for- ward in sickness, and if with a family, the sick mem- ber alone was registered. The disinclination to regis- ter, when in health, led to impositions upon the parties \vho were authorized to give orders for attendance on these persons as paupers in sickness. There were causes of dissatisfaction on the part of the medical men, But i fear that some of them were indifferent also to their engagements ; and living cm the borders of two parishes they obtained districts in each, and thereby undertook to perform duties which it was im- possible they could accomplish. The districts in each parish being already more extensive than they should have been. No. 10. Edward Evans is the coroner of the pa- rish of St. James. He has no other occupation than that of coroner. He resides at Montego-Bay. Is remunerated, at present* by fees alone. His proha-* ble income is £210 per annum. The average num- ber of inquests from 1841 to 1850 inclusive, is sixty- two per annum, and that of post mortem examinations arising therefrom) five and five-tenths. Freponder- Appendix. ating causes of mortality according to the verdicts, “ natural causes.” No. 1!. It appears to me that it might be of advan- tage to nave the office of coroner filled by a duly qua- lified medical practitioner. The enquiry instituted to discover the cause of death, involves very frequent- ly the pathological condition of the deceased, and it is therefore reasonable to conclude that he who is acquainted with the structure and diseases of the hu- man body, woo’d be more likely to make a fuller in- vestigation, and, if required, to assist a jury more efficiently than cue who has not any knowledge of them. • No. 12. On reference to the clerk of the vestry’s of- fice of the parish of St. James, 1 find that by an act of the assembly, seventh Victoria, chapter fifty-four, a registry of births and deaths was established on the 4th June, 1344 ; but which was very irregularly complied with by the inhabitants. This act was repealed in 1346 by the tenth Victoria, chapter six- teen, which repealing act was disallowed by the queen in council, in '848, and since that disallow- ance the registrations, up to the present time, have been still more irregular. No 13. IVver and dysentery appear to have been the most common causes of death amongst the num- ber registered, No. 14. My information leads me to believe that during the apprenticeship, and immediately after emancipation the rite of marriage was observed to a considerable extent by the peasantry; but the num- ber of marriages diminished very much, indeed, af- ter the last mentioned period, and consequently, the offspring from illicit intercourse of the sexes greatly preponderates now. The number of mar- riages has increased, however, I understand, since the visitation of cholera. No. 15. IVIyalism prevailed to a considerable ex- tant in St. James a few years ago, but signal exam- pies were made of the parries engaged in it, and it has .Appendix* riot been heard of since to my knowledge. There have been only three convictions for obeahism in the parish within the last, two years. Concealment, how- ever, is enjoined by the persons who practice it, and as the minds of their victims are enthralled by them, fears are entertained that it is carried on. No. 16. There are uneducated black men in this parish who practice upon the sick, but it is difficult to arrive at a knowledge of the payments they usual- ly receive. An instance of this kind occurred, how- ever, just at the commencement of the late epidemic cholera in which one of these persons, a former hospital attendant, charged sixteen shillings as was shown at a coroner's inquest for a visit and a pill.— The distance of the patient from him w as under a mile. No. 17. I do not know of any instances where de- Jiterious or noxious mixtures have been administered by such persons. No. id. The negro is fond of secrecy, and attach- es much importance to mystery, and by these means connected with bold assurances as be expects very generally to be cured at once, lie is imposed upon ; and it is doubtful, under these circumstances whe* ther educated practitioners of honourable principles could hold a footing against the impostors with such a class of people as the negroes, if they should have to pay for the medicines and attendance. But quac- kery in St. Janies is not confined to the “ black men.” Persons who are of a better order are en- gaged in this practice, and it is sometimes done un- der the pretext of charity, and while there is little doubt that money, to a large amount, is received for what is done. Negroes have often come to my house by mistake to “ see mistress,” and get advice, and have had the money with them ; but on finding their error, have gone away. To bring up such per- sons for violating the law, would be a fruitless at- tempt, for it is more than probable that the witness ■ Appendix. 190 es having sought the assistance, would not ba got to disclose the fact. If medical attendance and medi- cines were to he offered as a gratuity, I think the negroes would often take advantage of it, but if pay- ment is to be made for them, they will, it appears to me, prefer going to a quack, although this may not be done until the sickness has continued for some time. No. 10. I do not think that assistance is sought for from such quacks during parturition, nor do 1 know of any instance where unskilful treatment has result* ed in injury to the mother. These patients are usu- ally attended by midwives, and they have not any knowledge of what they undertake beyond receiving the child after a natural birth, and performing the simple operation which is required at the time.—*. Where injury arises to the patient, I am of opinion that it occurs rather from the omission of that assistance which is required, and which the midwife is unable to give, than from commission. No. 20. The crime of infanticide is scarcely known in this parish. I have not heard of more than one case of it. No. 21. I have already expressed an opinion bear- ing reference to this query ; but I would repeat, that a legislative enactment, having for its object the encou- ragement of medical gentlemen as expressed in it, would, I dare sav, be acceptable to the labouring classes, provided they be not called upon to contri- bute towards the expences attendant on it; but 1 do not thinkthat the gentlemen who might be invited to reside here, would meet with such a share cf employment as lo afford them the means of living, if they are to depend on the labouring classes. No. 22. In alluding generally tc such an impost as is contained in this query, I would say that I do not think that it would be willingly paid. If, how- ever, a tax should be imposed, a capitation tax would be the fairest one I should think, Appendix. No. 2.3. There is, I believe, a very good supply of medicines in this parish to meet ordinary epidemics, but not adequate, 1 imagine, to meet such a one as cholera. G. M. LAWSON, M. D. Gustos, St James. Ilcntego-Jdjy, 1 Gth October, 1851. Goshen, P. O. 21st October, 1851. Sir. Your letter cate dthe 8th ultimo, directed to me by the desire of the committee of the Central Board of Health had been, some how or the other, miscarried and had come to hand only four days since ; conse- quently my answers to the questions therein are not so prompt and full as 1 could wish. Respecting the sanitary condition of the parish of St. Elizabeth, it is somewhat similar to the state of ail the other parishes of the island—a mere nonentity. But the requirements are great on account of its ex- tent. The parish requires, at least, six able duly qualified medical gentlemen, with as many active as- sistances, and with a proper and adequate supply of medicines provided and kept in the parish particu- larly, in tiie event of any epidemic diseases appearing therein. I have the honor to be, Sir, Your most obedient servant, (Signed,) A. DEWAR. To T. James Brown’, Esquire, Kingston. Cj Answer of Dr. Dewar to questions appended to cir- cular of the oik September t 1851. No. 1. St. Elizabeth is the largest parish in the island, in extent about one thousand one hundred and forty-four square miles ; population scattered ; land is both mountainous and in large plains 'r 192 Appendix. the inhabited localities in the plains are accessible by safe roads, but not so good ; the roads in the moun- tainous districts are mere bridle tracts, very bad, and unsafe. No. 2. I cannot say ; the estimated reduction by the cholera is from three hundred to four hundred ; cannot say whether the adult survivors are princi- pally male or female. Occupation, principally agri- cultural, with few exceptions. No. 3. About fifteen sugar estates, twenty penns, and about fifteen coffee and pimento properties i:i cultivation. The demand for labour is greater than the labouring population can or will supply. No. 4. The average amount of wages paid to an estates labourer, per diem, is l.v —but the labour on sugar and oilier estates, is principally paid per job or task work regularly, and all in money. The people are not willing to work in the cultivation of estates, and the cause that contributes to their unwillingness in a great measure, is their facility of purchasing or leasing land at a trifling expense. No. 5. The amount of pauperism is about £500. Few persons, except paupers, are unable to contri- bute anything for providing themselves with medi- cines and medical attendance. No. (>. Seven qualified medical practitioners with- out practice ; three of the number reside about Black Fiver, three in the Santa Cruz mountain, and one in the Nassau district. No. 7. There, is neither a hospital nor public dis- pensary in the parish. No. 8. The negro population in general, are not willing, when sick, to apply for medicines, unless they are certain to obtain it gratis. No. 9. 1 am perfectly aware that the dispensary act of the ninth Victoria, did not work well in this parish and throughout the island, and the cause of its failure was attributed to the trifling charge of three shillings and six-shillings, as the case might be, from ?li applicants for tickets of enrolment, The only part Appendix* cT th£ act that worked well was vaccination, for this simple reason, that it was done for them gratis. IS;o. 10 Jokn Cuff, esquire, proprietor of penn* at present, 1 believe, remunerated by fees. IFfis pro- bable income, the average number of inquests held yearly within the last ten years, the number of post mortem examinations, and the preponderating cause or causes of mortality, l cannot say No. I i. Yes, 1 think it is impossible for any coro- ner who is not a medical man, always to know when medical evidence is necessary, and us Ivrmight choose to dispense with it in cases where it would be abso- lutely essential to the finding of a correct verdict, it should lie unlawful for a coroner to hold any inquest without taking the evidence of a duly qualified medi- cal man, except in those cases where the cause of death is so obvious as not to admit of any reasonable doubt, it ought not to be deemed sufficient to re- cord the following vague and indefinite verdicts, viz.: “ died by the visitation of God.” “ Death from 11a* (lira! causes,” “ Found dead.” “ Over laid,” &c„ &c. but that the true and proximate cause should al- ways, it possible, be stated. No. 11. None to my knowledge. No. 13. 1 cannot say. No. 14. No, far from it, consequently there are many cases where the offspring is the result of the illicit intercourse of the sexes, No. !o. Very common. No. IG. Yes, ! cannot say what payment they re- ceive, that being kept a great secret. No. 17* No, but I believe that such cases have oc- curred. No. 10. Yes, I think so, and consider that in many cases preference would be given to “quacks,” No. 19. I do not think so* hut l believe that the unskilful, after treatment of ignorant mid wives*' and “nurses,*5 often result ia injury to both child and mother. No. 29. Yes, I have, Hare cases occur- r.cw anti Appendix. then ; hot by the mal-practice of “ quacks," but by the mothers themselves. I think more extended and cheap medical relief would tend towards the suppression of such crimes. INo. 21. No, I do not think so; and any medical gentlemen coining here would more likely meet with actual starvation, than a fair share of employment, producing a competent living. No. 22. The impost would be paid unwillingly Unless provided by indirect taxation. No. 23. None whatever. Answers of Dr* Horlock, of St. Marys, to questions appended to circular of 8th September, 1851. St. Mary's, Port-Maria, P.O. 26th September, 1851* Sir, I have to acknowledge the receipt of your commu- nication of the I Oth instant, and in reply, beg leave to state fertile information of the committee of the Cen- tral Board of Health, that the district under my im- mediate superintendanee, is at present in an healthy condition, and have reason to believe that the rest of the parish is in a like state. With respect to the requirements alluded to, I beg leave to observe that there is a sufficiency of both medical aid and medicine for the present wants of the community, there being four medical gentlemen re- sident in St. Mary, and a fair supply of medicine on hand ; this latter part, however, i propose answering more fully to question INo. 6. I have the honor, to he, Sir, Your most obedient servant, (Signed.) THOMAS W. HOIiLOCK, T. J. Brown* Esquire. Secretary of the Central Board of Health, Spanish-Touaiti, Appendix* Answers of Dr. Altman to questions appended to cir- cular of &th September, 185 E 1st. I have no means of ascertaining the number of square miles. Kingston, of course, is surrounded with numerous suburbs, accessible by good and in- different roads. 2nd. Estimated population about fifty thousand ; unfortunately six and perhaps seven thousand fell by the cholera. 1 should say there is very little agricul- tural occupation. Mostly the mechanical arts re- quired in large towns give employment. 3rd. This question does not apply to Kingston. 4th. Same. 5th. Pauperism is very great among the humbler classes in Kingston, and hundreds and hundreds are unable, by their own account, to contribute any thing for medical attendance. 6th. Eleven qualified practitioners in the city ; the number is inadequate to the population, but adequate to the remuneration. 7th. There is a dispensary and an hospital. The latter supported by the island, the former by the is- land partly, and by private subscription and monthly payments from persons entering themselves as reci- pients for the benefit conferred by medical attend- ance from the dispensary. The latter, one principal- ly the very humbler classes, who, contribute but in- differently in spite of the manifest advantages con- ferred. For one shilling each month, an adult re- ceives, for the whole month, at his house, constant medical attendance, and if he has a child, he pays in .addition only “ three-pence"’ a month. Thus pro- viding, humanly speaking, for bis life’s safety by so small a sum, and yet with difficulty can they he imade sensible of this proper provision, and with more difficulty do they consent to obtain it at the expenca Appendix. perhaps of some sacrifice, each month, of an article for which they have no neci Yet it is a singular fea- ture, that those who do belong to the dispensary soon perceive its advantages and do not fail to be grateful to the institution. The private subscribers of a guinea each, have the power of keeping one sick person always on the books, and it is astonishing as Well ns gratifying to perceive, as a whole, what great benefit the Metcalfe dispensary confers. JNumerous persons who languish in sickness and have seen bet- ter days, too poor to employ medical advice, and too proud to go to the parish, are supplied by these means with medical attendance, and the head of the family is often by these means snatched from sick- ness, and his family again obtain his exertions for maintenance. One hour every day is devoted to the reception of out door patients, by medical attendants. There are two medical practitioners attached to the dispensary, not resident, but visit the dispensary.—• They reside near. The salary, from the indifference of the class for whose benefit, and to whose benefit it largely administers, is now reduced to fifty pounds a year each. The number of persons relieved, not- withstanding last year, were about eight hundred.— This not including the cholera cases, which amounted to more than another thousand, treated by us at the Me t cal Fe d i s p c n s a ry. 8th. Tlie negro population are willing to apply for medical relief, and submit to medical treatment, but they are (as I have written) unwilling to pay monthly proportions to the dispensary, anti 1 attribute the re- luctance of those who can pay, not doing so, simply to the inability of being sensible to the necessity of foresight, forethought, precaution, and the ’prepara- tion to meet danger, which they never acknowledge, unless it exists, and which, because they cannot see, they do not believe can exist, 9th. This act was never applied in our city. 10th* B. JNaar, esquire, is coroner for our parish, Appendix. resident in Hanover street. I believe he is remune- rated by fees. Income l have no means of arriving at, nor of the number of inquests, nor post mortem examinations. He is an indefatigable and good co- roner. i am afraid the prepnn. (era:ingcauses ox mor- tality are to be nUribuied to self-neglect and intern- O' :wnxre among a bc'ge class. ! 