HUNT'S MERCHANTS' MAGAZINE AND COMMERCIAL REVIEW. OCTOBER, 1856. Art. I. QUARANTINE. THE rigid and isolating measures of ignorance and coercion in endeavoring to put a stop to epidemics, have always increased their virulence and added to their expansion, while a careful and humane attention to the wants and miseries of the sick has contributed to both the prevention and spread of disease, and to its speedy termination. The most ancient physicians, even as early as the sixth century, argued that epidemics did not spread by contact; they were therefore opposed to isolating the sick, and supported the principles of humanity inculcated in the constant care of the diseased by the healthy, as not only the most effectual means of curing sickness, but as being equally efficacious in preventing its extension. The experience of all ages accords with these most ancient views. Quarantine originated with the great epidemics of the fourteenth century. It derives its name from the last or fortieth critical day, according to that age of medicine when the course of "ardent" diseases was thought to be marked by particular crises. Hecker, a believer in the benefits of quarantine, informs us that the first regulation which was issued for this purpose originated with Viscount Bernabo, and is dated the 17th January, 1374. Every plague-patient was to be taken out of the city into the fields, and there to die or recover. Those who attended upon a plague-patient were to remain apart for ten days before they again associated with any one. The priests were to examine the diseased, and point out to special commissioners the persons infected, under punishment of confiscation of their goods, and of being burned alive. Whoever imported the plague, the State condemned his goods to confiscation. Finally, none except those appointed for the purpose were to attend plague-patients, under penalty of death and confiscation. In 1383 the same prince forbade the admission of people from infected places into his dominions, on pain of death. Bernabo's example was imitated in numerous places during his lifetime, and enforced with all the spirit of the age. An individual, whose human kindness exposed him to even the last look of sympathy from a dear departing one, was shunned with hideous terror, forced into seclusion, or burned to death by the stern executioners of the law. Yet "Black Death" reigned with unprecedented sway. The southern commercial States of Europe strictly enforced, with the wildest fanaticism, the severest laws of quarantine, and their commercial cities were almost closed against navigators, for fear of the importation of plague, as they professed in most cases to trace its outbreak to the arrival of some ship. In 1347 it was said to have been imported into Genoa by ships from the Levant; on this account suspected ships were forbade entrance into their ports, and consequently sailed to Pisa and other cities on the coast, where plague likewise prevailed, and was likewise attributed to importation by ships. In the latter part of the fifteenth century-when plague and the severest quarantine laws were prevailing together with an unheard-of vigor and fatality-a special council of health was established in Venice for the prevention of its entrance there; but scarcely had the force of their strictures been realized ere they were followed by a plague so severe as to create a suicidal frenzy, rather than fall victims to the plague, or its alternative, the quarantine. In its progress, every human barrier seemed to add fuel to its terrible ravages; one fled from another—a neighbor from his neighbors-a relation from his relations-terror took the place of every kindly emotion-brother forsook brother, sister the sister, the wife her husband, the mother her child! Each and all abandoned, unvisited, uncared-for, unsoothed-quarantined! Bills of health were probably first introduced in Italy during the prevalence of plague about the year 1527, though Lazarettos had been established some forty years before. These were usually upon islands at a distance from cities, where all persons coming from places suspected of plague were detained, in conjunction with the sick, under a strict guard. If the disease appeared in the city itself, the sick (with their families) were dispatched to the old Lazaretto, where they were to remain, with all those who had intercourse with them, till cured-or until, what was much more frequently the case, they died; then they were transferred to the new Lazaretto, situated on another island, where they were detained forty days longer. In this way Venice was the pioneer "council of health." Other commercial cities followed the Venetians, and about the year 1665, bills of hea'th had become general. Defoe, in his "History of the Plague in London in 1665," who, though like Hecker, believed plague to be contagious, fully shows that the terrible horrors of quarantine were, nevertheless, even worse than the plague itself: "A whole family was shut up and locked in, because the maid-servant was taken sick; these people obtained no liberty to stir, neither for aid nor exercise, for forty days; want of breath, fear, anger, vexation, and all the other griefs attending such an injurious treatment, cast the mistress of the family into a fever ; 405 