Second annual report of the Board of Health of the State of Georgia 1876 [1877]

Compliment-s of The Gemgia Slate Bomd of Flea7 .
s~co D
ANNUAL REPORT
OF 'I'HR
BOARD OF HEALTH
OF 'l'HE
STATE 0] GEORGIA
1876.
ATLL'lTA, GA. : J.o\.S. P . HARRISON, STATE PRINTER,
1877.

SECOND

ANNUAL REPORT

-

OF THE

BOARD OF HEALTH

OF THE

STATE OF GEOR-GIA

1876.

ATLA.NTA, GA. : JAB. P. HARRISON, STAB PlllN'l'BJI,
1877.

MEMBERS OF BOARD.
J. G. THOMAS, President ............................. ~..........SAVANNAH N. J, HAMMOND, Attorney-Geneml...........................ATLANTA W. L. GOLDSMITH, Comptroller-General..................ATLANTA GEORGE LITTLE, State Geologist .............................ATLANTA BENJAMIN M. CRO.\IWELL...................................... ALBANY GEORGE F. COOPER...............................................AMERICUS F. A. STANFORD......................................................COLUMBUS JOSEPH P. LOGAN ...................~ .............................. ATLANTA G. E. SUSSDORFF.........................................................MACON
G. w. HOLMES...............................................................ROME
HENRY F. CAMPBELL.............................................AUGUSTA H. H. CARLTON .......................................................... ATHENS V. H. TALIAFERRO, Secretary ........................ .........ATLANT-'.

TABLE OF CONTENTS.

Annual Report of the President ................................ . Annual Report of Secretary.................................... .
Circulars to Ordinaries ................................... . Circular to Medical Profession. . . . . . . .................... . Letter to Health Commissioners......................... .. Letter from Henry Baker, M. D., 8uperintendent Vital Sta-
tistics of Michigan .................................. .. Letter from D. W. Bliss, :lVI. D., Registrar of Vital Statistics,
District of Columbia................................ .. Form for Births, Marriagas and Deaths .................. Flnancial Statement...................................... Table of Births................................................ . Table of Marriages............................................ . Table of Deaths.............................................. .. Minutes....................................................... . Report on Yellow Fever Epidemic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Heport on Yellow Fever at Macon, by G. E. Sussdo1ff, M. D. Railroad Transportation of Disease Germs-Yellow and
Dengue Fever in Augusta, by H. F. Campbell, M.D .. . Food, etc., by G. F. Cooper, M.D.............................. .. Relations of Health Boards and other Sanitary Organizations with
Civic Authorities, by Ely McClellan, M.D., U. S. A ....... . Lunacy in Georgi&, by Judge B. H. Bigham ......... ,. .......... .

Page. 8- 7 8-87 17-28
19 24
25
29 32-85
86 89 42-45 48- 62 63- 92 93-152 129
132 152
162 196

APPENDIX.
Testimony of J. H. Hogg, City Surveyor ; E. C. Anderson, Mayor; J. T. McFarland, :r.I. D., Health Officer of Savannah; Dr. Estern Yonge ....................... .
Dr. T. J. Charlton and Dr. J. C. Habersham .............. . Dr. J. C. Le Hardy ..................................... .. Dr. J. J. Waring......................................... . Dr. William Duncan..................................... .. Dr. W. H. Elliott and Dr. A. A. Woodhull ................. . Dr. Wm. Charters ....................................... :. Ed. White ............................................... . T. H. Brown............................................ .. A. J. J. Blois ............................................ . Angus McAlpin .......................................... . S. G. Haynes ............................................ .. G. W. Garmany.... . . . . . . . . . . . . . . . . . . . . ................. . Dr. L. A. Falligant ...................................... . Henry C. Hall, Consul General. .. . .. . . . .. . .. .. . . ....... ..

1-10 12 18 16 17 18 19 20 23 24 25 26 27 28 31

2

TABLE OF CONTENTS.

A.. C. Smith, List of Vessels arriving at Savannah, from January 1st to September 1st, 1876 ................... .
F. W. S. Woolhopter ..................................... . Letter by Robert Myers .................................. . Analy&is of Ballast and.'Water, by Prof. W. J. Land..... . Letter by Dr. A. B. Lanier............................... . Letter by Edwin C. Davis ................................ . Testimony of J. T. Collins ............................... . List of Vessels arriving at Brunswick, from Jnne 1st to No-
vember 1st, 1876 ..................................... . Testimony of James S. Blain, M.D ...................... . Letter by James Holmes, M.D., Health Officer, Darien ... . Letter by Spaulaing Kenan ............................... . Statement and Testimony of Dr. D. W. Hammond........ . Testimony of Dr. A. L. 0. Magruder ..................... . Testimony of Dr. T. W. Mason .......................... . Testimony of A. E. Boardman........................... Testimony of Dr. H. A. Mettauer ........................ . Testimony of Dr. W. R. Burgess ......................... Testimony of Dr. W. F. Holt ............................. .

38-35 . 86
50 50 51 52 53
55 56 57 59 60-63 68 67 76 75 80 85

REPORT.
OFFICE OF THE STATE BoARD OF HEALTH, ATLANTA, GA., January 17th, 1877.
To his Excellency ALFRED H. COLQUITT, Governor:
DEAR SIR :-I have the honor to submit the second annual report of the State Board of Health, for the year 1876.
In complying with the law which established this organization, I beg leave to call your Excellency's attention first to the report of the Secretary of the Board, and to the various and timely suggestions tterein contained. It will be observed that the collection of vital statistics has not been as successful as is desired, though perhaps as much so as could have reasonably been expected. It is very evident, however, that registration of births and deaths by the Ordinaries is not arpreciated as it should be. The .officers who are required by the law to keep these records, do not fully appreciate their importance, and in some instances have refused to perform the duty. It is equally evident that its importance is not fully realized by those whose duty it is to report the births and deaths to the Ordinaries. Everybody is familiar with the old custom, which has been handed down to us for many generations, to record all births and deaths which occur, in the family Bible. This is a family record which is kept by all judicious and thoughtful parents for their private use. The Good Book is often lost or destroyed, or at any rate does not descend very far along the family line. This apparently very simple habit, which enlightened people have kept up for many years, is very suggestive. The State is commonly called
the mother of her citizens ; and yet she doe~ not keep any

4

REPORT OF PRESIDENT

record or take any such notice of the death and birth of her children.
Her wisest statesmen rise up and serve her through life, and depart; and yet she does not, in any official way, recognize their birth or death any more than if they had never existed. Does it not seem reasonable and right that the State should make provision and require that all the children born unto her should have their birth recorded in the county in which they are born, and that the same notice should be taken of their death ? How else can the State consider them her legal children unless they are registered? From this point of view, it would appear that a more general interest should be manifested in making these records. It is a more or less prevalent belief that they are kept and sought alone for some supposed benefit to the medical profession. There is another idea abroad, too, that they are solely for the use of the State Health Board. To all those acquainted with the value of such things, this must be considered an unfortunate error, and, if possible, should be dispelled from the public mind. It has been well said that such records form a part of the ''anatomy of the Nation,'' and no country's history is complete unless its vital statistics are well studied. Sanitary organizations, such as the State Board of Health, find these records the most definite way of arriving at the condition of the health of the peo: ple, and from them is derived the most correct knowledge of the localization of disease.
The Registration of vital statistics is, by universal acknowledgement of enlightened sanitarians, of fundamental importance to the operations of a State Board of Health, The yearly number of births, as compared with the annual mortality, is of the greatest importance in estimating the ravages ofdisease in various parts of our State or through.~ out the State as a whole. Without such registration, th~ Legislature, the people, even the Board itself, cannot have the data by which to estimate the evils of neglected sani,.

STATE BOARD OF HEALTH.

5

tary measures, nor, on the other hand, to judge of the value and efficiency of the application of even the most judicious efforts for the prevention or quelling of disease.
This great interest, however, has been demonstrated to be an enterprise perhaps too far advanced in enlightenment for the progress of the age in the State of Georgia. It has been found as entrusted to the Board itself, to bring this body in unpleasant conflict with the medical profession of the State and to excite antagonisms which are injurious to the interests of registration, and specially to the more legitimate objects of the Board. We propose, therefore, that the duty of the collection of vital statistics-births, marriages and deaths-be committed to some other department of the State Government, and that to the Board for the present be committed the duties which more strictly pertain to the investigation of epidemics, the sanitary condition of cities, public institutions, rural districts, and to the prevention of disease throughout the State, according to the system of enlightened sanitation at present offered in the advanced state of the science of State medicine throughout the world.
In the course of time, the collected statistics may be submitted to the Board and the results worked up by them for the instruction and government of the people. Many years are required to collect the statistics necessary to these results for the consideration of the Board, but, in the meantime, the Board regards sanitary measures for the preservation of the health of the people too important to be neglected, and suggests to the government that this clause of the act should be perfected by provisions under it, giving plenary power, and sufficient pecuniary means to be used or not, according to the necessities of the sz'tuation, to put it into the highest position for efficiency.
I beg to call your Excellency's especial attention to the report of the Board made upon the subject of the epidemic of yellow fever, which prevailed during the" last
'

6

REPORT OF PRESIDENT

summer, and fall in the cities of Savannah and Brunswick. This report has been made at great cost of time and labor on the part of the Board. They have spared no pains which would enable them to arrive at correct conclusions as to the origin of the disease. The sufferings which the people of those cities have undergone, and the great cost in life and wealth, admonish the entire people of this Commonwealth, to aid in avoiding a like catastrophe in lhe future. It has been well said that ''epidemics are nature's protests against her violated sanitary laws."
This epidemic forms no exception to the above rule, which I trust has been made clear in our report. The State is largely interested in preventing a repetition of such scourges upon her sea coast, and, therefore, the recomm~ndations which are there made should meet with the most serious attention of the next General Assembly. Public hygiene is fast becoming one of the great questions of this age, and Legislatures will have to meet it sooner or later. Small local communities, or municipalities, can no longer be left alone to work out the problem of their own healthfulness.
It must be taken hold of by the States, and in time, perhaps, by the general government, in order to wrestle successfully with such pestilences as have invaded our State this year. The great loss in population, which is more severely felt than loss in trade or wealth, demands the powerful interference of State governments in all matters pertaining to the health of the people. The wisest statesmen of the day are waking up to the realization of these facts. The oldest and most enlightened governments of Europe are taking the lead in the inauguration of vast measures having the sole object to promote the health of their subjects. Large expenditures of money are annually made to this purpose, and experience and close calculation has proved that it is returned many times over, not only by the saving of life, but by the increased productive

STATE BOARD OF HEALTH.

7

power of the people. Our sanitary law is but a beginning in the right direction, and if our law-makers are wise, they will add to it until it is nearer perfection. But they must first realize that no great sanitary 3Cheme, such as is contemplated by the present law, can ever be perfect in its operatipn or highly beneficial in its results without a large increase in the appropriation set apart for this purpose. The work of our Board has been greatly hampered this year by the great lack of means to carry out their designs, The members of the Board have been. and are still willing, to give their time and talents to the work without compensation ; but they are not willing to go further unless ample contingent means are provided to carry out such measures as are contemplated by the law under which they are acting. It is believed that in no great lapse of time, there will be a general feeling that this department of the State government is of as much importance as any other, and that it will prove itself indispensible to the welfare of tbe people. Until it is understood and appreciated, the Board are willing to make many sacrifices, feeling that all such things have to be nursed until their value is macie apparent to those for whom the benefit is designed. But, on the other hand, even in the short time of its existence, the Board has found that very much is expected of them, and that they cannot fulfill public expectation without a very large increase in the power as well as of the appropriation. Therefore, they feel that they would be doing themselves a great personal injustice, and perhaps inflict a heavy injury upon the cause they represent, if they did not make this fact clear to the representatives of the people.
I am with grea'c respect, Your obedient servant, ]. G. THOMAS, M.D.,
Prest"dent of the State Board of Health.

ANNUAL REPORT OF THE SECRETARY OF THE STATE BOARD OF HEALTH.

To the Board of Health of the State of Georgia:

GENTLEMEN-I have the honor herewith to submit the second

annual report of the Se<cretary, embracing the period from October

12th, 1875, to October lOth, 1876.

The last session of the Legislature, which convened January,

1876, amended the Health Law as follows:

SECTioN 1. Be it enacted by the General Assembly of the

State of Georgia, That so much of the 11th section of the act

entitled an act to create a State Board of Health, for the pro-

tection of life and health, and to prevent the spread of diseases in

the State of Georgia, and for other purposes, approved February

25th, 1875, as imposes a penalty of ten dollars upon physicians, be,

and the same is hereby, repealed.



SEC. 2. Be it further enacted by the authority aforesaid, That

so much of the 12th section of said act as imposes the penalty of

ten dollars on parents, is also hereby repealed.

SEc. 3. Be it further enacted by the authority aforesaid, That

for making the record of births and de;tths, as now required by

law, the Ordinaries of the several counties of this State shall

receive five cents for each person so registered.

SEc. 4. Be it further enacted by the authority aforesaid, That

County Boards of Health are hereby created, to consist of the

Ordinary, who shall be ex-officio a member of said Board, and two

practicing physicians, to be chosen by the Commissioners of Roads

and Revenue, in those counties where such commissioners are

allowed by law, and in other counties by the grand jury of the

first term of the court held after the passage of this act, and the

term of office of the members of said County Boards shall be the

same with the Ordinary.

SEC. 5. Be it further enacted ll!J the authority aforesaid, That

the Ordinary of each county shall be ex-officio Secretary of the

County Board of his county; and said Board shall correspond with,

and report statistics to, the State Board of Health, through its

Secretary, giving special attention to gathering statistics in accord-

ance with the provisions of the act of which this is amendatory,

SEc. 6. Be it further enacted by the authority aforesaid, That

said boards shall have supervision of the sanitary condition of t!!leir

STATE BOARD OF HEALTH.

9

counties respectively, subject to the direction of the State Board of Health.
SEC. 7. Repeals conflicting laws.
Registration, under the original act of the Legislature creating the Board of Health, was put in practical operation about the 1st of August, 1875; ,so that the machinery of vital statistics was scarcely under headway before the amendment of the law in 1876.
Under the original law, many of the medical fraternity complained heavily of the penalty-clause, while the Ordinaries complained, with equal seventy, of no remuneration for the work required of them. Most of the Ordinaries took hold of the work in such a way as to give no encouragement for its faithful performance.
Under the complaints of the physicians, at the penalty-clauBe, and the Ordinaries at the no-pay feature in the law, the prospects were certllinly far from encouraging.
It was under this state of things that the Legislature amended the law-striking out the penalty-clause, and giving pay to the Ordinaries. While both physicians and Ordinaries were sufficiently pleased with the changed law, the work has not been prosperous, and for reasons which, to my mind, are sufficiently clear.
It will be seen, from the accompanying report of vital statistics, that eighty-five counties have made returns, and fifty-two counties have not reported. The reports from the counties making returns are far from satisfactory.
I will endeavor to present to your honorable body the causes which have conduced to theRe unsatisfactory and imperfect results, and the measures proposed as remedies.
The operation of registration laws must necessarily be always complicated, requiring, as it does, the duties of so many different classes of persons, and encountering, also, the opposition incident to ignorance and indifference. We could not, therefore, have reasonably expected satisfactory results for several years, giving the necessay time to accustom and familiarize with their respective duties the several classes of persons whom the law made responsible for the execution of the complicated work of vital statistics.
While, indeed, we have encountered difficulties on account of the newness of the board, and the bitter opposition incident to ignorance; and, while on this account, we could not have expected other than imperfect results, our greatest barriers have unquestionably depended upon glaring defects in the law. Nor can we attach blame for such defects when the subject of State medicine is, to most of us, so new; and when we find, too, from the history of vital statistics at home and abroad, that difficulties are constantly being encountered, and remedied as occasions and emergencies re-

10

REPORT OF SECRETARY

quire. It will, perhaps, not be amiss to call your attention to some few of the changes which have been found necessary in registration laws in the States where vital statistics are most successfully
managed. In the State of Massachusetts, where registration and State med-
icine are oldest, and where these have attained, perhaps, greater perfection than Plsewhere in this country, the law concerning registration has, from time to time, undergone changes to meet existing difficulties as they were encountered. In the original law (as in that now existing) the town clerks were made the chief agents in the collection of vital statistics, but "as the process worked slowly'' toward perfection, "in the year 1865, to facilitate the registry of births, the duties were transferred from the town clerks to medical practitioners, and was found, upon trial, to pro~ duce an unfavorable effect, and therefore repealed."
For the District of Columbia, the Congress of the United States enacted health laws, under which a Board of Health was organized in 1871, but registration and collection of vital statistics were not at all satisfactory until the law was amended, in 1874, authorizing the Board of Health to "make and enforce regulations to secure a full and correct record of -vital statistics, including the registration of deaths and interment of the dead in said district," thus giving to the Board, as will be seen, plenary powers, in all matters pertaining to registration.
The law of Michigan concerning the record and return of births, marriages and deaths, enacted in 1867, was found defective, and amended in 1869.
In the city of New York, although registration laws had been in operation since 1847, no satisfactory results were obtained until the law was revised and amended in 1870.
In the State of Rhode Island registration laws have been in operation for nearly twenty-five years, and have, from time to time, undergone amendments-the last of which was in 1875. The law in this State, as that in Michigan, is, in the main, a copy of that of Massachusetts, and is giving great satisfaction.
These facts are presented to show to your honorable body that the defective registration in our own State is what 'lll the other States have encountered in the beginning, and should, therefore, give us no cause of discouragement, but stimulate us in the effort to ascertain the diffculties in our way, and the proper remedies to overcome them.
We will consider the defective features of our own registration law under the following divisions :
1st. The voluntary features of the law. 2d. The duties of physicians, coroners, parents, etc.

STATE BOARD OF HEALTH.

11

3d. The duties of Ordinaries. 4th. The duties of ministers, justices, etc. The health law as originally passPd by the Legislature in 1875, provided:

" That all physicians in the practice of medicine in this State shall be required, under the penalty of ten dollars, to report to the Ordinary in the forms to be provideu, all deaths and births which may come under their supervision, with a certificate of the cause of death, etc."

When this law had heen in actual operation but a few months, and certainly not long enough to test its practical working, the following session of the Legislature, in 1876, amended this portion of the law by striking out the penalty clause. The practical operation of the law was thus rendered purely voluntary. Large classes of persons are here called upon to perform certain duties without reward fm its execution, and with no penalty for noncorwpliance.

If registration laws, where they have been longest tested, have established any one fact, certainly it is that voluntary duties in the work of vital statistics cannot be relied on.

In the annual report of the Board of health in the District of

Columbia, for 1S74, the following statement occurs in the report of

the Registrar : "Under the old system, no precise results could

be obtained, as there was no means of enforcing compliance with

the demand of the board seeking information as to number, cause

of death, sex, race, etc.

Returns were

considered voluntary, and were, therefore, sadly neglected."

Under the new law forth~ District passed by Congress, in 1874, a penalty attaches to every violation of its provisions, by a fine of not less twenty-five, nor more than two hundred, dollars for each and every such offense.

The Registrar of vital statistics, in his report in 1875, (this being the first after the passage of the new law), says: "Owing to the absence of suitable legislation upon the subject of vital statistics in this district, until the passage by Congress, in 1874, of the law now in force, this is the first occasion, in the history of the capital of this country, where a report upon this important subject, in any degree approaching correctness, could be made."
The annual report of the Board of Health of New York City, for 1870, states: "The registration of marriages and births has heretofore been a neglected branch of the service in this bureau. The statute has required these returns to be given since 1847, yet no effort to enforce it had been made until the latter part of the past year. The duty of making such returns had come to be regarded

12

REPORT OF SECRETARY

as voluntary, and the result is that these records are extremely imperfect, and, for all practical purp0ses, well nigh useless.
"In order to secure compliance with the law, the board commenced the prosecution of delinquents. The result has been a most satisfactory increase in the returns of both marriages and births, and a much nearer approximation of the actual number of each than has heretofore been secured."
In the State of Rhode Island, where registration laws have been in operation for nearly twenty-five years, with now most satisfactory resuts, we find rigid compulsory laws in force, as appears from the following from the law, as amended June 31 1875:
"bEC. 11. If any clergyman, physician, undertaker, town clerk, clerk of any meeting of the society of Friends, or other persons, shall wilfully neglect or refuse to perform any of the duties imposed on, or required of him, by this chapter, be shall, at the discretion of the court or justice trying the cause, be fin.ed not exceeding twenty dollars for each offense; one-half thereof for the use of the town in which the offense shall occur, the other half to the use. of the person who shall complain of the same.
"SEC. 12. In order that it may be more surely ascertained that no clergyman, physician, coroner, undertaker, or clerk of the Society of Friends, neglects to make the returns specified in this chapter, each of the said parties shall cause his name and residence to be recorded in the clerk's office of the town where he resides.
" SEC. 13. No letters of administration or letters testamentary, shall be granted by any court of probate, upon the effects or estate of any person, until the death of such person, or the facts from which the same is presumed, shall be duly certified, as near as may be, to the town clerk, in order that the same may be duly registered, according to the provisions of this chapter."
In the State of Michigan, where registration is in successful O:Peration, compulsory measures are prominent features of the law, as appears from the following extract from the laws of the State relating to the record and return of births, marriages and deaths :
"SEC. 7. Every physician, surgeon or midwife, who shall have been in attendance upon any deceased person, shall, upon the application of any supervisor or assessor of the township, city, or any ward thereof, in which such death occurred, make out and deliver to such supervisor or assessor a certified statement, without fee,* containing the name of disease, or cause (if known), producing the death of such person ; and if any medical attendant, who shall neglect or refuse to give such statement, or who shall wilfully make a false statement in relation to such death, shall, for such

"'Italics ours.

STAtE BOARD OF HEALTH.

13

offense, be liable to pay a fine of not less than ten nor more than fifty dollars, and the cost of prosecution, which fine thesaid super~ visor or assessor is hereby required to sue for and collect, in his officiai character."
In the State of Massachusetts, where the registration laws have been so long a time in successful operation, penalty measures are in force, as will appear from the following from the laws concerning registration, etc., viz:
"SEc. 3. Any physician having attended a person during his last illness, shall, when requested, within fifteen days after the decease of such person, forthwith furnish for registration a certifi~ cate of the duration of the last sickness, the disease of which the person died, and the date of his decease, as nearly as he can state the same.
"If any physician refuses or neglects to make such certificatei he shall forfeit and pay the sum of ten dollars, to the use of the town in which he resides."
"SEC. Every Justice of the Peace, minister of the gospel, and all other persons authorized by the laws of this State to solemnize marriages, and clerks or keepers of records of the meetings in which any marriages among the Friends or Quakers, shall be solemnized, who shall neglect or refuse to make a record of such marriage, or to deliver to the county clerk of the county in which the marriage took place, a certified copy of such record, or who shall refuse, on demand, to deliver to the parties to such marriage the certificate thereof, as required by section two of this Act, or who shall wilfully make a false or fictitious entry in his record of marriages, or in the certified copy of such record delivered to the county clerk, or in the certificates of marriages delivered to the parties thereto, shall be deemed guilty of misdemeanor, and upon conviction thereof, shall be punished by fine not exceeding one hundred dollars, and in default of paying the same, shall be imprisoned in the county jail of the county in which such conviction shall be had, until said fine be paid, but not to exceed the period of ninety days."
In the State of Wisconsin (State Board of Health organized in 1876) we find the following in the law concerning the registrations of marriages, births and deaths, viz:
"SEc. 15. Any clergyman, Justice of the Peace, physician, or other person who shall neglect to comply with the provisions of sections two, three, four and twelve of this chapter, shall forfeit for such. neglect a sum of not less than fifty nor more than one hundred dollars."
Thus it would appear from our own short experience, and the 1lxperience of other States cited in the matter of vital and.l)lortu-

REPORT OF SECRETARY

ary statistics, that compulsory laws are not only!allowable, but

absolutely essential to success in registration.

The conclusion, therefore, is irresistible that the registration

law of our own State is essentially defective, and must remain

practically inoperative so long as its voluntary features exist.

As a remedy, then, we would apply the penalty measures to all

persons who have duties to perform under the registration law,

and we would have provisions made for the rigid enforcement of

such penalties. The forfeiture should be from ten to fifty dollars

for every violation of the law, upon the part of physicians, parents,

etc., the amount being proportioned to the gravity of the offense,

whether from ignorance, carelessness, wilful neglect, or actual

refusal.

Instead of the reports as now made by physicians directly to

the Ordinaries, I would suggest that we profit by' the experience

of Massachusetts, Rhode Island and Michigan in the matter of

registration, and require the returns of deaths and births to be

made by parents, next of kin, guardians, etc., these obtaining the

physician's certificate of the cause of death, the physician being

required to furnish such certificate when requested.

For neglect or refusal of the Ordinary to discharge his duties

under the law, the penalty should not be less than twenty, nor

more than one hundred, dollars for every violation. One-half of

all such forfeitures should go to the informant, and the other to

the county in which the offense occurred.

I would have the law provide for the report of all delinquents

to the State's attorney, and he be made responsible for the prose-

cution of all such delinquents so reported.

For all false entries and returns, tbe person or persons so making

them, should be chargeable with a misdemeanor, and indictable

under the law as such, and subject to fine or imprisonment.

The last session of the Legislature provided that the Ordinaries

should receive five cents per capita for registration of births and

deaths, but failed to specify the manner in which this was to be

paid. The five cents per capita for this work is not an adequate com
pensation. Five cents for registration and five cents for returns

I
l

(per copita) to the Secretary for births, marriages and deaths, is the minimum allowable upon any just basis. This is far less than is paid by any other State for registration.

l

I would suggest that the law should provide for their payment

for the future, and for the year past.

1

Each Ordinary Bhould have the certificate of the Secretary of

!

the State Board, as to the number of returns made, entitling them

to pay, and should receive pay for only those so certified to, I

STATE BOARD OF HEALTH.

15

would also suggest that the Ordinaries should receive the five cents per copita for all marriages, as well as for births and deaths, as no diffocence occurs in the amount of labor required in the records and returns. If, indeed, there is ::tny difference, it is in the greater amount of labor required in the record of marriages.
The Ordinary should be the principal agent for the collection of vital statistics. 'rhe chief responsibility should rest upon him, as in the State of Massachusetts the town clerks are made the almost exclusive agents for the collection of vital statistics in their respective townships. It is made "his duty to supply all deficiencies by carefully ascertaining every fact required by law, and not reported to him by others for registration. 11
The Ordinary should be required to keep a correct record of all marriages, births and deaths, upon blanks furnished, and in such manner, and at such time as directed by the Board, to transmit an exact copy from his records (upon blanks furnished), to the office of the State Board. He should be required to preserve the records of his office, and from time to time, as they accumulate, have them substantially bound and ixdexed, such binding to be done at the expense of the county. The copies from his records, sent to this office, should likewise be bound and indexed. This plan is recommended in place of the monthly returns made to this office on the small blanks. This would insure, always, an exact copy at this office of the Ordinaries' records. There should, at the same time, be kept at this office, the consolidated record, as at present,
Ministers, justices, and all persons authorized to perform the marriage service, should be required, under the law, to report all marriages occurring at 'their hands to the Ordinaries of the county in which such marriage occurred, within ten days after aU such marriages, upon blanks furnished (upon application) by the Ordinary, under the same penalties and forfeitures of physicians, parents and others.
HEALTH OF THE STATE.
Since our last annual meeting the State has been remarkably healthy, and free from epidemics, until the recent outbreak of yellow fever in the cities of Savannah and Brunswick.
In reference to this epidemic, I would respectfully suggest the appointment of a commission from this body, to take the subject under advisement and investigation.
I would suggest that this investigation be made at as early a day as may be thou~ht best calculated to subserve the purposes aimed at, and that it be as rigid and thorough as practicable. The result of such an organized and systematic investigation cannot be overestimated, in its importance and value to scienae, humanity,

16

REPORT OF SECRETARY

,and to the State. Should nopositive results be obtained, which, however, would doubtless be done, it is at least very certain that sufficient data would be gathered to prove valuable guides to future investigations. We must, at any rate, conclude that, if the cause and prevention of this terrible scourge and blight to our beautiful sea-coast cities is to be found, it must be by some such special organized investigation as the one proposed.
The Board should be empowered by the Legislature, to summon and examine witnesses, to devise such measures, and to expend such sums of money, as may be found necessary to carry out full:y the purposes and objects of such investigation.
COUNTY BOARDS OF HEALTH.
Comparatively few counties have reported the organization of their county boards of health. These are ,as follows: Campbell, Cherokee, Decatur, Dougherty, Echols, Effingham, Fannin, Fayette, Franklin, Fulton, Harris, Lowndes, Macon, Mitchell, Monroe, McDuffie, Pulaski, Randolph, Rockdale, Troup, Quitman-21.
Commissieners of roads and revenue and grand juries have sadly neglected the requirements of the law in this particular.
Some of the Ordinaries write us that the grand juries refused or failed to make appointments when requested to do so. ,
One Ordinary writes that the grand jury of his county failed to appoint a board because the foreman of the jury was opposed to it.
My opinion is, that it would be better for the appointing power
of these boards to reside in the State board, and that they be in the entire control of the State board.
The past year has demonstrated that the commissioners of roads and grand juries feel no interest in the m&tter, and in most of tbi:l counties have failed to appoint the boards, and, in some instances, after being requested by the Ordinaries to do so.
Were the appointing power in the State board it would be in charge of a body appreciating their importance, and of course greatly interested in their organization and working capacity.
Again; in some instances, boards have been appointed which have manifested no interest whatever in the purposes of their organization, and, indeed, in some instances, have manifested actual opposition to the entire machinery of State medicine.
It is, of course, desirable, under such circustances, that such boards be reorganized, and the State board should be authorized to do so at its discretion.
I am convinced, from our experience so far, that this is the only means by which we can hope to have efficient health boards in all the counties. We should have bad, by prompt compliance with the law, county boards in our sea coast counties that have b~en so scourged by an epidemic of yellow fever. They could, perhaps, have

STATE BOARD OF HEALTH.

17

done but little to stay the progress of the epidemic after its outbreak, and it would, ofcourse, have been improper for them to have instituted investigations during its prevalence, which would have necessitated the opening or disturbance of sources of atmospheric contamination, but they would have been in positions to have observed its commencement and watched its progress, and thus been of material aid to such investigations as might, at the proper time, be instituted.
Since our last annual meeting the following circulars and letters have been issued from this office, viz :

TO THE ORDINARIES OF THE RESPECTIVE COUN'l'IES.
OFFICE OF STATE BOARD OF HEALTH, } ATLANTA, GA., March 20th, 1876.
Dear Sir-The Legislature, at its recent session, amended the Act creating the State Board of Health as follows, viz : ".AN ACT to amend an act to create a State Board of Health for
the protection of life and health, and to prevent the spread of diseases in the State of Georgia, and for other purposes, approved February 25, 1875.
"SECTioN 1. Be it enacted by the General .Assembly of the State of Georgia, 'fhat so much of the 11th section of the act entitled an act to create a State Board of Health for the protection of life and health, and to prevent the spread of diseases in the State of Georgia, and for other purposes, approved February 25, 1875, as imposes a penalty of ten dollars upon physicians, be, and the same is hereby, repealed.
"SEc. 2. Be it further enacted by the authority aforesaid, That so much of the 12th section of said act as imposes the penalty of ten dollars on parents, is also hereby repealed.
"SEc.. 3. Be it further enacted by the authority aforesaid, That for making the record of births and deaths, as now required by law, the Ordinaries of the several counties of tl:lis State shall receive five cents for each person so registered.
" SEc. 4. Be it further enacted by the authority aforesaid, That county boards of health are hereby created, to consist of the Ordinary, who shall be ex-officio a member of said board, and two practicing physicians, to be chosen by the commissioners of roads and revenue, in those counties where such commissioners are allowed by law, and in other counties by the grand jury of the first term of the court held after the passage of this act, and th~ term of office of the members of said county boards shall be the same with the Ordinary.
2

18

REPORT OF SECRETARY

"eEc. 5. Be itfurther enacted by the authority aforesaid, That the Ordinary of each county shall be ex-officio Secret>try of the county board for his county; and said board shall correspond with, and report statistics to, the State Board of Health, through its Secretary, giving special attention to gathering statistics in accordance with the provisions of the act of which this is amenda-
tory. "SEc. 6. Be it fu1ther enacted by the authority aforesaid, That
said boards shall have supervision of the sanitary condition of their counties respectively, subject to the direction of the State Board of Health.
"SEc. 7. Repeals conflicting laws."
Thus it will be seen that the Ordinaries are entitled to the pay of five cents per capita for the registering of all cases of births and deaths.
I t will be seen, also, that the law, as amended, requires the organizRUon of county boards of health in each and every county in the State, and !hat the Ordinaries of their respective counties are ex-officio members and secretaries of the boad. We would be glad if you would bring this part of the act to the notice of the commissioners of roads and revenue, and to the grand jury in case of no such commissioners in the county, and urge the early appointment by them of the physicians who are to constitute, with you, the county board of health. So soon as the appointments are made, we would respectfully urge that you convene the board for ihe purpose of organization, and that such action be reported to this office as soon thereafter as practicable.
The couuty boards, as you perceive by the law, are auxiliary to the State board, and are intended to operate under its immediate supervision and direction.
The annual reports to the Governor from this office, and through him to the Legislature, and to the whole country, will contain a clear exhibit of the work done by each Ordinary, and by each county board. It is earnestly hoped that your county will be found among those doing their full duty, as required by the law. The physicians constituting, with you, this county board, will, of course, use their best and most industrious efforts to aid you in gathering full returns of vital statistics, and we are confident will do their whole duty in getting full returns made to your office by physicians and others whose duty it is to make them.
The eounty board, in its organization, should pass such rules as would secure its meeting at stated intervals-say once in two or three months, as may be thought best. At these stated meetings, special reports should be made relative to the health of the county, the prevailing diseases, and causes, if known, of such diseases,

STATE BOARD OF HEALTH.

19

together with the proposed measures for the removal of such causes.
Any epidemic, or unusual prevalency of disease, should engage the attention of your board, and should constitute the subject of a special report to this office.
The board should especially consider the matter of vital statistics in the county, taking cognizance of, and using their best endeavors to remove any obstacles in the way of gathering these vital statistics.
There should be made to this office, promptly by the 1st of September of each year, your annual report. This report should show the difficulties, if such exist, to the collection of vital statistics, and your proposed remedy for these difficulties. It should also show what diseases have most largely prevailed, together with any known local cause of such diseases, and the proposed measures for the removal of such causes.
It is earnestly pressed and expected that you will interest yourself in the efficient organization of your county board of health, and that you may be the means of keeping your people informed as to their relative health status, and the existence and causes of any unusual death rate.
We send you consolidated blank forms for the making of your returns of vital statistics to this office, in place of the separate forms you have been sending heretofore. These, as you perceive, will greatly lessen ycmr labors, also the amount of postage necessary for mailing your returns. Each of the consolidated forms, as you will see, is for two months; blank spaces being left in the heading at the top for the name of the county and for the two months, and also for the names of the months between the lines on the left. In the report for deaths, the names of the diseases are to be written in the blank spaces under "Cause of Death." In order that you may thoroughly understand the manner of filling out these returns, we send you a blank partially filled. The consolidated report to this office, which should be made every two months, must of course be made from your register, kept in your office, and upon which you register all returns made to you by physicians and others.
Yours, very truly, V. H. TALIAFERRO, M. D., Secretary State Board of Health.
TO THE MEDICAL PROFESSION OF GEORGIA.
OFFICE STATE BoARD OF HEALTH, } ATLANTA, GA., Aprill7, 1876,
The inauguration of sanitary medicine in Georgia embraces the collection of the vital statistics of the State. This trust is confided

20

REPORT OF SECRETARY

to the med,ical profession. A comparatively short time will determine if this trust has been misplaced.
The Ordinaries of their respective counties are made the media of communication from the profession to this office. From some of these Ordinaries who are making but partial returns, and the few who are making no returns at all, complaints are made that the physicians, although furniflhed with blanks and solicited to do so, make no reports to them-thus throwing the responsibility of failure upon the physicians of their counties.
The Legislature, at its recent session, repealed that part of the act creating the State Board of Health which imposes a fine upon physicians for failure to make returns of births and deaths. It was claimed that this feature of the law was offensive, and that the law would be more fully and cheerfully complied with if left to their own voluntary convictions of its importance.
By the meeting of the next Legislature, time will have determined the wisdom of this clmnge in the health law, or the necessity of additional changes for it'l perfection. 'rhe law itself is a step forward in advanced statesmanship and civilization, and hence may be regarded as a permanent fixture. There will be and can be no retrograde move in a matter so vital to the State's interest. One of the chief and most difficult problems in sanitary medicine is the collection of vital statistics, and it was to further this purpose alone that tlle law has been amended, and the compulsory clause abolished. If the law, as it now exists, sllould still prove inefficient, then additional legislation (whether of a compulsory character or not rmnains to be ,;een) will be necessary for the fulfillment of the important purposes aimed at.
A prominent feature of the health laws in the other States in which vital statistics are collected, is a penalty for non-compliance in the reporting of cases. Let us hope and trust that the confidence of our people in the profession of this State has not been misplaced, and that it will not be necessary to resort to the penalty measure, as in other States, to insure the returns of births and deaths.
It is true that the filling of blanks, and retul'ning them to the Ordinary, is attended with some little trouble and inconvenience, but it is a dut.v now not only to the laws of the State, but a duty also to humanity and to science.
Cannot the medical men of their respective counties contribute this mite for the purpose of determining the death-rate of their people, their relative mortuary percentage as compared with other portions of this State and other countries, and also the character of diseases most conducive to this death-rate? Is it worth nothing
to a people to know when they are dying too rapidly, and to

STATE BOARD OF HEALTH.

21

know if the causes of such increased death-rate are remediable?

It is now known that quite a large number of our most fatal dis-

eases are preventable by sanitary measures. We can ascertain

what these diseases are, and the extent of their fatality, only by

carefully collected vital statistics, and thus be enabled to take

steps and devise measures to effectively lessen the rate or percent-

age of deaths.

.

We appeal to the medical men of the State, of all sects and

schools, in behalf of the law, of the people, of humanity and of

science, to come squarely up to the demands made upon them,

and make punctually and faithfully their reports of births and

deaths to the Ordinaries of their respective counties. When once

accustomed to this duty, it will cease to be onerous. Carry con-

stantly about the person one or two blanks, fill these out as occa-

sion may require, and return them to the 0Tdinary. If the blanks

cannot be completely filled, either from inability or from consci-

entious objections, fill them as far as may be, and so return them.

By far the most important item connected with vital statistics, is

the fact that a birth or death has Qccurred. It is, of course, de-

sirable to have the report as full as called for by the blanks, but

when this cannot be done, let it be remembered that it is still val-

uable, and important to be returned, however meagre in its details. Have we a justifiable excuse for not making returns when we

say that we have no faith in the results 9 Is any excuse tenable,

when the fact remai.ns that the people of the respective counties

have called on the medical profession, through their representa-

tives, to do this gratuitous work-looking as it does to the amelio-

ration of sicknes& and suffering in their midst, and to a decrease

of their death-rate? The combined wisdom of the medical profession of this country,

and of the countries of the old world, are agreed as to the inesti-

mable value of vital statistics, especially in their relation to the

percentage of mortality in communities; and that it is in fact the

only efficient means by which the death-rate of the people may be

surely and markedly decreased. In pursuance of the recent amendment to the health-law, author-

izing the organization of county boards of health, there will soon be a board of health in every county in the State, having its ex-

istence by authority of the Legislature, and working under the

direction of the State Board of Health. These boards are impor-

tant sanitary bodies, and it is earnestly hoped that the medical

men of the respective counties will do all in their power to aid

them in their labors, and thus subserve the interests of the people of their counties, and of the State at large.

V. H. TALIAFERRO, M.D.,

Secretary of the State Boad of Health.

22

REPORT OF SECRETARY

TO THE COUNTY BOARDS OF HEALTH.
OFFICE OF STATE BoARD OF HEALTH, } ATLANTA, GA., August 15, 1876.
To the Ordinary of--County, Ex-officio Secretary ofthe County Board of Health:
DEAR SIR-A circular of instructions to the county boards of health would have been much earlier issued, as was intended, but for the_slow process of organization in a large number of the counties.
We had hoped, and indeed expected, that before this every county in the State would have fulfilled the measure of the law, and had their boards organized and in full working order. In thi'l we have been disappointed, though the failure may have been unavoidable. We take the Uberty now again to call upon the Ordinaries (ex-officio Secretaries of the boards) to use their best endeavors to have their county boards organized at the earliest practicable time, and report such action to this office; and in case of failure, to report the. cause or such failure.
At the annual meeting of the State Board in October next, a report will be made showiRg the status of the county boards. May we hope that no county will appear as a delinquent in the fulfillment of this law?
In reference to the more important duties of the county boards, we would call y&ur attention :
1. To the collection of vital statistics. 2. To epidemic, endemic, or any unusual prevalence of disease. 3. Special sources of disease - a.s vegetable, animal or excrementitious decompositio:n.. 4. Contaminated water supplies. 5. Rules and regulations of county boards. 6. Annual report of the county boards to the State Board of Health. The collection of vital statistics should constitute the paramount object of the Board. Every available means should be used to stimulate those whose duty it is to make reports, to the discharge of their duty, and, in case of failure, the causes inducing such failme should be carefully studied and noted, and the facts thus observed and gatJ1ered embodied in the annual report of the Board to this office. Should any county be visited by an epidemic or endemic, or any unusual disease of malignant type, it should be made the subject of earnest study, and investigation by the board, and, as far as possible, the causes of such disease determined. All facts gathered in reference to such matters should be embraced in the annual re-

STATE BOARD OF HEALTH.

23

port of the board to the State board. Should such epidemic or prevailing disease be considered alarming in character, then it should be made the subject of a special and immediate report to this office.
The class of zymotic diseases, the board should carefully study and observe, with reference especially to causes and preventive measures. Any facts worthy of record thus observed should be embodied in the annual report to this office.
Diseases of a malignant type can frequently be traced to their legitimate sources, as in vegetable, animal and excrementitious decomposition. Indeed, these are the sources from which comes poison to our atmosphere and our water supplies, inducing the large class of malarial disorders, typhoid fevers, dysentery, cholera infantum, etc.; diseases to which are attributable a large percentage of our mortality, and which are largely, if not absolutely, preventable, especially their more epidemic or malignant types.
The sources of prevalent diseases in the respective counties, as far as can be ascertained, should appear in the annual reports.
The annual report of the county boards to the State Board should be made promptly by the 1st of September next, and annually thereafter. These reports should embrace, in addition to special matters already mentioned, all sanitary measures adopted or proposed by the board for the prevention of disease or the iip.provement of the health of the peoplfl.
The county boards shol'ld pass such rules and regulations as would secure regular meetings at stated intervals. The work of the board should be systematized, so that definite duties may fall to each member.
It is earnestly hoped that these boards will take a positive and active interest in the purposes of their organization, both in the matter of vital statistics and sanitary medicine, and that we may have, as a result of their labors, a marked decrease in the sickness and the mortality of their respective counties.
Very respectfully, V. H. TALIAFERRO, M. D.,
Secretary of the State Board of Health. N. B.-File this circular for future reference.

CIRCULAR LETTER TO THE ORDINARIES WHO HAVE SO FAR FAILED TO MAKE RETURNS TO THIS OFFICE OF VITAL STATISTICS,
OFFICE OF THE STATE BOARD OF HEALTH, } ATLANTA, GA., January 12th, 1876.
1b the Ordinary o f - County:
DEAR SIR-We have failed, so far, to receive any returns from

24

REPORT OF SECRETARY

you of the vital statistics of your county, as required by law to be made by forms furnished you from this office.
We trust you will use your best endeavors to have returns made to you by physicians and others. As they become accu;;tomed to the work, and get to understand the purposes to be accomplished, they will become interested, and cease to regard it as onerous We trust you will give us your important and necessary aid in getting the work under way.
We believe the Legislature will make provisions for your remuneration, and in the meantime, we will be glad to get your returns, that we may not be compelled to report at our next annual meeting no returnsfrom your county. 'l'he published reports will make a bad showing for the counties making no returns, as the people are interested in the relative death rate and birth rate in these counties.
Let us hear from you and oblige, Yours, very truly, V. H. TALIAFERRO, M. D., Secretary of State Board of Health.

CIRCULAR LETTER TO THE SEVERAL HEALTH COMMISSIONERS.
OFFICE STATE BOARD OF HEALTH, } ATLANTA, GA., March 20th, 1876.
MY DEAR SIR-The Act creating the State Board of Health, as amended by the Legislature, at its recent ~:>ession, requires the organization of county boards, which are "to consist of the Or<linary, who shall be ex- officio a member of said board, and two practicmg physicians, to be chosen by the :commissioners of roads and revenues in those counties where such commissioners are allowed by law, and in other counties by the grand jury of the first term of the court held after the passage of this Act, and the term of office of members of said county boards shall be the same with the Ordinaries."
It is important that these boards should be organized as soon as possible, and that they be composed of the best men in their respective co1mties. We would be glad if you would interest yourself in this matter, and use your influence in your district to accomplish this end.
We believe many physicians do not appreciate how essential full and complete reports of vital statistics are to the usefulness and valuable results to be attained by our board; and are, therefore, indifferent, and fail to report many of their cases.
We would suggest the propriety of your issuing a circular to the physicians of your district, showing them the responsibility rest-

STATE BOARD OF HEALTH.

25

ing upon the profession in this matter, the importance to humanity and science of vital statistics, and urging them to report every case of birth and death, and as o;oon after their occurrence as possible.
The penalty, as you know, of a failure to comply with the law has been repealed, and we have, therefore, to depend entirely upon the liberality and voluntary co-operation of the profession for its execution. We are of the opinion that such a circular issued by you would be of far more service than any appeal from this office, as it would be brought more directly home to them by one whom they know and can appreciate. Would suggest that this be done as speedily as possible.
Unless we work hard in this matter, our vital statistics will be a failure under the law as at present. Let each of' us, then, do all we can to inform medical men as to their duty. Let us do this, not only once, but continuously, and we are confident that opposition will yield, and inte:est in the results gradually grow.
Yours, very truly, V. H. TALIAFERRO, M.D., Secretary 8tate Board of' Health.
The following important commuications have been addressed to the board in reply to letters asking for facts in reference to the value and results of vital statistics:
LETTER FROM HENRY B. BAKER, M. D., SUPERINTENDENT
OF VITAL STATISTICS OF MICHIGAN.
V. H. TALIAFERRO, M.D.: Dear Sir-In rm;ponse to yours of the 5th instant, requsting
statements of statistics, etc., bearing upon the utility of measures for promoting the public health, I send you the statistics and com- putations following, which I have entitled:
THE MONEY VALUE OF HEAL'.rH IN A STATE.
It may seem hardly humanitarian to deliberately count the money value of life and health to a people of a State, but money represents much for hurnan happiness, and the old and true maxim that "public health is public wealth," indicates that the public care more for the wealth which health brings them than for the health abstractly considered.
In the United States census of 1870, some of the great masses of figures, which go to make up the vital statistics, are condensed on page 3 to show the death-rates in the several States. Selecting the two States-Georgia and Michigm-lct us make some comparisons for the years mentioned in t~e table. \Ve must admit at the outset that the st::ttistics do not take into account the ages of the inhabitants and of decedents, therefore the difference in the
..

26

REPORT OF SECRETARY

death-rates may be due to differences of this nature. These are however, the best statistics now published, and it has been held by some that they m::ty be used as such, while insisting upon the necessity for better statistics.
In Michigan the death rate is shown to have been decreased at each succeeding census exhibited in the table. In 1850 it was 1.14, in 1860 it was .99, and in 1870 it was .94 per cent. These seem to be very insignificant figures, having only minute differences, but, if they are ttue, and not due to differences in age of inhabitants, they imply an amount of human suffering, and an amount of loss, or prevention of loss, of money, which is worthy of very serious consideration by the State. Let us see what the apparently sli.ght differences mean in deaths, in cases of sickness, and in dollars and cents. If the death rate had been the same in 1860 that it was in 1850, the deaths would have been 8,540 instead of 7,401, as appeared by the census of 1860. Here was a decrease of 1,139 deaths in a single year. It has been estimated that there are at least twenty cases of serious sickness to every death. At this rate there was a saving of 22,780 cases of sickness in a year. If it be estimated that each case of sickness costs on an average only forty dollars for medical attendance, medicines, nursing, loss of time, etc., there was a saving of $911,200. The expense of funerals, and burying of the dead, at a moderate estimate of twenty dollars each, would be, for 1,139 decedents, $22,780. Add the expenses for sickness, we have nine hundred and thirty-three thousand nine hundred and eighty dollars ($933,980) in money saved in a year, as the difference between a death rate of 1.14 and .99 per cent. in 1860, in Michigan. If the death rate bad been the same in 1870 that it was in 1850, the deaths would have numbered 13,498 instead of 11,181, as returned. The saving in human lives was thus 2,317 in a single year. At the rate above mentioned the saving in sickness was 46,340 cases. The amount of human misery thus avoided is incalculable; but at the previously mentioned rate the saving in money amounted to $1,853,600 for expenses in sickness and $46,340 for funeral expenses, making a total of $1,899,940 saved in one year, because ot a death rate reduced from 1.14 to .94 per cent., for the year ending June I, 1870. In 1871, Michigan provided for the erection of a new capitol, to cost about $1,000,000. The money saved in one year because of the lessened sickness and mortality, as above computed, was very nearly enough to build two such buildings.
There must certainly have been some cause of this decreased mortality, and although it is difficult to estimate bow much was due to each of the various influences known to have been at work, and bow much to influences at present unknown, we may believe

STATE BOARD OF HEALTH.

27

that it may have been due, in great part, to the improved sur-

rounding conditions, which had been modified largely through the

individual exertiOI'lS of an intelligent people, but also through wise

measures fostered by the State, among which may be mentioned

the drainage of swamps, marshes and other wet lands, the estab-

lishment of a system of vital statistics which has served to attract

attention to subjects relating to health, and finally the establish-

ment of a State Board of Health; all of which measures are ex-

pressions by the people of a desire to have the State to perform its

highest functions, namely: to protect the lives and health of the

people who constitute the State, and who furnish the material re-

sources for its maintenance.

Turning, now, to your own State of Georgia, we find that in

1870 the number of inhabitants was almost precisely the same as

in Michigan, (Georgia 1,184,109, Michigan 1,184,059,) but the

death-rate was 1.15 per cent.; nearly the same as it was in Michi-

gan in 1850, being more than it was in Georgia in 1850, when it

appears to have been 1.10 per cent. I cannot pretend to estimate

the cause of the apparent increase, but can compute its value by

the method just employed. We find that if tlle death-rate in

Georgia had been tlle same in 1870 as in 1850, the deaths, instead

of being 13,606, would have been 13,025, or 581less. The increase

of cases of sickness was, therefore, (at above rates,) 11,620. The

increased cost of sickness was $464,800, and of burying the dead,

$11,620, making a total of $476,420 for a single year.

The fact that the death rates have, at different times, been about

the same in two States, may be an indication that the lessened

death rate in Michigan, in later years, is not altogether due to

natural advantages of climate, etc., but may be partly due to the

same intelligent forethought of the people, which has found ex-

pression in State laws for the drainage of swamps, and the promo-

tion of research into the causes and methods of preventing sick-

ness and death. Whether this is true or not, the facts are that

Michigan established a system of vital statistics in 1867, and a

State Board of Health in 1873, and I believe Georgia has not yet

established a system of vital statistics, although it organized

a State Board of Health in 1875. As to the comparative amounts

of land drained through State action, I am not informed, but on

examination of the index of the revised Code of Georgia, published

)n 1873, I find no mention whatever of drainage of lands, of rec-

ords of death, vital statistics, public health, or even of local boards

of health, all of which are common words in our compiled laws of

Michigan.

...

If the death rate in Georgia in the last census year, 1870, had

been that of Michigan at the same time, the number of deaths

28

REPORT OF SECRETARY

would have been 11,130 instead of 13,606, as reported, a difference of 2,476 death~, representing 49,520 cases of sickness, costing $1,980,800, which, added to $49,520, cost of burying the extra number of dead, would make a total of $2,030,320 in a sigle year lost to the State of Georgia, through the difference between a death rate of 1.15 per cent., and one of .94 per cent.
I trust you will go over my figures and estimates carefully, and if any error or wrong estimate can be found, that you will make all proper modifications ; after which I am entirely certain that you will find ample evidence of the importance of this subject to the people of your State, to warrant. your Legislature in devoting a large share of its time and energies to this subject, with a view of taking action in various ways whereby, through the expenditure of amounts of money, counted perhaps by thousands, measures may be inaugurated in your State which will result in saving to your people millions of dollars in money, and what is vastly of more importance, though not much mentioned in this communication, will result in preventing thousands of deaths and cases of sickness, which would involve an incalculable amount of human suffering.
In closing, allow me, with feelings of heartfelt satisfaction, to congratulate you upon the inauguration of a State Board of Health in Georgia. I take this as an indieation that the people of your State are alive to their highest earthly interests, and that your Legislature is sufficiently intelligent toactout this the highest function of a government, to do its utmost towards the protection of the lives, health and happiness of the people whonht represents.
Very respectfully, HENHY B. BAKER,
Supt. Vital Statistics of Michigan. LANSING, MICH., February 9, 1876.

The above letter makeR an important and suggestive showing for Georgia. 'Vith a population about equal to that of Michigan, her death rate in 1870 was 1.15 per cent., while in Michigan it was for the same year .94 per cent.
In climate our State possesses essential ud.vantages over that of Michigan, and her death rate should be as much le:ss as it is in excess of that State.
While the rate of mortality in Georgia steadily increased from . 1850 to 1870, in Michigan it steadily decreased for the same time.

STATE BOARD OF HEALTH.

29

LETTER FROM D. W. BLISS1 M. D. 1 BEGISTRAR OF VITAL STATISTICS IN THE DISTRICT OF COLUMBIA.

DISTRICT OF 00LULBIA1

}

BOARD OF HEALTH, OFFICE OF REGISTRAR,

WASHINGTON, April 31 1876.

DEAR DocTOR-Your favor of February 5th, 18761 lies upon my table unanswered, and I offer as an apology the extraordinary de-

mands, professional and official, upon my time since its receipt.

Fully realizing the value and importance of its subject-matter

to your people and the general public, I am pleased to furnish the

information requested, and trust it will not be too late to serve

the purpose for which it is desired. The value to aggregated com-

munities of sanitary Grgans, clothed with adequate authority,

executed with vigilance, has been fully exemplified, especially in

this District, as exhibited in the remarkable reduction of the

death-rate from zymotic, or preventable maladies.

Since the enforcement of the recent act of Congress, (viz.: since

August 1, 1874,) an absolutely correct record of deaths has been

obtained in this District, and exhibits the gratifying fact, that a rigid

enforcement of the wholesome sanitary regulations of our organi-

zation has reduced the death-rate from preventable diseases, at

least one-third below that of any locality in this country, where a

correct registry is obtained. In making this statement, my

opinion is in no wise prejudiced by reaso11 of my official connec-

tion with the health department of this District, but the fact is

borne out by the exhibit in the mortality tables of the more prom-

inent cities of this country, very few of which secure an abso-

lutely correct record of deaths and interments. As regards expen-

ditures for sanitary purposes, in this District, in my judgment

they are merely nominal, when compared with the services per-

formed, and the substantial result obtained. The appropriation

for sanitary measures, in this District, (with a population of

160,000,) fur the present year, was $52,000, which is disbursed as

follows, among Lhe more prominent branches of our service, viz. :

For the registration of births, marriages and deaths, which re-

quires the constant supervision of one member of the board, (the

Registrar,) the services of three clerks, whose salaries aggregate

$3,800 per annum, and the purchase of books of record, blanks,

stationery, printing, postage, etc., etc., at an expense of $21500 per annum.

This will not seem such an extraordinary expenditure, if it is

taken into consideration that $1 1700 of this latter amount was for the purchase of books of record, permits and blanks, which will last

this office three years, and for the printing of circulars of various

kinds to physicians, undertakers, superintendents of cemeteries

30

REPORT OF SECRETARY

registrars of other cities, etc., etc., in order to secure a perfect system of registry, and I may be pardoned for saying, that I believe we have the most perfect system in this country.
For the thorough daily inspection of the streets, avenues, alleys and private premises of the entire District, which requires a force of nine Sanitary Inspectors, at an annual salary of $1,200 each ; the daily inspection of all articles of food exposed for sale in the public markets, and" green groceries," which requires theser rices of three expert Food Inspectors, at an annual salary of $1,200 each; the daily inspection of all marine products brought to this market for sale, which requires the services of one Inspector, at $1,200 per annum; the dis~harge of the duties imposed upon the Board by Congress, of preventing domestic animals from running at large, which requires the service of one Pound-master, at a salary of $1,200 per annum, and an average force of four men, together with horses, wagons, and other incidentals, at an annual expense of $3,000, not including the salary of Pound-master; the supervision of the collection and removal of an average of sixty tons of offal daily, (including human excreta, garbage and dead animals,) by rail, to a point twelve miles distant from the corporate limits; the supervision of the medical service for the poor, and the purchase of medical supplies for the same, which includes the1appointment of nine physicians and twelve apothecs,ries to the poor, and the weekly examination of their reports, which must indicate a judicious expenditure, by the accompanying prescription as a voucher. The proper supervision of this entire service requires an executive officer, designated Health Officer, who receives an annual salary of $2,500. It is the duty of this officer to execute the, ordinances and regulations of the board of health, taking personal supervision of the entire force of inspectors, examining daily their reports, and to make daily personal inspections to verify the same. This duty occupies the entire time of the officer, and, as you will readily appreciate, requires extraordinary capacity and qualifications. In addition to the general supervision of this service, it is his duty, through the Medical Sanitary Inspector, to investigate and report to the Registrar, as to the cause of death, in all cases when deaths occur without the attendance of a physician, except such as require the official action of the Coroner, and to investigate the pecuniary condition of persons who apply for the burial of their friends at public expense. To properly perform the duties imposed, and keep suitable record of the same, he requires a clerical force and a Medical Sanitary Inspector, whose salaries aggregate $5,300 per annum. The Board also employs a Chief Clerk, at a salary of $11500 per annum, and three messengers, whose salaries aggregate $960.00.;per annum. The Board is composed of five members,

STATE BOARD OF HEALTH;

31

who receive a salary of $2,000 each per annum. For more special

details of the service, and its sanitary results, I respectfully invite

your attention to our fourth annual report, which I this day for-

ward to your address. You make reference to the death rate, as

exhibited in my report for 1874, which is incorrect, as I state in

the report, (vide page 79,) and by the chart accompanying, it

will be seen that for only two months, viz., August and Septem-

ber, of the year, a correct record was secured under the Act of

Congress now in force in tllis District. For the future, as from

August 1st, 1871, reports of the death rate will be based upon an

absolutely COl'i'Pct recod of de::ttll, Rild the effective results of the

sanitary labor of ovr boRrd will be fully demon~>tra;ed. By refer-

ence to my report of 1875, you will be able to secure all the salient

points relative to the death rate in the District of Columbia during

the past year, and by reference to table No. 12, a comparative

statement of the death rate in the more prominent cities of this

country, wllere exhibits of the death rate is believed to be approxi-

mately correct. It is proper, however, in this connection, to state

that it is believed by statisticians best advised, that the District of

Columbia and the city of New York, are the only localities in the

United States, where an absolutely correct record of deaths and

interments of the dead is secured. In view of tllis fact, it will be

seen that statements of the mte of mortality in cities other than

those named, would necessarily lead to error, such as is exhibited in

our own reports, prior to the execution of the comprehensive 1aw

of Congress now in force in this District.

You will readily appreciate the fact, that statistical exhibits are

only valuable as they are positively reliable. Hence I believe, as

I have heretofore stated, that it is the first great luty of sanitarians

throughout this country, to endeavor to secure the enactment and

enforcement of suitable legislation, looking to the demonstration

of the value of intelligent sanitary labor for the promotion of

health and the pre.;ervation of life. In view of the recognized

fact, that the first and most important duty of a government is to

provhle for the health and lives of its people, I join with you in

pleading with your Legislatme for the preservation of an organ

wisely instituted for the promotion of this most important interest.

Very respectfully,

D. W. BLISS, M. D.,

Registrar.

The following new forms have been issued to the Ordinaries, for use in making returns to this office:
1st-Form for report of births. 2d-Form for report of marriages. 3d-Form for report of deaths.

32

REPORT OF SECRETARY.

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36

FINANCIAL STATEMENT

V. H. Taliaferro in account with the State Board of Hea 7tlz.

Dr.

1875--Nov. 25. To executive warrant........... $ 79 00

Nov. 25. To executive warrant........... 200 00

1876-Jan. 15. To executive warrant........... 8 25

Jan. 21. To executive warrant........... 5 50

Feb. 10. To executive warrant........... 22 30

March 2. To executive warrant........... 35 75

March 11. To executive warrant........... 87 28

March 27. To executive warrant.......... . 49 00

April 7. To executive warrant.......... . 250 00

April 22. To executive warrant.......... . 19 00

July 6. To executive warrant.......... . 250 00

Aug. 12, To executive warrant.......... . 10 00

Oct. 5. To executive warrant.......... . 250 00

Oct. 11. To executive warrant.......... . 28 70--$ 1,294 78

Cr.

1875--Nov. 25. Paid for moving office.......... 5 00

Nov. 25. Paid express on returns......... 1 00

Nov. 25. Paid traveling expenses ofDr.

G. F. Cooper................... 20 00

Nov. 25. Paid traveling expenses of Dr.

B. M. Cromwell ............... 30 00

Nov. 25. Paid traveling expenses of Dr.

F. A. Stanford ............... 23 00

Nov. 25. Paid on salary .................... . 200 00

1876--Jan. 15. Paid for desk for office .......... 8 25

Jan. 21. Paid express on returns ........ 5 50

Feb. 10. Paid on salary ..................... 22 30

March 2. Paid express on returns .......

85

March 2. Paid express on returns ....... 1 00

March 2. Paid postage on returns.......

48

March 2. Paid express on returns...... .

25

March 22. Paid postage on returns ...... .

22

March 2. Paid P. 0. Drawer rent for

first quarter, 1876............ 300

March 2. Paid for 150 ten cent postage

stamps .......................... . 15 00

March 2. Paidfor500onecentstam.ps... 5 00

March 2. Paid for stationary.............. . 9 95

March 11. Paid on salary .................... . 87 28

March 11. Paid on salary ..................... 50 00

March 27. Paid for 6,000 forms for ordi-

naries ..................:.......... 35 00

March 27. Paid for 1,ooo;3-page circulars 10 00

STATE BOARD OF HEALTH.

37

March 27. Paid for 1,000 printed envel-
opes ............................... April 7. Paid on salary.................... . April 18. Paid on salary .................... . April 22. Paid for printing 3,650 circu-
lars ............................... . April 22. Paid express on returns ........ April 22. Paid for 500 one cent stamps May 19. Paid on salary .................... . July 6. Paid on salary .................... . July 27. Paid on salary ..................... Aug. 12. Paid for 300 one cent stamps Aug. 12. Paid for P. 0. Drawer, rent
third quarter, 1876.......... Aug. 12. Paid for printing 500 circulars Sept. 1. Paid on salary .................... .. Oct. 5. Paid on salary ...................... Oct. 11. Paid expenses ot Dr. Crom-
well, attendingmeetingof Board ........................... ..

4 00 200 00 25 00
12 75 1 25 5 00 100 00 125 00 125 00 3 00
3 00
4 00
50 00 75 00
28 70--

Expended from organization of Board to

$ 1,294 78

1st Report, Oct. 12, 1875......................... $ 1,198 70 Expended from 1st report to 2d report,

Oct. 12th, 1876....................................... 1,294 78

Amount remaining from 1st report............

$ 301 30

Amount appropriated by last Legislature..

1,500 00

Amount remaining subject to Board,

Oct. 12th, 1876.......................................

506 52

All of which is respectfully submitted.

V. H. TALIAFERRO, M. D.,

Secretary Board of Health of the State nf Georgia.

TABLE OF BIRTHS.
Showing the Total Number< f Births in the State, and in each County, also Color, Sex, Place of Birth, Nativity of Parents, Number of Twins, Premature, Still-born and Illegitimate,- from Sept. lst, 1875, to Sept. 1st, 1876.

COLOR.

SEX.

II I'AfL:ICRETHO.il.'

~ NATIVITY OF PARENTS. ~ No. OF TWINS.

II White. I Black. 1

l I I II Father. I Mother.

White. Black.

.

~ I.I~" '" """""' " "" .. "' " ~ ~0 zl ~ -~-)i~ll j ~ TOTAL I" STATE...............

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2,196]1,7041 4921 ... 1 9071 7771 2461 227139 56811,6201 sl]2,o8ol

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i8 51

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1 ... 72

1 ...

0

Burke......................................

5 4 1 ... ~ 2 I ...... ... ......... 5 ...

5 ........ ... 5 ............

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Butts........................................ Calhoun.................................... Camden.................................... Campbell................................ Carroll......................................

2 2 ...... ...

1 ...... ...... ... ......... 2 ...

7 7 ......

4 3 ...... ...... ... ......... 7 ...

7 7 ...... .. 5 2 ...... ..... ... ......... 7 ...

38 35 3 ... 15 17 I 2 3 ......... 38 ...

97 94 3 ... 49 45 2 1 ...

68 28 1

2 ......... ...
7 ............1 7 ......... ... 38 ............ 97 ............

2 ............

7 ............

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97 ............

1

21 3, ...

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Catoosa .................................... 23 2? I ... 13 9 . . . I . . ......... 23 ... 23 .........1... 23 ............

Chatham.................................. Chattooga.......... ....................... Cherokee................................ Clarke...................................... Clay......... ......... .......................

85
115 8
11 9

68 17 ... 33 35 12 5 ...

78 7 ...

94 21 ... 39 46 14 8 8 ......... 115 ...

8 ...... ... ' 3 ...... ...... ...

3 5 ...

9 2 ... 7 2 I I ...

I 10 ...

6 3 ... 4 2 ...... 2 I ......... 9 ...

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10o ......... 10 113 .........

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Coffee....................................... Colquitt.................................... Decatur.................................... Dougherty .................................
Early....................................... [ Effingham................................ Elbert....................................... Fannin.....................................

3 3 ...... ... 1 ........ 1 ... 9 9 ...... ... 16 12 4 ...
8 7 1 ... 21 20 1 ... 9 8 1 .. 8 8 ...... ...

1 2 ...... ...... ... .........

1 ...... ...... ...... ... .........

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3

7 7 1 1 ...

8

5 2 ...... 1 ... .........

11 9 ...... 1 ... .........

4 4 ...... 1 ... ........

41 4 ...... ...... ... .........

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8 ... 21 ... 9 ...
8 ...

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16 ........... .
81 ............
21 ............ 9 ............ 8 ............

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9 ........ 16 ........
8 ........ 21 ........
9 ........ 8 .............

"""1"'1"' 4 ...... 1 1 ... 1 ...... ~ (0

TABLE OF BIRTHS-CoNTINUED.

-1:--

0

COLOR. \II.
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[White.\ Black.

I I II :tt I PLBAIRCTEHO. F

NATIVITY OF PARENTS.
I

Father.

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I'~~ I No. OF TWINS, I
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g[~!.~~ji:::::;i:~~~~~~~>~~~~~~~::~::.:~:: Liberty.....................................
Milton......................................
l Mitchell ....................................
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3 7 30
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1 17 .. .

~~ : ~ ~; ~~ 1:~ k~~~ :~ ~ ; ~: ~ ~ ::: 3 .........

7 28

....2........

18 .........

4 ...... 4 2 ............

.:... Pickens.......................... . Polk................................ . Pulaski.. ........................ . Putnam .......................... ..

16 21 22
20

15
15 19 15

1 ... 13
6 ... , 9 3 ... 7 5 ... 8

2 ...... 1 ... ,.........

128 14 .....2. .'.".[' ........7.

5 3 13

3

161'"
1i~7ll'..~.

16 ........ . 16 5 .. 16 I 5 16 I 3

i~ :::~ ~ :~ :::~

...... ...... 1
3 ...... '.' 2 ............

!

:::::: .::::: ::::::

2 ...... 1

Quitman..........................
Rabun ..........., ......, .. ~ Randolph ....................... .. Richmond ........................ . Rockdale......................... . Schley........................... .. Stewart ........................... . Sumter ............................ . Talb~t . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..

,2

2 ............... 2 ...... ...... ...

1 1 .. .

2

2 ....... I 1 1 ...............

2 .

37 35 2 ... 18 11 2 ......... . 6 31 .. .

I 223 169 54 ... 1 87 81 29 26 ' . 11 188 35 .. .

85 64 21 ... 43 22 10 10 ...

15 70 ...

21 14 7 ... 10 6 ...... 5 ...

21 ...

21 14 7 ... n 8 3 4 ...

3 18 ...

8

7 1 ... 4 1 ...... 1 2

2 6 ...

38 28 10 ... 16 14 4 4 ..

3 35 ...

2 .........
2 ......... 27 1 9 192 31 ... 85 ......... 16 ...... 5 21 .........
7 .... 1 38 ........ .

::~r:::: .: : : ::::~:::::: 2 ......I...
2 ....... ..
32 ...... 5 96 27 ...
~I' ::::~ : : : . . .~ :::::~ 85 ........ 2 ;...... ...... ...... 2
17 ...... 4 21 ......... 8 ......... 38 ........ . 4 ...... ...... 2 2

1 ...... 1
18 :::::: ...i.o
4 ...... 1 2 ...... 2 .. ...... 1 2 .......... .. 4 ...... 2

~
r:J

Taliaferro......... relfair............................. Upson .............................. . Warren ............................ .
W a y n e . . . . . . . . . . . . . . . . . . . . . . . . . . . .. Wilcox............................. Wilkes ............................

29
4 80

21 8 ... 3 I ... 42 38 ...

13 2 32

8 1 19

1 5 2 ~ .........
1 .................. 21 18 ... .. ..... ..

29 ... 4 ...
80 ...

221 .., 69 22 47 ... 13 9 25

19 50 .. .

2 8

II......... 2 ...... ...
8 ...... ...

1 1 ....................... 2 ...

2 6 ...............

8 ...

12 10 2 ... , 7, 3 1 1. ...

10 2 ...

27 ...... 2 27 ...... 2 2 1 1 ........... . 1 1 ...... bJ

73 ..... 71"'1:I"'1.1.."."..'1.."."..".1.."."."..1."..'. 4 .........
73 ...... 7

4 .........

2 2 4 >0

60 ........ . 2 .........

60 ......... 2 ...... ... 2 .................... ..

11 8

i':l
tj

8 ......... 10 ...... 2

1~ .::::: ::: ::: 1.::::: :::::: :::::: :::::

0
'%!

til
>r~:J
~

,j:>.
~

TABLE OF MARRIAGES,

~ t-.:l

Showing Ages of Grooms and Brides in each County.

Under 15. IBet. 15 & 2o.IBet. 20 & 25.1Bet. 25 & 30.1Bet. 30 & 40.IBet 40 & 50. IBet. 50 & 60.1Bet. 60 & 70.1 Over 70.

---- --.,..-- ----1----:---1--.,----l----.,-

COUNTIES.

'"'"I~'"~ ~I'"~ ~., ~'" 0
0

'

"]~

0
0

~~

0
0

~~

~0

~~

0
0

~~oi

~0

~~

0
0

~~oi

0
0

~~

~0

~~

~rJ'~1s~~:::::::::::::::::::::::::::::::::::: ::::::::: --------~ --i ~ ~-~ i ........i ----i ...._..~ ~ ::::::::: --l--1 ::::::::: ::::::::: ::.:::::: :::::::::

~
1:!:1

Bibb .._. ..... _._..................... ...... .........

1

5 45 57 44 23 14 16

7

8

3

3 .........