3 tli. A ill:;) igh Mr. Nanr is a most excellent' coro- ner. and ia application and lalent of investigation, entitled to much praise; a medical prnclioner should hold the cbMee, i consider of coroner ; simply, that where life and death turns thousand to thirty thousand. The cholera must have carried off between two thousand to two thousand five hundred ; no correct list can be obtained. The sexes are pretty equally divided. Agricultural la- bourers. No. 3. Between forty to forty-five; the demand is greater than the supply. No. 4. The labour is one shilling and six-pence per day, generally job work. It is paid regularly and always in money. They are unwilling to work, ex- cept during crop time ; their unwillingness seems to proceed from the facility which they can get their wants supplied from their grounds, &c., and an in- nate laziness. No. 5. The paupers consist principally of those in the poor house, averaging about forty-five, and some twenty receiving out door relief. These are the only part of the labouring population w ho cannot contri- bute something towards medical relief. No. (). Six, Dr. MacDonald (an invalid) at Hermi- tage, Savanna-la-Mar ; Dr. Mason at the rectory, Savanna la-Mar, and Villa, twelve miles from the town ; Dr. Tullis at Morgan’s Bridge, nine miles from the town ; Dr. Jelly at Walbro Hall, nine miles from the town ; Dr. Harvey at Windsor, two miles from the town ; and myself in the tow n. Were all the inhabitants to seek medical relief, their number is not adequate, but so few do so, that all the medical men keep druggist establishments, which is the prin- cipal means of their support. No. 7. No dispensary or hospital. The poor house is used as a hospital for paupers. Dr. MacDonald is employed to attend it as well as the out-door poor, for which he gets a paltry pittance of £60 per annum, and has to supply medicines. He lives about a quar- ter of a mile from the poor house. There are always upw ards of forty inmates sick at the poor house. No, 8. They apply willingly enough for medicines, if to be obtained gratuitously, and they resort for that purpose to the poor house surgeon, they do not Appendix. 207 like to go to the poor house, and very many die with- out medical assistance, from disinclination on their part to lay out money for that purpose, and they ge- nerally only call a medical man when it is too late, and frequently for the express purpose of saving an inquest. No. 9. When I came to the parish, in one thousand eight hundred and forty-eight, the dispensary act had just expired ; it it were properly carried out it ought to have been a great boon to the population ; from the information I have obtained on that subject it was a failure owing to the inattention of the medical men, and to want of proper inspection. No. 10. John Deleon. At present a penn-keeper, formerly a storekeeper; he lives at Mount Ricketts, about fifteen miles from the town. He has a fixed salary, I believe £ 120 per annum, and a mileage fee of one shilling and six pence per mile. The remainder of the question I cannot answer. Post mortems only occur when there are suspicious circumstances at- tending death. No. 11. Most decidedly—upon the same grounds as those which have been adduced in England. No. 12. There is no office of register of births, deaths, and marriages, the only register kept is of the baptisms performed in the churches, the marriages by the established church, and the deaths of parties interred by the clergymen. No. 13. As there is no register whatever of the deaths, this is unanswerable ; the negroes, generally speaking, bury their dead themselves in the imme- diate neighbourhood of their residence, and no one hardly is the wiser of it, or has any knowledge of a death having taken place. No. 14. Marriages are not generally observed by the labouring classes and others, and the offspring consequently is illegitimate, but since the appearance of cholera here the number of marriages that have taken place is incredible of parties who have been living together for years. Appendix. No. 15. Gheali is becoming common here, particu- larly among the Africans. No. 16. Very many; they take anything they can get, money, food, or horses, and are much better paid than the medical men to whom they generally resort when, alas ! it is too late. No. 17. Yes, very many; and with danger to life. No. 18. No; not if they could obtain advice and medicines gratuitously, except, perhaps, by the Afri- cans, who resort to obeahism. No. 19. The negro women generally assist eaeli other; I have known instances where unskilful treat- ment lias ended in the death of the infant and injury to the mother. No. *20. I fear it prevails to a great extent both by the mid wives and the mothers themselves, for the purpose of avoiding the expence of supporting their offspring, and sometimes to avoid the disgrace of be- ing expeiled from their church. Religion and educa- tion can only prevent the crime, as it is wilfully com- mitted. Abortion, wilfully caused, prevails also to an alarming extent in the early months of pregnancy. No. 21. Were the government to remunerate ade- quately such medical men, it might be acceptable ; but they would assuredly starve if they depended solely on medical practice for their support; of the six already here all are obliged to keep druggist es- tablishments, and two, Messrs. Mason and Tuliis, are large merchants in general business. No. 22. It might be willingly paid, if they could, in consequence of it, obtain medical relief without further pay, otherwise it would be very unwillingly paid. It should, l imagine, be raised on land, whe- ther rented or owned by the labourers, and upon their breeding marcs. A poll-tax would cause great opposition, l should imagine. No. 23. I should say that there is always an ade- quate supply of medicines here to provide against liny emergency. To conclude I would reccommend that the parish Appendixi fchould he divided into districts, and a medical man ap« pointed to each; that he should be compelled to visit such district at least three times a week, and Softener if necessary; that the districts should, if possible, be ap- portioned according to the location of the medical men *r that the magistrates he compelled, or tLie clerks of the peace, to ascertain if the medical men have duly and re- gularly paid their visits to the sick in their different dis- tricts, and ascertain if any complaints of neglect exists The medical men, for such duty, should be rewarded by a tax levied for that purpose, but their salary should be fixed and payable quarterly by the receiver- general ; that the medical men should establish a dis- pe nsary in their district, and keep it properly sup- plied with medicines. I would advise an office of register of deaths to be appointed, anti without cite certificate of a medical man, no body should be interred, or in the absence of a medical man, the certificate of a neighbouring overseer; and parties disobeying this order should be summarily punished in a fme, say of twenty shillings. i would likewise advise strict sanitary regulations to he attended to by the medical men of the different districts, and lo be summarily enforced by a small penalty. "(Signed,) JOSEPH ADOLPHUS, Surgeon. Answers of the honorable Richard C, JBurhe to the questions appended to circular oj the 8ih September, 185 hr No. 1. The extent in area of this parish is about eighteen spuare miles, it is scattered ; there are some plains along the sea coast, but it is generally moun- tainous. The inhabited localities are generally ac- cessible by roads, but they are, toi* the most part, in* different, and in the rainy seasons many of them are nearly impassable. No, 2. The estimated population, before the Appendix* pearance of the cholera, was thirteen thousand eight hundred; the estimated reduction one thousand five hundred to two thousand. It is principally agricul- tural. No. 3. T he number of sugar estates in cultivation is nineteen ; the demand for labour is very great, and only in very settled weather can be obtained ri Ids I impute to the me?re steady and able of our labourers retiring to their own small freeholds which they cul- tivate, only coming to the estates in fair weather, or to supply any particular requirement; and it is to he observed the further they re;ire from the estates in this parish, the nearer they approach the Kingston market; also obtain superior soil for provisions. No, 4. I he average amount of wages is one shil- ling per diem, but an able labourer will perform the work he engages to do for this sum in five or six hours, and cannot be induced to take a second task except at mill or boiling house work; the wages are invariably paid in money, and regularly, as far as my information goes. No. 5. There are about fifty paupers receiving: weekly relief from this parish, and an asylum for sb K. paupers, attended by a. medical man ; the expense to the parish is iloGO per annum. N o. (! One qualified medical practitioner, Dr. Tho- mas Choke; he resides at Beilefieh! pen, five miles south of Atmottn Bay, but has a dispensary and place of occasional sojourn at the hay. If the services of a qualified medical practitioner were duly sought after, it would require two or three more adequately to sup- ply the medical necessities of the population of this parish. No 7. There is a parish asylum, which .also, on a limited scale, answers the purpose of an hospital; it is suppoited solely out of the parish taxes ; it is at- tended by the above named medical practitioner at a salary of £ 3-5 per annum; it is contemplated by the vestry to abolish th»s institution at the end,of the yeaiv ia consequence of the pressure of the taxes. Appendix. No. o. The persons who enter this asylum are ge* fterally tlie most wretched and friendless; they sub- mit readily enough, to the discipline and treatment. There is no parochial dispensary, but the negroes ar& always ready to apply at the private dispensaries for medicines and advice, provided the latter is given gratuitously. In a few instances they contemplate paying, and do pay. IN'9. 9. It was a complete failure ; the reason of the failure was that the negroes wished to secure all the benefit of the club system (on which it was, in a great measure, based) when sick, without its incurring obli- gations while in health, so that the suhseiptions fee of three shillings to six shillings, which no doubt the legislature supposed would be generally contributed as towards the construction of a system of medical support, was paid only in individual cases of sickness for attendance and medicines, to which it was, of course, a quite inadequate remuneration. Indeed the medical man, finding himself not at the receiptor a merely modi tied remuneration, but an absolute and serious loser by the exercise of his calling under an application of the law, such as the legislature never contemplated, evaded it as much as possible. Per- haps the negro doctor also influenced the people against the system. No 10 i). It. Ball is coroner for the parish; tai- lor by trade, residing at Enfield ; lie is paid a certain amount fixed by law for each inquest, (£3,) besides mile money. Income about t‘120 per annum, but m my unnecessary inquests are held ; there have not been more than two or three post mortem examina- tions Ihi- year; the average for some years past is about six ; the preponderating causes of death, within Dr. Clarke1* experience, is plenro pneumonia. No. J l. That the office of coroner be only filled by a medical man I consider one of the most valuable suggestions that has been made, particularly under existing circumstances • a reversionary interest in the ©ilice would be au, encouragement to medical men to Appendix. settle in the island. The opinion of a medical coro- ner would be well founded as to the necessity of a post mortem examination, and consequently alike conducive to the ends of justice as well as economy ; and I believe they would, as a body, shrink from a merely mercenary traffic in their functions. By a clause in the art they mav be debarred from holding any other parochial appointment, leaving the hospi- tal or asylum, out-door poor, health officer, police, to a second medical practitioner; this would se- cure two medical men to every country parish ; they would also have their private practice, and if a healthy and extensive system of immigration was commenced, (the only means left to stay this agri- cultural country from a further retrogression,) it may be the source from which a third resident medical practitioner could be introduced. The great want of medical aid is so pressing and so immediate, it is a subject well worthy of legislative consideration how far it would be practicable to remove and compensate the present holders of the coroner’s office. No. 12. A register was kept in this parish of births and deaths ; it commenced in 1844, hut was never regularly made available by the people ; a good ma- ny births were registered until ihe act was repealed, (but the repeal was disallowed,) from that time it fell off and has become a dead lei ter, no names hav ing been registered for ihe last year. No. 13. Without any register to refer to, it is the opinion of Dr. Clarke, resident many years in this parish, that amongst the adult and able bodied por- tion of the population, by far the most ordinary cause of death is neglected inflammation of the contents of the chest, particularly pleuro pneumonia. No. 14. There are many married couples among our peasantry whose conduct is unexceptionable, but I regret to add, the rites of marriage are not so ge- nerally observed as could be desired , in very many instances young men have married women consider- ably older thau themselves, who had acquired money Appendix. In earlier days, either by industry or prior connec- tions, and, 1 fear, in these cases the wife often sub- mit'-!, and even panders, to the desires of her hus- band. No. Jo. Obeahism and myalism is, I fear, on the increase in this parish Melancholy proofs of this came out during the cholera. No. 1(3 There are three or four. 1 am informed of one who charges live dollars for a case, with more or less after, according to the result. I know of one who was very attentive, and said to he very success- ful in stopping diarrhoea in this district during the recent epidemic. No. 17. 1 do not think this class use any drugs with the intention of doing injury ; but l fear they sometimes resort to powerful medicines injudicious- ly, and there is strong reason to suspect, that under the system of obeahism and myalism, sugar of lead has frequently been administered in poisonous doses in this parish. No. 18. I doubt if the present generation of ne- groes will ever be induced to volunteer a fair remu- neration to duly qualified medical men, who, at pre- sent, are seldom called in before the case is in its last stage, or utterly hopeless ; and then the sole mo- tive which actuates the sick man’s family is, that it may be said the “white doctor,” as they call the re- gular practitioner, has seen the patient, and thereby they “ save inquest,” as they express it. The quack doctor, being a man of their own class, and in the habit of familiar intercourse with them, has means of obtaining payment, which a gentleman cannot descend to. The quack doctor is often a church leader, and has it thus in his power to use several in- direct influences among their own people to induce payment; then lie does not insist on a cash fee, hav- ing other means to enforce payment as just recited, whereas if the medical man does not get paid a cash fee he may give up all prospect of any after settle- ment ; at the same time the negro yeadiiy avails him- Appendix. self of the superior skill of I he regular practitioner, when it ran he obtained gratis. No. IP. In some rases. No. 20. The crime of infanticide is unusual among our people, hut there is, in many instances, very great and culpable neglect in the treatment of their young children, and when we compare the anxiety, or pre- tended anxiety of the mother, often witnessed in slavery, with the many instances of gross indifference since evinced, we begin to doubt the sincerity oflhis feeling at the former period. No. 21. Such a measure would be very beneficial, but would not, in my opinion, enlist the voluntary support of the people. 'I he habits of civilized life have vet to be formed ; a direct tax for this purpose would raise the negative principle of their nature into active antagonism, and thus defeat its own end ; the only way they can be made to contribute to the end in view is by indirect taxation. The use of spi- rits is much on the increase, the spirit licence might, it is fair to infer, be raised at the same time; simps without licences should be more strictly looktd after; this even, if successful, could of course be only one necessary means. No. 22. Answered with No. 21. No. 2d. There is generally a very inadequate sup- ply of medicines kept in the parish, in the event of any epidemic disease appearing, A well regulated public dispensary, in a central part of the parish, at- tended by a well informed dispenser, under the gene- ral instructions of a medical man. would be very va- luable indeed. During the late epidemic, the people in the interior were in very many instances wholly destitute of medicines and medical aid, our only me dical practitioner attending principally in the town of Annotto Bav. (Signed,) RICHARD C. BURKE, Custot. Appendix. Answer of Dt\ Tarrant to circular of 8th September, 1851. T. James Brown*, Esquire, Secretary to the Central Board of Health, Kingston. Sir, 1 herewith forward ray replies to certain questions received by a circular letter of date the 18th ultimo, from the committee of the Central Board ot Health, Kingston, which 1 hope may be received in due course, and aid the members of the committee in their labours; some few questions remain unnoticed, ow ing to the difficulty experienced in obtaining infor- mation from persons capable of giving it ; on another occasion, I will take the earliest opportunity of rec- tifying the omission. In reference to the second paragraph of vour cir- cular, i am happy to say, Vere, St. Dorothy, and the lower part of Clarendon, in all of which places 1 am in the habit of practising, have, since the disappear- ance of cholera, been healthy, with the temporary ex- ception of influenza, chronic pains, and diarrhoea, and ] am not aware of any reqniremets, in either parish, sa\e those the legislature may think proper to adopt in addition to their present requirements. 