and visitors came into the house and said it was the plague, though the physicians declared it was not. However, the family were obliged to begin their quarantine anew, on the report of the visitor or examiner, though their former quarantine This oppressed them so with anger wanted but a few days of being finished. and grief, and, as before, straitened them also so much as to room and for want of breathing and free air, that most of the family fell sick-one of one distemper, one of another, chiefly scorbutic ailments, only one a violent cholic-until, after several prolongations of their confinement, some or other of those that came in with the visitors to inspect the persons that were ill, in hopes of releasing them, brought the distemper along with them, and infected the whole house, and all or most of them died, not of the plague as really upon them before, but of the plague that those people brought them who should have been careful to have protected them from it; and this was a thing which frequently happened, and was indeed one of the worst consequences of shutting houses up.' Watchmen were placed at the doors of the sick to prevent escape, and the passer-by shuddered when he looked up and saw the fatal mark of isolation on the door-a large red cross painted on the door, written over, This merciless imprisonment was pur"Lord, have mercy upon us!" sued with a heartless obduracy engendered by the belief that it was the only means of averting death to those who inflicted it. The same historian records the noble deeds of some of the health officers and some country people, who constantly sought out the suffering, procured and carried them food, and such "very seldom got any harın by it," and were therefore deemed to have been miraculously preserved; while hundreds and They had the taint of thousands of those who fled, died in their flight. the disease in their vitals, and after their spirits were so diseased, they could never escape it." 66 And thus prevailed the epidemic of quarantine, with its attendant symptoms of terror, starvation, and suicidal mania, " until it was impossible to beat anything into their heads, (convince them;) they gave way to the impetuosity of their tempers, full of outeries and lamentations when taken, but madly careless of themselves, fool-hardy and obstinate while they were well. Where they could get employment, they pushed into any kind of business, the most dangerous and the most liable to infection; and if they were spoken to, their answer would be, 'I must trust to God for thatif I am taken, then I am provided for, and there is an end of me.' 'Why, what must I do? I cannot starve; I had as good have the plague as I must do this or perish for want; I have no work, what could I do? beg Burying the dead, attending the sick, or watching the infected, their tale was the same." Many such were "miraculously preserved," and as their number increased, whether by defiance of quarantine or selfsacrificing humanity, the epidemic declined. The plague broke out in Leghorn about the beginning of the present century, unattended by the incidental arrival of any ship or importation to which it could be assigned. Finally, it was traced to a mummy which some scientific men had unrolled for examination. On this the contagionists rested, though it had been locked up for a period of over two thousand years! Ingram, an English writer on plague about the middle of the last century, records that "If in the sultry months we examine into the diseases of Newgate, the Savoy, or any of the jails in England, or those of other cities in Europe, we shall find a pestilential diease every year in them, though not so malignant as the pestilence in sultry climes, nor of so long continuance, yet sufficient to destroy many of the prisoners. And this disease is also contagious, because it takes its origin from putrid air. Mariners also, in long voyages, especially those that belong to the navy, frequently too have felt the experience, not so much from the coarse diet, as from the ships being crowded from such numbers of men, from whose breath and bodies arise hot steams, which shows the necessity of ventilators to draw forth the corrupted air, and at the same time to refresh them with better. The breaths of people confined a short time will destroy themselves, as about nine years ago, in St. Martin's prison, many being close shut up, some died in a few hours. "Such like epidemics are not confined to jails, navies, or camps, but they are almost yearly felt in many cities, and sometimes they are so virulent even as to be contagious, terminating in carbuncles, one of the true symptoms of the plague; so that we may affirm that every year we are afflicted with the plague, in a milder degree than those cities which lie in southern latitudes." This concise statement of contagion and its cause is worth more than all the volumes that have ever been written on it, for a proper appreciation of the nature of epidemic contagion. Plague has thus lengthily been dwelt upon, because it has usually been considered among the most contagious of epidemic diseases. When cholera broke out in 1832, the measures of isolation were begun with the same vigor as characterized the quarantine of plague, centuries before. Attempts to isolate the sick and