3 ........................... [;;

~~~!~X-:1~//-:! !~j : ; :.:. ;! ~ 1 ~1 Chatham...................._.............. .........

1

8 57 68 80

g~~;~~!~~:::::::::::.:::::::::::::::::::: ::::::::: ....._..j 11 ~~ i~ {~

J:J !; ~::~ .;

iJ :::; l 1!: : :::;

55 33 51 ~5 14

3

4

2

1

3 -- ........

I~

~

~ ~ ~ ~ ~ ... ........ ..... ..... ::::::::: ........j ::::::::: ::::::::: .::::::::

0
'lj
>s:;:a:
:;a
;;
Q til

i ~~~[~~~Itf~tTi~i?iti)t.\t~H~L~/HtL'.

HE!;;;;;;;~ :::::::!1
...:: ;:i

:f
:i

~i
il

i ; ~ :~. J1~1::::~1:::::::t:;;;~ :~:/1:::/::/2;;;;;} /ii!: iHE HiE

i i ;

I [ ..... .

[fl

~:~~~~~::.::.:::::.~.:::::::::.:::::::::::: :::::::::1:::::::: i ~ 1~ 1~ --.....6 ) ........~ ) .......1::::::::: .......1::::::::: ::::::::: ::::::::./::::::::: :::::::::
~~.:~~~~:_:_::::_:_:_:_:_::::.:.:_:.:_:_:_::::::::::::::: ::::::::: ::::::::i 2~ ~~ 4g......~-~ -----~-~~------~ i ir: ::::::::~ :::::::.~ ::::::::: ::::::::~ :.:::: :::::::::~:::::::::

Greene ..................................... .....-.. GiDnctt................................. .........

1

1 89 66 26

8

3 10 66 65 38 27

4 4

7 5

8 6

1 2

II s

11.........

1

1

1s ............................-........................

Hall......... .......................:........ .........

1

4 18 19

9 10

6

4

3 ......... .........

2

2

2 ...........................

Hancock ....................................................

1 22 33 42

9

6

6

7

6

4 ..............- ..

2

11 ..................

Haralson................................... ......... ......... .........

2

4

2 ...........................................................................................................

Harris....................................... ......... .........

3 14 12

4

5

3

2

1 ......... .. ....... .........

1 ... ......

1 ..................

Hart......................................... ......... ......... Heard....................................... ......... .........
M~~~lo;;:::::::::::::::::::::::::::::::::::: ::::::::: ........~

4 12 I3

7

2 .........

1

1 ........................................................................

4 I3 I3

3

2

I .........

1

1

3

2

2 ......... .........

1 .........

i 2~ I~ 1~ Ii ~ ~ ... '"6 .......2::::::::: ""'"4 ........i ::::::::: ::::::::: "'"'"i .::::::::

Jackson.................................... ......... .........

7 I3 30

4

4

2

1

1

1

1

1 .........

1 ...........................

: : : : : : : : : : . . . . Jefferson................................... ......... ......... .........

2

1

2

3

2 ......... .........

1 .........

1 .............................................

t1!~~~~~:~;~;:~:i:~:~~~:::::::::::::::::

:::::::~

t?a':,'tn~~~::::::::::::::::::::::::::::::::::: ::::::::: ........i ~

~ ::::::~ :::::::~ ~ ::::::::~ ::::::::i .......f::::::::: ::::::::~ ::::::::: :::::::~ .:::::::~ ::::::::: ::::::::i ::::::::: 2~ 2~ 2~ 1~ 5 .....io .......;; ::::::::: .......23 ::::::::: ......-i ::::::::: ::::::::: :::::::::

(fJ
~
t:t:1

McDutfie................. .................. ......... ........ ..... ...

Mcintosh .............. ........ ......... ... ......... .. .......

1

Miller...................................... . ...... .........

1

Milton ... ..................... ............ ......... .........

1

2

4

2 ......... ......... ......... ......... ......... ......... .........

1

1 .......................... o;

4
7 2

4
11 1

2

3 .. ....... .. ... .... .. .......

1 ......... ... ...... .......

1 .........

1 .........

10

3 .........

2

1

1 ...............................................................

1 ......... . .......

1 .................................................................................

0>
~

l\Iitchell......... .......................... ......... .........

2 13 16

8

6

2

1

1

1 .........

1

1 .................................... t::l

Mouroe......... ........................... .........

1

7 43 43 27 17

6 12

3

1

1

2

1 ......... .........

1 .........

:~~~K~~;~:::::::::::::::::::::::::::::::: ::::::::: :::::::::

~ ~~ ~~ !i 2~

~

~

! ........i ........i ........i ::::::::: .......2i ........i :::::::::

0 '>J

Newton.................................... .. ....... .........

1 ..... ...

1

Oconee...................................... ........ ......... .........

5 11

3

2 .........

7 ......... .........

1

3 ......... ..........

1 .............................................

I .................................................................................

::r::

Oglethorpe......... ......... ............ ......... .........

Pickens .................. ............ ...... ......... .. .......

Polk......................................... .........

2

2 22 31 22 11

2

2

3

9

6

2

2 .. ... .... .. .......

3 20 24 10

9

I .........

3 3 1 1 .............................................

1 ......... .. ....... .. .......

1 ....................................

3 .........

1

2 .............................................

>t:t:1
tl

Pulaski.................................... .........

2 c:4 36 36 17 13

3

5

6

5

3 ...................................................... ::q

Putnam.................................... ......... .........

7 40 43 13

34

2

23

1

1 .............................................

Quitman................................... ......... .........

8 12 12 11

4131

2 1 .........

1 2 ...........................

Rabun.........................................................

1

1

1

1 ..........................................................................................................

~~1l.ITi:.r=r.E:;:;:;, : :1~ !l ;; J 1 :: ~; ': lr 1::; i ; ;. .;;

Sumter...'.................................. .........

1

1 42 50 20 20

9

3

31 4

2 .........

1

1 .......i

1

1

~ ~Jf~ ~ : :: .:~.:.-: :::: ::: ::::: : : : : : ~ J :~l"""i; '"'"i~ ~ ~ ~ .J::::::~ ~ Talbot ...................................... ......... .........

G 20 3G 24

7

5

8

2

3

41 1 .........

1 ...........................

::::::::: ::::::::: ........

i ........ ....... ...... ........ ...... ::::::::: ........ ::_::::::: ::::::::: ::::::::: ....

C-.?

TABLE OF ~\lARRIAGES-CoNTINUED.

........

I ~r Under 15.1Bet. 15 k 20./Bet. 20 & 25.)Bet. 25 & 30.,Bet. 30 & 4o.)Bet. 40 & 50. Bet. 50 ,, 60.1Bet. 60 & 70.1

70.

'

'I.

.

.I

'



'

'

COUN'l'IF,;8.

s . I s I s s ~ I s s I ~ s I s ~ I s 20
:!l

~ ~6
~

20
c:>

~~6 a::

I

20
e!>

~ ~6
~

20
c:>

~ ~
~

~
e!>

~ ~6 a::

20
c:>

~ ~ a::

20
e!>

~ ~6 a::

20
::!:>

~ ~ a::

u
2
:!l

~ ~6 a::

=I---; 11 1................. = =I== W.lr~=----=~===-1=

~149-; l o --4~--4 --;; --2~--2

- - 21----;

Wayne ..................................... 1 ................. .........

5

4

3

1.................. .....................................................

~

W1Jcox...................................... ......... 1 W1lkes ......................................:.:.::.:.::.:.:.::::::

_

21
_2

~~7--1~ 2! --7 ~'2

_

2 _1

_

1 _2

_

1 _1

_

I _2

........ _ _2

.

.... _

............. _1:.::.:.:.::.::

.-..-.1.~.:....:.:...:...:..::1.:::.:::.:....:....:.:.

Total........................... . . . .. ....... 31 1 230 1,2051 93 ssol 501 221 1 243 1821 1141 651 60 21 38

9

sl

2

1:0 t'"
~
0

>Ij

:;:::
>
~ ~
;;::
G'l
~
[fl

L.

TABLE OF MARRIAGES,

Showing the Total Number of Couples, White and Black, the Total Number of .Marriage;; in each County, the Number of Marriages in each County for eaeh Month,i and the NatiYity, from Sept. lHt, 1875, to 8ept. 1st, 1876.

I IJanuary~~r'-:.- Maret~-~~~ I I Total Sept. j' Oct.
Coup1es.

Kov.

Dec.

~

~

l April j May

\ .June. \ July.

August. Nat1v1ty.

"' ~~ ~ ~90~I-\3I1~ ~~-j ~187[_~1~\_~:~jZG'I ~ ~ "'1~ I-\1'1~1~1~\;)~-:11~:::1"" .:--:::;\j-~ ~.~~~;~;~2 _:'_otal

--~1-------1----.- ----1------1---1

--

. . . . . . . . . II ,.

I .I

~

.I lli . ~ ' .

~~

-~~2

.~.:::~C~Q

.~.c=

.~s

~~

~~

~
::::

{~3
CQ

~~

-~\~1

I ~
:::

I~l,!~:l
I

I
II

';~:\q~S;j:2~=:~~:~Q I

2.::.LI~~

I

I

~
?-
I

C~Q,:::~;

I

I

iP1:l: ..::~: I ~~

--1~
o s_I ~
<l)

:~i o~ ~~

-

-

1668 125:J

50 166 llb:

1
:lGi: 3!1!1 _Hu; !Ill 13U, !lUi 5ii--;;;;: 10

41

:;4i 12

_j

.J..,,
~
0;1
0;p

J.. Jj;}, ::: ::: :: ~r~.~~:~::::::~:::::::::::: :~ 6~ :::::t::::.: .....~ ..... 1~1 .:i;[.....~l :::::r:::: :::::: :::::: J~ :~ 1

Brooks...................

!

3

11

:::;;61

:::::61 ::::::[ ::::::1::::::1:::::

1 :::::: ::::::[

2\

I ....... .1 ...... [............ 2 ...... """[""' .......

1............ 1 ...... .....

1 ...... , ........... j ............ [...... ...... ......

~ ......

~rf;~:;;~i;;;;:~~~~~~~~ ~i :~ : ): : : ...t:::~...~ ::) ~.~:::~ ::::J:~~:J::::~ .::~: :::::.:::::~ ~~ :~ .:::;,i::> ....1:...

:::::J ::::J:::::; :::::x:::: :::::: :::::: :::

Cg~a~~m~~p~b:e::l:l::.:..:.:.:.:.:.:..:.:.:.:.:.

~"Q~

12 :; 11 3 1 s\ :J
i :::::::::::::::::::::::: ....2\::::::

"!1~1I

R
i

8, z: Iii 11 "1......
::::::1::::::1::::: i::::::i.::::::'-:::::

::

...1.1,:::::1:1~.::::1:,1::":"::":,:.:.:.:..:.:1::.:.:.:.:.:.

I"'"' ...........
:::::: ::::::::::::,::::::

~552

..... .
:;9 :::

:>;)
t:J
0 "1
:I: ;t'p1
~
:I:

Chatham ................ 100 1081 4 5

IlK...... Chattooga ............... l...... Cherokee ................

83 44

10! 1

10 1 11 ......

15 15 G3
10 1

10 17 1 ...... 81 ......

151 20 181 221 12] :ll. 14! o 121

l...... 7 2, !I
15 ................. j ......

1' .... ..1...... 1!
t ...... ; ...........

l...... IS 1

.............!............

~

...... \............ 2i J 23

1............ 1...... 1 ............

1GV 1 4 88 ..... .

l...... l'"'"l""' ...... ............ ..... 40 ... 2

1

~~~fi~~-::i: j ~I ~ ; ; l J ::) ~I.']] 'iii i II II :! I} I :

!

.. ... .. ...: .. ::::J:::::c::: ::::::::::::r:::i:::<::::i:::::: :::::. ::::::::::::: :::::: iii':i :: !re~!E~::-::::::::::::::1 i~ ~il::::~ ::::~ ::::~ ~ ~::::::~ ~ ;~~ Douglas..................\ 19

2[ .............................. i...... 19

..! ...... \............ \"'" ............. \...... i...... 1 ............ \ ...... 1 ...... ) ...... \ ...... \ .......... :f:::::G

21 ... 1.. .

1

....
en

TABLE OF MARRIAGES,

~
o:>

Showing the Total Number of Couples, \Vhite and Black, he 'rotal Number of :\larriages in each County, tl1e

Number of Marriages in each County for each Month, and the Nativity, from Sept. 1st, 1870, to Sept. J.'t, 187H.

1-- I ~=--~-~-~- - Fe~~v~~:::c~~-~ :~.,:~-=-~ ;:-~ ~t~:~~:~;~~~~~.:,~~~l~~at-/ ~-- ~-- ------ i'o('uTpote1asl. Sept. !i

. " "' "-I I . I . I I " ~ I,, ~J3
I~.=::i

s~e.:l,I;:"~~:~

s s i ~. ~. ~ ~ ~ ~ ~

~l.=::i
Sj~

~A
~

c:

De:.-January

-

-

-

1

~
-

-

-

-

-

1-~--~ ~---1

---

g ~-- ~ t1v1y.1

.8. I ...
A~<::i
~i

s A~~. le. :~":'
~

-~~ I ~
AI. ~"
~~i

.e I . 3l ~ 2 I ~

.!J B I ~

-~ I ., " ;:; i A~'"' ,-.>:III"~ ........
~IS~ ii(~

~~-~:;oI ;:"
Jii~

.8. ~

~d

I>

.~

0 :::

I~ ,a 11i.- ::; "" ~a~ .....,..

c0 j

..::::l

~~

~~ ~ '""';:::;

~~~~;~;:::::.::: ~=il::::::l=i 21:::::: ::::: ..... 1_:] ~-41 lj::: ~} ::: ::: f::::::lll~ ~t~ ::::::::1 i{

.. ~.; F~:l~o~~yl~uW.;.;.:.:.:.:.:.:.:..:.:...:.:.:.:.:.:..! 2~5~.
i Greene .................... 2!1

114~ ....~4~1:::..2.11
49 ...........

()winnett ................ : 100, 13 5 ... 1

91"""""6 ::::::i.:::::1:::::::::::: ::::::1:::::: ::::::! ::::::

:.!..... .....: . .... J::::::f::::::c:::l::::::i::: .....: ::::::::::::1::::::1 ::: :; ~ 2 ... .. ...
4 ....

1~9.1.\

l~ 12 .....
2

+il.....\....~

........ 1...... 1_.._..1 .... 1.................. 1.....11....... ....::11:::::: ...

........

......

.....

;~ 21 ...

1 4 J:::::J ~

! J::::: .. 6 ...... ...... 20 22

211 .............................. 6

1. . . . . . . . . . 1. . . . . . 1. . . . . . 1 . . . . . . . . . . . . . . . . . . . . . . . . . .

11 ..... .

1~ .....; 1 ~~~ 2 ....._, ....., ..30 .. (i ... 3!. ~~ . 2f:::J1

l ::::

2 113

;!
~
bl
0 >r:
s: >
~

:;;:

);:

Cl t'1 'J:

......\ 1~1 ii:::r::~ ::::J.. -~1:.-.:::_J::.J< :::::1 ....: -~ .. : ~ .: .,~_: : I~:. :-:-:.: ,1::::. :.I,. i::.. . :::::I::::I::J::::::I ;~ ::: _:_:_:

11 .. I -t-.... Milton........... ......... 2

1 ..........

2 f ...... f ..... \ 1 .................. 1.......

ll1itcbell,....... : ...... 7, 21 ...... .. ... .... 2 1 2 2 5 1 1 1 1 1 ... ... ....

I.
I1

1.... ....

I



.:

1.... ..

.. ! :; ...... 1 .......... I 28 .....

MourOE"................... . Murray................... .Muscogee............... . Ne,vton................... Oconee ................... .

3340 ...5..4.J .....3. ....4. 41 631 ...........;

.... ...... "'!'"' I..... ... . l."... .. ...... ......... 9!"""1 291...... ["""184 ... 62~1~.

.

..

..1.1
10

2I ....7.....1.0.]...... 10 .. 3 .. ... . ... '"j"7 .... I, . .l.:ll, ..

IS 2RI of II

fo

I

4 101.....

. """]"'I""']""'......
.. ........ f .....

r 31r .. 1..
103 I ..

1

Oglethorpe ............ .

Pi{:kens...................

Polk....................... .

Pulaski................... .

Putuun1 ..................

~~~~~~~.~~.::::::::.:::::::: l

37

1 Riacnhdmolopnhd .............. .
R o c k d a l e . . . . . . . . . . . . . . . ..
! ~chley .....................

74
19 1

r I r I '" I ,. Stewart...................

c[ 57
58

7

~:~

21
10

:;
'2

;;
G11

20 ...... 1 ........... / a'

+........ ~ .............. .3 ......1................. ...

"r t I 1

.71 16[1"1. H11 23[
11 '20 1i'i Jl 21
411............ 4 2,
1
I I,

1
,1.\
4
,1 1

i" "1... ,... .......... "[
,,

21 4

...
10

ri

~1

...

..

..

..

...

:

..

....

1. .

..

..

..... ......

1......
' ......

1..........
:...... ' ...

...
...

1 ~ 2.1
,, ;I .... 2 11

,;

10' . . . . . 1 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

J .... :.I...<. .....

j ... / .... 1 ....... ! ......

Dt.: ... l.. .
12ril 7 ...
:J4a1-...........

Sumter.................. .

Talbot ....................

Taliaferro ...............
1 1 Tellair ................... 1

lJ pson ................... ..

Warren ................. .

~ ~1) i ;!ji:;~.!i:.:l..,~.::;.:llll~I~::1J2.!(I~I:i ~~~~g~::::::::::::::::::::

Wilkes....................

,

~
;.. >-l
t7j
tJj
0;.. :>:I tl
0
>Ij
:r:
t7j

NOTE.-In the returns of Otdinaries thf:' agel:' of l/J20 grooms and brides wrre not given.

;..
t:;

;r:

-*"l'

'l'ABLE OF DEA'l'HS.

fl:>.

00

Giving, by Countie~, the Color, Resideuce, Condition, Nativity and Occupation.

COLOR. RESJDKNc~e.l

Co:mrTION~

I li NATIVITY.

ucccPATIO".

-

-~-- - - ,-~----~------,-~~ - i

[ I ,cnl

I ~

I {--~

i - : 3 a COUNTIE~.

II

II~.~::

"."I
_!_

.

!
II~~t

~d~~

'for~~~-~~: <ix:(_~~ ti9il~I ,~! <>(_;;~~'~/: 1_!'1~_41 '_"'[~:_25)1 4!l51~ ~537

Appling............... Banks....................

I

S

~ 1......... 8 ...
.......... 9 1

II

-g~

I ~~.

I

~
~0

~ ~ . d I

" : .;

~ ~ II G ~ ~ ~

~0 ~ ~ "' I I ~ ~"II ~0:

I ..;

~p

~
~12_iI

~
~-

1IE.9

\~"'

s

I
i

~~

~
~~~

III~~,,

-~
)I~ "~
lgo

~B"3~

;:i
~"~

''""i_2"'11-.'' _"''__ \'!:......... ;;f
21

21
5

~
~

......... [
......... ,

11:
1

~\ .........
U] ......... I .........

: ..........

12o
!"""["'""' ..

1_
\

_
......

1

1

~~

?I~

..... .. . ...... . ... .

2.. 1 . . I .; 2

...,
;..
'Jl t"'"
t'l

~ Bibb.................... 1 41 :m 31

Burke.................. II
..j.. Calhoun................ 11

1 :1

.....2. 1..................

201...

20

........... \

2 1

42

7

21......

1 ...................... 1' .l ........................ I

.f ......... 11 ,,,, 1

.J 1.........

ol......... 11......

11 ...... 11' .................. ! ........ 1

11i

o1 Si

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1]"'

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1 .. \ .... 1 4l ..

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:::... ,1

i :::::::::

:;1..1: ......

1:::.1

~arroll 1~1 6~ 1~1.......3...1i"'li ....... ..1. .... ~ ~~~~~~~a;;:.:.:.:.:.:.:.:.:.:.:..:.:.:.::I 11~;f2.~.J..II ........:.;7..~1)

I..... :l ('hattoog.t.............. 24 111 ........

Clarke................... I
~ I ,;,.. J ....... ll <ilay.., ....................
< olqUltt ................

2 11 .........

51

I .........

1 ...... 1 ......... 1

f......... ...... Decatuo ............. 11 5 2

:;'

J. 1 'I Dougherty ........... I
Douglas ...............

4 ll

61

11

........

j

17,...
7%5i
M...
.11...

9~'
10 21
21

129101~11.............2..21.11,..............;1.;.......;;.2I.,,1 1 ......... ......... ...... .\[ ......... 1,......... ......

29~! ......

r

..

ll.........
:i

21 ....... il

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o c1(..J...;,I

1if ..
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I

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71
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...

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4[ 1,.. .............
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]

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11

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......... .........

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......

11........... t.. ... ..

I ........ ,..

7 ......... ] II ................ 1........ 1

' ....... 1 ....... 1 . ..... I [

!...... , I .... J

....................

7

1....... 111 ... 12 ...

6 11

1......... I. 4 ............[.........

1......... ......

1

1G

2 ... 1

1. . . . . . . . . . . . . . . . . . . . . . . . '1 ......... \ .. ,,........

2 ............ I .... 1.......

-' .11 ......

2j .......

1 ... I

1
............. 1

1 "["""...

:!

~~~!;;;;~:.:::::::::::I ~~ 3:~,11":::::::1 110:'t:::: ~I 1~1l'"..".'.".'.."i ::::::::::::::: 1~ ,:::::::::::::flii::.:.:..:.:.:.::\"'"")1::::::::: ~1:::.:-[:::::::: ii,l::::::::::::l~:::::::::::::, ~1::: ~~:!:b~e~:r:t~::.:..:.:.:.:.:...:.:.:.:.:..:.:.:I,
I '!-........ ...... ...... ......... }_loyd...................

:::::::::,

1~4~1)

.......
....
7(!

.....

... i 3[

4! ... 1i.......~zi[

12 ...

5

11 7

I 1......... lo.rsytJ:o................. 2f ~~~

1) !l~ ...

1
101 16

F1ankhn............... ] Fulton................. \

1.~1

Ureene .................. 11

1 ......... 1 "...

1)
i1

21~

2 .... lU,...

2, 2

G, 1:1

81

7

1 ............... [.

1.......41 ..::.:,

1 ......... , 21 !

2 21 1j

11' .1~

............... 1 ......... 1 1

11 2 .........

1tl:::::::::~ 41 ......... '.... 11'.......... ,
ii

2 ...............
;,,::::::::: ::::::

1:.::.~

................~

151 ......... ,... 11......... 1
:ll\ ......... 1 1[.........

11 ......... 1 1, ......

21] 1 ~~ 51......... 1 ... 1 ......... ]......... 2 .. j

1 1

1111..................1

181. ........ 1.,

1

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2~ ... [..... [.... J~1:.:.:.

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I

21 2 5[

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HGawlll.n..n.e..t.t........................... Hancock................ Harris..................

241 /

811
.....

1

3 7 ..

4 1 .

13 16

2

1 ......

1 ........................

2

6

1

1 .... ..

1

4 ........................

Hart...................... 4 1t 2

2

3 ........................

Henry.................. 8 3

4

5

2 ...............

Houston................. 6 4

3

6

1 ...............

C>Jackson.............. 1 1

2 .............................. ..

Jefferson............... 1

1

7 ........................

Jones.................... 4

5 .

Lincoln................. ........ 7

7 .. .

5 ...................... ..

4

1 ...............

Lumpkin.............
Macon.................. McDuffie.............. Mcintosh .... ,......... J\Iiller ..................

3 ........ 9 13 2 ...... 1 .... 23

3 .. . 22 ...
2 ... 1 ... 5 ...

2 ........................

15

2 ...............

2 .......................

1 ........................

4 ........................

rn
>>-l
>-l til

Milton.................. 1 ....

1 ...

1 ........................

Mitchell .............. i ........ 3 Monroe................. i 15 13 Morgan .................! 5 5 Murray.................i 9 5 Muscogee ... .......... i 3 2

3 ... 27 .. 10 ...
14 ...
4 ...

2 ..................... .

14

1

22

8 ........................

6

1 ...............

4 .........

1 ......

t:O 0;.. ~
t:l

Newton ................. ; Oconee.................. ' Oglethorpe......... ! Paulding ............... '

21
5 ...... 44 2 .... ..

3 ...

2

1 ........................

5 ...

1

3

1 ............. ..

8 .. .

2

3 ......... ......... 3

2 ...

1

1 ........................

0 "1
::c

Pickens................. 4 ........

4 .. .

I

2

1 ..............

Polk..................... ' 5 4 Pulaski..................' 6 6 Putnam ................ 5 10

9 ... 10 ... 3 12 ...

9 ........................
+........~ ::::::::: :::::..1[

Quitman ............... i 2 ........

2 ...

2 ..........................

til
~
t'<
:>:c-l

Rabun ..................
Randolph ..............' Richmond ............' Rockdale ...............! tlchley..................
1-;tewart................. Sumter..................

2 ........
.1 7
45 32 95
ii 2 78 96

2 ...
4 8 ... .
62 15 .... 4 10 ... 7 .... 2 13 .... 4 11 .. ..

27

"""81 5 3~1 ......... -- ...... .
....... """"i

5

7

2 .................

1~ il 4

2

::::::::: :::::::::

3 12 ..........................

Talbot.................. 12 6

l Taliaferro.............
Telfair.................. Union ...................

14 12
1 .......

Uvson................... 11 9

Warren................. 11 8,

6 14 ....

7

3 1~~::::::I:I1""'"81

1 18 ...

t;

7 ......... ......... 6
~1::::::::: ::::::::: ::::::::
~ ........i """"j ......1

7

4

2 ........

>i--'-0

50

TABLE OF DEATHS

I s ..'1 ~0 tq~qs:
-~=""alplniJ,OL~ ~-- :~
I 'UO!SSOJO.Ic[

oi
0
u0'"'

TABLE OF DEATHS. Giving the Total in each County, Sex, Number in each Month, and Age~, from Sept. 1st, 1875, to 8ept. 1st, 1876.

~

II DEATHS.

~[ONTIIS.

AGES,

SEx.

COUNTIES.
. .; I~ ~ ! ~ : ~J . ~/" -----------

I 1-;: g ~ ~ ::;; ~ ~ ' ~. ~ & ~ ~ ~a00 .:..<I ~.,.....,

...:
32. 0

.;;
:::
~~

8.::J
:::: ~

2;j I ;.:;. I I
.,.., ... ..0 !
~ ~ ~ ~ 1 ::,1 ~:1:: i

I

~ .3_. ~ ~I 6 I
hiI'~
;j I

h

2 _...; ,...-

IQ

~lfJI.:i"'1;j

~ I~ '~ 0,. .].1....0....~o~0~1

0
M
o
g

~ ~ 0 0 ~ 0 0 Q ~ ... (,0 1- 00 '0
g ~ ~ ~ ~ ~ ~ o ooooi=:J4

~
;,.. >-l tXJ

_20~IN ST~::.::.:.:::.:.:.:.:.::.:It:!20 ~G 3!11~.:211701_1_~!~~I~~~ ~1--=l_:r;l_: ~6~::]~~~ 8~~~~~~~ G!J:l 461
14 BApanplkisn.g................................................................................... 10 85 34 1;;

s4'l

~11

~. 1J ...... /

:::1 21] ....11............ ............ ........... .....2. .....4. ............ .../2 2l ...1.1..

2l

215 ll ........l. 22 ..1. ......

o:l
;0,..
::>;)
t"1

0
'"!j

~i~i~~:-:.~t:-;;;~~~~ :1 "! l'I '(i<;i :,lli t: , ': . 'j jl "1J ;Ij ji!; jl~ I ]

[r

Catoosa.......................................... Chatham .......................................

8 402

6 234

14241...2..4.'1

li~

Chattooga...................................... 3 3 22 11 ...... 1:\

:.147~" ~ 11 ...
oli 3.5, G 4 ......

............ 1.... ...... 1 ..................

3l 4 ...... sx 1:3 42

1

1
1 ...... i

'" '
1 i 1 ...... ...

w. 1 ... 1 1 ...... R 1 1 ... [ .. .

14G 13 Hi

50] 5;: 34 21 161121 ..

14 4 1 .. a: 2 ... a 4 l 1 .

:r:: >tXJ
ti
F"

1 1
~~~'.~~-;-::~ ,! 1.: j !lj 1]1' ; t: 'I ; ;' :1i; )i i:. ):;:)~ , :=:

. . . . .: : .: : : .: : : : : : : : : Early............................................
~re~~~-~~:

F~aaynentmte.

........................................ .........................................

Floyd...........................................

"!" j R 2 1 ...... [ 31 ............ J ............. : .:.fjt ...... ...... ... 1

1 ...........: :.. 1j ...

. . . 1~1
14
15H

~~
~
7
8

~
"~
I

~ i ~~ i .....~ i: .....2'i ..J:::::: :::::: 1 ...........~.......:J......~.~.....!..................[!......[~~
ol 2 'I 3 ............ . . .

:::::: 6
......
......

:::::: 4
......
......

:::::s: .:.:.:.:.:.:
...... ......
...... ......

.:...-.r-s~j~:.:.:.1.:.:.:

...
...

l
3

13 ......

:::
1! ...
2

.....a .....~1::: .1

2 ........., ...

11

l
1

.1...1.

~~-1
11 1 :[1
22

~
... 1


:::
1 1
l

yr

Forsyth........................................., 31 12 19 ...... 8 4 3] 21 2, 4 ...... 2, 2 4 ............... I 121 1 ... ... 21 4 3 ... 1 3 51... ~

'fABLE OF DEATHS.

Crt
~

Giving the Total in each County, Sex, Number in each Month, and Ages, trom Sept. 1st, 1875, to Sept. 1st, 1876.

DEATHS.

MONTHS.

AGES.

II COUNTIES.
~~~11 """ ... _,__,__,_,_...1_,_,_1_ -~.,I-I~~~.I~ - ::lo o 1l11:- Franklin.......................................
Fulton .........................................
i ;;iil1 Greene ..........................................
Gwinnett ..................................
2L..~ .....~ ~\- ~ .....~ ..... ~ ~ ~ ~ ~~ ~ ~ :/.:~ -~ Hall.............................................
Hancock ...................................... Harris .......................................... . Hart ............................................. Henrv ..........................................
1 Houston .......................................
.Tackson ........................................ .
Jefferson .................. u ...... Jones ............................................ . Lincoln ........................................ . Lumpkin ....................................
!I .~ .~ II ;..I!I ii!I ' II ~ ~ 1 .1 ::11, !:!!i ::I:i\! Macon...........................................

'I
"' " " ~ ~ ~ 31 ...... 5 21 i~ ~ 1~ ~ ~ lg

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1

3i

6 ..... .... ..... .....: ..... ..... ::::: :::::: :::

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,! lllclntosb ...................................
+ J \ I i l l e r ...... _ . . . . . . . . . . . . . . . . . . . . . . .

r ...... ........... ........................ .... ....,. ; ...... 11 !...... 51
11 32

...

41 --1 ..1. 1......

1
.....1.

1............ .-j- .......................'......

1 ...... ......

1 ......

~ 1! 1 ........... .....................

! .............................. 1 ... ] ..........

11 ......1...1....1.................. :::/::._

4I~-JI'.........

1 .................
21.....1I......1......

.::.:..~.::

~}~J~~i{ii(i:\((iif./(\\\)))\iiii\~~\~\\ I r i . 2~B~[ ~1F.

l 1\l uscogce ......... .............................. !
J.. . I................................. II . .,. . . . . ~ewton ........................................

a5,.....2.

76
:::pi i : i i :: ::: : .....i 4/...... I ...... I "...... I

5~

2~

4~

62
.... 2 ::::::

31
.....i 1::::::

4
::::::

l
::::::

...........
1:::::: ::::.:

:::::.

:::

~~10 0 . . 1 1 1

~31

I -4~ 1 2 2

1

u, ............11............\................................

I

1

21...

1...1. ..... 1...... 1 1 ....

1 ... /1 ........ .

1

1

,

1 ::> i~ ~ ~~:::::~ ~~:1 :::~ ::~:j~~~+.:~:.:: :~:. :~ ~ : : :~: ~ 1,.:~':\:;~ :~ : ~.: ; +. "". H ~ :1 11 }jl"):::::: 2~1 .::::.1::::::\:::::::::::: ::.. ::::
~ .....2 ~ ....... 111 ..........,;............. \ ...

. . .

:::.:1

2 ::.~::.hb\"i "j ::: ":i ::::::\ ~
1 ... 111 ..................i .....
::: :::::: ::; ::;

1....1[::::: 2 1
1~ ...i.ci

~ ::::: 1 ............ ..... 1

1

I 7< 47 ~II ...... 21 1:1 11

1 1...... ................. ......

i .....;oli :::: ....i ::::::]::::: ...

G

4 ]II 2...

14 5 H 1

I1 2 1 ...... 1 1 + 11.....

7 o 2 ........... [........................ 2....

4'. 1

l.o 5 1 11 4. 21 1o[ 6 8 1\ 11
"I20i 10 10 ...... l i 1 4 ...... .....

" :1 1

z[ ..... o41

22
\""'

......

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o .... ..:.....
........... : .....

:li ......

1

2: l

1 1 1 ...... i......

31 2
1,......
"I 2u1 12
IH; 10
~ 2~ ; :::::: .....: ....~; i~ ::::::1'::::: .. ]I:::::1.:.:...... ~I

!...... j ...... I ...... :l ......1..................1............

l...... I...... 1 ..... , ,,

f . . . . . . ] . . . . t . . . . [ . . . . . . . . . . .

,, 3'

4, :1: 11 " 1 2 2 11.....

I 2: 2 G: 2! 3~ 2 1 ...... ...... ......

...,; ..... I 11 ~~ ....... ...... ,...... ,...... ,......

1...... 1.....

~-----

------------- ---

-------

..... ... ... ... .. ... .... ... ... ... ... 1

.:::: :::1 J1 ::: "2 i "1 ;::: 1::: :;

12 21
1

:2 11

c; 1

G 2

l:l 8 .......

1

7 2

? 1

... 2

2 .. . ..... .

... l, ... f ... I 211 .........

1 1 ...... 1 11 ... 1 1 ... [a

1 ...... ;.... [... 2 ... ... 1 1 . G

(f)
..,,>-

1

---

... 4j. I .... 2 1 4 l ...

a' . ...

1 .... 1 .. I... ... ... 1

...... )2 ...., 1: ... 1"' ..1...

!~ ~ I ...[ .....[........ ... ......

~[ l~l . l .... 4 2 ........ 1.1 n j ... ,

J 1 :~ 2 ....! 2 11 2 2

..1,11:::1:1..1

::::

..
"11

..~

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:::

- - - --~-------~-----

:"l 00 0
:>-
~
t'i 0 "1

:r: ~

~

?=

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CAUSES OF DEATH.

.C....t.

COU~TIES.

DISI,ASES.
"'I 11"1"1~ ~ I . ~ ol
0
f-<
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~g~t'"f:


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~

I r'

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2~~"." 1.-~=~;;-l!-=t~~c;- ,:.!':?l..._li--~6n=-

!""'" .................... ..:. 1""" ......."."..".!.".."."................ 611"" 'I""' 11...... """1'"""""!""'1'"" 1 ... .....1......1""" AtJortion......................................lj.
Ahsees~ ..................................... .. 1 ....................... !1.................. """'[""" ......"1 ...... 1 ...... 1............

1~~~l~~y:::::::::::~::::::::::::::::::::::::i
~i ::.J:::::: ....h::::r:::: ::::::,::::}::::: : : : . . . :::::::::::::C:<::::: ::::::::: :::::~ Asthma.......................................

i ::::::r:::::: ::::::

'l""" 'l ...... j ...... l ..... 1' . . . . . . (' . . . . . . . . . . . .
::::::1:::::

llrain, Inflamation of .................. 5

Brain, Congestion of, ................... 31'

>>-l
til r' t'1

Brain, Softening of...................... 5

Bowels, Inflammation of............... 9

0

Bowt>ls, Congestion of.................. 4

"1

Bowels, Obstruction of................. 5 Bronchitis............. , ..................... 14 Burn ............................................ ~ 14 Cancer ........................................ . 10

tJ t'1
>.._,

Cephalitis.................................... 2

:r:

Child-birth ................................. R

[JI

Cholera Morbus........................... 5

Cholera Infautum........................ 26

Conge,tive Chill ........................... 5

Consumption ............................... 95

Convulsions ........... .................... ! 2:l

~roup .....:......~_.................... ~9

Compress1on of Coret .................... 2

Cyanosis ...................................... 2

Debility....................................... 16

Diarrhrea..................................... 38

Diphtheria.................................. 41

Dropsy, ..................................... . 33

l>ro"ned ...................................... 23

Dysentery................................... . 11

Dyspepsu.................................... li

Enteritis ..................................... . Epilepsy ............................... Erysipelas................................ Fever, l\Ialarial.......................... Fever, Continued ........................ Fever, Congestive........................ Fever, lnternuttent..................... Fever, Remittent ........................\
~~:;=~~ ~~~)~~ei;~;i: ::::::::::::::::::::::::
11,racture ......................................
Gastritis .................................... . (Travel ........................................ . II eart Disease ............................
Hydrocephalus........................... Hung ..........................................
~:~~~f~~~~.:~::::::::::::::::::::::::::::::::
Hernia ........................................ .
Hydrothorax ................................ Inanition .................................... Influenza .................................... . lntemperance ......................... .. Kidney, Dl>'ease of.......................
Ltver, Disease of .......................... Lungs, lJisease of ........................ Laryngiti~, A.cute ........................ .
.1\larasmus ................................... .
1\fentngitis............................... .l\1urdtr ....................................... Oid Age...................................... Paralysis.................................... . P e r i t o n i t i s. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..
Poison ......................................... Puentnonia ................................ .. Rheumatism ................................. t:lcarJatina ................................... .
S a l l - p o x . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ~croiula ...................................... .. Still-born ....................................
Strangulation ............................ .. !Stricture Urethra...................... ..
~:~~~:::::::::: ::::::::::::::::::::::::::: :::

~
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CAUHES OF DEATH.

Or o;,

I

COU~TIES.

---------,---.---.---

DISEA5ES.

,;,



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--------r-: --- ~rthing...................................... 1? !...... ...... -\-...- ....- .....- ....- .....~ .1..- .... .- ..... --lJ-...-..~...-..-...-. [-....-. --_.;....;. 1~....-..1~....-.. 1~..-1-...-.. 1-...~...1-...-...~-----1- .-...

1 1

1

~~::~~1:~:::1:::::): "(]~ : :j ~ i ~ ~ )i :~ ;: ' ~ ~ ~ i~ I ~ ;I 'I . I ,I ::::::::::::::.:::::::::::::::II

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::::::

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CAUSES OF DEATH-CoNTINUED.

COUNTIES .

DISEASES.

I f .~ i . ~ ~
~
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Abortlo................................................ ...... ...... ...... ...... .... 1 ...... ...... ...... ...... ...... ...... ...... ...... ...... ....... ....... ........ ... ...... I ...... 1 ......

Abscess .................................... ,........................................................................................................................................................... .

.~..,

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CAUSE8 OF DEATH-CONTINUED.

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62

TABLE OF J::EATHS

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SECOND ANNUAL MEETING
STATE BoARD OF HEALTH
0FFJC'E ~TATE BO,\Hl> OF HEALTH,
~~TLAN'L\, U~\., Odoller 111, 187.-i.
The boan1 <<JllYemd in annual H'.'~inn, at tlll' Pnsidcllt of the :-icnat<''~ room, :it 1ltnc o'doek 1'. :~r.
Pn,;ent: Drs. Lor~an, CrmHWl'll, ,\ttorney (;encral J[amnwnd, State ( ;pologi,:t Litll<, and ( ~nm1Jtroller General Uoldsmit!J.
The l're~ideut (J)I'. 'J llomn:'' lJdng :.chsont, on motion, Dr. Logan was ('ttlhd to tho chair.
On motion, the nadilll! of tile lllinuteb of tile last uweting was rlispenHed \\'ith.
The following coHtnlllil ir:::.tion from tho President, Dr. 'l'hmnas, was rea1l by tho ~ec-rl'tary:
To the Ueu,via State Bou rd of llcalt!t, Atlanta, Gcmvirt: GE~'l'LE}fE)f-lregret exctedingly my inability to meet you at
the annual Hessioll of the Board. Our entire ~tate profoundly nnlizeR the calamity which iK upon
this city, all(] whil'h kPtps me hLre. 1 llan been trusting that thb dreadful seour)[e would n,:H' iu tinw for nw to meet you on the llltlt instnat; but, up to the preHent, I dq not fed that there has be<n suJlieicnt u.h:ltemPlt for 111<' to IPaYe m:: po,t, l'Yen for a day or two. \' ou .~ut, doulJtle~s, '"dl infonned of the terrible PJ>idemi< of yrJlo\\ feYer whicl! Las s'Yept oYer Sa'.auuah for the pa't ~ix week' I thi 11 k the tir~t del'! a red ease o1eurreu on the :!1st of August, in tltc tastent part of the city, iu a loeality noted for it.: insalubrity. By thL :!tlth of August tlwre was ~ueh manifest tendt'llL'Y to tlw c.pn:a1i of tlw infection, that a ~peeinl meeting of the M<'dioal ~<JI'iet~~ y:as tallefl. From the n~ports mtcde by the Yarimts mcdien l gen tlcmen pre;,;pnt, (anu thl'l'e was a fullnweting,) I fomwd tlw opinion that thUi'l' \H're not more: than fifteen or twenty house~, :1t th;;t time, infected by tlw poism1. At this meeting, whi1h ,,.a,, only ~eYcn dayl'l after the Jir,;t case, I offered the following n,;olutions:
Resolved, 'l'hat tiH) l\Iayor be requested to require daily report:> a

64

SECOND ANNUAL MEETING

of all cases of yellow fever, and their locality, from all the physicians in the city.
Resolved, That the Mayor be requested to organize a corps sanitaire, and place them under active, energetic officers, and that they be instructed to cleanse and disinfect all privies, ynrds, and houses, where the disease is reported, and, as far as possible, all places in the city where dirt and filth exist.
These resolutions were passed, I believe, unanimously, by the Medical Society, and ordered to be presented to his Honor the Mayor. The next day I visited the Mayor in person, and explained to him in detail the ideas involved in the above resolutions, and, at the same time, offered whatever active co-operation he might demand. I desire, also, to state, that, about a year ago I addressed his honor an official letter, tendering my services in all sanitary matters, and especially in the event of an epidemic. Up to the present date, I have never been called upon to act in my official capacity.
During my visit to his honor, on the day of the meeting of the Medical Society, alluded to above, I was informed that all the infected localities were being disinfected.
I need scarcely remind yon that the law under which the State Board of Health is organized gives this body no power to interfere with local or municipal authorities. 'fbe duties of the board are clearly defined-to give advice to those in authority in case of epidemics, whenever asked. The resolutions given above were presented to the Medical Society for its endorsement, and most earnestly recommended to the Mayor by me, as the representative of the State Board of Health.
'l'he nature of the poison whicil causes yellow fever was explained to him, how that it would take Ilou;.;e by house and street by street, and tilat whilst I Ilad no experience in trying to stop the progress of tile infection, yet I was supported by the most eminent sanitary authorities in tile world, in the opinion that, by the prompt institution of proper measures it could he stamped out at that stage of its progress. On the eighth and nintil days of tbe progress of the disease, I began to consider the question of calling the board to meet m Havmmah. After examining the law, and the rules of the board, I was in much doubt as to whether I had the power to order the board to the scene of the epidemic. whilst seriously considering this step, I was prostrated upon my bed with fever, brought on by over work and effects of exposure to the sun. On the third day of my illness, several of my brother physicians came in and earnestly recommended that it was necessary for my
speedy recovery, that I should go to the country for a few days to
restore my strength. I reluctantly yielded to their wishes, and

STATE BOARD OF HEALTH.

65

was absent from the city just eigllt days. With a sense of my duty still before me, on my way baek to Savannah I went to Atlanta to consult with such members of the board as I eould find there. At this place I called together Dr. Logan, Attorrwy General Hammond, and Cornptroller General Goldsmith, (tile two latter ex-officio memlJers of the board-the Attorney General being its legal adviser,) and ~ubmitted to them the question of summoning the board to meet in Savaniwh. 'l'lle Attorney General gaYe it as hiH opinion that, under our rules and the law, I, as the President, had no power to order the board to meet anywhere outside of the Capitol of the State. He said that I might request one or two members to meet at any point, bnt it "would be (ntilely optional with them whether they complied with the request. I was aware, too, that there were at this time, and had been for some time previous, a b~ent from the State at least three of our most experieneed members.
The three memb0rs of ( board mentioned aboYe, who were kind enough to giYe me their counsel at Atlanta, thought that no good could rewlt from the board meeting in Savannah at this period, and particularly as they knew that the medical gentlemen of the city were willing and able to give their advice, which was all the board could do. After thiR I determined, on my return, to follow up, with as much Yigor as possible, the advice already given, and to represent the board to the beRt of my ability. On my arrival in Savanuah, on the 1:2th of September, I became at once so pre-occupied with attention upou the sick, that but little time was left me to coneentrat<> my thoughts upon the sanitary situation. After the most carpful consideration, I came to the conclusion that, although the disease wa,; well-nigh spread throughout the city, yet muclt might still be done to mitigate the epidemic by the free use of disinfectants, spreading quick lime upon damp ground floors, basements, yards, etc., and by hygienic measures. To do this, I know, would re(gtire an immense amount of these materials. My thought" at once reverted to New York, where I knew these things in such abundance were especially to be found; and, under such circurm;tance:<, the liberality to furnish them free. I wrote at once to some of my rnedieal friends in New York, and explained to them the situation. In consequence of my applieation, there was a large meeting of medical men held in that city, comprising the first talent in the country, prominent among whom was Dr. Elisha Harris, Sec1et:try of the American Public Health Association, to whom 1 a<ldressed a letter.
On the ac~journment of tile m.eeting, I was at once i~formed that they would supply me with a eargo of quicklime, n cargo of disinfectants, and an unlimited amount of all kind". of hospital

66

SECO:-\D i\ c;r;l' \ L :IIEETING

supplies; and further, that Dr. 0. A. \Yhite, a gentleman cPa~nned to yellow fever, and a '' mastPr in itH treatment," and experienred in snnitary matter~, "'as nt !11,\' eomnum<l.
I plnced the tP!egram, and S<'Vernl letters, tcnderiug this liberal aid to our pestilence-stricken eity, iuto tlw hand~ of his Honor the Mayor, and begged that the offer be a<<epte<l 1t mwt. After much delay and seeming lw~itatiou, tlw di~illf<c1:lllti>, as "'ell as the servi<es of Dr. \Yhite, Wf'rt' aecepted.
T felt that in doing what I had flone, I was acting more in the line of real goo<l to tltis dreadfully rltTtiete<llwoplP than by calling the board here, the n1o~t of whom 'vould lmve furni~he<l, JlerhaJl~, fresh food for the dif'(ase, tlwy lll'ing entirl'ly nnaedimate<l. In this view T think Tam ~Uj)[Jorte<l by the MP'-lic'd ~miet.v, for mauy members have expressed the opinion that it wa~ little less than a crime to invite men here who an entirely un~P,tscmed to the dbease.
In conelusion, let me ~ay that, while I think it manifei-ltly una(lvisable that the boanlsbonl<l nwet in Sanmnah for the present, I respectfully ;.>ugge~t that \H' take into eousideration the question of meeting here at us Parly n day a-' po~sihlu after the .~uhsi<lence of the epidemic, fOl' the 1mrposp of invPstigatin~ aml reporting upon the enuse and :wigin of tltb, cme of tlw most fearful epidemic" that hns <~nr ~eourg<'d a eity Oll the Atlantic eoast.
Trusting that the spirit of wis<lont \Yill guide you in ~'our rldiberations in ende:woring to <lbeovpr how to pn'Yent that dass of maladies 'vhieh ucrw SlllTOUlHl us with fenrful fatality, and which to witness is suflicient to fin tltl' iHtellect of the dullest., and to soften the heart of tlw most inseusi ble.
I have the honor to remain Your obedient servant, .J. G. 'l'HO.l\f AS, :M.D., PrPsident f'itate Boanl of Health.
On motion, the communication of Dr. 'l'ltomas wa~ referred to a committee of Drs. Cromwell aml J1ittle for nport.
Dr. Cromwell, chairman of tlli>' committee, rqJortecl as follows:
Rcsolvcci, That the (OJnmuniration of Dr. .T. G. 'fhomas, President of tho f'itatP Roan! of Health, rc"1weting his official action in connection with the prPstnt Ppirlemie of ,\'ellow fpver in the city of Savannah, hP reePiYctl ami ~pread upon the records of this body.
Resolved, 'fhat in the opinion of this body he has not only fully di:<~harged his duty a~ ~anitary Commissioner for his district, and President of tho Rtate Boanl of Health, but that he has done all that he was allowed to do by the:<taw creating the body

ST.\LE LlO."'-ED LlF [JE\LTH.

67

and deserves great credit for hi~ etftnt-; to arrest the epidemic of ellow fever in the city of ;-la \'[lllnah. ) On motion of Comptroller General Gold>'lllith, it was-
Resolvea, 'fhat a eonHnittte llP appointed to report suitable resolutions upon the death of Dr. :Xottinghan1 at the next meet-
ing of the board. Committee: Dr,;. Thomas, Campbdl and Sussdorf[ On motion, it wasResolvea, 'l'hat the meeting stmHI adjourned, subject to the call
of the President. V. H. TALIAFERRO, M.D.,
~eeretary f:3tate Board of Health.

OFFICE SCJ.'ATE ROAHD OF HEALTH,
A'l'LAX'I'A, GA., 1'\ov. 21st, 1876.
11 O'CLOCK A.l\1.
Adjourned session of the Annual meeting of the board convened pursuant to the call of the Preshlent, Dr. Tlwmas.
Prest>nt-Drs. 'l'homas, Coo]Jer, Cromwell, Cnrltun, Logan, Little, and Comptroller Ge1wral Goldsmitb.
Meeting was called to onler by the President. Minutes of last meeting wei't" read and confirmed.
On motion, the board adjourned to meet at a P.l\L

3 O'CLOCK P.l\f.

Boanl convened in the Pre~ident of the Senate'~ room.

Present-Drs. 'fhomas, Logan, Cooper, Carlton, Little, Cromwell, and Comptroller General Gold~mith.
Board called to order by tlw Pre~ident.

Reports of committees callell. Committee on Finance, Dr. Logan thairmau, made the following report:

The Committee upon Finance ot tlw StatP Board of Health

respectfully report that they htwe examined tlw expemlitures of

the Recretary, and find then:t correct.

.J. P. LoGAN, W. L. GOLDS;"~1ITH,

Com.mittee on Finance.

Committee on Stationery and Printing, Comptroller General Uoldsmith chairman. l'\o report.
Prudential Committee-Dr. Logan dulirman, made the following report:

68

SECOND ANNUAL MEETING

\VHEREAS, It has been clearly demonstrated that the State

Board of Health cannot discharge efficiently the duties imposed,

or meet public expectations, in consequence of defects in the law

under which it is acting, having no power to enforce registration,

or the observance of sanitary laws, and not being provided with a

suffif'ient appropriation to meet itf' indispensable necessities, and

are therefore unwilling longer to oPcupy such a position.

Resolved, That a committee of three of its members be ap-

pointed to present the subject to the next meeting of the Legisla-

ture, and to repr:esent to that body the necessity of appropriate

legislation, if it iR desired, to continue the existence of the present

board.

J. P. I,oGAN,

Chairman Prudential Committee.

Under the above re,;olution, the following Pommittee was appointed-Drs. 'rhomas, Logan, aud Attorney General Hammond.
Committee on Endemic, Epidemic and Contagious Di~eases Dr. Campbell chairmnn. X o report.
Committee on Hygiene of Sehools, Prison,; and Public Institutions-Dr. G. E. 8uss(lorff ehairman. No report.
Committee on Geology, 'l'opography, etc.-Dr. Littlt> ehairman. No report.
Committee on Poisons and Spedal Sourees of Danger to Life and Health-Dr. Stanford clmirman. No report.
Special Committee on Disposal of Exereta and Decomposing Organic M~1tter-Dr. Logan chairman. Asks for further time. Granted.
On motion, the special committees were continued. Dr. Logan called attention to the following official communic-ation by himHelf, aH chairman of the Prudential Cmnmittee:

H'l'A'l'E BOARD OF HEAL1'H.
Editor .i'rion~ing News-My attention has been called to an article. publiRhed from the Savannah r{ew8, reflecting upon the State Board of Health, find avowedly deHigned to prevent a proposed investigation b;y tlw t body into the Cl\Uses and means of prevention of yellow fever, as connected with the late c>pidPmic in the city of Savannah. Preferring to trent the subject in a diflerent spirit from that exhibited by the author of the eommunieation rereferred to, I have to say, a' n member of the board, participating in the late meeting, that tile State Boan1 of Health has not, in any way, manifested a disposition to interfere with the local authorities of Savannah, or eisewherc, in the management of their sanitary affairs; but so far from thit;, has confined itself so strictly within the limits of the law by which the board was created as to become the subject of criticism in Savannah and elsewhere, from

STATE BOARD OF HEALTH.

69

a misapprehension as to that law, and the real objects of its or-
ganization. The State Board of Health being simply designed to promote
and diffuse sanitary knowledge, to give advice to local authorities, when called upon, and to make annual reports to the Governor and Legislature upon the sanitary condition of the State, with neither power or means to control or interfere with the authority of any locality, and having confined itself strictly to its legitimate sphere, such reflections as are contained in the article referred to are wholly
unjustifiable. In connection with the epidemic of ;yellow fever recently pre-
vailing in the cities of Savannah and Brunswick, no advice has been sought from the State Board of Health, and of course it requires but little reflection to understand that if it had been otherwise, and the board had possessed or desired to exercise such powers as some had supposed, who had not investigated the law or the objects of the board, no fit opportunity of investigating properly the causes and means of prevention of yellow fever in those localities could have been afforded during the existence of the epidemic.
The board has, lwwever, a duty to perform under the requirements of the law of the State which lies at the very foundation of its existence, whicll cannot Le ignored, and which cannot, in any proper sense, be regarded as interfering with the rights of any community, and which cannot be properly construed as in any degree whatever a reflection upon the capacity of the citizens of Savannah or any other locality to manage their own affairs.
No such idea as an attempt (as intimated in the article referred to) to supersede or otherwise interfere with or reflect upon any movement of the city of Savannah for an investigation into the cause of the late epidemic has occurred to the hoard of health, but so far from this, the results of any effort in this direction would be regarded as the most valuable material to which the board could have access in making up the report to the State authorities, required by the law under which they are acting.
Notwithstanding this statement of facts, it would unquestionably be the duty of the board, by its own committee, to collect these, and any facts or opinions, which might by possibility throw llght upon so vital and vexed a question as the origin and propagation of yellow fever upon the coast of Georgia. In other words, without arrogating to itself any extraordinary intelligence or power, it would be discharging a plain and imperative duty to the State government, and, in a very limited view of the subject, one involving the welfare of the entire people of the State. Indeed, the intelligent accomplishment of such a work could not be esti-

70

SECOND ANNUAL MEETING

mated, cm!JraC'ing, as it might, in tlw future, tlle destruction or salvation of itlllllPll.~e mas.~es of lmmaulife and millions of \nalth, not only in the localities referred to, but as afi'ccting the nwterial interc~b of enry portion of the extenrle<l coast of Georgia, and of many other State.~, besides possibly a!hling a eontri bution to sanitary seienee affceting, to some extent, the entire world.
"\Vitlwut undertaking to elaborate the various matters intimately connected with the duties of the State Board of Health, as regards the late visitation of yellow fever into the f-ltate of Georgia, [ would simply refct to the vital importanee of detcrmining,:if possillle, wlwther the eities ofour seaboard are, for all time, to be neer-sswily subject to PpidPmics of yellow fever, or whether it nUL)' not be thcfad. that with proper sanitary regulation><, embracing quarentine, effident removal of excrernentition'"' and other foul and decomposing matters, and a thorough ~.rstem ofdrainage, they may not be exempt from such a fdl destroyer. To tho t<olution of tltif' question, it will at once be ]ll'reeivo<l that the cau~ts for the non-appearanCl' of the !liseas8 at othel' points, a11parcntly as liable to its ravages a~ tliose affected, woul<l :llso neco:;sarily come under review as itnportant factors in m:tking up a reliable and fnll report, aml would require an inves1igation into the rl'latiYt' f'anitary eonclition of a number of other loealitit>s besi!lcs those ,ihat have been 80 severely desolated.
Witl1 the highest rcspeei for t'w intelligenm of the citizens of
Savannah, and tt speeial admirntiou for its eminent and devoted medical m<en, the i-ltate Bo:l]'(l of Health mu~t not stultify itself
upon any imaginary idea or ill<leli,:wy or itnpropriety (as ~uggested
by the writer rd<'l"rl"d to) l>y faili:Jg to make an pfl'()rt, mHler an imperative obligation, to take ad\unt:l.~u of sueh an opportunity of adding "onwthit1g to thP grent '''ieuee for the promotion of the health aud the salvation of tho life of the human family.
The State of Georgi;t eannot atliml to leave anything undone which will throw even the mo~t feeble light upon a question in whieh the interests of her pooplP arc so intimately aud fearfully bouwl up.
The writer of this article is not \dthout hope that it mny he rnad<J apparent that, with p:oper r<anitary regulations, tlw eities of Savannah and Bnmswiek may JWnT again he yj,:ited by atl epidcmk of yellow fever; alHl, \\ithont a~suming any ;.;uporior knowlcd~c or sagacity, in vie\v of the dnty imposed uy the Legislature, and of the antagonisn1s m:: nifestld in tllC' 11ewspaper dbeussions upon this subjoet, in Savannah, bdicves thnt as the Stat<" Hoard of Health po:<sesses an iml>ortant qualifieation for intt'lligent investigation in the freedom from local pn,judice or !'Omplieation

STATE BOARD OF HEALTH.

71

(only otH' member out of t\\'Plve residing in Sav::mnah,) good results an likely to lw obt:Line<l by its Jul,or~.
But whcther poss0ssing the~ neec,s~ary qunlilieation~ or not, the board mu:'t make an uff(Jrt to clisehargt tile duly impo~ed in a faithful alld fearless manner, without reftrenee to local jealousies, contliets o: O[lpo~iti<>n, and will not, 1 am ,.;ure, rely in Ynin npou every desirable courte~y front the citizens auzl mcdicnlmen in any of the localities involvPrl, to Ptwble it to lH'P~cmt to the Legislature a full and accurate statetuent of the fact", with its own deductions, to the end that surh legblation may be adopted as will possibly relieve tl>e sen boanl of the State fr01n such a desolation in tlle

future. As to some extent representing the hot>rd during the interval
between its meeting~, l have regarded it a~ appropriate to coJTPCt the misapprelwn~ion~ to whirh I hnvo referred.
J. P. LouAK, ill, D., Chairlll<lll Prudential Cornmittee Rtate Board of Health. Atlanta, Georgia, November 8, 187G.

'l'he Semetary nat! the following eomnnmication from tlw

Governor, whieh, ou nwtion, was ordered i'pread upon the Inin-

utes: ,

A'l'LAK'l'A, GA., November :ll, 1876.

Dr. J. G. Thomas, President, etc.,

DEAR f-:IR-As the f-ibte Board of Health is about to eonVPIW

in regular session in this city, 1 avail myself of tlw oc;easion ns-

pectfully to suLmit tc your IJocly a sugge~tiou, which ~t'Pill~ to be

called for Ly the best intcrest:,; of the State gmtPrally, and e~pe

cially of that large hotly of onr eiti:.~ens "llo re~ide in tire <ities of

the eoad. It is with a view to a more tllorouglt iJtnsti.l.!;ation into

the caus<s, nature, efl:bct allll treatment of the epidcll!i( which

has so retmtly scourged tlte (ities of R:wannah and Bnmswick, and

their vicinities, that the State Board of Ht>alth slrall hohl all ad-

journed llleeting, in the city of Savanuah, at sueh time a~ may suit

the convlnienee of its rnem ber,.;, and at as early a day as may be

found pn:eticahle.

I am sn tisfied that an inquiry, eomluetecl mt the spot, where ;-;o

great :1n ;t,Jnount of testimony i~ available, and where eaeh meJn-

ber of tlw board ean sec awl judge fm him:-;df, would proye the

most efle..tive plan for the C<llleetion of fad~, and nrriving at Rat-

isfactory ('onelusions. If found neeessary, the Hoard might also

visit the city of Brunswick, where a tliHtreut state of facts may

be developed, which nmy aid tltetn in their in\e.~tigation.

V ~ry respectfully, your o],e,lient sernmt,

J Al\m;-; 1\I. S:\H'fH.

On moti m, meeting adjourned tilllOo'doek tomorrow morning.

72

SECOI\D ANNUAL MEETING

NOVEMBER 22, 10 o'clock A.M.
Board met. Present: Drs. Thomas, Cooper, Cromwell, Carlton Logan, Little, Comptroller General Goldsmith and Attorney Gen~ eral Hammond.
Meeting called to order by the President. On motion of Dr. CooperResolved, That Drs. Thomas, Logan, and Attorney General Hammond, be appoiutell a eommittee to memorialize the Legislature, at its next session. Adopted. The Secretary read his annual report, which, on motion, was received and adopted. On motion, the communication of the Governor waH tal;:en up for consideration. On~motion of Dr. LoganResolved, That this Board receive with pleasure the sugge;;tions of His Excellency, Governor Smith, as to visiting Savannah, and it may be Brunswick, to investigate the causes of yellow fever there; and will proceed to make the investigation. So impressed are we with the importance of this duty, as required by the law of our organization, we intend performing it, even though the meagre appropriation made for us is exhausted, relying upon the future for a proper appropriation to meet the exigencies of the case. Resolved, That a copy of this resolution be furnished by the Secretary to the Governor, as reply to his communication. On motion the board adjourned to meet at 3 P.M.

Board convened.

3 O'CLOCK P.M.

Meeting called to order by the President.

The annual election of officers called.

On ballot, Dr. J. G. Thomas was unanimously re-elected Presi

dent.

On motion, the salary of the Secretary was continued at $1,000

per annum.

On ballot, Dr. V. H. Taliaferro was unanimously re-elected Sec-

retary of the board.

On motion of Dr. Cooper-

Resolved, That when the board adjourns, it adjourn to meet in

Savannah, on the 12th of December next. Adopted.

On motion of Dr. Logan-

Resolved, That the Secretary of the State Board of Health he

reque;;ted to notify the city authorities of E:lavannah, the Health

Officer, and the Georgia l\fedieal Society, of the meeting of tbis

body iu the city of Savauuah, ou the 12th of December next, awl

STATE BOARD OF HEALTH.

73

uest their co-operation in the labors of the board, with special reference to the investigation of the causes and prevention of yel-
~:w fever upon the coast of Georgia.
On motionResolved, 'fllat the President, Dr. 'fhoma~, be requested to notify the authorities of the city of Brunswick, that the Stnte Board of Health will meet in that city Home time in Derember next, immediately following tbe termination of their session in Savannah. On motion, the board adjourned to meet in Savam1ah on the
l2th day of December next. Y. H. TALIAFERRO, M. D., Serretary State Board of Health.

CITY OF SAVANNAH, METROPOLITAN HALL,
December 12, 18i6.
The State Board of Health met pursuant to adjournment in the city of Savannah, in Metropolitan Hall.
PrPsent-Drs. Thomas, Logan, Holmes, Cooper, Little and Cromwell.
Meeting called to order by thn President. A communication from the Mayor, offering the eouncil chamber for the use of the board, was received. On motion,_the board adjourned to meet at 3~ o'dock P.M.
METROPOJ~ITAN HALL-3~ O'CLOCK P.M.
Board met; called to order by the President. Present-Drs. Thomas, Logan, Holmes, Cromwell, Cooper, Little. Visiting by invitation-Drs. McClellan and \VocdllUll, of the United States army; ami Dr. McFarland, health officer of the city of Savanuah. Dr. McFarland made sugge-;tiom; in reference \o the order of business, whieh would best facilitate the work of the board.
On motion of Dr. CromwellResolved, That the Secretary be instructed to wait on His Honor, the l\Iayor of Savannah, and inform him that the State Board of Health is now in :,;e~sion in this city, in pursuance with the reqliiremenls of the law creating this body; and, also, in compliance with a HlJecial request of His Excellency, the Uovenwr of the State, for the purpose of looking into and examining all the fact;; relating to the origin and spread of the late epidemic of yellow fever that visited this city; that we will be pleased to receive any communications from him, and to have his co-operation in such manner a:; may seem appropriate to him.

74

SECOND AXNUAL ~lEETING

Re~;ol1ed, 'fhat the Se(oretary ~ommunicate to Dr. McFarland tlw Lcmlth officer of Ra YannaL, the fact that tile State Board of'
Health Las eonvened ill this eity for the purpose of investigating
tile late epi<lemic of yellow fever, am! to invite his co-operation am! preseuee with tlle Lonrd whenever it shnll Le convenient for him to mcd them.
Resolved, 'fhnt the me,lieal soeiety of the city of Savannah Le informed that the Rtate Board of Health has couvent>d in the eity for tLe purpo~e of in \"e~tigating the late epidemic of yellow fever, and that they invite their co-oppration.
On motion, it wasResolved, 'fhat the board aecept the tender of council chamber by the .Mayor and Couneil, and that tlie Loan! meet there tonwrrow after 12 o'clock. At the im;tance of Dr. :\IcFarlalHl, the following communications were directed to he sent by the 1:-lecretary, viz:

To Capt. Loubroock, Chief of Pilotage:

Jl.fy DBAR SIR-1 am imtrueted hy the Shtte Hoanl of Health,

now in session in this city, to inquire the date of arrintl of ve:;sels

from CuLa at 'l'ylJee, from .Tuue 1 to ::-leptemllcr 1, Hi/G.

\Tery truly,

V. H. 'l'ALIAFERIW, l\I.D.,

December 12, ltl7H.

Secretary State Board of Health.

James Atkin8, Esq., Collecto, of Customs:

:\[y DEAn i-irn-I am inHtrueted by the State Bounl of Health,

uow in sesRion ill thi~ dty, to inquire of you as to the arri\al of

ve~::;eb from Culla, at thh< por(, from June 1 to Septeml Jer 1, lSiG.

Very truly,

V. H. 'l'ALIAFE1WO. J\LD.,

De(;ernbcr 12, IH7U.

Secretary i'ltate Board of Health.

On motion, the board adjourued to meet at 10 A.J\L to-morrow.

ThfETROPOJ,T'l'AX. JIALI,,
December J:i, 1870-10 o'CLOCK A.:IL Boa1d met. Present-Drs. 'l'homas, Holme~, Logan, Little, Cooper and Cromwell. .Meding ealled to order by tlw President. .Minutes of last meeting read and approYed. On rnotiou of Dr. CooperRe8olved, That the board, haYing received an invitation from the Georgia Medical Society, through their President, to attend a

STYfE BO.\RD OF HEALTH.

75

:reeting of the society to-night, (December 13), when the subject yelloW fever will he discusfwd, that the invitation be, and iR

hereby, acceptt>tl.

,

On motion of Dr. Log:m, Drs. 1',. l\[eClellan and A. A. \Yood-

hull were invited to mcd with tlw !Joan! and participate in its

deliberations. On motion of Dr. CoopPrResoll'cd, That a committtP hP appoilllt<l to noti(v the chairman
of the ~avnmuih Benevoltnt Assoeiation that the :-:tate Board of Health is in 'iC.'Rion for tlw purpose of inn,;tigating the origin,
etc., of the lnte "l'i<klllii' of yellow fen;r, and invite tlw co-operation of that assoc-iation and their <<~mmittc>e in sueh inYcf<tigation.
CommitttL-Drs. Cno]Jcl'1 Logan and Little. On motion of Dr. Cmmwc>ll-Resol!'Cd, That the Mci)'OI' anrl City Snneyor lw requested to furnish the bonn! any JYJ<I]l~, :-;urveys, and other information bearing on the topcgrnphy, drainage, ~ewerage, ete., nf the eity and
its environ,. That a eomrnitteP of one be appointed to carry thir-;

resolution into effe<t. Committee: Dr. Littl On motionResolved, That the remainder of this day J,e oceupi<'ll in m~lk
ing an pxploration of tllt' eity of f-laYannah and its surroLmdings, so far as tlwy may ht supposed to have any hearing upon the

present inYestigation. On motion of Dr. Coopcor-Rcsolvcrl, That the Prc~ide11t wait on the ~layor and requc>st
him to rc>n<lcr assbtan<<> to tlw board in making a pc>rsonal in-

spection of the eity. On motion-Resobccl, 'l'ha t tlw Henetary be authorized to employ assist-
ance in the clerical tlutie~ of the b<Jar<l. On motionResolvecl, 'l'hat a c01nmittee be appointed to wait on the l\layor
and notify him that the board is ready to make an inspection of the city.
On motion, the board adjourned to meet at the Council Chamber at this hour, (1~ l\L)

CFrv }IAJ,J,: 1:2~ o'cT.OCK P.l\L
Board met. Present, a full meeting exeept Dr. Thomas. Meeting called to ordc>r by Dr. Logan Committee avpointeu to wait upon the Benevolent Association report, through the chairman, Dr. Cooper, that they have had a conference with the committee of the Association, and find them

76

SECOND ANNUAL MEETING

ready to co-operate heartily witl:t the board in their investigations.
Colonel Screven appeared before the board, and in behalf of the Benevolent As~ociation tendered the aid and co-operation of the Association in furthering the objeets awl purposes of the board.
On motion, the board adjourned to make a tour of investigation of the city, and to meet at the Exchange to-morrow morning at 10 o'clock.

EXCHANGE, December 1+, 1S7G: 10 O'CLOCK A. )1.
Board met. Present: Drs. Logan, Holmes, Little, Cooper, Cromwell. \'isiting: Drs. l\fcClellan and 'Woodhull.
Meeting called to order by Dr. Logan. Minutes of preYious meeting read and approved. Communication>' received from the .:\Iayor and Custom House officers were read, and, on motion, placed on file. The chair (Dr. Holmes presiding) appointed the following cornmittee, to report upon plan for ex::unination of witnesses. Committee: DrR. Logan, Cooper, Cromwell. Dr. Logan, chairman of committee, offered the following, which, on motion, was adopted: "\VHEREAS, It is important to Rystemati,;e our business, and to avoid irregularity likely to r0~ult in the unprofitable ('Onf'umption of time, Resol1,erl, That tho following interrogatories be propounded by the President, or any member of tile bonn! he may designate, t~ persons who are called upon to testify before thiR body concerning the residence of the witness before and during the epidemic, and the facts iu hiH po~session in regard to the origi"n and progres~ of the epidemic of yellow fever of 1S7G. Resolved, 'rhat any member of the board desiring to interrogate the witness, shall do so in writing, through the appointed examiner. First. Did you reside in Savannah previous to and during the epidemic of yellow fever of 1R7G 'I Second. What do you know of the origin and progTesK of the epidemic? Dr. Easton Y ongo was HUmmoued before the board, and was requested to give his testimony upon the points proposed, and briefly complied. On motion of Dr. Little, Drs. UcFarland and 1-ltone were invited to come before the board. On motion of Dr. Logan, Dr. Little was excus0d from regular attendance upon the meeting;; of the board, and upon his completion of a topographical survey and investigation of the water

STATE BOARD OF HEALTH.

77

supply of the city, would be permitted to return to his official du-
ties in A.tlanta. Col. John Screven, Chairman of the Local Investigating Com-
mittee, appeared, by request, before the board, and favored the members with his Yiew upon the origin, cause and virulence of the disease ; but begged to be excused from being placed in the position of a witness, owing to his peculiar relations with the
local committee. He stated that he wac-; perfectly willing to impart to the board
any information within his power to faeilitate their investigations, and would be plea~ed to place at their disposal documentary evidence bearing upon the ~ubject.
He expressed himself candidly, aml the hoard was greatly enlightened by his candid and intelligent opinions.
On motion, Dr. Stone wail requested to meet the board at the
night session. On motion, the board took a recess until 3~ p,l\I.

EXCHANGE, 3~ P.M.
The Board re-assembled, and was called to order by the Presi-
dent. On motion, Dr,;. Cromwell and Logan were appointed a com-
mittee to vh;it Mr:s. Heilgate, and interrogate her in regard to yellow fever at her house.
After some infonnal discussion, the board took a recess until 8
P.M.

EXCHANGE, 8 P.M.
Board met. Called to order by Dr. Holmes. Dr. Cromwell, of the committee appointed to visit Mrs. Redgate ami interrogate her in reference to yellow fever in her house, etc., made the following statement, which was ordered to be placed on the minutes:
The committPe appointed to visit Mrs. Redgate and Capt. Sexton for the purpose of ascertaining what, if any, information they could furni~h, respectfully report as follows:
Mrs. Redgate 'being interrogated, says: 'rhe "Maria Carlina" came to her wharf August IGth; that the sailors, or some of them, brought their bedding with them from the vessel to her boarding house; that their bedding was very clean, and neatly strapped up; that the whole number that lodged with her were eleven or twelYe; that while staying with her the cook was sick for two days with fever, and was attended by Dr. Duncan; that she was informed by the cook that when the vessel was two days out from

78

SECOND ANNUAL MEETING

Havana one of ltm erew die<! and was thrown overboard; the nature of his illms,; was not kumvn to the eook, but he did think that it was yellow fLYer; that another nwn was injured, either before lca villg the port or whilc> on tlw Yo~age; that he was taken sick \Vhile st<.l:yiug nt her IHJUs<>, and was taken to the hospital in ~annmah ; that her hoys wel'l' in the habit of visiting the Spanish vessels l)ing at tlw \dwrf, and that tlwy luHI met otlwr boys playing on the wharf, ;md especially rPllll'!llhers ~ecing 'l'mnmy Clary p!ayiug in thl llalln:-;t from tho.-<e vessels.
'l'he ;-;pnnblt Consul nt this port beiug interrogated, say,;: The ":\[aria ('arlina" iefr the J>ort of Havam1 with a crew of thirtet>u; that the" Olympia" left Hanma on the !Jth or lOth of August; that slw arrind at (ltmrantim ~\ugust lith or lHth; that she \Vas in qunrnntim \',lr forty day~; and that August liith, on hN pa~sag<', niH' man tlietl of yellow feYer.
Hcspcetfully ,;ubmitterl, B. F. f'RO:\IWELL, .T. P. LoGAN.
Dr. Gt,o. H. StmH' appeared before the board, ami gave a detail<ell statement in reference to the Jirst UISC>< of yellow fever in 8nvamuth seen by him~l'lr.
Dr. .:\lcFarlan, Health Otlicc>r of Sa\annnh, testified lJpfore tht> boal'(l as to thl' appc-antlll"C of tlw fcycr, its caus<c>s, et<.
Dr. Hat1er,;ham abo came bcfore the board.. His testimony was in eorrohm';tiion of that. of Dr. .:\Id<'arlan.
On motion, the lJoar<l adjourned to meet to-morrow at 10 A.:II.