1 have the honor to he, Sir, &c. &c. W. TAKRAKT. Hides to be observed by lie members, to a selfsvpportm rug dispensary. 1st. That the benefit of this society is confined to the inhabitants of Kingston ; and anv member, on go- ing to reside out of the city, will forfeit all claim to be visited by the subscriber. 2nd. That the object of a self-supporting dispen- sary is to afford to its members medical and surgical advice, surgical operations, and medicines, and at* tendance at the abodes of afi such of its members, as Appendix*, are not able to call on the subscriber, at his resi- dence, or at the dispensary. 3rd. That attendance on midwifery is not con* templated as a benefit arising from the dispensary# such attendance, when needed, will form a separate charge. 4th. The subscription will be two dollars the quar- ter, or forty shillings the year, payable in advance* for all persons above fifteen years of age, and half these amounts for all persons under that age. 5th, That no person after, the 1st January, 1839* will receive the benefit of the dispensary, who is not. in health at the time of subscribing, unless by paving an extra quarter's advance of two dollars in addition to a year’s subscription of forty shillings ; in ail eight dollars. 6th. That at the time of an individual becoming a member, personal attendance on the subscriber wifi, in every instance, be required, and then and there to give their proper name, age, occupation, and resi- dence, in order that a register of the same may he kept by the subscriber ; and in the event of its being afterwards discovered that an individual has given a wrong name, age, occupation, < r residence, such member will forfeit all fmflier claim to the benefit the dispensary holds out, as well as of the remaining period of attendance. 7th. That at the time of the payment of subscription, and upon ail subsequent occasions of receiving same, each member will be furnished with a circular letter, explanatory of the ends of the dispensatory, the time of attendance paid for therein specified, and signed by the subscriber, as well as the name, age, occupation, and residence, given by the member at the time of paying the subscription ; and on no consideration whatever will a subscriber’s letter of admission le transferable to another individual. 8th. That every member, when requiring advice er medicines, will be expected to call at the dispen- sary, (for the present held at the residence of tiie Appendix, subscriber, 59, Duke street,) between the hours of nine and two o’clock in the forenoon, or three and four in the afternoon, and to bring their letter of ad- mission ; and that members shall, upon no account whatever, require the attendance of the subscriber at their own residence, unless the illness is such as to prevent their attendance, in w hich event every atten- tion w ill bo paid by the subscriber when so called upon as in private practice. 9th. That all members, requiring the attendance of the subscriber at their own residence, in order that they may receive early attention to their calls, are ex- pected to forward to him their letter of admission, before seven o’clock in the morning, or four o'clock in the afternoon ; no attention will be paid to calls made at any other periods, except in cases of emer- gency, and then at the option of the subscriber. H)lh. Every change of residence must be com- municated to the subscriber when called upon for advice or attendance, and the letter of admission to be brought to, and left with, the subscriber upon every occasion so wishing advice, as the medium of ensuring early attendance and a correct reference! of address. 11 th. The period of attendance to commence and terminate at the dates specified by the receipt on the endorsement of the letter of subscription, either quar- terly or annually, as the payment may be ; and it is exneeied that all the rules herein contained will be strictly observed by the parties. 12th. The subscriber reserves to himself the right of excluding from the benefit of I he dispensary all such persons as he may consider not coming under the denomination of the class of persons whom it i£ intended to benefit. W. TARRANT, M.R,C.S,L.> S.A* kcr ,Kingston, July 1st, 1838, 59j Duke Streetv Append^ Answers of Dr. Tarrant to questions appended to cir> cular of Si/i September, 1851. No. 1. Vere is neither scattered or congregated ins. towns and Tillages, t lie re being no town, and but a few' negro hamlets, strictly speaking, say half a dozen, or thereabouts ; the parish is level, and accessible in dry weather to all parts, with fair roads. No. 2. The reduction of population in Vere, by cho- lera, as shewn by the parochial register’s returns, was. seven hundred and eighty individuals ; namely, three, hundred and eighty-five males, and three hundred and ninety-five females; tlie survivors are chiefly agri- c'lil turrets. No. 3, The number of sugar estates m cultivation- in Vere, is, I believe, twenty-five or six ; iyom per- sonal experience, 1 consider the available labour in the parish is very deficient; and that double the number could readily find employment, owing to the* caprice and indolence of its peasantry. No. 4. Out of crop the rate of wages in the parish of Vere may be said to average from nine-pence to one shilling per day, for adult labourers ; elderly people and children half these sums : in crop time, the former, from one shilling to one shilling and six- pence ; but at all periods contract or task work is preferred, and considered more satisfactory to the employer and employed ; their wages are always paid; in specie, and usually every week. No 5. The number-of persons receiving parochial- relief may be said- to average about fifty-five per week during the entire year; they are chiefly elderly or dis- eased subjects, or cripples. These, with any deserv- ing poor persons, receive medical attendance and me- dicines gratuitously on the recommendation of the clergy, churchwardens,, justices of the peace, or mem- bers oil the vestry ; for which duties the sum of one hundred pounds per annum- has, for the last three or- four years,, been assessed in the ways and means of Appendix. \he parish each year, the same being divided into three districts, according to the number of medical •practitioners at that time residing in the parish, but since which period, a fourth, Dr. C. Tniteh, has re- turned thereto, but has not expressed a desire to par- ticipate in the same. No. (3. There are four resident medical practition- ers in Vere, namely, Dr. Trutch, residing near to the Milk River Rath, Dr. R. G Bruce, Lancet Hall, near to the Alley, Dr. J. N. Challinor, in tbe Portland district, and myself, near Sait River ; this number is, in my opinion, more than required for the wants of its parishioners. No. 7. There is no public dispensary or hospital in iiiis parish, yet, as stated to query number five, £ 100 is paid annually to Drs. Bruce, Challinor, and myself, conjointly for our professional services and medicines on the paupers and other deserving poor of the parish, at the request of certain authorities. No. 8. See my reply to the preceding question. No. 9. N o t h a v i n g b ee n o ne of the med i c ul attend - ants under the dispensary act of ninth Victoria, the same dividing this parish in two districts*, although there were then and still are four resident medical practitioners, (a division I consider partial,) I cannot, from personal observation* answer this question sa- tisfactorily, , ,t No. 10. Robert G. Bruce, esquire, Lancet Hall, ’Surgeon, ids remuneration is, 1 believe, by fees; JDr. Bruce having promised me to reply to tills question fully, he being more interested than myself will doubtless give the circular of the committee fuller in- formation than 1 could afford them. No. 11. I have always entertained the opinion that a medical practitioner, from bis knowledge of the ana- tomy of the human body, as well as of medical juris- prudence, the most fitting person to fill the respon- sible ofiice of coroner, and thereby forwarding tb« ends ofjusticec 220 Appendix. No. 12. There is, but I have not as yet been able to refer to the records. No. 13. For the reason assigned above, I am un- able to reply hereto. No. 14. Not generally so. Since the cholera I am informed some parties who had previously lived in a state of concubinage have been married ; the ma- jority of offsprings being however the result of illi- cit intercourse* No. 15. Not that I am aware of. No. id. 1 regret to say that there are far too many. The negro practice, 1 have good reason to believe, is chiefly confined to this class of persons. 1 cannot, from personal knowledge, say the amount of remune- ration they receive, although ! should think it to be quite as much as any practitioner would charge per- sons in their station of life if applied to for medical aid. No. 17. I cannot say that, I do ; but not long since an inquest was held on a coloured female in comfort- able circumstances, (the widow of the late pound- keeper, and an aspirant for the office of coroner,) whereupon evidence was adduced that she had been shortly before bled by a black man; she died from extensive inflammation of the arm, and side of the body, and, in my opinion, bad she not been bled by an unskilful person, death would not have occur- red. No. 18. From my knowledge of the negro charac- ter, l feel confident in saying that nothing short of gratuitous medical relief would induce the majority of negroes to leave the illiterate for the regular prac- titioner, and not then in all cases. No. 19. Not that I am aware of; old women, very deficient in the art, usually attend on labors, and i know of death resulting from bad treatment. No. 20. None, to my knowledge, in the parish of Vere. Some years since 1 was called to attend a co- roner’s inquest on the decomposed remains of an in- Appendix. 221 some time interred, when it was impossible to arrive at any satisfactory conclusion as to the cause of death. 1 am inclined to think the evidence ad* duced went to prove the secreting of the birth, and XI ot infanticide. No, 21. I can conscientiously assert that the me* dical practitioners 1 am acquainted with complain they are not sufficiently remunerated for their ser- vices ; and [ would add this is not merely confined to the lower classes, but in many instances to those of a higher grade, who either physic themselves, friends, and family, or but badly remunerate their medical at- tendant. Eight years practice in this parish, the lower part of Clarendon, and St. Dorothy’s, confirms that opinion. 1 likewise consider (excepting per chance a few* parishes) that there are already quite sufficient medical gentlemen, in every point of view, for all sanitary .purposes. 1 could not therefore think of suggesting the idea of calling in more of the faculty to emigrate to the island, particularly at its expence. The best mode to ensure the continuance of the pre- sent body of practitioners in the country, and also to add to its number, would, 1 consider, be by encou- raging those already in it, by legalizing their charges for professional services, and by offering them every and any encouragement the legislature could effect. In support of these sentiments I would observe that in the parish of Vere there are four resident medical practitioners, and has continued so since 1844. Of this number only one may be considered as living by bis profession ; the remaining three (myself included) possess our freeholds, more or less comfortably ap- pointed, which mainly adds to our support. 1 may add my annual receipts in the three parishes for ne- gro practice, does not average five pounds per annum, whereas, in Clarendon, I know of three medical gen- tlemen leaving it, not being able to acquire a mere competency, whilst one withdrew from practice on that account, and a fifth lived chiefly on the proceeds of a retail drug shopj and a sixth, lately deceased, &ppen(li!t-. was looked upon more in tire light of a general shop- keeper than that of a medical man. During the same period, St. Dorothy had four practitioners, three left the island, not being a hie to procure a living, and the fourth died penhyless, if not in debt. No *22. Thi's I feel the most difficult . W. T A HRANT. 3I R.C.S. London, <§rc, fyc. Answer of Dr. Allan to circular 8/A September, 185 L Mcmcltior.enL St. Thomas in the East, 30l/i September, 18,51. Siry In conformity with your letter of 8 th instant, ad % dressed to me, I herewith, transmit answers to the. several questions, submitted by the committee of the Central Hoard of Health, on the subject of medical relief. I beg leave also to state, (according to your request,) for the information, of the committee of said Board, “appointed to consider the sanitary state and wants of the different parishes,5’ that with regard* to this district of the parish,, it is scattered over a large extent, in each division o,.f which., there are se- veral populous villages, lately settled by the labour- ing population. The greater part of the dwellings in, those villages, are constructed* without any regard to, yentilatipiiA and bei.n.g generally too. densely site.atedi Appendix. and confined in their apartments, the inmates are thereby rendered much more liable to such diseases as arise from sudden changes of temperature, damp- ness, impure air, &e. &c., and when in such ill venti- lated and unwholesome localities, they do become sick, the success of medical treatment, under such un- favourable circumstances, must thereby be consider- ably diminished. The evils arising; from the crowd- ing and huddling together of the negroes, must be sufficiently apparent to the more enlightened of even themselves, but without some legislative effort to dispel the prejudice and ignorance still unfortunately existing to a large extent in this matter, little, 1 fear, can be accomplished in the way os’ sanitary reform. I have, in too many instances in this island, seen and marked the direful ejects of impure and contami- nated air arising from the overcrowding of apartments and from neglect of proper ventilation. To such neglect (in such a climate as this) much sickness may still be attributed both amongst adults and children. These evils are greatly aggravated by the too com- mon practice adopted by the negroes of planting, close to their dwellings, trees and shrubs, which, shortly increasing, sometimes surround and overhang their already ill ventilated and confined apartments, and thereby greatly diminish the current of air.