intercept their intercourse with the well, were set about with an alacrity only surpassed by the alertness of the disease. Calling out troops or a strong body of police around infected places was even talked of, as one means of staying its progress. Proposals for locking up infected houses and dropping food at the doors, which was to be taken in by ingenious machines to be worked by the collapsed patients, were discussed as of more importance than the uncleaned gutters and lanes flanked by dark, airless abodes, on which the sun had never shone. Illy-ventilated emigrant ships were detained at quarantine stations, or their passengers transferred to the devitalized air of hospitals to await its ravages. Yellow fever has been no less the subject of quarantine, and innumerable are the cases of mild intermittents, which would have speedily been eliminated with the privilege of pure air, doomed to black-vomit by quarantine detention. The haunts of deadly reptiles are not more peculiar to their localities, than are the equally native diseases nourished and propagated by causes in proportion to their abundance. The most favorable comparison of the advancement of human science is, that the benefits it has conferred on mankind are entirely consistent with such arrangement of the elements of the universe, that wherever there is an evil arising, an all-wise Providence has endowed man with the means, through the exercise of wisdom and virtue, of overcoming it. “If there be in the land famine; if there be pestilence, blasting, mildew, locust; or if there be caterpillar; if their enemy besiege them in the land of their cities; whatsoever plague, whatsoever sickness there be," from the plagues which Pharaoh so stubbornly resisted, to the latter part of the last century "Hypochondriac fancies represent Animal and vegetable decomposition, dwellings without provision for light and fresh air, filth and vermin, were then, as they are now, beneath the notice of the ignorant and uneducated, while they can grasp at comets, meteors, and earthquakes. In early ages, before agriculture became general, epidemics were of much more frequent occurrence wherever large bodies of men were gathered together, than they are at this day. The soil was everywhere covered with animal and vegetable matter in such abundance as to absorb the greatest possible amount of moisture, in order to its decomposition, the going on of which, whenever temperature favored, evolved the cause of disease to such an extraordinary degree as to be followed by effects which we are now taught to appreciate, by confining our observations to such conditions as comprehend the same circumstances. The differences in epidemics, though they all pertain to the same general causes, arise from the development of organic matters with different properties, depending upon particular conditions connected with local circumstances and constitutional tendencies. That such is the case, may be deduced from the specific effect of certain medicines, food, and drink, as well as the circumscribed limits of some epidemics. The most deadly epidemics of ancient times are usually characterized by the numbers they destroyed, and it is only by studying the history of cotemporary circumstances that we can approach the true causes and nature of them. The "hot, burning boils and blains, breaking forth into pustules and corroding sores upon man and upon beast," as signified by the blistering ashes from the furnace, is no unfit emblem of smallpox; and that a grievous hail, inundation, drought, heat, and famine, were followed by a pestilence, which arose at midnight and attacked with characteristic severity the wealthy and luxurious Egyptians who resided on the banks of the Nile, is but a faint illustration of the effect of the same causes whenever and wherever they exist. Epidemic is a word used to designate that character of a disease which attacks a large number of individuals at the same time. Endemic is an epidemic confined to a particular place as goitre and cretenism in the Alps, cholera in the delta of the Ganges, plague in the delta of the Nile, and yellow fever in the delta of the Mississippi. An endemic that leaves its place of usual prevalence, as cholera has most frequently of late years, becomes a true epidemic. There is no difference in the disease; epidemic and endemic are the same-only one, epidemic, is general, and the other, endemic, is local. Infectious diseases are those produced by a vitiated state of the atmosphere, a condition always owing to the want of free access of pure air and light, the which, were they constantly present, would wholly do away with infection. Persons in health may be kept in confined air until it becomes vitiated and infectious to themselves, and consequently they may become poisoned and killed by it; and such air will affect alike one or many individuals who may be exposed to it, whether the infection has arisen from the deadly effect of too close confinement of diseased or (to begin with) healthy individuals. Epidemic, endemic, and infectious diseases are uncertain in their development from the time of exposure to the time of attack; disease may occur very soon-immediately-or it may not for months. Contagious diseases are those epidemics which at first arise from the |