ExcHANGE, Dee. lf>--10 o'clok A.M.
Board meL Pre~tnt: Dr,;. 'l'hmnas, Logan, Coopcr, CromwPII, Little, Holmes.
Board was called t,l order b.Y the Presi<lt>nt. .:\linute:- of the prcviou,.; meeting were read and approved.
Dr. I~eHanly appe<HL'd, uy invitation, beforc tlw board, and
testifie<l at ltngth in rcfenJH~<' to the earliest cnses of yellow fever in the eity.
.:Hr. Hogg, City :-->urveyor, app('ared before the board, am! tlstified a,; to the drainage of tht' city and its environs.
Mr. \V. \\'. \Yoodbridge wa~ introdu~;ed, and queHtion<'d in regan I to hi.~ kutndengc of the ,;ewern.go "Y"teJn.
Dr. '1'. .T. Charlton C<tmu heforu the board, and tec;titicd as to his early ea~c,; of yellow fenr.
On motion, the board adjounwd to meet at 3<\- P.M.

STATE BOARD OF HEALTH.

79

3z o'CLOCK P.M.
Board met. Called to order by the President. Minutes of the previous meeting read and approved. Dr. "\Vm. Charters appeared, by invitation, before the board, and testified as to the sanitary condition of the city, the water
supply, its purity, etc. Dr. Theo. Starbuck gave a brief history of the first cases of
yelloW fever which came under his observation. Dr. Waring came before the board, and testified at some length
88 to the causes, nature, etc., of yellow fever in the city. On motion, tile board adjourned to meet at 8 P."'r.

b O'CLOCK P.~f.
Board met. Present: Dr,;. ThomaH, Cromwell, Cooper, Logan. Meeting called to order by the President. Mr. Geo. H. Garmany appeared, by invitation, before the board, and testified in reference to the drainage and sanitary condition of the lands surrounding the city. Mr. S. G. Haynes appeared, and was interrogated in regard to his knowledge of the surrounding country prior to the epidemic. Mr. Angus McAlpin appeared and testified as to the condition of the railroad wharves. Dr. McFarland gave testimony regarding an early case of yellow fever, which occurred before the disease had been recognized. Dr. Ely McClellnn, U. S. A., at the solicitation of the board, made a statement in reference to some chemical and microscopical examinations he had made of ballast obtained from the Gulf Railroad wharf. Dr. Cromwell offered the following, which was adopted: Resolved, 'hat Dr. McFarland, port physician of the city of Savannah, Drs. Charlton and Habersham, and Colonel bcreven, and such other citizens us tlley may desire to be associated with them, present to this board a paper embracing such recommendations of changes and additions to the quarantine regulations of this port as will, in their judgment, render them more thorough and efficient.
On motion of Dr. LoganResolved, That Drs. Campbell, of Augusta, and Sussdorff, of Macon, be requested to furnish the Secretary, at a very early day, with all the facts to be obtained in reference to the existence of yellow fever, and the cases occurring in these re;;pective places during the past summer and fall. On motion, the board adjourned to meet to-morrow, at 10 A.M.

b

80

~ECOND ANNUAL MEETING

EXCHANGE, December 16, 1876-10 o'clock A.M..
Board met. Called to order by Dr. Logan. After some discussion, it was decided to visit the surroundin"'~
and. of the city, and inspect the drainage and sewerage >lystem;
at therefore, the board adjourned for this purpose, to meet again
three P.M.

3 0 1CLOCK P.M..

Board met. Present: Drs. Thomas, Cooper, L"~.~an, Cromwell

Bussdorff-Dr. Woodhull, of the U. S. Army, visiting.

'

Mef'ting called to order by the President.

Dr. A. A. Woodhull, Post Surgeon, made a statement in refer-

ence to yellow fever cases occurring some miles from tlw city.

Dr. 'IVm. Duncan appeared before the board and testified as to

early cases of yellow fever in his practice.

Dr. W. H. Elliott tPstified as to cases of yellow fever, and the

sanitary condition of the city for the past year.

A communication was recei l'ed from the grand jury of Chat-

ham county, asking the cause of yellow fever, an(! desiring some

advice in reference to small pox, now prevailing in the city of

Savannah.

The President appointed the following committee to tn ke under

consideration this communication, and report to the board. Com-

mittee: Drs. Logan, Cromwell, Snssdorfi:

The committee made the following report :

The committee to whom the communication of the grand jury

of Chatham county was referred, respectfully report, that as re-

gards the cause of the late epidemic of yellow fever, that they are

at this time engaged in investigating the facts relati11g thereto

for the purpose of making a report on the Bubject of the late epi-

demic of yellow fever to the Legislature, at its next session, with

suggestions for its prevention in the future, a11d will be pleased to

furnish the grand jury of Chatham a copy as soon ns practicable.

In regard to the information concerning small pox, deRired hy

the grand jury, we will direct our Secretary to furnish a copy of

our annual report for 1875, in which is emllodied our views on

that subject, and which, we bPlieve, if adopted, will exterminate

the disease.

J. P. LoGAN,

B. l\1. CROJ\1WEI.I.

On motion-

Resolved That the board be divicled into two committees, after

to-night's session, one to remain in Savannah to finish up the

work, the other to proceed to Brunswick, on Monday, to investi-

gate the late epidemic of yellow fever there.

STATE BOARD OF HEALTH.

81

Committee appointed to go to Bnmswick, Drs. Logan and Crom-
well. Committee to remain in Savannah, Drs. TLoma;; and Sussdorf.
secretary to remain with the latter committee. On motion, the board adjourned to meet at 8 P,JIL

8 o'CLOCK P.JII.
Board met. Present: Drs. Thomas, Logan, Cromwell and Suss-
dorft. Meeting called to order by the President. Mr. T. H. Brown, Dr. L. A. Falligant, Mr. A. J. J. Blois and Mr.
Edward "\Vhite appeared before the board, and gave testimony in regard to the couditio11 of the city before and during the epidemic, incidents in relation to the first eases discovered, and other information of interest.
Dr. McClellan, U.S. A., made a statement in reference to a case of yellow fever occurring in the city August 11th.
Dr. Le Hardy nuvle a statement in reference to small pox, as now prevailing in tlw city.
The Secretary read the following paper:

REPORT OF THB COJ\11\UTTJ;JE ON

"J,AW ON SJIIALL

P

O

X

11 1

APPOIN-

TED BY 'rHE GEORGIA i\IBDICAL SOCIETY.

In consideration of the fact, that the law in the State of Georgia relating to small pox has proven both inefficient and defective, and that under its existing provisions the spread of the disease cannot be stayed, your committee propose the following additions to, or changes m, the Code :
The section 1,375 of the Code of 1875, we propose to change as follows:
"The corporate authorities of any city or town shall establish, in them or in the vicinity thereof, hospitals or pest-houses, and erect euitable buildings for the reception and accommodation of persons suffering with small pox, or any other contagious diseases, where they shall receive the same care, and have the same attention and comforts, as are given in welt regulated modern ho~pitals. 'l'hese hospitals to be subject to such regulations, not contrary to law, as such corporate authoritie,; ruay make, to prevent the spnd of the above said diseases, but in all cases where sn<Jh authorities of a town shall establish hospitals or pest-houses out of their own jurlsdictorialllmits, such e,.;tablishments shall be on land acquired by such corporation, for protection against the spread of diseases Within its own limits; in all other cases, the Ordinary of each county, respectively, is vested with the power to establish such hospitals, and to make such regulations.

82

SECOND ANNUAL MEETING

"The corporate authorities of Rucb town shall also be required to furnish amlmlanceR of t!Je best modern pattern, and careful drivers, for the ~afc transportation of the sick."
In section 1,300, we propose to ehange the last clause to read thus: "And to furnish them with medical attendants of known skill and experience, who will give daily all needful medical attention to the sick; to furnish thern with a suffieient number of competent nurses, stewards and cooks, and provide them with all necessary nourishment and medicines."
'ro change seetion 1,390 as follows :
"The Ordinary or corporate authorities shall provide strict quarantine regulations to prevent the spread of said diseases, and it shall he their duty to remove all persons, as soon as practicable, to the hospital>; provided for that purpose, whenever they are known to have the auove !'laid diseaHcs: Provided, That no person shall he forced to leave his or her home to go to the hospital aforesaid, if they do provide effectually for their safe keeping, in an isolated house or room, to be guarded by at least two responsible persons, by the authorities, at the expense of the patient~ or their guar<lians. And auy person who shall fail to provide effectually for his safe keeping, etc., and shall not go to the hospital aforesaid, shall be deemed guilty of the offense of spreading the disease with which he or she may be affected, in violation of the law; and after his or her recovery from said disease, on conviction before the Superior Court of the county in which he or she lives, be fined i~ the sum of one thousand dollars, or imprisoned in the comon jail of the county for six months, or compelled to work for six months on the chain-gang, at the discrf'tion of the judge of the court in which he or she may be tried; and moreover, in the meantime, (that is during his sickness,) shall be forcibly removed to the pesthouse or hospital establishment, in pursuance of the previous section of this law.
" 'l'he Ordinary or corporate authorities shall also rigidly enforce proper quarantine on all persons who have been in contact with those having said diseases, and they shall not be permittell to go at large until properly disinfeeted and vaccinated, if so required by the health officer.
"It shall be the duty of the physician or health officer, appointed by the Ordinary or by the eorporate authorities of any city or town, to visit all per,;om; reported, or supposed to be infected with small pox, or any contagious or malignant disease; to give his opinion upon the nature of the llisease ; to order and superintend the removal of the diseased to hospital; to order and superintend the disinfection of infeeted houses; to order the llUarantine and disinfection of petsom; having been in contact with the disease; to

S'l'ATE BOARD OF HEALTH.

83

accinate those not protected, or those who, in his opinion, are not

v ftlciently protected; to visit daily and give all needful medical
:~tention to patients in hospital; to order a sufficient number of

mpetent nurses and cooks; to see that the stewards, the nurses

:reC:d the cooks perform their several dutieR, and that the patients well taken care of in every particular. It shall also be the duty

of the health officer, as far as lies in his power, to vaccinate all per-

sons in the neighborhood of infected houses, who, in his opinion,

require vaccination."

Respectfully submitted.

J. C. LE HARDY,

Chairman Com. Ga. .Medical Society.

SAVANNAH, December 13, 1876.

On motionResolved, That a committee be appointed to write out the report of the board, and prepare it for examination and discussion, at a meeting to be held at an early day, in Atlanta. Committee-Drs. Logan and Little. On motion board adjourntd to meet at 10 A.l\f. to-morrow.

EXCHANGE HALL, December 18, 1876-10 o'clock A.l\L
Tbe committee appointed to continue the investigation in Savannah met.
Present: Drs. Thomas, Sussdorff and Campbell. Meeting called to order by Dr. Thomas. An interesting letter was read from Gen. Henry C. Wayne, calling the attention of the board to what he considered an influential agent in the encouragement of diseases in the city. Gen. Wayne, by invitation, appeared before the board, and gave his opinion as to the sanitary condition of the city, the origin of the yellow fever, etc. Mayor E. C. Anderson came, by invitation, before the board, and testified as to the cause of yellow fever in the city. On motion the board adjourued to 10 A.:M. to-morrow.

Committee met.

EXCHANGE HALL1 December 19, 1876-10 o'clock A.M.

Called to order by Dr. Thomas.

Minutes of previous meeting were read and confirmed.

The followin~ letter was read by the Secretary :

84

SECOND ANNUAL MEETING

THOJ\IASVILLE, GA., December 18, 1876. To the Secretar.1f of thr State Board of liealth, Savannah, Ga:
DEAR SIR-Having > c1 some experience in health matters in
Massachusetts, and he: ri,1g your board was investigating the cause of the late epidemk in Savannah, and feeling an interest in the health of our State. (for I am now a resident of this city,) 1 desire to ask if your board will act upon the suggestion I propose to make'? A trip through Savannah the last of December, 1875, discovered to my senses that an unnecessary amount of filthy deposits had been made on the streets and about the houses in certain portions of the city, to create in time just such an epidemic as swept the city the past summer; and I am firmly of the opinion that the impregnation of the drinking water (used by the inhabitants) with the impurities of the filthy stuff thrown upon the ground from nearly every household, by the process of filtering through the ground, or being washed into tlw wells, hail caused, or was the cause, of the excessive fatality of the late scourge.
Pure water is one of the greatest blessings we can have, and I wish your board would freely and fully investigate this view of the subject. For an instance of water-poisoning, I refer you to an article in the last annual report for 1876, issued by the Massachu.setts State Board of Health.
With well-wishes for the continuance and success of your board, I am, dear sir, yours faithfully, A. VVINTHROP HASTINGS.

Dr. H. F. Campbell was appointed a committee of one to investigate the origin of yellow fever cases occurring in Augusta, and to obtain all the testimony possilJle lJeariug upon t3e portability and transmissibility of the yellow fever poison.
Dr. G. E. Sussdorff was appointed to investigate the subject in regard to Macon, and prepare a report, to be presented at the meeting of the board in Atlanta.
A communication was received from Dr. S. Dupont, giving a history of the yellow fever at the Isle of Hope.
The following resolutions were offered, and unanimously passed: Resolved, That the thanks of the State Board of Health are hereby respectfully tendered His Honor, E. C. Anderson, .Mayor of the city of Savannah, for assistance and courtesies extended to the board during its session in this city, while investigating the late epidemic of yellow fever. Resolved, 'fhat the thanks of the board are respectfully tendered the medical profession of Savannah; Dr. 'f. J. McFarland, health officer; and the citizens generally, who have so freely and cordially aided the board in its labora.

r

STATE BOARD OF HEALTH.

85

Resolved, That the board recognizes the valuable services extended it by Drs. E. McClellan and A. A. \Voodhull of the United States Army, in their yellow fever investigations in_iohis city, and for which it is pleased to return its thanks.
Resolved, That the board recognizes its obligations to Mr. B. H. Richardson, city editor of tho .JJiorning News, who attended every session punctually, and daily published interesting synopses of the proceedings, and who, by his remarkable rapidity and accuracy of execution in recording testimony, has greatly assisted and facilitated their work, and for wh1ch they are pleased to return to him their thanks.
A:~D WHEREAs, Certain railroad corporations, recognizing the benevolent and public character of the State Board of Health, and the entirely di~intorested natnrt> of their diort to investigate the causes of a most destructive and ealamitons epidemic among the people of the State, (or upon our eoast), have libt>rally given free passes to the me1nbers of the board to and frorn tlw scenes of their recent prevalence.
Resolved, That the thanks of this board and their high appreciation be publicly expressed to the following officers and authorities of these roads: First-to Colonel \Vm ..M. Wadley, President, and to Colonel \Vm. Rogers, 8uperintendent, of the Central Railroad; second-to Colonel John Screven, President of the Atlantic <tnd Gulf Railroad; third--to Hon. J. E. Brown, PreRident of the Western and Atlantic Railroad; and to Captain J. A. Grant, Superintendent of the Maeon and Brunswiek Hailroad, for the above mentioned faYors in facilitating the important labors of the State Board of Health.
Resolved, That the thanks of the board are due, and are hereby tendered, to Mr. ""~Nm. E. \Vhite, reporter of the Savannah Ne-ws, for a classified mortuary reeord of Savannah, embracing the period of the late epidemie of yellow fever in the city.
On motion, the board adjourned sine &ie. V. H. TALIAFERRO, M.D.,
Secretary of the Board of Health of the State of Georgia.

OFFICE STATE BOARD OF HEALTH, ATLAN'l'A, GA., January 17, 18i7-12 o'clock M:.
Board convened by call of the President. Present: Drs. Campbell, Logan, Little, Holmes, and Comptroller General Goldsmith.
In the absence of the President, Dr. Thomas, Dr. Logan was, on motion, called to the elmir.
Minutes of meetings in Savannah wcr, read and approved. Dr. Logan stated that he had an arii:. on lunacy, by Judge
Bigham, and as Mr. Bigham was present, >3 suggested that that

86

SECOND ANNUAL MEETING

gentleman read the paper. Judge Bigham said he would not then read the paper, but would briefly state to the board its substance and the objects he had in view in writing it, which he did in ~ very clear and impressive manner.
The board was higllly instructed and entertained by his remarks On motion, the board adjourned to meet at three o'clock P. Ill., in the Senate Chamber.

SENATE CHA"'IBER, 3 o'clock P. Ill. Board met. Called to order by Dr. Logan. Minutes of the previous meeting were rPad and approved. Dr. Logan requested Dr. Campbell to take the chair, and, as chairman of committee, read the report on the epidemic of yellow fever in Savannah, in 1876. On motionResolved, That the committee's report be received and adopted as the report of the board, and tllat it be printed with the annual report, together with such testimony bearing on the subject as may be thought proper.
On motion, the board adjourned to meet to-morrow morning at 11 o'clock.

OFFICE S'l'ATE BOARD OF HEALTH, January 18, 1877-12 M.
Board met. Present-Drs. 'l'homas, Campbell, Holmes, Little. Meeting called to order by Dr. Thomas, the President. On motionResolved, That a committee of three be appointed to wait on his Excellency Governor Colquitt, and inform him that the board is now in session, and would be glad to receive any communication he should be pleased to make. Committee-Drs. Thomas, Holmes, Little. On motionResolved, 'l'hat Dr. Campbell's report on the transportation of disease germs, and on the epidemics of yellow fever and dengue fever in Augusta, be printed in the proceedings of this board as a supplementary report to the board report on yellow fever. On motion, the board adjourned to meet at 3 P.M.
OFFICE STATE BOARD OF HEALTH, January 18, 1877-3 o'clock P.M.
Board met. Present-Drs. Thomas, Logan, Campbell. Meeting called to order by the President. On motio11-

STATE BOARD OF HEALTH.

87

Resolved, That, after careful consideration, the paper presented b the committee, Drs. Logan and Little, be adopted as the report : the board's investigations of the yellow fever epidemic in the
0
State of Georgia in the year 1876. J. G. THOMAS, M.D., W. L. GOLDSMITH, Comp. Gen., GEORGE LITTLE, State Geol., BENJ. M. CROMWELL, M.D., GEo. F. CooPER, M.D., F. A. STANFORD, M.D., Jos. P. LOGAN, M.D., G. E. SussDORFF, M.D.,
G. w. HOJ,MES, M.D.,
H. F. CAMPBEJ,L, M.D., H. H. CARL'l'ON, M.D. The committee appointed to prepare the ~port of the yellow fe\er epidemic upon the coast of Georgia for lhe year 1876, desire to acknowledge, and to have it recorded, that they are under special obligations to the distinguished epidemiologist, Dr. Ely McClellan, U. S. Army, for most valuable assistance in their labors.
J. P.LOGAN, GEORGE LITTJ,E.

SENATE CHAMBER, January 18-7 o'clock P.M. Board convened. Meeting called to order by the President. Dr. Ely McClellan, U. S. Army, was introduced by the President, Dr. Thomas, a.nd read a very interesting paper "On the Relations of Health Bonrds and other Sanitary Organizations with Civic Authoritie;;." On motion of Dr. CampbellResolved, That the thanks of tLe board are due, and are hereby tendered, Dr. McCl~ellan for his able al)d valuable paper just read, and that he be requested to furnish the board a copy of the address for publication in our proceedings. On motion, the paper of Dr, LeHardy on small-pox was read. On motionResolved, That the paper of Dr. LeHardy be referred to the Committee on Legislation, and that they examine into the law and proposed amendments, and place it in the hands of Col. Payne, of Chatham county, for presentation to the Legislature. On motion, the paper presented to the board by Judge Bigham, on lunacy, was read.
On motion, the paper was referred to the Legislative Committee and Committee on Publication, with power to act.


88

SECOND ANNUAL MEETING

The committee appointed for the purpose submitted to th

Legislature his Excellency the Governor the following:

e

ATLANTA, GA., January 23d, 1877, J'o His Excellency Alfred H. Colquitt, Governor of Georgia:

DEAR SIR-'l'he undersigned Leg leave to state that they have been appointed, upon behalf of the Board of Health of tile State of Georgia, to represent to your Excellency, and through you to the!Legislature, the difficulties which interferred with the successful operation of the law creating the board, and, in accordance therewith, respectfully submit the following statement, with the request that you will transmit it to the Legislature at your earliest convenince:

'l'he Board of Health of the State of Georgia, after careful con sideration, have decided that it is due to thems(~lves, to the State government, and especially to the important public interests committed to their charge, to represent that, after a sufficient time has elapsed since their organization to make the experiment, they are forced to admit that they have not been able to accomplish fully the object~ of the law, and are fully convinced that its intents can not be attained without most radical changes, and thus conforming it to the;measures which have been found necessary in other Stat~R where boarcts of health have been successful]~' established.
It is not rPgarded as necessary or advisable to elaborate Pither the obsbcles or the remecties, and they may be thus briefly stated:
Under the existing enactment, the board has no power to enforce any part of the ends for which it was created, and it is left entirely to the will of the people and communities whether they adopt any sanitary regulations whatever, and to the .same voluntary disposition of physicians, ministers and Ordinaries- upon whom has been devolved the duty of executing the registration features of the law-for the rPturns of births, deaths and marriages.
For reasons which are apparent to the board uncter the present statute, these laws of health will not he observed, and these returns will not be made, except under the pressure of r;,bsolute compulsion. If, therefore, the board of health is to be continued, or unless the vital objects which have been sought are to be abandoned, the most stringent and positive legislation must be adoptect to force obedience to the demands of the board. If it should be regarded as desirable to continue the existence of a registration law, it would be advisable to relieve the board appointed ror the execution of a health law from the performance of a work which could be much more readily all!l efficiently performed by the Tax Receiven;, Ordinaries and the Comptroller General, and of antagonisms with the cla~ses alluded to as responsible for the retul'illl,

STATE BOARD OF HEALTH.

89

Iculated to cripple their influence in the discharge of the more

:mediately pres;;;ing and legitimate duties connected with. the

rganization and enforcPment of a thorough ~yst12m of samtary
0
equirements throughout the State. This system should embrace
~e absolute eontrol of epidemics of evpry class, including con-

spicuously the power of enforcing vaccination and isolation duril~g

the prevalence of small pox, the hygeine of cities and towns, the

quarantine and disinfection of ships, steamboats and railroad cars,

of health regulations for asylums for the insane, blind, deaf and

dumb, of hospitals, schools, prisons and manufacturing establish-

ments. While the value of vital statistics, to be obtained only

through a system of rigid registration, is, after a number of years,

very great, it is by no means necessary that they should be col-

lected through the agency of a board of health, as it is with the

result8 and returns of such registration that we have to do, as tho

basis for a tabulation, to be used ultimately as a valuable adjunct

In promoting the health and general welfare of the State.

As the result of onr experience with the present law, and inve;;-

tlgation into the operation of health boards and laws of registra-

tion elsewhere, we would suggest, as inclispl'n~able to the success

of either of the object:,; contemplated, and to which reference hn:>

been made, that the State should arlopt such legislation as will re-

quire the returns of birthH and dcatbR to be made by lwads of

families, only requiring the eertificate of the physician as to the

cause of death ; but with such stringent provisions in the Iaw as

will be equally efficient in enforeing sanitary regulations, am! in

tbe collection of vital statistics, as the laws for the collection of

taxes or the suppression of erime, neither of which are, in our

Judgment, in any degree more important.

While, therefore, the present board might be willing to continue

to discharge the duties imposed in this connection, as a gratuitous,

and we fear unappreciated work, and as a labor of love in the

interest'! of humanity, under a law which would give absolute

power and ample means to enforce its requirements, and are pre-

pared to suggest such provisions as would accomplish the object,

if it should be desired, they are not willing longer to remain as

suppliants for existence, or the subjects of criticism for inefticieney

in the discharge of duties which they have neither le"al powers

or means to perform.

For the more full consideration of this subject, embracing tlle

dlmculties and the remedies, we would refer you to the able and

comprehensive annual report of the Secretary of the board.

Respectfully submitted.

J. G. THOMAS,

J.P. LOGAN,

H. F. CAMPBELL,

Committee.

90

SECOND ANNUAL MEETING

The committee appointed for the purpose, consisting of Drs. 'fbomas, Campbell and Smsdorff, submitted the following extract from the Athmta .llfedical & Surgical Journal, by W. H. Burges~, M.D., as an appropriate memorial of the late Dr. C. B. Nottingham, a member of thii:> board:
IN MEMORIAM. DR. C. B. NOT'l'INGHAM.-Dr. Curtis Bell Nottingham was born in North Hampton county, on the eastern shore of Virginia, May 21st, 1818, and died in ~Incon, Georgia, 14th of March, 1876, in the 58th year of his age. His academic education was received at home, under the guardianship of hiH eldf'st brother, Mr. Leonard B. Nottingham, and completeJl in Carlyle College, Pennsylvania. Having determined to make the science of medicine his profession, be worked faithfully to that end, and graduated at Jefferson .Medical College, Philadelphia, in 1840. His professional labors were begun and carried out with marked success for nine year:;, in Perry, the county site of Houston eounty, Georgia. Gifted by inherit::mce with all the attributes of a perfect gentleman, Dr. Nottingham failed not in winning the confidence, admiration, and love of all with whom he was brought in contact. Thus endowed, it is easy to imagine how readily he won the confidence and liberal patronage of the people who deligbt~c:d to honor him in his new home. For nine years his professional labors grew more extensive and arduous, when he determined to change his field to Macon, in Bibb county. In this new location was afforded a wider range for the development of a superior order of talent, that was destined to shine with ever-increasing brilliancy to the close of his life. Here he met peers before whom the doubting might feel inclined to shrink. Not so with Dr. Nottingham; with full confidence in his ample qualifications, and an ever-guarded determination to enter upon no other than the legitimate domain of his chosen piofession, nothing was more in harmony with his aspirations than to measure strength with an honorable competitor. In Macon his practice was attended with like successful resultR as bad so signally marked his labors in Houston county. His patronage grew steadily and rapidly, until he stood in the front ranks with the leading men of the profession of Georgia. Naturally of a delicate constitution, the severe tax levied upon him was making perceptible inroads, when he concluded to change his pursuits to the field of agriculture, and to this end moved to Louisiana, in January, 1860. 'l'his new enterprise, with the advantages of >Jcience to guid~, must have yielded abundant fruit, but he was not suffered to remain long in the quiet and uniform repose of tba

STATE BOARD OF HEALTH.

91

husbandman. 'The tocsin of war had sounded. H would have

dbe~ny

unlike himself had be not at once responded to the and his country. vVitl! tlle appointment of surgeon,

ealJs of he was

;lgned to the supervision of an important military post in the

State of bis adoption, where be served with chnract..ristie fidelity

to the end of the war. The disastrous results of hostilitie~, left him, like most of the
Southern people whose fortunes consisted in land and negroes, in the midst of poverty. His agricultural prospects thus rudely terminated. be resolved to return to Macon, where be resumed practice on January 1, 1866, among friends who warmly welcomed him

to his former home. For two or three years after his return his health was quite
feeble, but with the exception of a few short intervals when acute disease forced him to his coueh, his indomitable energy, and a will that bowed to nothing but the absolute detrees of Deity, bore him triumphantly through a laborious work until the rose-tint of health bad been restored to the blanched cheeks. His progress was onward and upward, until he was justly entitled to the. first

piace on the medieal staff of the city of Macon.

Some years before his death, his able mind led him to enter 'lUCceesfully the higher domains of gyn::ecological surgery in successive operations for ovarian tumors. It was the writer';,; pleasure to 888ist in several of these operations, and with pleasure be bears testimony to the skilful and fearless method which accurate knowledge of his workenabledhim to exhibit. 'The brightness of the dawn in this new field gave abundant evidence of the noon-day splendor just ahead bad his life been spared.
Perhaps the most cherished theme of his whole professional life was the inauguration of a State law of registration; and although his immediate effort failed to meet the approbation of a majority of our legislators, whose proceedings, I regret to say, were freqtently savored with a disposition to ignore all great measures of public weal, this ideal was at a later day secured in the establishment of a board of health for the State, in which was incorporated the registration feature. His Excellency, Governor Smith, gave to Dr. Nottingham a place on the board, which was duly appreciated 1tnd highly honored by the appointment. His appreciation and full realization of the reSlJOnsible position he had accepted was evinced by the ceaseless labors bestowed ou the work. He was in correspondence with every portion of the continent, and not a leaf was left untnrned that could throw light on the subject.
In the writer's opinion, this new work, coupled with his ordinary laborious duties, had much to do with f c1ortening his valuable life. The tax upon mind and body of a constitution naturally frail was

92

SECOND ANNUAL MEETING

too great, anti all that was mortal of this trnly great and good man

perished. Dcatll had no terror to him. C'nlmly his soul passed

into the blessed renlms of peace.

Macon, Ga.

\Vn,LIAl\1 R. BURGESS, M.D.

On motion, the board adjourned sine die.

V. H. 'fALIAFERRO, M.D.,

Secretary o1 the Board of Ht'altll of the State of Georgia.

REPORT
Of the State Bomd of Ifealth of the Late Epidemic of Yellow Fever in the State of Georgia.
The Board of Health beg~ lmwe to present the following, as their report upon the yeliow fever <;piuemic of tlw past year within the State. This report c'mlmwes an accuunl of the epidemie at Savmmall, Brnnswick, Doboy, Maeon and Augusta, with such faets as eoultl be collected as to the causation of the epidemics.
It is but proper to state that thi~ inYestigation. whieh was properly within the province of the Board, and undertaken at the suggestion of the Govemor, has been a matter of eonsiderable <~ost to the individual members of tlw H:mrd, who were ohlig<ed to abandon their priYate businc~s, and to defray all the expenses of the investigation out of their private nwans.
The report consists of: I. Topography ofSavamwh, Brun~wick, .i'viacon nnd Augusta
II. Meteorological report;;. TIL The sanitary eonrlition of Ra vanJJah prior to and during
the epidemie. IV. 'l'he history of the epidemic at Savannah. V. Evidence in favor of the importation of the disease. VI. Evidence in favor of the malarial origin of the disease. VII. 'rhe epiEl.emie in the vicinity of Savannah. VIII. 'l'he epidemic at Brunswick. IX. The epidemic upon Doboy lHlanrl. X. The epidemie at :\ft1eon. XI. The epidemic at Augusta. XII. Conclusions and recommendations a;; to the pr(wention of
tho disease.
'l'OPOGRAPHY OF SAVA"'NAH.
.From the "HiBtorical Hecord of :-;avannaiJ," published by J. H. Estill, the following exstraets are taken :
Topography.-" ~trde!1ing along the southern bank of the Savannah river stands Savannah, the Forest City of the South. A

94

REPORT ON YELLOW FEVER EPIDEMIC

sandy plain, fifty feet above the level of the sea, and about eighteen miles by the C'ourse of the river from it, is its site. This plateau upon which the <ity rests, is almost a level, ueing forty. eight feet aboYe the level of the sea at the Pulaski Honse, fifty feet at the intersection of MontgomC'ry and Gwinnett streets, and forty-six feet at the Park; at this point and level commences a ridge or back-bone of dry pine land, extending due south, and aptly marked by the \Vhite Bluff road, which curiously divides the waters of the Ogeechee from the \Yaten; of the Vernon river. This ground was originally covered \Yith dense forests, which were cleared away very soon after the introduction of the Royal Government in 1752. '!'here is au area of country, determined by two measurement;.;, a north and south line of nine or ten miles in length and an east and west line of about the same length, which must be of great future interest to the well-wishers and actual inhabitants of the city of Savannah. This area lies between the Savannah river as a northern limit, the Ogecdwe and Vernon rivers, with their tributarie~, as a Houtlwrn limit, the St. Augustine creek and Vernon river as an eastern limit, :md the great tidewater s\vamp stretching due south from the Savannah to the Ogeechee river as a western limit. 'l'he thorough and complete drainage of this Mesopotamia, now in contemplation, would add untold wealth to its people and render their sanitary condition the most enviable in the world.
"This area, on the mid-~wrthern edge of which Sa,annah rests, is bisected by an elevated, piney ridge, npon which run the \Vhite Bluff and Middle Ground roads. All the waters of the eastern slopes of this water-shed empty into the Vernon river, through a swamp about seven miles long, and extending from the Catholic cemetery on the Thunderbolt road, to the tide-water of Vernon river at Hanner's bridge ; and all the w:atcrs of the westem Hlopes of this water-shed empty into the Ogeeehcc; river, through a great swamp extending from the dam or lmek-watcr of the Springfield plantation to this river's channel. Thus this area iR drained by two long swamps, whose waters belong severally to the V<;rnon and Ogeechee rivers."
"It is worthy of not<", that this western swamp, with all its multitudinous ramifieations, is a tide-water swamp, subject to a greater or less influx and efflux at each tide, and stretrhing from the Savannah river to the Ogeechee. Between these points there is a gradual rise of the land to n summit revel, three to J-ive teet above mean high-water mark, and about the tltreP mile stone of the Ogochee plank road, from which >mrnmit level the waters have a natural tendency to flow north to the Savannah river, and south to the Ogeechee. 'l'his is in striking contrast to the Vernon river

STATE BOARD OF HEALTH.

95

swamp, which has a steady rise of fourteen feet to the Catholic
cemetery." ,, 'fhis extensive tide-water HWarnp i8 uncleared and uncultivated
in its whole extent, except immediately upon the western edge of the city of Savannah, where, before the year 18:.l0 (the date of the dry culture contract), an extremely valuable rice plantation existed stretching from tlw river front to a back-water dam, built by th~ original owner, Joseph Stiles, an Oglethorpe Colonist. 'l'his dam is parallel with the most extended southern limit of the city. Unhappily for Savannah, tile dry culture eontraetcaused an entire alllmdonment of tllese once culti \"atcd swamp lalHlH, and in consequence the ditcbeR, canals, dams and gates llave all gone to decay, and the last coudition of them is ten-fold wurse than the first. 'fo increase tile embarrassment, the high embankrueuts of the Cen~ trnl railroad and Ogeeehee canal divide this plantation in two parts, on the line of Liberty street, and thus permanently intercept tile uatural lines of drainage. 'l'his Springfield plantation contains 500 acres, and is a narrow belt of low laud three hundred
yards wide." 'fhe eity front a little west of north on tile river, Bay street
extending nearly east and west from tile gas-works on tile east to the water-works on the west side of the eity. Laurel th"ove cemetery is in the southwest corner. The Atlantic and Gulf railroad depot in tile southea:,;t eorner. The Atlantic and Gulf wharf in the northeast, and the Central railroad wllarf in the northwest. Bilbo canal bound;,; the eastern side of the city, extending from the Atlantic and Uulf railroad wharf, southward, to tile terminus of the main Bolton street ,.;ewer. On the east side of thi,; eanal begins the wet culture of rice, on tile Lawton plantation and old ';brick ponds,' and :,;outll of these tile 'boneyard,' where dead animals frmn the eity are left to decay. On tile west, near tile Central railroad wharf, i,.; the outlet of the \Yest Boundary street sewer, wllicll empties its contents into the riYer near the Screven sewer, which drains a part of the Springfield plantation, on which the oftitl of the city is deposited by tile City t'icavenger, on sandy land belonging to the city and rented by himself.
1'hese sewers empty below the mouth of Musgrove creek, whieh runs througll the Springfield plantation, and from this tl1e waterworks take tlleir water at llalf-ebb tide. Through this creek also empties the drainage from the swamp lands whieh lie west of the city.
The water is taken into the reservoirs without filtering, except such as keeps out so much of the gmss, weeds, etc., as would obstruct the working of the pumps. From the reservoir this water,
J.

96

REPORT ON YELLOW FEVER EPIDEMIC

\Vhich has been exposed to the contents of the two sPwer,.;, nnd the creek which drains the swamp lands, and the filthy water from the wharves, carried up by the riRing tide, and finding ih; first eddy immediately in front of the entranee to the rescn'oir:;, h; delivered, without filtration, except as it is done m private bouse:".
Even in this condition, it is possibly less injnrious than that supplied from wells ten to thirty feet in depth, in a ~oil of almost pure sand, varied in points by a hard pmL This "'Pll or pump water is no doubt contaminated with the pt>reolntinn from this very porous sandy soil, containing the solution" from the privy vaults, which are emptied directly into the sn11rl, forming no obstacle to organie matter dissolved in it to the water bearing stratum and to the pumps.
There is no growth of vegetation on either the eastern or western side of the city, as protection against the malarious atmosphere from the swamp, filled with decaying vegetable matter, and extending for miles east and west of the city, excepting in Laurel Grove cemetery in the southwest.
Beyond theSprinfield plantation, which, during the past season, was entirely overflowed, and not successfully drained until late in the season, there are other 'brick ponds,' which would furnish abundant vegetable matter and stagnant water to infect the atmosphere, borne by the west winds over into the city.
\Vith these surroundings, taken in co11nection with the neglected condition of the drainage of tho Springfield plantation, the Lamar canal, and Lamar creek, Bilbo canal, and the quantity of stable manure-cow and horRe Rtable depoRits in shaded back yards-and foul sewer gasses, the wonder iR that malarial or other fevers did not alone decimate the population of this beautiful city.
TOPOGRAPHY OF BRUNSWICK
The location of Brunswick differs from that of 8anwnah. \Vhile Savannah is situated on a river eighteen miles from the seashore, Brunswick is on a point of land almost entirely surrmmded by sea water. Turtle river on the one side, and St. Simon sound, with its inlets, on the other, flood the salt marshes at every influx of the tide.
The city itself is built on a dry sandy soil, covered with live oak, palmetto and cedars.
The population does not probably exceed two thousrmd fiye hundred, though it has been estimate<] ns hi~h as four thousand, and is scattered over an area of several hundred aeres, There is no large accumulation of offal or animal deposits, There are nn fresh water swamps in the immediate neighborhood. There are no ice

STATE BOARD OF HEALTH.

97

plantations, no lands devotetl to dry culture, no sewnge, no canal,

no river water, possibly taintetl with injurious matter, no crowded

houses, large privy depo,.:its, no staL!eH of consequence. Still the

fever has prevailed with alarming fatality. MACON-Is Lnilt mainly on the drift deposits which horder the
older granitic rocks. 'l'hese depo:-;its are mainly gravel, 8and and clay, forming a good dramag~c material a!lll a healthy location.
In the eastern part of the eity, and near tlle Cm1tral railroad depot, the city is flat and level, alHl built upon an nil uvial clay soil, borllered by swampl< ~mel overflowed lands. In this portion of the city the malarial condi1ionH prlndl, and here the yellow

fever, introduced from Savannah, found it:-; vietimtJ. AuGUSTA-Like Macon, is just on tlH ~JOrclcJ' Lmd between the

metamorphic rocks and;tert!ary lime und day for,nations, with the quaternary sands, clay and gravel (overing the line of junction.

The soil is a deep sand ; on the hillt< eminPntly hettltlly; but the Savannah river ha~ made a deposit of alluvium below the city, which, in years past, has been overflowed and again exposed to

the aetion of a summer sun, with the accompanying (lecomposition and tkeay of vegetable matter, us well a~ organic animal matter which had here accumulated by eddies and currents.

Here, again, under proper ctmditions, we find a lwt bt>!l for propa

gating fever;; of any and every type, so soon HH the germs are introduced and patients furnished in a proper condition tu receive infection.

JIIECJ.'EOROLOGY.

There is one remarkable fact which attrtwts attention in considering the table" annexed, ,;bowing the daily means of !..teat, rain-

fall, uirertion of wind and moi.qture of the atmosphere during the four mouth" of .Jmw, July, August and September, at Savannah.
'flw a vemgc rainfall during tbe month of Jmw, for the years

1873, 1074 and ltl75, was a little over four inellctJ, and (luring tlle

same month in 1876, it was 18.8 inelle;;, and thi:; was nearly all

witllit1 ten da;p;.

Ther.

June, lf\7~ .............................80

June, 18"/il........................... 78.il

June, 1874............................ 80.7

June, 1875............................ 79.4

June, 1876............................ 80.6

Rain. 9.52 4.64 4.85 4.1 18.8

Wind. Humidity.

s.w.

69.3.

W.S.\V.

74.8.

S.E.&S.W. 73.2.

s.

71.4.

S.\V.

71.2.

98

REPORT ON YELLOW FEVER EPIDEMIC

METEOROLOGICAL TABLE-I.

JUNE.

JULY.

AUGU,T.

SEPTEMBER.

DATE, 1872.

.s..

""" ~"
~~ Qa

,..-:i

;d.

00
"c"
~

s...

."c
~

~

~_ -~
c.., i;::;

.~-

00
~"
~~
;1.

~

00
]

""" .c
~

;:::

= .~ ;;; -~

I~
~ 1 Q)
i

~ I "'

~~

I ~ -~

;:::.1

~--

~
d::

w - -. =~ :;s - - ~ 84-- Nw's6r:-~~:-~ -"I~~.-.~.. NE

2<1 ..................... 84
3d ..................... 81 4tn ................... 83 5th ...... .. .... 78

6 .22 ~~W~~842
.93 u n o N 1 83

1--.. -,u .02

~~l'r~

S2 :,'s9



.;tJ, N~\~ ", :
;_,1, ,E 76

........ :s-~e NW

u" t; 7G

8.5'711

,, o SE 80

tiE: t:lW

6th................. 78

NWI83

.03 SW 77 2.11 HE 82

tiW

7tn ................... 80
8th ................... 85 9th................... 85 lO!h ................... 82 lith ................... 78

Bb3

.77

I SWI79

.54

.07

s 82
NSWW\82

.... .'.1..~?

84

7 9 N~fE:~-s o
0 s~E:~ 117899
u

1 ....._. .J.~ 0
~----:ii2
.........

NES2 NE Kl NE ::'0 NE 76 NE:77

SE t-iE SE .II NE .HI NE

12th................... 80 l:Jtb ....................%

S 83 SM

sE 82

12

SE 84 j .... .'....

:"F'i78 SE 78

..7lf7l

S S

Hth.. _., ....... , ... 82

SW 80

.70 SW 83 1......... :i 7G

.02 E

15th ................... 79 16th.......... , ....... 7S 17th................... 75 18th................... 76

2.10 SW 81 ......... 1 SE 84 I

2.15 SE 83

S Rt

.fiO E83

SW79

1.24 NE 84

SWill

S 74 S W 76 SE72
E 75

E

SE

.12

~

.10 SW

19th.................. 77 20th .................. 76
21st .................... 7ll
21<1 ..................... 79 23d ..................... s:l 2~tb ................... 79 25th................... 7~

NE 82

NE 79

.15

E 82

NE 84

S Sii
.81 sw 86

.2\l

~ 87

W 82

KE 70

W

:::::::::1 .Oli

~Ill

.07 NEt71

NE

1......... .20 SW 82 N.W ~~

NE 7R SE 77

E SE

SW S4

QE H

.IJS SE

w '~

.3v t-IE 7:;

.3!> E

l-iE 83

~ E 77

.06 N

26th ................... 79 27th................... 79 28th................... 78

8 .VS SsW~ 8s9.,

1 07

8,

29th ................... 81

SW 83

3<lth................... 84

SW 83

31st.................................. ,......... ti5

2 1.... ..~. . 1v .........
......
......... \

SE ti2

w.,
1

Q. '~~

S 1 81

SE 82

i:i73

1.........
.lll ......... ......

SW 78

,; W

swn NW 73

.16 NW 1.:>1 I:SE

tiW 81

SW

NW 7~

11 NW

NE ...... ................

Monthly means.. 80 .................. 83 '1--------1 ....... 84 ......... \ R.52 3 5:1 3.52 .........

Totals..................... 9 52..... ...

4 36

1~ !>1 ...............1................ .

STATE BOARD OF HEALTH.

99

2\IETEOROLOGICAL TABLE-II.

JUNE.

JULY.

AUGUST.

SEPTEMBER.

J.L.:==:-:-: 6~ -~.0!II . 8~ DATE, 1873.

a~ .
t:;::::;:'J~
~ -~

-~ g ~~ -$s ~.....;
~> l : l~; : :-:~

p., N

"'.05

2d .................. 71

.74 NE >l"l .....

3d ................. 75

.07 tiE 85

4th.................. 78

.03 S W 84

5th.................. 83

SW 8?>

.12

6th .................. 83

'' 79

.40

7th .................. 80

.:10 SW 81

8th .................. 77

.01 NE 80

.77

9th .................. 74 lOth .................. 7G

:NE 79

.21

SE 82

.01

lith .................. 76
mL::::::::::::::: 4~
14lh.................. 75

.28

E 76

.0-l

.oo
2.14

~~ ~~
SE 81

1::::::.0::3

15th.................. 82

.05 NW 82

16th.................. 83 17th.................. S~

.04 SW 83 .Oo SW 82

18th.................. 83

W 85

,15

19th.................. 87

W,Su

.18

20th .................. 87

Wl78 1.11

21st................ 83

.16 W 77

.34

~~~::: .. ::::::::::::J~ I::::::::: J~~~~ .64

24th .................. S:J ......... !:'E 79

25th .................. 82

.18 SW 82

26th .................. 73

.07 NE 84

.08

27th ............... 76 ......... N E S2

781I 28th .................. 74 1 .27 NE 79

29tb............ . 79

.07 SE 76

.17 1.02

30th ..................

.14 SW,82 .........

______:.:: 8lst....:.:.:.:::::.:::.::::.:.:.:: ::.::.::.::_ ::.:.::.::.::1~

.-~g ta1;Jj ~

:w> ~

l :~
8:

l

=;
~.02

SW 83 NW 80
SE 82 S 75
NW 77 SE 17
SW 80 SE 83 NE 78
SE 80
~~ ~b

......... .9:1 .85 .78 .33
:~~

E 80

E 79

SE 80

SW 80

.08

SW 80

8\V 78

.46

SW 78

.07

SE 80

.26

8~ ~~ :~~

E 81

SE 80

SE 83

SE 86

S 77

.31

8W 80

.54

SW 79 .........
:>W ~ ~

I r~ g. ~s~ ~.

1.
~'g

:w 8: . :.. ;:.:~;:::

~

Cl)

;

p~ .

1 :W

SW 86 S 85
S 82 SE 81 NE 80
E 81
SE 78 SE 71
S 72
SE 72
~~ ;~

.........
.25 .04 .04
.91 .01 .06

SW SW SE SW SE SE NW NR NE
NW
~~

SW 77 SE 69 SE 75
S 75 SW 75
SW 73
SE 73 SE 70
N 'r +~ c;r 75 SE 78 SW 77 NW 78 NE 75
NW 75
NW 77

SE NE NE .06 NE .21 E
1.34 8E ~:
NE
.es ~~
.02 SE NE
.19 8E .02 NE
N
NE
.85 SW

SW::.:.:.:::::.:::.::::::.:::.:::

Monthly Meansf78.8 .................. 181 .................. 80 .................. 76.4 ......... 1.........
Total ............... ...... 4.134 .. ...... ...... 5.44 ......... ...... 5.45 .. ....... ...... 4 03 ........ .

100

REPORT ON Y, Ll.OW FEVER EPIDEMIC

METEOROI"OGICAL TABLE-III.

JusE.

Jn.Y.

SEPTU:.MBL1:.

I

Jr--il ~ ~ ~--~-r J ~ ~-~- -1T-~ ~ f i DATE, 1874

_____: __1_ 1 1 ~~~ ~ ~::l

):J

I 1 -

.

ii

I ' ;:

::I

-1 ~ :;; I ;-: -
;i;

1

-~ ~ I .,: "

-~ !=: I ... "'

;;'!

"p:
d;

=
~il

~~p= ~II


:; h

r IS4 Jst ................. ........ sw Si I tiE So

sw 74 .0< NE

2d .............. 81

3d ................. 82

~4tthh

................. ................

JS71~

6th ................. ", '

I1 ......0.8..1 .I!G l."S u-I

N~EF~7842

. 0.) 1 3.0o

Sf. SE

78 s.;

rI.36

..u..:!'".1 I-I

">" 1"v'

SC HG
S 80
NE 78 till 77 -nr..,.l'. "/.''

.......

I .28

.24

1.........
I. . . . . . . . . .

I

SW 76
N:'. Ef.l7777 E 7G J,' _I,...,,

........ K

.........

E

-"~' NE

.011I .........

NE
ln'.~.T.V

7th ................. 81

_tq

S1 r, 1 .0~

E ,9 ......... ~E IS .........

E

8th ................. ,..;:{

8\V 7B

.flf.l SE 77 ! 1.94 S W 'i7

.0;5 NW

9th ................ 84
lOth ............. s4
11th ................. 811 12th ................ "' 13th ................. 7G

SE HI

S": 7G
.o, <'W z,r.,~.

SW

.50

N 79

:.<!;::,,
.88 .112

:-;E81 S 81
StiEEIS8G4
t-iE Sil

......... 1......... \
I I
1I .391

NE 7V

NW ,:';~

7z,2;

~' ,,

NE 7G

......... ......... 1
.:21 1.5:)
.12

N\1'
IV
\1 NE NJ<;

14th .............. 77 J.Jth ................ 1To

1 .cl .til

XE- 81 :NE 79

.........
1

~..... E~"'x8o1

.......1.11

:S E 18 NE -.:n

.G6 :01-:
.111 s'v

::::::::: I (......... i~:L

~;,

!.8th ................ 74

1

:~~
1~9!

~"'~1 ~~
~-'~. ~,':,

19th ................. 7D ......... "'"

,~~~n ~-:::: ~:~~~~

Nf't~/:K!

.......U...lr,

N.~~.~~~~_f)
..

2.11i S\~
SSEE

""(j:l ~~~;l............ ~~ r:_:_:_:_:_:_:_:_:_!1
22d .::::::::::::::::: 81

~~
i:>E

:S~~

:

:-~:):.l~

~Se~W.~~~~j

~::: ;~
:,: :-;w i'2

s~
1\'

23d .................. 81 !....... j S W 80

.ii(i lS W 82

70 ti W 7:;

(;9 ; N E

N{qs. .....::.) Nf: ~~tL::::::::::::: ~! 1:::::::::! ~;~ ~I [::

~~- ~t, ..:~.~

I 2Gtl.t ................. 85 ;.... : \V 7,)

.92 NW 75 ......... 1 N~"i' l ......... ,

E

27th .............. ., .F1

.P-2! W 78 ....... SL 7:l ........ SC /)

,O(i Sl:

28th. ............... \oo , .u'l c,WI 7!1

.1,

s 69

.01, JSJjGK

3.7.1 ~w

~~~~ :::: :::\~g ~.~1 1 ~~~~ ~t, ::::::.
3Mhotn.t.h..:l.y::..m::.e:.R:.:n.:s...:I:S.:I.-I..-i=::.:..::.:.:::.:.:::I.::::.::.f:.:::::.:-.:=L1~'":._:.:.:::.:.::.:..::::::1

.:.:~:1:~_"~~>; E:~.:.:~1.:.~I:i:~

~\\~~:;~ :::::::.'1 s{~
NL:.:=:.:.::.:.:::~ ...:.::.:.::::175 ,J ::.:.::.:::._ 1' g

Total"-:::,~ ..... 4 85 ........... ... 10.14 ............ 1 6 581 .. Hsvi .......

STATt l30ARD OF HEALTH.

101

METEOROLOGICAL TABLE-IV.

=-----------

,--

DATE, 1875.

JUNE.

JULY.

a

8

-" '-;;

E:-<

~

"";:";:

1;0;
I'<

I"~""

s
iil
-" E:-<

,; ;;

")'1

<a
~
-"o;
~

.,;
~".
~
~

AUGUST.

~

.,;

"~

'-;;
~

~"

~ 1;0;
;;; ~

,;
.,~..

::;EPTEMBER.
-s-------.,-_-
~~ ~ :=::
~""'

1sL................ iti

E 82

BE go

l:i 77

.44 N

2d...---------------- ~~
:ri.:::::. ::::::::::::: 7s
5th ............. ,,,.,. 78 6th ................... r7

N\zyl~~

:::::::::1 sEs

ss 81

\ :_:_:_:_:__:_s:_:_o:_

t;83

S~W~ 8~1~
s 78
SE81

~ ~~

:~~

8~~88s514

~8.lE 8 S

7th .................. 7\1

.74

S 82

SE SO

.o; t; 83

E

8th ................... 11

.1:l NE 82

SF: 76

.~0

S 79

F.

9th .................. 71

NW 8~

8E 81

SE SO

:NE

10th ..... ------ ...... 7.! 11th ................. 78

bE 84 W 85

SW 79 SW 78

.05 .45

S S

8n 0

i-iE NE

12th................... :l3

.JO SW 87

SW 77 1.89 SW 71

NW

13th ................. 81

E 84

SW 79 1.01 SW 76

.05 NE

14th........... , ...... 8:!

SE S;;

8W 80

BE 11

NE

15th................... 84 16th ................... 89

1i SG SW 89

.15 SW 81 tiW 79

SW 78

.24

8 78

NE
.>2 s

17th ................... 83

E 88

SE 80

.27 SW 80

SW

18th ................... ,ci5

E 90

SW 79

BW 81

SE

19th.................. 81 20th................... 76
21st .................... 76

861:::::::::' ;; w:.01

E 59

2

S 87

.521 SE

S 80 SE 79
79

SW 75 NW 71
SE t:9

.64 ~o>W W
N

~~L::::::::::.::::::: ~~ .::::::1 ~ ~~ ......... s,? ~~ - ..:3-~1 ~~ ~~ :::::::::1 ~~

I ~~l~::::::::::::::::::l~t ::::::::1 ~ ~

26th................... '2

~ ll5

~ ~g
s 74

.55

N~ ~~
NE u4

"'i':o51

N~
N

27th............. .. . 83 ......... SE 84

S\7:l

.09 N 64

.32 N

28th ................... 82 29th""""""""--- ,;,

:; S3 1.06 SE 7!i

s 85

s 78

NW 71
w 73

9" E
sw

30th............ , ...... S2 ........

S 82 ......... SW S2 ......... SW 74 ......... SW

-= =. . . . . :::~~~;;:~~~::~--- ~-!;:~~::::::::_ -------~:so :::::::::1 s,: 8718.4 :::::::::, s~~-;~--~ ~-~
Totals................ 4:JO ::::=:-:= 151-=-::: :-:= 6:14 ::::= '"3:ii5 ::::=

102

REPORT ON YELLOW FEVER EPIDEMIC
"1\fETEOROLOGJC'AL TABLE-V.

JUNE.

.fULL

"\tlGUHT.

:-3EP'l'E~!EE~.

--,...--- ~----1-

-,-------,--1-c.....,--

:' DATE, 1S76.

~S,$

~'

I - c[ =

2.,...,
------1-'"'-'

~l:e

1---::25 1st................... 7ri
2d ................... R2 I

I~- ~ e "" "".:::: Q

__:;

d 'I ,:;;

II <ll

.e .....: 'i ::::

m

0

~ I~ ~ ~ ~:; ~ ~ ~ ~ > c

o I~ I

'I

E5

c

> c ::::

>

., , - "' r7G-::-2JI-xi---;;61--:J(ji\V II P"-"1S' E~1-:.;.,'%"--~.a!-.

'-!
c..

~.::::

~IV

~ II Cl3

10-<

:l...

~C" )

~.Q::j

;::
P-t

s w R7

SWI79

.11

S Sri .05 W

I ~rh.:.:::::::::::: ~~
5th................ ,,)

:g~
........

~~~~~~8~7

. . . . . ~~~~~~:~I~'~H :g,~ ~~ .~s~oI l:~~j ~,~~

6th ................. 77 1.........

hRb

Sl\ 86

E Sl ;.........

S

7th ................ 77 .........

E!>i7 I

SW 82

l:i 8~1 sw

8th .................. 7G

.u:;

9th .............. 7!1 .........

8SEE:1Rs9:{

.01

N 83

........ 1 SWR4

.2~

8 ol,......... 1-:iW

.1~

tl S4 1.........

S

lOth .................. SO 1......... lith ................ 71i 2 4< 12th .................. 7;> :U)I

Ej9u
SSEEjI.8%6

I...........1I

W SJ
s"OJ 81

8E S:! ......... SW

sw

1
S2"1

.:)4

\V

.117

IV ;!t ......... 8E

13th ..................
1t.45tthh.~:::::~:::.:::::

1lc;>;
:i;i

42 SE 90 .. :.._.::...'1 SW 78

.........[ 4. Jf,
:2./l.t

SREE[~9J0l

SS\W\'1F~U1

1.12 f; ,.,_I
.05 SW 7!' .:H t:l\V /!J'

.0:3

E

10 NE .6:; Celm

16th
gn::::::::::::

:~::::1:'7~S~

~ .37
!... ...3.7

1 1 +1 ; 21?g"if,_:_:_:_:_:_:_:_:_:_:_:_._:_:_:_:_:_:_1~,:~ : ..2:5j

_

, 1.........

22dd ..............

1.........

1......... 23

81 . . . . . . . . . . . . . . . . . .

.12

24th ................. 88

25th................ 1 ss I .01

. . . ;g ~~~s~~9~0

:;,.~[ I .lt2i .....

~tW!':lS~I

~~~:~i
swWl~1xl7
xw ""

~. ,~~ 1

1......:.o,..,.7.j.1i1

siVI;u

IV !' ,,

sbOt

I i'W 81 I 2:24 i"i\V "l
sw 71 1.32 NE b2

. . . . . ~~r,. :: .1'1 tiW 73 .112 .02 ~~~1 ~~
El 3.4o'l ~~ 7' 21
.................. ~~,. 7'"8 .......U..G

I ......... ,
.........

" 7!1 "I "7 .......

w~ S\~
t-nv:
w"
NW NW

26th ............. IRS
27th....... Iss
28th...... .. ... 89

El61i ........ sw S" 7i

1.

.

.

.

.

.

.

.

.

1 1

78 1 .01

NE84 XE 82

......... sw. H .......
.O'JI1 w 1 (,; .........

>lW t\3

Ill ti II' ~ill

IJ3

NE
NE KL

29th ................ sr;

1.12 >liV S> ! ........ 1:3W 80 ......... f:>E 72 ......... NE

=.::..:.. .:.:.:.:.:.:..: 30th................. 1s>
31st.......:::.:.:.:______ _..

.2> sw ;u

2.11 sw 82 ........

" 7'l ......... sw

~ 1__:'12 S W '::'.__ =::.:_: ~IV ~~ _:_:_:_:.:::_ ~

:Monthly Meansl180 G1......... 8W 84.51. ....... "W >2.1 11 :-; <b ...... i:lW
Totals......... ..... ...... 18.80 ......... ...... G.ll ......... ...... G.SS ......... 1... . 2 b~ .........

r

STATE BOARD OF HEALTH.

103

METEOROLOGICAL TABLE-VI.

I

HUMIDITY.

1---

DnK.

1 I

1872.

I

187:1.

"] 1-f--i !-l[-f ,-~ -c-:-~---;~-=-~

I I I Ist.::"=-=~:-::-=.=~157 G6i65 78'-:w -IG666

2d............................................... 61 . 68 3d................................................ 68 72.

72 79

72 55

98 87

74 72

I

72 81

64 66

4th.............................................. 64 62 83 6G 82 71 78 74

.5th.............................................. 0:1 68 SO 63 66 70 89 75

6\b.............................................. 5;) 68 89 63 Gf, 79 85 78

7th.................. .................... .... 7<'1 m1 SI 7o so 77 87 78

sth...... ............ ...... ...... ............... 62 so s:1 74 so 78 72 ~4

9th ...... ........... ...... ..................... 61 72 81 78 60 77 76 88

lOth.................. ........................... GO 7-l 81 92 1 55 77 73 87

11th.............................................. 66 GS 7!! 86 s; 84 80 89

f~lL~~~~~~~~~:~~~~::~~~:~::::::~::;:::~:::::J ~J ~~ f~ ,g ~~ ~~ ~i !~

16th.................. ........................... H 17th ............................. -.. ......... s1

69 6H

72 71

71 s<

74 11

6n 7

79 78

80 87

18th.................................... ......... 76 1;7 79 77 70 70 82 90

19th.... ............................ ......... 65 1;9 74 64 GO 7G 84 90

20th ........... ......................... ......... 78 7>i 76 6~ ;)0 82 83 78

21st......................... ..................... 82 1;7 73 6-J G!l 78 78 SO

22d............................................ ... 75 GS 72 72 7:l 73 88 80

23d........... .............. ...... ............... G3 G4 6;J Sli 75 83 74 85

24th...... ............ ......... ............ ...... 78 58 76 93 70 76 78 SG

25th................................. ............ 75 ;)H 73 80 76 GS 'iS 85

26th.................. ...........................
I 27th.............................................
I'" 28th.................................... .........
~~!L::::::::::::::::::::::::.::::::::::::.::::: ---~-::... (;~ ~r_ . .~.(~. . ~l: ~: ~;, I ~~ ,...~~--- 29th............ .................................

74 G;) H

73

,)j

72

8~18

6\J

II.

71 71

1I

78 92 G7

74 I 71

74

! 82 I 80 I 78
72 I 70 Sl

.. ... i

72 94

60 00

8! 70

I

85 84

~~hly Means....:.=--::-~==:... 6!!.~ GS 74.6 71.3 74.81 70 78 81.0

104

REPORT ON YELLOW FEVER EPIDEMIC

METEOROLOGICAL rrABLE-VII.
f{UMIDITY.

- - - - --~----

!JATK.

1874.

1875.

1876.

n-1---::-1 :r::-:~-:---:-:- --r-,.::--:-,-.. -

:~0~ "

'

3
...,

.:.::::1w~1;>::-:-:,"-:~::~;:e :!n>f- r >>=- "">a

;

:-:<1!



"' oo

:==:: "76llffi SZ G2:69 G"if8117J7z 7z R4 Go 1st.............................
821 2d.............................. : 7:11 t;;J 1 1>:1

711 67 67 69 G9 IJG 78 63

3d ........................................-!

75 1 D0 1

7!J 1

77

{)'/

G7

72

8:1

74

70

73

86

4th ......................................... 1 17: 81 81 72 G7 7:2 7R 74 74 Gl 76 80

sol lith ................................. i 84f 7o G!l 77 tiS 74 72 65 72 63 71 65

Gth.......................... ...............

7:3 G:; 7-lj 1;:; 70 68 65 60 6:3 71 69

7th......................................... 77 SO GG 72' 61i 74 75 71 5S 62 72 69

sth.......................... ........... 74 sz 84 77 sll 12 s:J 78 66 11 72 72

9th......................................... 71 79i 66 72 72 70 73 68 64 66 72 68

mL:::::::::::::::::::::::::::::::::::::: ~~ ~~ ~~ ~~ zg x~ ~b ~~ ~~ ~~ ~~ ~g

871 12th......................................... 74 F4 10' ~r;.1 ill 6i 83 79 87 GS 7:2 79

13th......................................... 82 8:1 81

76 Gli 79 8~ 81 64 79 85

14th........................................ ,., , , n 85 72 c_,sl 79 7s oz u1 s1 81

15th......................................... 81 SO 7-l 81 72 64 7,5 78 89 57 76 7S

16th......................... 7:i 70 75 81 50 57 77 83 89 57 76 84

17th....................................... 18th......................................... 19th........................................

877?141

69
74 90

71
so
77

8-1 82 7;J

67 G5 61 59 7:J 54

78 78 76

78
so
81

851' 87
58 71
62 74

72
68 61

78
64 69

so 20th......................................... 76 91 ';;) 82 80 GO 64 66 7~ 67 67 71

21st............................... ......... 68 90 76

82 66 74 64 69 69 89 82

22d ................. .... 68 76 74 U 79 57 76 62 G5 73 69 78

23d ...... ......... 641 781 73 84 77 59 76 61 68 63 66 66

2245tthh......................................................

62 53

67.:)11]

85 80

87 73

75 !J3

60 GO

8(i 74

G705

62 GO

67 90

64 70

60 66

26th....................................... (i1 f 86 65 71 G9 iiG 76 87 58 77 7l 57

27th.......................................... 78: 77, 67 77 72 67 77 85 63 81 77 51

: 28th........................................ ' 7G K1 1 SO 71 78 liS 76 89 GO 71 78 67
29th ......................................... 71if 78 91 64 721 64 70 7G 69 63 67 6& 30th......................................... 76 80 89 60 71 68 66 74 H 77 70\ 56 ~..:.:..:.=:- .:::.:::....!:.~==~~==~_!_!_.:.:::.:.:

1 Monthly means ......... 73.2 178.8 74.2 77.6)71.4165. 74.9 78. !71.2 68.7 72.6 70.4

STATE BOARD OF HEALTH.

105

SANI'rARY CONDITION OF SAVANNAH.
The sanitary condition of the city of Savannah, prior to the outbreak of yellow fever, in 1876, was exceedingl_y objectionable. The low lands which surround the city were undrained, and the terms of the dry culture contracts were evidently not complied
with. The condition of the sewers was objectionable, for the reason
that ample arrangements had not been made for flushing them, and, judging from the inspection of the Board made in Decen<ber, 1876, the outlet::; of these sewers must l:mve Leen prejudicial to the public health during the surnmer months.
Bilbo's carml which is now the outlet of some of the main city sewer;;, was, and is, in a disgusting contlilion. During the month of Decem!Jer, 1875, it was ;;ractica!Jle tv di:stinguish fcecal matter floating in the stream. .i\Iuclt of such material must lodge upon the banks of the canal.
Lamar's canal was found in an objectionable condition, from the fact that it contained stagna,nt water, t!Je mouth of t!Je canal having been filll'd up. The lands south and east of the city are, however, Ly no meum; considered to be as prejudicial to health as those upou the we;;t side.
Comparatively few water closets in the city are found to communicate with the sewers. The majority of the houses are provided with out-side privy conveniences. 'l'he method of cleansing these privy vaults and the disposition of their contents is considered most objectionable to the health of the city.
Grave charges are also found with the method by which the offal of the dty is disposed of, it being considered that the present system is one exceedingly dangerous to the public health.
The water ;;upply of the city is contaminated with organic matter ; a large part of the inhabitants of the city are found to obtaiu all water for domestic purposes from wells within the city limits. In the character of the soil, through which these wells have been dug, it is impossible but that the water which they contain should be contaminated with organic matter.
The snurce of the water supplied to the city by the water works is also objectionable.
Two samples of this water were examined by Mr. William J. Land, analytical chemist, whose report will be found in the appendix, which shows that the water from the river is very impure and contains foui" times the amount ot organic mater, as that from the wells of the city.
The canal through which the river water flows to the basins, and from which it is pumped up for use in the cit;y, is, in part, covered by or in close proximity to the wharf depot of the Georgia

106

REPORT ON YELLOW FEVER EPID)!MIC

Central Railroad. Into this canal abo much drainage water from the low lands is emptied, as well as the f()l[\ river water.
'!'here was found much whid1 in the opiHion of tlm Board was prejudieial to the public health, and eau~es of malarial disease were found to have exi;,;ted in profw;iou.
~Mr. John H. Hogg, who i,; tile cit.v Surveyor and who has held the poliitiou for many years, who has charge of the general drainage of the city and its surroundings, who has control of the movements of the Dry ~Julture lm;pector, ha:s given evidence which will be found in appendix. As tLiifl e\"idence is official and as it is found to be free from theowtkal uia,;, it is in this connection submitted a;; the authority upon which the,;e opinions are based in regard to the sanitary condition of the city.
DRY CUL'l'URE.-rhe sumrnary of l\Ir. Hogg's evidence is as follows: The eondition or tlre dry culture lauds this year does not differ in many respects from that of previous years. Springfield plantation had not the usual amount of work done on it tiris year; no work of any consequencP was done on it the entire summer. These lands were overflowed in .June, partly by heavy rains but more particularly by the Glowing out of a trunk. Those portions near Gwinnett street and Ogeechee Hired remained under water about two weeks. 'l'he other lands sontll of the bridge leading to town were under water some tinw. Smne of the ditches were very foul; there were more weed~ in tlren.t than usual.
'rhese laud,.; after the heavy rain in .June, were very offensive. Some said there was tt sort of iishy smell.
'!'here i::; now no great amount of water on Hutchenson's Island. During the high spring tirle~ tl1e Lanks being Lroken in different places, the \Vater tiows in, awl eamrot get off. It finds its way into the small lagoons and remains there until the next tide rolls in to freshen it. No work has been done on this Island for the past twenty-five years. In a straight line the Island is about 200 yards from River r-;treet, and directly opposite the city.
BILBo's CANAL.-The accumulations on Bilbo's Canal extended all the way dowu after heavy rains; when the weather became dry, the channel was narrowed on either side by the accumulations of sand and hou;;e deposit. It has always been customary to clean out Bilbo's canal early in the spring or summer, and then, if there was any accumulation of offal or other obstructions, after that it was worked. Nothing was done on it the past year. This is the only failure for the past five or six years to clean it out.';' '!'he Bilbo Canal has been notoriously offensive. Complaints this year not more numerous than ordinary.
*In a letter of the 13th in st., l\Ir. Hogg corrects this testimony by the statement that he has since been inforll'l.ed that he was mistaken. and that the usual work had been done in the spring.

STATE BOARD OF HEALTH.

107

LAMAR'S CANAL.-Lamar's canal was in a foul condition. Tlle cause was its being filled up by the owllcr from t!1e river end am\ that portion left between River street and the flour mill had no outlet. The city had a small truuk put in which carric<l the surplus into the creek. It has been in foul eowlition all the ~mnmer.
SEWERS AND DRAH\S.-~o watl'l from tl>e hydrants i,; turned into the sewers. There are e'1teh ba~ins in ead1 l'orner, three feet in diameter and six feet in depth, coliNtrude<l with the usn,ll \Yater trap, to prevent tl1e e:<capt~ of efl-luYla frow 1he sewer~. Eul'h is supplied with a stop-coek to fmnbll \Yater from the works to eleanse them out. There is no flushing of tlw se\n~n; by brge volumes of water thrown into them for cleansing. The street traps nrc not in a worse condition thnu usual. 'l'lw etnnYb sonwtimc~ nriRing from these traps is not so much to be attrilmtc>d to sewer gas, as to the presence of dead dog.~ and eats nt the bottom of the traps. Sonw of the traps in East Rroarl and \Vest Tirond street" arc not constructed in the same manner as tlw other,;, uncl, po>'siilly, are more open to the escape of sewer gas thau i~ healthy.
'fhe capaeity of the sewers for outlet is very large ; they are not liable to be choked up. The mouth of the sewer emptyiug into Bilbo's canal is mueh higher than the ri wr level. HaYe never known any sewers of thP eit;: to he hloek<d up. 'l'here are now about 150 water closet Ponnections 'Yith the s<twers. No privy is allowed connection with tllem.
'l'he plan of operation in regard to the soil of privies, is to transfer it to a pit, dug for the purpose, aml then tocon~r it with earth. Some foul gasses will e~eapc through tlw earth, lmt gradually the mass becomes solid and ming-le,.; with the soil. The city fixed the price for cleansing these vaults au<l appoints the time for the work. Men are liceni-\ecl for the purvose, iu order that the work may be efficiently done.
Many privies and water closets are connected with dry wells, the only outlet for the gas evolved in them being through the pipes leading from the dwellings or through the ,;oil.
The scavenger departlnent has charge of the oflhl, and clepo~its it where the Mayor or chnirnum of the Street and I~ane committee directs. It is probable that the provision.~ of the ordinance are not carried out. 'fhere is a large deposit on a portion of the Springfield plantation near Gwinnett ~treet, also on the eaRt bank of Bilbo canal, near the Atlantic and Gulf Railroad wharf, and some has been dumped in the elay pit,; in tlmt vidnity.
\VATEH \YORKS.-Tile watee \\orks are located between the canal and Musgrove and Ogeechee creeks. 'fhe ereek;.;, from the nature of the country through whieh they run, are tainted with swamp water, and are liable to admixture of impurities from the wharves.

108

REPORT OK YELLOW FEVER EPIDEMIC

The location of the water works is had. The intention was to have had it at some point further up the river, wlwre there woulct be less of the objections noted.
'l'he water is not filtt>red at the works. The outlet of the Savannah river and Ogechee canal i.~ a hont one hundred yards uelow the point at which water is taken into the basin~. The outlet of the new Springfield canal is nuout one hundred yards above. Four sewers carry water closet sc>wage into the Sav:tnnah river. During the business season, ships along the wharves throw their refusu into the river. 'rhe sewage mn,tter is carried up and down with the tirlc anrl some of it must find its way into the reservoir. "rell water is used to a considerable extent in the eity. It is anything but pure. There is a peculiar taste to this water. In some portions of the city, it is something like Epsom Salts. (See Analysis in Appendix). That little or no sanitary work was performed by the dty authorities prior to the outbreak of Yellow Fever is shown by the further evidence of Mr. Hogg. The trunk noted m; having been blown out, on Springfield plantation, was replaced in July and the lands wen after that a,; dry as usual. 'rhe ditch running through the centre was cleared out as far as Gwinnett street. Never saw this ditch foul to any g]'(at extent. None of the other ditches were cleaned out. The railroad lands west oftheSpringfield canal were put in tolerable order. The main canal from Central railroad to the river was changed from its direction, so as to commu11icate with the new canal. Workmen were employed on this for nearly two months. More attention has been paid to the clean>ling of the sewer traps, this year than usual. The city employs constantly four mt>n, whose duty it is to make their rounds and clean tht>m out. As Mr. Hogg was in a position to speak authoritatively as to the sanitary condition of the city in formPr~ears, his evidence on that subject is offered:
In 1855 there watl a sewer on \Vhitaker street, which passed through OrleanA Square, out Barnard to Huntingdon, then East passing through the Park, and had its outlet in a swamp on the land of Dr. waring. This also existed in 1858.
The drainage system of the low lands prior to the war was not as good as it is at present. In 1S54theSpringfieldplantation wasiu very bad condition, the ditcht-., filled up and the land frequently under water. In the eastern portion of the dty, there was a dense swamp just south of the bridge on the 'l'hunderbolt road, which was cut down during the war. It was never thoroughly drained. At that time the only portion of the low lands of the Springfield

STATE BOARD OF HEALTH.