—• The district of Manchioneal has in aii a popula- tion of nearly five thousand souls. About fifteen years ago there were three resident medical men in practice in said district, hut at present 1 am the only medical practitioner therein. I shall now proceed to answer the several questions in their order as they stand, which 1 shall herewith enclose. I have the honor to be, Sir, Your very obedient servant. W. B. ALLAN. Appendix*■ 225 Answers of Dr. Allan to questions appended to cir- cular 8th September, 1851. No. I. The extent in. square miles of the whole parish 1 am unable to state. This district of the pa- rish (iVianchioneal) extends along the sea coast over a space of about twelve miles, and varying* in breadth from four to eight miles. Some of the roads are in good condition, and others very bad. The land is partly mountainous and partly in small plains. No. 2. The estimated population of iVianchioneal, before the late visitation of cholera, was about four thousand eight hundred, of whom about seventy died of that disease; the female sex, 1 believe, now preponderates ; the occupation of the peasantry is princi pal 1 y agricid fcural. No. 3. Theie are nine sugar estates iu cultivation in this district, and two estates occupied entirely in the cultivation or arrowroot. The demand for labour is fully equal to the supply, but the supply ought greatly to exceed the demand, were each able bodied labourer to give a fair dav's work for a fair elay’s wages. Some of the more industrious agricultural labourers- residing here, proceed occasionally to the other dis- tricts of the parish, w here, on the larger estates, they obtain higher wages, and from this cause also the supply of labour in this district, is considerably less- ened. The field labourer on day’s wages on estates here most frequently turns out to work at about half-past eight, a. m., and withdraws at half-past three, p. m., taking out of the time stated two hours foi breakfast, thus leaving only five hours fora day’s work. No. 4.Theaverage amount of wages paid an estate’s labourer per diem, in Manchioneai, may be stated at about one shilling and three pence, but by job or task work, two shillings per diem might be made,, and frequently more than that amount per diem is- Appendix. made by task work in the field; there is, however,, on the part of the labourer, a very general reluctance to take job work. The labourer is generally paid weekly, or sometimes once in two weeks. I cannot say (hat the people generally evince much unwilling- ness to work in t he cultivation orestates, unless indeed some pressing requirements urge them,.which sel- dom occurs. No. 5, The number of paupers in this parish, or in this district, I have no means of knowing, nor can I say how many, from sickness or other disability, arc unable to contribute any! h in g fo r p m v i d i n g the m s el vest, with medicines and. medical attendance. No. 0. The number of qualified medical practition- ers at present m this parish is five, viz.: — three at or near Morant Bay, one in Plantain Garden River district, and one at Manchioneal. This number 1" do not consider, adequate to the requirements of:the po- pulation. No. 7; There is no public dispensary,or, hospital in., this parish.. No. 0. There being no such dispensary cr hospital* m this parish, I am not prepared to answer this ques- tion, (No. 8.) No. 9. During,the existence of the dispensary act (ninth Victoria, chapter forty-three,) in 1846, (being the first year-hi. which the act came into operation,) 1 had entered subscribers amounting to one hun- dred and thirty-five, and paupers, twenty one, total for 1846, one hundred and fifty-six. The following year of its duration, (1847,) 1 had entered eighty- eight, and paupers nineteen, total for 1847, one hun- dred and seven. The greater part of my first year's subscribers renewed their subscriptions the following year, which shows that they at least did, in some manner, appreciate the advantage of the act. In this parish, however, and I believe throughout the is- land generally, the act did not work, well, chiefly, -as I*believe, because it was left entirely to the option of Mpfstidix „ parties, (the labouring classes,) far whose ad- Vantage thits act was intended, to avail themselves of it or not, as they might think 'proper. No. 10. Duncan M‘ Pherson, esquire, is the coro- ner of this parish. lie resides on his own property* in the Blue Mountain Valley, a distance-of at least thirty-seven miles from Manchioneal Bay, and forty- five miles from the extreme part of the parish. I be- lieve he is remunerated partly by fixed salary, and. partly by fe’es. Hk probable income 1 do not know, nor can 1 state the average number of inquests o'r post mortem examinations arising out ef them. No. 11. 1 believe that great advantage would arise from the office of coronet being filled by a duly qua- lified medical practitioner ; chieffy because by his professional knowledge, he might, in cases of doubt or difficulty, with much advantage offer his advice ■■and opinion, cud thereby greatly assist a jury in the onerous duty of forming a correct verdict. No. 1-2 In the church of England only is there any tegi. There are, in this parish, uneducated black and brown men, and women, who practice on the sick as “quack doctors;” the payments they receive are generally trifling. No. 17. 1 do know of instances where noxious mix- tures have been administered by such persons, and have reason to believe that such cases have occurred. No. 18. I do think that recourse would be had commonly to such “ quacks.” If the professional ser- Appendix, vices of a number of duly qualified medical men could be obtained at a fair remuneration, 1 consider it doubtful, more particularly in the case of young1 practitioners, that a preference would be given to such last named persons. No. 19. The negro women generally apply to such (female) “quacks” during the season of child bear- ing. 1 have known instances where unskilful treat- inent has resulted in injury to the child and mother. No. *20. Infanticide is a rare crime in this parish. No. 2t. I do think that, a legislative provision* having for its object the encouragement of medical gentlemen, to visit and reside in this island, from England, Ireland, or Scotland, might be acceptable to the labouring classes of this country, but the gen- tlemen so coming here would not be likely to meet a fair share of employment, producing a competent living In this parish, within ttie last three years, it was put to the test by having two additional qualified practitioners, and signally tailed. No. 22. If the legislature should impose a tax for the purpose of providing medicines and medical aid throughout the different parishes of the island, under the denomination of a “ Medical Relief Tax,” I con- sider such an impost would be paid rather unwilling- ly. The method I would advise for laying it should be on property. The description of property 1 should advise to lie land and horse-kind. 1 would advise the same amount or tax to 1)0 laid on every large and small freehold, leasehold, and “ squattery,” and a further tax on riding horses, riding mules, and asses. No. 23. I keep always a good supply of medicines, and in case of an epidemic disease appearing in the parish, resort for additional medicines would be quickly had in Kingston, from which we are one day's journey. It occurs to me as possibly useful to be known to the Central Board of Health, that it might be ad- visable to have a central depot of medicines and fresh vaccine lymph in Kingston, or Spanish-Town, avail- Appendix'* able to the different parishes in case of need. A sub-depot of the same might be kept in each parish, under the charge of the senior medical practitioner. If it is determined on to introduce more qualified medical practitioners, they might be stationed in Spanish-Town, ready to assistany parish in which an epidemic might prevail. (Signed,) C. F. RAPKEY, M.R.C.-S. Answers of the honorable J. It. Grosett, custos of St* George, to circular 8til September, 1851. Spring-Gar den, St. George,, 22nd September, 1851. Gentlemen, In reply to the enquiry contained in your circular, as to the present sanitary condition and requirements of this parish, it is now free from cholera, which had lately appeared in some parts of the parish, causing about twenty deaths ; for the most part the attacks were sudden, and the illness of very short duration. The same unknown causes, which introduced and rendered it so fatal last year, may occur again ; and as the same complete ignorance as to any specific cause or treatment continues, it would probably be attended with a like proportion of deaths ; for I fear the negroes, instead of being more careful or prudent, would become less so. I believe the system adopted by the local board of health of this parish, while more economical than in most, was not less efficacious than in any ; no hospi- tal was attempted, which, in a parish like this, would have been ruinous ; speedy burial with the clothes or bedding was specially recommended without waiting for coffins, the cost of which, soon after the first out- break, except for interments in the churchyards, was refused ; but allowance for graves was made in ne- cessary cases. I do not consider the parish at pre- 234 Appendix. sent stands in need of any requirements, but if cho- lera should unfortunately return, both medicines and money will be required, the parish being too impo- verished to bear any increased expenditure. I am, gentlemen, Your most obedient servant, (Signed,) J. It. GROSETT, Custos of St. George. To the committee of the Central Board of Health. Answers of the reverend doctor Williams, rector of the parish of St. James, to quest ions appended to circu- lar of Hth September, 1851. No. !. The parish of St. James, in its superficial extent, is about two hundred and twenty-five miles square. Its population is scattered, but in some places (as in its villages and only town, Montego Bay) it is congregated, It is chiefly mountainous, and its main roads are in tolerable order, but those leading to several villages and through tracts of country, are generally the reverse, being in many places only ac- cessible to travellers on horse back, and that with danger. No. 2. According to the census taken in 1844, the population was twenty-five thousand five hundred and forty-two. On a moderate estimate, taking natural and acquired increase, and deducting a supposed de- crease, it appears that ten per cent, or thereabouts, may he added, thereby making the population, imme- diately previous to the epidemic, in round numbers, twenty-eight thousand. The number of deaths from cholera has been estimated at two thousand five hun dred and twenty-eight. No. 3. The' clerk of the vestry reports fifty-seven sugar estates and four breeding penns in cultivation in the parish. No. 5. The clerk of the vestry reports two hundred and twenty persons on the pauper list of the parish. No. 0*. There are seven medical practitioners in Appendix. 235 the parish, of whom five reside in Montego-Bay and the other two in the rural districts. No. 7. There is a hospital and also a poor house, both supported at the public charge, to each of which two medical men are appointed. There is also a surgeon for the out-door poor. No. 10. According to the report of the coroner, whose name is Edward Evans, resides at Montego- Bay, and only occupation that of the office which lie holds; his income is about £210 per annum, deri- vable from tees entirely ; the average number of in- quests for the last ten years, sixty»two annually ; post mortem examinations fifty-five for the period in ques- tion, averaging thereby five in each year, and prepon- derating cause of death, that of nature. No. ll. I should think it would be advantageous that coroners should be medical men, on this simple ground, that they would be better qualified to direct juries in the finding of their verdicts. No. 12. The clerk of the vestry is official parochial registrar. He states, by an act of the legislature of this island, a register of births and deaths was esta- blished on the 4th of June, 1844; that it w as acted upon very irregularly, and that it was repealed in 1840, but that the act, by which it was repealed, was disallowed in 1848, since which the registrations have been more incomplete. No. 13. The parochial registrar states that fever and dysentery appear to have been the most preva- lent causes of death. No. 14. During the apprenticeship, and immedi- ately after emancipation, the rite of marriage was ge- nerally observed by the peasantry, but of late it has not been so, and the children presented for baptism are, for the greater part, illegitimate. No. 21. There can be no doubt that medical aid would be highly acceptable to the peasantry, but the question is, how are the medical men to be remune- rated ? The peasantry would receive the benefit gra- Appendix. Uiitonsly, but they would be unwilling to pay for it, or if they did, they would do so inadequately. Taxation seems to he the only mode of procuring the means of doing for the peasantry what they so crutch require. Answers of Dr. L. Ashenheim to the questions ap- pended to circular 8th September, loot. No. 1. The area or extent in square miles of Tre- lawny is about two hundred and sixty-four miles. It is both scattered and congregated in towns anti vil- lages. It is chiefly mountainous. The roads, gene- rally speaking, are good. No. *2. The population of Trelawny, before the ad- yent of cholera, was estimated at thirty thousand.— The reduction, by pestilence, was two thousand three hundred and eighty-eight. The adult survivors are principally females. Their occupation is chiefly that of praalia! labourers, principally agricultural. No. 3. There are about sixty-seven sugar estates in Trelawny. Of these six are nearly out of cultivation. One has no works at all, and another has its works in St. James. No. 4. The average amount of wages paid to an es- tate's labourer is one shilling per diem. In general, wages are paid regularly. They are principally paid in money. I should say that the population, as a whole, are willing to work in the cultivation of es- tates. No. 5. It is impossible to state the exact amount of pauperism in the parish. The pauper list is not a complete one, as independent of this there is a large number of superannuated individuals who have not the means of supporting themselves. No. 0. There are seven medical practitioners re- siding in the parish. Of these five are in Falmouth and two near Duncan’s. I do not consider the num- ber adequate to the wants of the population. Appendix. 237 No. 7. I answer the; whole of this question in the negative. No. 8. The negro population are very unwilling to apply for medical aid. 5 attribute their reluctance to two causes : first, to a general unwillingness to part with money for this purpose; and second, to the re- collection of the times of slavery, during which they received medical aid gratuitously. No. 9. The dispensary act of the ninth Victoria, chapter forty-three, worked badly, and proved a total failure, it failed from the causes assigned in ques- tion eight. No. 10. George Lyons, esquire, is the coroner for Trelawny. He is a printer, and resides in Falmouth. He is remunerated by fees. 1 am not in a position to afford any information either on the probable in- come of the coroner, or on the average number of in- quests held annually, or on the number of post mor- tem examinations arising out of these. No. l i. I cannot see any great advantage derivable from the tilling of the office of coroner by a medical man. On the contrary his practice, if at all exten- sive, would interfere with his duties, and would, occa- sionally, be the cause of great delay. No. 12. There is a registrar; but no register, to the best of my knowledge, has been kept. No. 13. 1 am unable to answer this question. No. 14. 1 do not believe that the rite of marriage is generally observed by the peasantry of Trelawny. I believe that the majority of their offspring is illegi- timate. No. 15. The practice of oheahism or myalism is rare in this parish. No. 16. There are uneducated individuals who practice in Trelawny as “ doctors.” They sometimes receive as much as twenty shillings as fees. No. 17. 1 have reason to believe that, on some oc- casions, noxious medicines have been administer- ed. No. 18. 1 do not. think that regularly educated me- dical men would he employed by the population, in 238 Appendix. preference to flie “ quacks” already referred to, un- less some law were enacted to compel them to do so, and at the same time punish quackery. No. It). Th e negro women generally employ illite- rate women of colour to attend them during* the pro- cess of parturition ; I have unfortunately, known many fatal cases resulting* from rash, ignorant, and unskilful treatment. No. 20. 1 have good reason to believe that infanti- cide, or more properly speaking, infantile death, is very often caused by the mothers themselves. I do not, however, think that this is accomplished with criminal intention, but from the want of knowing better. With a stringent law, more extended medi- cal relief would be highly beneficial in preventing this mortality. No. 21. J am convinced that no legislative provi- sion, in connection with medical men from England, Ireland, or Scotland, will ever be productive of any good, either to the members of the profession, or to the labouring population of this parish, unless it con- tain items of a compulsory nature upon the latter class. No. 22. If the legislature were to impose a tax for providing medicines and medical aid throughout the island, I firmly believe that in this parish, at all events, the impost would be paid very unwillingly.— 1 do not consider myself competent to suggest how this impost should be laid, whether on the person, or on property, or on what description of property. No. 23. In the event of any epidemic disease ap- pearing in this parish, there is no proper or adequate, supply of medicines kept in it by authority. Were such a misfortune to hefal this parish, the medical men would be driven upon their own resources, and the stocks in hand of the apothecaries. I have nothing further to state for the information of the Central Board of Health on the subject of me- dical relief. LEWIS AS HEN HEIM, M.D. Falmouth, 22d October, 1851* Appendix. Answers of the reverend Samuel II. Stewart, L. L. I). to the questions appended to circular 8th September, 1851. No. 1. By a survey made within eight years, it ap- pears the parish of Clarendon contains three hundred and fourteen square miles. It is scattered ; there are not two towns of any size worth calling so; the vil- lage of Chapelton the largest. Four Paths and Bread Nut Bottom contain a few houses each ; at the for- mer there are four large stores for the sale of general provisions and supplies. The parish is entirely moun- tainous, except a stripe of Hat land running east and west, from the line of St. Dorothy to that of Manches- ter, and north and south from the line of the parish of Vere, south to the main post road, along the base of the first tier of hills. All the roads are exceedingly bad ; the main roads, including the post road, are nearly impassable in wet weather ; in the mountain districts there are literally no roads. People cannot reach church or market but at the risk of their lives ; nor can l fulfil what I deem one of the most import- ant and imperative duties of a clergyman visiting among his parishioners but at the same risk. No language I could use could approach to an adequate description of the wretchedness of our roads. No. 2. The estimated population, at the census, was something above seventeen thousand ; but I have no reliance on its correctness. I should, from tole- rably sullicientdata, estimate it, in 1844, attwenty-two thousand ; and it has certainly increased since. The reduction by the pestilence is not yet accurately as- certained ; the special registrars not having made re- turns. I think one thousand five hundred died of cholera; they were, I may almost say, without ex- ception, able, and previously, healthy people. 1 am parish treasuser, and pay the paupers; only one died, and he perhaps was one who was barely entitled to be on the list. The survivors are nearly balanced in 240 Appendix. number; as regards sex, 1 think a greater number of men died than of women. The parish is altogether agricultural. No. .3. Twenty-seven sugar estates and sixteen penns are in cultivation. The demand for labour is greater than the labouring population does supply ; whether if they were industrious and regular in their labour they could supply all that is required, is scarcely to he doubted ; that they do not supply it is certain. No. 4. There is a good deal of labour done by task. I judge the average rate of wages to be about one shilling per day. I have no doubt the wages are re- gularly paid, and in money. 1 never heard of a pay- ment in kind ; there has been a good deal of holding back since the pestilence, i am certain, as a trial, whether the rate of wages can be raised. I think the people do not labour on estates, except when urged by their own wants. In this there is much fluctua- tion, the result of caprice and habits of idleness ; that, and the facility of getting land by purchase, or squat- ting, contributes to their unwillingness. No. 5. I cannot answer this question with any pre- tension to accuracy. The amount of pauperism, in consequence ofage, infirmity, or disease, is very great. The amount dealt out in pittances of one shilling, or one shilling and six-pence per week, derived from, various sources, must amount to upwards of £500 per annum. There are about twenty persons on the pa- rish pauper list, namely, persons w ho were formerly in respectable positions. The maximum vestry al- lowance is £l2 per annum, and thence downwards to less than half. The number w ho are able to pass an existence of privation w hile health continues, but who could in no way find means to provide adequate medical attendance or medicines w hen sickness in- vades, must be counted by hundreds, if not thou- sands. No. 0. There are two qualified medical practition- ers in the parish. One, i)r. George Husband, dis- Appendixv trict censor, who resides at Ashley, about half a mile' from Chapelton. The other, Dr. Craig, an elderly gentleman, lately come to the country, who resides at Mount Pleasant, the great house of Ludlow sugar estate, on the Old Woman Savanna; his residence is nearly on the line between Clarendon and St. John. It is manifest the number is wholly inadequate to the requirements of the parish. Two medical men, Drs. Tait and Peter Tabois, died of cholera, and Dr. John .Ewart died, not of the disease, but shortly after it broke out; no one has come to replace them. In the lowlands of Clarendon, indeed from SpanisloTown to Mandeville, there is not a resident medical man. 1 should have mentioned a third qualified practition- er, Dr. Lachlan McLean, but, for reasons I do not state, he does not practice. No. 7. There is no public hospital or dispensary of any kind, except a house which 1 got set apart dur- ing cholera as a hospital at Chapelton. It is, how- ever, unfurnished, except with two wooden platforms as bed places, and has no establishment of any kind ; the expence of any casual patient is or has been paid on application to the vestry after the case has been attended to, to death or recovery. There are no re- gular voluntary contributions ; the negroes pay no- thing. Since the ninth Victoria became inoperative no provision of any kind was made to remunerate medical men for their attendance on the poor until the last vestry in July, except that I, as rector, and some few as churchwardens or magistrates, invoked, in such cases as were brought under our notice, the aid of a medical man, and the supply of medicines* I speak for myself generally out of my own private means, but where this was not so, accounts were attested by the person who called for the aid and sent into the vestry . These were usually paid with grumbling and disinclination on the part of the persons in high places. At the vestry in July, from various causes, there were a few more cases than the average num- ber, and the same process of dissatisfaction* &c. hav- 242 Appendix. ing been gone through, a sort of’ compromise was made. It was resolved that forty pounds a year each be paid to three medical men, namely, to Dr. Craig, in the northern district, to Dr. Husband, in the cen- tral district, and to any one who would undertake the lowland district, there being no one there then or now, and after some dis cussion about the means of obtaining medicines, it was decided that the forty pounds, in each case, should be extended to fifty pounds per annum, the doctor engaging to supply the medicines. Dr. Husband and Dr. Craig were pre- sent. They agreed to the arrangement. The third district is unoccupied, and will, I fear, remain so. I stated the whole case, both in reference to the vestry grant, the prospect of general practice to be paid for, and offered my best assistance as to residence and other matters which would have conduced to com- fort, and it happens that in this way I could have been useful, but the whole affair did not afford any thing like sufficient inducement, and the people are left to their chances. No. 8. 1 think, nay, 1 know, the negro population are in general unwilling to apply for medicine ex- cept it be given gratuitously, and even then it is taken and used with suspicion and doubt. 1 attri- bute this to the suspicious feelings which a state of slavery must have produced, and from which they have not yet disenthralled themselves, f rom the ne- glect which must have arisen in consequence of the small number of medical practitioners to be found, from the dissension which arose between those who were paid for medicine and medical attendance, and those who thought their attendance should be fairly paid for, from the reliance put on hospital assistants’ advice, or old women s nostrums, and finally upon a prevalent opinion that the “country,” (1 use the term in their own acceptation of it,) was and is bound to pay for all they want. As regards the necessary dis- cipline and medical treatment provided in hospitals, and which I know are absolutely necessary, 1 do not A ppen dix\ think negroes are more disinclined to them than i have known persons in the labouring and other hum- ble classes ot’societv in European countries, or when they come here as emigrants. The wrant of order and system in their habits, and their disinclination to anything like restraint, are the causes of their reluc- tance to submit to any well arranged regulations.— The remedy for such errors 1 leave to persons who know much more than I do. I do think, however, while no adequate system of moral and religious in- struction is brought into operation, while the misera- ble, at such education for the purposes of upholding slavery and making the people more subservient slaves, which produced quiet, and even beyond that purpose, good results are withdrawn, and that total disregard of anything like instruction now exists in such matters, it is vain to enquire why persons, in such a posh ion, disregard sanitary arrangements, the obtaining of medicines, or medical advice. No. 9. 1 believe if tbs dispensary act of the ninth Victoria had been allowed to work itself into opera- tion, and had been met by the legislature in such a spirit as would have induced them to make it better from time to time, as its deficiencies or errors were discovered, in practice it might have worked better than, it did. I do not think that any voluntary sys- tem of procuring and remunerating medical attend- ance will work well here. It certainly never has elsewhere (as far as I know) among ignorant, suspi- cious, and reckless people. No. 10. The coroner is Edward Ewbank, he was a planter, and was and is clerk of the vestry; he re- sides at a place called Oaks’, in the centre of one of the mountainous districts of the parish. The island act states how coroners are paid. Mr. Ewbank says his average income is from £100 to £120 per annum, at the highest. The present coroner was elected about March or April, in this year; all those who held the office before him are dead ; if they were liv- ing I doubt whether I could answer that part of this V44 Appendix. juestion which relates to the average number of m- juests and post mortem examinations. I have search- ed the vestry office, but could find no documents to aid such an enquiry. The preponderating causes of mortality, to my knowledge, during eleven years I have been rector of this parish, have been carelessness in mill houses and engine rooms, where persons have got entangled in the machinery ; in boiling houses, where they have fallen into boiling liquor pans ; in conducting waggons, w hereby they have fallen asleep through carelessness or drunkenness, and have been killed by waggons crushing them ; in recklessly at- tempting to pass swollen rivers, of which, in rainy weather, there are many dangerous ones in this parish ; by violent riding horses or driving waggons, or other •vehicles on the roads, as well in dark as in light. The cases of murder, or intentional man-slaughter, have been very few indeed. No. 11.1 have heard and seen this question many times discussed. While 1 confess my utter incompe- tency to enter into the merits of it, I feel bound to say, 1 can see no good to result to the living from a “par excellance,” being coroner. The coroner has to do with the dead. It appears to me that a medical practitioner, in such a place as I live in, could not be both without a sacrifice of the duties of either. In the present state of the lawr no practical saving could result. A medical man, although coroner, would not make a post mortem examination if he were not paid for it at the same rate as the medical practition- er he now calls in ; besides, if he did, w ho is to take his evidence ? A coroner is a judge in his own court; would it not he rather anomalous for a judge to ex- amine himself and charge the jury anent his own tes- timony ? 1 have not given the subject much consi- deration ; at present, 1 cannot perceive any advan- tage from the office of coroner being filled by a medi- cal man. No. 12. There was, when the lawr first passed, a registry of births and deaths. It was, however, a very Appendix. imperfect one, and since the disallowance of the law it has wholly ceased. The parish registry of bap- tisms, marriages, and burials does not record any thing concerning diseases or causes of death. No. 13. Fever is very common, and 1 think is the most common cause of death. No. 14. There are a large number of married per- sons in this parish. In less than eleven years six hundred and seventeen couples have been married in the established church; and, in the previous five years, before the dissenters marriage act, one thou- sand three hundred and twenty-three couples were married. There is, however, much illicit intercourse of the sexes. No. 15. I think not. In 1849 a man, calling him- ■self Dr. Taylor, w ent through the parish, carrying on such practices He w as taken up, tried, and on con- viction, sent to the penitentiary, as these practices, to any extent, were introduced by him. 1 believe they ceased on his removal. 1 was not in the parish dur- ing the six months he was carrying on these things. No. 16. There are uneducated “ quack doctors” in the parish. I do not think there are many, and I cannot tell how they are paid. No. 17. I have heard of a fewr instances of such ad- ministrations, but they w ere not well authenticated ; still, 1 have no doubt, they do often occur, but they are concealed. No. 18. I think a very short time will serve to in- duce the peasantry to resort to duly qualified medi- cal men in preference le sue a quacks. No. 19. 1 cannot, of my own knowledge, say that negro women, during the time of child-bearing, do so resort; but, except in some cases of very great difficulty, I have seldom known a qualified practi- tioner called in. No. 20. I believe infanticide to be very rare, and I am certain that the death of children, even from care- lessness, is not frequent. No. 21, I think the labouring classes would be 246 Appendix. glad that medical men were so increased in number as to bring them within easy call, but f fear any num- ber, approaching to what would be required, could not obtain a competent living, unless tiie legislative enactments were made. No. *22. I think the tax alluded to would not be very willingly paid at first, but 1 believe that unwil- lingness would soon wear away. 1 am certain no- thing effectual can he done without its imposition, and that it ought to be laid on the person. No. 23. There was a moderate supply of medicines on hand when cholera disappeared, and 1 used such influence as prevented its being sold. The supply is certainly not adequate if any epidemic disease of any considerable extent broke out. There is a private place for the sale of drugs and medicines at Chapelton, and one at Four Paths, which are constantly open, but 1 believe the supply is not large, and if I w ere to judge from what occurred at the outbreak of cholera, the charges would he outrageous if any emergency were to occur. 1 have been compelled to sign orders for one pound of calomel, at one hundred shillings. I will willingly, and to the best of my ability, an- swer any questions proposed, but I do not feel com- petent to give any valuable information from my ow-n suggestions. I would, however, anxiously and ear- nestly urge on the Board that some effectual system of vaccination should be established, even if a com- pulsory enactment be necessary. I find it almost im- possible to obtain lymph, even for the use of persons strongly inclined to have their children vaccinated. 1 have the honour to be, gentlemen, Your obedient servant, (Signed,) SAMUEL H. STEWART, Four Paths, 23rd September, 1851. Appendix Answers of the reverend W. May hew to the questions appended to circular 8th September, 1851, Preliminary Statement. The plain of the parish of Westmoreland is inter- spersed with many morasses, and in the wet season a considerably larger portion is under water. A great portion of the dry part is very much in bush, and needs clearing to afford a free circulation of air. it is not found advisable to cut down trees and bush in the neighbourhood of the marshes, as they absorb much of the malaria and prevent its spread. Some years back, when a clearing was made on the east side of the town of Savanna-la-Mar, an epidemic fever was the result. A better style of cottage building, especially pro- viding that they si sail be upstairs, so as to be open to an atmosphere above the cane tops which now grow quite to the houses, is a great desideratum ; and mo- ney would be well laid out if prizes were offered for models of a cottage suited in expence, in material, in structure, &c., to the climate of Jamaica, foi the la- bouring population, it is probable that if a success- ful experiment were made, each parish might be in- duced to erect one or more as samples for the pea- santry, A law enforcing the removal of pigsties to a cer- tain distance from dwelling houses is much needed. As regards the town of Savanna-la-Mar, a supply of good water has always been needed ; the water pro- curable is very unwholesome ; and in dry weather only to be had by going a considerable distance. In anticipation of cholera, the board of health pro- cured a boat load of puncheons of good water from Bluefields, and offered to retail it at the same price as the indifferent water carried about in carts, but as the people had to go to the wharf to fetch it, they would not buy, and the experiment was abandoned. Appendix. 