109

plantation that eould be cultivated 'vas a small traet near the Ogeehee canal. After the war ditches were cut and the land improved. The low lands east of the city were, previous to the war, sufficiently dry to be cultivated. 'l'he lands bordering Lamar's canal were not in bad condition. 'l'he lands on the eastern slope were boggy and never dry, until a drain was cut.
There was also obtained much evidence corroborative of that of Mr. Hogg, which will be found in appendix. Attention is asked to that of the Hon.'E. C. Anderson, l\Iayor of the city, Drs. Charters, I~eHardy, \Varing, Elliott and others.
It is in evidence that during the months of June, .Tuly, August and September, Hl7G, the faetorR of malarial disease, both telluric and meteorologic wore unusually and extraordinarily active in and about the city of Savannah, and that from these eanses there was instituted prior to the oecnrrence of yellow fever, an epidemic of malarial ~iseases, which epidemic, modified by the graver disease d"veloped at a later period, was in existence until late in the fall.
Thai the dty of 8avannah habitually suffers from malarial diseases is evi<lent from the following extract from the mortuary tables of Dr. Duncan:

In 1870 there was a total of 1015 dc:tths of which 248 were from mi:tsmaticdiseases

In 1871 "

1033

235 "

In 1872 "

1165

288 '

In 1873 "

1200

271 "

In 1874 '' In 1875 ..

1036

192 "

887

162 ,.

In six years there was a total of G,42G deaths, ofwhieh 1,3!JG were from miasmatic diseases.
'rhese figures indicate not only a low rate of mortality for the city which contains, according to the census of 1870, nearly 30,000 inhabitants, lmt the faet that miasmatic diseases have contributed very largely to the grand total. In 1870 thc.~e diseases were24 per cent. Tn18il they wore 23 per cent. In 1872 they were 25 per cent. In 187R they were 21 per cent. In 1874 they were 18 per cent. In 187.5 they were 17 per cent.
The Board has not yet been able to obtain the mortuary record for 187G, but there is every reason to believe that during that year they will be found to exceed greatly the numler recorded upon any of the proceeding five years.
In this connection a careful consideration is asked to tho meteorological records which have been obtained from the office of the Signal Service at Savannah.
The first recognized case of yellow fever in the Savannah epidemicofl876, was that of a man named Schull, who was admitted

110

REPORT ON YELLOW FEVER EPIDEMJC

to the l\Iarine Hospital on the 28th day of .July, from the Ameriean schooner "Sever,;." He had been previously ]treated for a fever of one paroxysm, which was followed by congestion of the lung~. \Vlwn admitted to hospital he lla!l no fever. Previous to admi~sion a blister had \)een.applied to his back, the enticle waR removed, and the tis,.;ue~ were discolored and bleeding. On the :10th of July, whilst. setting up in bed calm and cheerful he was t.aken with sudden hemorrhage. The blood p;;caped in quantitieH from t.he mouth, was red and frotlly, death ensued almost immedia ll'ly. Autopsy four hours after death. :->kin yellow, lungs infiltrated and Jillf'd with blood; traces of ineipien t tubercles in lungs; ulcer;-; on exterior surface of the ,.;mue; linr of complete boxwood 1olor. This record b takeu from the oftkial r('port of Dr. Geo. H. Stone, Af'sistani :Surgeon, Marine Hospital Service.
'rhere is u fartlwr history of this case whi<-h i" as follows. 'rhe ,;ehooucr "Severs'' arrived at Savannah on .Tul.v lOth with a load of ice. 'rhi,; ice was dicharged at a wharf in th! !My, when the "Severs" dropped dO\nl the river to the wharf of the Ailantie and Gulf Hailroad company for a eargo of lumber. At the time thP "8erver:<" was at this wharf there wen two 1:-lpanish vessels reeeutly arrived from Havana, al,.;o taking on board lumber, these ves,.;eb were thP " Yue;," and tlw " l\laria." 'J'hl' "SPYers" lay within a hundred yard~ of tlwse vessels. 'Vhile tlw "Severs" was reeeiving her eargo Schull was taken ill, was removed from tlw vessel, and was earriPd through the city to a boarding house upon Indiau street, in the extreme western portion of thP eity, and at 110 great di,;tauee ftom the wharf depot of th! CPntral Hailroad eo!llpauy, where he was tnated by Doctor "'illimn Dunean, who dingnostd the cast' as mw of Cm;gestive fever.
Frcm the house he was removed, without the kuowlPdge of Dr. Duncan to the Marine Hospital, located in the eastern portiou of tlw eity. It will therefore be ~een thnt this r'ase of undoubted yellow fever was twi('e l':tl'l'ied through tlH ~trPnts of Ra ntnnah, prior to thP gtJwral cpidtmie outbreak.
On th!' nth of Augn,;t, a hoy named 'flwmn~ Clcary, who is about l5years of agP, and who l'P~idPR with his parPnts on 'Vright Htreet, east of east Broad and lwtw!'en Bay awl Bmugll!on stre<'ts was talwn ill, with what was nn<loubietlly yellow ftwtr.
Tt is nere.~sury to ask Pl-lpteinl attention to tltl' l>lork into "hieh 'Vright: "trcet mns; it is hounded by East 1\mad, Bay, Heynolds and Broughton RtreetR. Upon the map of Sa \:llllJah puhlislwll in 1868, this bloek is dPsiguutted as "Garden.'' But 'Vright strt<>i pierePs it on tlw west for 011~-half its width, while East Boundry pierces it 011 the nortli, to one-third itf\ depth. The portion oft.hiH hloek at the cor11er of Buy and HPynol1ls iR or,lnpicd by thP (ity

r

STATE BOARD OF ltEALTH.

111

gas works, while the sides ofthe block are occupied by small tenement houses.
Thomas Cleary was taken sick, as we have said, on the 6th day of August. This sickness, as described by the boy and his mother, is as follows: "\Vas taken sick with pains in his bones, with "yawning and stretchings, and became so weak and staggery that ''he had to go to bed. Had fever and great pain in the front part "of his bead, wanted drink all the time, had very short breath, "and felt all the time as if he had to gasp to get it. when he got ''up be was very weak, and could not walk-was very yellow all "over." 'l'he fever in this case lasted ten days, during which time be was confined to his bed.
This boy states positively, and corroborates the statement under oath, that during the month of July, 1876, he, in company with several other boys, named James 1\IcCarty, George Bussell, Bill Ray and George Lappin, was in the habit of going, after school hours to the wharf, of the Atlantic and Gulf Railroad to look for shells and rocks amongst the ballast discharged from vessels.
August 17th.-James Patrick Cleary, aged 11 years, a brother of Thomas Cleary, and residing in the same house in which he had been sick, and in which he was convalescing, was taken with yellow fever. As the boy Thomas had been successfully treated without medical aid, no physician was called to the case until August 21st, when Dr. Stone was called in. 'l'he case terminated fatally the same day. At the autopsy the 11urface of the body was found yellow as gold, the liver boxwood; farther examination not permitted.
August 18th.-A mulatto boy living near the Atlantic and Gulf Railroad depot was taken with yellow fever, and died the same day. Reported by Dr. W. H. Elliott.
This locality is upon East Broad street, distant (according to map of the city) but three ulocks from the Cleary case.
August 20th.-Ella Scott, living on west side of Reynolds street, north ofBroughton (in same block as theClearys), had yellow fever, but recovered.
'fhe same day Lenia Smith, living on Reynolds street, nearly . opposite to Ella Scott, took the disease, from which she died August 26th.
August 2Ist.-Bill Ray, one ofthe boys who frequentf>d the Atlantic and Gulf wharf with Thomas Cleary, and who lived on Broughton and East Boundary streets, was taken with yellow fever, but recovered. 'fhe same day John Fountain, living at the north end of East Boundary street, was taken with the same dilliase, but recovered.

112

REPORT ON YELLOW FEVER EPIDEMIC

August 22d.-A child of John Lynch, who liwd on Wright street, a few doors east of the Clearys, died of yellow fever. The same day 1\Irs. Keogh, living at the north end of East Boundary fitreet, wa~ attacked with the disea><e, and <lied Angu,;t 27th.
August 23d.-George Bussell, anotller of Thomas Cleary's comrades, was .takeu ill with yellow fever, but recovered. 'rhis boy lived in East Boundary street, north of Broughton.;
August 2Gth.-.Jobn Lynch and Mrs. John Lynell died of the diseae at the same place as that at which the ease of August 22d had died. 'l'he same day Michael Delaney died in East Broad, two doors north of Broughton.
August 27th.-Fred Lawson, living in Randolph and President street, died.
August 28th-The children of Thoma,.; Keogh, living on north 11ide of Broughton street, west of Reynolds, are reported to have been sick with the disease-one case was fatal.
The majority of the~e cases oeeurred in the practice of Dr. Geo. H. Stone, and are reported from records obtained from hb note book ; some are noted from the annual report of the Mayor of Savannah in the JJforning .News of January l-lth, ll-l77.
The disease .~pread ravidly in the imm.ediate vicinity of this block first infeeted, aml then appeared in and spread from Stone street, a short street, running from \-Vest Broad street between Liberty and Harris street:;, in the opposite side of the city. 'l'he first of these ca~eii occurred in the person of .i\lr". Mary E. Malcomes. 'rhe same day a fatal ease was reported on State street, between vVhitaker and Bernard, in the person of Edward L. Drummond.
It has been shown that prior to the occurrence of these eases, the disease was under full epidemic headway in the northcn"tern portion of the city, from which locality it is simply impossible to trace any connection with those last noted, nor indeed is it considered at all necessary to do so, as the migrations of individual~ and their effects eannot always be observed. It will, however, be shown hereaftt>r that, in all human probability, a focus of infection was established in the northwestern portion of the city, as well as in the northeastern, for on August 29th, Dr. Wm. Duncan reports a yellow fever death on Indian street lane.
Attention is however asked to the case of one Lawrence Kelley, who is a foreman for the Master Stevedore of the city, and who resides at the corner of .Jonchim street and Indian street lane. This man claims that on the 11th of August, he was taken with yellow fever, after removing the ballast from the 8panish bark "Neuva Ygnacia," July 14th, and the brig" Pepe," August 1st, at the Central Railroad wharf.

STATE BOARD OF HEALTH.

113

'!'here are grounds for thinking that this was a case of yellow fever, and that further investigation in that locality may develop additional facts.
As to the advance of the disea~e throughout t)le city, the board has received a valuablecontributionfrom Mr. F. W. S. vVoolhopter, of Savannah, secretary of one of the benevolent associations, who bases his report upon the records.'*
By the benevolent associations the city was divided into 16 arbitrary districts, forming them first upon the extreme western portions of the city; secondly, the extreme eastern portions; thirdly, the central portions, and the last district the 16th, being in the extreme southwestern portion.
From this report a tabular statement has been formed, showing the locality of each district, and the numlJer of deaths in each from all causes, for variable periods, from September 1st to October 7th.
*See appendix.

, .\ 9t~TJ-GCiS 01'~ s.~. THh

I~e'fen dRys, Three days, SPvtn <lay~.

VA\'1'- AH BENEVOI.EN'l' AsSOCIATION. endinf!

ending.

.ending

-~==r ~ix day~, .Se,en days, 8even days, Total

ending

ending

ending den.ths from

.............
>+'-

- - - - - - - - - - - - Sept.~~~ ;:;rpt.~~= !;ept.~ Octoh~~~~~

lJistrid .So. 1.

Vt'f:-t ]3, o:(l, 1-!iYer, < g l'CI.tL ( au:.,J :tiJd Bn Pn 1-ltret~ts ........... ;J deaths ...... :3 dcatlJs...... 1-t deaths .... lG death~ .... 11 deaths ... 4 deaLil~......

57

Distri<t ~'a. 2.

1

I West Brn~1d tl.l d O;!CPdFe (_'~m:d, B.rY::n <llld Zu: y stn ets.......... ~deaths...... ~o dentb ..... 8 deaths ..... t tleaths .... l. dtaths...... 5 deaths...... ! IhJnt J\n. ;),

21

;;c
('1)

West Bro<H! ~n.d. OgNdh e. ( an~< 1 , Zub~ aul );ew t~lr~cl~ ............. ~u U.eath .... No death .... {) dekt.bs ..... \J tleatlJs..... G d~aths...... ~~ de.. ths........

;W

Di.,trirt J11. -L

West Brur..U,~prit~gfiC'l(! PJantatiuiJ, Little J01~es liiHl Gwinnell} street.'-', ............................................................................

:''de.'lths ......

1 d e,.lt!1l

......

'3''

f1r

"tl .. 1s

....

11

t1(',at! 1~....1.5

d

ath t. s ....

10

d.

th. Pas.....

~'>..

'0
0,;.;.c,

lJi:.,trict .JYo. ."'>.

En~t Broad, "Lamar latlds.'' B<~y hnd Broughto11 street~............ 11 death~ ... 1 de .th....... 7 deaths...... So drat h ..... 1 death ...... I death.......

21

0:;..:

District 1Yo. U.

Enst Hr0ad, Bill){)':- Canal: Bwughton and Lil1erty s:rcf't~......... :2 UtcatiJs ..... /4 deatliH ..... Gdeaths...... 2 deaths ...... No death .... No death.. .

1i

><

Di: t riel ..1.\'o 7.

I I E(ist Bread, Bilbo'~ (:mnl, l-iberty and Andf'r80ll streets ............ ! U(ath~...... :; de,lths..... 8 deaths...... 110 death::. ... 2 <ll'aths ...... 5 deaths ..... 1

East Broad and

Bull

~trt:'cDts,i

stri lU

ct ve

Ao. o.
r and Brou

gh

t

on

s~reets ..........

5

dt:aths ......

6 death~...... 8 dealhs

....

10 deaths.... 6 death~

.

b dtaths.. .

S:Z -4:1

! District J..O. U.
East Bro"d and Bull strepts,.Broughton awl Liberty streets ...... 8 deaths ...... R deaths ..... 9 deaths...... 11 deaths.... 19 deaths.. 6 deaths.....

46

IJistlct No. 1.

J

I

('1)
r' r' 0
:8
~

East Bread nnU Bull Htreets, Liberty and Gaston streets ........... 14 deaths .... No dtath 4 deaths.... 'I'~ deaths ... 19 deaths ... 18 de.Lths...

i"JL'i

l!islnct No. 11.

I'

I

East Broad mHl Bull "-treets, Bull and 'Vest Broad strerts........... 1 death ....... 1 death ..... 4 deaths...... 8 death!'!...... 17 deaths._, 8 d("8ths.....

2~)

< t;';1c

IN" I Dhtr1ct 1\o 12.
Rive! all<! Droughwn stred, Bull and West Broad ,trts ........ 2 deaths......

, death ..... 12 deaths... 11 deaths..... 8 deaths.: ... 4 deaths ...

:n

lJi.~t1 ct .1..Yo. 1:1.

(':)
~

Broughton and I~Jbcrty streets, Bnll and \Vest Broad streets ...... il deaths...... 4 death~ .... 20 death'-' .... ~2 (leath" ... 12 deaths ... 10 dPaths.....

7i

t:l

JJi.<tri<l ll'o. 14.

Bull and West Bro .d ,(Jccts Lihe1ty .. nd Gastou streets...... 'l dcaths..... No <Ieath ..... 16 deaths... 1G deaths ... 16 death 11 deths....

Gl

Di!-Jitid l'.o. ll. Bull antl ~ est BrP.td s1T{'I~t-:, G.t~ton aud ~\ndrrson strt'ets........ No deatb ..... l de.,th .. 8.deaths..... 10 deaths ... ~l.death.s ..... 11 deaths....

.. I No '\~~

Dis'' ict lY(,, Hi.
~;r<~~~~~~~:.~:.~.i-~~-~~~~~-~ ~~~~~~~~~-~~~~1.'..~-~~~~:~~-~-~~:-~.~-~~~-~~~}

1No

1 death ..... jl\'o

death .....

3

deaths .....

death .... 1 death ...... 11 deaths ..

;-w

-('1)
s::
(')

At St. Jf'heph,!' Infirmary there were 51 deaths. At the City Hospital thl:'re were 17 deatb1-1.

STATE BOARD OF HEALTH.

i.l5

The facts of the epidemic, during the period named, (September tst to October 7th), may be thus summarized from this report.
1. That during tlw fir;;t week of the month of September, the lOth District, in the very heart of the city, suffered the mo;;t severely. That the 5th, in the northeastern portion of the city, the tst, in the northwestern portion, the !lth, in the eentral portion (east), the 13th, in the eentral portion (we~t), aml the 8tl1, in the central portion of the river front (east), wen the worst infected districtR, while the 2d, 3d, 4th, 16th, oth and 7th, expo~Pd to the worst malarial infiuenceF<, escaped almo:-<t entirely.
1\fr. 'Voolhopter also asks attention to the following significant fact, in relation to the prevailing wincls rluring tlw months of August and Septmnber, 1876:
During the first week in August, the wind wm< fcmrtPl'll times from the northeast, east, southeast and south. H was fiYe times from the north, and seven times from the .~outhwest, west and
northwest. During the se!"ond week of August, the wind ww< nine times
from theN. E., E., S. E. and S.. hut onee from theN., and three . times from the R. vV., ,V. and N. vV.
During the third week of August the wind wa;,; three time,; from theN. E., E., S. E. and S., four times from the N., mHltwentyone times from the S. W., W. and X. vV.
During the last week of Augu~t the wind was twice from theN. E., E., S. E. and S., on!"e from theN., and seven timeH from the 8. W., W. and N. W.
During the first week of September there were eighteen winds from theN. E., E., S. E. and S., one from theN., nine from the S. W., W. and N. vV.
During the <"econd Wf'f'k of September there were tive wind;; from the X. E., E., S. E. and S., two winds from theN. and thir-
teen from the S. W., vV. and N. "' During the third week of September there were six winds from
theN. E., E., S. E. and S., seven winds from theN., and twentyone from S. vV., vV. and N. vV.
During the fourth week of September there were eleven wind!! from theN. E., E., S. E. and S., and five from tht> S. vV., vV. and N.W.
Only a west or southwest wind could bring malaria from Springfield plantation.
This expor;e bearr; very heavily upon those who lay so much stress upon the Stone street case;;. This street is in the northwest corner of the 14th District; Lut in the 14th Distriet but two deaths occurred, while tbe lOth District had fourteen, the 5th had eleven,

116

REPORT ON YELLOW FEVER EPIDEMIC

the 1st had nine, the 9th had eight, the 13th had nine, and the 8th had five deaths.
2. That the districts rnost exposed to the malarial influences of the low lands west and southwest of the city, Districts 1, 2, 3, 4, and 16, with but one exception, exhibited no excessive epidemic influences. That districts 1, 2, il and 16, which were exposed to the full brunt of those malarial influences, had, from September 1st to October 7th, a respective mortality of 57, 21, 30 and 8, while district K o. 4, although protected in some measure by the embankment of the Central Railroad, suffered very severely, while district No. 16, exposed to the full blasts of malaria from the Springfield plantation, escaped almost entirely.
This report, which is presented in tlte appendix, 1vill be found to be worthy of careful study.
EVIDENCE IN FAVOR OF THE IJ\IPORTATIO~ OF THE DISEASE.
It is officially settled by the letter of Consul General H. C. Hall, dated Havana, October 21st, and addressed to James Atkins, Esq., Collector of Customs at Savannah, and which is hereto appended, that yellow fever was epidemic during the months of June, July and August, 1876, at'Havana, and that during these three months no less than 1,226 deaths occurred of that disease. It is also stated by Mr. Hall that the disease had appeared the san1e year at Matanzas, Cienfuegos, 'l'riuida<l and Santiago de Cuba.
'l'hat vessels directly from these infected ports did arrive at the port of Savannah ilnmediatcly prior to and during the early development of the epidemic, is f-ihown by the following records obtained from the custom house authorities :
"June 19th.-The British brig' Joshua King,' from Cardenas for Liverpool, with eargo of molasses, came to port disabled. Detained three days at quarantine station. Discharged cargo, and was repaired at the old bonded warehouse in Yamacraw, (the' Western river front of Savannah).
"July 13th.-The Spanish bark' Nueva Ygnaeia,' from 1\Iatanzas;, after seven days at quarantine, discharged 100 tom; of ballast at the Central railroad wharf, also 11 mattresses and blankets, with the clothing of the crew, which articles were taken by the crew to sailor boarding houses in the city.
"July 16th.-The Spanish brig' Yne,.;,' from Havana, having been detained three days at quarantine, arrived at the city, and discharged 50 tons of ballast at the Atlantic anfl Gulf railroad wharf, also 8 mattresses and blankets, and articles of clothing, which were carried by the crew into the city.
"July 17th.-The Spanish bark' Maria,' from Havana, having been detained three days at quarantine, arrived at the> city. and

STATE BOARD 01" HEALTH.

117

diRcharged 140 tons of ballast at the Atlantic and Gulf railroad wharf, also 13 mattrPsses and blankets, and articles of clothing, which were carried by the crew into the city.
"Augttst 2d.-The Spanish brig' Pepe,' from Havana, having been detained eight days at quarantilw, arrived at the city, and discharged .50 tons ballast at the Central railroad wharf, also 6 mattresses and blankets, with clothing, which were carrif'd by the crew into the city.
"August 16th.-The spanish bark '1\faria Carlina,' from Havana, having been detained fourteen dctys at quarantine, arrived at the city, and discharged 'two hundred tons of ballast at the Atlantie and Gulf railroad wharf.
"August 18th.-The Spanish brig 'Profita,' from Havana, having been detained ten rlays at quarantine, arrived at the city, and discharged at the Atlanti( and Gulf railroad wharf one hundred tons of ballast.
"8cptembe1 28th.-'l'heSpanish bnrk 'Olympia,' from Havana, having been detained fo1ty day.s at quarantine, arrived at the city, and discharged at the Atlantic and Gulf railroad wharf two hundred tons of ballast."
The list demonstrates the fact, that in the month of July, 1876, three (3) 8panish vessels arrived at Savannah from Cuban ports, which were infected with y01low fever prior to their departure. One of thes0 vessels diRcharged one hunctrcd tons of ballast at the Central railroad wharf, and her crew of fifteen men, with their mattresse.s, blanket.s and clothing, went into lodging houses in the western portion of the city.
Two of these vessels discharged one hundred and ninety tons of ballast at th( Atlantic and Gulf railroad wharf, and their crews, consisting of twenty-four men, with their mattresses, blankets and clothing, went into the lodging house of a Mrs. Redgate, which is but one square from the block first infected in the city.
During the month of August, 1876, between the 2d and 28th of the month, four Spanish vessels arrived at Savannah from Havana, at which port, at the time of their departure. yellow fever was epidemic.
One of these YessC'ls discharged fifty tons of ballast at the Central railroad wharf, and her crew of ten men went, with their mattresses, blankets and clothing, to sailor boarding houses in the westf'rn portion of the city.
Three of these vessels discharged five hundred tons of ballast at the Atlantic and Gulf railroad wharf, and their crew of forty men, with their mattresses, blankets and clothing, went into sailor
boarding houses (probably Mrs. Redgate's) in the eastern portion of the city.

118

REPORT ON YELLOW FEVER EPIDEMIC

These 11even vessels had all been detained at quarantine for a variable period.
'i'he ''Neuva Ygnacia" was quarantined six days. She was seven days from JUatanza~, therefore she was fourteen days from port to port.
The "Ynez" was quarantined three days. She was out eight days, therefore she was eleven days from port to port.
The '' Maria '' was quarantined three days. She was five days out from Havana, therefore she was eight days from port to port.
The "Pepe " was quarantined eleven days. She was eight days out from Havana, therefore she was eighteen days from port to port.
The" Maria Carlina," was quarantined fourteen days. She was nine days out from Havana, therefore she was twenty-three days from port to port.
The" Profita," was quarantined ten days. She was seven days out from Havana, therefore she was seventeen days from port to port.
The "Olympia," was quhrantined forty days. She was seven days out from Havana, therefore she was forty-seven days from port to port.
This data as to the length of time these vessels were quarantined is taken from the published report of Dr. George H. Stone of the Marine Hospital service.
As to the quarantine upon the Savannah river, Dr. J. H. McFarland, the Health Officer, testified that the quarentine station was at Tybee Island, about seventeen miles below the city. Vessels from infected ports are there stopped until hP can visit them, when he examines their papers, musters tile crew and inRtitutes especial inquiries as to any who may be missing. 'l'hat the usual detention is ten days from port to port if the vessel has a clean bill of health-any greater length of detention rests entirely with the Health Officer. At the quarantine station thPre is absolutely no means of enforcing sanitary orders. The crews of vessels can communicate with the city if willing to take the risk.
'l'he testimony of Dr. McFarland as to quarantine regulations is fully corroborated by that of his Honor the Mayor of the city, and Dr. J. C. Habersham who was for many years Health Officer of the port.
'Vere either of these vessels infected with yellow fever? is a question which at this time assumes important proportions.
Dr. McFarland testifies, that the first vessel which arrived in the city to which suspicion of yellow fever was directed was the bark "Maria." In mustering the crew, one man was missing, anrt it was reported that he had fallen from the masthead and b2cn kil!ed.

STATE BOARD OF HEALTH.

119

Being satisfied that the statement was true, the vessel was permitted to pass up to the city.
It is not stated however what caused the suspicion of yPllow fever to be attached to the" Maria." Was it simply because one man was missing?
The second case was that of the bark "~'[aria Carlina :" again one man was missing, reported to have died of cholera morbus; one man was taken sick three days after arrival at TybeP. Of what? Dr. McFarland does not state, although he snys: "I expressed the opinion to thP Mayor, that the man did not have the yellow 'ever. He afterwards recoveree!.'' This vessel was thoroughly fumigated.
From the bark "Olympia," upon 'vhich vessel a case of yellow fever was known to have occurred, infection could haye rpaeLed the city only by unauthorized communieation with tlw vessel.
The only fads connected with thpse Yessels, of intereRt to EpidemiologiRts, which ii'l at present ah~olute, is that they cleared from a port infected with yellow feYer, and thtt prior to their arrival at the port of Savannah no authenticated cases of the disease had occured in that eity.
The Cuban history of thesP vessels is ab~olutely unknown. They may have hPen infected with the diRense while at anchor, before or after taking in ballast. What epidemic influences had their crews been subjected to? \Vere any of them conYalescents from the Havana Marine Hospital?
It seems an absolute fact, that no case of yellow fever arrived at SaYannah upon any of these vessels, unle~s it may he that the man taken siek at Tybee was a ease of the rliseaHP; nor can this ease be absolutely rejected from all consideration, although he was, upon October 9th, admitted to the marine hospital with that disease.
The necessity of obtainin~{ inforn:mtion as to the Prews of these vessels is evident from the testimony of Mr. Angus McAlpine, who informed the hoard that he had been informed, when ou hoard vessels at the Atlantic and Gulf wharf, in his official capacity as inspector of lumber: "That the eaptain of the 'Maria Carlin a' had died at HaYana of yellow fever; tlmt the mate was also taken sick, but started for his home in Spain. 'l'he captain died on Rhore in Havana; the mate was ;:ick at the Havana Marine Hospital. The captain in commaud of the vessel on her arriv<<l, was pL~ in charge of her at Havnna. The baggagp of the first captain was on board; none was, to hiH knowledge, brought off the vessel."
None of the first cnses at :Savannah could be traced to absolute contact with these ves~els: the first case, Schull, of tile schooner "Severs," wa;; not known to have gone on hoard of either the

120

REPORT ON YELLOW FEVER EPIDEMIC

"Ynez" or the'' Maria," but he waR taken sick after the" Severs" had been for some day~ at tile same wharf with them.
The hoy Thomas f:lpary positiYely denies that he or any of his comrades E>vcr went on hoard any of these Yessels. But Cleary was taken with the disPaRe only after lw had gone many times to f!ig among the hnllaRt dischargerl from theHe VE>ssels, and hiR comradE's in this, with but two exeeptions, all had the disease about the same time.
Again, the loeality in whieh the first group of yellow feYer cases occurr0d, waR the nearest block of tenements to the Atlantic and Gulf railroad whmf, and wa;;; direetly in the line of communication between the Pity and vt>ssels taking in cargo at that point. It iR also a matter of great signifieanee that at this identical point all former epidemics of yellow feYer originated.
It is also denwnstrated that two of these ves~els discharged ballast, and that their crews of twenty-five men, with mattresses, blnnkets and dothing. WIOnt upon shore and into boarding houseR in tlw northwestem portion of the city This fact certainly furniRhes n clew by which tile eases which oceurred in that portion of the eity may be traeed.
The eharacter of the ballast discharged at the Atlantic and Gulf railroad wharf is a matter of much interest. An examination of the custom house reeords at SaY:mmth show that in 187G, 2,130 tons of this ballast was unloaded at tlw Atlantic and Gulf wharf.
Mr. W . .T. Land, analytical ehenlist, reports that the Havana ballast consists prineipally of blue clay possessing great absorptive power.
That its specific gravity i~ .....................................................2.315 The nitrogenious eonstituents ................................................0.192 Water expelled at a red heat.. ...............................................7.582
By a YPry large proportion of the medical men of Savannah, the importation bypotlc~is is rejected, and that of the local origin is warmly maintained.
It baR already been ~hown in this report, that the board has taken cognizance of 1his view of the epidemic, and that it is fully aware of the intense malarial influences to which the inhabitants of that city are subjected. A tabular statement of the mortuary reports for six years has bcc~;n presented, in which it is shown that the percentage of deaths from miasmatic disorders is very great. This beeomes strikingly suggestiYe, when it is known that the deaths from ~uch diseases in Sanmnah, with her less than thirty thousand inhabitants, rivals the death record from the Rame diseases' in the eity of New York, with her one million two hundred thousand inhabitant;;, which she draws from all quarters of the globe.

r

STATE BOARD OF HEALTH.

121

That an epidemic of malarial disorders, of an exceedingly acute grade, was prevalent in the city of Savannah, prior to and subsequent to the month of August, 1876, is shown by the testimony of Dr. J. C. Le Hardy and others, and the board is strongly of the opinion that to the excef'sive malal'ial charging of the atmosphere, the miserable !'lanitnry condition of the city and its surroundings, is to be attributed the intensity of the epidemic influences. But they fail tofindany evidence which does away with orinvalidates the circumstantial evidence in favor of the ilnportation of the disease.
Had there been 110 virulent outbreak of the disease at Havanahad there been 110 .tlTival of ves~els open to the suspidon of infection, prior to the SavanNah outbreak-had the di"eaf'e originated in, or during the early weeks of the epidemie shown its malignancy in those districts of the city n10st exposed to malarial influences, there could be no decided question on thf' subject. But the epidemic of 1876, at Snvannah, can be found to differ in no essential from all other epidemics known in this country-so far 11s relates to its inception-since 16!l3.
In view of all the eviden<:e obtained, although it cannot he proved that any eases of yellow fenr were carried into tlw city of . Savannah by vessels from Cuba-while it eannot be proved that any of the early eases in the epidcmie had perRonal eontact with such vessels-still the fact remain~, that no ease;; of the disease occurred at Savannah, until after the arrival 'of vessc!R open to suspicion of infection-that the outhnak of the disease did not occur at a point far removed from tbe~e \'<sseb, hut it did occur in the nearest inhabited hlock of the city to the wharf at which >laid vesRels lay; and further, that the two fin;t easts of the disease had been in the immediate vicinity of the ~nspeeted vessels.
THE EPIDEJ\HC AT OTHER LOCALITrES.
The Isle of Hope, ten miles below Savannah, was considered a point of refuge to the inhabitants of the city. Dr. S. F. Dupont states that at lt>ast three thousand individuals were added to the resident population. The disease did not, at this point, occur until after the epidemie was fully established in the eity.
It is a fact of great significance, that Bethesda School, which is situated but a short distanee from the Isle of Hope, was ent':cly free from the disease. Dr. Wm. Duncan remarks:
"If local causes gave rise to the disease at the Isle of Hope, th., same causes would have given rise to it at Bethesda."
Oliver Station, No. 4~, on the Georgia Central railroad, fortyfive miles from Savannah, was selected as a camp of refuge for the garrison of Oglethorpe barracks, Savannah, during the epi-

122

REPORT ON YELLOW FEVER EPIDEMIC

demic. Surgeon A. A. vVoodhull, U.S. A., furnishes the history of two cases of yellow fever which occurred in the command after the removal of the garrison.
Dr. A. B. Lanier, of Oliver station. records a most interesting case, which was contracted by a resid(nt of Station 4~, after sleeping one night on a train which had arriYerl the same Pvening from Savannah.
BRUNSWICK, GEORGIA.-At almost the identical time at Which the yellow fever outbreak occurred at Savannah, the same disease oceurred at the port of Brunswick, Georgia.
The hoard prese11t the evidence of Col. J. T. Collins, the Collector of Customs at that port, and of Dr. J. S. Blain, the health officer in detail.
Colonel Collins states that "on or about the 15th of July, 1876, the American schooner" J. M. Richards," from some Cuban port for New York, put into St. Simon's Sound with yellow fever on board; that she anchored nine miles from Brunswick, remained forty-eight hours, water was furnished her, and it was believed that she hacl no other communication with the town."
A1(gust l.~t.-The SpaniRh bark "Marietta," eight days from Havana, with a crew of fourteen men, arrived at Brunswick. Her bill of health, dated Havana, July 19, lil76, and signed by the American consul general, states: " Yellow fever prevails in this city and port.'' This vessel eame in ballast and for a cargo. No yellow fever occurred on !Jer during the voyage, but whilst at Havana her crew was taken with the disease, a portion <lied, and the balanee were sent to tlw marine hospital. S'.:Je was there manned by yellow fever eonvalescentR from the ~ame hm;pital. The ballaRt of this vessel was diR,-,harged at Cook's wharf. There was no ;,;iclmcss at Brunswick until Augm;t 21st, whf'n the captain of the schooner "Ed Jolmson ," which lay not ovf'r twent~, yards from the "l\fariPtta," was taken with yellow fever. He was taken on r;hore to the City Hotel, where he died on August 24th. Two of the seamen on the "Johnson" took the clisea;;;e and died. The schooner "\Vm. H. Boardman" lay alongside of the "l\farietta," and lost one of her ere\" hm1 the disease. The schooner "M. M. Pate," which lay along~idP the "Boardman," lost one of her crew. The firRt caseR which ocwur;"d in the city, after the death of the captain of the "Johnson," WPre men named Zeigler, ToatP, Hertzog, and a fpmale named vVeRt. Zeigler and Tonte hnd, upon several occasions, dined with the enptain of the" l\farietta," on board hig vesHel. Hertzog was a butcher, who supplied the "Marietta" with fresh meat." Mrs. "\Vest did SPWing for the captain of the" Marietta," upon clothing taken from the vessel to her house.

r
!

STATE BOARD O:F HEALTH.

123

'l'hese were all fatal cases, and all occurred within a week or ten days after the death of the captain of the" Johnson."
Dr. J. S. Blain, Health Officer of the port testified that" during, the period from the 7th to the 12th of SelJtember, ::\irs. \Vest, Zeigler, Toate and Bttrnes, died of yellow fever, but, being sick himself, did not see any of them. The fir,;t case he saw was on the schooner '\V. H. Boardman,' August 20th. The captain called on me to visit the steward of th.c ve~sel, who in my opinion had yellow fever. 'I'he captain said he had another sick man on board, but he wa,; all right. That m:m however died the following day. The captain of the schooner 'Ed. Johnson,' came on board the 'Boardman,' while the body of the dead man was on deck prior to burial. ::-law the captain of the 'Johnson,' on August 22d; h.e died August 24th of uncmic poisoning in a convulsion, no black vomit. The 'Boardman,' was lying along side ofthe 'Marietta,' whicll came from Havana witll a crew of convalescents from yellow fever. Messr,;. Zeigler, Toate, and Hertzog, were on term;; of companionship with the captain of the 'Marietta,' as were also ::\Iessrs. Beitzer and Doerflinger, who about the same time had yellow fever." 'l'he disease was carried
to different parts of the city, against a North-East wind that pre-
vailed during the whole epidemic. The town was perfectly healthy up to the breaking out of the epidemic. There was absolutely no malarial intluPnces affecting the town nearer than the rice fields, which are twelve miles ofl:'.
DoBOY IsLAND.-On the 23d of August the Spanish bark " Valentine" arrived at Brunswick from Havana. Had no bill of health-was in ballast. Did not discharge at Brunswick, but left immediately for Doboy Island, where she discharged ballast and took in a cargo of lumber. Within ten days of her arrival, yellow fever broke out on the island. (See testimony of Col. Collins, Mr. E. C. Davis and Dr. J as. Holmes, and letter from Darien.)
MEMORANDA.-In a private letter to Surgeon E. McClellan, U. S. Army,''' Col. Collins states that he finds l\Irs. \Vest (one of the early case;,; -at Brunswick) did no sewing for the "Marietta," but for the schooner" Johnson." l\Irs. \Vest went on the" John.son" after the di~ease was among her crew; got two or three suits of woolen l'lotheH, repaired them, pressed them with a hot iron, returned them to the vessel on the evening of Reptember 2d, and was taken with yellow fever thEo next day.
In regard to the epidemic at Macon and Augnsta, special attention is asked to the Yery valuable papers of Dr. G. E. Sussdorff,

:::A distin.gui'3h. d epidemiologist, to whom we are indebted for most valuable assist ance in the preparation of this report.

124

REPORT ON YELLOW FEVER EPIDEMIC

of Macon, and Dr. H. F. Cainpbell, of Augusta, which are presente1l in detnil.
And at this point, before entermg upon the conclusions of this report, while not bearing directly upon the immediate objects of this in veHtigation, we cannot omit, as among its conspicuous de. velopments, the self. sac-rificing fidelity which characterized the able band of medical men wlw stood to their posts so nobly, during this awful scourge. Ami in the same connection, we must mention the distinguislle!l <tnd timely services of the brave and eminent Dr. 0. A. vVhitc, who came to the rescue at the instance of the physicians of New York, in the midst of the pestilence, and, as we are assured, rendered most valuable aid, by his counsel and services, to the medical profession of the city of Savannah.
CoNCLUSIO.iS"S AND PREVENTIVE MEASURES.-For all practical purposes, it is not necessary to demonstrate whetller yellow tever is always imported, or whether, under certain peculiar and exceptionable circumstaucc~, it arises upon our coast from local causes alone. That it can be imported, and will or can become epidemic, from the neglect of proper sanitary regulations, in certaiillocalities, will not be questioned. 'l'hat it may be imported, and not become epidemic, in the absence of the circumstances which favor its propagation, will also be admitted without discussion. The very warm contest, therefore, which has been carried on for many years in regard to the exotic or local causes of yellow fever, does not seem to be justified by the necessities of the case, or the importance of arriving at conclusions of a definite character, with reference to the possibility of excluding it altogether, as an epidemic, from our shores. Let the facts of importation, or of local origin, or of both, be as they may, no argument is needed to establish the proposition, t~tt no means of preventing the 00cmTence of yellow fever should be neglected, which could by possibility be brought into requisition. The evidence in connection with the history of yellow fever, and that specially bearing upon this investigation, and developed during its progress, that the disease was probably imported, is very strong, and the evidence that the disease may have originated from, or was aggravated !Jy, local causes, is sufficiently strong to arrest our most intelligent attention, from the fact, that whether true or not, equally serious results may occur from a neglect of local sanitary precautions, in furnishing the favorable conditions for its propagation wllen introduced from abroad. In the case bQfore us, so far at least as Savannah is concerned, it would seem that there was no sufficient reason why the disease should not have been imported, from the admitted inefficiency of what has been culled by sanitarians, "external hygiene," or "quarantine," ali found on our

STATE BOARD OF HEALTH.

125

coast; or, upon the other hand, no reason why thir,; or any other disease possible to the locality, might not have originated in Savannah from the great neglect of its internal hygieue.
Tile value of a properly regulated system of quarantine cannot he successfully eontroverted; tile value of an enlightened and tllorough system of internal sanitary regulations cannot be estimated. In both points of view, the facts developed in regard to the reeent epidemic of yellow fever upon om coast, ls a :,ad eomroentary upon the wisdom and fidelity of both State and local authoritie,;. That a more rigid and eflective sy,;tcm of quarantine, and one at the same time judieiously adapted to the want,; of commerce, as well as to the hygienic welfare of conununities, should long since have been adopted, either by the State or Federal govermnent, is readily established by a very oouperfidtll glance at the subject. It i:; admitted that "the mean,; of protection attempted to be emiJodied in the first crude and imperfect syc;tem,; of quarantine, and the elToneous manner in which the,.;e were carried into practice, not only rendered them unavailing as a protection from the introduction of disease, !Jut caused them often to bceome, in themselves, agents of positive mischief."''' But tLmt quarantine has now established itself as one of the u~efnl in~titutions of the age, and is to continue to maintain anll enlarge the elmracter it bas for several centuries enjoyed, as the only safe preventive system for the preservation of public health fJom the introduction of diseases from abroad, may be regarded as a propositiou ~ettled beyond cavil. But even now, with tlw overwhelming evidence in its favor, it has hitherto been impossible to obtain for it, fro;n our legislators, the laborious and accurate investigation requirerl to compreheiHl the intricate, vexed, and still, to some extent, unsettled principles which have a direct IJearing, am! a eontrolling influence upon the subject. 'rho question i,; con,;tantly asked whetller any system of quarantine i,; likely to be efteeti ve in preventing invasions of yellow fe,er. 'l'hh; question may be confidently answered in the affirmati n, and it may be stated that the objections to quarantine arc largely IJased upon ignorance of the facts connected with its operation or of the origin of disease it is designed to limit, and U.:,'On the seltlslmess of commerce, exaggerating the inconveniencies necessarily attcndan t upon its exeeution, and magnifying the obstacles to tmffie, and thus produeing a false impression as to the real interests of localities, which, under a proper system of quarantine, would be really benefitted instead of being injured by a plan which might be adopted aftbrding an absolute protection.
Third Nationol Quarantine and Sanitary Convention, New York, 1859.

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REPORT ON YELLOW FEVER EPIDEMIC

It is significantly remarked by another,* and strikingly illustrated by our recent epidemic, " that a strong argument may be found in favor of a quarantine, on the varying aspects of public opinion at the South. It is found that cturing periods of health, the sentiment of the Southern people it~ strongly opposed to quarantine, but should there be a danger of the approach of the disease it is astonishing what a unanimity there is upon the subject. The 'press m.akes ferYCmt appeals to the Boards of Health to increase the efficiency of quarantine; leading men, both in and out of the profession, u;,;e all their influence to urge its establishment; and, should the disease unfortunately break out, the authorities are denounced in the Keverest manner for their neglect. The Medical profession may prove to their own satisfaction that the disease is of local origin, but the community does not believe it; and, in times of pestilence, they see what dreadful losses accrue to them from the prevalence of the disease, and all are quai'antinists."
Without undertaking at this time to elaborate such an inexhaustible subject, we will state in this connection that the argument drawn from the history of epidemics of yellow fever in the United States is altogether in favor of its importation, as exhibited briefly by the fact that its occurrence is in localities in commercial connection with infected ports, and that the first cases are usually those who have been in some way, either directly or indirectly, associated with the vessels engaged in such commerce ; or that the di~ease has first appeared in the vicinity of modes of transit by which the disease may bave been conveyed; or it has occurred near the docks, or in the nearest points of habitation to the harbor, or to the termini of lines of communication inland from such ports.
'l'he recent epidemic upon our coast affords, upon the whole, no exception, but a coufir:nation, of the fact just stated. 'l'he disease waH unquestionauly iutrodueed into the city of Brunswick through her port, having first appearell in connection with the vessels in the harbor, and having gmdual!y spread throughout the town from that quarter. And so almost certainly in regard to Doboy, to the Isle of Hope, to point~ upon the Central railroad, and to Macon and Augusta.
The facts in regard to all these localities amount almost to a demonstration, or, to say the least, are absolutely convincing, and while such positive eYidcuce may be wanting in Savannah, from the inability to trace directly tbe line of infeetion, and from the unquestionable complication of local causes, doubtless largely concerned in the extensive and malignant character of the epidemic,

''Quarantine on the Southern and Gulf Coasts, by Harvey E. Brown, M.D., U.S. A.

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the point at which the disease first appeared-its connection with the sailor boarding house-the fact that these particular localities were in no worse condition than in former years, and upon the presumption that they (if furnishing the germinal principles) should be affected every year, furnishes an inferential argument which is difficult to resist, that Savannah was no exception to other localities in the origin of genuine yellow fever during the year 1876.
We find, also, that the cause of the fever in this epidemic was, to a great extent, the duplicate of its history in other localities, in following the lines of trade and travel, as illustrated on the Gulf coast in Louisiana and Texas. But while it is not de;;igned to discuss this subject fully, it would be a manifest injustice to fail to indicate the fact, that the direct argument is equally conclusive as to the efficacy of quarantine, with disinfection, as strikingly exhibited in connection with its practical working in the ports of New York,''' New Orleans, Philadelphia, Baltimore, Natches, on the coast of 'fexas and elsewhere. In New Orleans and Galveston, especially in constant connection with infected ports, have the results of quarantine with disinfection in transitu, been strikingly manifested, and in 1875 and 1876 the additional precaution had been taken to re-disinfect all vessels from the tropics, after being laid to their wharves in the city, and upon the discharge of the cargo, and it is stated that in no vessel so treated has a case of yellow fever occurred during its stay in the city. But we are warned that a volume might be written upon this branch of the subject alone, and that the time and the circumstances do not warrant its exhaustive consideration. Itris admitted, as already intimated, that in Savannah particularly, and probably to a greater or less extent at the other points wbere the fever prevailed, local influences operated largely in extending the disease and in furnishing an element of malignity constituting a most important factor in its epidemic cllaracter, and doubtless originated a severe type of malarial or zymotic or blended fever, forming a large part of the prevailing pestilence, and adding immensely to its mortality.
We cannot speak too strongly of the unfavorable sanitary con-

*In the past season three hundred and sixty-three vessels arrived at New York from ports at which yellow fever was prevalent, and on ninety-nine of these there were cases of this malady, yet no cases of the fever occurred in that city, save such as came by rail from infected cities in the South. By quarantine regulations, embracing disinfection and a limitation of these vessels to the transportation of cargo and crew, these results were accomplished. (Health Officer's Report.)
J

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dition of the city of Savannah, and it is only now referred to, as the basis for the farther suggestion, as an indispensable necessity to the salubrity of that eity, that there should be, in our judgment, the most radical changes in the drainage, sewage and water supply. The low grounds surrou ~!ding the city, as with a cordon of malarial influences, should be thoroughly and systematically drained, at whatever cost.
The excrementatious and foul decomposing matter should be removed entirely from the city-rapidly, effectually, and inoffensively, in accordance with plans well understood and in successful practice in a number of the cities of Europe and of this country. If a system of sewage, or water carriage, is adopted or extended at all, which, in our judgment, is of doubtfulr,olicy, and a question requiring the gravest and \\"isest consideration, it can not be safely and efficiently done without a large addition to the water supply, furnishing the conditions for the rapid and complete removal of excremm-1t aud foul fluids, by a frequent and thorough flushing of smooth sewer:-;, to Le emptied into the Savannah river, or some other stream, at a much lower point than the present entrance of Bilbo's canal, thereby avoiding the possibility of the contamination of the air of the city Ly foul exhalation and the water supply, which it i:s altogether possible is to some extent in danger from the present location of the debouche of the sewage matter. But whether this, or a daily, or weekly removal of excrement by wheel carriage is adopted : only allowing other foul fluids to enter the ~>ewer~: there should be no further deposit of such matters in the soil, to still further inevitably contaminate the already poisoned wells of the city, if they are to be relied upon at all, to supply 'vater to the people. And surely nothing can be more manifest than the absolute necessity for a change to a much higher point on the river, of the source from which the reservoir is filled, and for a very large increase in the amount of water to supply any additional demand which may be needed by the possible abandonment of the wells for drinking purposes, but most certainly for the thorough and constant flushing of the sewers, should the policy of thus removhig the excrement be still continued and extended.
\Vhile we have thus endeavored to bring into review such points of the late epidemic as seemed to be vital to the present consideratiou of the subject, its full and comprehensive history must Le deferred to a time when all the fact~:; have been gathered, and time has been allowed to analyze them in the light of all their developments, and when the investigation has been freed from the necessary errors, prejudices and antagonisms of the present.
Ami, in a final conclusion, permit Uli to assure you that it is our

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firm conviction that, with a proper regard to the laws of health, as indicated in this report, and as demonstrated by sanitary science, in connection with an enlightened system of external and internal hygiene, Savannah, or Georgia, should never again be visited by so desolating a scourge. That these questions, involving the welfare of large portions of her people in their mean's and health, and the value of lives and money beyond calculation, should become the subject of the benevolent care, as well as of legislative interference and control upon the part of the State, is, in our judgment, the imperative duty of the hour.
J.P. LOGAN,
GEORGE LITTLE,
Committee.

REPORT
On the Epidemic of Yellow Fever at Macon, Georgia, in 1876, by
G. E. SussdorjJ, M.D., Member of the State Board of Health.
In the early part of the month of September, two cases of fever occurred ln citizens who resided in the southwestern part of the city of Macon, adjacent to the cotton factory, wllich cases the attending physician considered suspicions ones, that resembled very closely yellow fever, and he so reported them. Both cases quickly proved fatal, and in consequence considerable excitement ensued in the
community. By request of the Mayor, Mr. vV. A. Huff; a post
mortem was made upon the body of one of these persons, by Dr. H. A. Mettaur, in the presence of a number of intelligent medical gentlemen of the city. No positive diagnosis was concluded, much difference of opinion existing as to the nature of the disease, as will be seen by reading the testimony. No other cases like these occurred in the neighborhood of the factory, but about the 8th of September, Dr. Mettaur states he saw the first case offever which occurred in his own practice among residents, and a little later, about the 21st of September, Dr. A. L. C. McGruder's case occurred. (See Appendix.) About this period cases of fever were seen by other physicians, Drs. Burgess, Mason, Hall and others, and the disease began to assume the character of an epidemic.
As nearly as can be estimated, from all sources of information, twenty-five cases occurred in persons who had been exposed to the infection in Savannah and Brunswick, who were refugees; and about fifty occurred in persons, residents of this city, who had not, in a single instance, as far as could be ascertained, been exposed to infection in those cities. In all, there were seventy-five cases

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REPORT ON YELLOW FEVER EPIDEMIC

reported, which, aecording to testimony, resembled, in almost every essential particular, those whieh occurred in Savannah and Brunswick. I am inclined to think there were more cases here than have been reported, as the disease, no doubt, affected persons who did not reside immediately within the city, and were not seen by physician:;.
Were these cases genuine yellow tever ? Dr. McGruder states positively, from extensive 'experience, acquired in five epidemics at Natehe:.~, that all the eases he saw, (twenty-two,) were undoubtedly yellow fever, and he cites a typical case. Dr. Mettaur testifies as positively that his twenty-three cases were yellow fever, giving also the leading symptoms ; and Dr. '1'. W. Mason, city physician, says he treated at least ten cases of yellow fever, and enumerates characteristic symptoms. As will be seen by the paper herewith, by Dr. D. \V. Hammond, he does not think all these cases of fever in native residents should be set down as yellow fever. Does not think the two factory cases were yellow fever. He thinks he bas seen, in previous years, cases much like them in the flame locality. Dr. \Vm. F. Hall agrees very po:-~itively with the views of Dr. Hammond, and Dr. Wm. R. Burgess' diagnosis of these two cases was not positive. For particular~; reHpecting the several opinions of theo;e gentlemen, reference is made to their testimony. 'fhe conclusions of Dr. Burgess respecting the ,;ix or eight cases which he treated, seem to me intereBting, and worthy of a more thorough and minute investigation. The question, therefore, as to whether all these reported cases were genuine yellow fever or not, seems by the weight of testimony to be answered in the affirmative. It seems equally certain that the disease was rapidly assuming an epidemic form. Its malignity appears to have been proportionately as great, if not greater, than that which attacked the inhabitants along the sea coast. Dr. Burgess states in his testimony that, according to his observations, the percentage of deaths -in this epidemic in Macon was greater than that given by statistics of epidemics of yellow fever in this country in previous years, and Dr. Hammond stated the same fact to me verbally? It was not my privilege to be in Macon during the prevalence of this disease, and I am, therefore, unable to speak from personal experience; but, from a careful consideration of statements made by most of those who treated it here, as well as from information acquired in Savannah, I am of opinion that the same type of fever existed here in an epidemic form, as that which prevailed so inteniely in Sava:B.nah and Bruilllwick.

STATE BOARD OF HEALTH.

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Having arrived at this conclusion, the next point claiming attention was respecting its causation-whether the disease originated from imported infection, or from local and indiginous agencies?
The etiology of yellow fever is still unsettled, and is likely to remain so for some time to come; and as I have no especial prejudices upon this point, will not attempt to theorize, but simply note a few facts which may havP some bearing upon the subject, in this particular locality.
We must leave out the twenty-five cases ""hich came from Savannah and Brunswick, which were scattered about in different parts of the city, because in no instance was there an authenticated case of propagation by contagiou. 'l'he native casesremain, therefore, for consideratiOn only.
Of these fifty cases, about forty occurred in the immediate neighborhood of the Central, Southwestern and Brunswick R. R. freight depots, which are situated in the southern part of the city, and the remaining ten were located in other parts of the city, some distance from the otherH, but likewise within that district known to be subject to malarial influences. In no instance is it believed that the disease was propagated in these native cases by contagion, but, as will be seen, the testimony mostly favors the theory that the disease was originated by infected air brought from Savannah and Brunswick by means of railroad trains, and box cars especially, which were closed in those places and opened after they came to thiR city. 'l'he forty cases above cited were in the immediate neighborhood of the;;e freight depots, and it was here that the disease attacked its victims with greatest malignancy. This theory, at first thought, seems sufiicient to explain the causation of the disease, and the views expressed are very interesting, still there were other circumstance;; which point to local causes as important factors in the causation of the disease.
Dr. Hammond and others locate the epidemic within certain malarial districts, long known to be such, in which eases of bilious and other malarial fevers occur, with more or les" malignancy, every year-and this is a fact familiar to all per,;ons who live in the city. My own knowledge of this part of the city is in accord with the above, and especially is it so with reference to the statement made by Mr. A. E. Boardman, of this city, whose experience as a civil engineer entitles him to credit. By reference to the evidence herewith there is but one opinion about the district surrounding that point in which the disease was greatest. Its influence is decidedly pernicious, and it is evident at once that the best
possible conditions exist in that section for the propagation, if not for the actual causation, of the fever which occurre<i.

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REPORT ON YELLOW FEVER EPIDEMIC

The same local conditions are found about the factory, only in a less degree, and I think the evidence points strongly to circumstances which must settle the two first cases which occurred at this point to have been yellow fever, or, at least, that they correspond closely with those which occurred later, and were acknowledged to be such. (See Dr. Magruder's report.)
Restricting the consideration to facts as given, and from my personal knowledge of many of the local conditions and circumstances, I do not think the question of causation, as between imported and local infection, can be positively answered. 'fhe facts are evenly balanced. That an epidemic form of yellow fever existed in this city during the summer and fall, and until cold weather, there is ample evidence, and should be accepted as a fact.
Whatever may have been the source of infection, I am free to say, that had not the local condition of that particular section been most favorable for the development and propagation of that especial poison which causes yellow fever, there would have been but few cases among the residents. I do not think that in those portions free from malaria, the infection could possibly propagate. I would direct particular attention to the report of Mr. Boardman, which demonstrates clearly the unsanitary conditions surrounding the city to the south and east, and wherein is also indicated the measures by which it may, in my opinion, be deprived of its pernicious influence, and most earnestly advise means with this object in view. With reference to quarantine, I consider it by far the safer plan to require at least disinfection of trains and individuals before coming into the city, but would not carry it so far as to interrupt free communication. It would have been more satisfactory to me, could I have devoted more time to the duty assigned me, but circumstances intervened to prevent.

A REPORT
To the Board of Health of the State of Georgia.- The Railroad Transportation of Diseases.- Germs.- Yellow Fever and Dengue Fever in Attgusta.-By HENRY F. CAliiPBEI,L, M.D., Sanitary Commissioner for the Eighth District of Georgia.
The medical history of Augusta comprehends two acknowledged epidemics of yellow fever and one of dengue. A brief reference to these several incursions will not be out of place, in connection ~ith the occurrence., of the past season.
The epidemics of yellow fever above referred :to, ocourred re

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i!!pecti vely in the years 1839 and 1854, while the single terrible incursion of dengue took place in 1850.
Augusta, lat. 33 deg. :28 min. N., Jon. R1 deg. 54 min. "\V., ifl situated on the west bank of the Savannah river, at the head of steamboat navigation, being over 130 miles from the mouth of the river, one hundred and twenty miles north northwe~t from Savannah, and one hundred and thirty-six miles northwest from Charleston. Its elevation above the sea iR one hundred and eighty-five feet.
Augusta may be said to have four direct avenues of communication with the Atlantic coast, viz : One by water, the Savannah river, and three by lines of railroad- -the South Carolina railroad, connecting it with Charleston, the Central railroad, connecting it with Savannah, and the Port Royal railroad, connecting Augusta with Port Royal, and less directly with both Charleston and Savannah.
Of the yello\V fever epidemic of 1839, little that is accessible to us can here L<' made availa!Jle. 'l'he present writer had occasion, in 1852, to furnish to the fifth volume of the 'l'ran~actions of the American Medical Association';; such scattered details as could be collected from the writings and discussions of that <lay, in regard to this first invasion of yellow fever. 'fhe outbreak, contrary to the appearance of the disease in other placPs, if we are rightly informed, and different from the meteorological conditions of the past season, was preceded and attended by a long protraeted period of not only extreme heat, but also of excesHive drought. 'l'hat magnified and most mfallible hygrometer of thi>< entire region, the Savannah river, whose lowness or fulne~s pretty surely indicates the rain fall here, and in thP upper regions of om Rtate, was extremely low for many months previous to the occurrence of the first suspicious case of fever in '839. Men and boys on horse-back, and even drays and carts, crossed and were driven from the Augusta to the Hamburg bank, with ease and without swimming. Henry Schults, the founder of" New Hamburg," and the implacable litigant against Augusta, with the view to some fancied ad-
vantage it might be to him, in the future contest of his claim for
the Augusta bridge, availed himself of the extreme lowness of the river, and planted its exposed bed with turnips, this bed remaining unC'overed long enough to allow his crop to attain a considerable advance toward maturity. The daily temperature, though it cannot now be here accurately recorded, waR, to all sensible observation, unquestionably high, and remained so during

*See report on blending and conversion of types in fevers. by Samuel Henry Dickson, M.D.. nf Charleston, S.C.. vol. V. page 127, American Medical Tlan-
~ction~.

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REPORT ON YELLOW FEVER EPIDEMIC

many months of this eventful season-in full keeping, no doubt, with the dryness indicated by the empty river.
'' The first notice of the existence of a gravc form of fevPr is dated August 21st," and these early notices evidence both the entire strangeness of the ghostly visitor in our city and the extreme reluctance of not only the municipal authorities and of the citizens, but also the medical profession, to give it recognition.
Dr. Dickson thus condenses our report made to him in 1852: "The notice of this first case contains the positive declaration, on the authority of the Mayor, ' that having consultect the medical gentlemen of the city in relation to the character and supposed origin of the disease, the faculty have reported that it varied, in no material features, from that frequently exhibited in the ordinary summer and autumn fevers of all southern climates ; that it was neither contagious nor infectious ; that it was confined to narrow limits, and originated in some local causes which had :;ince been removed.' A call was afterwards made for 11 general meeting of the physicians, and the following report was issued August 29th by the board of health: 'We are also of opinion that the disease is the bilious-remittent of the se11son and climate, aggravated by some loc11l cause.' On September 2d, the board reported three deaths, and st11ted th11t ' but few of the cases can be considered malignant.' Here we have a foreshadowing of the public terror as to the character of the epidemic.
"Shortly after, in answer to a letter of inquiry from the J\iayor of Charleston, S. C., concerning the nature of the disease, which the Mayor of Augusta received, and referred to Prof. Milton Antony, who had been long and extensively familiar with all forms and modifications of m11ll1rious fever, Dr. Antony writes: 'No case of yellow fever has originated in Augusta during the whole season ; that the disease by which our community has been visited is the same in its general character with the fever which generally affected our city by its annu11l recurrence in the autumn, the same which prevailed last season in certain districts of Georgia and South Carolina, and elsewhere, (unquestioned bilious-remittent); that its occurrence now, after three years of unparalleled health, is owing to unusual local' influences, etc. These causes have introduced a fever, the general character of which is, primarily, inflammatory bilious fever. In"a smalrportion of the city, a considerable number of cases were so modified as to render them highly dangerous. 'fhese cases were;;,properly denominated congestive cases of bilious fever.' "
To continue our extracts from the former report: "There was also published a letter to the authorities of Augusta, written by Dr. S. Langley, of whom it is said that he was a gentleman expe-

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rienced in the observation and treatment of yellow fever. It reads as follows: 'In the several cases of disease that I have seen in the city, there is not, in my opinion, the least vestige of yeilow fever. As far as my observation extends, the cases had the aspect of bilious-remittent fever, assuming, in the latter stages, the typhoid type ; and here and there I have seen a case of bilious-in-
termittent fever.' Dr. Langley then describes with clearness and accuracy the diagnostics which distinguish yellow fever from malarious fever.
"It appears, then, that in these early stages of this first epidemic, that by the declarations of those who slwuld have been supposed to be most competent to decide its character, it was not admitted at all to be yellow fever; an able practitioner, of enlarged experience and long personal familiarity with bilious-remittent, decides that the disease was of this well-known eharacter, and in eonfirmation of this decision we have the eoncnrrent opinion of another, " an expert" also, and well acquainted, as we read, and as his letter shows, with the "hcemigastie pestilenee,'' that he did not reeognize it then and there in any form. Yet, bofon~ tlte termination of the season, there was no dissentent voice to the universal admission, that the epidemie was, and had been frum_ the first, yellow fever, and 'at the present time," (1852) adds Dr. Campbell, 'it i;.; not by any one doubted that it was yellow fever in the beginning, in all its, charaeteristies.' ''
"Ve have thus given all that is pertinent, as we find it condensed in Dr. Diekson's reports. A valuable body of faets pertaining to this epidemic were eollected in a pamphlet in the form of a report by the physicians, prepared by Dr. F.l\I. Robertson, at that time of tllis eity.'i' "Ve regret that we have not access at this time to that paper.
The discussions held at the time as to the origin and eause of the disease, eontained mueh that was interesting, and, with the light which subsequent investigations and occurrenees can be made to reflect upon them, no little which migllt be made instruetive. The sanitary eondition of the city was at the time most narrowly scrutinized, and no alleged focus of morbific influence was allowed to remain without being subjected to the closest examination in connection with the local outbreak and gradual spread of the epidemie over the various portions of the city. Many such foci were brought to light; the storing of cabbages and other vegetables and fruits in eellars and baek rooms in Bridge Row and its vicinity, near whieh the earlier cases originated, the importa-

*Report on the Origin and Cause of the Late Epidemic in Augusta, Georgia, 1839.

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REPORT ON YELLOW FEVER EPIDEMIC

tion of West India fruit, and other less special circumstances, were confidently regarded by many as the undoubted sources of the disease. The one grand and most unquestionable of all the sources, however, of the epidemic, was, by almost univer~al consent, fixed upon aR the "Trm;h \Vharf."
This term was commonly used to designate the locality of an immense pile of trash, garbage and filth carted from every portion of the city at that time, and dumped from the bank into tne Savannah river, about opposite or just below Elbert street. 'l'bis festering mass of rotting materials bad been accumulating for many months-perhaps for years-strange as the fact may now appear to us, since the promulgation of our modern and more enlightened ideas of sanitation. On the other side of the river, nearly opposite to this heap of filth, was at that time, the passensenger and freight depot of the south Carolina railroad, the only railroad communication of our city with the seaboard, or with any other region.
The trash and garbage thus disposed of, when dumped from thE' bank of the river, found its way to the bottom ; some floating off, but a portion:always remaining, then gradually arose from the bottorn of the river. An immense pyramid of these materials, thP broadest base of which was ordinarily below the water-line of the river surface, was thus formed. During the months of June, July and August, the gradual decline and final extreme lowness of th0 river, exposed an immense surface of this loosely packed, moist and rotting mass of deathly materials to the burning sun. The pestiferous emanations and the stenches exhaling from this deadly accumulation may well be imagined, and for their accurate and graphic presentation, we refer to the strictures to be fonnd in thee daily city papers of those alarming times. Doubtless such are them to be found, describing in glowing terms this redolent mass of putrefaction and disease.
After the epidemic hall ended, when the report of cases began to be made up, it was fon11'1 that about as early as thee 5th of July, Dr. Alexander Cunningh.l m, then Professor of Practice in the Medical College of Georgia, had bad a case in a region of the city in near proximity to this trr>~h wharf, which could now be pronounced as the first case of yeellow feever. All the earlier cases were found to have originated in streeets bordering upon or lying near the river, and it was also found that from this direction the epidemic bad made its gradual and fatal progress over other and remoter portions of the city, until thee eentire area of the inhabited portions of thee town had been subjected to its deva,;tations. The citizens promptly abandoned the city in vast numbers, leeaving it
to the care of the negro population, during that epidemic, but lit-

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tie subject to its ravages. Yet, as is known, the mortality was very heavy, amounting to two hundred and forty-three deaths from yellow fever, and only ceasing with the return of freezing weather.
Among the causes assigned, of course those who advocated the doctrine of contagion sought to prove the origin and spread of the disease had resulted from the importation of cases from Charleston, where also at that time the yellow fever was prevailil'g. This, however, \Vas most conclusively demonstrated to be groundless, as the cases in Augusta bad been occurring constantly from the 5th to the 26th of July, when it is known that the first cases from Charleston did not reach Augusta until the 27th of the same month.
What influence the situation of the South Carolina freight and passenger depot, on the bank of the river opposite the locality at which the disease began, and the arrival and stoppage of trains bearing Charleston air, and also the constant prevalence of southeast winds during this entire season, may have had upon the introduction of yellow fever in our city in 1839, are questions which, if we find time to discuss them at all, we must consider in other connections than in the above brief sketch of the epidemic of 1839.
'fbe second epidemic of yellow fever in Augusta was that of 18.54. Like that of 1839, the outbreak was preceded by a long period of high temperature and a protracted and remarkable drought. Unfortunately, we are again unable to give either the thermometric record or the rain fall in inches for that season. For a succession of months, July, August and September, from the few private records made, and especially by the memory of reliable citizens still living, the heat was most oppressive and the dust almost suffocating, on account of the entire absence of rain. The Savannah river, as it had been in 1839, fifteen years before, and once or twice in the interval, again become attenuated to a meagre stream, filling only a narrow channel-shallow everywhere, and exposing extensive areas of its bed. Horses were again ridden across, and draymen saved their bridge-toll by driving over from the Augusta to the Hamburg bank.
The prevailing winds were from the northeast during the months of August and September-by common observation, the wind changed but little in uinety days. During these months, in the absence of anen10seopie record, we may mention that all curtains in dwellings suitably situated were constantly blowing against the windows on the west fronts. Numerous observations of this kind were made at the tJme, which are aecuratdy rembembered now. So much for the meteorological condition of our city during this

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REPORT ON YELLOW FEVER EPIDEMIC

season, as can be inferred from data which are confessedly b t

unavoidably, imperfect.

'u

In 1839, as we have stated, our only (lirect communications With

the Atlantic coast were by the Savannah river, floating a few

small steamboats and flats of very light draft-all laid up for some

time before on account of the low river; and secondly, the South

Carolina railroad connecting Charleston with Augusta by daily

trains. The depot of this road was at that time located on the

east bank of the river, nearly opposite Centre street or Bridge

Row. In 1839, yellow fever prevailed in Charleston from June to

October, and, according to Dr. Bennett Dewber, as quoted by Dr.

Toner, there were 13 deaths."'

In 185, our Railroad connections with the sea coast had been

increased, by the establishment of a direct line to Savannah-tht'

Savannah and Augusta Railroad. Daily freight train;;; regularly

arrived at the depot of this road, located in the north-easteq1 part of the city, corner of '-Vashington and Calhoun street~. A fearful

epidemic of yellow fever had lJeen prevailing in Savannah since

August 5th. Deaths variously estimated, from 580, (Hume as

quoted by Dr. 'l'oner,) to 613, (Sexton's report.) In Charleston also, from August toNovember, there were in this year 627 death~

by yellow fever. (See Dr. 'l'oner's paper.) As late as August 7th, it

was clairned in Charleston, that the disease had become epidemic

while at that date, as we have seen, it was making the most fear-

ful ravages in Savannah.

In Augusta, the epidemic yellow fever of 1854, dates from Sep-

tember 14th. The Board of Health reports one death from yellow

fever on the 14th. The subject was a mulatto girl, about 15 years

of age, (Constitutionalist I.5th,) also, a german, J. Roahl, aged

80 years, who contracted the disease before his arrival here. The

case of the mulatto girl, occurred, acconling to the report of Prof.

L. D. Ford, neal" the church of Atonement, on Fenwick street, in

west end of the city. A case, afterwards recognized as yellow

fever, had occurred previout!ly, on lower part of same ~<treet. To

indicate the health of the city at the time of the outbreak of this

fearful epidemic, and the frightful progress which it made, we

quote the following front the columns of the Constitutionalist:

"For the benefit of those absent from the city, we would state,

that from the 1st to the 17th of September, there were only twenty-

one interments in our city cemetery. Of those, four were brought

from the country; leaving for the city only sixteen up to the 17th

*On the Natural History and Distribution of Yellow Fever in the United States, etc., by J. l\I. Toner, M.D. Read before the American Public Health Association, New York, November 12th, 1873.

STATE BOARD OF HEALTH.

139

fSeptembcr. There has been no year within our memory, since 0 have been resident in Augusta, that the bill of mortality in

: ~ttneemssb.e"r, 1f1i~een days

up to the same period, will bear any comparbon for And yet in the same paper of October 7th, the last of September had added sixty-six deaths, making the

bill of mortality for the month eighty-two-fifty of which were

ported as deaths from yellow fever! " 'rhe number of deaths

:uring the last 15days of September," continues the editor "with

ur diminished population, would be equal to 400 or 500, with the

:rdinary population at home."

The epidemic of 154, continued to make fearful ravages on our

diminished population during the month of October. There were

six deaths reported by the Board of Health on the 24th of October,

and five on the 30th. From September 12th to November 20th,

one hundred and twenty-three had died of yellow fever-whites

110, blacks 13. (Sexton's report.)

During this period, though no strict record was kept of the

weather, we find by the reports-October 2oth-that " the earth

1s parched for want of rain, and vegetation wilted by the heat and

dryness." The state of the river we have already noted, as being

driven over by draymen, and its bed exposed, except a narrow

shallow channel. As a "black frost" is recorded on the 14th of

November, this may be regarded as the elate of the ccsomtion of

the epidemic of 1854. During the month of November tile city

sexton reports but thirty-two deaths, six of the number tlying

outside of the city-whites 19, blacks 13. Twenty-four deaths for

the entire month of November now indicated a condition of health

fully equal to that which marked the fir'lt sixteen day;; of Septem-

ber, just before the outbreak-less than one death to each day.

In closing our brief notes of the two epidemics in Augusta-

.1839 and 1854-we will here call attention to the fact, that the

first recognized case in 1839, and a considerable numuer imme-

diately succeeding it, occurred in Reynold street, with a clear

open space before it, fronting the east bank of the Savannah river

and opposite the South Carolina depot"' there ;located, where

both passengers and freight were daily arriving from Charleston,

then a locality devastated by epidemic yellow fever. From this

point, and from tlie neighborhood of Bridge Row, near by, the

disease rapidly spread throughout the city. Secondly we would

1 ask that the fact be noted, that at the time of the outbreak in 1854, increased railroad communication with the Atlantic coast had

been accomplished, freight trains coming directly from Savannah,

and discharging on the west side of the city; and further, that

*This has ~ince been removed to the Augusta side of the river, and is now located on Reynold street, opposite the dwllings first infected.

140

REPORT ON YELLOW FEVER EPIDEMIC

yellow fever had been epidemic for more than a month in both Charleston and Savannah at the time our first case occurred. 'rhirdly, that while in 1839 the epidemic began opposite the discharging depot of our only railroad avenue with the coast, viz.: on Reynold street and Bridge Row, in 1854, the early case, though not in the immediate neighborhood of either depot, was still on the west side of the city, and sufficiently near to the Savannah depot to admit the assumption of its influence in their origination.
We would further call attention to the fact, that though from 1768 to 1838 there had been about twenty-seven visitations of yellow fever in Charleston, and seven visitations in Savannah from 1807 to 1854';', the disease never had found its way to Augusta till 1839, and that its more widespread outbreak (of initial cases), was in 1854, after the establishment of discharging depots on both sides of the town.
We would still further ask that it also be noted, that the meteorological conditions of the two seasons, 1839 and 1854, so far as they can now be estimated, were in this chief essential almost identical, viz.: extreme heat during the protracted period, and a long period of drought, as indicated by the dried up river of both seasons; and further, that the prevailing winds of both seasons blew directly from the coast, with but little change, for months preceding and during the epidemics of the two years.
" Heat and moisture " has become proverbial as the conditions under which the protean forms of malarial fever have been found most frequently to prevail, and these may be two of the conditions also in which yellow rever, in some of its many localities, has been found to become epidewic; but in the case of the two epidemics which devastated Augusta, the extreme opposite to one of these conditions seemed obviously to prevail. 'rhc empty river, with carts and drays driven across its channel, " the parched and dessicated earth and the wilted vegetation," throughout both seasons of its prevalence here, are significant facts contradicting any theory that moisture is always an essential element in its origination. Indeed, we may find hereafter, from a brief consideration of the inconsiderable number of cases of yellow fever which occurred in Augusta during the season just past, of 1876, in connection with the meteorological record, that possibly one of the elements of our escape from a desolating epidemic, was the moisture

* J. 111. Toner, M.D., op. cit.