248 A good dispensary system, supported by taxes, is very essential. it seems absurd to spend great sums to import emigrants, and not to provide against an extensive diminution by death, tor want of a little medicine and medical aid. A census appeal s very desirable next year to tell us our real position. No. I. Area three hundred and eight square miles. There is but one town, (Savanna-la-Mar ;) there are many villages. The parish is about equally divided between mountain and plain. The inhabited locali- ties aie all accessible by, at least, bridle roads. No. 2. By census of 1844 the population was twenty-four thousand six hundred, and judging by the increase between 1838 and 1844, at the former of which dates it was a little over twenty thousand, the estimated population in 1851, before cholera, would be about thirty thousand. It is supposed that one thousand five hundred have been lost by cho- lera. The medical returns of fatal cases are not yet made up, so as to distinguish as to the incidence of morta- lity with respect to sexes. The occupation in this parish is chiefly agricultu- ral. No. 3. Forty-four cultivated estates ; five thousand other properties. Want of labour is not excessive, but that it is considered by the planters insufficient, appears from the number of coolies introduced, many of whom were worthless, and died off in great num- bers. No. 4. One shilling per diem, paid pretty regular- ly in money. The parish is a very wet one, and pro- visions are plentiful, which affects a regular supply of labour, as the people can earn more than they need. No. 5. The number of out-door paupers receiving parochial aid is two hundred and forty-one, at a cost of £1000 per annum. The number of paupers in the poor house is forty- Appendix. one, at a cost of £480 to the parish. But there are doubtless many others who could not pay for medical aid. No. 6. Dr. Mason, Savanna-la-Mar, Dr. Tullis, Morgan’s Bridge, Dr. Jelly, close to Morgan s Bridge, Dr. Harvey, close to Savanna la-Mar, Dr. Adolphus, Savanna-la-Mar, Dr. M‘ Donald, Savanna-la-Mar—a very inadequate number. No. 7. No public dispensary or hospital. Dr. M‘Donald gets £60 per annum for attending the in- door and out-door paupers, but his services, neces- sarily from the inadequate pay, and the extent of the parish, are confined to the immediate vicinity of Sa- vanna-la-Mar. No. 8. Many negroes refused to take medicine during cholera, as thinking it of no avail. No. 9. That act was a perfect failure, and the me- dical men got their money for nothing. The negroes were required to purchase tickets at six shillings when they were in health; they would not do so till f hey were sick, when the medical men would not fur- nish them, as a matter of course. It is found here as at home, that the poor are short-sighted as to paying any thing to be free of a risk. If no illness has oc- curred in the year, they consider the money thrown away, and decline subscribing further. No. 10. John Deleon, esquire ; not in any busi- ness ; lives upon a mountain property, Mount Rick- etts, twelve miles from Savanna-la-Mar, and is also much at Savanna-la-Mar. He has no salary ; his fees and mileage money average about £275 per annum. The average number of inquests, for the last ten years has been about sixty per annum ; the average num- ber of post mortem examinations, about four per annum. But one case of infanticide in that period. No. 11. It would throw a certain number of prizes to the medical practitioners, and pro-tanto encourage their settlement here. It would also enable the co- roner to sum up the medical evidence more to the p"»,pose, and in case of its being impossible to pro- Appendix. cure the attendance of another medical man, the co- roner could himself act. No. 1*2 and 13. The register extends back as far as 1741, but is very scanty and imperfect, in the ear- lier years. There is no record of diseases in the form for registering burials by the clergy of the church of England. No. 14. The baptisms bespeak a considerable illi- cit intercourse. The cholera has alarmed many into marrying. No. if). Very rare. No. 1 (j. Yes, plenty. They charge sixteen dollars for curing sores, some take eight dollars for a sore leg. A good deal of cholera elixer was sold at a dol- lar an ounce. No. 17. No; except in cases that have appeared* in a court of j ustice. No. 18. Quack doctors would still be resorted to for sore legs, for they take the trouble of dressing them off the friends hands, which the medical men do not. In other cases medical men would be pre- ferred. No. 19. Where a midwife is considered insuffi- cient, resort is had to a regular practitioner. Arms have been pulled off bv midwives, and in case of false presentations, the lives of both mothers and in- fants have been lost by unskilful treatment of mid- wives. No. 20. No; except in cases that have occurred in courts of law. No. 21. Their presence would be very acceptable, but they would not get competent employment from a negro practice. No. 22. it would be very unwillingly paid as a tax. If a tax were laid, it would seem advisable to conti- nue the house tax for that purpose, when it has paid off the expences of cholera. No. 23. Yes ; though not by the parish, yet in pri- vate dispensaries. Appendix. 251 MISCELLANEOUS STATEMENT. The establishment of a self-supporting dispensary, and systemized itinerant visits, had the fullest and fairest trial in this parish. After freedom, l)rs. Mason and Tullis, in partner- ship, established four dispensaries, one at Phoenix, Hanover, and three in Westmoreland ; they had three medical assistants, and an itinerant dispenser at each station. They found medicine and medical attend- ance at six shillings a head per annum ; for the first two years they had on their list about five thousand names ; afterwards they began to be irregular in pay- ing, and finally the whole project was abandoned, as the people would not pay without being sued Under the dispensary act, ninth Victoria, chapter forty-three, medical men in Westmoreland got £125 a year. The largest number, two hundred and twenty, was on Dr. Mason's list. It was a failure. Answers of the reverend S. 11. Cooke, rector of St. 'Thomas in the East, to circular 8tit September, 185 h Parsonage, M or ant Pay, September 23rd, 1851. Sir, I beg to acknowledge the receipt of your favour of the 8th instant, received on the 19th, addressed to me by desire of the committee of the Central Board of Health, annexing certain queries which 1 shall have great pleasure in replying to with as little delay as possible. With reference to the desire of the committee, that 1 should at once give a statement of the sanitary con- dition and requirements of my parish or district, t regret to say, that as regards this district, which, ac- cording to the act for the sub-division of parishes, is in extent twenty-eight and three-quarter square miles, Appendix. "with a population of upwards of five thousand souls, nearly two thousand of whom are resident within the township of Morant Bay, nothing can be more de- plorable. Numbers of the peasantry die, without being seen by any medical man; for no medical practitioner can afford to attend them gratuitously, and they decided- ly have not the means of remunerating him, if he w ere sent for and w illing to attend. There are no hospitals for the sick, the aged, or the infirm, and no relief is afforded except by the casual order of the churchwarden, in cases of accident, or in extreme destitution, in the immediate vicinity of the town, and even in these cases it is very limited. Much valuable time is often lost before a churchwar- den’s order can be obtained, his residence being ra- ther more than a mile from the town, on the west side of the Morant river, which is not always fordable, an inconvenience which can only be remedied by the appointment of a surgeon to the poor, who shall be resident within the tow n, and the erection of an hos- pital for the reception, not only of the poor of the town and the neighbourhood, but of such persons as may be suffering from any casual accident, requiring prompt and continued surgical attendance, w'hose place of residence is too far from the town, or even from the residence of any medical practitioner to ad- mit of their receiving that medical or surgical treat- ment and care absolutely necessary for the saving of life or limb. 1 have the honour to be, Sir, Your very obedient servant, (Signed,) S. H. COOKE, Rector. To T. J ames Brown, Esquire, fyc. fyc. Sfc. Secretary to the Central Board of Health, Spanish-Town. Appendix. 253 Answers of the reverend S. H. Cooke, rector of St. Thomas in the Cast, to (/uestions appended ta cir- cular 8til September, 1851. No. 1. The parish of St. Thomas in the East is di- vided into five districts, containing twenty villages, besides the towns of Morant Bay and Bath. In these villages a very large proportion of the labouring po- pulation are located. The land is partly level, and partly mountainous. It is in the mountainous part of the parish many of the villages have been formed, the access to which is by roads always bad and often im- passable. It is in extent two hundred and thirty-five and seven-twentieths square miles. No. 2. According to the census of 1844 twenty- five thousand five hundred ; decrease by cholera, ac- cording to the returns made to the Board of Health, three thousand six hundred and twenty-six. The actual decrease may be fairly stated at four thousand. Of one hundred and twenty-two deaths by cholera recorded by me, not one half of the number were re- turned to the Board for this district; fifty-six were males, and sixty-six females, very few of whom came under forty years of age ; principally agricultural. No. 3. There are yet forty-four sugar estates, and four coffee plantations in cultivation. The demand for labour is always equal to the supply, and often much beyond it. No. 4. In the western part of the parish one shil- ling per diem for field labour, undone shilling and six-pence for tradesmen, such as coopers. In the eastern district, one shilling and three-pence and one shilling and nine-pence, at present; last year, at the commencement of crop, it ranged from one shilling and six-pence, to two shillings and six pence for field labourers, in the Vale of Plantain Garden River. In Manchioneal, the average is nine pence, per diem.—• i have never known an instance of wages being paid A ppendix. otherwise than in money, and usually every second week. No. 5. There are not more than sixty persons on the pauper list, hut there are numbers of poor, but respectable people, who, when overtaken by sickness, become perfectly destitute, and unable to contribute any thing towards providing themselves with medi- cines and medical attendance, or indeed attendance of any kind. No. 6. Five ; Dr. Allen, Mancbioneal ; Dr. Hen- derson, Plantain Garden River, physician to the bath; Dr. Porter, no fixed residence at present that I know of; Dr. Cooke, town of Morant-Bay ; Dr. Murrough, the vicinage of the towns, but about to remove to the Blue Mountain Valley district. No. 7. Not any ; although I have repeatedly press- ed upon the local authorities the necessity of both, but in vain. No. 8. Yes ; if obtained gratuitously, I firmly be- lieve they would eventually, whatever might be their reluctance at first, gladly submit to hospital discip- line and treatment. No. 9. It did not; but this is no argument against the measure. It failed because it was not properly understood, and the act was too short in its duration to test its usefulness. The people were, 1 firmly believe, taught to regard it as a mere trap to find out their domiciles for the purpose of taxation. It inter- fered too with the gains of the black quacks, who naturally opposed it by every means in their power. No. 10. Mr. Duncan McPherson; he has no other occupation that I am aware of at present. He is re- munerated by fees. The income is estimated at £150 per annum ; his residence is at the very head of the Blue Mountain Valley district, distant from the town of Morant-Bay, twelve miles; Port-Morant, eighteen; Bath, twenty-five, or by the old post road, over the hills by White Hall, sixteen ; Amity Hall, Plantain Garden River, twenty-three miles ; Holland Bay, Appendix. thirty; Manchioneal Bay, thirty ; Priestman's Ri- ver, the line of the parish, forty-two. No. 11. Most certainly. As the office is one of the highest importance, itsduties ought not to be entrusted to any but persons of a liberal education. A know- ledge of medical jurisprudence appears to me, to be absolutely necessary for the proper and efficient dis- charge of the duties of such an office. A great sav- ing, 1 am convinced, would be made to the public by the avoiding of unnecessary post mortem examina- tions, if the office were held by a medical practitioner. I have no means of ascertaining the number of in- quests for the time mentioned, or post mortem exami- nations, or the causes of mortality. 1 may state, however, that from the great difficulty experienced by coroners generally, in arriving at any tiling like a satisfactory conclusion on most of the cases brought before them, they are obliged to call for medical evi- dence and post mortem examinations, the expence of which, would, in most cases, be saved if the office were held by a medical practitioner. No. 12. As far back as 1708. No. 13. The register of burials affords no informa- tion as to the cause of death. No. 14. Not to the extent it ought to be. On refer- ring to the register of marriages for the ten years end- ing 31st December, 1850, 1 find the number of mar- riages, for that period, to be seven hundred and forty- one. The number of baptisms of infants for the same period, live thousand two hundred and eighty, of these one thousand five hundred and seventy-seven only were the offspring of married parents. No. 15. Cholera carried off most of the myalmen—* myalism is confined in its practice chiefly amongst the sect called Native Baptists. Some of its priests still carry on a very thriving trade, but not to the same extent as some three or four years ago. No. 16. There are still some of these people lurk- ing about in the villages, although many of them died during the cholera ; the fee is more or less than sixteen Appendix. shillings* with maintenance during the illness of the patient, besides the cost of the medicines. In cutane- ous diseases I have heard of six pounds to nine pounds being paid to one of these quack doctors. No. 17. Not to my own knowldege; but 1 under- stand there is a most noxious mixture called “ Ris- bey,’’ made by French women, and openly sold in the Kingston market, which the negroes place great faith in. Its effects are often most painful, causing to those who take it years of suffering, and often death. Its cost is sixteen shillings per bottle. No. 18. In many cases they would. The law is not stringent enough to put down quackery. Every censor of a parish ought to be made liable to a severe penalty, who, when a case is properly brought to his knowledge, should fail to carry out the law to the utmost I brought a case before the late censor for this parish, Dr. Ward, but be took no action on it.— In his own dispensary 1 have known one drug sold of a most deleterious nature, and which, if taken, would have caused death, instead of the one asked for, through the ignorance of his dispenser. No. 19. I apprehend this too is much the case, and that the medical practitioner is only or seldom called in but at the eleventh hour, and then more from the fear of coroner’s inquest, than from better motives. No. 20. I cannot say. No doubt but the evil ex- ists to a most lamentable extent, which more extend- ed medical relief would tend greatly to lessen. In the state of Pensylvania, and I believe it is the same throughout the union, if either the mother or child should die without a medical man being in attendance, there is a penalty on the person neglecting to send for such medical assistance of five hundred dollars. No. 21. I hardly think so. At present I do not think there is a medical practitioner in this parish re- ceiving £400 per annum. No. 22. I have not the least doubt but that it would be as willingly paid as a tax for any other purpose; and a capitation of two shillings on all persons from Appendix'. the age of fifteen to fifty, would, if collected on only: one thousand two hundred, out of the twenty-one thousand seven hundred and eighty, the estimated population of the parish, give a sum perfectly suffi- cient for all sanitary purposes. No. ‘23. No; but they could be procured in a few hours from town. I would suggest that in all the large parishes, there should be at least two coroners, who should be com- pelled to reside in their respective districts, and as much as possible in the centre of such districts. The necessity of this is apparent, when reference is made to answer No. 10. Every parish should be divided into districts ac- cording to M‘Geachy’s map for the subdivision of parishes for ecclesiastical purposes. To each district a medical man should be appointed as under the late sanitary act, who should be compelled to reside in his district. There should also be a dispensary in each district supplied with the most useful medicines, and a dispenser at a moderate salary, to be under the sole control of the medical practitioner for each dis- trict. i would urge and earnestly press the necessity for the establishing of an hospital in the town of Morant Bay, the great focus of the poor and needy, which should be placed under the care of the medical prac- titioner, appointed for the Morant district, with a dis- penser and nurse resident within the walls of the building. Every minister of religion, magistrate, or vestryman should be empowered to call upon the medical man of the district, to visit any person residing within its limits, any sick person not in a condition to pay for such medical attendance. And each medical prac- titioner should be authorised to send all such cases, as lie might deem absolutely necessary, to the hospi- tal, provided there be any wards vacant at the time. 258 Appendix. Ail persons applying for medical advice and medi- cines at the several dispensaries, should he encou- raged to pay for the same, however small the sum may be; the amount so received to be paid to the churchwarden at the end of every three months. By this means, 1 have every hope, that in a very few years, these dispensaries would be self-supporting, and the people led gradually on to depend more on themselves than at present, and to place a greater value on such institutions than they will perhaps do at first. No enactment for less than three or five years will be of any use. Had there been a hospital at Morant Bay when the cholera first appeared here, I am con- fident the same number of deaths would not have taken place by one half. Numbers died from sheer neglect, having no one to administer either medicines or nourishment. (Signed,) S. H. COOKE, Rector, St. Thomas in the East. Answers of the honorable J. Barclay, custos of St. David, to questions appended to circular of 8th Sep- tember, 1851. No. 1. Seventy-four square miles ; a great propor- tion mountainous ; the localities are accessible but by indifferent roads ; one village, viz.: Yallahs. No. 2. Six thousand inhabitants by the census; nearly eight hundred deaths by cholera ; they are principally agricultural; the sexes are, l believe, nearly equal. No. 3. Five sugar estates, about twenty-six coffee mountains, and five penns. The demand greater than the supply. No. 4. One shilling per day, paid weekly and monthly, and always in money. They prefer work- ing their own grounds, and the more independent they become, the less they are inclined to work. No. 5, Fifty-four paupers are supported by the pa- Appendix. rish, at an annual cost of £2220. In my opinion there are none that might not contribute towards medicines for themselves, if so inclined. No. 6. None. The public in general will not con- tribute any thing for their support, from which they often suffer in sickness. No. 7. None. The charge for first visit from a me- dical man, five dollars. No. 8. The people are averse to sending for medi- cal aid in a great number of cases ; they would sooner suffer. No. 9. It worked very badly ; the failure arose from the medical men being unable to enter into any terms with the people. No. 10. William Mowatt, planter, proprietor of River-Head estate, (totally abandoned ;) remunerated by fees and salary ; income about £80 to £100 per annum ; average inquests twenty-five per annum ; on about one half of which post mortem examinations, are held. No. 11. A medical man being appointed as coroner would enable him, with what practice he might get, to live comfortably, and induce him to live in the pa- rish. No. 12. The registry comes down to December, 1848 ; at present what registers take place are kept by the clergy. No. 13. The principal prevailing diseases are bili- ous fevers and pleurisy. No. 14. A great number are married, and 1 think it is increasing, although they do not strictly adhere to their marriage vows. No. 15. It used to be; several have been con- victed ; 1 think it is now on the decrease. No. 16. I cannot say there are any. No. 17. I have every reason to think that such me- dicines have been administered, and convictions of such have taken place—one on my own property. No. 18. In several instances they prefer applying to their black doctor.ernpiricks. Appendix. No. 19. They generally employ mid wives. No. 20. 