STATE BOARD OF HEALTH.

141

and the rain fall during July, August and September immediately preceding its appearance.'~
THE EPIDEMIC DENGUE OF 1850.
'he association of dengue with yellow fever is a most congenial one, and to discuss the Augusta epidenlics of the latter without givings orne brief notice of the remarkable incursion of dengue in 1850, would be a strange and unnatural omission. Not only do yellow fever and dengue resemble each oth,.- in the fact that they are fevers essentially of a single paroxysw, but there are many other characteristics pertaining to each and C<Jrumon to both, which indissolubly bind them together in a clas~ of which we may say, so far as our knowledge extends, they are the only members. We believe a specific and peculiar morbific agent is the cause of each, but that these poisons, whatever may be their individual characters, very nearly resemble each other in the phenomena they give rise to, there cannot be the slightest doubt. Dengue is by no means "a mild form of yellow fever; " but, though scarcely ever fatal in itself, it is yet, for grade of fever, for intensity of suffering, and for tardiness of convalescence, by far the more distressing of these two dreadful forms.
The year 1850 was remarkable for the wide-spread prevalence of dengue in epidemic form in various localities, pertaining principally to the south and south-west. Its occurrence in Augusta in 1850, was preceded, as it was in many other places, the same year by a protracted period of unusual heat and drouth. Cases were recognized as early as the 22d of August, but not until about the lOth of September did the epidemic become fully manifested in its unique and indubitable individuality. From this period until late in the autumn, the disease prevailed throughout the city with the most distressing severity. The following, taken from our history of the epidemic given in 1851, will give some idea of its universal invasion of all classes of subjects among om citizens:
"Fron< various calculations we have seen, we think, the number of cases in Augusta during the past season, may be estimated at between eight and nine thousand, the majority of which did not receive the attention of physicians, being subjected to domestic treatment. Out of this vast number, we have not heard of a single death from the epidemic uncomplicated. Indeed, the prognosis of the disease, under ordinary circumstances, was invariably favorable."
During the entire period of the prevalence of dengue, we did not

*See meteorological record kept by the War Department at this station, and kindly furnished by the obs~rver, Mr. H. Bessant, as appended to this report. Jnly, 14 days of rain; August, 14 days, September, 7 days.

142

REPORT ON YELLOW FEVER EPIDEMIC

hear of any cases of yellow fever. We are positive there were no fatal cases of the disease here that season. The connection of dengue with yellow fever during the past season will be recognized in the reports, as we have with difficulty, and most imperfectly, been able to collect them.
THE YELLOW FEVER AND DENGUE, AS THEY OCCURRED IN AUGUS'l'A IN 1876.
It is no1v a generally admitted fact, that during the past season a number of cases of yellow fever originated in Augusta, and that in all probability we narrowly escaped a devastating epidemic. With the opinion of the intelligent and experienced practitioner before us, from whose report we derive our principal data, it would be unnecessary to enter into a detail of cases to confirm the fact of its existence, even were such details accessible. We shall, therefore, after our conference with Dr. Edward Giddings, and others witnessing some of these cases, confine ourself mostly to the notes found in his published record_in the Chronical and Sentinel of the 3rd of December.
" 'l'he extreme virulence of this disease in Savannah," writes Dr. Geddings, "the closeness of our connection with that city, by water and two line~:; of railway, and the unusually favorable atmosphereic conditions during the summer, had led those familiar with yellow fever, to fear that Augusta woultl probably not escape the pestilence, and justified the anxiety felt by the public, and also some of the precautions taken by the authorities. In September matters became Htlllmore ominous ofimpendingdisaster. On the 19th A. Haley h~1d died, at No.- 'l'wiggs street, with symptoms which aroused the suspicions, not only of his physicians, but of several neighbors who had become familiar with yellow fever in our seaboard cities. On the 22d I. Ferber was admitted into the city hospital, and pronounced by the Nestor of the Faculty, Dr. L. D. Ford, to present a mild case of yellow fever, an opinion justified by the course of his convalescence."
As the case of Ferber was, in certain particulars, strictly recorded upon the books of the hospital, we state them here briefly. Ferber was, at that time, a baker, occupied at his vocation on Mcintosh street, between Broad and Greene streets. As stated to Ul5 in conversation, by Dr. D. T. Ford, he was constantly subjected to ch.mges of temperature incident to his trade. It appears by the hospital registry that he was admitted September 21st, at 10:30 P.
M., and immediately put under treatment by his physician.
10:30 P.M.-temperature 103~; pulse 94, full. September 22d, 9 A.}f.-'l'emperature 101 ; pulse strong and full, but compressible; urinated at daylight, and bowels moved at that time..

STATE BOARD OF HEALTH.

143

11:30 A.llr.-Pulse full and soft; skin moist; generally comfort-
able. 3:30 p ..M.--;:-Pulse 86, soft; temperature 10H; operation atl o'clock.
:No urine.
S:30.P.lii.-Pulse llcl, soft and compresHible; temperature 104; no roovement; urinated 17 ounces at 5 o'clock P.M. 10 P.M.-Pulse 98; temperature 105.
September '23d, IJ:30 A.llr.-Pulse 90; temperature 102; movement and urine in ~ame vessel.
8 P.M.-Pulse 82; temperature 102; movement. September '24th, 10 A.M.-Pulse 80; temperature 100}; operation
and urine in tile night. 5:30 P.llf-Pulse 80; temperature 101; no operation; urinated, at
4 P.M., 16 ounces. September '25th, 11 A.llr.-Pulse 8'2, full and strong; temperature
100; operation last nigilt, a!l(i urine. Nose bled twice during night, and once, moderately, til is morning.
3 P.M.-Nose bleeding and dark urine. September 26th, 10 A.M.-Ferber convalescent; dark urine. Nose bleeding. Liberal diet.
The auove, by no means the most marked of tile case::l referred
to, was, uy its record of symptoms, and by the opinion of Drs. L. D. and D. S. Ford, the attending physicians, undoubtedly, as Dr.
Geddings has characterized it, "a mild case of yellow fever." "Light dengue forms of fever, whicil alway;.; accompany epidemic
of yellow fever," continues Dr. Geddings, "were mopping out here and there in tile city, and everything indicated that the poison had reaelwd us, and was only awaiting favorable atmospilcric collditions to burst into a friglltful epidemie. Under these eircustances, the death of John Murphy, on rrwiggs street, near Holey's place of residence, witil symptoms, which, on the closest analysb, could not De distinguished from tilose of yellow fever, was a matter of the gravest import, whieil I did not feel justified in withholding from the knowledge of tile Board of Health, etc." Dr. Geddings, who regarded the making public of the few inititd cases of y<'llow fever as injudicious, on account of tile premature alarm it might give rise to, in a public spirit llighly commendable, but temporarily self-sacriiiciug, did not enforce with arguments tile diagnosis he had made in his report to the city board of health. " To have done so," to use his own word::;, "would simply have stampeded the city."
"Three days after-September '27th-occurred the case of Miss K. G., on Jackson street, within two ilundred yards of where Murphy worked. In tilis case tile symptoms of malignant yellow
II

144

REPORT ON YELLOW FEVER EPIDEMIC

fever, even to copious black vomit, and death, appeared in such regular succession that not even a non-professional person who had ever seen such a case, could mistake it for anything else." 'rhis case occurred in the same locality of a series of ,.;imilar cases extending through the months of October and N ovember. "In all, counting light and serious, my list Hhows thirteen caRes, with four deaths. Nearly all the cases, and all the rleatbs, occurred. within a few hundred yards of tlle localities where the first two made their appearance. I have hear<l of others, but I speak only of my persunal experiences."
As to the sanitmy condition of the city, we cannot report that there was any eondition of the city generally, nor any local accumulation~ of filth in tlw region first infected, which could reasonably account for the occurrence of the fe\v cases we had last autumn. The closest scrutiny failed to detect any adequate local cause. At Miller's mill, in that region of the city, there was a hog pen which elicited some concern on the part of the citv authorities. The subjPct, however, wa,; earefully investigated, and no suffieient cause found to account for the eases. 'l'he canal was al:m found to afford no elue to it~ origin. It is indeed singular that these cases all originated in Augm;ta in the immediate vicinity of the ga~ house, a region redolent with the antiseptic('.') effluvia of coal. And no less curious was it that the frightful epidemic of i:'lavannah, !aRt season, has its initial cases "near the gas house."
In the eonclucling paragraph of Dr. Gedding's remarks, we find the only reference that he make,.; to meteorologieal conditions prevailing at the time of this slight invasion: "'rhe question will naturally be asked, \Vhy did uot the infection spread into an epidemic'! The awnver is easy-cold and drought are the swom enemie,.; of yellow fever. At t,he time the first case occmred, a crisp northwest wind had been blowing for ten days from the mountains, and the thermometer fell rapidly, and reached 48 on the 29th of September, (mean temperature 6(;0 -see signal service register attaehed to this report,) on which clay frost was reported from several neighboring localities. Although not sufficient to kill it outright, this no doubt effectually stopped tlte disease. To these physical agents, and not to drain-cleaning and disinfection, or to the eruel quarantine established (contrary to th<' tlci\'ice of the faculty) against our sister cities in their hour of trial, should we attribute our esc.~tpe from one of the most fearful scourges known to man."
The prevalenee of dengue must have been eveH more general than indicated in the briet extracts from the foregoing pages. Returning from Philadelphia September 26th, we soon had the

STATE BOARD OF HEALTH,

145

portunity of bearing witness to the fact of its presence in the
~fty, in a form which presented all ~ts pec~liar and w~ll-rn~rkcd
haracteristics. 'rwo cases, located m porhons of the c1ty Widely :eparated, were particularly noted: Mr. C. T., living on 'l'elfair street, between \Vashington and Centre streets, was taken on tbc night of the 27th; and Ellen, a colored servant, nearly white, livIng on Broad street, had her first symptoms on tlie 29th. In both these cases, tlie protracted and uninterrupted febrile paroxysms of over seventy-two hours, unmodified by quinine, was a feature in common. The lumbar pain and aching of the limbs, were also observed in both cases. The eruption was of a kind simulating scarlatina, beginning on tlie knuckles, elbows and faces vi both patients, and extending pretty generally over the body, which was well-marked. In one of the patients, Ellen, the hemorrhagic tendency was obvious, while n0t apparent in the other. Being within a week of her menstrual period, the flow began in the early part of the 9-ttack, and was unusually profuse, and contiuued Juring convalescence. In both these cases the return of appetite was tardy, and the convalescence protracted and unsatisfactory. We regarded them as typical cases of the disease-as well-marked as any observed by us during the great epidemic of 1850.
The above completes our record of what may be called the "aborted epidemic" of yellow fever in Augusta in1876. We have heretofore called attention to a few facts to which we desired a certain amount of significance should be attached :
First-That yellow fever had never appeared in Augusta until the establishment of a railroad communication with a yellow fever
port. Secondly-'rhat, in the invasion of 1839, the initial cases occurred
on the Augusta side of the river, almost immediately opposite, with an open space between the location of the South Carolina depot, on the Hamburg side, and that the prevailing winds were blowing directly from that depot to the region first infected ; that there was a trash wharf emitting deadly affiuvia, and that no yellow fever cases occurred in Hamburg till after its prevalence in Augusta, are admitted adverse facts, which we will not now discuss, but which could be, in some degree, conciliated.
Thirdly-That in the epidemic of 1854, while yellow fever had been prevailing for some weeks in Savannah, and for a shorter period in Charleston, the opening of an additional line of communication with the seaboard-the Augusta and Savannah Railroad -landing on the opposite side of the city, seemed to determine, in some degree, the locality, or at least the general vicinity, of the outbreak. The initial cases now presented themselves 011 the northern side of the city, in localities not distant from the depot

146

REPORT ON YELLOW FEVER EPIDEMIC

and city tracks receiving and giving pa;,sage to the freight trains from the infected city. To recognize all the facts, we here again admit that 'felfair street is not in the immediate vicinity of the Savannah depot, and that houses in that vicinity were not firilt infected.
Fourthly-'fhat in the case of the incursion of 18i6, yellow fever prevailing with concentrated intensity in Savannah for many weeks, our initial cases all occurred in a restricted r<>gion again not distant from the i::lavannah depot, ami from the city track:; along which the trains were shifted.
From the above series of facts, relating to the initial cases of the three visitations of yellow fever in Augusta, though ]Jerhaps without further investigation, we should not venture to affirm their origin as being solely the result of railway communication with infected ports, we would strongly urge that particular and more careful investigation be directed to such connections as the probable means of transportation of infected air, or of air co11veyiug '' disease-germs'' frotn infected ports to inland towns and cities. And further, that a strict quarantine-as strict as that which coulrl possibly be applied to boats, skips, and other means of water transportation in ports-be made to eontrol the ineoming of railroad trains from infected ports and cities during the ]Jrevalence of yellow fever. ~ever let a sittgle car come to Augusta that was freighted or took passengers in an infected port. Let them be met at least twenty miles l.Jy fresh cars for passengers and freight.
In the above recommendation we here distinctly state, that uy ''quarantine'' we do not refer to the exclusion of persons, either well orsick, arriving from the infected regions. This element ofquarantine would comprehend that which we do not hold as a tenet of our faith in regard to yellow fever- the doctrine of contagion. Give hospitable refuge to all those who are well, to those who have been infected, and are about to be attacked, to those already overtaken in their flight from this dread pestilence, hut exclude the cars which have borne them away from their infected homes, and ventilate and purify the trunks that contain their clothes. The yellow fever SUQjeet is lal.Joring under the dire effects of a poison, and thousands of observations, and centuries of experience, have demonstrated that he can no more communicate his disease than can the ~ubject poisoned with strychnine conunuuicate his frightful tetanus to hil'l friend or to his nurse. AH in the one instance, the strychnine itself is required to procluee another C'ase, so in yellow fever, a fresh supply of " disease germs" are required to produce " the hremigastric death." 'fhese "germ.~," or hypothetim~l el~<ments of disease, many observations ha n convinced us, are transported in the ears arriving from infected ports, retain-

STATE BOARD OF HEALTH.

147

a1~lrg.

their virulence through hundreds of miles of pure country In substantiation of this, the cases at Union point, in 181)4,

Dl&Y be recalled. Mr. L. and Mrs. L. were both in the daily habit

of entering the passenger cars arriving from Augusta. Both be-

came infected and died of yellow fever, with black vomit, within

a short period, after some weeks of such <laily exposure. The fol-

lowing statement was given us by Dr. A. B. I"anier, of Oliver:

This place is loeated on the Central railroad, forty-five miles (Sta-.

tion 4~) from Savannah. "All the railroad employes at Oliver,

wko slept about the cars, had yellow fever. Those who did not

sleep about the cars, though all other circumstances pertaining to

the two classes were identical, did not take the disease. A young

man named I"ufborough, a farmer of the neighborhood, twenty-

one years of age, perfectly healthy, had not been near Savannah

during the entire season. On the night of the 13th of September

of the present year, Mr. Lufborough went on board the accom-

modation passenger ear, that remained over night at Olivet. He

slept in the car that night. He was taken with yellow fever on

the night of the 16th, and died with black vomit on the 21st. Af-

ter the epidemic in Augusta, in 1854, there were numerous eases

which occurred, after several "black trosts, '' which originated in

persons who, 'on their return to the city, set about overhauling and

putting to rights their ward-robes, trunks, book cases and bureaus,

that had been closed on leaving the city at the time of the out-

break of yellow fever. One such case, most marked in 1be cir-

cumstances of its origin, occurred under my own observation.

In regard to the problem : Why did the infection of 1876 not

spread into an epidemic? we think much light can be gained by

a comparison of the meteorological conditions of the past season

with those present here during former epidemics, we may say, of

both yellow fever and dengue. In the epidemics of both 1839 and

1854, prevailing east winds, prolonged heat, accompanied by ex~

treme drought, antecedent to and during their prevalence, are al-

most as well established as though a strict meteorological register

had been kept. The longing for rain in the newspapers, the com-

plaint of the "parched earth" and "wilted vegetation," and,

above all, the dried-up river, indicate but too well the thermome-

tric and hygrometric conditions of our atmosphere, to admit of

any doubt of their entire diverseness from those recorded by the

signal service at this Rtation during the past season. It is true

that in July the prevailing wind was south, and in August south-

east, but during Reptember, the very period of the infection, the

wind was northwest or north almost stBadily from the 17th to the

close of the month. The thermometer seldom indicated a very

high mean daily temperatures, and the rain falras recorded, gives

148

REPORT ON YELLOW FEVER EPIDEMIC

14 days rain, 6.26 inches, for July; 14 days, 3.66 inches for August; and even for September 7 days of rain, 2.56 inches. The exact state of the river, as an indicator of humi<lity, we have at present no means at hand of recording, though low, as usual in the summer months, there was no comparison between its conclition last summer and that during 1839 and 1854.
As to dengue, it will be recollected that in our report of the great epidemic of 1850, it is recorded that the outbreak was preceded by a prolonged period of heat and drought. From a review of thiH second series of observations, we may conclude :
First. The meteorological conditions most favorable for the prevalence of yellow fever and dengue fever in epidemic form, in Augusta, are, unlike those favorable for the prevalence of malarial forms, and perhaps of yellow fever in other localities, not prolonged heat and moisture, but prolonged heat and dryness, with the continuance of east or southeast winds preceding and (luring their prevalence.
And secondly. That, though the heat of the past season was perhaps sufficient part of the time to have sustained that one condition for an epidemic in Augusta, either of yellow fever or dengue, the other two important conditions failing- the prevalence of winds and the long-continued drought-the infection failed to spread into an epidemic.

STATE BOARD OF HEALTH.

149

METEOROLOGICAL 'rABLE-I.

LOCAL

I

0BSERV ATIONS.

DATE, 1876.

July }~~.".".".".".".".".":'.".".. .".:.".".".".".".".".".".".".".".".".".".".".".".".":.".:::.::::::."."."...".":::::::::::: ~i ;~

:~~

,i

;)(!. .......................................................................... 81

77

.11

s

4\h................................................... ................. ...... 80 70 .03

,.,

:.:. . :. :_ : : J 5th.......................................................................... s~ ~~

s

~ff:~::::_:_:::_:_:_:_:; _:_:_:.:;~;.:.:.:_:_:_:.:_:~_:_:_:.:.: ~.:.:~~~~:;~ :~ :~~ i~ ~~ 6~ ~

1

lOth........................................................................... RS 1:2

~

l!tlL.......................................................................... 87 )U

S

12\h........................................................................... So 61 13th........................................................................... 87 6:l

NwE

14,h........................ ...................................... .......... 80 86 1.74 S\1'

13th........................................................................... 88 64 16th........................................................................... s;; r,2 17th......................................................................... 84 67 18th........................................................................... SG 63
19th........................................ ......... ............. ........... 85 60
20th........................................................................... 86 68 21st......................................................................... 82 69

ti

~w

SE

SEs 15

.5~

S

'22d.................. ....................... ...... ... ......... .............. 82 74

.02

H\\'

2:1ct... ......... ..................... ............. ........................ 86 Gli
24th........................................................................... 79 6ti

N\V

.-15

N

~.ith............. ... . ......... ............... ... ...... ........................ G7 81 11.(17

}!E

'2tith................ ....................................... .................... 76 tll .........

Nl:

~~~== ~~rr~/::::)::::: ~..-i(i~/~~:~:;::::;':':(:;~.:~t\:;t~;.-:~-~;~~:~! ~~ ~~ : ::~1 :~
l-----;;2 }!onthlv Me,ms..................... u ...........................

Highest Temperature, !10 on the lOth; Lowest Tt>mperature, 62> on the 2.Jth; monthly range of Temperature, 36'); Greatest Daily range of Temperature, 23u on the lOth and 21st. Total Rain Fall, 6.2H iuches. Prevailing wind, south. Number of days on which rain or snow fell, 1-l.

,
.'

150

REPORT ON YELLOW FEVER EPIDEMIC

METEOROLOGICAL TABLE-II.

-1

I ~~ LoCAL

I

OnsERVATIO~s.

1

;:: 'C::::

-:.:~

DATE, 1876.

~1... ~i ri!~-,lI ~:; 0

~M ~$

es:l
.

:cs~3~;,

~>e

'"""' ~; .:::; Hl l! il ':': ;i ------------ ~; . ~o .~'"~J2N

8~ I Gth..... ....... ........................................................

I 71 1......... 1

NW

(i,~

70

iO

.01

7"1

.15

iG

0"'

71

GQ

.08

70

fi5

i)'i

(i;;