1 do not believe there are any. No. 21. Not without law to compel them to employ medical aid. No. 22. Not willingly—on the persons and heads of families. No. 23. I have every reason to think that proper medicines have been and are obtained when required. There is no public department. Sir, I have to acknowledge the receipt of your letter, 18th ultimo, with twenty-three questions to be an- swered, and now take leave to enclose them, and hope they will be considered satisfactory. 1 am sor- ry they should have been detained so long, on account of the inclemency of the weather. 1 am, Sir, your most obedient servant, (Signed.) .1. BARCLAY, Custos. Answers of the reverend John Smith, rector of St. Anns, to questions appended to circular 8th Septem- ber, 1851. No. 1. The extent of square miles in this parish is three hundred and eighty-two and a half. Small towns and villages are scattered throughout. The land is chiefly mountainous, with plains here and there; inhabited localities are accessible, some by good and some by very bad roads. No. 2. The estimated population of this parish, be- fore the late heavy visitation of cholera, was twelve thousand six hundred and fifty-six males, and thir- teen thousand one hundred and sixty-seven females, and the estimated reduction by the pestilence is five hundred and ten males, and five hundred and eleven females. The occupation of the survivors is princi- pally agricultural. No. 3. I believe the number of estates to be about fourteen. I know not whether the demand for la- Appendix. hour is equal to, or greater than the labouring popu- lation can supply. No. 4. The average amount of wages is, I believe, one shilling per diem, paid regularly in money. The people, I believe, are willing to work in the cultiva- tion of estates, except during the pimento picking, when there is rather a scarcity of labour by their pre- ferring to go to the pimento walks. No. 5. I am unable to give an answer to this ques- tion. No. 0. There are, I believe, five medical practition- ers, and 1 cannot give their places of residence, ex- cept Dr. Bayley, who resides on St. Ann’s Bay. I consider the number totally inadequate to the require- ments of the population. No. 7. Dr. Bayley keeps a dispensary on the Bay, where there is also a hospital, supported by the pa- rish. Dr. B., as l have said, resides on the Bay, who receives <£63 per annum from the parish for his ser- vices. No. 8. The negro population are, I doubt not, wil- ling to apply for medicines, but 1 am told not so wil- ling to pay for them generally. They are certainly reluctant to submit to the discipline and medical treatment in the hospital. I do not know to what to attribute their reluctance. No. 9. The dispensary act of ninth Victoria, chapter forty-three, did not work well. The medical men can better attribute the cause of its failure. No. 10. S. W. Rose, esquire, the coroner of this parish. He resides at the Farm penn. He is remu- nerated by a fixed salary. The remainder of the question it is not possible for me to answer. No. 11. This question f am unable to answer, never having given it any consideration. No. 12. There are registers of births, marriages, and deaths kept in this parish in accordance with the clergy act, which extends as far back as 1768. No. 13. The d iseases, shewn by the register of births and deaths, kept by the registrar, to be most Appendix. common and fatal since 1844, are fever and dysente- ry, excluding, of course, the cholera. No. 14. The rite of marriage is generally observed by the peasantry, but i regret to sav there are a great many children registered, the result of illicit intercourse of the sexes. No. 15. Not to my knowledge. No. 16. Not to my knowledge. No. 17. None; nor have i reason to believe that such cases have occurred. No. 18. 1 cannot say. No. 19. 1 have known of no instance of the kind. No. ‘20. None. No. 21. This question 1 cannot answer. It would of course depend upon circumstances. No. 22. This question I leave to abler and more experienced heads in such matters to answer. No. 23. Very inadequate, as exemplified in the late epidemic. (Signed,) JOHN SMITH, Rector of St. A nn’s. Ansucrs of Dr. Jhebner to the questions appended to circular 8th September, 1851. No. 1. The parish of Hanover extends over an area of five hundred and twenty-five square miles. Its ge- neral aspect is mountainous, with intervening, and in many instances, marshy flats. The sea coast particu- larly abounds in these noxious marshes. The principal town is Lucea. Lucea contained one thousand four hundred inhabitants before cholera; ot these three hundred perished. There are several negro town- ships scattered over the parish, selected without any regard to healthy influences, and rendered positively unhealthy by the peculiarity of the negro in surround- ing his dwelling with vegetation up to the very door, apparently to hide his proceedings from his neighbour. If any other adventitious circumstances were required to render the negro villages unhealthy, and the inha- Appendix, Infants of them peculiarly susceptible of epidemic diseases, it is readily to be found in the low, ii! ven- tilated (and in many cases not ventilated) houses, which the negroes, for the most part, construct. The kind of houses constructed by them at this day, is no bad test of their advancement and progress in civili- zation. The public roads throughout Hanover are tolerable in dry weather, but they have, for years past, been notorious for being, in the rainy season, wretched mud holes, and in many districts impassable without damage to horse and rider. The negro villages are accessible only by narrow tracks or foot paths. No. 2. Hanover contained some twenty-five thou- sand inhabitants, of whom about two thousand three hundred perished by cholera. The occupation of the negro population is chiefly agricultural. There is a great paucity of tradesmen among them. Since the emancipation the negroes have, in very few instances, endeavoured to teach their children any thing useful or good. No. 3. There are fifty-four sugar estates and ten breeding penns in actual cultivation. The demand for labour is certainly greater than the supply, but it is beyond a doubt that the present la- bouring population could, if they were industriously inclined, do three times more than at present. No. 4. The field labourer receives one shilling, on an average, for four hours work ; (a great deal of es- tates work is done by task, and 1 have seen labour- ers daily returning from their work, for which they are paid one shilling, after four hours.) The labourer is paid every week, or every two weeks, but regularly and in money. The negro labourer could earn three shillings per day without injury to his constitution, but being naturally indolent, and seemingly devoid of a proper and correct estimation of the responsibilities of prudence, and his wants be- ing few, he contents himself with the one shilling a Appendix. day, spending the balance of the day, for the most part, in idleness, satisfied that he can make up the difference by the sale of yams, cocoes, and other pro- visions, out of his ground, which ground he cultivates on Friday and Saturday, and by which he is, in a great measure, rendered independent of the planter. No 5. Fhe parish relieves, during the year, (as paupers paid small weekly sums, and as occasional or transient poor,) some two hundred persons. The persons most incapable of contributing any t hing to provide themselves with medical attendance, are some of the coloured people. There are doubtless also some among the black persons incapable to do so, but they are not many ; and in too many instances they are old people, who are thus got rid of by their families. No. (>. Some twelve or fourteen years ago the pa- rish of Hanover supported, in a comfortable manner, some sixteen medical practitioners. Of late years. I am sorry to say that tiie want of interest evinced by the upper classes in the medical profession, coupled with the carelessness and disregard by the negroes of human life, only four duly qualified practitioners ma- nage to drag out an existence in the whole parish. Of these, Dr. Keieh keeps a retail drug shop, and lives in Lucea. Dr. Potts lives two miles out of town, but keeps, in Lucea, a retail drug shop. Dr. Breb- ner lives lour miles out of town, and keeps also a re- tail drug shop in Lucea. Dr. James Mason lives in the Green Island district, eighteen miles from Lucea. Each of these gentlemen say that they would be un- able to live by the practice of physic, if it were not from the assistance derived from the vending of drugs, and the resources of their respective country residen- ces. This number is, however, quite inadequate to the requirements of the population. No. 7. There is no public dispensary or hospital, properly so called, in Hanover. Certain small ill venti- lated rooms, (selected generally for their cheapness,) capable of containing twenty-eight persons, by Appendix. 265 placing sometimes two in one room, are rented by the parochial vestry for holding houseless, aged, and de« crepid persons. This is properly an alms house, and is supported out of the general amount of taxes levied yearly in the parish. Dr. Potts receives twenty- four pounds, or twenty-seven pounds per annum) to find medical unguents, &c., for the people, who are, for the most part, covered with old ulceis; he visits the alms house twice a week. I receive forty-two pounds per annum to attend on about ninety paupers, and any transient poor besides, who may apply to the churchwardens for medical aid ; for this beggarly pit- tance l am to attend the transient poor in Lucea, and for twelve miles, in any direction, taking Lucea as a central or stationary point—finding medicines also. Some parts of the parish have not even this mi- serable provision made for the poor. No. 8. There is, as 1 have said, no public dispen- sary or hospital in Hanover, to which the negro can apply, as in civilized countries, if he felt inclined.— So regardless is the negro of the lives of his nearest of kin, when sick, that it is only after having ex- hausted all his own efforts and skill, and when he sees too plainly that matters are becoming desperate, that he resorts for aid to the medical practitioners, with whom he drives as hard a bargain as he can ; but even this is not general, for in many cases six-pence or one shilling’s worth of such medicines as he (the negro) deems requisite, are purchased and adminis- tered by himself throughout the case. I am satisfied that the mortality, for years past, has been very great among the negro children during the period of den- tition; many perish from dropsy, supervening on neg- lected diseases. No. 9. The salary given to each medical practi- tioner by the public, under the ninth Victoria, chap- ter forty-three, for attendance on the poor, I consider to have been inadequate, considering the duties re- quired of them. The legislature, perhaps, expected Appendix. that the labouring classes would gladly have availed themselves of the provisions of' the act, and have sub- scribed in large numbers, thus making up the “de- ficit,'’ but as it was optional on the part of the la- bourers, comparatively few of them enrolled their names, thus it became a hardship on the medical man, for, by fhe act, be was liable to pains and penalties.— I consider the ninth Victoria to have been objection- able, in not fixing one general rate of salary to be paid to each medical man, instead of leaving it to the determination of parochial vestries not to exceed a certain amount. The members of parochial vestries generally (at least of our Hanover) too frequently im- port local prejudices into their proceedings, and have never been remarkable for the liberality of their deal- ings, with an enlightened and heavily taxed profes- sion like that of medicine. The pittance given by the Hanover vestry during the second year of the dis- pensary act rendered the medical practitioners care- less. The scavenger’s salary receives as much atten- tion and consideration, if not more, at the Hanover vestry board, than the medical practitioners. By the ninth Victoria, ministers of religion of every denomi- nation, the churchwardens, the magistrates, and ves- trymen were all permitted to send orders to the me- dial practitioners of the district. This privilege is at times likely to be misused. The chief cause of the failure, however, of the dispensary act was the having it optional with the negro to subscribe or not, and pay voluntarily, which he will never do. INo. JO. George Robert Johnson, is the coroner of Hanover. He is upwards of eighty years old ; had no other occupation since he became coroner. He, for a great many years, was paid £3 4s. ()d. for each inquisition, and one shilling and six-pence per mile. By the tenth Victoria, he was reduced to a salary of £100 per annum. The tenth Victoria not being now in force, his mode of receiving payment is unsettled. 1 believe the coroners each received a grant from the- Appendix. late sessions previous to tue passing of the tenth Vic- toria ; the average amount of salary received by Mr. Johnson, our coroner, was £.350 The coroner for- merly resided in Lucca, but now, for the last four years, he has lived with his son some sixteen tn'les out of Lucea. He is morally and physically imbe- cile, and quite unfit, to hold the situation. It appears that he is tolerated in the office from respect to his advanced age. The magistrates occasionally hold in* quests when convenient. 1 cannot obtain correct data to fix the average number of inquests ; but the amount of salary per annum of £350, will shew that they were many, 1 think ten post mortem examinations yearly would be rather above than under the average, for the inquests were held apparently more as a matter of revenue to the coroner, than for the purpose of arriving at correct conclusions as to the causes of death ; and ignorant country jurors too frequently took upon themselves to return verdicts, unaided by medical tes- timony. A good many of these inquisitions shew such verdicts as the following:— “ Died from want of medical attendance.” “ Died from neglect on the,part of the parents, &c. &c.” No. 11. Under the present election law, those who cajole the electors are most likely to be appointed to offices of trust and responsibility; for such appoint- ments depend now entirely on the labouring classes. It can hardly be expected that under such a state of things gentlemen of education will be appointed.— Setting aside the above consideration, the coroner, if a medical man, would be of considerable assistance in explaining and placing evidence in a manner intel- ligible to a jury, of necessity unacquainted with me- dical subjects, or at all events, in directing the jury whenever medical testimony and post mortem exami- nations were indispensible. He could aiso be able to determine with a greater degeee of accuracy, when 268 Appendix. an inquest was absolutely necessary from the history of the case, thus relieving persons who have their daily avocations to depend upon for a living, from wasting their valuable time, as I have frequently seen in this parish. The necessity of filling the office of coroner, in the person of a medical practitioner, is indeed too obvi- ous. No? 12. The register of births, marriages, and deaths, kept in our vestry office, is not to be depend- ed on at all, it never having been by law compulsory on any one; it might be embodied, for the future, in the Medical Relief Bill. No. 13. We have had none but the ordinary dis- eases of the country since l came to Hanover, in 1835. In 1837 a number of persons died from (ever, which assumed the typhoid type. No. 14. The marriage ceremony is often enough performed by the clergyman ; but, by the labourers themselves, the marriage vow is more generally re- garded in the breach than in the observance. The illegitimate children preponderate. No. 15. The practice of obeahism, or myalism, is common in Hanover, and largely on the increase, even among those who would ffiin be considered re- spectable people, and among the black and coloured people, servants or domestics, in the town of Lucea, of whom, from their constant approximation with the upper classes, more correct notions might be expect- ed, as our recent police records might shew. No. 16. There are many black doctors who prac- tice obeahism also; their dupes, as well as themselves, are too cunning to let it be known how they are paid. No. 17. 1 know of no instance wherein it has been proved that these quacks have administered deleteri- ous compounds, but I nevertheless believe that a con- siderable amount of mischief is done by such persons among the labourers, particularly in country districts. No. 18. The negro does not deny the efficacy of Appendix. medicines administered by a duly qualified practi- tioner, but it is the want of affection for his kin, a carelessness of human life, and a disinclination to pay his money to the doctor, which cause him not to apply till it is too frequently too late. If the negro knew that he paid by taxation for medical attendance, he would do otherwise, for he is not the one to neglect to demand value for his money. From cases which I have seen, and what I know of the negro character, 1 feel satisfied that these obeah men will continue to be applied to, to exercise their mischievous humbug, particularly in cases where the sick fancy that other persons have “ put them so,” as they term it, from motives of revenge, jealousy, &e. No. 19. I am not aware that these quacks, or obeah men, are ever concerned in the delivery of women during parturition, but they are consulted to prevent, by their supposed charms, women from hav- ing easy deliveries. A case occurred a few months ago, to my knowledge, in which, on the cessation of labor pains, the woman attributed her condition to the charms exercised by an obeah man, who had been employed by another woman to “ put her so.” The negro midwives are a most ignorant set, and not unfrequently do much mischief. No. 20. I am not aware that infanticide is commit- ted directly, but many infants do die from neglect and various other causes attributable to the parents. No. 21. Unless a legislative enactment provides for the payment of medical practitioners, they will he un- able to live. The few here are almost starving, (if I may use the term ;) the little that they make is by the retail of drugs. No. 22. The negro pays no kind of tax willingly. I think a capitation tax of four shillings would be best, and quite adequate to make a liberal provision for the medical practitioners. No. 23. No medicines were or are kept by the au- thorities of Hanover in case of epidemic disease. - 270 Appendix. During the kite visitation by cholera, there was a very imperfect and irregular supply of medicines to the medical men. Frequently have 1 made applications, and could obtain none, hi short, so disgusted was 1 with the local board of health, that 1 sent to King- ston and purchased medicines out of my private means for the people A ppendix* 271 APPENDIX I. No. 1413. King's House, October 14 th, 1051. Sir, I am directed by the governor to send you the en» Earl Grey to Sir c. Grey, closed copy of a despatch from the Jamaica. 431. secretary of state for the colonies, September fit!), 1851. , c • . . , • , With one enclosure, and of a letter which accompam- August23d. 1851. ed it from the General Board of Health in England, expressieve of the satisfaction of the Board with the soundness of the views advocated by the Central Board of Health of Jamaica in their First Notification, a copy of which, it appears, had been received from Dr. Gavin Milroy, and submitted by the secretary of state to the General Board in England. 1 have the honor to be, Sir, Your obedient humble servant, (Signed,) T. F. PILGRIM, Sec. John C. Macfarlane, Esquire, Secretary to the Central Board of Health, Spanish-Town, Copy—Jamaica, No. 434. Downing Street, September 6th, 1851. Sir, I have received from Mr. Gavin Milroy, a copy of the First Notification issued by the Central Board of Health of Jamaica. Having submitted a copy of it to the General Board of Health, I transmit to you herewith, for your infor- August 23d, iS5l. mation, a copy of a letter received from the Board in reply, expressive of their satisfaction at the soundness of the views contained in it. I have, &c. &c. (Signed,) GREY, Governor Sir Charles Grey, frc. Sfc. <$rc, Appendix. 272 Transcript copy. The General Hoard of Health, Whitehall, 23d August, 1851. Sir, In returning; to you the First Notification issued by the Central Board of Health of the island of Jamaica, the receipt of which was acknowledged in ray letter to you of the 1oi.li instant, 1 am directed by the General Board of Health to request you to convey to earl Grey the expression of their great satisfaction with the soundness of the views advocated by the Cen- tral Board of Health of Jamaica, and the sanitary efficiency of the measures recommended by them. i have, &c. &c. (Signed,) C. M‘CAULAY, Assistant Secretary. To Herman Merivale, Esq. Sec. S'C. Colonial Office, Downing Street. APPENDIX Jf-o it#* REPORT OF THE CENTRAL BOARD OF HEALTH J A M AICA, Praented to the Legislature under the provisions of the iiih Vk* chav, 60, and printed by order oj the Assembly. SPANISH.-TOWN: >KINTED BY F. M, WILSON, 6, M Alt I IN STREET, FOR TUB HONOUABl.K HOUSK OF ASSEMHIVf. 1052, 273 Central Board of Health Account with Receiver-General. 1851. £. s. d, £. s d. May *23. By amount of grant under act fourteenth Victoria, chapter sixty, to the order of the Central Board of Health ..... . 1000 0 0 To the following orders made on the receiver-general by the Board, viz.:— 1851. July 1. To order in favor of T. J. Brown, secretary, for incidental expences under the act, and accounted for in his account annexed . . . 30 0 0 Sept. 1. To order in favor of T. J. Brown, for his salary as secretary to the Board, ot this date . . . . . . ,2186 To order in favor of R. J. De Cordova, for balance of his account for printing Notifications one and two—amount of account £21 10 0 Paid and charged by secretary . . . 10 0 0 11 10 0 To order in favor of T. J. Brown, secretary, for incidental expences under the act, accounted for in his and Mr. Macfarlane’s accounts annexed . 30 0 0 Nov. 1. To order in favor of J. C. Macfarlane, secretary, for incidental expences un- der the act, accounted for in his account annexed . . . 30 0 0 15. To order in favor of J. C. Macfarlane, secretary, to pay sundry small accounts passed this day . . . . . . 29 1 6 To order in favor of the honorable James Dunstone, eustos of Trelawny, for relief to the suffering poor under small pox, and for medicines . . 50 0 0 To order in favor of the reverend H. G. Lawson, island curate of Hanover, to purchase medicine, and for relief to the suffering poor under cholera . , 50 0 0 252 0 0 £748 0 0 Many liabilities of the Board, (not yet ascertained,) to be paid, which will appear in a further account, J, C. MACFARLANE, Secretary. 274 Dr. Central Board of Health Cash Account .-with T. J. Brown, Secretary. Cr. 1851. £. s. d. July 22. To paid R. J. De Cordova, on ac- count of printing First Notification 10 0 0 Aug. 13. To paid Alexander Campbell, for sta- tionery . . .220 28, To paid Joseph Francis and compa- ny, for minute book . . 0 12 0 27. To paid Derbyshire, Norton, and com- pany, for a tin box and twenty-five quills . . . 1 5 0 To paid Dr. M'Grath s travelling ex- pences from Kingston to Spanish- Town, attending five meetings of the Board . . .2 0 0 ’To paid colonel Yule, attending four meetings of the Board, at 8s. . 1 12 0 To paid Dr. M‘Lean, ditto ditto . 1 12 0 To paid Dr. Johnston, two ditto ditto 14 0 To paid Dr. Milroy s ditto, four ditto ditto, at 8s. . . 112 0^ To paid messenger carrying letters and parcels . . . 0 10 0 To paid postages from 1st June to 1st September . . .840 To paid Dr. .T. W. Johnston, for post- ages . . . 0 5 2 To this sum remitted to America, through R. C. J. Flitchins, for vac- cine lymph . . .10 0 To balance carried to next month . 0 1 JO £30 0 0 1851. £. s. d. July, I. By received from receiver-general, un- der order of the Board dated 1st July . . . 30 0 0 £30 0 V 275 Dr. Central Board of Health Cash Account with T. J. Brown, Secretary, Cr. 185!. £. s. d. Sept. To remitted, through Mr. Hitchins to America, for vaccine lymph, per Illinois . . .3 0 0 To paid travelling expences of Dr. Johnston to meeting of 16th ‘Sep- tember . . 0 12 0 To paid ditto ditto of Dr. M‘Grath 0 8 0 To paid ditto ditto of Dr. jYTLean 0 8 0 To this sum retained for Dr. John- ston’s travelling expences to meet- ing of 0th September . . 0 12 0 To paid Secretary’s travelling expen- ces to the meeting of the 1st and 19th June, 1st and 17th July, 1st August, 1st, 6t,h, and 18th Septem- ber, at 8s. . .34 0 To retained, as salary, from 1st to 16th September, at the rate of £50 for seven months . . 3 17 2 To paid postages and queries of me- dical relief, and other correspon- dence, in September . .200 To balance carried down . *10 0 8 £30 1 10 1851. £. s. d. Sept, By balance brought down . . 0 1 10 By this sum received by the Board through an order of this date, on the receiver-general , . 30 0 0 £30 1 10 Carried by Mr. Macfarlane, as secretary, to credit of his account annexed, 276 Central Hoard of Health in account current with John C. Macfarlane, Secretary. (Jr. Dr. 1851 . £• 8- d. Oct. 18. To paid expences of Secretary to King- ston, on business of the Board 0 7 0 28. To paid Dr Smith’s travelling expen- cesto Green Island, to attend cases of cholera, to be by him accounted for 10 0 0 31. To paid Jordon and Osborn, amount of their account for stationery . 0 16 6 To paid Derbyshire, Norton, and Co. for ditto ditto . . .030 To paid sundry postages from the 2nd instant to date . . .310 To balance due, carried down . 113 2 16 0 8 Nov. 13 To paid Dr. Smith this sum sent to him in a letter addressed to Green Island, to be accounted for by him 10 0 0 15. To paid sundry postages from the 1st to date . . . 0 14 8| To paid Derbyshire, Norton,and com- pany, for stationery, as per account 110 3] To paid Jordon and Osborn, ditto 0 13 8 17. To paid the followingaccounts, per or- der of the Board, for £29 Is. 6d. : Editor of the Colonial Standard, for advertisements 2 4 6 Editor of the Morning Journal, for ditto 117 9 R. J. De Cordova, for printing circulars, &c. 2 0 0 8 1 6 Carried forward £19 0 1 1851 £. s. ci. Oct. 1. By this amount receiver] from the Board, being balance handed in by Mr. Brown, late secretary, at this dale, as per account current ren- dered . . . 16 0 8 V 16 0 8 Nov. 1. By balance brought down . 1 13 2 By this sum received by the Board, by an order of this date on the receiver- general . . . 30 0 0 Carried forward £31 13 2 277 Dr, Central Board of Health in account current with John C. Macfarlane, Secretary, Cf- 1851. £• 5. d- £. s. d. Brought forward IQ Q 1 $ov. 17, A. Feurtado, for horse hire in sending Dr. Smith to Green Island 8 16 0 R. and D. Morison, for medicines supplied to Dr. Smith, for use of cholera patients at Green Island .440 P D. Soares, for pre- paring appendix, re- port, and plans of Spanish-Town , 10 0 0 23 0 0 %4. To paid sundry postages from 15th to date . . , 0 10 2 To paid Jordon and Osborn for sta- tionery . • , 0 16 6 To paid Derbyshire, Norton, and com- pany, for ditto , ,14 0 To balance > , , 16 3 li £60 14 8 To balance in hand , , £16 3 11 1851. £. 5. tf. Brought forward 8L 13 2 Nhi;. 15. By this sum received from the Board through an order of this date on the receiver-general, to pay sundry small accounts . 28 l 6 60 14 y i £60 14 8 J. C. M ACF ARL ANE, Secretary. 278 Central Board of Health Supplemental Account with Receiver- General. 1851. . . £• s. cl. £. s. d' $ov. 15. By balance of grant tinder act fourteenth Victoria, chapter sixty, remaining to the order of the Central Board of Health at this date, per former account . . 748 0 0 To the following orders made on the receiver-general, by the Board, on and from 15th November, to and on 20th December, 1851, viz. :— Nov. 20. To order in favor of 8. W. Rose, senior magistrate of the parish of St. Ann, for the use of the poor of that parish suffering under small pox 50 0 0 To order in favor of J. C. Macfarlane, for payment of expences of making three copies of General Report; for comparing and examin- ing same, and the making up and binding said report, accounted for in his account annexed ... . 180 0 0 Dec. 3. To order in favor of G. M. Lawson, custos of St. James, for the relief of the suffering poor under cholera . . . 50 0 0 29. To order in favor of the honorable Bryan Edwards, custos of St. Tho- mas in the Vale, to be paid to reverend Mr. Pearson, for cholera me- dicines i . . . .665 To order in favor of reverend H. G. Lawson, curate of Hanover, ba- lance of account for cholera medicines . . . 7 16 0 To order in favor of J. €. Macfarlane, for newspapers advertisements, accounted for bv him in his account annexed 4 . , II 5 0 To order in favor of John Bristowe, esquire, solicitor, for his attend- ance at the meetings of the Board, and professional services render- ed to Board of Health . . . . 25 0 o To order in favor of Dr. Crawford Smith, for professional services dur- ing cholera in the parish of Hanover . „ „ 200 0 0 To order in favor of Dr. Crawford, R.N. for professional services dur- ing cholera in the parish of Westmoreland . . . 25 0 0 To order in favor of Dr. Dairymple, for services during small pox, and acting as vaccinator in the parish of Trclawny . . * 60 0 0 To order in favor of Mr. Walse, Newcastle, for cottage plans v . 3 3 0 To order in favor ol Mr. Calvert* for cottage plans . . .660 To order in. favor of G. M. Lawson, custos of St. James, to be paid to W, N. Cooke, esquire, for assistance in defraying cholera expences 50 0 0 674 16 J Carried forward t % £73 3 9 279 Ventral Board of Health Supplemental Account with Receiver-General. 1851. £. s. d. £. s. d; ,h/vv. 15. Brought forward . 73 3 9 Dec. 29. To order in favor of Dr. Clarke, Metcalfe, for services in recent cholera 10 10 0 To order in favor of J. C. Macfarlane, for salary as secretary to this Board, from 1st October to 31st December, 1851 . . . 21 8 6 31 18 6 Balance remaining in the hands of receiver-general . , £*41 5 3 J. C. MACFARLANE, 28th January, 1852, 280 Dr. John C. Macfarlane, Secretary, in account current with Central Board of Health. Cr, 1851. £■ s d Nov. 24. By balance due per last account 16 3 11 By order on receiver general, at this date, for expence of making three copies of General Report ; for comparing and examining same, and the making up and binding said Report . . . 180 0 0 Dec. 29. By order on receiver-general, at this date, to pay neswspapers adver- tisements . . . .1150 207 811 Carried forward £207 8 11 1851. £. s. d. .7W. 3. To paid postages, from 24th No- vember to date . . . 0196 To paid Dr. Johnson’s travelling ex- pences to attend sundry meetings of the Board . . ..240 To ditto Colonel Yule, ditto ditto . 14 0 To ditto Dr. Magrath, ditto ditto . 14 0 To paid the following accounts out of contra order for £ 180 for mak- ing three copies of General Re- port, &c. &c.:— £. s. d. C. C. Hamilton 17 15 6 David Melhado 26 17 0 J. H. Laing 15 14 6 Mrs. Hewitt 5 0 8 Mrs. Ramsay 7 8 1 Mrs. Laing 13 7 6 Richard Charlton 3 16 10| W. J. Clarkson 2 16 3 T. Mayo 2 15 1| Jaslyn Mayo 3 19 D. P. Mendes 6 6 0 Edward Shaw 9 2 3 G. A. Hague 12 11 3 S. Barrow 6 10 6 Peter Humphreys 17 0 J. R. Dubuisson 11 2 0 J. H. Branfoot 5 15 6 151 7 9 Carried forward £156 19 3 281 Dr. John C. Marfarlanc, Secretary, in account, current with Central Board of Health, Cr. 1851. - £ g ({ Dec. 29. 13y amount brought forward 207 8 l i Carried forward £207 8 11 1861. £. s. d. £. s. rf To amount brought forward 156 19 3 Dec. 3. Mr. Neil son, for his trouble in arranging and fastening toge ther several parts of three copies of Ge- neral Report, from time to time, and af- terwards binding three copies for pre- sentation to the ie- gi>latures 3 0 0 To paid for examination of said Reports 17 0 0 To paid for refreshments for persons examining copies Reports, lights. &c. 10 0 210 0 29. To paid postages from 1st to date 0 19 6 To paid Jordon & Osborn for sta- tionery * . . • .010 To paid out of contra order £ I I 5s. the following accounts lor adver- tisements in n< wsoapers, &c. :— £. s d. Morning Journal 18s ) , n _ Slandiinl . _ IBs { 1 "' ° ' 16 0 The Daily Advertizer to he arranged, and hereafter paid 9 9 0 115 0 Carried forward £180 15 9 282 Cr. Dr. John C, Macfarlane, Secretary, in account current with Central Board of Health. 1851. £. d. To amount brought forward 180 15 9 Dec. 31. To further postages . . .064 #To l)r. Milroy, travelling expences to attend meetings of the Board, while in the island . . . 1120 To paid colonel Yule, travelling ex- pences to attend meeting 29th De- cember . . . . . 0 12 0 To paid Thomas Cogill, for his at- tendance as servant at the several meetings . • . . .10 0 To balance in hand, to be repaid to the receiver general to the credit of Central Board of Health, sub- ject to the settlement of Daily Ad- vertizer's account. 23 2 10 £207 8 11 1851. £. s. d. Dec, 29. By amount brought forward 207 8 11 £207 8 11 J. C. MACFARLANE, 28th January, 1852a