~~~~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . j

~~

~~

.Oll N'~

~~~:_:_~_.::_:.~:::::::::::::.:.::::::::.:.::::::::_:_::::::::::::::::::::::::::: ::::::I ~:: ~~ l......oi;f ~:~~

~g~L::::::::::::::::::::::::::::::::::.::_:::::::::::::::::::::::::::_:.J ~~ ~1 j..<~l s~~

~ lt..::~;/22~~-~~::~:\~/\~":/:L~/::/:t::(:..~/: ~8:;1: II 1,;{1~ !_;;; :.~1=~

--- 1\Iontllly mean::l......::.:..:_:_.::_:_:_:..:__:__:_:.:.__:_:___-~:~_:_:_

I

Highest Temperature, 97 on the lRth and 20th; Lowest T('mperature, 79 on the 1st and 4th; MorJtbly range of 'l'emperatllre, 21; G-reatest (laily runge of Temperature, 21 on the 6th and 12th Total Rain Fall, nr :\-1e1ted SlltiW, :J.GG inches; Prevailing Wind, flout beast; Number of days on which rain or snow fell, 14; No. of Lunar Halos, 4

r

STATE BOARD OF HEALTH.

151

METEOROLOGICAL TABLE-III.

DATE, 1876.

LOCAL OBSERVATIONS.

September 1st....... ................................................... ........ 80 7>

NW

2d........ ........................................................... 83 6~

NW

3tl. ....... ..................... ................. ................... 77 53 4th ... ..... ....................................................... 78 68 5th.............................................. ................... 79 70

NEs s

6th.. .......... ..................................................... 79 72

SF;

7th .. .......... ..... ............................................... 81 6G

SE

Sth. ................................................................. 83 67 9th .......... ...................................................... 84 63

sS

lOth................................................................ 78 74 lith............................................................... 76 79

.SO .88

swN

12th................................................................. 77 7.5

NW

13th................................................................. 77 78

.25

NE

14th................................................................ 77 77

.11

SE

15th..... ............................. ............................. 75 84

.17

N

16th...............................................

69 81

N

17th................................................................. 72 70

NW

18th................................................ .............. 70 68

w

19th........... .................................... ............... 72 68

NW

20th................................................................. 75 68

BE

21st................................................................. 74 SG

.35

SE

22d .................................................................. 77 73

NW

2:\d.................................................................. 74 67

NW

24th...................................... .......................... 74 73

NW

25th............ ..... ......... ...................................... 74 69

NW

2f;th............ .... . . .......................................... 73 61

NW

M::~:~::::.::::::::.:::::::::::::::::::::::::::::::....:::....~:::: ~~~-~ ==~ 27th................................................................. 64 59

NE

28th....... .. ..................................................... 6:J 5z

SE

29th................................................................. 66 68

NW

Monthly

No. of Lunar Halol:l, 2; Highest Temperature, 9fi0 on the 8th and 9th; Lowest Temper ature. 48 on the 28th; Monthly range c.f Temperature) 47c; Greatest Daily range of Tempuature, 28 on the 28th and 29th; Total Rainfall, or Melted Snow, 2.56 inches; Prevailing Wind, Northwest; Number of days on which rc.in fell, 7.

152

REPORT ON YELLOW FEVER EPIDEMIC

FOOD, ETC.
BY G. F. COOPER, Sanitary Commissioner for 3d Congressional District.
Civilization, in no inconsiderable degree, may be determined by the quality of a nation's food. In the past, as in the present history of civilization, it is found that attention to the matter of food has marked the progress of a people toward a well-ordered state of society. Governments, though largely interested in human force, are strangely inconsiderate of the wisest and best methods of its preservation and development. The wealth and health of a nation are convertible terms: the former is created and managed by the latter. To conserve the health of its people, is one of the chief responsibilities of a government, whereby its wealth and power are increased; and, while governments cannot ehange the laws of human life,-because these are determined by a higher power,yet, thP circumstances which surround life, and the measure of conformity to pref<cribed conditions, are largely subject to control, and may be wisely directed.
In the increased longivity, which characterizes the present century, the improvement of the quality of food has been a leading factor. It has been said the poor man's capital is his labor. How poor is the South; with what wisdom and vigilance should our State goverments look to the beHt methods of preserving and enlarging this capital.
Like air and water, food sustain,; an important relation to the general, and especially to the health-interests of eve1y people; and, though it may not be the source of as much disease and death as air and water, it is no difficult task to trace impaired health, and death, too, to food of bad quality. The development of mind and muscle are entirely dependent upon the supply of proper quantity and quality of food; and no government can be other than derelict that does not protect its citizens against the imposture and danger which eome through their food supplies. 'fo secure this end, or labor even in this direction, one may not meet with great publie applause, but such will be entitled to, and future history will award, the merit of being benefactors of the race. The reward of the good is largely in the futnre; indeed, the recompense may come only at the resurrection of the just.
In his "Human Physiology" Carpenter says: While on the one hand it may freely be conceded to the advoeates of vegetarianism, that a well scleeted vegetable diet is capable of producing (in the greatest number of individuals) the highest physical devel-

STATE BOARD OF HEALTH.

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opment of which they are capable, it may, on the other hand, be affirmed, with equal certainty, that the substitution of a moderate proportion of animal flesh is in no way injurious, whilst, so far a,; our evidence at present extends, this seems rather to favor the highest mental development.
Whatever may be said as to the contr0versy, whether animal food is necessary to the highest development of our being, there c:tn be no question that it constituteH one of the staple articles of food amongst us, so that the supply of meats, both as to the quality and <llmntity, concerns alike the sanitarian and political economist, and the health of the body politic, n10re than t"eir pockets.
To provide sound and health-sustaining meats, and afford complete protection b the consumer, would require sueh radical procedures that we cannot hope to reach it; for the manner of rearing and feeding such animals as are slaughtered for use would require attention, and tlw very education of meat growers, together with a long series of years to impress its importance upon them, an<l bring them up to its observance, would be involved; but what is more attainable, and what more <lirectly concerns us, is the condition of animals when slaughtered, the state of meats before they are used, and the rigid and faitllful lnspection of all meats exposed for ;;;ale, the unsparing condemnation of all that is tainted or disease<l, and the speedy punishment of reckless venders. It is a shame to civilization that there are those whose avarice overrideH all regard for the well-being and safety of their fellows, and whose remon;eless cupidity victimizes a large clas~ whose poverty' renders them powerle~s to e;;cape imposition.
rrhese evils exist in llenser populations to an extent not to be found, of eourse, where they are scattered; but observation teaches that they are to be seen in our own State.
Putrescent and diseased meats, fowls and fish, are not unfrequently exposed to sale. Parasitic meats, if inspected, would be found in the market;; oftener than one would Huppose. In Washington City, for tl:,e year '73, even with an acknowledged imperfect system of inspection, there were condemned as unsound and unfit for use, 11,650 lbs. of beef; mutton, 1,305 lbs.; veal, 11,296 lbs.; bacon, ham and pork, 3,853 lbs.; birds and rabbits, No. 453; poultry, No. 828; which, if sound, would have amounted to more than six thousand dollars. Of 1,394 hogs, taken at random, and examined by the Chicago Academy of Sciences, twenty-eight were found infected with triehinm. This is a large proportion, and is accounted for upon the supposition that an epidemic prevailed at the time. "In Germany, twelve trichinous specimens were found in six hundred and twenty-two examinations of American baeon in Rastoek; eight in two hundred and ten in Gothenburg; and

154

REPORT oN YELLOW FEVER EPIDEMIC

twenty per cent. of that examined in Elbing contained trichina>. It cannot be doubted that the frequency of the disease in swine is probably as great in America as elsewhere, if not greater, but man is Bot so often infected with us, as less raw, or underdone, sausage, ham, bacon, etc., iH eaten than in Europe."
It is a well established fact, that vile meats, in large quantities, escape detection by being ground into sausages, and for which larger prices are realized than if sound and sold in bulk. "In London an average of one hundred tons of meat is condemned yearly." Dr. Chambers further says, that "tons and tons of decayed and purulent meat, which, if seen by the inspector, would properly be condemned as unfitted to the dignity of the human table, are yet surreptuously made into sausage."
A large number of parasites are known to infest the several meats consumed as human food. Of this number, two especially deserve a passing notice in this report, viz: the trenia Rolium, or tape worm, and the trichnre spiralis. It is known that the former, which is fully developed only in man, is introduced in its larval form from the use of swine meat, originating mainly in the swine that feed upon human excreta, animal offal, etc. The latter, which is the most commonly dangerous to man, comes from the same source. Until a very recent date, their effect upon the human system was overlooked-many cases passing for poisoning, typhoict fever, and other diseases.
Unsound vegetables, unripe and decaying fruits, in large quantities, are thrown upon the market, and, when eate.n, are a common cause of gastro-enteric disorders and inflammations. The increase of population and facilities of transportation are rapidly increasing the rlemand and extending the use of thec;e articles of diet, so that the public good is constantly becoming more inYolvect and calls more loudly for protection.
PRECAUTIONS.
The meat which is most usually infected with parasites, and from which in turn we become infected, is Rwine meat. The hog is the scavenger of many slaughter-houses, the garbage of which constitutes its staple food, and in town large numbers have free acce'ls to human excreta, this being the chiefmeans ofdisposing ofnight-soil. These, in time, are also slaughtered and thrown upon the markets. If the people were informed, these sources of unhealthy meats would be readily and largely corrected.
Trichinous pork, ordinarily, can only be detected by the use of the microscope, but this is by no means impracticable, especially in our towns and cities, where diseased meats are more likely to be sold. One, by its practical use, would soon become sufficiently familiar with the microscope to make himself an expert, and

STATE BOARD OF HEALTH.

155

thereby a reliable inspector. Thoroughly cooked, meat thus infected would be made innocuous, the parasite being destroyed by a heat of 180 F.
MEANS TO PREVENT THE SALE OF IMPROPER MEATS.
The transportion of live stock, especially designed for butchers' meats, should be regulated by legal enactment.
It seems not to be generally !mown that Congress enacted a law, as far back as 1873, to regulate tlle transportation of live stock ; and, though designed to prevent cruelty to animals, in some respects its operation would prevent disease and reducing animals to a state in which their meat would be unfit for the table.
Here is the law-the sections reciting the penalties are omitted : Be it enacted by the S1mate and I-Iouse of Representatives of the United States of America, in Cong1ess assembled, That no railroad company of the United States, whose road forms any part of a line of road over which cattle, sheep, swine or other animals shall be conveyed from one State to another, or the owners or masters of steam, sailing or other vessels carrying or transporting eattle, sheep, swine or other animals from one State to another, shall confine the same in cars, boats or vessels of any de.scription, for a longer period than twenty-eight hours consecutively, without unloading the same for rest, water and feeding, for a period of at least five consecutive hours, unless prevented from so unloa!ling by storm or other accidental causes. In estimating such confinement, the time during which the animals have been confined without such re,;t on connecting roa!ls from which they are received, shall be includeu, it being the intent of this act to prohibit their continuous confinement beyond the period of twenty-eight hours, except upon contingencies hereinbefore stateu. Animal~ so unloaded shall be properly watere!l and fed during such rest, by the owner or person having the custody thereof, or in case of hi;.; llefault in so doing, then by the railroad company, or owner,; or master,; of boats or vessels transporting the same, at the expense of said owner or per:;ou in custo!ly tllereof; and ,;aid company, owners or masters shall, in sueh cases, have a lien upon such animals for food, care and custody furnished, and shall not be liable for any detention of such animals authorized by this act. Any company, owner or eustodian of such animals, who shall knowingly and wilfully fail to eomply with the provisions of this act, shall, for each anu every :mch failure to comply with the provision~ of this act, be liable for, and forfeit and pay a penalty of, not less than one hun!lred !lollars or more than five hundred dollars: Provided, however, That when animals shall be carried in car!'l, boats or other vessel;;, in which they can and do have proper

156

REPORT ON YELLOW FEVER EPIDEMIC

food, water, SjJaCe and opportunity for rest, the foregoing provisions in regard to their being unloaded sb~ll not apply.
Of necessity less swine meat is consumed at the South since than before the war, but even now it is more generally used than any other meat. In wholesomeness it is not comparable to some other meat~, and should be discarded by our people. The heat of our climate obviates the need of introducing into our systems-as in cold climates-so much heat-making material. In abandoning it we not only Jessen the risk of disease, but economise our limited means, a lesson so important, but which, as a people, we are so slow to observe.
'Ve should be more thoughtful in selecting the methods of cooking our meats. The one in most common use throughout the South, is manifestly the most objectionable and unwholesome, we mean frying. This, in a measure, rids the meat of its juices, and hardens its tissue, and thereby renders it less palatable, more difficult to masticate and more indigestible. Let the grid-iron everywheJe be ;.;ubstituted for the frying-pan, and our meat dishes will be more savory and wholesome.
BREAD.
\Vhile it cannot be assumed that the various kinds of bread are. as frequent or common sources of disease as unsound meats, there can be no reasonable doubt that had we reliable data upon which to base an opinion, or facts from which truthful deductions C'ould be made, it would be found that hurtful remits could be traced to the use of impure breads. 'l'he quality of bread, as well as the charaeter of meat, was the- subject of Divine legiHlation, and is us old as the time of Moses; but this f~wt in no wise lessens its value to civilization or the health of the people. It is a well-known faci that for the pa~t dozen years, immense quantities of Indian corn have been shipped from the :N'ortb-"\Vest to all points of the extreme Southern StateH. 'fhe most eursory examination of this grain showed that 110 care was obilerved in shelling and preparing it for market. Much of it was rotten, or in a positive state of decay; some of it was musty, from being sacked dump or getting wet on the route, and, without assorting, it was fed to stock, and ground into meal and sold. Some of the impurities, it is true, were driven off by machinery in grinding, but many mills are illy provided with machinery, so that it was impossible to get pure bread from it.
Damaged wheaten flour is often found in the markets, and sold at low priees to those who have not tlle means to purchase the purer and higher-priced grades. It cannot be that these, for any considerable time, could be eaten, and no hurt come to the consumer. It may be conceded that that wonderful laboratory- the

r

STATE BOARD OF HEALTH.

157

human stomach- with which nature has provided us, would, for a time, not only tolerate, but perhaps purify such noxious ingesta, as to prove exceptionally hurtful; but impure articles of diet continuously taken into the stomach would overtask its power to purify, and disease in varied form would follow. Even from good meal and flour, very poor and indigestible bread is often made, especially when fermented. By carelessness, fermentation is allowed to proceed too far, and the bread becomes excessively acid, the effects of which when eaten, would be to disorder digestion and produce bowel diseases. Unwholesome bread is often made by being sodden with hog's lard, aud from being imperfectly kneaded, which kneading, if thoroughly done, would make the bread both more palatable ami digestible.
In all our towns and cities, where bread is a commodity, rigid inspection should be enforced, and that which falls short of au authorized standard unhesitatingly condemned.
Fo1mulas for, and methods of, making good bread should be given to the people, most of whom would, with a little encouragement, adopt and observe them.
INSPECTION.
To protect human life i.s one of the chief duties of governmentthus would the jurist decide; to preserve it, the phil>mthropist would say, is equally its duty: prevention is less expensive than cure. A truly wise government would look to the health of its people, as well as to the protection of life and property. If what has been said be true-and the half has not been told-is it not the duty of our State authorities to require the careful inspection of all food wherever collected in con;,;iderable quantities'? The pennywise and pound-foolish course which ignores the health of the people is not creditable to the wisdom of our law-mal{ers.
Honest butchers and meat-dealers would not object, but rather welcome a law that required the inspection of cattle on foot and after they were slaughtered ; and this would reflect upon the grower to stimulate him to carefulness in rearing auimals for market, eonstraining him to protect, feed well, and transport with the least possible hurt, all beasts intended for the slaughter-house and market.
The almost universal poverty and helplessness of our people demand interference at the hands of rightful authority for their protection, so that money could not be more wisely expended than iu providing for the competent and thorough inspection of all live and slaughtered meats, grain, bread, vegetables and fruit, upon which multitudes of our people subsist, and whose health

158

REPORT ON YELLOW FEVER EPIDEMIC

and working force ;;o largely depend upon the quality of the food they consume.*
In answer to some circular~ sent out: Dr. Hopkins, of Thomasville, replies : The food, on the coast, in general use, was sufficiently varied, and I have reason to believe was in this section. For the past year it has not been so in this section. In my travels through the country, I have found that bacon -most of it from the \Vest-with greens and corn bread, and flour C\Vestern), in the shape of biscuit, filled the bill of fare. More salt meat than fresh is used, and the grease is often substituted for butter. Coru bread i~ chiefly l!lsed in the country, and is cooked to suit the taste of the con;;umers. I believe, as used, it contains little else than corn meal, water and some salt. 'fea i;; but little used. Coffee is used everywhere, mostly in the country, in the form of a weak infusion. 'l'o sum the whole thing up, I will give it as my opinion that the people of Southwe~tern Georgia, and most of 8outllern Georgia, live chiefly on salt meats, with corn bread and vegetable8, and timt uo healthier people can be found in the State. As laborers in the field, tlley ~;tand the heat of summer awl the cold of winter better than any others, who indulge in luxurtous living. Many years of my life have been spent among the country people, who live on the fare above mentioned. I am ,.;ure that they are more exempt from disease than are the residents of our cities who live on the fat of the land. Dr. Stanford, of Columbu~:~, says : After consultation with some of our favorite butchers, I am unable to answer you satisfactorily. There i~ no law, municipal or State, regulating the sale of meats or uread, with u~;. As a rule, beef and mutton are tile meat~ mostly applied for and consumed. Fresh hog meat is very little used at any season of the year-scarcely none at all during the summer months. 'he clerk of the market has the authority to condemn and reject such meats as he may judge to be unfit for consumption. As regards bread, our people use largely of baker's bread, although agreatdealis ofdomestic make. I do notrernembcr evert" have had a case of illness, where uad or impure food could be a~criued as the cause of sickne~;~.
Dr. Taliaferro, of Atlanta, and Dr. Burgess, of Macon, write that no reulations exist in either city, with regard to the inspection and sale of meats and bread. 'he latter says the whole matter is left to individual taste, so that he is unable to determine what effect might be produced on health.
Dr. Cromwell, of Albany, Georgia, writes:

''In preparmg this paper, free use has been made of the annual reports of the Mass. Htate Hoard of Health for 1874 and 1875.

STATE BOARD OF HEALTH.

159

ALBANY, GA., September 27, 187G.
DEAR Doc'.rOR-I will endeavor to answer your inquiries as concisely a~ I can, ami in the order named by you.
Question 1st.-" If any, what regulations exist in your city co!lcerning food, etc. ? "
Answer.-None, that I am aware of, looking to the protection of the citizen in buying stale, or otherwise unwholesome, articles of
diet.
Ques. 2d-" Is the food in common use sufficiently varied in kind?"
Ans.-'The articles of food in general use by the laboring and poorer classes, are corn bread and bacon, with boiled greens, (collards,) field peaR, sweet potatoes, syrups, quite frequently; and, in the early summer, fresh vegetables. Milk, also, is becoming more of an article of diet than formerly. I think the attailHtble supply is sufficiently varied for all purposes of health.
Ques. 3d---"Are the proportions of fresh and salt meats, vegetables and farinaceous food, such as you would approve?"
Ans.-In replying to this inquiry, it is proper to remind you that our population is a mixed one, made up of two distinct race~ of people-the white or Caucasian, and the tropical Negro. Now, while I belicv<> that the bacon diet, almost univer;oal amongst u~, is, for reason~ to be given, the best that can be devised for tile negro, it is not a wholesome article of diet for the white man; and the reasons for this, I will also give, as briefly as possible.
As a slave, the negro throve and multiplied in a manner that excited the astonishment of observers. He was subject to no cmJstitutional diseases peculiar to his race, and was practically exempt from those endemic and epidemic diseases that offered so formidable a barrier to the settlement of our alluvial lands by the white race. Consumption was scarcely known amongst them, so much so, that I do not recollect ever to have seen or heard of a case among the plantation bands, but, occasionally, amongst bouse servants, a case would occur. vVben, however, they were freed, and were thrown upon their own resources, consumption quickly made its appearance amongst them, and beeame quite common, even among the regular field laborers. Now, the significance to be attached to these facts, is, that as slaves, they were required by law to be supplied liberally with meat; and as bacon was the kind that they were most fond of, this meat was the one universally furnished. But when they were obliged to shift for themselYe~, they could procure but a scant and precarious supply of this, to them, indispen:,;able article of diet, and hence the absence of the regular ingestion of oleaginous food enabled consumption to mau-
h

160

REPORT ON YELLOW FEVER EPIDEMIC

itest itself in a formidable manner. Hence, we may venture the assertion, that, as without the negro, the development of the South to its present state of completeness would have been impracticable; so, without bacon as a constant element of dietetic supply, the maintainance and growth of the negro race ou thi>; contineut would have been highly problematical.
Not only does the consumption of this oleaginous food seem to prevent the formatiou of tubercle in the negro race, but it is shown to be au extremely valuable diet for them, in view of the fact that, as a dass, they are engaged in occupations that require the expenditure of a great amount of physical force. Now, the present view of the production of force in the body, as well as out of it is, that it is converted beat, ami as the heat of the body is maintained by the oxydation of caruon through the lungs, it follows that a htuorer, who expends daily a large amount of force, must consume daily a large amount of carbonaceous food-just as a steam engine (~onsumes fuel in proportion to the work requireJ of it.
For reasons the reverse Gf these, bacon, as an article of diet, b uot suited to the white races of the South, especially during the summer months. First, beeause they are not prone, in our climate, to the development of tubercle, and the oils are not required to arrest a natural tendency to this disease, as is the case with the negro. Secondly, because, as a class, they do not engage in occupatiou~ requiring the expenditure of great physical force, and uecause (except during the winter months, when the free use of oleaginous food is alone admissible,) the temperature of the surrounding medium, the air, corresponds so closel~' with the normal temper<.tture of the body, as to require but little aid to keep it at the proper stanJard, and this can and ought to be ,.;upplied by the starch anJ sugar furnished by our vegetaule and farinaceouil articles of food.
Clinical ouservation supports these viewH quite strikingly. \Vhen a heavy diet of oily food i;,; indulged in by n non-laboring man in hot weather, he uecomes bilious, which mean,.; that the depurating functions of the liver are over-taxeJ in the endeavor to eliminate from the blooJ the excess of carbon that has been needlessly introduced into the economy, and we have fatigue of that important organ, resulting in torpidity, conge,;tion, etc., tmLl fever, as a (~onsequence of derangement of the :,;ecretions.
But to return to the more immediate consideration of the sulljeet of your ltH!Uiry. I have said above, that I considered the attainable supply of fariuaceou,; and vegetable articles of diet was r-;ufticient. Let me add, that I think the supply of fresh meats, fish, poultry, eggs, etc., is also adequate, and that they would be made abundant

STATE BOARD OF HEALTH.

161

if our people eould only be induced to believe that the health of all

those who live in malarial di;,;tricts would be materially improved

by a more liberal use of these, and an abandonment of the standard

bacon and greens.

Ques. 4th.--" What of the cooking? What breads are in most

common use? Is it well made? What of the pastry, tea and

coffee, etc ?"

Aus.-T.he most objectionable feature of our modes of cooking,

is the almost universal habit of frying everything that can be

abused in that way; our steaks and chickens and eggs are fried,

our batter is fried into fritters, nay, even our bacon is fried ! as

though it were desirable to add one element more of indigestion to

this alrea(ly trying article of diet.

Our corn breads are usually made up with salt and water alone,

but occasionally milk, egg and butter or lard, are added to lighten

them.



Our breads made from wheat flour are usually made up with

yeast (ri:-;en bread) or lard (biscuit bread). When the lard is used

moderate!~-, and the dough is well worked and made light, they

are dige~tillle and wholesome.

Tea is drunk to a limited extent by the upper classes, but coffee

is the beverage of the people generally. It has come to be regard-

ed as a necessary of life by even the humblest classes; and after

all that i;; written and said against it, I cannot but regard its use

as beneficial.

Vcry respectfully,

B. M. CROMWELL.

PUBLIC HEALTH P APEHS.
No. 1.
On the 1elations of Health Boards and other Sa.nitarv Organnations, with Civic Authorities.
By ELY McCLELLAN, .M.D., Surgeon U. 8. Arrny.
That th~e wealth of a nation, depends in a great measure upon the health of the nation, was recognized by America's earliel't and most (listiuguished philosopher. "Health is wealth," wal-l an aphorism of Fr,mklin, and i.~ certainly the truest and most ~ug gesti ve of the many pithy utterances to be found in Poor Riehard'~ Almanac. Few individuals, without health, can acquire wealth, and indeed but few who are possessed of wealth, but denied the boon of health, can maintain their grasp upon that which they have.
'l'he great financiers of the nation, the Astors, the Stcwart1-1, the Vandcrbilts, and otlwrs of less note, were of rugged frame and of constitution :-;o robust, that the mental and physieal fatigue which would have prostrated men of fee!Jler power, :n1ssed them without leaving a trace.
If this 1s true, us regards individuals, so is it equally true as regards nations. A healthy nation is inevitably a wealthy nation. Her ship;; navigttte all seas, l1er armies are invincible on land. But, Ro soon aO:\ the inevitable results of sanitary negligence occur, and unheeded, are allowed to obtain strength and virulence, then the national glmy sub~ides, and more healthy nations will absorb all that may remain.
The truth of these asKertions is proved by history, both ancient and nwdern.
If it be true that healtli is wealth, it is equally true that knowlledge is power, nnd sanitary knowledge is a most powerful engine by 'vhich llv health of a nation may be seeured and national prosperity pre8erved.
Among the older nations of the earth, this truth is recognized. Among nations who are favored with the uuder~tamling that masses of ltununity cannot safely be left to work out their owu unrestrained wills, but require an enlightened govermnent, .which may eompel each individual atom of humanity to so conduct himi:!elf, that he may not endanger his neighbor, statesmen are in-

STATE BOARD OF HEALTH.

163

terested in promoting all sanitary measm:es, and sanitarianl'l are the recipients of royal favorR.
On the other hand, nations who are governed by the masses, !HU<ll1g whom the vote of the man of edueation and rdinement iR Jost beneath those of the ignorant and superstitious, authorities hesitate long before they adopt meaRure~ whid1 nmy in the next eJection influence votes against their party : and it is only when the explosion which might and Rhould have been prevented occurs, that any effort" at sanitary reform are nttemph'<l.
Amoug the last, the sunitariau is looked upon with di~trust. It is said that lw iR attempting todepriYe the people of their rightsthat he dt>nmnd~ an expenditure of the pul>lie funds, for which th<'Y can sec no return-that he i;; an alarmist eonstnutly harping on the subject of disease-tlmt he wishes to make c;apital for himself of tlH' work of others-that he desin,.; thP Pstablishment of a bureau of whi<'h he i" to he th~ functionary. For these rea,;onR, and others equally <"ogent, he must be snppre'<sed ; and to aeeomplish tbiH, all that human ingenuity can u(vise is brought into action ; or cYen when deei<led and absolute opposition i,.; not made, the theory of " how not to do it" beeomes equally efi('ctive.
But how different the cmHluet of such pen.;ons, wllen malignant disease devastates communities ! \Vho cry more lou<lly f,n aid '? Who more persistently persecute the loeal <lllthorities, for what might have bel'n? Frantically they Rtrive to repair the brokeJl dam, to arrest the rush of the mighty waters-but how futile are their efforts; and they are filled with despair. vVe ask you, fallowmen, after <lark and weary days, when the Angel of Death has hovert>d over a pro,.;trate eomnmnity, upon whom .-;hould the responsibility rest? \Vho has dimmed bright eye,; and broken happy hearts'? \Vho caused yonder chair to stand vaeaut '? \Vho sent yon widow and her little oneR out into the eold world? \Vho robbed that strong man of her who was dearer to him than life?
Was it the man, who, while plenty and prosperity were in tlw land, lifted his warning voiee and bade you beware of the time to come-who offered you tbe means of escape-who put into your hands the weapon with which you might have arrested the first aggressive move1nent of your foe-or was it be who lulled you to reiit and security, to "a little more sleep, a little more slumber, a little more folding of the hands to sleep?"
It is surely a matter to be lamented, that in America at the present day, public health i8 held to be subservient to individual, or to corporate interests; that it is absolutely true that human life is held to be of less value than the financial in-

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terests of commerce, and that the organization of health institu. tions is invariably met with bitter anrl unreleuting opposition.
At the present day but thirteen of the Federal States hav
authorized the organization of boardR of health. Of thPse bu~
eight are upon the eastern frontier of the nation, vi:r,: Massachusetts, Rhode Island, New Jersey, Maryland, Yirginia, Georgia Alabama and Louisiana. California stands alone in the ocehi(nt' and ~\lichigan, Minnesota and Wisconsin represent the north-west:
Of those portions of the nation subjected to territorial goYPrnment, the District of Columbia stande alone.
Of these State Boards, the eldest and most efficiently organized is that of the State of 1\fassachusetts. Next in rank, come those of the northwest and California. Of those whieh remain, what can be said? Without proper appropriations, without power, subjected to official and personal animosities, what can they do? VVhat they have done, what they can do, is dPmonstrated by the magnificent results obtained by the State Boanl of Health for Louisiana. That board, although harassed alrno:-t beyond human endurance, by legislative neglect, by executiYe interfcrciHoe, by legal injunctions, by debt, and by all else that petty spite could procure--has demonstrated beyond a peradventure that;ycllowfever is subservient to disinfection. For this alone, the executive officers of that board, deserve from the world more. we fear, than they will ever receive.
'J.lhroughout the country many local boards of health for rities and towns haYe been established. The organization and composition of these boards, in the vast majority of instances, cannot be considered but as objectionable. They are a step in the right direction, it is true, but in their composition there exists much which prevents the full accomplishment of the object for which they were created. Exceptions to this expression of opinion might and perhaps should be made in favor of the citie~ of "New York and Philadelphia. But the organization of the hmlth board of the last named of these two citieR is far behind that of the former.
Shall boards of health, as administrative bodies, be the subordinates of political organizations, or shall they, in the exercise of their functions, be clothed with autocratic powcer, which will enable them to issue edicts upon all matters pertaining to the pnhlie health? is, at the present, a query of the utmost importance to the general public.
It is true that health organizations must owe their Yery existence to the body politic; that without the exereise of the legi~lative power, the necessary authority cannot be assumed; but thesP are only more cogent reasons why the general assemblies of tlw States, in the exercise of their supreme power, should frame just lawR,

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(! unded upon known sanitary requirements; and having providPd (io the organization of health boards in all communities withiu : i r jurisdiction, 8ee to it, not only that compliance with the law be enforced by proper penalties, bnt that the health organization;.: themselves be clothed with the power of bringing offenders to
justice. Sanitation can no longer be looked upon a,; an elegant accomJishment, to be acquired at odd moments of busy professional
~fe. It can no longer be considered as one of the perquh;ites of
successful politician:;, or as an amusement of tradesmen; but it is an exact and positive science, so broad and comprehensive in its bearings that no single life has yet been long enough to afford time in which each detail may be mastered; and from necessity special lines of sanitary study have been adopted by individual Rtudeuts, whose aggregate studies have contributed power to sanitary knowledge. It is therefore a matter of primary importance, that when legislative authorities proceed to enact laws, which shall govern the vital interests of commonwealths, all secular and local prejudices should ue laid aside, and perfect sanitary legiHlation should
be attempted.
But what service to the general public can health boards render? 1s a question which has been, and will continue to be, asked. The inbabitauts of inland counties fail to realize that there exists any just reason wby they should be taxed to prevent disease o'J.tside their county limits. Resident;; of inland counties can sec no reason why they should be asked to consider the health of :;ealh)ard counties. 'l'hey cannot appreciate the fact that the cost of a great epidemic of acute infectious disea:;e, iu any large dty of the State -an epidemic which paralyses trade and commcree, which depn~ ciates property, which RWecps from exiHtence numberd of the producing cla:<~es-must ultimately come out of their pocketH. B 11t such is the al>solutc fact, which has but reecntly been clemon..;trated to the inhabitants of the State of Georgia.
Savannah, paying about one-thirteenth of the ge1wral tax for the support of the State Government of Georgia, is rendered almost bankrupt by an epidemic, which occurred during months when the tide of commercial prosperity should lmYe ueen at its height. How is the' city to meet this tax? The government of the State must be maintained! By whom shall the Savannah quota of the State tax be paid'! Manifestly by the tax-payers of other ~ectious of the State. Therefore, one item of the cost of this epidemic must come from the pockets of the classes to whom we have referred.
A State Board of Health, com;tituted with ample power, and

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equipped with a liberal appropriation, will serve the g-emral public-
f. By a Sanitary Survey of thP- State. By this a thorough inquiry into the causes affecting the health of the various counties, cities, towns and villages is accomplished.
IL By the Establishment of a System of Vital Statistics. By which an accurate record of marriages, births awl deaths will be obtained, with a registration of prevalent diseases.
IIL By the Sanitary Prevention of Infectious Diseases. By which the agency of common carriers in the transportation of diseases will be restricted, and the most approved measures adopted to ''stamp out" disease whenever it may appear.
UlHier the first would be included sanitary engineering, as dramage, sewerage and general Ranitary police, public water supplies, food of all characters, the sanitary supervision of public ;;chool8, ho,;pitals, a;;ylums, alms-houses, prisons, penitentiaries, burial grounds, manufactories ofall kinds, and all places ofpublie; assembling.
From the institution of a system of vital registration is to be gained-apart from the very important legal status to whieh, in the course of a few years, such an office would grow-a most aetive agent in developing the resources of the State.
The subject-matter of the third head would include the sanitary Hnpervision of common carriers, upon land and upon the water. 1'\0 louger would railway or steamboat companies be permitted to transport infected individuals, fabrics or atmosphere, to infect healthy localities.
'l'here would also be embraced popular instruction in hygiene, and tbe system of enforcement of sanitary police.
If such ends are to be attained, the organization and the composition of the boards by whom the laws enacted shall be executed is a matter of vital importance.
'rhey should be composed of men of known and tried sanitary acquirements-men who have had an especial training in this braneh of science-men who are able to weigh all matters of publie hygiene, which may be presented to them, with unbiased and unprejudiced minds.
'rhat such boards should contain a majority of medical men, i~ obvious. The work to be performed is such, that it demands mi!l(ls trained as theirs have been, but associated with them should be mPn of ability, whose peculiar province it should be to act as authoritative advisors upon all points offinauce, law and sanitary engineering.

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Experience, however, has by no means made it clear, that the power of appointing the local members of such boards should he vested in the chief executive officer of the State, for Governors of States, although in the majority of cases gentlemen of irreproachable character, are more or less subjected to the caprices of party politics, and the same influences are most likely to govern, in great measure, the selection of individuals to fill all official positions.
It is suggested that the apppointing power, if vested in the Supreme Court of a State-the appointments to be confirmed by the State Senate-would increase the efficieney of such bodies. It is not always the medical man who stands highest in the estimation of the eommunity in which he resirles; it is not always the most skillful and experienced practitioner who is the best sanitarian. The man who may most successfully combat the progress of an epidemic, may be mo><t at fault in tracing its cause, or in instituting measures for its prevention. Indeed, experience teaches us that sanitation is a speciality which, when handled by the busy general practitioner, who has no time to look beyond his immediate surroundings, who measure;.; all he does not see by his individual impression of what he thinks he does see ; who is willing to allow nothing for the experience of others upon the eause of the same disease, in other loealities, when they differ from what he thinks he observeR within the limits of his own horizon, beeomes an en,gine ofincaleulablP misehief. Almost PYery individnal here present ean probably recall inRtanees which bear out the truth of this assertion. There are at this day numerous eom.munitie'l in whieh the wildest speculative hypothe~es are lleld upon the subjoet of infeetiouR diseaseR, because of the teachings of some local practitioner, either in the past or in the present.
It is by no meanR intended to retiect upon the appointment of genera.] practitioners to sueh positions, bnt it is urged that popular suceess and reputation for professional skill and experienee is but a poor criterion of n man's sanitary knowledge ; and that thE> seareh after that knowledge whieh is power will as often lead to the abodeR of men whose lives have followed the old story-
" Mental worry and toil ! Patient research a.nd thought!
Gallons of midnight oil! What returns have ye brought ?
'L'o wait till patients comeTo sit till somebody sends-
To find and feel how natTOW the sum Of patients, patrons and friends ! "
as to the offiee of the man upon whom fortune has ;;howered the ehoicest favors.

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In order to secure proper and harmonious working of a system for the preservation of the public healtll, all l<)Cal boards should be subject to the authority of the State Board.
Local boards should exist for all counties in the State; upon them the civil authorities should ue represented by the county judge and the county surveyor-but the medical members should be appointed by the State Board.
For all cities and towns whose population amounts to ten thousand inhabitant~ or over, a board of health should be appointed, npon the same basi;.;.
The officer of each county and town who shall be designated to
act as the registrar of \'ital statistics, should be provided with ample means to secure full and prompt compliance with the letter of the law.
It is a fact which ha;; been so often demonstrated as to require no further argument to prove its truth, that men who devote their lives to scientific study are rarely po~sessed of greater pecuniary resources than that which affords a bare subsistence. The cost of scientific investigations is, in the majority of instances, simply enormous. A mechanic without tools or material is in no more pitiable condition than a scientist without books or instruments. But one exceeding great difference exists. The mechanic may su:pply his wants at but comparatively small cost, while the high rate at which scientific books and instruments are held, reduces the lives of most scientists to alternations of enthusiasm and despair.
Ample appropriations should be made for the expenses of health boards, the officer;; of which should receive remunerative salaries, and each member should be compensated for the time he may be required to devote to his official duties. 'Ve propose to show hereafter that these expenses, although they may in the aggregate amount to a large sum, 'ltill sink into utter insignifieance when compared with the cost of a single epidemic of an infectious disease in one large city.
Surely it is a clit.;grace to ask medical men to perform the important duty of attempting to protect from disease the public health of a great commonwealth, ot attempting the removal of all causes of disease, of doing much towards elevating the social and finaueial condition of the inhabitants, and yet, not only begrudge them eompensation, Lut actually expect. or demand, that they not only abandon their private interests, but also defray their penwnal expenses while discharging their official funetions.
During tlw past ten years, the United StateR have been visited by a series of acute infectious diseases; some of which raging with intense virulence, attracted demonstrations of public sympathy

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throughout the nation, while others moving in a more restricted circle (although counting their victims by the score) occasioned but a passing notice.
The southern sea-board and the valley of the l\Iississippi, especially suffered from these infectious explosions. Asiatie cholera, yellow fever, typhoid, typhus, scarlet and relapsing fever, smallpox, erysipelas, puerperal peritonitis, diphtheria, dysentery, and cerebro-spinal meningitis, have each for a time had sway, and each subsided, only after many valuable lives had been sacrificed.
It is a matter of public regret, that when any of the great cities of the country were thus infected, the local authorities used great efforts to conceal its existence; nay, in some instances they did not hesitate to officially deny its presence within their corporate limits, and were only driven to an acknowledgement, when all control was lost, and the disease was invading alike, the homes of the rich and poor.
It is a matter of record that each epidemic of yellow fever and Asiatic cholera, which has occurred in the United States, was preceded by outbreaks of the disease, in foreign countries, with which the United States bad commercial relations.
It is a matter of record, that each of these American outbreaks was preceded by the arrival of vessels from foreign ports, where the disease, at the time of their departure, was epidemic; and that the American epidemic occurred only after free and constant intercourse between the infected and healthy ports.
It is a matter of record, that, in each instance, the foreign epidemic of these diseases was sufficiently pronounced to have given fair, full, and timely warning of its existence to all American seaboard authorities; and it is further a matter of record, that the same authorities, so far from being upon the alert to detect the advent of the disease, adopted few and inefficient, or no sanitary precautions; and that, when the importation of the disease did occur, it found "hot-beds," telluric and atmospheric, already prepared for its reception, and it was allowed to germinate, bring forth fruit, and spread to the community before any measures were adopted to arrest it.
Is such madness manifested in any other municipal danger? Had a hostile squadron threatened the city of Savannah from the sea, would her authorities have waited until the war-vessels had crossed the bar, had ascended the river, and were throwing their "shell" into the city before they commenced their measures of defense'? Yet, although danger threatened this city from the Island of Cuba, no precautions were adopted. The port was practically left free and open to vessels from Cuban ports, and it was not until

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REPORT ON YELLOW FEVER EPIDEMIC

days had passed, after the first cases of yellow fever had occurred, that any organiz!'d effort at itR Rnppression was att!>mpted.
During the months of June, July and August, 1876, one thousand two hundrefl ann twenty-six deaths from yellow fever ocC'urrefl at the city of HaYana 'l'his would indicate that an unusually seYere outbreak of the disease had occurred. Matanzas, Cienfuegos, Trinidad and Santiago fie Cuba-ports of the same Island-were also infected. Yellow fever prevailed upon the Island of Cuba until the rlose of the month of October.
During the months of June, July and August, 1876, l'ight vessels, manned hy Spanish seamen, arrived at SaYannah from the Island of Cuba. One of these yesf'els was from the port of Cardenas, one was from 1\Iatanzas, ami ;o;ix were from Havana. Six of these vesi<elR flischar!):ed at the wharf of the Atlantic and Gulf railroad (on the extreme northeastern front of the city) an aggregate of seven hundred and thirty tons of ballast-six hundrefl and thirty tons of which was soil taken from the immediate vicinity of the city of Havana. Two of the:::e veRsels discharged at the wharf of the Georgia Central Railroad, in the extreme northwestern front of the city, one hundred and fifty tons of ballast of the same character. From these vessels, their crew with their clothing and bedding went into sailor boarding house,; in the city.
A small quantity of the earth composing thifl ballast, taken from a pile of the same, and from about two feet below its surface, was placed in a test tube, which was afterwards filled with distilled water nnd allowed to stand for twenty-four hours, when microseopk Pxnmination revealed a considerable amount of organic matter. Sufficieut time has not elapsed to allow this investigation to be prosecutefl.
An examination of a <JUantity of this ballast was made by Mr.
vV. J. Land, Analytical Chemist of Atlanta, who reports-
'fhe specific gravity of this ballast.. .............................2.315 The water (expelled at a red heat) .............................. 7.582 pr. ct. ~itrogenous organic n1attQr ...... ................ ..................0.192 '' ''
\Ve have been informed by Dr. B. ~L Cromwell, of the State Board of Health, that during the investigations of that board at Savannah, he learned that Dr. W. 'f. Fray, of Savannah, had discovered in 1876, growing from some of the Cuball ballast which had been carried from the Atlantic and Gulf Hailroad wharf to the upper portion of the city, an Indian plant, C'alled the Riedlea IRrsuta, whinh is known to he a foreign tropical plant, and that he (Dr. Fray) had never seen the plant before, and is convinced that it was imported in the ballast.
The specimen was also identified by other botanists. Such incidents strengthen the chain of circumstantial evidence.

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Upon one of these vessels, at least, there iH every reason to suppose that yellow fever had occurred, while riding at anchor in the Havana harbor. Upon two, deaths bad occurred during the passage, but the>'e, it was strenuously insisted by tLe master of tLe vesselR, were not yellow fever. AK yet, absolutely nothing is known of these ve,.;sels, prior to their arrival off'rybee Island; but this much is mo"t positive, the dh;ease did not exist in the city of Savannah, prior to their arrival, and although absolute contaet of the first cases of the disease in that city with them cannot be traced, yet, the fin;t cases occurred among persons wlw had been in their immediate vicinity, and who lived in the houses of the city nearest to the wharves at wLich they had been tied up to diRcharge ballast and take in cargo.
"\Vhat stronger chain of circumstantial evidence could be forged'! Time and future inve~tigations may add facts wLicb will amount to absolute proof of infection.
'l'o cope wit.!:! this invasion of exotif disease, there was a health offil"ler, whose duti~os were confined strictly to the quarantine system in vogue at the port. This olficer visited at Tybee Island all vessels from infected ports. 'l'he only measures of detentions that he could e: n ploy was to order pilots to bring the vesseh; to mwllor oft" Tybee. The only measures of quarantine inspection in his power were to board said vessels, inspect their papers, muster and exarnine the crew. It was in his power to order the detention of any vessel at quarantine for a variable length of time, and this could be enforced by fine and imprisonment. He could order that certain measures for disinfection of vessels should be adopted, he eould order tLat no communication should be hehl between vessels and the land; but there was no way provided him of causing these orders to be strictly complied with. After he left the deck of the vessel, he absolutely bad no more control over her, save in the single particular of specifying the date at which she might come up to the city, than any other eitizen of Savannah.
At this quarantine station there is notLing provided, save the bare anchorage. Cases of yellow fever or of epidemic cholera occurring upon vessels, must be treated upon the vessels ; the sick can be segregated in no way.
It is a disgrace to humanity to longer tolerate such culpable neglect. It is an insult to the profession to ask medical men to assume the duties of the health office of the port of a large city, and furnish them absolutely nothing.
The pre~ent incumbent of this olfice at the port of Savannah, and his immediate predecessor are gentlemen who have performed their duties to the extent of their power, against whom no charge of neglect of duty could possibly be made, but th(:J

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health officer of that port has always been, and still is, powerless to act efficiently for the preservation of the health of the city.
'rhere was a board of health for the city, consisting of the Mayor, ex-officio, ex-officers and the chief of police The inspectors of :be board were policemen, and policemen were employed to supervise the disinfection of infected localities.
No trained sanitarian was called to assume sanitary control, by this board of health. The overtures of the President of the State Board of Health, although not rejected, were utter!~ neglected, and wearily the days passed on, lower and lower the death cloud settled upon the devoted city, and a large detachment of its inhabitants were sent to join the already numerous cloud of witnesses who, at some period of eternity, will testify against the human ingenuity employed in disobeying the grand laws which Omnipotence has provided for the preservation of human life.
Of Savannah's financial losses, years may obliterate all trace. Prosperity may again exi~St within her walls, the vessels of all nations may make fa~t to her wharves-but will all this compensate for the live;;; that have passed'? Will financial prosperity take the place of those whose eyes were closed, after hours of agony'? Can money relieve broken hearts, lift up bowed heads, or render less acute the regret for those now resting beneath the great oaks of Bonaventure?
Had the board of health of the State of Georgia, in the summer of 1876, been possessed of sufficient power to have enabled it to assume sanitary control of the city of Savannah-had the President of the State Board the right to appear before his Honor, the Mayor, not as a fellow-cit!!:zen, advising the formation of a corps sanitaire, but as a superior, ordering that it be done-how different would have been the story!
We write emphatically and warmly. But the day has past when such matters should be handled with velvet gloves. The gauntlet of iron is more appropriate. The voices of the slaughtered at Savannah ring out from eternity. The cries of the widowed and the orphans in that City by the Sea, appeal to the nation to redress theirwrong, bypreventing, in the future, any repetition ofthisdark history.
It would be wrong to acknowledge, more so to intimate, that there rests aught of imputation upon the gentlemen who controlled the civii affairs ofthe city ofSavannah during the past season. They are brave, earnest, conscientious men, who avoided no danger, who would -have willingly sacrifierl themselves to the public good. If they erred at all in this matterit was an error ofeducation, not ofeither head or heart; for had they not been taught that there

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was no danger to be apprehended from any foreign source'? Had they ever been taught anything but the one-sided theory of local origin? 'l'he Springfield plantation, and its adjoining ,;wamp lands, were in no worse condition than they had been during previous years, when there was no yellow fever. Bilbo's canal was in no more offensive condition than it had been in previous years, when there was no yellow fever. Why should they have expected an epidemic"? Upon what grounds could they have based such belief?
Oh, men ! Endowed with understanding minds, can you not see, that for nearly two hundred years this local o1igin theor.IJ has been a cur,;e to America'? Can you not see that no good thing bas ever come from it'? that it ends only in death"? Is it not time that you turned your minds to other theories'? Is it not time that you abandoned the teachings of your fathers, and thought for yourselves? Is it not time that you should judge the method by which this disease is diff"used, by the facts attending all diff"usions, and no longer trouble your 1ninds over single and obscure cases?
It is pitiable to walk through the ;;treets of Savannah this day, and listen to the oft-told story of the local origin of thiB disease. One woPld almost think that it was but an echo from the debates of 1797. Men, possessed of acute minds in the management of their personal affairs, will discourse by the hour upon t!Je local causes of the yellow fever to be found upon the Springfield plantation, or in abandoned brick-yard ponds, or from the slimy banks of Bilbo's canal, and who ridicule the Cuban vessels ; who eonsidder that the surroundings of the Atlantic and Gulf railroad wharf, save in a malarial aspect, are unworthy of notice; who talk of the brick walls, and of the beautiful old trees that line the city streets, as factors of the disease; who con:;ider quaratines as but relics of the dark ages; who can acknowledge no hun'tan agency in the diffusion of the disease. 'fhese men stand willing and ready to admit ships from any yellow fever infected ports. Should another epidemic of yellow fever decimate the beautiful Forest City, upon their heads be the guilt.
'l'he narration of such events naturally leads to the query,-what is the chief end of health boards? Are they called into existence to protect the financial interests of commonwealths? Are they subRervient to the mercantile interestH of communities'? Are they but agents to cover the responsibilities of common earrier:s upon the high seas, or upon the laud, as porters of infectious diseases'? or, are they organi:r.ed for the protection of the people from all that may result in disease, and the consequent loss oflife, which, when occurring among the producing classes, constitutes a national calamity'?

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REPORT ON YELLOW FEVER EPIDEMIC

Such queries are no mere idle suggestions, but are caused by the stern realities which the nation has been called upon to suffer during the past decade ; and from which it is urged that vital lessons may be learned, which may be made profitable by a recognition of the violations of the grand sanitary laws, which each outbreak of these infectious diseases exhibits.
In theBe latter days, the dogma of the dark ages, that plague and pestilence are evidences of the Divine displeasure at the sins of the world, eannot be accepted-nay, while we bow with profound humility before the Majesty from whom all proceeds, while we acknowledge the immensity of the revealed will-we cannot but be impressed witll the fact, to be read every where in nature, revealed at all point'l by science, that fixed and immutable lawH govern the world. Laws originating in an all-wise, all powerful and ever existing mind, never to be changed or modified to suit the necessities of mortals. Laws all sufficient for the welfare of each atom, the violation of which is death.
If we deprive our bodies cf food and water, death results. If we subject our bodies withu~!t d,Jthiug to extreme low temperature, death results. If we etst our ho<lies into deep water, and folding our arms, resign ourselves passively to our fate, death results. Because in each instance, the fixed and unalterable laws by which this world is governed, has been disobeyed. The law says, the body deprived of food, heat and air, must die. By the exerci5e of our will, we have deprived our bodies of food, heat and air, therefore we die.
If an individual sick with small-pox, or other acute infectiouR disease, be carried into any community in which the disease has not before existed, and no human effort is made to protect that community, an outbreak of the imported disease will inevitably result.
If into a healthy community, trunks, boxes, bales, barrels or bundles containing fabrics soiled by contact with small-pox, or other acute infectious disease, and atmospheric air of the locality where the disease was in existence ; when trunk, box, etc., were closed up, and no human effi)l'ts are made for the destruction of the contagion, an outbreak of the disease inevitably results. Because it is a fixed and unalterable law governing the world, that infectious diseases are diffused by means of the contact of unprotected individuals with the specific poison of disease.
That this grand law is exhibited differently by different diseases, th&t the method by which the virus of these diseases reach individuals is not the same in each and every instance, is no proof that the grand law does not exist. In one form of disease it may require absolute personal contact of the healthy with the diseased;

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in another, it may require that the specific poison be inhaled with the atmosphere; in another, that it be swallowed 'vith food or drink; but t!Je gcnernl application is the same: the grand law by which frecliom from disease wa:-; to be secured was disregarded and an outbrt>ak of disease was the result.
In this nineteenth century, tile surgeon ;,;eduously separates ease::;, whose wounds emit septic ]lOisons from those which arc healthy, and he uses the most exaeting precaution;; that surgical dressings and appliances, employed with one set of cases, do not come in contact with the other set. 'l'hc obstetrician, in whose care a ca,.;e of puerperal peritonitis occurs, dt>dines the risk of infecting any other puerperal female. \Vhy? Because both recognize the grand law which governs the diffusion of infectious disease.
The negle<;t of sanitary laws, by any nation or any community, is punished by disease. \Vhat are these sanitary laws? 'fhey may be comprehended in but a single word--cleanliness. Cleanliness in everything; cleanliness of the individual person, of families, of communities. Cleanliness of clot!Jing, furniture, room~, house:,; and of their surroundings; cleanlines:,; of food, water and air; cleanliness of privic':s, cesspools and refuse-pits; cleanliue:;s of streets, lane:; and alley,;; cleanliness of gutters, drains and sewers; cleanliness in the segregation of tbe diseased.
Disobedience of sauitary law lm,; been punished in the old world by the occurrence of plague, cholera, small-pox, typhoid, typhu,;, relapsing and scarlet fevcn;, <ly:,;entery, diphtheria, cerebro-:-;pinal meningitis, and a host of lesser evils.
Dh;obedieuce of sanitary law has been punished in the new world by the domesticatiou of all the diseases of the old world, save cholera; and by the developmeut of yellow fever.
The llL'Ces,;itie~ of mankind dernaml an interchange of commodities between nations. 'l'he vice,; of manldnd effect an interchange of diseases. But despite the facilities offered, epidemic cholera from the east and yellow fever from the west, have as yet been but occasional visitors beyond their natural ha!Jitats, and then only v>hen the fixed and unalterable laws have been violated.
While pestilence and plague ravish the earth, while myriads of human beings are swept from time because of infractions of those immutable laws, the same Omnipotence by whom they 'vere created has placed withiu the grasp of humanity means by which the grand laws regulating the health of the world may be preserved, or the severity of the penalty for their violation mitigated.
.M:an, created and placed upon this planet, is raised above and beyond all other created objects in the possession of a mind which enables him to become au absolute free agent. 'l'he means of preserving his body and soul alive are placed within his grasp, but of
i

176

REPORT ON YELLOW FEVER EPIDEMIC

coercion there is naught. He iH permitted to accept and live, or to reject and die, as seems lJest to himelf. But this is only as relates to himself as an individual-no one has received the right to involve any other human lJeing in the punishment which his individual disolJedience of known laws entail. \Ve speak of the moral right, which doe not exist, while most assuredly the human power ctoes exist, and most disastrously iH it often exer-
cised. Indiyidual contact with the poison producing infectious diease:;,
is the cause of the reproduction of the respective diseases, and all the human misery which heir presence entails; but sanitation has been able to furnish an antidote, by which their ravages may be mitigated, nnd the disease itself stamped out. One of the most important of these measures is the segregation of infected individuals. Is it not as logical to appl;v the same mea:mres to masses of individuals, or countries:
When those individual-., who arrogate to themselves the po,;itiom; of sanitarian;; open their minds sufficiently to absorlJ all the truths which each HUcceeding year of epidemic$ develops- when ,;rich pei"son:,; sullmit them,;elves to draw condu,.;ious from the grand mas of fact'> which may be obtained, and not from their restricted personal observation-when the financial prosperity of commonwealth i made ,;ubervient to the neeessities of public health- when the intere;,;t,.; of a few individual,; no longer outweigh those of the masse,;-when the sanitary interests of eommunitie::; are controlled by men powerful in knowledge, rather than in politics, then will tt sanitary millenium dawn upon t!1e earth, and wide-spread, devastating disettse will lJe unknown-a most utopian dream.
'rhe history of each epidemic of cholera or yellow fever, which has occurred upon this continent, furnishes indubitable evidence that these dbeases artJ of exotic growth, that they have never originated upon the continent of North America, and that they have occurred only after tht> proce::;s of importation ltad been accomplished.
'rhe machinery of th<> government is employed to eollect em;toms upon all importation:-;. 'l'he schedule of the tariff emlJraces
innumerable articles required for vublic or domestic u"e. Yet upon infectious diseases, the emlJargo is so slight, that the inhabitants of this favored land are constantly expost>d to irruption ot disease,; which, originating in the old world, are imported to devastate the new. It i:; true that .tt all port:> of entry, liUttmntine regulation::! are in foree, but :-;ave at lJut two of the great American ;wa-ports, thet~e quarantine regulation amount to ausolutely nothing. 'l'he exceptions we make are in favor of the quarantinPs of the port::l

STATE BOARD OF HEALTH.

177

of New York and New Orleans, anrl of them only during the past feW yeun;, when these stations, passing into the hands of men of advanced understanding, the obsolete quarantine of detention has been replaced by the far more efficient quarantine of observation, which ensures the absolute disinfection of vessel and cargo, thus effectually destroying the germs of the disease.
The quarantine regulations of the port of New Orleans require that all large steamships carrying passengers should be provided with a medical officer. 'rhat at infected ports all passengers shall be subjected to an examination, and any person found to be predisposed to the disease shall be rejected. 'l'hat all baggage shall be exposed to the air and disinfected or fumigated as soon as possible after coming on board, and again before arrival at the quarantine station.
That before receiving cargo at infected ports, the vessel shall be thoroughly cleansed and disinfected. That so far as practicable the hatches be kept open, both while in port and at sea, and that every effort be used to fully ventilate all portions of the vessel. That the process of diRinfection be repeated every iive days and that when the cargo is broken, the hold shall be fumigated with with sulphurom; acid, or chlorine gas.
That at infected ports, as little communication as possible with the shore sl~all be allowed the officers and crews of vessels, and that sleeping on deck be permitted to none. That at the close of each day, while in yellow fever ports, all the crew shall wash their entire persons, amlleave offall the clothing worn that day, which shall be waslled before being again taken into use, and that after leaviug port, all mattresses, bedding and clothing be sunned and aired for several hours. 'rhi,.; last proceedure to be often repeated during the voyage.
All ves:,;els, upon arriving at the quarantine ;:;ttttions, are subjected to an especial process of disinfection, which consists of forcing into the holds large quantities of sulphurous acid gas, by the aid of an appamtu:; devised by Dr. Alfred W. :Perry.
_,\-t tlle same time, carbolic aeid is freely used in the bilge, forecastles, etc. After breaking cargo this process i,; repeated. Tlle detention required is a period sufficiently long to allow ten day~:> to pass L>etween the departure from and arrival at port.
Individuals sick with tlle infectious diseuse are removed to hospital, and the detention of the vessel is reasonably prolonged.
How mud1 more reasonable i;; this tllan the arbitrary detention of a vessel at a quarantine station, and while there, leaving ller crew to their own devices ; for, as Dr. vVhite wrote in 18"i'4, " If not probable, it is pos:;ible, that uule:;s efficient ventilation and disinfection be practiced, the yellow fever poison in a ship may in-

178

REPORT ON YELLOW FEVER EPIDEMIC

crease, both in amount and virulence, during the detention at quarantine."
All cases of the dbea~e which may oeeur in the city, are "stamped out," by the free use of disinfectants, and as a retmlt of this wise precaution, the city of New Orlean!-\ is to-day almost free from the disease. i:lince 1873 no cases of yellow fever have been brought into the city by vessel!-\ from foreign ports, while each year the disea~e has been brought into New Orlean;, from otller unprotected American ports.
At the New York quarantine, under the wise supervision of Dr. S. 0. Vanderpoel, health officer of the port, similar results have been obtained. 'fhe tedious detention of quarantine is auolished, but the city of New York ha;.; been saved from the incur~ions of exotic infectioul-l diseases. 'fbe same precautions which, in 187a,were adopted against cholera, are employed against yellow fever. 'fhe health officer's report for l87u, ~howt> that during that year 36B vessels arrived at theNew York quarantine station from ports at which yellow fever was prevalent, and that on 9\l of these vessel:; there were caset> of that disease. 'fbese coases were all cared for at the quarantine station. All the vessels were subjected to a rigid system of disinfection, and no cases of the disease arrived at the city from any ve~sel.
Impressed with the value of the results olltained by the Louisiana State Board of Health, the late Dr. G. \V. Peete, who was for many years the health officer of Galve,.;ton, '1'exas, adopted the same precautionary measures, all(l obtained the same satisfactory results.
But by whom were tllese results obtained-to wllose exertions are they due"? Can they be a:-;cribed to the quarantine institutions: Why, quarantines have been in existence upon the eoast ofNorth America tor nearly two centurie,;. Tlldr abuses have driven them into almost utter di,.;repute. For have they not exhibited the mo;,;t fearful instances of inhumanity, of shutting up the healthy witll those sick from infective di,..eases '.' Were any steps taken to remedy the evils of quarantine, until after properly constituted health boards bad been established ?
'l'he abuses of tlle ~ew York quarantine were corrected, and the office of health officer of that port was llas,.,ed into the bands of a high-toned and competent medical rnan, only after the institution of the Metropolitan Board of Health.
'fbe abuses of the Mississippi river quanmtiMe which, in 1873, passed epidemic cholera into the country, wen eorrected, and the existing grand system was obtained only after the rltate Board of Healtll had grown to sufficient power that, as a body corporate, it could exercise efficient control of all their dependents.

r

STATE BOARD OF HEALTH.

179

With such marked illustrations before their eyes, with such sad memoriesupou their hearts, can the General Assembli of the State of Georgia hesitate to clotlw tbeir StlttP Board of Health with ample power, which will enable them to institute such measures as may improve the general health of the inhabitants of the State, as well as to protect them from infectious diseases of exotic growth?
Both yellow fever all(! Asiatie cholera were formerly unknown upon this continent. They were imported-the former in 1693, the latter iu 183:.l. Sinee the dates uamed, both diseases have been frequent visitor;.; to Korth Ameriea. Each has swept away scores of victims-tach exhibited an inevitable dew to its origin. In each epidemic of these diseases, the speeifie poison of the disease was imported in vessels from. abroad, or, where this eould not be proven, the first cases in the outbreak of the disease could invariably he traced to the vicinity of ships from infected ports. The history of the yPllow fever epidemic of 1876, in the eity of Savannah, preHents nothing strange, nothing unusual-it is but the repetition of a story tol<l before, time and again.
As it is our province at this time to trPat especially of yellow fever, we have been at the pnins to tabulate a statement of all epidemics of the disease which have oecurred in the United States since 16D3, and as the matter of its importation iR alone of value to us at this time, no other data arc included.
The authorities from whom these tables are compiled are ac-cessible to all RtudentR. By refennce the accuracy of our statements may be proved, and the full facts as to each epidemic may be learned.
I. Quarantine on the Southern and Gulf coast, by Assistant Burgeon H. E. Brown, United States Army. A report made in compliance with the requirement~ of a joint resolution of Congress, approved June 6, 1872.
II. Circular No. 1. Surgeon General'" office, 1R68. Report on epidemic cholera and yellow fever in the army of the United States during the year 1867, by Surgeon (then Assistant Surgeon) 1. J. Woodward, United States army.
III. Vols. 1 and 2, Reports and Papers of the American Public Health Association.
IV. Reports of the Louisiana State Board of Health.

180

REPORT ON YELLOW FEVER EPIDEMIC

Tabular Statement of Localities in the United States which have

been infected w1:th YC?llow Fever.

------ ==========;=====~==-

I YEAR OF
EPIDE~Uc.!

LOCALITIES INFECTED.

ORIGIN OF 'rHE INFECTION.

169LI Bo~to-;,- J\ti~ss ............ Imported from Bftrb;does. - - - -

1699.... Phrladelphm, Pa ......... Imported from Barbadt>es.

. . .. . 1Charleston, S. C . . . . . . . . . . No record.

1702.... INewYorkCity ............ Imported from 8t. Thomas.

1705.... 1, Mobile, Ala .............. No record.

1713.... :Charleston, S.C .......... No record.

1728.... 1 Charleston, S. C .......... No record. 1732.... lCharleston, S.C .......... Imported from West Indies.
1739.... ICharleston, S. C .......... Imported from West Indies.

1741. ... 'Philadelphia, Pa ......... Imported from Barbadoes.

1744. . . . 1745. . . .

Philadelphia, Charleston, S.

Pa C

.... ....

.. ..

.. ..

. .

1IImmppoorrtteedd

from from

West West

Ind.ies. Indies.

New York City ............ No record.

1747.. Philadelphia, Pa ......... Imported from West Indies.

1748.... Charleston, S. C .......... Imported from West Indies.

1762. . . . .. .... ..

1:PChhialraldees tlopnh,i aS, .

Pa .......... C ..........

Imported from INo record.

Havana .

1765.... !Pensacola, Fla ......... Imported from West Indies.

. . . . !Mobile, Ala .............. Imported from Jamaica.

1791. ... !New York Crty ........... Imported from West Indies. 1792... [Ch~rleston,_ S.C .......... Imported from ~est In~ies.

1793.... 'Phrladelphm, Pa ......... Imported from St. Dommgo.

. . . . . . . jCharlesten, S. C ........... Imported from West Indies.

1794.... !Philadelphia, Pa. . . . . . \No record. . . '!Btlltimore, Mel ........... Carried from Philadelphia.

I . . . .. . . . ICharleston, S. 0 .......... :Imported from West Inclres.
1795.... New York City ............ \Imported from St. Domingo. . . . . . . . . Norfolk, Vtt .............. Imported from West Indies. . . . . . .. . ,Charleston, S. C .......... Imported from West Indic~.

1796.... New York City ........... iNo record.

. . . . .. . 1,Knowles' Landing, Ct ..... Imported from St. Domingo.

.. .. .... \Chatham, Ct.. . ........ Carried from Knowles' Landing.

. . . . . .. . Wilmington, N.C ........ No record.

. . . . . .. . ICTha;leston, S.C ......... Imported from West Indies.

. . . . . .. . ,Ne\\ Orlean,, La .......... No record.

1797.... !Providence, R. I. . . . . .... No record .
I1 . . . . . .. -jPhil~clel.phia, Pa ......... Imp~'dfrom Hav~na&Po~tauPrince.
. . . . . .. . .Baltrmore, Mel ........... Carned from Phrladelphra.
. . . . . . . . '!Charleston, S. C . . . . . . . . . . ImpOI'tecl from West Indies.
1798.... Boston, Mass ............. No record.
... .. ... 1ISalem, Mass.. . ......... Carried from Boston.
. . . . . .. . Portsmouth, N. H ......... Carried from Boston.

. . . . . .. . New York City .......... !Imported from West Indies.

Norwalk, Ct .............. ICarried from New York.

........ Hartford, Ct .............. Carried from New York.

........ New London, Ct ........ Carried from New York.

. . . . . . . . Philadelphia, Pa ......... Imported from St. Domingo. .. .. .... 'ICheste~, Pa ............... Can~ed J~om Philadelpb~a . . . . . . .. . .Maron" Hook, Pa ......... Carrred from Phrladelphr,t. . . . . . .. . jWi_lmington, Del. ........ \Carr!ed from Phi_laclelph~a . Bn<lgeton, .. .. .. .. I' N. J ........... Car~~ed fr:om Phrladelphr_a. . . . . . .. . Woodburry, N. J ......... Carned from Phrlaclelphra.

. . . . .. . 'City Point, Va ........... Carried from Philadelphia.

STATE BOARD OJ'I' HEALTH.

181

Tabular Statement.- Continued.

YEAR OF EPIDEMIC.

LOCALITIER INFECTED.

ORIGIN OF THE INFECTION,

------------

........ Petersburg, Va ........... !Carried from Citv Point.

. . . . . . . . Charleston, B. C .......... :Imported from West lr>_dieH. 1799.. _ Philadelphia, Pa ......... jimported from West In~ies. .

. . . . . . . Staten Island,- N. Y....... From vessels at qua_rantme stahon.

. . . . . . . . Charleston, S.C ......... :1 Traced to West Indmn trade.

. . . . . . . New Orleans, La .. _........ ;Importation. Record not attainable.

1800.. _.IPro~idence, R. I. . . . . . . . . .Confined to the v~c~n~ty of \~ha~ves .

. . . . . . . . Baltimore, Md. _... _

.:1Confined to the VICimty of \\halves.

_ New Bedford, Mass . . . . . . 'Imported from Demerar~.
.. .. ... I1Norfolk, Va ; . . . . . . . . ... !~mported fron;- Wes~ Indies.

. . . . . . . ]Charleston, S. C. . . . . . . .. ,Traced to West Indian trade.

1801. . _. Norfolk, Va ........... __ . Not known.
-~Charleston, S. C- .......... :Tracerl to West Indian trade.
. New Orleans, La .......... !No record.

1802.... Philadelphia, Pa........ _. No r6cord.

Charleston, S. C ....... _ . i":raced to West Indian trade.

. 1New Orlean;;, La .......... ]i;o record.

. . Baltimore, Md. _.......... \No recorrl .

. . . . . Boston, Mass ...... _.. _... :No record .

. . Alexandria, Va ........... ,No recOl'd.

New Haven, Ct....... . . 'No record.

Providence. R. I.. . ... No record.

1803.... New York City.

. ... !Imported from the West Indies.

iC,1tskill, N. Y...

. .. ICarl'ied from New York City.

_!Philadelphia.... _. . . Not known.

Norfolk, Va ............. !Not known.

Charlest on, S. C .......... :Traced to the West Indian trade.

1804.... New York City ...

'Imported from West Indies.

. . . Ctarleston, S. C

. !Imported from West Indies.

_ .. New Orleans, La.

.;No record.

180o. . . Boston, Mass. .

. No record.

. . . . . . . . New Haven, Ct ......... _. No Iecord.

. . Providence, R. I...

No record.

l'hiladelphia, Pa. . . __ No record.

Baltimom. Md........... No record.

. . Norfolk, Va.... . ....... No record.

Charleston, S. C ....... _.. Traced to the WeHt Indian trade.

. _New Orlem1s, La.

. .. No record.

1806... Now York City..... . .. _No record.

. . . . . . . . CharleHton, B. C. . . . . . ... [Traced to the West Indian trade.

1807.... New York City.......... No record.

. . . . . . . . ClHtrleston, B. C . . . . .... Traced to the West Indian trade. 1
. . . _. . . St A"gnstine, Fla ........ !Imported from Havana.

180H.... Brooklyn, N. Y.. . . .

!Imported from Havana.

. . . . . . . _ Ntw OrleJ.ns, La . . . . . ... 1Nu record.

1811. ... Pert J Amboy, N. J ....... Imported from West Indies.

. . . . . . . . r:_ensacola, Fla...... . .... 1No record.

. . . . . . . . New Orleans, La.......... 1No record.

1817. . . Charleston, S.C .......... !Imported from West Indies.

. . . . . .. . BeanfOl't, S. C ............ ~Carried fro_m Charleston.

. . . . . . . . New Orleans, La ......... ,Imported from Havana.

.. .. .... Natc.hez, l\liss ............ ['Carried !rom New Orleans.

1818.. _. Baltimore, Md........... No record.

182

REPORT ON YELLOW l"'EVER EPIDEMIC

Tabular Statement-Continued.

YEAR OF I

LOCALITIES INFECTED.

I

ORIGIN OF THE INFECTION.

EPIDEMIC.

Q~arantine -'~est 181LINew York

..... jimported from

Indies. --

........ New York City ........... !Confined to V!Cnnty of wharves.

. . . .. . . . !Baltimore, Md. . ........ !Imported from Havana.

Wilmington, N. C.. . . .... INo record.

Charleston, S. C . . . . . . . . . . No record.

Mobile, Ala . . . . . . . .

Imported from Havana.

New Orleans, La...

Imported from \Vest Indies.

. Natchez, Miss...... .

Carried from ~ew Orleans.

1820.. Savannah, Ga ............ No record.

Middletown, Conn ........ Carried from Savannah, and imported

from Santi!lgo de Cuba.

.. . .. .. . '!Wilmington, N. C ........ No record.

. . . . . . : Philadelphia, Pa. . ...... Imported from S.mtiago de Cuba.

. . . . . .. New Orleans, La. . ..... Impmted from Havana.

1821.. Staten Island, N. Y ..... Infect'd from vessels at N.Y. Quart'n.

. .. !Norfolk, Va: ........... Imported 10m Gn,td,tloupe.

Wilmington, N. C .... Imported fror,1 :Uatauzas.

. .. St. Augustine, Fla ...... Imported from Havana.

1822... !New York City. . ..... 'Imported from West Indies.

Pensacola, Fla. . ........ Imported from Httvana. 1
. INew Orleans, La.......... :Imported from Pensacola.

1823. . :New Orleans, La. . .... IImported from West Indies.

. . . . . . Natchez, Miss ............ 1 Carried from New Orle>ms. . . ; .. -~Brook-lyn, L., I ........... ICarried from New Orleans.

18:!-t ... Charleston, S. C ......... ,:No record .

. . . . . . . . Key West, Fla ............ No record.

. . . . . . . . New Orleans, La ...... Impmted from Havana.

1825.... New Orleans, La .......... No record.

. . . . . . . . Pensacola, Fla............ Imported from 'Vest Indies.
. . . .. . . . Natchez, Miss ........... I Carried from New Orlenns.

. . . . .. . . Was~ington, Miss........ !Carried from Natchez.

. .. . . Mobile, Ala............... :No record.

182G.... Norfolk, Va ......... _.... iImported from West Indies.

New Orleans, La .......... No record.

Washington, L>t ......... Imported from New Orleans.

1827.. . New Orlettns, La ......... No record.

Savannah, Ga ............ No record.

. . Pensacola, Fla............ No record.

. . Charleston, S C .......... No record.

Mobile. Ala .............. No record.

1828.. Savanu'ah, Ga ............ No record.

New Orleans, La..

No record.

Charleston, S. C .......... No record.

- ....... Pensacola, Fla............ Imported in war vessels.

. . . . . .. . Washington, Lft .......... Imported from New Orleans.

182\J.. _. New Orleans, La..

Imported by Mexican refugees.

Mobile, Ala............... No reconl.

....... Natchez, Miss ............ Carried from New Orleans.

. . Baton Rouge, La.......... Carried from New Orleans.

Opelousas, La . . . . . . . . . . . . Carried from New Orleans.

1830.....New Orleans, La.. . . , ... No record.

1831. ... -~New Orleans, La.......... No record. l 832.... New Orleans, La.......... Imported from West Ind~es.

1833.. . New Orleans, La.......... 11mported from West Indies.

STATE BOARD OF HEALTH.

183

Tabular Statement-Continued.

YEAR OF EPIDEJ>IIC.

LOCALITIES INFECTED.

ORIGIN OF THE JNFEC'.riON.

- - Natchez, Miss.-..-.-.-..-.-.-.-.-. Cttrried from New Orleans.

. . . . . .. . Baton Rouge, La ......... Carried from New Orleans. Opelousas, La ......... Carried from New Orleans.
1834.... P~nsacola, Fla ........... Imported in war vessels.

Charleston, S. C .......... No record. 1835.... Charleston, S. C. . . . . . . . . No rec~nl.

1837.... Mobile, Ala .............. No record.

New Orleans, La.

Importeil from West Indies.

Natchez, Mi8s ........... Carried from New Orleans.

Baton Rouge, La. . . . . . . Carried from New Orleans.

Opelousas, La ............ Carried from New Orleans.

Plaquemine, La ........... Carried from New Orleans.

1838.... Charleston, S. C ......... Imported from Demerara.

1839.. Charleston, S. C. . . . . . Imported from Havan:t.

Augusta, Ga . . . . .. . . .... Carried from Charleston.

St. Augustine, Fla ........ Carried from Charleston.

New Orleans,; La...

Impt'd from West Indies and Mexico.

Mobile, Ala.......

No record.

Pensacola, Fla ...

Carried from New Orleans and Mobile

Tampa, Fla .............. Canied from New Orleans.

Biloxi, Miss.........

Carried from New Orleans.

Galveston, Texas ......... Carried from New Orleans.

Donaldsonville, La ....... Carried from New Orleans.

Waterloo, La .......... Carried from New Orleans.

Plaquemine, La .......... Carried from New Orleans.

Port Hudson, La.....

Carried from New Orleans.

Fort Adams, La. . . . . . . . . . Carried from New Orleans.

Natchez, Miss ............ Carried from New Orleans.

Grand Gulf, Miss. . . .

Carried from New Orleans.

Vicksburg, Miss .......... Carried from New Orleans.

Alexanrlria, La. . . . . . . ... Carried from New Orl~ans.

Franklin, La ............ Carried from New Orleans.

New Iberia, La ........... Carried from Plaquemine.

St. :Martinsville, La.

Carried from New Orleans.

Opelousas, La ............ Carried from New Orleans.

1841.. New Orleans, La ......... Imported from W~st Indies.

St. Augustine, Fla.

Imported from Havana.

Pensacola, Fla . . . . .

Imported in war vessels.

Vicksburg, Miss .......... Carried from New Orleans.

1842.... Mobile, Ala. . . . . . . . . . New Orleans, La . . . . .

No record. No record.

Pensacola, Fla

Imported in war vessels.

Galveston, Texas . . . . No record.

1843

New Orleans, La . . . . . . . . . . No record.

Mobile, Ala......

Carried from New Orleans.

Charleston, S. C . . . . . ,, ... Imported from Havana.

Pensacola, Fla ............ Imported in war vessels.

1844.... Galveston, Texas ......... Imported from Vera Cruz.

Houston, Texas ........... Carried from Galveston.

Pensac~la, Fla. . . . .

Imported in war vessels.

1845.... Pensacola, :Fla ........... Imported in war vessels.

1846. . . Pensacola, Fla ........... Imported in war vessels.

1847. . New Orleans, La.. . . . ..... Imported from Vera. Cruz.

. . . . . . .. Galveston, Texas ......... Carried from New Orleans.

184

REPORT ON YELLOW FEVER EPIDEMIC

Tabular Statement.- Oont?:nued.

~- ~------~~~--

i YEAR OF

EPIDEMIC.

LOCALITIES INFECTED.

I . ~- ORIGIN OF ~:FECTION~.- - - -

.... Pensacola, Fla........ . . . !Imported in war vessels.

. . Mobile, Ala

. ]No reeord.

1818 . . . Staten Island, N. Y..... . ,Carried from New York Quarantine.

1849.... Charleston, S. C. . ....... 1Imported from Hrwa~a.

1851. . .:\Iobile, Ala. . Norfolk, Va.

. ....... No record 1 Imported from Havana.

1852. Charleston, S. C....... Imported from West Indies.

New Orleans, La.

No record.

Indianola, Tex. . . . . . . Carried from New Orleans.

1853. . Philadelphia, Pa. . . . . Imported from Cuba.

_!New Orleans, La...

Imported from Jamaica.

Pensacola, Fla.... . . .

Imported from Tampico.

1

_,Tampa, Fla . . . . . . .... Carried from New Orleans.

;Key West. Fla ............ Carried from Tampa.

1\Iobile, Ala._. . ...... Cr<nied from New Orlemrs.

Spring Hill, Air<.

. . Carried from Mobile.

Citronelle, Air<. .

Carried from Mobile.

. ,Dog RiYer Factory, Ala. . . Carried from Mobile.

:Napoleon, Ark. . !Shreveport, La.

I.. !Carried fr:-m New Orleans.
. Carried from New Orleans.

Galveston, Tex.

. . Carried from New Orleans.

. jlndianola, Tex.

Carried from New Orleans.

. .. . :Washington, La. .

Carried from New Orleans.

. .. . Natchez, Miss...

Carried from New Orleans.

. ,V1dalia, La.

. ... Carried from New Orleans.

. . . . . Brownsville, Tex

Carded from from Indianolr<.

1854. ,Norfolk, Va......

. Imported in French war vessel.

'Charleston, S. C

Imported from Havana.

. i Wilmington, N. C. . . . . . . C'lrried from Charleston, S. C.

. ,Savannrth, Ga ............ Imported from the West Indies.

New Orleans. La._

. Imported from St. Thomas.

. . . . . .. . G.tlveston 'l'ex. . . . . . . Carried from New Orleans.

. . . . . .. iKe.) West, FJ,, . . . . . . Continued from previous year.

1855. ,New York Quarantme ... ,Imported from West Indies.

IP<~rtsmuuth, Va

.. !Imp. by l! S. w~r Yes. from St. Thomas.

llH1lton, FL>.

_1By clothmg of a yellow fever case.

1856 .... 1Cnurlehton, S. C ....... Imported from Havana. . :New York Quarantine .... Imported from West Indies.

I Fort Hamilton, L. l. ..... Carried from quttrantine. . 1\Jovemor's Island, N.Y. H.!1Carried from quarantine.

. .. :New York City.

. .. Carried from quarantine.

1857.... !Charleston, S. C

.... Imported from Santiago de Cuba.

. . . . . . . . !New York Quarnntine ... :Imported from Havana.

1858.. _.!Charle,;tm,, S. C. .

. :Imported from Cuba.

. . . . . .. . ,New Orleans, IA.

. ',Imported from St. Thomas.

.. .. .... ]Galvesto~, Tex .......... ICan!ed from New Orleans.

. . . . . .. . Brownsv11l' Tex..... . . 1Carned from Brazos. . . . . . .. . iindianola, Tex. _..... !Carried from New Orleans.

. . . . . . . . !Brazos Santiago, Tex...... ,Cartied from New Orleans.

1859 _... Galveston, Tex ............ No record.

[Nassau.

1862 .... IWil_miuglon, N. C.... . . :Imported on blockade runner from

........ Sm1thvr1le, N. C .......... ;Imported from Nassau.

. . . . . .. . Ch:trleston, S. C .......... 'Imported on blockade runners.

STATE BOARD OF HEALTH.

185

----I YEAR OF
EPIDEMIC.,

Tabular Statement-Continued.

LOCALITIES I:NFECTED.

0RIGI~ OF !NFECTTO~.

---1----------

.

1862.... Key West, Fla ........... Imported from Havana.

'S:1.bine, Texas..

Imported by hlocka<ie runner.

!Austin, Texas . . .

Carried from Sabine.

. r Matagorda, Texas......... Importe<l by blockade runner.

r Indianola, Texas ......... Importe<l by blocka<le runner.

. iHilton Head, S. C ........ ,Carried from Key West.

1863..... U. S. sqna<lron, N. OrlE>ans!From infecte<l store ship.

Sabine, Texas ........ !Imported from blockade runner.

Be,;umont, Texas..... . . !Carrie<l from Sabine.

Houston, Texas .......... jCarried <rom Beaumont. [Nassau.

1864.... ,Charleston, S. C. . . . . . . . :Imported on blockade runner from

.U. S. vessels at N. Orlerms.I'From infected war vessel Vin:;inia.

I Key West, Fla.. . . ....... Imported from Nassau.
.Galveston, Texas ........ Im!JOrted on blockade runners.

New Berne, N. C ...... :Carned from Charleston, S. C.

Beaufort, N. C......

carried from New Berne.

1.865.... Key West, Flct ............ Imported from Havr1na.

1867.... New Orleans, La. . . .. . . . . Imported from Havrtna and Verrt Cruz

Pensacola, Fla . . . . . . .

Imported from J:11naicu.

.Key \Vest, Fla ............ Imported from Havana.

Dry Tortugas

Imported from Havana.

Mob1le, Ala.......

Carried from New Orleans.

Indianola, Texas .......... Imported from Vera Cruz.

Galveston, 'l'exas ........ :Carried from Indi,mola.

Houston, Texas ......... i Carried from Galveston.

New Iberia, La ........... , Carried from Inc1'mwb.

. Navasota, Texas .......... Carried from G:,,lv(eoton.

Millic,m, Texas ........... Carried Irom N<W:lsvta.

Chapel Hill, Texas ........ C!trried from Houston and Galveston.

. . . .. . . . 1Alleytown, Texas...... Carried from Houston.

. . . . ILaGrange, Texas.... .

Carried from Houston and Galveston.

. :victoria~ Texas ........... C,l.l'ried from Indianola.

. ,Goliad, Texas ............ Carried from Victoria.

. . Corpus Christi, Texas..... Carried from Indianola.

. . IRio Grande City.......... Carried from Corpus Christi.

Brownsville, Texas ........ Imported from J.Vlexico.

Jttckwn, Miss.....

Carried from New Orleans.

1868.. Fort McHenry, Md.

From vessels at quamntme.

1869.. Key West, Fl:t......

Imported from Cuba.

'Hampton Roads, Va ..... Imported in a French war vessel.

1870.' Phil'a quarantine station .. fmported from Jamaica.

Philactelphia ............ Carried from quarantine.

. . . .. . . . 'Wilmington, Del. . . . . Carried from Phila. quarantine st'n.

. . . .. . . . Mobile. Altt ........... , .. Imported from Havana.

. . .. . . . jNew Orleans, La .......... :Imported from Honduras.

. . . .. . . . :New York quarantine .... Imported from West Indies.

Governor's Island

From infected ship at Atlantic dock,

1871. ... New Orleans, La ... , ...... Imported from Havana. [Brooklyn.

Charleston, t'\. C .......... Imported from Bull's Bay, S. C.

Beaufort, S. C

Imported from Bull's Bay, S. C.

Cecl>tr Keys, Jo'la

Imported from Havana.

'rampa, :FIa .............. iCarried from Ct chtr Keys.

Hampton Rnads, Va ...... Carried on schooner from Charleston.

186

REPORT ON YELLOW FEVER EPIDEMIC

Tabular Statement- Continued.

I YEAR OF/.

LOC'ALI~'IES lNFECTE]J.

___________ __________________ - - - EPIDEMIC'.

, ]

0RI(i-IN OJ!' INFECTION.

.

1872.... New Orleans, La......... INo record.

1873.... New Orleans, La. . .... Imported from Havana.

Memphis, Tenn

... !Imported on tug "Bee" from N. 0.

Mobile, Ala ............. INo record of importation. Tortugas ................. Imported from Havana.

Shreveport, ,La........... Carried from New Orleans.

. . Pensacola, } la. . . . . . . . .. Impm teil from Havana.

1

Montgomery, ALL

.... !Carried from Pensrreola.

1874.. . New Orleans, La.. . ... Imported from Havana.

. IPensacol.t, Fla........... Imported from Havaua.

Pascagoula, Miss...

Imported fi'om \Vest Indies.

187.5.. . Ne'v Ol'leans. La..

Carried from PascagoulH., Miss.

Fort Banancas, Fla.. . . Imported from Ha,;ana.

Coushatta, L<t . .

Carried from New Orleans.

Pascagoula, :i>Iiss.

Imported from Havana.

East Pascagoula, Miss ... Imported from Havana.

. R~mnton, Miss.
.IMoss Point, Miss.

. .. Carried from Pascagoula. Canied from Pascagoula.

. . . . .. .. !'Ocean Spring, Miss ....... /Carried from Moss Point. . . . . . . Biloxi. Miss. . . . . . . . . . . Carried from Moss Point. . . . . . .. Bay St. Louis, Mi''" ..... Ca~neil from Pascag~ula.

. . . . . . . Port Eads, La . .

. ... Can1ed from. New Oilcaus.

NOTE.-The record of 1876 is omitted for sufficient reason~. It is by no means thought that the items of this table are absolutely correct. The author will gladly acknowledgt> any notes of correction or of additiou which he u1ay receive.

From the~e tab!eR it will he seen that yellow fever has been carried into the following Atlantic and Gulf ports:
Boston, Ma.~s.-During four yean;. Providence, R. L-During four yean;. New York-During twenty-one yParR. Philadelphia, Pa.-Dming seventeen yearR. Baltimore, .lfd.-During ~even yearR. Norfolk, Va.-During t0n years. Wilmington, N. C.-During six y0ars. Charle.ston, 8. C.-During forty-four years. Savannah, Ga.-During four years. Mobile, Ala.-During sixteen years. Pensacola, Fia.-During twenty-two years. New Orleans, La.-During forty-one years. Galveston. Texas.-During nine years. This refers simply to years in whieh the disease obtained some epidemic foothold at the ports named. How many times infected vessels arrived at tile quarantine of each port, is impracticable to determine.
Boston, Mass.-Was infected with yellow fever in 1693, 1798, 1802 and 1805.

STATE BOARD OF HEALTH.

187

Providence, R. L-Was infected in 1797, 1800, 1802 and 1805. New Ymk wa;; infecte<l in 1702, 17-!5, 1791, 179.\ 1796, 1illS, 1799, 1803, 180-!, 1806, 1807, 1809, 181 ll, 1S:l1, 1822, 1S2il, 18-!8, 18.55, 1857,
1870. Philadelphia was infected in 1609, 17-!1, 17-!-!, 1747, 1762, 1793,
1794, 1797, 1798, 179H, 1802, 1803, 180.'), 1820, 1853, 1870. Baltimore was infected in 1194, 1787, 11-100, 180:l, 1805, 1818, 1869. Norfolk, Va., waH infected in 17Hii, 1800, 1801, 1803, 1805, 1821,
1826, 1852, 1854, 11555. Wilmington, N. C., wm; infected in 1796, 1151\J, 1820, 1821, 1854,
1862. Charleston, S. C., was infected in Hi99, 171:3, 1728, 17.32, 173H,
1745, 1748, 1762, 1782, 1793, 1704, 1795, 179G, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, UHi, 11519, 1824, 1827, 1828, 1834, 1885, 1838, 188\J, 184H, 18-!9, 1852, 1804, 1855, 18.')6, 1857, 1858, 1862, 1864, 1871.
Savannah, Ga., wru; inf~<cted in 1820, 1827, 1828, 1854. Mobile, Ala., was infected in 170.'i, li65, 1819, 1825, 1827, 1829, 1837, 1842, 1843, 1847, 1851, 18.5.3, 115lH, 1870, 1873. Pensacola, Fla., was infected in 176.'i, 1811, 1822, 1825, 1827, 1828, 1834, 1839, 18-!1, 1842, 18-!3, IS-!4, 18-!5, 184li, 1847, 18.SB, 1867, 1873, 1874, 1875. New Orleans, La., wa,.; infected in 1795, 17H9, 1801, 1802, 1804, 1805, 180\J, 1811, 1817, 1819, 1820, 1822, 182:), 1824, 1H25, 18:2(;, 1827, 1828, 1829, 1830, 1831, 1882, 1883, 18H7, 1H:)9, 1841, 1842, 18-!3, 1847, 1852, 1853, ISM, 1858, 1868, 186-!, 1H67, 1H70, 1871, 187H, 1874, 1875. Galveston, Texas, was infected in 183B, 1842, 184-!, 1847, 1854, 1858, 1859, 1864, 1867. Such tables are replete with practieal ~uggestions, one of the most important of which is the evident refutation given by the figures to the theory of the local origin of the disease. The record as it relates to the city of Charleston is taken as a striking example. Yellow fever did not oceur at that city until six years had passed after it had been imported into Boston, Mass., and the y~ars of epidemic;; and the year,; of freedom from the disease read as follows:

188

REPORT ON YELLOW FEVER EPIDEMIC

~-~-

Years of

Years of 110

Years of

Yt'ar;; of no

Epidemic.

Epidemic.

Epidemic.

Epidemic.

1699
1713 1728 1732
1745 1748 1792 to 1807 1817 1819

1700 to 1713 1il4 to 1728 172\l to 1832 1733 to 1739 1746 to 1748 174!! to 1792 1808 to 1817
1818
1820 to 1824

1824 1827 and 1828 1834 and 1835 1838 and 1839
1843
1849 1852 1854 to 1858
1862 1864 1871

1825 to 1827 1829 to 1834 1836 and 1837 1840 to 1843 1844 to 1849 1850 to 18.52
1853 1859 to 1862
1863 1865 to 1871

Therefore, in a period of one llUndred and seventy-two years, Charleston was infected 'Witll yellow fever but forty-one years.
\Vhy these seasons of infection and exemption from the disease are so marked, it will be our endeavor to show.
Of the early epidemics of yellow fever, no records are to be found save such fral!mentary accom-1ts as may be gathered trom private letters of the period. In them the disease is designated as the Barbadoes distemper, and that "whenever the disease appeared, it wa;; easily tracell to sorne person who had lately arrived from the \Vest Indian Islands, where it was epidemic." (Dr. Lining, quoted by Brown, p. :l:l.J
Dr. Brown has shown (p. 23) "that from about 1728, the commerce of Charle;,:ton with the \Vest Indie,; had attained con;;iderable proportiot1s, and that there were many arrivals at the port from the W PHt Indies every year; but, towards the last of this period, this trade had been gradually growing le:;s, in consequence of the unjust restrictions plaved on the trade of tht' colonies by Parliament, in tiw various navigation acts, and other measures, tending towards a commerdal monopoly. By 1750 the trade had almost entirely ceased; and it wa:; not revived until the independence of the United 8tateo; was secured, and affair:; settled down once more on a quiet basis. By a singular coincidence, yellow fever disappears from the annals of Charleston during the whole of thh:1)ong period, and only makes its appearanve again in 1793, when the trade had again become large with the West India port:;.''
From 1792 to 1807, ~ period of fifteen years, the city sufilred cunstantly from the disease.
vVe again quote Dr. Brown: "The local hygienic conditions of Charleston have alwa.r~:~ had a most important bearing upon the spread of the disease, and, as believed by many of her ablest practitioners, upon it; origin.

r

STATE BOARD OF HEALTH.

189

"The city situated at the junction of the Ashley and Cooper

rivers with the bay is on very low ground, the average fall in drain

age being not more than five feet. In early time:;, and to some

extent still, there were numerous salt marshes extending from the

river towards the town, and to a considerable extent within the

limits of the city. 'l'hese were washed twice a day by the tides,

and as long as they were left alone did not seem to be deleterious

to the general health; and, previous to their being filled in, the

yellow fever was confined to what i;; known as Old Charleston, in

the southeastern part of the city. Gradually, however, as land

became more valuable, by the natural extention of the town, many

persons owning lot;; on these salt marshes filled them in, thus de-

stroying the natural drainage in the vicinity. 'fhe material used

for this purpose wa,; often of a highly injurious charaeter, consist-

ing of old wood, offhl, the debritus from the drains, and filthy

dirt heaps, thus making a vegetable cornpost of highly putrefying

capacity to lie exposed to the hot sun. In every case where this

has been done, yellow fever has extended its area over the newly

filled localitieH, until now there iH hardly any portion of the city

that ean be con,;idered exempt.

"For the la,;t seventy years the condition of the drain,.;, privy-

vault~, latrine;;, ~ewers and yards around the houseH has ueen

,;uch as to call forth severest comments from all that have inter-

ested themselves in the health of tlre city. Offal an<l garbage,

and the debritus of cow-ycuds, have been openly pla~ed in the

streets; the drains lrave not unfrequently been opened in summer

to be cleaned, and their content,; strewed over the surface to fill up

vacant lots.

~' ,;, *

l:::ltill another source of disease is the

large number of burial place~ in the most thickly settled portion>J

of the city. These are very much crowded, and often in the heat

of summer exhale the most offen;;ive odors."

Is it, then, to be wondered that the disease wa so long present

in that fated city? Is it, then, to be wondered that Ill ally of the

most prominent physicians embraced the local origin theory'! ls

it not rather to be wondered that tlre disease has not taken up its

abode at Charleston? It is, however, possible to trace the majority

of these epidemics to the arrival of ve~sels from infected West

Indian ports.

It is a matter of record, that the hygienic condition of thi;; city

was frequently and earnestly reported to the civil authorities by

the health otlicers, but without effecting any important changes.

'fhe Charleston News and Courier, of January ll, 187i, contain;;

the reeord of a meeting of the uoard of health, and we abstract the

following from the report of the registrar then presented:

"STREET GARBAGE AND FIL'l'H.-'l'he filling of lot;;, portions

190

REPORT ON YELLOW FEVER EPIDEMIC

of streets and other places, with the garbage of the scavengers gathering of the city is a nuisance, and must ever be a continued cau;;;e of disease, in winter and summer. 'l'he experience of our eminent physicians, from 1798 to the present day, concur in opinion that thiR practice has been a prolific cause of malignant and yellow fever in this city under high temperature. The few cases of the past summer can be traced, in nearly every case, to these garbage vats, or fermenting deposits. The attention of the board is specially invited to thi::; head."
Had the State of South Carolina an efficient board of health this state of affairs would long since have been remedied by the strong arm of the law.
The history of yellow fever, af:! it affected the city of New Orleans, is almost identical with that of the city of Charleston. But Charleston was infected with yellow fever 96 years before the disease reached New Orlean,;, and during those years Charleston had 12 distinct epidemics.
So frequently has yellow fever been imported into New Orleans since 1796, and so often has it therein held uninterrupted sway, that, taking )nto con::;ideration the topography of the city, and the character of a very large clas;; of her inhabitants, it may be within the range of possibility, as claimed by many of her medical men, that in certain localities the disease has become domesticated, and that each year so-called spasmodic cases of yellow fever may occur independently of importation. Be this as it may, the board of health has demonstrated its ability to cope with the disease, and to stamp it out wherever or whenever it may appear.
If health authorities can control yellow fever whenever it may appear at the ports of New Orleans and New York, and we think that it haH been fully demonstrated that they can so control the disease, why may not the same preventative measures be adopted at Charleston, Savannah and all other ports?
Upon a previous page we stated that, although the cost of maintaining a properly constituted health office would be large, that it would sink into absolute insignificance when compared with the cost of one epidemic of an acute infectious disease occurring in any large city. 'rhis has been again and again demonstrated In volume II. of the Reports and papers of the American Public Health Association will be found a most elaborate paper by Dr. Benjamin Lee, of Philadelphia, in which it is shown that the epidemic of small-pox of 1871 and 1872 cost that city a total of $21,848,977.99.
We shall attempt nothing so elaborate as regards the late epidemic at Savannah. We will endeavor to keep all our estimates

STATE BOARD OF HEALTH.

191

strictly within or below the line of probability, trusting that by so doing it may, in reality, make a stronger exhibit.
In attempting to estimate the cost of an epidemic of an acute infectious disease in any community, it is necessary to take into consideration all the items of cost which may really have occurred. We will, therefore, present our estimate of the cost of the yellow fever epidemic of 1876, to the city of Savannah and the State of Georgia, under the following lleads :
I.-THE LOSS, BY THE EXPENDITURES OF OVER 8,000 REFUGEES. Experienee llas taught the residents of our Southern seaport
towns, that at the outbreak of an epidemic of yellow fever, safety is to be outained in a prompt removal from within the limits of the lines of infection. Therefore, when an epidemic is announced an exodus of the better classes of the community takes place. All who arc possessed with sufficient means, and the ability to employ tilem, make haste to escape. Tile houses of the majority of the better classes are closed, and of necessity, all expenditures therefrom cease. Servants are discharged to shift for themselves. All classes of trades-people suffer from the loss of patronage.
The number of refugees from the city of Savannah was esti mated uy a writer in tile Savannah Morning News, of October 30, 1876, at about 8,000 individuals, and the same autilority estimates the loss to tile city, in their expenditures, at $500,000.
A careful consideration of this subject, aided by an elaborate calculation of items, leads us to accept this estimate as an approximation to the truth, and as being rather under than in excess of the actual amount, a~ we were at one time led to think.
II.-THE LOSS IN SALES OJ<' MERCHANDISE.
Tile article of the Morning News, already quoted, estimates this amount at $500,000, and we accept the figures.
In this calculation, all estimates as to the losses of dealers who were properly considered in the former calculations were excluded, and the losses of wholesale merchants and the shipping interests save those of cotton dealers, are taken up.
III.-THE LOSS BY THE DIMINUTION OF COTTON RECEIVED FOR
EXPORT.
Although the epidemic did not entirely arrest the delivery of cotton at the SaYammh market, still it most seriously interfered with the trade, and large quantities of that staple were diverted to other ports.
The actual loss was estimated by the writer in the Morning News at $50,000, but the epidemic lasted an entire month after that estimate was made, and we are led to think that it would be no exaggeration to add thereto the sum of $25,000, making a total loss of $75,000.
j

192

REPORT ON YELLOW FEVER EPIDEMIC

IV.-THE LOSS TO RAILROAD COMPANIES BY THE DIMINUTION OF
TRAFFIC.
It is too soon after the epidemic storm to be able to obtain full data upon which to base an accurate estimate of thi;; loss, but we have been informed by a gentleman largely interested in the railroads leading into the city of Ravannall, that the sum of $200,000 would not cover the losses whieh sucb companies have sustained.
V.-THE LOSS IN RENTS AND THE DEPRECIATION OF PROPERTY.
The lo~:; under tllis head was e01timated by the Morning News at $250,000. To that amount, in consideration of the prolonged existence of the diseaRe, we would add the sum of $50,000, making a total loss under this head of $300,000.
But will the sum of $BOO,OOO cover alone the actual depreciation of property '?
VI.-THF. LOSS OF TAXES .ro 'l'HE CITY.
The ftiorning 1Yews estimates this loss at .$50,000, and we may presume that the estimate is corred.
Vli.-THE LOS;:; OF TAXES TO THE STATE.
The i::itate tax upon Chatham county in 1876 was $110,5B4.23. The larger portion of this tax-nay, almost the entire amount-was to have been paid by the city of Savannah. Upon inquiry at the office of the Comptroller General, we learn that but $10,000 has been paid, leaving a debt of $100,5B4.:l8.
VIII.-THE LOSfl '1'0 PROFESfliONAL MEN.
A severe epidemic of any iufeetious disease is inevitably disastrous to all professional men dPpending upon the daily practice of their profe8siou:;, while it arrests tile incomes of all other;;.
Upon none does thb burden fall more heavily tllan upon medical men, for, while their revenues are either destroyed or most :seri ously diminished, their professional cares and rcsponsibilities are infinitely increased. It is estimated that there were at least 15,000 sick in the city of Savannah during the prevalence of thii:i epidemic. To each of this 15,000 it would uoi be an over-estimate to assign 5 visits, wllieh, at $0.00 per vi:,;ii, would amount to :jp225,000, of which amount prolmbly not over :ii20,000 will ever lJe collected.
But medical men were not alone the suiferers-dergyrnen, lawyers, and literary men of all grades were atiected, and it i,; not considered au over-estimate to place their uuitedlosses at $800,000.
JX.-THE LOSS TO HOTEL PROPRIE'.rORS.
It is very important to take into con~ideration the losse:; of individuals of this class. 'l'he employes of hotels are so numerous, and the daily expenditures of such establishments are so large, that many iudividuals in every community are directly influenced by the good or bad fortune of the proprietors.

STATE BOARD OF HEALTH.

193

After consultation with a gentleman of large experience in this business, we are led to estimate this lo~R at $25,000.

X.-THE LOSS OF WAGES TO THE WORKING CLASSES.
During the epidemic of 1876, a eeusu~ was taken by the police authorities, .by which it waB determined that there were 11,614 negroes and 7,3,)3 white>~, constantly resiiliug in the city of Savannah. Of these 18,967 individuals it is by no means an unrair estimate to say that 12,6-14, or two-thirds of the entire number, were, by the epidemic, deprived of their ordinary means of obtainingtheir support, and were obliged to ~ullsist upon public or private charity. Estimating the daily earning~ of this number of individuals at $1.00 per day, for the nilwty days duriug which the diseaRe lasted, aucl we lmve a total loss of ::0:1,1:l7,H60.

XI.- THE LOSS 1:-.; IHTMAK LIFE.
It is hard to place a money value upon human life, but as producers and consumers, human beings represent a certain value in money to the State. This value has lwen e~timated lly variouR writers at figures ranging from $500 to ;39,000. Taking into eonsideration the value of skilled labor in all communities, and the influence which such labor has upon the value of personal and real estate, the estimate must of necessity be an arbitrary one. In this in~tance, being desirous of kpeping our figures as near the truth as po,;sible, we will estimate the value of an adult life at $2,000, and that of a minor at $.SOO.
The absolute> figures of the mortality of this epidemie are not as yet at our command. 'rhe supplemeut of the ~4forning ~New8 of November 28, 1876, gives the total deaths during August, September, October and }'\ovember of that year a1 1,.574, of which H-10 were rom yellow fever, and 634 from other di~easc~. Of thi" number 1,104 were adults, and 470 were minors.
From the annual report of the Mayor of 1:-lavaunah, published in tt"oe Morning News of January B, 1Ri7, we allstraet the following item.; of the report of Dr. 'Villiam Duncan on vital ;.;tatisties, yet to be published : "During the epidPmic there were reported deaths from all causes 1,351, of which lllO we>re from yellow fever;" and in t.tlis report we find it stated, that a large proportion of the deaths asnriibed to other rauses, were, in all probability, genuine cases of yellow fever. \Ve are unable to make any classification from this report in its present fragmentary condition, and therefore must use those furnished by the Morning New8, and which we tirst noticed-1,104 adults at $2,000=$2,20S,OOO, and 470 minors at $500= $285,000, making a total money Joss of $2,44a,ooo.

194

REPORT ON YELLOW FEVER EPJDEMJC

XII.-THE LOSS FROM EXPENSES OF THE INTEHJ\IENT OF THE
DEAD.
Estimating the cost of each .of the 1,574 interments at the low figure of $20, we will have a total cost of $31,480.
XIII.-THE LOSS IN THE CARE OF 'J'HE SWK.
It has been estimated, that during the epidemic at 'Savannah, there was a total of 15,000 cases of sickness. It beeomes a question of some importance to determine the cost of their maintenance. We will estimate that the very large proportion of this number were subsisted upon public cllarity, and therefore must not be included under this head ; but it is by 110 means an unfair estimate to take one-fourth of tlle entire number, or 3,750 individuals, who were subsisted by their private means. If to this number we allow an average of twenty days' illness and convalescence, we will have a total of 75,000 days, which, at a per diem of 50 cents, surely a low estimate for the subsistence and care of the sick, will yield a total cost of $37,500.00.
XIV.-THE LOSS IN THE COST OF SPECIAL SANITRY WORK.
\Ve have been informed by the Hon. E;. C. Anderson, ::\layor of
the city, that $cll,OOO was expended by the eity authorities for sueh work, during the epidemic.
XV.-THE LOSS IN THE AMOUNT OF EXPENDED PUBLIC CliARI'J'Y.
\Ve have been informed by responsible persons, that tliC wm of $120,883 was expended in public charities.
TO'L'AL ESTIJ\IA'L'ES.
1. Loss by the expenditures of over 8,000 refugees ......$ 500,000 II. Loss in sales of merchandise ................................ . 500,000 III. Loss in diminution of cotton for export.. ............. .. 75,000 IV. Loss to railroad corporations ............................... .. 200,000 V. Loss in rents and in depreciation of property....... .. 300,000 VI. Loss of taxes to the city ...................................... . 50,000 VII. Loss of taxes to the State ................................... .. 100,534 VIII. Loss to professional men .................................... . 300,00 IX. Loss to hotel proprietors ..................................... .. 25,000 X. Loss of wages to the working classes ................... . 1,237,960 XI. Loss in human life ............................................... 2,443,000 XII. Loss in interment of the dead ............................. . 31,480 XIII. Loss in the care of the sick ................................ .. 37,500 XIV. Loss in the cost of special sanitary work ............. .. 41,000 XV. Loss in amount expended in charity ..................... 120,883
$5,862,357 Against this loss of $5,862,357, what is placed? The answer we will not attempt.

r

STATE BOARD OF HEALTH.

195

In attempting to condense a subject of such magnitude into the space your patience would grant us, it has been impossible to deal other than in generalities; in assertions of truths, rather than elaborate arguments, and arrays of facts to demonstrate that they are truths. \Ve have, however, endeavored to substantiate the truth that sanitation is an essential adjuvant to national prosperity; and we assert that if the great law of nature be recognized, that human intercourse is the efficient means by which infectious diseases are diffnsE>Ll throughout the world; if it be recognized that the most fearful of acute infectious disea:<es known upon this continent are of exotic growth, and only appear in America after they have been irnporhd, tlwn measures may he perfected by which their importation may be arrested. For America stands isolated, surrounded by great bodies of water, having a hemisphere to herself; she is in position to bid defiance to the filth-engendered diseases of other nations. It is very true that the habitat of yellow fever is not far distant from her shore~, yet the distance is sufficiently great for all practicaule purposes.
And 1ve would rPproduce and assert the truth of the statement of Dr. Brown (page 89 of his report) that "pt>culiar meteorological conditions, defectiYe drainagP, poisonmis gases, rotting VPgetable debris, ean no more originate yellow fe\'er thau they can smallpox; !Jut they may so vitiate the vital capacity for resisting disease as to render thu organism peculiarly receptive to the influences of a morbid poison."
\Ve would go furtlwr, and suggest that an atmosphere thus impregnated is a suitable nidus, in which the poison of yellow fever may indefinitely ruprm1uee itself; that the atmosphere of any locality may be thus charged "ith the poi~on, and that the process once fully established, it can only be arrested by a lowering of the temperature to at hast il:l Farh. Should no such change of temperature occur, the diseasp may hold over indefinitely. Its virulence may become modifie(l by the oecurrence of strong winds, which may so dilutP the atmosphere of any locality that, for the time being, the progress of tlw di~Pase m:1y be arrested; but with first calm, the procp,;~ of germination again takes place.
Finally, we woul(l nutiutain that morbifi( influences are in great measure, if not entirely, within the grasp of humanity, and that the great agents by whieh they may be destroyed can efficiently be handled by health organizations alone.

196

LUNACY IN GEORGIA.

LUNACY IN GEORGIA.
To the Board of Health of the State of Georgia :
In the year 17fi0 a new departure was taken in the treatment of the insane. Previouc; to that time, they had been permitted by the public authorities to roam at large, the subjects of jeers and violence, or else they were imprisoned in the common jails with felons, or in asylums but little better, if any, than prisonR. To America belongs the distinction of first inaugurating the humanitarian system for thc treatment and cure of lunatics. It was in 1792 that the good and celebrated Pinel inaugurated this system in Europe, by releasing, in the Hospital Saltpetriere, au Englishman who had been chained in his cell for forty years. 'l'o Pinel, you know, antl to his worthy succeHsor, Esquirol, is attributed the honor of the change in Europe.
But, in 17.'i0, Dr. Bond. of Philadelphia, took the first step toward building <t hospital for this unfortunate cla~s. Franklin warmly co-operated with him. They presentect a memorial to the provincial Assembly of Pennsylvania on the 23d of January, 1751, and on the 7th of February thereafter, (all honor to the delegates!) a eharter WR:< prepared for the PennRylvania Hospital for the Insane WITHOUT A DISSENTNG VOICE. An appropriation was made for the buil<ling. Dr. Franklin prepared the inscription upon the corner-~tnne, and on it he wrote: "For the relief o.f the sick and miserable. ll-fay the God of mercies bless the undertaking." And the God of Il1'"rcies has blessed it. More than a <'entury has elapsed, an(l that good old Quaker institution has dispensed sanitary treatment to thom;auds, anct iR still leading in the good work.
In 1773, the Virginians built a similar institution at "Williamsburg. In 1779, the Bloomingdale Hospital was opened in New Xork, and in the same year the people of Maryland opened a hospital at Baltimore. In 1817, the Society of Friends built another hospital at Frankford, Penm<ylvania. In 1818, the first hospital was built in Massaebusetts. In 1824, ':'onnecticut and Kentueky built their first hospital. In 1828, Virginia built her second hospital. In 183:1, the second hospital in Massachusetts was built. In 1837, Massachusetts and New York each built another hospital, and Vermont huilt one. In 1840, Maine built. In 1840, New York built another, and New Hampshire built. In 1843, New York and .iV[aryland each built another, and Georgia built her present excellent hospital. And so the good work has gone on. In 1848, there werelfour hospitals huilt in the United

STATE BOARD OF HEALTH.

197

States; in 1852, two; in 1855, six; in 1858. three; in 1860, four; in 1861, three; in 1866, three; in 1874, tour, and there are now in process of building as many as eight public hospitals in the United States.
Without counting a. number of excellent private institutions that have sprung up in the more populous parts of the country, there are now completed and receiving patients in the United States, 95 hospitals for the insane. Of that number 14 are in New York, 7 in Pennsylvania, 7 in Massachusetts, i in Ohio, 6 in Illinois, 3 in each of the t-ltates of New Jersey, Virginia, Kentucky and Connecticut, 2 in each of the States of California, Maryland, Michigan, Wisconsin, Iowa and Rhode Island; and there is one in Washington 'ferritory, and one in the District of Columbia, and ONLY one in Georgia.
Does not the reflecting mind at once enquire, why is this disparity? Our population is greater than that of Connecticut, of New Jerl:ley, of Maryland. It is much greater than that of Rhode Island. Yet each of these States has two well organized hospitals for the insane, and we have only one! Even a territory, with society scarcely organized, is on a par with us in this humane work; and New York, Pennsylvania, and other States, are far ahead of us. Kentucky has three, North Carolina has two, and the new State of California has two hospitals. So the question recurs upon us, why is this disparity?
Vital statistics show that the proportions of insanity to population, the civilized world over, is about the same; and yet these other States have made much more ample preparations for this unfortunate class than we have. I believe the people of Georgia desire that the full measure of duty shall bP done in this matter, yet it is apparent we are not up to the full measure. We all know our hospital at Milledgeville is crowded with a little over six hundred patients, and the painful fact is upon us, that the jails in many of the counties incarcerate lunatics. I happen to know that a number of gentlemen in the State !lave been, for some time, looking specially to this matter, and they are prepared to show there is scarely a county in the State that has not lunatics within its limits, for whom there are not accommodations at the State hospital. Some of them are upon their families, and we all know that no family, however wealthy it may be, can properly provide for their protection and cure. Many of them, male and female, are in the jails, where there are cases in which females have been ' subjected to intimacy with felons too revolting to mention.
A few years ago, the people of New York, under similar circumstances, built the hospital at Ovid. Auxiliary to the movement then put on foot, they organized, by legislative enactment

198

LUNACY IN GEORGIA.

a board of enquiry, consisting of sixty-three physicians, the result of whose humane labors has brought to light the fact that in 1872 there were as many as 6,755 lunatics in ~ew York. Taking the ratio of our population to that of New York, the number of persons suffering under mental diseases is not far tiom 1,800. Of these not more than G:.l5 ttre under treatment in our State Hospital. Some are in ho,;pitals of other States, far from home and friends; others arc given over to inadequate private treamcnt, or are at large, endangering themselves and their neighbors, or else in prisons, with criminals. \Vhat, then, shall we do? \Ve cannot stand still-what shall we do'?
Is not the answer plain ? Will not our General Assembly make that answer at its next session?
I have before me the history of the Willard Hospital at Ovid, New York. 'l'he plan of this hospital appears to me to be the best and most economical for the purpose;; contemplated. It originated in the Medical Board of the State-a phyc;ician drew tlH' act of the General Assembly under which it was organized. What wfll the physicians of Georgia do in this matter ? Are their representative men ready to give assistance and direction to this good work, by giving it the benefit of a good word? \Vill the doctors advise us and lead us, so that by all working and counseling together we may be enabled to adequately meet a nect>ssary duty that is upon us us a humane people and a civilized State, that cannot well be postponed, in the most economical way that ean be devised? :May uot this be done either by supplementing tile present hospital, and erecting clleaper buildings for tlle chronic insane, epileptics and idiots, or by locating another hospiLtl?
Very respectfully, B. H. BIGHAM.

APPENDIX.
JoHN H. HoGG-l am City Surveyor of Savann~h. It is part of my duty to look to the general drainage of the city and surroundings. The dry culture inspection is nuder my order,, but I am under direction of committees of Council. Have general superYioion of the work. The condition of the dry cultme lands this year does not differ in many respects from tha, of previous years. Springfield plantation and Bilbo's canal, which are under dry culture contract, have not had the usual umoant of work this year. No work of any consequence was done on them the entire summer. Springfield plantation lands in the southwest portion of the city were overfiowe:l in June, partly by heavy rains, but more particularly by the blowing out of a trunk protecting those lands. That portion near Gwinnett street on the south and Ogeechee on the north, remained nuder water about two wcol,s. As soon as the trunk was replaced and the river water excludecl, the water ou the laud ran off. The flowing of the tide up the Springfield canal acts as an ob"truction to the drainage of the land. The trunk was replaced in July. The Janda, after that. were about as dry as usual in the summer. Some of the ditches were very foul; there were more weeds in them than usual and tha water was confined to the bottom, mixed up with the weeds, etc. 'l'here was no ditch cleaned out but that running through the centre up as far as Gwinuett street. The portion near the colored cemetery was in bad condition; examined the water tlJ.Cre and found it covered with a green vegetable matter; never saw the centre clitch foul to any extent. The Springfield lands this sicle of the bridge, leadin3 to town during the month of June suffered in the same \Yay--the water remained on it some time. None of the ditches here were cleane(l out. Subsequently some work was done by Col. Wadley on the railroad lands west of the Springfield canal, and they were put in tolerable order. At this time the fever had made some progress. The main canal from Central Railroad to the river waJ changed from its direction so as to communicate with the new canal recently cut by Col. Wadley. The dry culture hands, with the chain-gang, were engaged nearly two months in making this change. No work at that ti mA wa;,~ done in cleaning out ditches or drains on Springfield plantation. The accumulations on Bilbo's canal extended all the way down. After heavy raim, when the weather became dry, the channel was narrowed on either side by the accum~latiom of sand and house deposit. It has always been customary to thoroughly cleanse out Bilbo's canal early in spring or summer, and
then if thcra was any accmnulation of offal, or obstruction after that, it was worked. Nothing was done on it the past year. This is the only failure for the past five ur SlX yc::trs to clean it out. No water from the hydrants IS turned into the sewer. There are catch b"'sins on each corner, three feet in diameter and six feet in depth, constructed with the usual water trap, to prevent the escape of effiuvia from the sewers. Each is supplied with a stop-cock to fnrni;h water from the wurks to cleanse them out. No other water except rain water can get into these traps. There is no flushing of the sewers or large volume of
la

II

APPENDIX.

water thrown into them for cleansing. I was City Surveyor in 1855 ; there was a sewer on Whitaker street at the interoection of :clicDonough. which passed through Orlcane square out Barnaru to Huntingdon. then e~w t, passing through the park. and hau its outlo~ in :t "wamp on the land belonging to Dr. Waring. No water clo8et8 communicated with that sewer at that time. Of late yeam the number of permits granteu for making water closet connections with the sewers averaged thirty or forty per year. These pmmits were limited in number until after the war-I think about a dozen. Thc same state of affairs continued in 185H. Tho dh;t~nce between the swamp land where the sewer mentioned was uischarged and Bilbo's canal. iA ahout tln,c- quarters of a mile. The urainage syatem of the lo"- buds prinr to tho w~r w<ts not as goou as the present .,ystem. Iu 1854 Spriu;;fielu plantation was iu Hll'.~ had condition-tae ditches filled up and the Janel was frequently under water. In the eastern portion of <he city there was a denHe swamp just ><onth of the bridge, on the 'rlmnderbolt road, which was cut clown dnring the wttr. It was never thoroughly drained. the uitches in that vicinity were in a very bad condition. At that time the only portion of the low lands of the Hpriugfielu plantation that could be cultivated was a small tract near the Ogeechee canal. After 'the war ditches were cut, all(l ground improved. The lowlands eaet of tho city were, previous to the wa1, in sufficiently dry condition tf) be cultivated. The lands bordering Lamar's canal were not in bad condition. The principal trouble at that time was at the east ern slope; the hmd there was bog:y and never WttR dry U11til a drain was cut, which now enters into Lam:tr's creek east ol the canal. 'l'hiA year Lamar's canal was in a foul condition. 'l'he cause waB its being filled up by the owner, from the rvier, and that portion left between River street and the flour mill hitd no outlet. The city had a sm,tll trunk put in, which carried the surplus into the creek. It has bee'll in foul condition all the smumer. Pre,ious to the filling in the river tide came in twiile every twenty-four hours. The city ha" never cleaned Lamar's canal. The city made no objection to the closing of the canal, as"it is private property. It is boggy and spongy; very little water in it now ; not very deep ; continual under-ground springs from the surronnrling lands run into it. The Bilbo canal hail been notoriously offensive; people who ride out the Thunderbolt road lmvc complained of it-complaints not more nnmeronB than ordinarily. The Spl ingfieid landH west of tho Factory, after tho hmLYY rain in June, were very olfensive. Some say there was a fishy Hort of smell. I had no occasion there ea.rl.v iu the 1norning Ol' evening, and at noou tho t:nnell i;-; not as noticeable-at. least I didn't notice it prticularly. as my sew;o of smell is not as MUlH3itivc a;--; t'ome other;:;, Tho tltreet traps are not in a 'i.\'Orse condiTion than urmal. When they become foul they are cleaned. Notification is usually ,;ent to my office. Thn efiinvia somotimeH arising frmn the~e trapR is not so n1uch attributable to eowore as w the presence of dead dogs anu cat,; in the bottom of the traps. Frequently three or four doa.d cats, rate, etc., have been taken from the trapfl. Tlwy sometimes fall into it, or are thrown in. Cats chascu by dogs will sometimes run into them to e,;cape, and being unable to get out, <lie. More attention htts been paid to the c!ean,;ing of the><e tnps this yua1 than usual. 'l'he city keeps employed throughout the year four men, whoso duty it is to make their rounds and clean them out. wme on East Broad and We>'~ Broad streets are not constructed the same, and possibly arc more open to sewer eflluvia than is healthy. I consider the traps efficient in preventing the osc<tpe of foul gasses from the Hewers. 'rho lower portion of them ill filled with water. and when thie

APPENDIX.

III

becomes foul it is disp!aced by fresh water from the stop-cocks in the manner I have stated. I could not positively say that, in the event of heavy rains, theRe traps might not, em1t a little foul air. but it would be very little. This is not the case with the sewers, which have larger capacity for outlet and are not liable to be choked up. In case of heavy rain. if Bilbo's canal should become full and the water back up to the sewer. there would be no danger of damage resulting, as the mouth of sewer io so much higher. Have never known them blocked up. Have never known the main sewer on Bolton street to be more than half fulL Thev arc ten f0ct in diameter-larger, in fact, than is absolutcly'necesbary now. bot they were built with reference to the future and increase of the town, On the pavement streets thoro is no absorption of rainfall. and it is bound to run into the "ewer trap". On the commons the water is absorbed rapidly. There are now about 150 water cloeet connections with the sewers. In 185~J or 1860 the ordinance was repeaJed prohibiting sewer connections. A dozen or twenty connection" were made. Since then the number has beeu increased. No privy is allowed connection v;ith tho ~ewers. The piau of operation in regard to them is to transfer the deposit into a pit, dug for the puqloso Hear tho place. which ie then covered np. Some foul gasses will escape through the earth. bnt gradually the matter Lccomcs solidified and mingles with the soil. The city fixes the prico of cleaning these vaults. and appoints the time for the work. 1\Ien are licensed for the purpose. in order that the work may be properly aud efficiently done. Tbe sewer on Bolton street could be continued to the Cuyler swamp. and this was the original intention. No extraordinary expense would be required in draining the low-grounds about Lamar's canal and creek and Reynolds street. The deposits filling the cttnal are naturally liable to decomposition. Estimate cost of completing the filling here to be $200 or $300. The sowers have access
to the basins from which the water work" draw their supply. The water worb
are located between tho Ogeeehee canal and Musgrove creek. These creeks. from the nature of the country through which they rnn, are taint0d with swamp water. and are open to mixture of impurities from the wharves. Tho location of the water works supply is bad ; the intention was to have it at some point farther up the river, where it would be loss open to the objectit.ns noted. I made a survey for that purpose, but from ~ome cause:no change was madP. The water is not filtered at the works. Well water is used to a coneidorable extent in the city. It is. in my opinion, anythiug else lmt Jnno. I had on my own premises as nice a ''"ell as could be found. About thirty yards from the well 1 had constructed and stmk in tho ground a bane], as a receptacle, iuto which was conducted the refuse water from my house. In a short time the well became so offensive that I had to close it up. There is a peculiar taste to this well water; in some portions of the city something like epsom salts ; never saw any analy.is of it. Tho scavenger department has charge of the offal and deposit it where the 1\Iayor or Chairman of the Street and Lane Committee directs. It is probable that the provisioue of the ordinance are not tt!l carried out. Thero is a Iorge deposit on a portion of Springfield plantation. nmtr Gwinnott streot; also, on the east bank of Bilbo canal. near the Atlantw and Gulf Raihoad depot. Some has been dumped in the clay pits in that vicinity, and possibly there may be such dcpoHits at other points. There are no groves between the lowlands and the city; the only grove now is Lame! Grove CemetPry. but this lies south of the city limits Previous to the war there was one extending from Gwinnett atreet, north, ou the ell-stern edge of the Springfield lowlands. but this was cut

IV

APPENDIX.

down during the war. Dr. Arnold was very much opposed to the destruction of

groves bordering on the city. The lowlands of this county can be drained not

alone into the Savannah river, but can be thrown into the Vernon and Ogeechee

rivers. That, in fact, is the natural drainage of the swamp, so-named. Two-

thirds of the water of 1\lusgrove creek might be diverted in another direction

with benefit.

1\:lr. Hogg re-called on Saturday night :-The level of low water mark iil

the river is taken for a great portion of the Bilbo can:.tl between thn rtver and

Thunderbolt road ; from thence to Bolton street there is a fall of seven feet,

but the tide will flow up to the br1dge and would be effectual in cleansing;

above that point. however, it is difficult to cl,,a,.se it in this way. S!JmH plan

may be used to prevent the accumulation, and the grade of the sewer could

be easily preserveil. The same object could be easily accomplished by contin-

uing the Bolton street sewer to the former bead of the Bilbo canal. The

effect would be beneficial to the sanitary condition of the eity. Bilbo canal

could. be kept clean with ordinary vigilance without the contimumce of th~ sewer

as indicated. The cost of continuing the sewer to the canal "~>ould probably be

$30,000. Don't think the sewerage percolates through the soil in the surround-

ing country. The sewer straightened could be flushed to the depth of five feet.

The boggy condition of the lowlands of Springfield plantation was caused

mainly by the blowing out of the trunk, the foundation of which was, pos.ibly,

not entirely sound. The rains of June cau~ed a large amount of water to

collect on the land; that it was found necessary to cut a bar away in m-.ler to

prevent damage to a large nortion of the country. The reRnlt was that the

mass of water had no outlet to the river, the tide forcing tho water bark. This

water remained on the ground some ten days. Do not cmH-i:1cr thi-. etttte of

affairs due to negligence on part of the authorities. Tbe outlet of the Savan-

nah and Ogeechee canal is about one hundred yards below the pccint whore the

water is taken into the basins to supply the city. The outlet of the new Spring-

field canai is about the same dist,ance on the wect. Four sewers carry closet

sewage into the Savannah river; know that. during the bnRiness season ships

along the wharves throw im],Ur<l matter into the river. Thn 80\\ag-e matter

is carried along by the tide aud some of it, undonbtdly, finds its way into the

reservoir. There is now no great amount of water on Hutchinson's Island.

During the high s:r;ring tides the banks being bto!ien in ditl'crent places, the

water rushes in, and can't get off: finds its way into the o;malllagoons, and

remains there until the next tide rolls in to freshen it. Han; known no work

to be done on this island for tho past twe:ity-five years. The land is under dry

culture contract. In a straight line the island is ab,1ut 200 yard; from River

street and directly opposite the city.

JOHN n. HOGG,

City Hurveyor.

EDWARD C. ANDE&BON.-Am Mayor of the city of Savannah. I have no theory in reference to the origin of yellow fever in Savannah. I can only say that for twenty months previous to this epidemic we suffered an unusual drought, and then in the early pat-t of tho present year the city was visited with heavy rains; th3 swamps were dry, the back water reserves were entirely dry, and the rains did not remain in them, the water being rapidly absorbed. The:.e rains were followed by a long period of intensely hot >veather; the wells were all dry and had to be attended to. Under these circumstances it is natural to Rup-

APPENDIX.

v

po~~e that the surroundings of the city exhaled certain miasma, but this had been often the case before, and I can see no reason why 've should have been a.ffiicted with yellow fever this season. Great care had been taken in cleaning up the streets. It was the last year of my term of office, and I was particularly desirous that the condition of the city should be unusually good. Immediately on hearing of the appearance of the fever at the house of Cleary, on Wright street, in the eastern portion of the city, I visited the locality with the Chief of Police, examined the premises, employed a large gang of men with di<infectants and cleansed thP home and premises thoroughly. Whilst there I met ex-Sergeant of Police Foley, who informed me that he thought the boy Cleary had died from gorging himself on the sweet locust found in the fields in the vicinity. All the epidemic" of fever in Savannah have originated in the eastern quarter of the city. The promises adjoining Cleary's were also thoroughly cleansed, and the work of disinfecting was continued through the entire eastern portion of the city. and thereafter through every portion of the city. The fever jumped over to the western portion of the city, its approach to the city proper being gradual, only c<Lses here e.nd there being heard of until some time after tho epidemic hail commenced and the western and eastern portions were decimated. The city record shows that men were employed all the time throughout the city in the "'ork of ilisinfecting. The prevailing winds in tho summer are from the southeast. No cases of yellow fever on vesseL-; arriving here were brought to my official notice ; the quarantine was in force and vessels from infected ports were kept in quarantine. Some were detaineil so long that the Spanish Consul became impatient, and made complaint about the delay. I think it likely that the sailor boarding house runners do communicate with vessels in quarantine. I think the entito quarantine system of the Southern coast very ilefective, and should be under the control and management of the General Government. !:lome years ago a proposition was made to me to endeavor to enlist Savannah in a movement for this very purpose, but at that time I thought it inadvisable on account of the tendency of the Government to meddle with State affairs. The case is different now. We have represenbtion in Congress, and I think it would be beneficial. There is no use for s~vannah to run a quarantine system of her own, in fact she has not the means to keep up an etficient quarantin.e unless an equally rigid system is observed by Brunswick, Ch.tr!eston and other ports; and hence the advisability of having the entire system under one head. If the l:ltate of Georgia would undertake to establish quarantine on her own coast, there is no reason why the health officer of Savannah should not be under municipal appointant. It would be better to have one of our own physicians who is fully acquainted with the local diseases and immediate surroundings of the port. I think the quarantine laws are essentially defective, especially with regard to small-pox. I would recommend the establishment of quarantine hospitals at Tybee, by either the Government or the State. See no necessity for a warehouse at that point. Have never known a vessel in ballast to be discharged except at her wharf. Have been in the United States uavy for many years. In regard to the portability of poison in vessGls I would say I have been on two ships which had the yellow fever. This was during the ::\Icxican war. One was the Potomac frigate. carrying 500 men. She was taken up to Pensacola and lost quite a number of men. The other was the "Jl.lacedonian." She had yellow fever among her crew. It is the usual custom when a war vessel has the yellow

VI

APPENDIX.

fever to send her off to some cold climate, ha.V9 her hatches opened and haTe

her thoroughly aired and fumigated; and even then there is danger of yellow

fever when fitted out for another cruise and sent to a tropical station. I have

never considered that the ballast thrown out at the Gulf Railroad wharf WaR

injurious or that it communicated disesse. These vesselR from the West Indies

have discharged ballast for years past at this wharf ; in fact most of the ground

in tlJ at immediate vicinity is made up of ballast ftom Spanioh and other vessels.

The ballast i;.; thrown into the marshy soil and in a short time sinks in the

sand until it finds a base I have never known per,;onally of but one violation

of the oauitary law". The Custom-house boarding offic1rs were in the haLit of

boarding theso vcst'els. The question arotC as to their authcrity to communi-

cate thus with vesseL< in quarantine and to return to the city after going on

board of them. VOlCn the fort was garrisoned, I u:;ed to request the

officcr there to lwep a sh3rp lookout upon the vessels in quarantine. Thoro

is notl,illg to prevent persons from Yisiting these ships. as there is now no

guard kept over there. Of my own knowledge, I cannot say that yellow

feycr existed in Havana the past season. I heard, through Dr. ~.IcFarland,

tho health ofllcer, that vessels had arrived on which it was :;uspccted

there !mel been yellow fever. Have no knovdedgo of any attempt being

made by crows on quarantined vessels to come up to the eity this season, but

there may have been. as there was notlling to prevent those who wanted to

come and were willing to risk the penalty. I do not think it would he objec-

tionable for the health officer at Savannah. under either State or Government

system of quarantine. to have jurisdiction over other ports in Georgia. Think it

woul<l be more advantageous to have quarantine under direction of the General

Government than the State government, for the formm has all needed appli-

ance;. Don't think the conJition of Hutchin,;on's Island has the slightest in-

fluence on the health of Savannah. The smToundings of the city arc about aa

usual. The city itself was as dean as effort ~ould make it. I was absent the

latter part of June and early part of .July. The duration of <flutrantine is op-

t.ional with tho l\hyor and health officer. In case of sickness on vessels in

quarantine they are treated on shipboard. as there is no place to remove them

to. Ca8es of small-pox. however, are removed to the pest hone.P.. T!w sick on

the vessels are made as comfortable as circumstances will permit. I can not

perceive how it is possibly to the interest of the pilots to violate the quarantine

laws; it may he so to tho sailor boa.rding house runners where there is much

shipping in port and crews arc wanted. The cle~tnsing of the sowers and basins

is well looked to. I comider the drinking >Vater of Savannah the best in the

world, when filtered. l\Iany pe'"eons use it free!~ for drinking purposes without

filtration.

E. C. A:\DERSON.

DR. J. T. l\IcFARLAND,-I am Health Officer of the city of Rannnah for tbiA ~ear. Was here previous to and during the epidemic. The qull.rantino station ig at Tyheo, opposi to Tybee light. and beyond Cockspnr Island about 2%' miles. It is said to he. in an air line. about seventeen miles from Savannah--though pilots differ upon the distance eomewhat-about fifteen miles ''onld be within hounds. It has hocn the enstom for years past to establish a quarantine on the 1st of .Jnne. Upon the arrival of a vessel from an inf~cted port I am notified by telegraph from the quarantine station. The vessel cannot come up to the city until I visit her, and give permit. The usual detention is about ten days.

APPENDIX.

VII

from port to port," provided she has a clean bill of health. If there be any sickness on board, or there be any grounds for suspicion that there is, the health officer can use his discretion and keep her at quarantine as long as he please. Upon going on board of a vessel the first thing I do is to muster the crew. The crew list is produced. and I have the men ranged on deck and check them off. If any are missing, I institute inquiries, and my action is guided upon what I ascertain and believe. No vessels arrived at tho city this season iu less than ten days-sometimes are as long as forty days or more on their trips from south America. I have no guarantee after leaving vessels that I h"oVe placed in quarantine that my instructions will be rigidly carried out: have no doubt the crewa sometimes have communication with the sailor boarding bouse runners, and they may como up to tho city. I have never known of snch violation. There is no guard bo1t or river police, and hence there iK nothing to prevent them from coming np to the city if they are willing to run tho risk of the peualty and imprisonment, which is imposed for violation of the orders. 'l'here is certainly a very grave defect in the qnarantine regulations; there is no lazaretto or hospital at Tybee, and no arrangements for treating siclmess below the city. In case of sm~tll-pox on vessel, the patient would have to be bronght through Lazaretto creek to the pest house. Cases of cholera would have to be treated on board tho vessel or vessels. I do not think there was any communication between Tybee !><land and the vessels in quarantine proviou>< to tho Oi)idemic here; the people on tho island are too particular. The Spanish bark "Olympia,' which arrived at Tybee on tho 18th August, had the first case of yellow fever that I know of on quarantined vessels. I gave her permission to como up to the city on the 27th September. '!'he usual time to keep vessels from infected ports at quarantine is ten days. This plan has been carried out in N<m Orleans as late as 1874, and has been the custom here so lung as to become almost a rule. On some occasions I have made it fifteen days, in others thirty day>< and more. There is no law or ordinance regulating the time, and in this ro:;pect tho hmLlth officer has arbitrary powers. Vessels coming from Havana with clean bills of health, are allowed to come to port in ten days -that is, ten da.ys from port to port. All vessels como in ballast about from the first of J nne. There is n' ordinance preventiu;; it. I never saw a vessel coming from the West Indio; bring a cargo other than fruit. No fruit vessel arrived this past summer-they all come in ballast In case of siclmess on vessels at quarantine, L esh vegetables, etc., are carried to them, and a small boat is dropped astern say 100 feet, the prevision>< are placed in this boat and then tho seamen pull it aloug .,ide and take the contents out-no communication with ;;eamen on vessel being allowed_ I have uever objected to this, as aithough there i:; no law requiring such supplies to be funJishcd, yet it is but a simple matter of humanity, aud I can imagine no combination of circmnstancos which would indnce me to refuse permission to sick seamen to receive such snpplies. 'l'he first vessel which arrived in the city to which suspicion of yellow fever was directed, was the bark )Iaria." She dropped anchor at Tybee on the 14th July, and came up to Savannah on the 17th July. When I boarded her and mustered the crew I missed one man. lt:CJUired of the captain concerning him, and was informed titat ho had fallen ft ,:m tho mast and been killed. tlaw evidence of the fact of an accideut in a clot of blood on deck around the mast, where the man's head had been split open. .!Hade the Captain sign an affidavit to this effect, and cxamiuetl the crew and other officers. Ratisfied that the statement was trna, and there being no iiclrness on board, I ~>!lowed her to come up. 'l'he ne"t case was the bark

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APPENDIX.

"Maria Carlina," which reached Tybee on the 2d of August and came up to Savannah on the 16th August. When I mustered the crew one man was missing. 'I'he Captaia told me he was taken sick on the passage from Havana. He had eaten a hearty supper and was apparently well. The Captain says near daylight following he was aroused and told that the man was dying', and he believed it was a case of cholera m01bm. I did not rely upon his statement, but treated him the same as though the death had been occasioned by yellow fever, and had the vessel thoroughly fumigated. Another man on the vessel was taken sick at 'I'ybee three days afterwards. I expressed the opinion to the Mayor that the mau dtd not have yellow fner. He afterwards recovered. The "Maria" arrived here one day prior to the taking down of Pat Cleary. The next arrival was the brig " Propheta." No sickness on board of her. I do not kuow how the briugiug of ballast here by Spanish vessels can be avoided, unless there is a wharf built down the river, and the vessel discharged t1ere and loaded with fresh ballast. She couldn't come up the river without ballast or cargo-would topple over. Don't believe yellow fever was brought here at all. Don't believe in importation or coutagion of it-my individual opinion. Think improved quarantine regulations would be beneficial, and that it would be better if the health officer was appointed by the State. The State has a right to make her own quarantine laws, and the present system could be improved upon. A lazaretto or ho"pital should be establislled at Tybee, and there should the health officer or deputy remain, th~t he might have vessels under constant surveillance. The present health ofticer is nothing more than a port physician, and has no authority over "urroundings ; tho draiuage, etc., is left entirely to the city, and the health officer is only c;lled in when medical advice icl desired. It is not my duty to supervioe the drainage. Do not think it would be advantageous to give the healtll officer appointed by the Governor jurisdiction over all the ports on the Georgia coast; would be better to have health officers at other ports. The authority of the health officee of the city extends at pre"ent to Ossabaw Sound. Think it best to isolate or individualize the health officers, and thus avoid antag-oniBtic interests of different ports coming into conflict. Don't believe yellow fever can be imported; don't think the quarantine would keep it out; defy any one to prove tllat yellow fever was ever brought into this port. I have never seen a particle of evidence of any epidemic having been brought heee. I believe, however, in doing everything in the way of purification of ;vessels from infected ports and in a rigid quarantine, so that there may be no error on the wrong siue. In the island of Cuba the yellow fever has raged every year from 1858 to 1876, and we have had no epidemic until this season. But there have been serious ones in Havana during this interin1, and each year they have visited this port. 'rhere have been from time to time sporadic Cltses nearly every year, and no particular alarm has been felt. The atmoophere during this season was in a peculiar condition. None of the cases occuring were traced directly to the vessels. In 1820, 1854, 1858 and 1876 the fever commenced in nearly exactly the same locality, showing that the condition of that section was favorable. Only one instance is recorded of it having appeared in the western section first. There were fewer number of vessels arriving this season with sickness than in 1871, and this foilowing au inundation of Springfield and Vale Royal plantations. I heard of a very important case the other day, the particulars of which I feel as"ured will be of interest and value to the board. It is the case of a child who died with the symptoms of yellow fever in this city on the 4th June.

APPENDIX.

IX

DR. l\icFARLAND recalled on friday night.-I have the statement of the case to which I formerly alluded. The gentleman, I have every reason to believe. is perfectly honorable and reliable. I will read his letter, which I received to-day:
A STATEMENT BY H. R. DRESSER TO DR. J. T. l'tiCFARLAND.
On Sunday, tho 14th of June, 1876, Henry C. Dredeer, aged 5 years and 7
months, residing at n Jones street, came into the house about 5 o'clock in the
evening, complaining of sickness at the stomach. His complexion was quite sallow, and his mother thought he might be going to have the jaundice.
He was accustomed to play on the side-walk between Drayton and Abercorn streets, and had not been further away from the house than the pBrk for several weeks. He declined to eat any supper, whereupon his mother administered s0me simple remedy. thinking his st<>mach might be a little out of order, as he was subject to attacks of dyspepsia, being of a very bilious temperament, and put him to bed. He slept with me and rested well, not waking once, to my knowledge, during the night. He awoke about 7 o'clock on J\fouday morning, and as soon as he raised his head from the pillow commenced vomiting. When I returned home at clinner time. I found him still suffering with nausea in a most aggravn,ted form, his stomach rejecting everything that W"lS taken into it, and immediately called in Dr. J. B. Read, who adminitered a remedy for the vomiting, which, however, did not relieve it. He came again the following morning, and remarked that, "the child had no fever, and he could not then tell what was the matter with him, but would watch hin1 closely and amit developments." 'l'he nausea c'mtinued at intervals of ten or fifteen minutes, during the morning. :tnd when I came to dinner he was in the act of vomiting, and I held his hc:td. as is customary, when ho threw up a worm about four inches in length. 1 ttt once reported this to the Doctor, who remarked that this worm had. undoubtedly, irritated the child's stomach. and wrote a prescription for him, but said this was not the whole cause of his siclmess. He continued getting worse, the vomitling continuing through the ni"ht and following day and night.
',On Thursday morning the Doctor came at an early hour, and while there the child desired to vomit, and he held his head, when a dark, coffee ground substauce w s ejected and as won as he had finished, the doctor took the vessel to the window and stood for some time looking atits contents. While he wast bus standing. my wife wen~ out of the room, and the doctor remarked to me, (not wishing to alarm her), "this is black vom1t.' and if the season was six weeks further advanced I should feel very much alarmed" As it was, I could not see that he was very much frightened. I should here state that the child had thrown off the same dark colored vomit once or twice in the early morning, before the doctor arrived. As near as I can describe it, it was very much like coffee grounds in color and a little stringy.
Before the doctor left, my wife remarked that Harry had the nose bleed during the night, and the doctor replied : "I am glad to know that, as it may bo that it is blood from the head that has gone into the stomach, and acted upon by the gastric juices, is thrown up as we see it," or something to that effect ; but he was still very much worried and went to work in good earnest, blistering the stomach and administering calomel and quinine in the form of enemas, and visited him five or six times during the day. '!'he same distressing stomach sickness, with great restlessness, continued through Thursday until12 o'clock at
2a

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APPENDIX.

night, when his bowels began purging, and I saw at once that he was better.

On Friday morning he said he was hungry, artd we gave him somo nourishment,

which was the first he had taken since Sunday dinner. The child was sick one

week, and was very weak. On June 13th we left on the "General Barnes" for

New York. He commenced improving rapidly, and <luring the entire voyage

had a ravenous appetite, and was entirely free from sea sickness, which was

quite remarkable, as on all previous voyages he had suffered very much fron1

sea sickues8.

I am a member of the firm of Randall, Daffin & Co., cotton !myers, and had

not been on board, nor never have been on board a Spanish vessel, and conse-

quently could not have been exposed to yellow fever myself if there had been

any infected craft in port.

[Signed]

H. B. DRESSER,

Father of Henry C. Dresser.

,J. r. McFARLAND. M.D.

DR. Es1'ERN YoNGE.-Oases occurring in hi. own practice: First case on East Broad street, 23d of August. Second case, on Broughton otreet, north sido between Habersham and Price. Third case, Indian street, west ide of the city, fifth door from West Broad. 23d of August. :Fourth case, Broughton street, between HaberHham aud Lincoln, on 25th of August. Impressed with the belief tha.t he saw a case of yellow fever the 19th of Au-gust, on York street, between Homton and Price. Did not at that time think it a caoe of the fever, but after the outbreak of the dhease as an epidemic, was convinced that it was a case of yellow fever. 'rhis case of August 19th had beeu out minding cattle in the neighborhood of toll gate, ou the Thunderbolt road, this being his regular business. He lived in the eastern part of the city. Does not know if ho had auy communication with the wharf. HENRY C. WAYNE.--1 reside in Sa\'aunah. was here during the the epidemic; have beeu here continuou"ly since ihe war, with exception of occasional visits. My ideas of yellow fever are principally formed from the reading of a work of an English Surgeon, who was for many years stationed in Jamaica, in which tho elements of the fever were graphically described. Wo are living in what may be called the yellow fever zone, that is, where all the elements nee 3osary to produce the disease exist. Savannah has been remarKably healthy since the war, the death rate per week averaging from 18 to 22, including whites and blacks. There are tJome matters of importance to be considered in connection with the fever this season. During the entire past winter we had scarcely any cold weather here, there W\LS not sufficient frost to destroy the vegetable growth, or fungi. In the early part of the year we had variations of wet and dry weather, and al~o extra)rdinary huat. What impr~><sed it on my mind was that we had similar weather in 1873, and that year the yellow fever here was very bad, though not assuming an epidemic form. We have, nea.rly every season, sporadic cases of the fever. From my reading and observatiou, I perceived early in the summer tb.at there was everything to produce yelloiY fever; tlw conditions were favorable and I anticipated it. It might however, in a measure have been a.voided, had proper and thorough dxainage been resorted to in time, and steps taken to get rid of the elements that is the fungi, or cryptog"ms. My attention has been always directed to the subject of health; it is the pa.rt of the training I received at West Point, and hence, now I notic9

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APPENDIX.

XI

everything bearing upon hygiene with great particularity. I don't think the importation theory will hold in regard to the fever here this summer ; there was no neces~ity of importing it from Havana, when we had all the elements for producing: it here. In my opinion the disease originated here ; produced here by the causes I have stated; it appeared as malarial fever, and as the season advanced and the conditions grew more favorable, developed into yellow fever. There is an extensive swamp of land just beyond me, corner of Huntingdon street and Lincoln street, which was for a long time covered with stagnant water, rotten wood and other stuff. I think the condition of Bilbo's Canal and Springfield plantation, highly conducive to the creation of the fever, which emanates, I think, from the fungi and spores nourished by impure surroundings. I did not think the condition of these places much worse than usual, lmt others thought differently, and had apprehended that we would have sickness from that cause. I noticed during the early part of the year, in the weekly mortuary tecords, that a large number of cases of congestive fever were reported. Remembering the favorable conditions mentioned, my mind settled upon this congestive fever as embryo yellow fever, and that we were going to have an epidemic. I don't attribute the cause of disease here to the condition of Hutchinson's Island. 'L'he city, so far as I observed in my usual walks, was very clean, except that scJme of the traps did not sef\m to be as pure as they might have been. I have frequently noticed a heavy mist arising from them, and inhaled unpleasant odors in passing. There was particularly, I remember, a very offensive sink near or in the vicinity of Gordon Street Lane and Abercorn street. It remained foul for a long time, and the stench from it was so great that one day I asked a city official whom I met, if the policemen of this city were provided with noses. I consider too much shade in the city proper as injurious; on some of the streets, the trees have grown to such au extent that their branches are interlaced; the sun is excluded from the wil, the pb~es are kept damp, and everything favors the growth of the fungi, which are noxious and poison producing; many of the sewer traps are shaded in the same way, when it is almost essential that they should be opened to the sun, I look on the sun as the great purifier, and I believe that if these traps were exposed to the rays of the sun, the heat would be drawn into them, and purilication greatly helped. It is well known that sewers not pwperly constructed are liable to produce typhoid fever ; they should be thoroughly cemented inside and be of egg shape, in order that no impurities could cling to the sides, and that when water was passed through them it would carry everything along. There was not formerly, and the same may be so now, a single pump in this city the water of which was not charged with gaseous matter from the privies ; chemical analysis will prove this. Not opposed to the shade trees, but think a thinning out advisable. Groves on the outskirts of the city would be of bene
fit in obstructing the poison, but in the city, t .e heavy foliage is injurious; the houses are kept damp, and in some cases smoll badly. The dense foliage on some of these streets cannot do otherwise than promote the growth of fungi. The immediate provocation of this letter to you about the trees of which I have thought as I do now for many years, was a complaint of some lady friend,; of the injurious effect upon their houses and themselves of the heavy shade trees on .Jones street. I saw myself that light was excluded from the houses, that they were cold and damp, and smelt badly. The matter is oue deserving of attention. I do not think the trees in the city prevented the malaria from being wafted into the houses. Had the trees been out of the city this might

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APPENDIX.

have been the case, but in the city they only served to keep damp and moist the atmosphere which receiveR the malaria, and which thus could not rise. Only believe in judicious weeding out of tho trees.
DR. T. J. 0HARLTO::<! .~Am a }ll'<lcticiug phy><ician of Savannah~was here during the epidemic. Sa"~> no cases of tho disea><e until after it had made. its appear~tnce in the city on the 23d of Augu"t. That was a young man named 'l'~tylor Walthour. who was engaged durmg the day at the Lower Frees, Gulf Railroad. <le slept at Judge Fleming's, corner of Lincoln and St. Julian street. The first fatal ca.,c in my pmctice was on the 30t.h of August. The patient was taken sick on the Sir h of August. ou Thnnderholt road, nen,r Liberty. I had one c~tse prior -a butcher~-who diell at hi>< residence on Perry street, two doors from l\Iontgomery. Sctw him on the 26th of August. He had bePn sick several
day" before I '"Y iJim. 1\Iy opinion it< that the fever originated here. The
suggestive fact in the> cases noted is that they occurred in the northeastern portion of the city. oiy attention has l>een attr:wted to that ballast at the Gulf Hailroad wharf. Sttw such immense quantities that I remarked, in a short time the Spanit<h ;csscls would have tllc island of Cuba planted on our river. The ballast is a i 1nron-, rock, or tt::tnd-:-:;tone-absorl.Js i1nmeuse quantities of noxious gases. anl under certain conditions must necessarily exhale them. I was once surgeon iu the United States nctvy. Am acquainted with the capacity of ballast for carrying poison. The smne is the case in a measure with coal taken in at an infected point. It was "~Vhile I was stationed at Sitn .Tuan, on the "Jamestown." The fever broko ont on board the "SusrJnehalla :" 100 men out of 500 died. 'l'he " Snsqnehana " had come from Gibraltar, and it was sup~ posed took on coal at St. Thomas. An Engli"h ship in port ttt tho same time suffered severely. Notwithstanding there wa,; 11large <Lmonnt of shipping in the harbor, the fever did not spread. I do not know what yellow fever poison is. Have heard that more ballast has been thrown out at the Gulf wharf lately Whatever the poison is, it is hke yoa8t to the dough, and rises rapidly. We had the dough prepared, and tho yeast mts all that was wanted. We got it, and the result it-3 knov.rn. I think tht~ quarantine regulations were rigid.
T. J. CHARL'l'ON, M.D.
DR. J. C. HABEl\SUAi\L~I am a practiuing physician of Savannah, practiced here during the t>pidemic. I saw none of the first cases in tho epidemic. The first case I saw was ou Stone street, on the 22d of August. Had been health officer of Savn,unah for five years 11p to 1874. The quarantine station wr~s then at Fort Jr~ckson: it was considered too near the city and wr~s then removed to Tybee Islr~nd during Col. Screven's administration. During C[Uarantine no vessel was ctUnwed to come up to the city without a clean bill of health. I r~m sati,;fied that commuuic<ttion can be hr~d with yessels a,t 'lnamntine: confident it was had. but uot with my kno"~Vledge or consent. One ca~e I remember, a negro escaped from the ship ctt quamntiue, came acro8s tho Island and managed to reach the city, but he was captured and sent hack. Think it probable that tho sailor boarding house must keep up intercourse with the vessels at quarantine. Dnring my five years of office, ouly t>vo vessels with yellow fever on board were reported; thesu ;11Tivud at Tybcc,and were treated there, not being allowed to come to the city. Another English vessel, at the same time had two cases of eickness which wore removed to the pest house ; one died of black vomit, the other recovered. The vessel was fumigated and then came up to the city. I
.I

I
I !
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APPENDIX.

XIII

dO"nt think the average of vessels arriving at this port with yellow fever exceed one during the season. The hatches of the vessels coming in ballast from Havana, on arrival at quarantine are kept open and the vessel is >~ell ventilated. I don't think the disease this seasou was brought here ; mn sati"fied it was of domestic origin. Dr. ::\IcFarbnd is a most thorough and efticient health officer, and vigorously enforced the quarantine regulation:<. He was, I am sure. stricter than I was, and I never had.an epidemic, altlwngh during my term of office tha yellow fever was raging fearfully in Havan11. I think the quanmtine system as now existing, very defective. I think it would be well to compel these Spanish vessels to load and discharge, at some point down the river. in fact, if the fever is to be brought here by the1ll, aud we are subjected to snell dangers, it would
be far bettor w break up the Spanish trade. In this season. however, I am con-
vinced tlw fever origiuated here. While I :tdmitit ie a porbtble disease, and can be brought hero, it was not neces"ary this year. as we had it aheady. I hold that it is an infoctiouH, and not a contgious disca,;e. TLink it well to be rigid in quarantine. \\'hen I"'"'" health officer, however. I used to :tllow the captains of veseels to come up occasionally from quarantine ,;talion. attend to their business in tho city auu then return. I believe Dr . .i\IeFarland \YOu!d not allow this, and yet I had no yel!o\v fever duriug my term. I agree with Dr. i\IcFarland, that it is better to havetlw quarantine system e,;la!Jlislwd by tho State. and the health officer so appointed for Savaunah, with jurisdiction over other ports on the
coast but with deputies at tho different ports. Buildings ~uit:tble for tb.e pur-
pose should be put up at qu<tmntino station, aud patrols established for vessels. J. C. UABEESHA::\1, l\I.D.
Dn. J. C. LEHA.I:DY.~I praeticcd iu Savannah unriug tho epidemic. I have practiced in two former yellow fever epidemics, and in both instttnces remarked that with th<J increased hettt of tho sun, those two se<tson", the intensity of the feverK al:::o increased- Iu 1858 \Ye had, in July. feVL'l' with congcKtion. producing paralysi", the seconu or thiru acceso either partittl or tal<ing lmlf of the body. This year, in July and beginning of Augnstj I Haw ca.::;es of eongestiYe fever rcsembllilK con"iderably tlw>o seen iu1H58. bcfore ihe yellow fever epidemic. The first case I saw was that of a womttH at the house of Glean l >Yas called on the 4th of August. Shu had, two day:; previously, had cllil', followed by fever. 'rho fever \Vent off. a.nd Hhe re~mmed her n9ual businoHs. F_eid~ty :d1e had fever again, followed by chill. When I got there she had the ftc\ er.
On 1ny next vitHt I found ht~r freu frurn f<:ver, and gavol1er ~oJno quinine, and did not expect to return. But uu :Sunday 1 \Y;u> sun1n1o:~ud h{-!Jtrn. aud found she had a chill at 11 o'clocl<. \She W>k\ mmilmud ctud her l!raiu so mmh affected that Hhe euuld only be arou~ed by hallthJiug in lwr earN, yet :-:he conld lJe aroused slightly. At thi8 stage I took tho tmnpuratnro and fvund it to l'O 10? 0 I returned at 5 o'clock and found tho temperatmu had incre::toc'l to 107~~o; the patiN1t was rrlmost dead--very pale--skin tinged~rattle co;un,ouccd. Thera were three or four reo~piratioos per minute, awl Hhe died ,;l;ortly afterward. There were no .-;igus or appe:tfancm.; of black vo1nit. ~he ha.J eaten a regular breakfast. Supposed what they call bhtck vomit i,; the usual llO:-Iing after death in cat~es of fever.
A few days later, on the lOth of August, I was calhod to see a gentleman n~tmed Ward. He had a very hot fever. I related this to tho Medical Society on account of tho peculiarity of the ca,e. He lived at the corner or near PriC9 and McDonough streets. Duriug !t part of the fever he became perfectly crazy

J

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APPENDIX.

&nd out of his mind, but during the remission his mind returned. The fever lasted from the lOth to the 18th. I gave quinine only in !arge doses. He re;;. covered gradually, and by the 18th was up. There was no manifestation of the ~tomach during the sickness.
On the 18th of August I was called to see llfr. E. Davis, in the northwestern portion of the city, on the corner of Fahm and Margaret streets. I found him in a similar condition--very hot fever, with temperature at 1067:; 0 Fever lasted for one day, and the temperature cooled down from 1067:; to 1027:;0 The condition of the brain remained the same as in the first rase, and on Sunday he died. There were no manifestations or irritation of the stomach. I brought these cases before you to show the different nature of the fevers as the season advanced.
On the 28th of August I was ca,Jled to see some cases that had been treated by another physician, on Indian street. There were five cases within one hundred yards square in that section. These were not my cases. and will be reported by some other physician.
On the 28th I saw Phil Dillon, in the southeastern portion of the city. The symptoms indicated the appearance of yellow fever, yet I did not consider it yellow fever. The fever disappeared in two days, and after the fourth da,y returned.
On the 30th I saw the first well marked cases of yellow fever in my practicethat of an Italian named DeRosa, in the central part of the city. corner of President and Whitaker streets; John Rogers. near East Broad sheet, on Gordon; Arthur Owene, on East Broad street, opposite York; Mary .\nn j\{ack, in Robertsville, near the Factory, in the western portion of the city; Henry 1\fcCarthy, on Wilson street lane. in Robertsville, and on the same day. two doors from l\IcCarthy's, I saw James Cavanaugh. The symptoms were so similar to malari~l at first that it was difficult to pronounce it yellow fever, and only recognized it as such on the day after.
The first negro case I saw was on the 31st-a girl named Emeline Brown, on East Dundary street, near South Broad. On the same day saw 1\rrs. Goodall, in the central part of the city, and pronounced her case yellow fever; also, three cases in Yamacraw--all initial cases.
During and before the epidemic the heat was intense for a month or more. The calmness of the atmosphere was remarkable an<l the moisture very great. I remarked several things in visiting my patients. The puffs of hot steam became almost stifling, espeeially in Yamacraw. At the incipiency of the disease the air was almost unbreathable in some houses. A few days later, in Robertsville, I noticed the same effect. On the appearance of the yellow fever the people were desperately afraid of the night air and would not venture out. There waR more danger in the houses, as the air of the rooms became charged with carbonic ga,ses, and the effect of inhaling this combination of gases was very deleterious. It will be seen by the initial cases that the disease spread nearly over the city, but the brunt of the disease was first in the eastern portion, next in the northwestern and at the same time in the southwestern, whilst the city proper was almost perfectly free until long afterwards. The most violent cases, according to the population, occurred in the rear of the Cotton Factory, the population there being greater according to the acreage-the houses being small and breathing capacity less. The sanitary condition of that part of the city was as fair ~ts it had been for years. Nothing extraordinary occurred in theso ca,;e,, and they wore woll taken care of. On the easter

APPENDIX.

XV

81ope, northwestern slope and southwestern slope, and immediately over the declivity of the bluff, the low grounds for months previous to the breaking out of the eoidemic were covered with stagnant water, and if we consider malaria is produced by stagnant water, this locality was certainly in the best possible condition to propagate the disease. Years previous the same points had all been regarded as beds of malarial disease. Since drainage, however, I have not s(jen one case where formerly there were twenty. The grounds have keen kept in better order since 1868. Since that time there has been. each succeeding season, a perceptible decrease in malarial fevers. On those points. however, as I have stated. as the epidemic increased the number of cases increased, while there were but few for days following in the central portion of the city. Here and there cases were reported, but the disease was more general and virulent. as in tho localities mentioned. The epidemic was at its height from about the 8th of September to the middle of October. About that time the heat began to decrease, the winds changed. and the atmosphere became rooler; with the cool ai.r came down tbe fever, very gradually, and toward the last of October the number of yellow fever cases measurably decreased; but the number of new cases of other fevers increased. During the height of the epidemic the relapses, which were very frequent-more so than I had ever known them before-were principally in yellow fever. During the latter part of the epidemic. the relapses were in intermittent and remittent fever. Out of 61.5 cases of yellow fever I had 51 relapse~; 37 relapses in intermittent fever, and 9 relapses in remittent fever. During the epidemic I treated 56 cases of intermittent fever, 17 cases of remittent fever, 6 cases of congestive fever. and other diseases 120. The winds from the east first strike the rice land and marshy places, where the malari& is most intense. n.nd capable of producing disease. In my view, danger to contract the disease was greater in the day, outside of the houses, and at night inside. ~fy record shows that in the greateat number of cases, the first paroxysm uf yellow fever occurred during the night. At \) o'clock, or about that time, the dew begius to f>tll, and w1th it the carbonic gases. ammonia and malaria poison, which furnish the food and moisture for tho growth of plants that are only kept alive in this manu or dnring seasons of drought; and evaporations drawn out by the snn, taking with it the malaria, rapidly spread over the city. Malaria! poison and the effects of extraordinary he:tt produce yellow fever. !'.Iy theory is that this poiwm penetrate" the houses, and while theJe it eccives greater life, as the carbonic aeid and ammonia exhaled from the l>odieK give it tho pabulum for growth. The influence of the prevailing winds, whieh are generally from the east d!n'iug the months of ,July, August and September. and sweep over the lowlands, is deleterious to the general health. The scavenging of the city is done by a single individual, who has :tccumulated considerable property, and exerts some influence with the authorities, is allowed to deposit garbage almost in the city limitB; :tnd at that point near the factory. where the disease was so intense, there are large beds covered with offal. The condition. however, was not worse this year than before. I saw Springfield plantation, noted it, condition, and smelt the terrible odor arising from it. Had known the place for over twenty years, but had never seen it in such condition as it was this ye~r. The condition of the land, in the southwestern portion of it, is much worse than in the centre of the city, and far worse than last year. The general hcaltb, as regards malarial fever, has beeYI better since 1868, up to this season. The land" during that period were much better drainer} than before. The whole surrounding lowlands this year are much worse than in 1868.

XVI

APPENDIX.

I think that with proper drainage the general nature of the fever wouid have been avoided, and we would not have had yellow fever even if the lands had been as well drained as a year or two ago. My idea is that there is no possi bility of having ~-ellow fever at below a certain heat. and that heat mn"t be continued for a long time before that disease can be produced. I speak not only from exponence and observation, but from reading the best authorities on the origin and causes of epidemic diseases. Malarial poison ca11 be wafted to a considerable distance: have known of it being carried to is<Olatod hmmes. I consider the general sanitary coudition of tho city, as compared with that of former ~-ears, as about as good as it was the previous year. In regard to drainage, there was necessity for work. There was some drainage done near my own residence, which I believe saved my family from the disease. There were two cases of yellow fever in my house, but they did not originate there-were contracted elsewhere. My own family escaped.
J. C. LEHARDY, l\I.D.
DR. J. J. WARING.-Am a practicing physician of S11vannah. I arrived here during the epidemic. on the 13th of September. I left here the 8th of July, on a visit north. Have practiced here since 1861. In regard to the character of this epidemic. I will say that my opinion so exactly accords with that of Dr. White, which was published in the "Morning News," of October 15th, that J will read it. On my arrival on the 13th, I was struck >Yith the universality of the disease. I have never known such before. It mh:;ht be sairl there was not a well person in the city. It was impossible for physicians to :tttend all the cases. In every house you would find two and three sick. People would stand on the steps and hail physicians as they passed, no matter who they were ; all they wanted was a doctor. These cases of sickness. however, were not all yellow fever. Out of 6.000 persons who wore sick at one time. there were probably not one hundred genuine cases of yellow fever. This is only my individual opinion. I have no data. as tho matter has not been professionally discussed. This continued until about the 1st of October. when a singular circumstauce occurred: tho winds veered to northwest. The wind during September prevailed fmm southwest, and tbat it never prevailed in September before for three years from northeast. I have a report here that will give the direction of tho winch; for the three preceeding years, during these months. And in order to facilitate your work, in which I am most deeply interested. I have prepared a series of papers giving my views, and experiences. which I propose to donate as a contribution to the board. I will now allude to a work I commenced here during the latter part of September. On the 30th of that month the drainage I had undertaken was completed. and from that time, while malarial diseases had ceased to occur, yet tho yellow fever continued, but with loss amount of cases, and continued until November. The cessation of cases was however eo sudden that on October 1st the change caused Dr. J\iicFarland to ask me if I thought my drainage of Springfield plantation had anything to do with it. On my return. as I stated, I wa, struck with the appearance of the city. The gloom, the mould and moss were everywhere
visible. July, August and September in former times were designated as tho sickly months. The last eight years. however, had shown such a chauge that during those months the physicians had but little to do, I do not believe the privy system caused this epidemic, b,.t was one of the causes. Rpringfield plantation, on the 15th of June, was one vast sheet of water as far as two miles. The same was its condition in 1871, when Alfred Haywood, chairman of conncil,

APPENDIX.

XVII

bad the place promptly and thoroughly drained. The overflow w:ts on the 18th of August. and we had yellow fever on that sloiJe in October, bnt at no other place. The first caso was broug-ht to my attention in the yttrd of l\-Irs. Marshn,!J. The fever then h1d been in t-l[\vannah three wool". Two died in charge of Dr. Walsh; third. Henry Stubbs in October. Dr. llcad rtttonded fifteen cases. I had some ten my,;elf, and there doubtless were one hundred c:tses in all. The manner in which ~Ir. Haywood went to work doubtless avoided an epidemic. For the first time in eight yc:trs there has been no drainage on either Hide of the cfty. On the tract behind Laurel Grove Cemetery, tho undergrowth was dense. and mixed with large quantities of "tagnant water which, when this growth was removed, escaped "ith marvelous rapidity. Tlw amount of work done, extending over eight miles. by forty hands, could not have been done if any great difficulty in the way of drainage existed, The stuff dried so rapidly that you could pick up bunches of it. I will here explain by the map. The Springfield plantation can be easiiy drained. In the triangular Hpace between the embankment of the Central Railroad is a timber basin which is an intensely malarial spot, and should be filled up. l\Iy views are more fully expressed in my contributions to the State Board of Health.
JAJ\1ES J. WARI~G.
DR. WM. DuNCAN.-! reside in Sav<mnah, and practice medicine. I practiced medicine hero during the late epidemic.
The first case of yellow fever in my practice was on the 28th of August, on Stone st,reet, near the Central Hailroad depot. She had been sick since the Thursday previous, aud had been without medical treatment, except a prescription !rom another phyHician who visited her the day she wa' taken bick, hut who never vioite<l her any more. It was a typical case of yellow fever, and tenninated fatally on the 28th, the day on which I visited her, and a few hours afterwards, having ejected quantities of black vomit.
I did not have time to trace the origin of the case to a connection with any other, although 1 was informed she had been a resident of th"t neighborhood for six years, and lutd not visited the northeastern portion of the city, whore I knew there had been several fatal cases of yellow fever. I saw auothor case of yellow fever which t,,rminated fatally with hlack vomit on the 29th day of August on Indian street Lane. My time was alw too much occupied to trace the origin of that cftse.
In regard to tho inUigenonB, or epidemic origin of the dit;ease, we all know that it prevailed to a great extent at the Isle of Hope, which was in constant daily communication with Savannah. I am informed that there were no casos of fever at Bethesada school which is situc.teJ lmt a comparatively short distance from Isle of Hope. If local causes gave rise (o it at Isle of Hope. local cauees would have given rise to it at Bethesada, in my opinion.
I have no doubt that the local con<litiOtm of the city of Savannah were favora-
ule to the spread of the disease and [ think that the malarial clement prevailed ;/
to a great extent during tho epidemic. 'l'he increase in the death record, commenced about the 21st of August, al-
though I am not prepared to contradict that cases of yellow fever occurred prior to that date.
I consider Hutchinson's Island higi.tly malarial and ge!ler<Llly deleterious to he sanitary ~tato of the city, but having no special bearing upon the origin of the late epidemic. I think the wunoundmgs of the city generally more favora-

XVIII

APPENDIX.

ble for the past season for the generation of malaria than heretofore, in conse quence of a protracted drought. followed in July by heavy rains and afterwards intense heat. The topographical surroundings of the city intensified the malarial influence during the past summer.
W. DUNCAN. M.D.
DR. W. H. ELLIOTT. -I practice medicine in Savannah, practiced here during the ls,te epidemic.
The first case I had was a mulatto boy eight years old, living in the vicinity of the Atlantic and Gulf Railroad depot; he was taken eick on the 15th of August and died on the night of tho 18th. A well marked case of yellow fever. Close inquiry elicited no exposure to known source of yellow fever.
I have no other fact in my possession in rega,rd to the probable origin of the epidemic. I am inclined to the belief that the origin was exotic. That it was not indigenous.
The only sanitary condition differing from the ordinary, was an excessive drought lasting a year terminating in June by heavy rains. With that excep. tion the sanitary surroundings were as usual.
During a practice of ten years in this city I have seen no sporadic cases of yellow fovor. anu am satisfied that none have occurred herA.
I do not. consider th:tt tho difference in mctcorological condition stated abov~ w-as sufficient to originate the epidmnic.
I don't. know that. Sprb,ficld plantation was overflowed. The heat of this prt~t snnmwr was not as great as at one spell during July and August of 1H75. when th0. eit:-, was free from any unusual disease. I do not consider that Springfidd plantation is any more unfavorahlo to the hcaJth of the city tltl111 any of the surrounding low lands. I am of the opinion that the snrronndings of the city. if capable of originating yellow fe.ver. are in sufficient hygienic conclition to produce the disease any summer. There are three modes in which excreta are disposed of in this city: one bythe privies. one b~' dry >veils, and the last by the sewers. There is no f<ystematic arrangement for emptying privies and dry wells. In dry "eather there io communication between the sewer gasses and the air of the city through the traps. During tho year of dry weather spoken of above typhoid and t:,.plw-malarial fevers prevailed to some extent. I am satisfied these fevers wore prodnced by mnanations from decomposing excreta in tho
seworl-i.
I noticed that during the epidemic tho sewer traps were kept properly supplied with water and that then no emanations were perceptible.
In my opinion the snppiy of water is amply sufficient to furnish the people with hydrant water and to do away with pumps. and that the pump water is impregnated with impnritie" from the surface of the earth, from the dry wells and privies.
I regard the influence of Hutchinson's Island upon the city as similar to that of other low lands around the city.
W. H. ELLIOTT.
DR. A. A. WooDHULL.-! am a surgeon in the United States army and the post-surgeon at Oglethorpe barracks in thi" city. By my advice the garrison was removed in order to escape the epidemic influence, August 29th, to Oliver station, 471;' Central Railroad, 46 miles from Savannah. I saw several cases of

APPENDIX.

XIX

yellow fever in that vicinity. The one of most interest was that of l\fr. John

F. Lnfbnrrow, a young mau of about 22 or 23. He resided in that vicinity, and

on the night of 13th September slept on an ac"ommodation train that came out

of Savannah and remained at that station. On the 16th he was attacked with yel-

low fever, and he dl8d on the 21st. I :w1 Hurc , :mt ,-as the only modo of infec-

tion to which he was exposed. I boarded in ''is hvi1RC. and saw him daily, and he

certainly did 110t vieit Savannah while the fcYer ),cwailed. The train to which

I refer ran regularly every evening from Sa> annah to station 4):), remaining

there and returning in the morning. All the employees who slept npon the train

were taken "ick, and all but one certainly had yellow fever. I do not know how

that one-a J\Ir. Charlton--was ill. On the other hand a l\1r. Ardon ~who was

daily employed at the Central Railroad shops in this city and came out in the

train every evening, but. dirl not. sleep in it, entirely escaped. There were in all

three case" of yellow fever in the Lufburrow house, two havi11g been brought

tlwre after J\1. Lufburrow's illness, but the disPaHe did not spread. It was said

that on the night of I\Ir. Lufburrow's exposure to the infection that the car

windows were closed on account of rain; hut this I do not certainly know. 1\Ir.

Lufburruw was not my patient. hut I saw him daily, and at nearly every visit of

his physician, Dr. A. B. Lanier. He died with black vomit: the body was at

first very yellow, and rapidly became discolored; and at the autopsy the liver.

which is quite small, showed the characteristic yellow hue, commonly called box-

wood.

A. A. WOODHULL.

DR. \Vlii. UliARCJ.'l<JRS-Have practiced medicine in Savannah for twenty-five years; was here during the epidemic; have no facts

to satisfy my mind in regard to the origin of the epidemic; according to my view, the city has not been in good sanitary condition, though it is pretty rnueh the same as for the past three years ; eonsider it no worse than during or preceding 1854 or 1858; in some of the surroundings there has been an improvement, in others not; believe the sewer system, although not well construeted, has been of benefit to the city, at least so far as ordinary cliReases are coneerned; have tested the well water on several oecasions, in various portions of the city, and in the rear; was chairman of a commit-

tee, appointed by the scientifie section of the Georgia Historieal

Society, several years ago, to analyze and examine the waters, and report on Hewcrage of the city; Mr. Phillips, a practical chemist, did most of the work; has left the city; our bom;t has always been that Savannah water was particularly healthy; Dr. Arnold stated that it eontained chloricles'1'; I found nothing but chloride, no am-

* CHLORIDES.-Our chief object was to show that there \vas direct communi-
cation between the dry wells, privy siuks, etc., and the city wells, and thus prove that in time coutamination from this source was probable. We also agreed that while the soluble salts of the excrement in these recepticles passed readily into the wells, the other material", with all their putl'idity, would spread around the circumference of the dry wells, and deleterious gases would rise gradually through the clean sand composing our formation, and escape into the city; this escape becoming more and more voluminous as time advanced.

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APPENDIX.

monia and no organic matter in any that I examined; all well water is impure, but not necessarily deleterious; my objection to it is the taste; it is well known that the matter from the privies percolates through the soil, and must affect these wells; the water supply from the ri Yer is good; there is more organic mattc>r in that; think the .sewage outlet into the river calculated to increase certain diseases, typhoid fever, for instance, but am not satisfied of its effect upon yellow f2ver; connections with the sewers, unless the outlet is kept free, will produce disease; the lack of drainage will produce malarial fever; noticed Bilbo canal as being filthy this year; in regard to Springfield plantation, my opinion cliftbs somewhat from others; I think that if the grounu iH kept wet entirely all of the time, the danger is less than under existing cireumstances; practiced in the western country, where there was a great deal of malarial fever; noticed that the ponds, which were filled in tlw summler, and were never drained until winter, never seemed to he productive of malarial disease; when rains were sufficient to kC'ep the ponds full, there was no disease; if they were drained in the summer, the bilious fever increased; you can't ef fectually drain the beds of ponds that have existed for centuries; I have known Hutchinson's !,;land; has been overflowed in three years ; the banks were broken in 1R54, and portion of tile place floode(l: there baR becm les,; malarial fever the past three or four -years tllan i '1 former years; Springfield plantation was partially covered with water during the Reason ; the place was flooded at various times-flooded and then dried off-whieh was favorable for the protluetion of di,;ease of malarial eharaeter.
vV. ::H. CHARTERS, .M.D.
\V-:~r. En. vYr-rrrn.-Livc in Savannah; was here during the epidemiC'; knowledge of the city's condition previou,; to the epidimie is confined to that of the western portion-with that I am thoroug;hly e<mVl'l'c'lll1t; 1 was planting with another in Springfield plantation: wa" tiJC're Parly and late, and hence saw it at all times; after JulHe there were heavy rains, and the grounds wt're eovered there for week; sonw time iu early part of July there appt,ared to he a giving away of a portion of the river front, and I learned from ,;ome partil'l3 that a dam was eut or trunk blown out, and tile water fmm the river eame on and went off; that portion of the land owned by vVm. Swoll wa:; eoverf'd for over two weeks, and the Htaudiug watf'r was so great as to kill the thistles and coffee plant ; tile water was then Jrained off, and the floodgate was replaced ; water remained on the land above Musgrove ereek. 'rhe laud owne<1 by Swoll was eovered with the uit.y deposit, which he had hauled out; thi~ was the debris from the yards, and was mixed up with tin <>ans, bricks, etc.; he had these brieks

APPENDIX.

XXI

and cane picked out by a lot of women; l heard afterwards of two cases of small-pox in the hou~e where this stuff was picked over; saw that manure heap up against the> side of the house, and another one in the field west of the creek ; it stood there and took the rains, and the water backed up agaim<t the,;e piles; the section where these manure heaps were locate(! was tliredly in front of Stone street ; there is no obstruction or houses to break transmission of the poison emitted by these reeking heaps; thi,; was the condition until the latter part of .Tuly ; from a piece of land lying between the canal aud the railroad, some time htst summer, I am not certain about the date, ;,;ome four or iive trucks were constantly engaged in hauling sod; it was ent from this open land between the Central railroad bank awl eanal bank, and carried, l presume, to the Confederate monument, in the park extension; this open earth was thus exposed to tlw snn; tltis was about the condition of plantation aud smToutulings, so far as I know. In regard to the city proper, my attention was ealled by Mr. Henry Beckett, yard-master of the Central railrmvl, to a bill presented him by .Jno. Thompson, for denningout a eertain privy on a place in \Vest Broad street, between BeJTien ami Little .Jone;;; Mr. Beckett was aver~e to paying the bill, and wanted me to say something in the paper about the imposition, ami abo the danger of doing sueh work in the summer ; that privy was opened about the time the rnilitary of this city went to CharlestoH, a period when the weather was intensely hot. In the latter part of .July, as I was passing up Stone street, I found a dry well open, in close proximity to the house where Mr. Malcolm died; the pipes connecting with the adjoining house led into the well; I told a policeman that the person who opened that well ought to be pltwcd on the docket; I did not go near it, the srnell was sufficient to appease my euriosity and keep me at a distanee. Again, the night after the medical society held their meeting to decide whether the fever was epidemic or not, in goinl!; home from the office with Mr. McNulty, we took \Yhitaker Htreet, and upon reaching State street, our noses were greeted with a powerful and unpleasant r;mell, and I said to Mr. Mc~ulty, "'fhey are opening a sink, let's go and see;" we found that rnen were then at work cleaning out a dry well at the corner of \Vhitaker street and York street; I thought at first it was a well connceting with the stable. we stopped at Dr. McFarland's, a short distance beyond, and in: formed him of the opening of the sink; saw the meu at work pumping out the eontents ; don't know whether the ordinance permits this or not; presume the police know the ordinances, and when they are violated; could get no satisfaction witLwut corning
to the Exchange, regist10ring, certifying to nuisances and making

XXII

APPENDIX.

charges, and this course was calculated to excite the enmity of your neighbors; duty of the officials to see the ordinances are observed; official attention was called to the pile of manure hauled upon Springfield plantation, but no action was taken, although notification was given in May; this pile was about quarter mile from the head of Stone street; it is on the south side of the canal just beyond the bend ; tilere are a good many houses in tha~ neighborhood, mostly occupied by negr0es, and there were numerom; cases of small-pox there; in the surroundings of Stone street tile fever seemed to be more malignant than in other sections of tlle eity; there are a number of these dry wells; after leaving Hull street, no sewer west of Bernard (except on Jemmson street) until you come to Canal street; tile dry well used for the purpose received water-closet deposits; this was near the corner of Stone and Montgomery streets; the fever commenced at l\Ialcolm's, went into the next house, jumped to Shearer's house on Harris 8treet, then into Ebey's, vVaddell's, Cameron's, Russell's and my lwuse-and, in my opinion, in that same scope, it it would have gone right along had there been any other occupied hou8es there; almost everybody who stayed here had the fever in those houses ; whether the malignant type of the fever was caused by the condition of the city, I know not. 'rhere are numbers of dry wells in that neighborhood, and if the connections are not kept well closed, those in the houses can smell them; I think the houses arc infected from this cause; these wells are said to be so constructed that there would be no trouble from effiuvia were it not that dish and greasy water iR thrown in them, and this forms a c0ating, so to speak, over the bricks, and prevents ab::;orption, and hence there must be some escape for these gasses.
There has been a break in the river front, directly opposite the city, and the water has poured in there at high tide; a portion of the island has remained covered with water for days at a time; it is under dry culture contract, and within the jurisdiction of the city ; during the early part of the epidemiC the city had carts and men employed, and considcrahle quantities of lime, and possihly other disinfectants, werP thrown around in the damp places, and infected districts; the condition of the land bordering Musgrove creek was very bad; for the benefit of the Central railroad it was stopped up, in order that a new canal might be opened; the bluish red mud was thrown up on the banks, and was allowed to take the rain,; and the sun ; nlm;g that canal the Central railroad had a number of acre;; under ,, :<ter the latter part August; this water was so hot and steaming d times, that young catfish that were caught in it died; I am employed by the Morning News; made a statement in the paper in regard to the open dry wells, and the

APPENDIX.

XXIII

deposits of filth on Springfield plantation, as already stated ; also

notified au official; the stuff was one reeking mass of corruption;

saw hundreds of buzzards on it; they were so tame that the ap-

proach of strangers had no effect upon them; the odor from them

was very offensive, especially when the wind blew from that di-

rection; on the Ogeechee canal, from the river to what is known

as the one mile lock, the canal was almost dry during portions of

the summer, and only when very high tide;; came on, did the water

cover the banks and weeds.

During most of the summer the Canal Company had a mau

employed in dredging the weeds from this section, and placing

them upon the north bank southwest of the Central railroad

bridges; these weeds were left to take the hot suns of the summer.

Presume the authorities had the right to order the full flow of

the canal, although it is private property. The canal is a recepta-

cle for dead cats, dogs, etc., etc., anu occasionally a little negro

baby finds its way into it.

In that section of the city surrounding the Central railroad de-

pot, and in and around Stone street, the privy vaults are in rather

a bad condition, most of them not having been emptied for some

years, and this section exhibited a very malignant type of the fever

as all physicians report.

w. ED. "\VHITE.

'1'. H. BROWN.-I am a sub-marine diYer and wharf builder; have lived in Savannah nine years; was here during the late epidemic. I was at work at the Atlantic aHd Gulf railroad wharf from the first to the sixth of July; while there I beard reports of yellow fever on board a Spanish bark .'1om sea; think she was quarantined; think her name was Maria Rosa; I did not bear of any cases on her while she was at the wharf; there were no rumors of that kind at the time, but heard subsequently there was a case on board when she lay at the wharf; heard this only a fev> days ago; I did not work there after the sixth, but was down there afterwards, but heard nothing more about the fever. I wa-3 (later) at work on the wharf above, adjoining the Central railroad wharf, and heard nothing of yellow fever until the latter part of July; I knew nothing personally of these cases, but heard aftenvards there were cases on board. A man told 1ne three dayH ago he was aboard this vessel every day she was in port; the mau's name was McAlpine; the vessel was the Maria Carlina. My information of the yellow fever was received from parties ou the vessel~:~ lying alongside of the Maria Carlina; it was rumored at the wharf, and believed by all, that she bad the fever on board; I do not know that any one died on board this vessel.

L

XXIV

APPENDIX.

MR. A. J. J. BLOIS.-Reside in Savannah; have lived here forty-two years; was here during the epidemic of tllis year, and the two previous ones; about the middle of July, I was one day in Dr. Hardee's drug store, corner Habersham and Broughton streets; tile conversation turned on the bad smell from the eastern portion of the town; Dr. Hardee remarked that he thought it proceeded from Biluo's canal, and thought an investigation should be had; a day or two afterwards I met Dr. Falligant, and he said he hoped some one would go out and examine Bilbo's canal; Irepeated the remark of Dr. Hardee, and I then agreed to to go down and see the canal; a day or so afterwards I called for Dr. Hardee to go with me; he was unable to go at once, and I walkeli on with the expectation of llis overtaking me; as I strolled along I examined the low lauds iu tile vieinity of the canal; nearly all the drains were impeded with cow-tracks; this was at the head of Broughton street, near the Lamar canal; several parties around there said they had made complaint against the bad condition, but no relief was afforded them; they thought it hard they had not the consideration given them (as they were also tax-payers) as those in the centre of town; I then went on through tlle fields to Bilbo's canal, and followed the line to the bridge on 'l'lmnderbolt road; I there met ~t:ajor Munnerlyn and engaged in conversation, and told him I had noticed the bad smell, though the canal itself seemed to be in pretty good condition ; there was a coating of sand on tllC bank edges; he said everything did not go by appearances, and said if I would pas~ my stick down into that coating, I would see what was beneath it; I did Ho, and at once there issued a most oftemive smell; this waR about the :20th July; it is impressed on my mind by the fact that a day or two afterwards I called to attend to bul'!iness with ~lcl\Iahon, in that section ; he said there were several cases of sickne,;s back of the gas house, which resembled the fever of 185; having been through the previous epidemies, my curiosity was excited, and I walked around;
discovmed the family located in the back alley near Lynch's house; learned that two of the children, aged about 11 and 14 year<:>, had been in the habit of carrying cigars and whisky to one of t ue Spanish vessels at quarantine; from the indications, my suspicions were aroused at the time, and I spoke to Dr. Read, who laughed and said it was all humbug, that there was no yellow fever; the firc;t case occurred in the same block where the yellow fever appeared first in 185; heard the name of the vessel which the children vbited, !Jut forget the name ; Mr. McMahon lives corner of York anLl Ea~t Broad street; don't know whether the children who were ~iek siill live there; I am satisfied, from my experience, that one of the children who died there in July died of

APPENDIX.

XXV

yellow fever; I informed Dr. Read of it, and he said it was nonsense; positive this was in July; I made no report to city authorities of the Bilbo canal; told Dr. Falligant, and presumed he intended making some report; saw Rev. Richard \Vebb on 22d August near Willink's wharf; he said he had been examining the canal; he saict he did not understand how any person could live in such an atmosphere twenty-four hours; saw dead cows lying around the canal, and other corruption; the weather had been rainy, but at this time was dry, hot and sultry; the cows had been laying there long enough to show signs of decomposition; the locality is on East Boundary street, wherethechild mentioned died; think it was about the 22d July; the condition of west side of the city is bad; too much water had aflcumulated on the land, and was allowed to remain; the damp offal within the city limits on the west I consider a fruitful souree of infectious diseases; I told no officer under the city government; my relations with the city officers are entirely friendly.
ALFRED J ..J. BLOIS.
ANGUS McALPIN-Born and raised in Savannah; spend all my summers here; am inspector of lumber, and my dutie>' ca'TY me to railroad wharves and depots, wherever lumber is delivered; route from home to Gulf railroad is down Broughton street and up East Broad; was here through the epidemic; have not noticed any malarial drainage on lands in vicinity of railroad ; some of the ditches have not been cleaned in two years; a place near Lamar's canal is always filled with water, and here are some scavenger deposits; have known Lamar creek and canal as the same; saw the street gang working at those ditches summer before last; did not observe much water in tl'lat section; on the Lamar land a fine crop of oats had been produced, showing the land is in good condition; could only see Bilbo';;; canal up and down from the bridge ; the tide, as a general thing, was allowed to flow into the canal; when the tide was up the drainage from the city lodged there until the tide would go down, and it was allowed to :ass out. there is a gate minder to attend to the shutting and closing of th~ g<tte; after the fever had commenced and had been declared epidemic, the gates were opened; there was no obstruction wher.e I crossed ; never noticed the smell of the water; it was like black swamp water, mixed with mud ; did not think it was fouler than usual; the banks were well grown up with weeds, but it did not obstruct flow of water; asked the cause of keeping out the river tide, and was told it was because of the weakness of the city bank, and the city was liable to all dama,ges from overflow ; know nothing about Springfield plantation; consider the lands around the
Central railroad not to be in bad condition ; no ditches about the
3a

XXVI

APPENDIX.

Gulf road to complain of; variou;; kinds of ballast, mostly brought by Spanish vessels, and di~charged at the Gulf railroad wharf; it is soft, bluish 1'<tuff, and sticks to your feet like mud, when it is dampened by water, and becomes pulverized in the sun; began to inspect the cargo of the Maria Carlina on lOth August; heard of no yellow fever on board of her then ; it wao; reported that one man had died on the voyage, and parties on tile ship along side of her stated that he had died of yellow fever; the captain died in Havana of yellow fever; that the mate was taken sick after arrival in that port, and went home to Spain; the man in charge was put oH uoard in Havana ; the first captain died on shore, in Havana; the rnate was sick at the marine hospital, in Havana. ('rhe history of this erew of the Maria Carlina is destailed in Dr. Stone's testimony.) 1'he impression on the wharf was that fever had been brought here lJy that vessel; superintended the loading of her; took my dinner in the vessel; the captain's baggage was on board ; none of the uaggage was brought off; none of the crew were taken ;;ick until the vessel was removed to Venus Point; she was five weeks at the Gulf wharf; I had yellow fever in 1858; know of no one who had it while working at the wharf; a young man working with me ten <lay:-; after, getting caught in a heavy shower, had a chill, succeeded by fever, on the 12th or 1.5th of September; be recovered, and had a relapse, which I understood developed into yellow fever ; no children had been in the habit of playing around that vicinity ; it was too far out ; had nothing to do with ;;hip Cushing, at Central railroad wharf, in July; Mr. Bacon furnished the cargo, and she went coast-wise; I inspected the schooner \Yhitwing; she loaded and left, and I afterwards heard she had put into Barceli)na with siekness on board; she came from New York here; the officers of the bark Maria Carlina never admitted directly that the man who died at sea had the yellow fever.
ANGUS .MCAI,PIN.

S. G. HAYNEs.-! left Savannah on the 2<1 July; know very little of the condition of lands around the city; only know that the aondition of Bilbo canal was exceedingly ba(l; in driving by rwould have to protect my nose on account of the offensive odors: passed there prior to July; ;;melt it in the months of May and June; never examined the canal; the odor was similar to that emitted by stagnant water anywhere in a marshy country; emtistied the odor came from the canal, which was in a worse condition than the previous year; did not observe particularly that the land around Laurel Grove Cemetery was in a worse eondition than usual.

APPENDIX.

XXVII

GEORGE W. GARMANY.-Live in Savannah; was here preceding tlle epidemic ; I left here on the 8th of September ; the fever llad been in progress fifteen or twenty days ; can not say 1 am particularly familiar with the sanitary condition of Savannah, and took no particular notice until after the appearance of the epidemic; I heard considerable talk about the bad condition; heard of the condition of Bilbo's canal from :Major Munnerlyn, whose duty it was to look after it; on the 6tll of September had a conversation with him, in which he spoke of the canal and the pra<~ tice of keeping it shut and not allowing the river water to flow up the canal ; understood this had been the case for several years ; Munnerlyn was employed as dry culture inspector by the city to look after the low lands east and west of the city, and was under the direction of the council. Knowing he had these matters in charge, I broached the subject to him when the epidemic was raging, and he stated that these lands were in worse condition than they had ever been; he said he had just come from Bilbo's canal, where he had been instructed to raise the gate, and that the water was then up to the sewer of Bolton street; the gate was at the mouth of the canal, and when the water in the canal was higher tllan in the river, it was pushed open, and when higher on the river it was closed; that when the tide was rising, it brought along excrement, etc., and when the tide fell this matter was left in the canal exposed to the sun; as usual, he was not allowed to open it, but on this occasion he had been sent to do it; on this point, I think, the citizens generally will be glad to have the opinion of your board as to whether it was more advisable to haYe the gate open or shut; don't know whether the chances of au overflow in case of heavy rains and high tide were increased by this practice, but know there have been a number of suits for damages on account of overflow since I have been here; it was enlarged some time ago; don't know of any suits for damages since then; Munnerlyn also spoke of ditches there not being cleaned out, b11t he spoke more particularly of Bilbo's canal; Capt. O'Neill, whose businc,;s took him down to the gulf wharves every day, also informed me that water had been standing in those ditches all the
spring and summer, and were very green and filthy; O'Neill is measurer and inspector of lumber; he said the stufrin the ditches was so thick that it was ''like jelly;" Munnerlyn expressed the opinion that it was not judicious to keep fresh water out of the canal, and disapproved of the practice; the council proceedings would show what occurred when the work of cutting tllrough Musgrove creek-the water was dammed up, and overflowed tlle lands on Springfield plantation; don't know the condition of those lands from June to beginning ot the epidemic; never

,

I

XXVIII

APPENDIX.

saw Bilbo's canal in the same eondition before the systern of

sewerage was completed; the land below :used to be cultivated;

am a merchant; never (liHcussed the propriety of continuing the

sewer to Perry lane sPW\c'r and closing it up, and leaving Bilbo's

canal open.

G. w. GARJ\IANY.

DR. L.A. FAr~r,rGANT.-1 have practiced medicine ever since 1858; have lived here forty years-all my life, in fact; practiced during the epidemic; am )Jersonally acquain tell with the surroundings of Savannah; I hall not much time to examine into the condition my::;elf, but requested .Mr. Blois to go and make a personal ins]Jeetion of Bilbo's canal ; the ditches of Springfield plantation had been full of stagnant water, covered with green coating of slimy matter; the lands of the Central railroad were pretty much in the :-;ame condition; the condition i::; worse than in the paRt eight or ten years, to my certain knowledge; in the early part of the ,;eason there was a ,;trong, perceptible privy smell-an eftiuvia was emitted from the sewer traps ; there had been many complaints from the citizens on the subject, and I noticed the same myself; this spring the condition was worse than before; observed the same in 1875, during which season typhoid prevailed to a large extent, and I attributed the smell to the sew_ ers; I noticed thest> things in walking out Whitaker street to my home after nightfall; 1 only know of the condition of Bilbo's canal from those in charge, and reports of person;,; who bad visited it; no case>; of blaek vomit to my knowledge prior to the 21st of August; the first case eame under my observation 1st 8eptember, in St. James Square; don't know the cau;,;e of the foul condition of the land in the vicinity of Musgrove ereek ; the surface water covered the ground for over half an acre. Jn order to furnish your Board with the fullest information on this important 1-!Ubject, and to facilitate the business of investigation, I have prepared a pa1>Jer giving my views, which I w'ill, with the permii:ision of the board, now read:
On the 27th day of June, 1876, I was ealled to the case ot' a negro, aged 21~ yean-;, named Jame::; Reynold~, whom I found in a state of great prostration and anxiety, attended with cold sweats, suppression of urine, and vomiting of a greenish mucous fiuid, tinged with blood-the ejecta being of i:IO adhesive or coagulable a nature, that the contents of the basin could be lifted in mass from the ves;,;el, by running a stick beneath the fiuid. There was no excitement of the pulse; on the contrary, the whole condition was one of marked depression of the vital powers. About the

APPENDIX.

XXIX

same time I saw, in the same neighborhood, several eases of fever

of a distinctly congestive type.

.

These parties resided in Eastland, lying on the nortlnvest border

of the Teynace and Cayler swamps, and between said swamps and

the southeast border of the city. These swamps were covered

with stagnant waters, and these waters in turn filled with slimy,

greenish yellow looking excrescent masses on tlleir surface. The

smell emanating from them was that known as of ~tagnaut mud-

puddles.

On the 1st and :37th of July, and ilth of August, I visited the

sick children of Mr. H . .T. Nungeyer at a place known as \Vood-

lawn, on the we;;tern border of the city. These eases were of such

a malignant type of fever that, in viewing the eondition of the

surrounding lowlands, which were in a ;;imilar .;tate as that de-

scribed in relation to the southea>Jt section of swamp lands, I ad-

vised Mr. Nuugeyer, that if he did not move his fnmily away at

once, it would probably cost the lives of one or more of his family.

He remained there with his family, never entering the city, or

permitting any member of his family to do so. About the last of

September hiR two youngest children were again taken sick, the

parents say exactly a1:< when I saw them in .July. The baby, eleven

and a half months of age, was brought into the dty (no physician

being able to go that far out) and placed under Dr. Charlton';; care,

who pronouuced the case malarial fever. The child died with

black vomit a day or two thereafter, (September first.) 'fhe oldest

one, a girl about three years of age, was a!Ro brought in the city

with a similar fever. 'fbi~ child was placed under Dr. Duncan's

care, and vomited black vomit, and died on October 3d. Neither

of these eases had any eommunieatiou with this side of the canal

prior to their last illness.

On July 16th, I visited a mulatto woman at Brownville, who

had been sick a day or two before I waH called in. The ease was,

in all respect;.;, Himilar to many in which I witnesHed black vomit

later in the season-great prostration following upon a severe fever

of three or four days' duration.

On August ith, I visited a lad named Edward Derby, corner of

Whitaker and York streets, in the centre of the ciy. I found him

suffering with a severe grade of fever, contracted from perambu-

lating too freely in the hot sm1 through the low lands adjoining the

city. 'fhis attack was eharacteri:.~ed by similar symptoms to those

Jttfecting himself and brother:.; in subsequent attacks in the same

house later in the season ;-three brotlwn; being all down at onee

with the fever.
On August 16th, r was called to Miss Bailley, matron of the

Abrams Home, corner of East Broad and Broughton streets, who

XXX

APPENDIX.

had (I am now satisfied) a well-developed case of yellow fever. The jaundiced hue of the eye and skin, and extremp prostration following upon the decline of the fever excited my attention at the time. About a week before that time I saw several c-ases of fever near the junction of Arnold and Liberty streets, having the flushed countenance and injected eyes like the fever of 1858, and remarked it to my friend Dr. Schley, who, by my advice, sent his family a,way shortly thereafter.
During the week commencing August 20th, I Haw several cases in various sections of the city. Amongst the number that of F. V. Masters, a plumber, residing on the corner of :Kew Houston and West Broad streets, which I unhesitatingly pronounced a characteristic and violent case of yellow fever. The same week I saw cases also in \Varingsville, on the southeast of the city. After this the spread of the disease was rapid, making its way from the borders of the city towards its centre.
In the early part of August complaint was made to me by residents in the eastern part of the city that the Bilbo canal, the sewage vent of the city, >Vas in a dreadful condition, and that its stench could be smelled at a distance of several hundred yards from its line, especially at night. To ascertain the truth of this, I requested my friend, Mr. A. J. J. Blois, to make a personal inspection of it for me, and, meantime, I inquired ot l\Iessrs. .John B. Hogg, city surveyor, and J. K. Munnerlyn, dry culture inspector, as to its condition.
Mr. Rogg replied that the floodgates at the river outlet had been out of order the whole season, and the authorities objected to letting the water flow in and out lest the banks might be overflowed, and the city be sued by Dr. Lawton for damages to ~1is crops, (as had occurred previously.) He admitted to me that no system of flooding or cleansing had been pursued since the previous fall. 'I'hat is, November, 1875.
Mr. Munnerlyn informed me that he was fully aware of its condition; that it was, if anything, in a worse state than had been represented to me; that he had called the attention of the Mayor to it, in May, again in June, and July; and that the :\layor had positively forbidden him to give any attention to it.
Some years previously I applied to Mayor Anderson in relation to draining certain surface ponds within and near the immediate southern border of the city ; but I was repelled with the deelaration that he "ol:\jected to spending any money beyond the taxable limits of the city." I plead that malaria would sweep from these ponds into the taxable limits, but my plea was of no effect, and the southern section of the city was left to suffer.
Immediately on receiving the above information from these

r
~

APPENDIX.

XXXI

officials, and having it corroborated by Mr. Blois' personal inspection, I published a letter pointing to these sources of disease so as to bring the weight of public condemnation on the authorities, and force them to give heed to the work.
I learned, a few days thereafter, that some steps were being taken to let the tides in and out of fmid Bilbo canal. In my judgment, the filthy condition of our adjoining low lands, the abominable atmosphere emanating from the Bilbo f'anal and itfl tributary drains, and the improper conversion of ~ewerR, originally constructed only as water-vents, into conduetors of human excrement, render it scarcely necessary to look much further for the causes ofour late terrible scourge. And in this view I feel strengthened by the evidence displayed, in tlw very nature of the rliHPase itself, since relapse after relapse was not uncommon-the system being re-infected with new poison as constant in it~ intluenee as it was cumulative from its inception. 'rhere is no source of typhoid and malignant disease known, so prolifie as that of decomposition of ~uman bodies and human deposits; and every practitioner who had any considerable experienee during thP season just passed, cannot have escaped from observing the peculiarly malignm1 t and typhoid character of vast numbers of the cases.
Respectfully submitted. L. A. FALLWAN'l', M.D.
NoTE.-Vessels have emptied their ballaHt in all previcmH yearH just as they do now. and no trouble has arisen therefrom.

[COPY.]
U. S. CoNsuJ,ATE GENERAL, HA YANA, October 21st, 1876.
JAMES A'I'KINR, Esq., Collector of Customs, .Savannah, Ga., SIR-I have to acknowledge the receipt, on thP 16th instant.
of your letter of the 19th September, aceompanying a eopy of another addretised to you by the Hon. .John Sereven, asking for information upon the several point,.; embraeed therein, respecting the preYalence of yellow fever in this city and adjacent places.
1st. "As to whether the yellow fever I' vomito') has existed at Havana previous to the 1st September, ultimo; and during what period previous to that date:"'
Several cases WPre reported about the middle of May, and the disease eontinued to prevail during .June, .July, August, and until about the middle of September, when it appearR to have eeased, except a few isolated cases.
2d. " As to the degreA of violence of the fever, and its epidemic extent?"

XXXII

APPENDIX.

The number of cases reported in the different hospitals of the city, during the month of June, was 298, out of which there were 145 deaths ; from which it will appear that the ratio of deaths was a little over fifty per cent.
The "Real Academica de Ciencias Medicas," etc., without furnishing the ration of deaths to the number of cases, gives the following as the total number of deaths from yellow fever during the three summer months :
June ............................................................................291 deaths. July ............................................................................ 685 '' August........................................................................259 ''
3d. "As to whether it prevailed especially in the city, or at any place or places near Havana?"
Its prevalence in Havana bas been to no greater extent than during other years. It prevailed also in other places, but to a very limited extent. At Matanzas there were a few sporadic cases ; at Cardenas no cases; at Cienfuegas, Trinadad and Santiaga de Cuba there were several cases. In all of these places yellow fever has prevailed during other years, to as great an extent, proportionately, as in Havana. At the date of this writing, it is believed that no cases exist in thi' or either of the above-mentioned places.
lt is doubtful whether the statements furnished by the "Acadmy" are complete; but it is quite impossibie to obtain others more trustworthy from any other source. The local sanitary boards cannot furnish them. In fact, there seems to be very little interest taken here by any one, in making up or keeping such statistics.
Yellow fever is known here as the endemic disease of the Island, '' la enfumedad endemica." The African and Chinese races appear to be quite exempt from it, as are also the natives of the Island, except in rare cases.
I enclose herewith the July report of the above-mentioned "Academy of Medical Sciences." On pages 119 and 121 appears a discussion upon the yellow fever, which I doubt not will be found of interest.
I remain yours, very respectfully, HENRY C. HALL, Consul General.

P. S.-Since the above was written, I have received a statement

Khowing that the number of deaths from yellow fever during the

month of September was 97 only.

A true copy.

J. R. DILLONS,

Secretary Local Committee.

APPENDIX.

XXXIII

CUSTOM HoUSE, SAVANNAH, GA., CoLLECTOR's OFFICE, December 13, 1876.
V. H. Taliaferro, M.D., Secretary State Board of Health, Savannah, Ga.:
SIR-In compliance with your request this day received, I have the honor to enclose herewith a list of vessels arrived and entered at this port from Cuba, from January 1st to September 1st, 1876.
Very respectfully, A. C. SMITH,
Deputy Collector.

a List of vessels entered from Cuba, at the Custom House, Savannah, Georgia, from January 1st, to September

1st, 1876.

__ --~ _______

<

==:======
.

I l ~ ~~

: , \z \z Date.

1 ~ativlty
I

Rig.

1 Nalllt' of Vessel.
I

Name of ~1ast<:r.

~rom what Poit. I 6~ 'Oti ~=;,;

I0

6

~~

.Janu~ry3~ Spatu~h=~..~= Bark ....~=j~Ltr~=-== Juau~wau ................... 1 Hava11a i----s;)--u-;)5B~

Jann~rJ: 12..... Span~sh .................. Btt_~k .... ::: Hapha~1.P?mar., ......... Fr,wc~sto Vurit ............ :l;~v:m~ ................... I 41~. 1? B~llast .

..Jamury 12....... tipamsh ........... ,.. ., .. Bng ..... jAJmoga\ei. ................. l\l.l\fl.let ...................... l.,tv<tn,t..................... January HL ...... American ............. Schooner .............. Geo. \Vashington........ S. P. Hoff .................... l8araeo:1.................. :

257.3Jj1

11. Ballast. 5 Cargo.

m~:ili ~t-~:~: ~~;~~~~: ~~~~ :~ ~~:~ l;tr~::::;~.:. ~.:.:.: ~nlt~i~~~:,~~:~t;~~::::~:~: ~~1:t~vf.~~t:>~~:::::::::~~~ii~~:::::::::::~::~~~;::: ~~fi 1~ ~~~im: ~ 1

:.: . i 1

t

.ranuuy 24 ...... rAmeric:r.u ............1Schooner.............. 1J, A. Brown .............. J.P. Collins................. ,<;::ardeuas ...................... li::il

.s Cargo.

~

l February 2....... 1')panish .................. Bark ...................... [Josefa......................... V. Jerrasin................ ICienfuegos .................... ! 1/,)l 1:3 Ballast.
Feuruary 8....... ]:\panislJ .................. ,Bark ..................... Antoinita ................... Jose Salihs.................... !Iavana ........................ 8~01 14 Ballast.

~
~

Februaryl:) ...... i..\merican ............. jSchoouer.............. 'E. M. Sawyer............. ~- D. Kelley............... IIIavana.......................... 131/ fi (~argo,

Z

Feuruary21 _.. !Spanish.................. Brig................... San Jose ..................... G. Plauas ..................... Havana ........................ l 2!JBI 14 Ballast. t:J

February 25 ...... 'Spanish ................. .'Bark ...................... XU Junio ................ J. Ri!Jeras ..................... IHavana ....................... ~ 570, 16 Ballast. ~

February 2G ...... :1Spaui;-;h .................. ;Brig ......... c ......... ~emesia ............... ~ .. J. Crusnas.................... ~C[!rJ.euas ...................... ! 2431 11 Ba:last



February29 ...... !Amt:.rkan ............. tSchooner.............. G-eo. Washington ......... Roff".............................. jBaracoa........................ l 7;-)j 5 Cargo.

March lst.. ....... ' American ............. 1Schooner............. B. F. Lowell ............... J E. Bunker................. Matanzas...................... l :125/ slcargo.

lllarch 2, .......... Am,;rican. !Schooner ........... IJ. A. Brown ............. J.P. Collins................ ]Cardenas ...................... !

1

0

~~~~~ f~: :::::::::~~;;~~~~l::::::::::::::::::::~:r"~::::::::::: : .::: ..~,:~~~:~ .;.~.:::::::::.:::::::: ~~~0~;~~.~:::::::::::::::::::::~~~~~::~ :::::::::::::::::::::::: :lfar~h 28 .......... Spanish ......... -........ ,Brig .........,........ Enrique...................... .\I. Lloria ...................... lfavana........................

Aprll5............. 1American ............... 1Schooner.............. .J. A. Brown................ S. P Collins .................. Cardenas......................
.I1 April2.!i. ,_ ........ 1;span~sh .................. Barl< ..................... Tres. Auroras ............. J. Castellaw .................. IIIavana.................. _.....

N. lllay !6 ............ Spamsh ...................Bark ........... .. .

S. de las Angelo..... l-\, Torras ...................... Havana........................

m;17:l.
150 17;;11
318[ 417:

June 1~1 ............ BrHis? .................. IBrig ....................... Joshua King............... Thomas Howard........... Cal'cleuas...................... 810,!

:f~l: }1:::::::::::::1:~~~~l~f1:::::::::~::::::::!~:1:: ~:::::::::::.:::::::::~~~~~~..~~~~~~~-:..::::::::: i ~~~lo~r;~~-::~:::::::::::::::lfi~~~r;l~~~:::::::::::::::::::::: ;1g~!

July l.l;"'"ldpan~sh .................. \Br~g ....................... Ynos........................... Jose Galjana ................ Ha\'ana........................ 1~1~

Aug-ust ~- ........ Rpantsh ................. ~Br1g....................... Pepe ........................... I->cdro Bayona .............. llavana........................ lol

7[Cargo.
iii~~D::L
v(Ballast. 71Cargo.
101Ballast. 14~!1BCaarlgloa.st.
i~[ ~:n~~:t"
11-Ballast. lOtiBallast.

AuguslJt; ......... J8panish .................. [Bark ...................... Maria Carolina............ Pablo Carran................ IHavann........................ G05 ~!~~-~~~;.:_:-_:_:_~~~~~~~~~:__"''''''''"'Brig ...................~r1ofita ........................ E. A1sina ..................... tlavana........................ 261

lB Ballast. 13 Ballast.

List of Vessels arriving from various Foreign (southern) Port~ from .January 1st to Fleptember 1st, 1876, other

than from Cuba.

------

k"0

Date.

Nativity.

Rig.

Name of Vessel.

Name of Master.
1

Port.

~

::;

~.,~

January 26..... French. i~=~.:::-:::::)stadtFrankfurt. =[c. H-;;-,.-;~~===l~I an Domingo................

~ 500

~

~

14 B:lat.

February 28..... Gtrman ................ Bark ...................... 1Marie Adelaide ........... B. Pocatls .....................,8t. Thomas................ :l~O 13 Ballast.

March 3............ Spanish .................. ,Brig ....................... Salvador .................... P. C. Amaas .................. LaGuaria, Yen.............. 161 11 Cargo.

.>,
~
t::l
~

March 8............ British .................. IStcamship .............. Ariel.. ................" ....... J. Isbister......... .

Hayti aud Jamaica....... 722 25 Cargo.

March 10.......... American ............... Schooner................ G. L. Bradley ............. C. Chipman ................. St. Thomas.................. 179

7 Ballast.

May 12 ............. September 28....

German .................. Spanish ..................

Bark................... Louisa Gcllm.............. !lark...................... !Olympia: ...................

Carl C. N

Steuve .... adal. ........

. .

. .

. .

........... ...........

1
)

B.io de Havan

aJa..n..e..r.o.....=..~....:..:._.._.._.___i4_3801_

11 Cargo. ___1_4_!l"ll_ast._

'''Arrived at Tybee, August 18. - - -

s

XXXVI

APPENDIX.

CONTRIBUTED BY F. W. S. WOOLHOPTER.

SAVANNAH, GA.
The Yellow Fever Epidemic of 1876 in ,Savannah:
The writer makes no excuse for pre~enting this paper, but the great interest he feel~ in the subject herein discussed. Three times in the course of a short life-time has he seen this fair city devastated by the pestilence that is now destroying our citizen,, and if his effort:; can aid in traeing the rise and progress of the epidemic, or give a juster idea of its nature, his labor will be well rewarded.
We did not commence this inquiry with any set purpose in view, merely desiring to ascertain in what sections of the city the yellow fever was most seriously prevailing; but, as we advanced, the facts presented themselves in such bold relief as to force conelusions, or, at least, strong inferences, upon us-and so we present them, tllat other mind;,; may see and judge.
Admitting that it is unsatisfactory to argue from incomplete data, we, nevertheless, open the subject with such information as we have access to, asking no more than due allowance for its weight, and hoping that some orF~ with more time, and better facilities, will pursue the problem further.
Our facts are gathered mainly from the reports of the district committees of the Savannah Benevolent Association, with some small additions from other sources.
On the 29th of August it was publicly stated on our streets, by physicians, that yellow fever was epidemic, and the mortuary report for the week ending August 28th, admitted nine deaths from that cause.
The Savannah Benevolent Association immediately organized its visiting committees, and on September lst they were fairly at work ; since which time to the present (October 8th, '76) they have reported closely approximating four-fifths of all the deaths that have occurred in the city from all causes. [Table D.] It iR proper to remark, that from the whole number of deaths reported by the Association we must deduct the number of deaths in the infirmary and hospital, because weca nnot determine locality of origin of sickness in these cases, which will leave us between twothirds and three-fourths of the whole number shown by the mortuary reports for the same period 0f time, to proceed with in our inquiry.
Tabulating this information day by day, and consolidating the figures once a week, or oftener, we may gain a very fair knowledge of the course and progress of the disease. The table (A) we

APPENDIJ(.

XXXVII

present ha~, on the left, the numbers of the districts, as laid out by the Savannah Benevolent Association, and described in its advertisement in the Morning News; opposite the number of each district are the figures representing the number of deaths in that district, for the time stated at the head of each of the >leveral columns. It is to be stated that the deaths reported were from all causes. We shall barely refer to the number of cases of sickness reported by the Association, as it is impossible to grade them. For the purpose of the enquiry, we are forceci to assume that the duration of sickness in fatal caseH averaged the same in all parts of the city.

XXXVIII

APPENDIX.

.

.'
Bilbo'ii Canal Is about half a mi.le east Sof B road iitrQet.

APPENDIX.

XXXIX

See map. [A word as to the situation, extent and population of the districts. The main dividing line was Bull street; extending eastwanl from it to East Broad street, commencing at the river front and going south, were cli~triet~ eight, to Broughton Rtreet; nine, to Liberty street; teu, to Gaston street; eleven, to Anderson street, the city limits-all these districts were seven block;,; from east to west. From Bull ~-;treet westward to West Broad street, commenciug at the river front aml going south, were districts twelve, to Broughton street; thirteen, to Liberty street; fourteen, to Gaston ~-;treet; fifteen, to Ander;;on street, the city limits-all these districts were five blocks from east to west. Numbers 8, 9, 10 and 11 were opposite to numbers 12, 13, 14 and 15, respectively, but the former were fifty per cent. the larger in extent, except that twelve, which has a projection toward the river, probably equals eight-eight and twelve were only about half the size of the other districts in their respective sections, and being the business portion of the city, are probably thinly populated as a whole. Numbers 9, 10, 11, 13, 14, and 15 comprise the heart and best portion of the city; and from. them, mainlv, was the exodus of six to eight thousand ilouls. Of the border districts there were, on the west, from West Broad street to the canal or other limits, commencing at the river and going south, one, two, three, four and sixteen. 'l'wo was a small district ; four wa~ large-all are densely populated, and contain many negroes. On the east, from East Broad street to the limits, commencing at the river and going ilouth, were five, six and seven. Five was not very large; seven covered much ground, but it is thinly populated-all contain many negroes.]
Review of week, September 1st to 7th : A study of the daily reports show that, at first, the association found five, the gas house district, on the extreme northeast, the worst infected in the city; while one, on the extreme northwest, was next. Both these districts are on the river front, the space between, some three-fourths of a mile, being the main business portion of the city. :From five the infection extended into the eastern edges of eight, (adjoining five on the >vest,) nine and ten; which latter uecame, in the last part of the first week, very bad, and ran up the largest bill of mortality on the hst for the week ending September 7th, and has ever since continued to show a heavy death-rate. Ten lies immediately west of the Atlantic and Gulf railroad depot yard, which, we have it on good authority, was in a condition during the summer, from stagnant water under the flooring of the cotton-yard, to cause or aggravate malarial disorder. Six and seven, to the south of five and east of nine, ten and

XL

APPENDIX.

eleven, though bordering the low lands to the east of the city, and nearest to Bilbo's canal, were very slightly affected ; and, it appears from the t<tble, that they have so remained. We have indicated, above, tte characteristics of these districts, (6 and 7); eleven, on the southeast, was but slightly affected.
On the west, five and three, to the south of one and nearest to the low lands west of the canal, were but slizhtly affected, and appear to have so remained, being similar irt this respect to six and seven, on the eastern side of the city. We have indicated above, the characteristics of one and two. Four, to the south of three, but having the lar~:;e depot of the Ce~tral railroad intervening, though bordering on the Springfield low lands, reported no deaths until the lai.ter part of the first week, and then only three; while sixteen, on the extreme southwest, was un:>cathed, >md has suffered very little until very lately, (October 8th, '76). Twelve, immediately east of one, was hardly touched in the fist week; but thirteen, south of twelve and southeast of one, was seriously affected, and showed the largest total of mortality on the list, though a fine and central part of the city, and much depleted by the exodus. Fourteen and fifteen, souLh of thirteen, have caught the infection slowly, but, since the lOth oi September, the fever has held a remarkably steady grip on the former, and latterly, (October 8th, '76,) has smitten fifCeen severely.
Thus, it appears, that up to the lOth of September, the fever was, in the eastern part of the city, raging in o.illy the fif~h or gas house district, with a good bola on the easter~1 edges of eight, (next west of five,) nine and ten; that, on the west, only the first was seriously hurt; while the thirteenth, in the west-centre, protected from the malaria of Springfield low lands by the high bluff of the Central railroad depot, west of it, and surrounded by districts almost uninfected, wa,; well afire. This was one of the phenomena of the epidemic.
Review of week, September lOth to 17th: Now. let us take the week ending September 17th. Here we shall note some changes. Iu five the disease appeared to be on the decrease; and here we may say that, since the 17th of September, only two deaths have been reported by the association, making twenty-one in all. Had the proximity of the gas house anything to do with this? We admit that we perceive no very noticeable odor on passing the gas house ; but the question remains. The disease surely did not run through with all the material at hand, for the association has reported, from September 1st to October 7th, only one hundred and ninety-six cases of all kinds of sickness in the district, of which number fifty-one were not reported as yellow fever, and it is probable many others were not.

APPENDIX.

XLI

Just here let us state a consideration. The ratio of mortality to cases of yellow fever might be inferred, from the reports of the health officer, for the time he published them, (93 deaths, 517 cases, up to September 7th,) to be one in four. As twenty-one deaths have been reported by the association in five, it would appear that about one hundred people there had been attacke!A. So much for five. This is the second phenomenon.
Six and seven showed a slight increase of mortality, but this appears to Lave dwindled away in succeeding .weeks, and they make a good :,;bowing in the table. In eight and nine the fever held on steadily, mainly in the eastern edges, with no marked increase. In ten there was a temporary decrease; whiie eleven was, as yet, but ~:ilightly affected.
On tile west, the first showed an increase, and the fever has held on there with great tenaeity since, not abating markedly until since October 1st. Two and three showed an increase, but this has not been followed up to any great degree, and they, as remarked bei"ore, like six and seven on the east, make a favorable showing. This is the third phenomenon.
The most noticeable item, indicated in the column September 17th, i:; tlw tremendous swath mowed in the fourth by the grim destroyer. Up to September lOth, only four deaths had been reported in thi,; district; iu the week ending September 17th, there were thirty-three-by far the largest number in any district, for any one week, and making its mortality for the whole time lm;s than that of the thirteenth only. 'fhe suddenness of the falling off in four was almost as surprising as the sudden increase; the table shows that the number of deaths in four, for six days next after September 17th, was eleven; since which time the fever has held on there at about that reduced rate. This l:lUdden ignition appears to L>we proceeded from thirteen, as we see twelve, to the north, and fourteen, to the south of it, were now in fiames, from probably Llw ;;arne centre. This is the fourth phenomenon.
By referring to the table of wind;:;, it will be seen that, during the time of the terrible mortality in the fourth district, and for some days previous and some days after, the winds were westerly ; so that, admitting that the fever spread from the thirteenth district to the fourth, fourteenth, fifteenth and sixteenth, it worked against the wimls at that time prevailing, into the fourth district, and across tllem into the fourteenth, fifteenth and sixteenth. This is the fifth phenomenon.
Now the whole western side of the city was ablaze, and the wave came sweeping to the eastward, to meet tht> other conflagration, which had seemed to burn less broadly, and bad not advanced in
4a

XLII

APPENDIX.

force further westward than about Price ,;treet. 'l'be fires seemed

to join about the 20th of September, a,; appears from the equaliza-

tion of the death-rate through all the central districts, in the col-

umn of September 23d.

,

Since the 23d of September there appears to be no special char-

acteristic of any one district, if we except the sudden, and con~id

erable, increa:;e in the tenth. There bas been some increttse, also,

in the southern part of the city, as a whole.

There seem,;, since October 1st, to be a premonition of a general

wavering, flickering-out, how long to be delayed we know not.

In the last week, \October 1st to 7th,) the fever has decreased in

all the districts where it ha,; raged most, except in one, (lOth.J

'l'he increase in the other di:;tricts will probably not be followed

up.

By comparison of statistic:; of three epidemics ['l'able t ] of yel-

low fever in this city and Charleston, it appears that they have two

weeks of climax, usually the fifth and sixth, which last will, in

this latitude, generally end between the 18th to 25th of September,

after whicit the decrea,;e of mortality is sudden and rapid. 'l'bis

decrease we might have experienced, and we bad strong indica-

tiow; of it on the 28th and 29th of September, but shortly after, it

is probable, that we began to feel the effects of the cleaning-out of

Springfield low lands, which has left the wet lands exposed to a

hot sun; so that, instead of a rapid decre;tse, we are likely to have

a continuauce of the climax; for the ordinary malaria seems to

be a powerful helper of the yellow fever type, and the former

seems to have rnuch complicated matters in this epidemic.

Referring to the table of winds, we may here remark that eas-

terly (N.E., E., S.E. and S.) winds prevailed dur.i.ng all of August,

exeept the time from the 15th to the 21st, inclu:o;ive, when westerly

(S.W., W. and N.W.) winds prevai.led. From the 1st to the 7th,

and from the 27th to the 30th of September, the winds prevailed

from the eastward, (N.E., E., S.K and S.); from the 8th to 26th

of September, the wind prevailed from the westward, (S. \V ., W.

and~- W.). Only the winds mentioned :1bove as westerly could

bear miasma into the city from Springfield and vicinity; south

wind,.; would blow it off-north wind>< would not seem to affect the

matter either way, except the southwest corner. We refer, in

passing, to the table presented herewith, showing comparative

mortality in eastern and western sections of the city, as divided

by Bnll street, [t>tble C] ; and, in the northern and southern sec-

tion:;, a:; divided by Liberty street, [table B].

Now to summarize: From the facts presented, it appears-

1st. That an isolated di:;trict (thirteenth) in the best quarter of

the city, was infected almost two weeks before its neighbors, and

APPENDIX.

XLIII

though much depleted of population, it has suffered most of all in deaths.
2d. 'l'hat the fever had almost disappeared from the district (fifth) where it i;; said to llave originated, in about three weeks having inflicted a comparatively small loss; and tllat there i;; a gas house in this district.
3d. That most of the districts (five, ;;ix and 8even, on tlle east, and two, three and sixteen, on the west) lying coutigious to the miasmatie low lands, have suffered comparatively little.
4tll. Tlmt one distriet, (fourth,) in a position as exposed to malarial intiuen<.oes as any in the city, was unhurt until, apparently, set on fire Ly a centrally loeated district, (thirteentil,) and that, after one week of fury, the disease held on there at a greatly reduced rate.
5th. 'fhat, while tile eastern conflagration ;;eemed much weaker than the western. and did not spread we~tward of Price street with any great force, still, the fever has appeared to make westward and southward from the thirteenth district to the fourth, fourteentil, fifteenth and sixteenth, against and across the winds then prevailing.
Kow, what conelu;;ions can we arrive at from this state ot facts? The di:oease is in one of the best, most central and most proteeted districts of tile city, about as soon as it is anywhere else, (13th;. In a very ,;hort time it almost disappears from the district \5th) where it is said to have originated, though this district would appear to be sul>ject to malarial influences. Six of the districts (5, 6 and i, m the east, and 2, 3 and 16, on the west) most exposed to malarial influences from Bilbo's eanal and from l::lpriugfield low lands, appcarto iltwe been sliglltly affected. Annther district (4th) equally ~xpo~ed, e;;cupes until, apparently, set on fire by the firstnamed central district, (13th). \Vhile the pestilenee coming from east stays it;; steps at or about Price street, and that from tile west ad vmwes gradually to meet it; that is, while the general direction of the epidernie, during the month of September, seemed to be to tile east, and while the winds prevailing during mo::<t of tllat mouth may have assisted this movement, still, during that same time, it appears to have spread southwestwardly and south. \Vouhl miasmatic cryptogamous spores, if l>lown upon the city from eitiler side, leave the borders so lightly toPchcd? If the wind Lore the germs of disease from Bilbo's canal on the east, would the centre of the city have escaped, for a considerable time after the eastern and western l>orders, (for the fever appears to have started in l>oth at about the same time,) had been infected'? The like question may be asked as to Springfield, on the west. And, further, if the germs were borne from Springfield by the

XLIV

APPENDIX.



winds, would they have spared the fourth and sixteenth districts, directly in their path, until the thirteenth had long been infected? Finally, if the winds bore the germs into the city, would the disease have "'pread gradually, from foci, instead of being sown broadcast? Affirm~ttive answers to these questions would seem absurd.
Let us srate, as plausibly as the fact~:; will admit, a proposition based on the theory that the winds bore the germs of disease into the city. To prcmi~e, Dr. White, of New Orleans, states that the fever manife~ts itself in about four days after the germs are taken into the system. 1" New,.," Oet. 21, 1876.) We will suppose that the ea~:;terly winds, whicll prevailed from the 1st to the 15th of August, were the means of infecting the eastern part of the city; and that the westerly winds, which prevailed from the 15th to the 21st of August, were the mean~ of infecting the we;,;tern part; for the fever broke out there just after tlle latter elate. Easterly winds, from August 2h;t to E:leptember 7th, increased the eastern fire, and kept down the western ; anotber change to westerly winds, on September 8th, brought the cryptogams into the fourth and other southwestern district8, and, these winds being continuous from the 7th to 26tll September, determined the direction of the fever wave from west to east. This, the best we can do with the facts, fails to aecoun t for the absence of the infeetion in the fourth, and neighboring cli~tricts, after the westerly wimh; from August 15th to 2h;t, which, we have suppo~ed, infected that part of the city. Again, we are at a loss to know why the central portion of the city was uniufected, by either easterly or we;;terly winds, unless we admit that cryptogams are blown only to a certain height, and, being lodged in the tr0es and against the houses of the suburbs, have to work their way gradually inward. But perhaps some modern Ulysses, having bagged all unmanageable winds, may explain these matters. Perhaps some familiar with eryptogams may know.
'rhe conclusion seems forced upon us, that the ,;pel'ific poison, or germ, which produces yellow fever, was brought here from abroad; and finding our atmosphere strongly charged with the ordinary miasma, whinh produceR among us remittent and intermittent fevers, and which, :u; we rcmarkerl above, when speaking of the work on E:lpringfielrllate in :::leptember, is a helper and conductor of yellow fever, it has found among u,; food and shelter. This position seems to be sustained by the large number of deaths, stated in the mortuary reports as from other fever,; than yellO\V fever. The effect of the gas house on the district in which it is ::;ituated, we leave for others to inquire into.
And now, finally, we say, that it seems to us, although we ad-



APPENDIX.

XLV

mit that our data are incomplete, that the labors of the Bavannah Benevolent Association have furnished a clue to the mystery; and that, if our authorities will take this clue, aml pursue it diligently through the labyrinth of details ;.;ubmitted to their inspection, they may issue into the bright light of truth, and it may be perfectly possible to free i"'\avanuah from the imputation of originating yellow fever withiu her borders.
It only remains to say, that whPro they are known, it is unnecessary to enter a plea for the pe1sonel of the 8avannah Benevolent Association.
SAVANNAH, GA., October Htb, 187ti.

NOTE.-We have spoken of the thirteenth diHtrict as the focus of the fever ill. the west-centre of the city, lmt wo fiud that it is claimed that the fira'i. case in that section was in Stone street. which is in the northwestern corner of the fourteenth district, close to the line of the thirteenth. The fever seems to have spread from there rapidly into the tilirteentb, 'and thence to have advanced on all sides.
It occurs to us to add a few observations:The writer was unaware, at the time the above artiele was written, that he had been preceded in some of hiR conclusions by observations elsewhere. In the News of October 21, 1876, it is announced, on the authority of Dr. '\Vhite, of New Orleans, that the yellow fever germ travels as often against air currents as with them, a~ in this epidemic, when it went from the thirteenth distriet to the fourth, against the winds then prevailing; also, that the disease ,.;preads from a focus or from foci, as notably in the ca;;e of tlH' thirteenth district, in this epidemic. The fever is of that class of diseases known as r.ymotic, that is, proceeding direetly from a germ or stem, which, being introdueed, may permeate the whole of the IJlood of a human body, or leaven a whole con1.munity, as yeast does a loaf. The Registrar General of Great Britain state~, thut about onefifth of the deaths in the British Isle are from zymotic diseases, and statistics show a like state ofaffain; in this eountry. 'rhis is a statement of much significanee, as it is considered possible to prevent them by proper precautions. The readers of the Jlforning News (August ill, 1876) will remember a remarkable instance of the prevention of yellow fever, given on tile authority of aU. S. Surgeon, (Cha>'. E. vVarren,) who claims to have prevented a body of sixty men from even taking the disease, which wa~ raging all around them, in the town of Brenham, Texas, in 18H7, by frequent disinfecting and whitewashing, and by the use of doses of mustard in whiskey. We do not know what estimate would ~be fair for

XLVI

APPENDIX.

'

the effect of mustard seed, hut we do not think it can be doubted

that the lime and disinfectantR were effective. \Ve conclude that

on the breaking out of an epidemic, the district infedPd, and even

the whole city, should be energetically disinfectetl and wllite-

washed.

EXTRACT OF LECTURE OF PROF. TYNDALL.
As to the theory that each disease is caused by its own spE'cific poison, we fin<l that Prof. Tyndall, in a lecture lately delivered at Glasgow, Acotland, says: " Our knowledge of fermentation, and tlle grouml it covers, is greatly augmented of late, and every fresh acquisition confirms the hope tha: its final issues will be of incalculable advantage to mankind." i:'lpe.tking of animalcuhe: "Tlle bact.-.rium remains a bactarium, the vibrin a vibrio, etc. Sow any of these in an appropriate liquid, and you get it and it alone, in the subsequent crop,. In like manner sow small pox in the human body, and your crop is small pox; sow Rcarlatina, and your crop is scarlatina ; typhoid virus, your crop i,.; typhoid ; choler<t, and your crop is cholera. The disease bears as constant n relation to its contagium as the microscopic organisms enumerated do to their germs, or as a thistle docs to its reetl. No wonrle1, then, with its analogies so obvious and so striking, that the eonvietion is spreading and growing daily in strength, that reproduf'tion and parasitic life are at the root of disease. The liviug ferments, finding lodgement in the body, increa~<' there and multiply directly, ruining the tissues on which they subsist, or destroying life inclirectly, by the generation of poisonou.~ compounds within the body. This conclusion, which comes to u~ with a pre~umption almost amounting to a demonstmtiou, is clinche<l by the fact thnt virult'nt infectious diseases have been discov0red, with whi<~h living organhm:u; were aR closely and indissolubly asHociatcd, as the growth of torula is with the fermentation of beer."-Savannah News, Nov., 13th, 1876.
In the Savannah News of 27th inst., (November,) Dr. Simms give,; instauces of terrible epidenlics at Gibralta, Spain, on a bare and lofty promontory, 1,500 feet above the sea. There were no mar,;hes to produce this effect. 'fhe epidemic germ must have been imported.



APPENDIX.

XLVII

A.

Deaths from all causes, for time stated at head of rflspective columns, as reported by S. B. A.

~~-~----------

--=------=-=:-:::=:==:::::.=__::~-

.~:_~.
.....

!.1~.2 -~..: ~~...., ~;; ~ ~ ~g..; ~2 .~ ~1-51..,1{-:o ~

.... (fJ

lt-..d .B~~~~~.;:.s~ ~z~:::. ~ - ".L

..,. "f. L _,

I

CO -

"fJ ~.~.:-: 'IJ

..... i:IS

~.s~ ~BQ "d ,... '.1) 'd ...;. 0

1--

t- tn

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~

..t.:.l..l

......:.:.

.-.....

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....,.....

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:-':'1

~

----~-------

! .............. \ 9

:J

I~

2 . ... ..... 2 ...... [ H

I !6 42 11
4 14 2

I 57

0

21

c.

3......... .... ....... u

9

!;) 6

9 80

4............... 3 3............... 1~

I I

:J!:l

...I..I....,

48
!~

1.'
I

10 1

7:3 - 181. ............... Western, 2!

~............... 4 ~ ~ 1~ ! ~~ ....~t ~ ~2-

tl8 Eastern.

s ... ............ 5
~~::::::::::::::: ~~

6 3

s
~

a1o 1 2!1 1 :::

"
~

s
~~

11............... I 12............... 2

4 12

I ' 1 14 7
u 2.1 s

8 4

iL:::::::::::: 2

iZ i~ ~~ i~ 1~

!.>............... ......... 1 8 10 1\l

11

16............... ......... ........ :J

:;

4

[nlirmary ... ......... 3 16 !0 29

15

Hn,pitals.... ......... ......... ......... ......... ...... .........

43
~~

2:l-
s7
~i

!i6 East'n Central

39- 214.. ........ \Vest'nCent'l
8- 8................. Western 51 --~ - 17 . 4'!ll 2:1,4

~:(; ~:
1s ---so 182 ~ 448121 ~ .715 ~.:~:: ~~-=~=______

Nos -{

-:=:. B.
--- - 571t"'N""o-,--4'".-.-...

'I

D.

n~ Deaths from all ('au~e:-; fr\lHl ,\1lg"ll~t

.. 2_.,::_:_ .:_:_ . :::.:_:_:_ 21 1

' 11~2~::::.:~::::::::

33071[1 :77\;

R................ 4311

i:..:.:.:::.::.: ~~~~

, 16 ............... 8 21, to October 7, ::s per Mortuary 14............... 61 HPport.. ..................................... ..

LO ............... !18 inclusive, pre.-ions 1~ .............. :)9 Derluct number from ~\uguHi 2ls~ tu

31st,

hn1ngtime

ll ............... 29 to operations of s. B. A ..................

7 ............ ' 2 N;~~,e~:;,~~n'1e~Y~;l~~(\\:?;,I~~~P~[l;~

...... . \

347 N. of L1borty st.

S. of Liberty st.

Numberofdeaths reported hy H. ~00 B. A., from September 1st to
October 71h ........................... 71.' Deduct number whod1eU ia In-
firmary and Hospitals............ 68

1,012 75
937

For purposes of investigation we have.................................... 647
Or somewhat over 7:1 of t:_!~-~1!~-~~~~~-

XLVIII

APPENDIX.



E. Mortality by weeks, in several epidemicR.

1 _c_h_ar_l_es_to_~__t_s_M_._ _"_~h_a_r_le_s_to_n_1_R_:Js_._

SavamHh, 1S:)4

SaYannab, 1Si6.

Aug. ln ................ 4 Aug. 7............. 1 Aug. lii............... 21i Aug. ~8 ................ 3g

26 .............. 20 Sept. 2 ............... 26
n ........... 10

14.............. 6

22 .............. Gl Sept. 4.. ............. 89

21. .............. ~8

29 .............. 92

11. .........124

28 ..... sn Sept. 5............ 1:~3

11' ...........205

23 ...............118 16................127 Sept. 4.......... 73 11. ........... 103

1129......................21H1!0I Oct.

2................ 25 .... 225 1ns

Oct.

30............... 72
1L::::::::::::::: ~~Oct.

21{3:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.

128
~~

Oct.

26 ............... 12!
1~::::::::::::::: i:j

9 ................ 165
~L:::::::::::::1 g

21. ............. 31

8 ............... 45

17.............. 26

30 .............. 40

28..... 23 Nov. 4............... 8

2135 .............................

41 22

24... ., ..... 31 Nov. 6 ........ 59

31.. ............. 20

1:1 ............. 40

11. ....... ... .. 6

30............ 24

11 & 15........... .... 9

18.......... ...... 3 Nov. 6.............. 12

25.................. 5

13............... 8

614 From News, Sept. 30, 1876.

680

993

1,376

From .New., 18,54. Compiled by tbe wri-

ter from the daily

reports.



r

APPENDIX.

XLIX

Record of direction of winrl;o;, obtained from Signal Offi<'<'.

~ I ~ ~ ~ ~ ~ ~ ~I ~~ "'(/~ II ~I~-:-- ~I I~ ==;===;=~=c;====i=e~==;===;==c=c=--1

:

i

. : ;,j

?

1 _ _ 1I_. ,:._._!

"".'

~~ ~

~
_

~.~
_

~

>~

~- ___<:::__ _:~:: _ _"~_

~ c.

:~;~~~.T;:l:

July 331011....~..w..!.1

swl NW s
sw. NW .........

Sept. 1 2

W N w KW --,_, ~~-

w WI NW N

'

Aug. 1 N
2311..................
4 .........

N ........ NE
N s.........

E

S ..........

N N .........

" NE 4 .........
il ......... li .........

RE SE
"I ,. ~E SL
SE SE

I E

:

tiE

tsl

5

ti

E

I'

ti

~~-"8'\v N\~ s~ ~ 14

J. . . . 7 .........

S SIV

S

~~~ ~~~ ;~~ ~~ 16

t~iH~: :'\~i. ~J :::::~~ H ~~~ ~J~I ~J~ ..~~

H::::::~~ ..~\~ ~t1 . 1~t ~ t~ :::~:~>:::~if:::::~~::::~~~ ' 2 1~

JlG71 s~v ~\v' ~~~ ....~,;.;

18

"'S\\

s w

u
S\V

19 w N\V NW NW

'2201 NWNI NN, w,v "".;,:.;;. .......E:. 3 4 21

~2~2

NE
:::::::::1

E~

'sS}l~;

~.~.~;.<E
.....

2ii ..... .

E SE .........

~~
zs

..... 1\ij
NEI

...:N.wE..,

... ~

'_.I:,_.\.....~..:.~.-.
o.

I

~~~ ,~~~ s~ 29 NE E t;L .........
_.....c:..:c:.......::::s..'c\:v..i._ _:____c_ sJ21

III
1

t<' x: N, Nw ........

1!<, ......... 20 .........

N'.\.[
~I

.

..

..

..

.s. 1

Ns

21 s: "',', ~WI sw

I ~22\:'1.i'~"~'~s'"~w:":,......:.;..~w....~...N.~.W.~..~I.......~..~.\.V:.. G 4,121

L., ii.. lSI. :,;[, NE

03:u;

~;.~
::;;,

x{~~~
:;w

;~w~'

~'~I
NW 11

I

!

.1

The Signal Offiee takes (7) seven obserYations daily. The otherR

are taken at 7.19 A.l\1., and 4.19 and 10.40 P.J\I.

Only a west or southwest wind will bring malaria from Spring-

field.

In the table we find observations as noted, viz:

July 30 & 31, & Aug.

September.

N.

7

N.

7

NE.

6

NE.

12

E.

12

E.

3

SEs..

15 14

sww..

18 9

SE.

11

s.

12

Sl.

17

w.

1.'5

NW.

11

NW.

16

92 Calm, 40

93 Calm, 27

132

1:20

The July observations seem to show more west, anrl southwest winds than others, but not a majority of the whole number.

F. W. S. WOOLHOPTER.

L

APPENDIX.



SAVANNAH, GA., January 14th, 1877.
V. H. TALIAFERRO, M. D., Secretary State Board of Health Atlanta, Ga. :
DEAR SIR : While the tltate Board of Health was in session here I re~ponded .in person to a summons, but nut being called upon, I made uo offer. I was in do,;c attendance daily, and felt that I could not add anything to the information you had already gleaned. I would like you to keep tLw following notes I herein send you.
First case of yellow fever I saw on 28th of August 1876, with Dr. W. M. Charters, situated on extreme north and east end of Broughton street, near Gas WorkR. My first case, (my patient,) for the others were Dr. ~"\tone's, occurred 30th of August, 1876, southwest part of city. First death from yellow fever, September 16th, 1876, a German who had nursed all his family with the disease; they all recovered and he died. .:\fy last case, a negro man, died November 14th, 1876, almost centre of the city, on York street, between Barnard and Jpfferson stJeet;;. In the early part of the epidemic I saw large number" of t!engue, or break-bone fever, with eruption over body, face neck and arms. Very, very few of them fatal. I saw al;;;o man.'! cages of t,ljpho-malarial fever au<l some few of a severe congestive type.
Bilbo canal, Springfield grounds or plantation, as designated on our map, tlw Pmptying of water closets into the sewers, imperfect sewerage and drainage, all tending to cause ''bad air," are the causes, with the extraordinary heat of June and July, of our late fearful epidtmic, in my opinion.
Very Respectfully, ROBERT MYERS.
ATLANTA. GA., January 15th, 1877.
DR. GEo. LITTI.E, State Geologist, Atlanta, Ga. :
DEAR SIR-Agreeably to your request, I have made a chemical examination of the water and balla.~t, brought from Savannah by the investigating committee. The observations which I have made are as follows, vi:o~ :
The Havana ballast consiRts principally of blue clay, possessing great absorptive power, yE>t containing less organic matt'.'r than tbe Liverpool ballast, which appearR to be an ordinary soil containing debris, as smith-cinder, fragments of coke, etc. The determinations made upon the ballast, result as given below, viz:



APPENDIX.

LI

I~iverpool. Havana.

Specific gravity of ballast....................... 2.269

2.315

Organic m.atter in balla,.;t (nitmgenous) 0.3cli pr. f't. O.l!JJ pr. ct.

Water, (expelled at a red heat).............. 5.3~5 " " 7.582 " "

The two :samples of water were taken ftom the well l on \Vest Broad street,) where the Malcomb family obtained their drinking water, and also from the Savannah city hydrant. The latter water is quite impnre eontn.ining a large quantity of OJ'grmic mrttter.

'l'he determination of this substance ::;howed.fow time,; ttl" much

as tlmt contained in the well water abov<' mentiotH'(l; rile latter is

however quite "brackish," containing- a large quantity of common sea salt,-chloride of soclium. 'rite total quantity of soli<l n~idue remaining after E~vapomtion of the water is as follows:

The sample marked" ~[alcomb," .................. 50.96 gmins.

The sample marked "Savannah Hydrant," ... 0.42 grains.

Yours truly,

W~L J. L.\KD.

OJ,IVER, GA., December 16th, 18i6.
To DR. J. G. THo~IAS, President of the State Board of Hevlth, for the StatP of Georgia :
DEAR DOCTOR-Agreeable to request, I herewith re~pectfully submit my report of tlw <'ase of J. 'I'. Luflmrrow, touching upon the possibility of the transportation of yellow fever by railway cars.
For the aceommodation of the Central Railrmul employees and others, during tlw epitlemi<o in tlw city of Savannah, a daily train was run to this point, remaining at night and returning to the city in the moming. On the night oftlw lOtl1 of September .T. 'r. Lufburrow slept on hoard this train, and on the night of the 16th, beC'ame suddenly ill, with all tltP ~ymptoms common to yellow fever, which case terminated in dlath oll the morning of the 21st preeeded hy blaek vomit three hour:-l.
To satisfy mysdf of the eorrectnes~ of my diagnosis, in cornpany with Dr. A. A. Woodhull, ofthe U. 8. A. wl10 b~td LPPn with me in the case, we obtained the consent of the family to a post mortem examinati,m, whieh was held, revealing the boxwood appearance of tile liver, together with all the other charaeteri,.,tics common to yellow fever.
A few hours bd'ore death his body was deeply tinge<l with yellow and for a day or two before his urine was entirely snppre,.;.~cd. The face of the patient was at first quite florid, gradually approaching a livid complexion, which was its peculiar appearance in and after death. His eyes were of a red awl yellowish appearance from the beginning of the attack to his death. I would also

LII

APPENDIX.

~;;tate that his death was ~udden, and almost unexpected at the time.
This young man was up to the timE' of this attack, skong and vigorous, his constitution unimpaired by previous diseasE'.
Very Re:o;pectfully, A. B. LANIER, .M.D.
OLIVER, GEORGIA. Personally came Dr. A. B. Lanier, who ueing duly sworn, saith
that the above is a true and correct statement of the case of John F. Lufburrow, who died at this place with yellow fever on the morning of the 21st of September last.
A. B. LANIER, M.D.
Sworn to and :mbscribed before me this December 16th, 1876. H. P. BREWER, N. P. & E. 0. J. P.

DOBOY ISLAND, January 1, 1877. Col. John T. Collins, Brunswick, Ga.:
DEAR SIR : As requested by you, I have made full inquiry concerning the fever that prevailed to such an extent on this island during the month~ of September and October last. I find that one hundred and one (101) persons had the fever-tllirty-nine whites and sixty-two colored, but the number of deaths were equal-seven of each-and six of the ~;even whites were of foreign birth, the other one being that of the Captain of the American schooner, "Ralph Norris," who died and wa" buried at Darien. This does not include those who left the island, aml were taken sick elsewhere. There wa~ no sickness here until after the Spanish bark, "Valentina," diseharged her balla~;t at tlw mill wharf, commencing August 28th or 29th. 'l'he fir~;t case that occurred was that of Mr. JuPsley, the superintendent of the mill, who went into the hold of the vessel to aseertaiu it:s earrying capacity; and the next case of sickness was that of .Mr. Haley, who had a general oversight of the wharves and store of ~fessrs. Hiltons, FoRter & Gel;;on, in the absence of the latter gentlemen. Mr. Haley was about the vessel several times while they were discharging ballaRt, and, no doubt, contracted the disease there, from which he died September 20th, after a severe relapRe of the fever, from which he had almost recovered. The next cases 'vere among the negro houses nearest where the ballast was deposited, and not more than one hundred feet therefrom. These people commenced to be taken down from the 5th to the lOth of September. Cannot learn from them the exact 1late, only that it waR a few days after the bark discharged her ballast. From these houses of the colored people, the fever appeared simultaneously almost all over the island. It was of quite a mild type, and with proper medical


APPENDIX.

LIII

attention and nursing, no doubt the death rate would have been

much less. 'rbe only wonder is, that it wa" not much greater, as

almost every person on the island wa~ ~ick-hardly enough being

well, at one time, to bury the dearl, to say nothing of nursing tlw

sick. There was no aid extended the sufferers from Darien, or

any other quarter, and the only notice taken of the island was by

a sanitary committee from Darien, who came down here on a

junketing excursion; and after deciding tilat there was no yellow fever here, returned to town, and left it to its fate. I under~tantl

that tile Spanish bark "Valentina" lo~t her entire crew from

yellow t'tver, in Hav<ttHt, just before coming here; and, from alll

can lern, ha vc no he,;itation in saying that the disease was

brought here by that vessel. Any further information we can

give yon, will be furnished with plea~ure.

Yours, respectfully,

EDWIN C. DAVIS, Darien.

BHUNSWWK.
Colonel J. T. Collins, Collector of Customs at Brunswick, Ga.: On the 15th of July an American schooner from Havana, with yellow fever, anchored in tile sound and remained forty-eight hours. Distance, nine miles from the city. The water furnished her was by a water-boat; crew, one man-no assistance needed. 'rhink she had no communication with the town.
The Spanish bark "Maretta" was from Havana; arrived first of August; eleared Havana 20til and sailed on 23d of July; crew, fourteen; in ballast, a mixture of dirt and pebbles; no yellow fever occurred on her during the voyage, but while at Havana her crew was taken sick with yellew fever; no sickness in port; cleared on 26th of August; ballast discharged on Cook'H wharf, between hig!J and low water mark; know of one case of fever, Captain Bean, of the schooner" Ed Johnson," lay just to the north, twenty or thirty yards, from tho SpaniHb vesRel "Maretta;" Captain Bean waH taken sick August 21st and died 24th; cases.of Zeigler, Toate, Hurtzag and a :\irs. \Vest, who die<l; Ziegler and Toate dined the captain of the Spanish bark on several occasions; Hartzog was a butcher, who supplied the vessel with meat; iVIrs. West did some sewing for the eaptain on clothing taken from the vessel; two of the sailorH of Captain Bean's vessel, one on the schooner "W. H. Boardman," that lay alongside of the "Maretta," one on the schooner" ~1. l\1. Pate," that lay to the southward of the 'Boardman," and alongside of the "Boardman;" these cases occurred within a week or ten days of Captain Bean ; Captain Bean died at the hotel; all the cases were fatal.
In the matter of the Spanish bark "Valentina :"-She arrived on the 23d of August; left Havana August 12th; had no bill of

XLIV

APPENDIX.



health; crew, thirteen; ballast, did not discharge; only communi-

cation was by the captain coming on shore; she went to Doboy

Island and discharged ballast and took on a cargo of lumber, and

within ten days of her arrivnl there the fever broke out there.

Do not think the port physieian has sufficient autLority; we

have no :-:uitable building for quarantine station, no provision made

for fumigation of vessel~, and none to prevent intercourse with the

town by pilots after bringing infected vessels to quarantine; all

infected vessels come from the south ward; Tybee is ninety milPR of

this point, and it would be a loss, possibly of weeks, to mal;:e VC'>-

sels for this port go to quarantine at Tybee, and would interfere

materially with the interests of commerce; think no general

quarantine station could be established.

.i\Ir. Collins continued : I think it practicable to establish an effi-

cient quarantine about six miles below here, either at Cedar Ham-

mock, of J ekyl Island, without lnterferring in any way with the

commerce of the port, or inland steamers. Such a quarantine

could be established without a great outlay of money, and in my

opinion would be of great advantage to the port. Ballast from

these vessels can be discharged at quarttntine, and the vessel

brought to the city.

Know that I heard of the existence of yellow fever in Savannah

prior to its occurrenee here. On the 22d of August I declined to

send two men, who applied, to Hospital in Savannah, because of

yellow fever in Savannah.

JOHN T COLLINS.

Mr. Collins further says, that at the time or before the outbreak of the epidemic, the wind was from the west, and that he noticed a malarial influence prevailing at the time. That these winds were depressing in their character, and he attributes the spread of the epidemic to the conjunction of the prevalence of these winds \Vith the importation of the disease in the vessels.
That the receptive condition of the town was the same in previous years, as in 1876, but the disease did not make its appearance because it was not brought here.

l

S'l'ATEMENT Of ve~sels entered at port of Brunswick, Georgia, from foreign ports, from June 1st to November 1st, 1876.

Date.

Name.

Master. :

----~--------

.

Cargo.

-------~~~-""'-Il ------ j \Vhere from

~~
1'o":>"m0
~~

8 '5 0'"~"~
Q.)C,.)

1

'05
oJ...t-:t=t

~!

;:A "

WHERE CLEARED TO.

Aug.ll. ........ Aug. 9.........

Sp. ;!cr.

Bk. Maretta........... Wm. H. Boardman

Juan Vincens... Richardson .....

.~\lliixxeedd

ballast, ballast,

1 ..... 3 .....

Havana.. ................. Castries St. Lucia......

8 14

14 ......... ,Palma Majorica. 6 ......... New Y"rk.

Aug. 17......... Scr. Winner................. Nash ............... >!ixed ballast, 1...... St. Thomas................ 12

6 .................. N{ eD'!ulYnoortkd.t.st:barge at Brunswi.Ck.

>
t'z"iJtl

Aug. 19......... Sp. Bk. ':"alentina: A!'libalzaga ..... M~xed ballast.: Hava?a....... ............. 11 1~ ......... lloboy Island.

tl

Sept. 11 ......... Scr. Anme Murchie...... G1hhs ............. Mixed hallust 1 FL. .... Madeua......... ........... 18 Sept. 19........ Brig Rover.................. White.............. Mixed ballast, 4...... Martinique................ 10

, ......... New York.

6

! ....... :.



B{

eWrmenu

dt

ato.

St.

Himon's.

""""" :><

Sept. Oct.

27 . . . . . . . . . 6.........

Scr. Etta ay............... Bk. Hermione...............

Webster ......... Lavers..............

MAsi~xoerdtebdaPllaarsgto.............

~assau ......... .......... Liverpool..................

Oct. 30 ......... Scr. Mary .T. WanL ..... Ward ............... Mixed ballast,!.. .... St Thomas...............

6

6 ......... Philadtlphia.

5l1~

'

12 7

1 .........

L1verpoo].

1......... New York.

1 Cook's wharf. 2 Bacon's wharf. 3 Littlefield & 'l'ison's. 4 Cotton PresH.
The Scr. J. M. Richards, of New Haven, Connecticut, was the vessel tllat put into St. Simon's sound, in July, with yellow fever on board. She was bound from some port in Cuba to New York.
JNO. '1'. COLLINS, Colleetor.

~

LVI

APPENDIX.

..

BRUNSWICK, GEORGIA.
Dr. J. S. Blain, Health Offieer, and have been since September 9th, 18/G. During the period from the 7th to the 12th of September, Mrs. '\Vest, Ue:;8rs. Ziegler, Toate and Barnes died of yellow (ever, but being unwell did not ,;ee most of them. The first case I saw on tlw sclwoner 'IV. H. Boardman, on the lOth of Augm;t. The captain ealled on me to visit the steward, who in my opinion had yellow fever, and the vessel sailed on the 22d. 'l'he captain ;;aid ile haLl another sick man on board, but he was all right. This man died on the following day. 'l'llis vessel diseharged her balla~St at Littlefield & Tyson's wharf, a little above iligh water mark, and took in lJer cargo at Carter's wharf. Captain Bean of the schooner Ed. Johnson, boarded the \V. H. Boardman, while the dead man was on deek, previous to burial. Saw Capt Bean on 22d; died on 24th of uremie poisoning, in a convulsion; no black vomit. 'l'lw schooner \V. H. Boardman, was laying along;;ide of the :Maretta, which eame from Htwana witil a crew of convalescent;; from yellow fever. 'l'he J\Iaretta discharged her ballast at Cook's wilarf. .i\Iessrs. Zeigler, 'l'oate and Hurtzog were on terms of companionsilip with the Captain of the Maretta, as al~o were .i\Iessrs. Peit..:er and Doerflinger, who about the same time had the yellow fever, (frum t':u ..:<til to 12th of September.) The di~ease was carried to difieroll~ :_>J;,;t;s in the eity, which aeted as a radiating force. 'l'hat it pre;, _2d against a northeast wind that prevailed during the whole of c~JC epidemic. 'l'he town was perfectly healthy up to the ou'b;c t.; of tile epidemic. It is cu;;tornary for us to have m,tlari:l[ :,,y(; here after the prevalence of a northeast wind. There ur! ,,,,,. lqc<>ly no malarial influences atlecting the town nearer than tiic o_iue :ields, which are 12 miles off.
I fully endorse all Col. Collins' statement concerning quarantine, and have this only to add, that the whole of the sea coast of Georgia should be taken in charge by the State or the general govern_ ment, becau:oe of the inability of the city to establish and keep up suitable quarantine :,;tations.
I will t:itate that yellow fever prevailed on the vessels in the vicinity of the .Maretta 12 or 15 days Lefore the disease made its appearance amongst tile residents.
JAMES S. BLAIN, M.D. Health Officer City of Brunswick.

DR. BLAIN'S SUPPLEJ\IENTAL STATEMENT.
The sanitar,y conditions of Brunswick are good. Ko fresh water streams, ponds, or marshes are in o: around it. Hain, when it falls, :,;oaks in rapidly, or is carried ofl' by the drainage. The drainage is sufficient to keep the place perfectly dry. There are


APPENDIX.

LVII

no dosld drains or f'c:wer,;. f-:alt 'Yater has acceBs to all of these

dr:tins at each tide. \Ye have 110 typhoid cli~eascf', t.'X<cvt ncca-

sirmal nccidcntal cn~cs. \Ye have but few malarial di~cn~c~, of a

mild t~pe. Our epidemics of scarlatina, ete., are of mild charnc-.

ter, ruvl ea~i1y InaHaged.

'l'lle excrpta from the Jlrivies is di~posed of by burying it in the

earth. HaYe 110 reason to "u~pcct tla drinking watPr, 'Yllic-ll is

excln~lveiy furnished h,y wells and pumps, is contaminated lly

draiuage from the excreta. 'l'herc are no condition~, in my juclg-

ment, to warrant the suppoc;ition tllat yellow fever eouhl origilwte

in the eit,y.

JAMES i:l. BLAIK, l\L D.,

Health Otficer C. B.

\Yill state that I rode over all the city with Dr. Blain, and saw

absolutdy no cause for the generation of malaria or any other

disem;e, at this time.

B. :\I. CHO:\I\VELL.

D~c\HIEX, .January 3, 18/i.

J. G. Thomas, JJI.D., President of the Stnte Board of IIcctlth:
DE/; 1{ i-:tH~-~At the rH]llC'"t of our friend, l\Ir. Robert Laclllison, I rt')'ly to the HeYeml ilH]nirie>; in your letter to him of the 20th ultimo, now before me.
l\Iy report to the boanl of commissioners of our county, to assemble to-day, will no doulJt be published, and a copy sballlJe forwarded to you; but as it may be too late for your report to the Governor, I give you the information ,you desire by this day's mail.
Tl e disease on Doboy Island was entirely local, in its provoking cause and origin. There had been no eommunieation with either Havannah or Bruuswick, or other infected ports. Tile ;;hipping season was over, and but one vessel in port, and she nearly remly for sea. Unc of the first cae,e;,; of tht disease was her captain, who died after a very short illness. 'fhis ease I did not attend, or even .'3ee; but every other eafle (with another exception only) came under my personal notice or treatment. 'fwo of the seamen of the vessel a Love alluded to were slightly attacked, and recovered without medical attemhmce. The fir~t eases, all colored, and employees in the steam saw mill of 1\Iessrs. Hilton, Foster & GillHon, 'vllose only obligation was to provide them with sufficient and healthy rations, and to pay them promptly for their lallor, but not to look after their health, so that no lJlame can Le attaebed to tllem for the di~;ease with which they were afflicted. '!'he shanties in which these mcn took their meab and spread their beds were filthy enough, ]Jut the grounds round about tllem was coYered by a mass of decayed wood, and filth of every description, and all this acted upon by the extreme high temperature then prevailing and previously,
aa

LVIII

APPE~DIX.



dbengnged the malaria, tainting the "hole atmosphere of the I:,land and protlnl'ing the f>thl fever. The whole northeru margin of the I~bud wa-; a mass of impurity, !t!Hl rt portion of the )JOard of Jwalth, ~~lw vi~ite<l the Islawl \Yith me to asl;ert:1in the ean,e of t!w fever, were at ouee satisfied by their o!Lwtorirs out of doors, a1Hl their mvestigation u:ithin, of the imme(liate, local antl abundant source of the existing tliKease.
The fir,;t car>es appeared dmiug tlw first week in Septemuer, and out of a population (then) of over 100, \Vhite and colored, not a half a dozen eseapml an attaek. There was no resitleEt physician on the ],.;land, and I regret to say that the negroe:,; had liltle or no mcdieal aid; many went to their families on the main awl recovered, but in no ease took the dis!mse to othe!'S there; those remaining <lied-14. 'fhe schooner on which the captain died lay at the wharf within fifty feet of the oft2wling nus" aml the steam mil!, when~ the negi'Oes workell mHl were attwkt<l, ,qtill ncwcr, and in one or two small building:-: on the remote part of tlw Isla!Hl, the occupants were not attacked. 'l'lw vhite rc,itlent::< were able to Sc)eure the daily att.enlhne<: :lf a phy,-ieiau, awl not a ;.ingle case terminat('d fatally. Several of'tlwir chihlren were F<ent to tlw ridge on the main, and the disease deYeloped itsdf on Uwm there, but yielded readily to treatmeJtt, a!Hl e()mmunicatml to none.
Added to the local aecnmulation of tilth, several vcs,.cls had c1isehurged their ballast, a gnat portion of whieh Wl~f-l ll.irt, a little below the Island and uot covered by the water.
In a word theu, the di:-:ease on Dohoy Island, wai'l not earried there, but originated there from cause'' above mt>ntimw<l.
Iu my report to the Board of H('alth, I have caHetl the disease low malariol fever, am1 think I could successfully <lefend my opinion before a board. of physicians familiar with the symptoms of yelbw fever. I mn not disenssing that point now, howen~r, but rntrely mention in pas,;iug, that l s~:.w no ca.9e qf '' vomito," m black pomit, and that it essentially dif1i,:rcd from the epidemic wli\eli raged here aud at Doboy in ]f).),[, awl the feYer l have oftpn attcll(letl on ship-board and our quamntinP from the \Vest fndieH.
'flw exemption of Darien front the fever during the pa>A ReaS<m, I nporc to our borml, was owing to two l'I'U~>Olt~, both teuding to the same end. First, the bmniug up of ew,ry building in the town1 mauy old and lteeuyed, and the tr'"1,.;h and filth ~H'<'tmmlu ttd ;n nil(\ about them for long years; a!J(l ~"e<wl, to tltt' ver,v dt)H!l <'tHH\it.ion of our new city uuder a vigilant awl faithful boanl of health, with their dlkient oftieers.
'l'lwre was no fever in Daden, oriyinating lwre. Mevernl ea;;efi m' mabrial fever were brought lwre fron1 Doboy, and OJ\(' ctlnl' a youllg bdy, just retunwd from the nortl1, having ~toplJell a f1lW



r
!

Al'PEND!X.

LlX

,,hyr. at 'rybee, and one night at Doboy, on her way lwre. Tllis ease I never sa\v, but tlle attending physician pronounced it ;yellow f<lver, an<l terminated fatally,
J have watched this li~easn at this port, as port ph,y~ician and health officer, most of the time for tifty years, and whenenr it has appeared in tlle town, I eould always trace it to obvious local cam;es, and when btrmlght l:wre, it has never spread wllen the at 1nospllere was not tainted by local filth and miasm.
Quarantine, however strict, would aYail but little, here or else \\'llere, if >'anitary precaution" at home were wanting.
Pardon this hasty scrawl whieh I trust you may be able to read. Y ery Hespeetfully, .l AM1<:S HOL~IES, l\I.D.
Health Officer and Port Pb,ysician Darien.
P. S.-tf I can assist you in solving any question connected with
:r.:mr very u,~eful and highly wortlly pnsitionl pray command me. .T. H.

AT,BAKY, GA., January lGth, 1877.

~!'he enclosed letter frmn Dr. Kenan, of Darien, is re~pcctfully

~ubmitted to the State Board of Health, as a part of the 1es gesta,

of the recent ycUow fever investigation.

'l'he letter it:> in reply to one I addrcs~ed to Dr. K. asking why Darien, which was so fearfully visited with yellow fever in 18:3~,

c-,;cape<l this epidemic. The auswer is as you see, that it was kept

on" hy i:ltrict quarantine.

Respectfully,

B. l\1. CROMWELL.

DAmJm, GA., January lltll, 1871. 'B. ~L CIW::ItWEJ,L, M. :0. Albany, Ga.:
MY 'DEAR STR-ln answering ,vom letter of 22d of December, conccrui11g the fearful <lpi<ll-mic of yellow fever, wl!iclt -~wept through oLJr sister cities-1:-lavmmalt aud Brunswick--it gives rne great pleasure to ehroniele the fad that not a caBe of this tcrriule ,<.;courge originated with us,; m1d I slmll always beHeve and fc,el our exemption was due to tllc righl quarantine observed, and the strict ~anitary rule;, and rcgulations passed and enforced by our authorities and bo:~rcl of health.
In tho '~~pidemic of IS.).J- we sntfl~rcd mm:e in proportion to popu, lation than did any other loeality on the sea-coast.
Darien is situated immediately on the eastern bank of the AHa maha river, smTonn<lc<l almo~t by riee-fiolds and low swamps. 'I'ho rice-fields are immediately in front, and to a eonsidcmble extent north and ;.;outh of tllc town. The ]Jrevailing winds of the

LX

APPENDIX.

summer, eom ing from a ~outheasterly, southwestrrly and we~tel'l~ (litu::tinn, sweep over the~e field~ upon us.
For seven or eight years after the war, these fields were not cnltivate<l, awl the mo,;t of our eitizeno; lived the entire year in the town, (,;ufllring only from intennitteJtt and rclllittent fever of a mil(l type, wnerally, 1 an ex1wriment but few thou~ht of attempting bdiJre the war, wlwn these fields were uwlcr general eultiYation.
:For the past three years these fields have gradually been brought back umler cultinttion; aml the prevailing summer and fall sickne~s has not only increased in the number of cases, but in gravity. \Ve suffer more from this malarial influence at the close of the summer and tlnring the f<tll months, on account of the withdrawal of the ' Harvest Flow" from the rice-fields, and the drying up of the swamp.
I was not the physician in attendance upon the cases of fever on Dohoy I~land, but it is thought by rnost of the residents there, to haYe been lJrought in by parties from Savannah: aJlll its spread is eertaini)' attributnble in a great measure to the filthy condition of the Island at the time.
Very Respectfully, SPALDING KENAN.

STATE-:IIEXT OF DR. D. W. HA-:IIJ\IOND, J\IACON7 GA.
I saw very few of the eases whieh occurred in the city last fall. These ease~ of fever occurred mainly in 8eptember and October.
'I'lte two first eases which were supposed to resemble yellow fever were at the factory, on Hazle street, the last of August or first of September, as well as I recollect. They were pronounced yellow fe\er by several intelligent physicians, while others were of a different opinion. 'These were the only cases which I saw in this locality, in a population of about one hundred. Under these circumstances, am! from the fnet of theRe patients having been sick for some time-one laboring under chronic chills and the other quite old and feeble-neither of which had the supra orbital pain in the head, no pain in the lumbar spine, nor the red, glistening eyes, and the dark, greenish fluid ejected from the stomach, not being flocculent, and also wanting in blood corpuscles under the microscope by an examination of one of the attending physleians.. It was thought by most of the physicians who examined the cases, that thPy were not yellow fever.
The 0ases which occurred later in the season-September and OctolJer-were of a different character. 'l'hcy assumed a more malignant type, and had many of more unmistakable symptom:; of yellow fever. I make this statement from the description of

APPENDIX.

LXI

the disease gh;en me by the physicians who treate<l them. Saw but tiw of the ]JPrsons affected; none of iho~c I ;.;aw dkd, pxeept one, a Mr. f-ihiYers. I wa~ ealktl to "ee him lJy i.he reqm,t of his attending ph~~if'ian, Dr. \Yright, ttftcr my retnrn from the centennial. He lw<l I wen i1l for spnral day~; 1 lcarEell that hb attaek wa~ Jneccded by a ehill; had headaelw; Yomited frequ<'ntly, tlll'O\\'ing up dark, grumons matter; thi~, lwwe\'er, wa,.; not ftoecuknt, nnd nearly soll'hle in water. He also passe<! a cou~iderahle <[mmtity of bloml from his kidney,.,, Dr. \Vright amlmy~c;li' eonsidei'l'cl it a high grade of Liliou~ fl'\'er; or it might be lllOl'l' proper Lo <:all it mnlarinl hrematuria or htl'nwrrlmgi<: feYer. He wa.~ delirious, quite yellow, and died the eighth day.
The district in wltieh this feyer pre\ailetl wa~ (onfinc<l mainly
to Fourth niH! Fifth street>':, from the intcr.'t'cLiou of I:Iazle ''tnet, on the ~outh, to \Yalnnt on the north-a dbiaJJce llf about three-
fourths of a mile. Fomth null Fifth ;;treets nm parallel with, aml a short di.-;tanee from, the line of the Floutlnn;Kteru all<l Brnnswid~
railroads ou the south aml east, and the Central on the northeast. Iu this area are located all the dejJ(>ts, workshops and ear-~heds belonging to these road8.
'l'he great lllllll ber of freight cars daily arriving at .l\Iacon frmn Savannah and Bruuswick, containing U:e foul air or miasm imbibed frmn these ports and allso<bed !Jy lhe frPight packed in them, are closed up before leaving, and arriving iu .:\Iac:on are OJWnLd an<l unloaded at the several rlepob, whkl1, a,.; LH.:fore allmlcd to, are in elose proximity to Fourth Hud Fifth ~t1ctts, cspedHlly to that part of the1n neare.-t tlw~t; loaded <":tl'><. lt is therefore rea.-ouaiJle to eoududo that the foul and pent up uwlarin, let loo~c IJ,v tlllloadiug the~e cars, \\'ltH hrougl1t to tlw <ity iu this way, a .; llliH fenr vrentiled in tlli~ Hection only. There enu l>e uo doubt that yellclW fever iH conveyed in ears, vessels and by formi tes to <H'onsiderablc distance, aml does afi'eet cities far from the source of its origin; and by tllh:> means alone the fever fouu<l its way to this part of the city.
'l'hc same thing bapp<ned in 180, wheu ilie Central railroad uepot was in East l\Iacon. 'l'bere \\'CJ'e many case~ of yellow fever in this part of the cit,v, wbi<:h is east of the Oemulgee riYer, and not a case on the west side. 'l'!Jis year the fcnr oceurre<l on the west side of the riYer, near the frdght cars, and none on the east side, showing condu~ively that it occurs Jwar the source of the cause which produce,; it and uowl:ere d~e. 'l'hcre is no eanse exi'lting in .:\Iacon suffieicut to pro<lu<:e yellow fever. .l\Incon is one
of the healthiest cities in the Stale. 'l'he loeation is undulating, and the water pass<'s off readily. 'l'he sewerage, together with ,~:,th.er bygie1.lie arraugement~, arc ample and perfect to }>reveut

LXII

APPENDIX,

I

any stagnant water in tlle limits of the city, consequently tlle air is pure and healthy. 'rhfs is clearly sllown Ly the report,; of the sexton, ranging frotn two to sc\en deaths weekly. Yellow fever cannot 0-xist Lut for a short time in a pure and salubrious atrnospherc; and when imported to a place of this kind, having no vehicle to spread it, soon dies out. Bnt if yellow feyer is importetl into a city where the sanitary condition is imperfect, ancl where the foul state of the atmospllere is sufficient to pr,1duce a high grade of biliou~ feYer, the type is changed and yellow feyer becomes epide1nic. ThiH is alNo proven from the course the fcYer took in ::\Iaeon; and from another fact: refugees to Iliacon from Srwannah and Brunswic-k were seattered all over the city among their friends, a majority of whom died, and there is no instance where any of the in mail's of these nnnilies contracted the malady. To quarantine our city u Hler sueh circumstances would Le totally .,unnecessary. In this connection I would suggest that if yellow feYer eYer occurs in Savan uah or Brunswick again, no cars shoulu be suffered to <:ome into :\Iaeon without being tlloroughi,y ventilated before entering the eity. They should be kept open the wlwle 'vay to i\Iacon in order to free thC'm of every partieJe of rrwlaria. 'l'hey ~Should not be allowed to come in at night, but during the day-discharge their freight an1l go out of the city at night By pursuing sueh a course as this, I think we would never ll~we a case of malignant fever in J\Iaeon.
D. "\V. HAliBIOND, .:'II.D.

MACON, GA., December 22d, 1876. Te~timony of DR. D. \Y. HA:IDfOND.
He presents a paper to the Board whieh comprised in a great measure the information required.
Question-Are you a resident of Macon'? Answer-I am. Question-How long havl' yon been praeticing medicine in the city? Answer-About :2~ years. Question-Have you in previous years seen anything similar to the fever which visited here tbi,; summer. Answer-Only inl8,)-l.
Question-"\Vitb regan! to these two cases which occurred at the factory, whicll you mention in your papers, were you present m; the po8t mortem examination?
Answer-No sir, but I was with both of them before they died. Question-It is your opinion that the cases were not yellow feYer '? Answer-'fhey were not.

r

1

APPENDIX.

LXIII

Question-'Vhat was your <liagnosis?

Answer-They hac! been having fevers for sometime, and 1 sup-

pose tile cases were of local origin ; I did not consider them yellow

fcvc>r. Question-Supposing, Doctor, that there could have been direct

communication with these parties from an infected district, what

would yon think then of these cases'!

Answer-I don't think ihPy wonH then be yellow feyer cases,

not even then.

Que~tiou-'Vhnt was the health of the city previous to f3ep-

tembc;; Answer-Better than it has been for many year:,;; no chills

scarcely.

Question-Do you consider the area surrounding the railroad

depot,.; an(l ~hops to be a malarial one?

Au~y,-pr--It has been for many years, uut not so much within

the lnst few years.

Que::;tion-Uid you eyer sc>e any (lisease resembling yellow feyer

iu ]ncvious years in that partieulnr locality'?

Anf,wer-Yes, ~ir; I have seen cases of malignant tyne ofbllions

fever, and many of those were fatal, about the factory, e~pccially

ju,;t about as bad cases.

Question-'Vere those cases generally fatal?

Answer-Yes, ,;ir, frequently fatal.

.

Question-Yon have stated in your paper that you do not con-

sider the atmospheric conditions of l\lacon favorable to the pro-

pagation of yellow fever?

Answer- Ycs, sir; I do not consider it favoralJle.

Question-How do you account for the spreading of yellow fever

from the first few ca:,;es, which occurred around the depot'?

Answer-From ears arriYing each day, and the malarial air in

the ears spread out; it did not reach very far.

Question-How many cases do you suppose occurred here alto-

gether, of those who were re:-idcnts?

Answer-I don't know, but I heard there '.Ycre fifteen or twenty.

I attende\l very few.

Question-Do you know of any eases of fever resembling those

which occurred in the city during September, in the country sur-

rounding the city'?

Answer-I do not; but I heard physicians say, who live in

Houston county, that they frequently have a disease there of that

character.

Dr. A. L. 0. MAGRUDER testifies as follows: (~uestion-You are a practicing physician in this city? Answer-I am.

LXIV

APPENDIX.

Question-How long luwe you been practicing here? An~wer-ALout fifteen years. Qlw.;tion-Di<l you see <lllY sickness here this summer that m at allreseml>lP<l ydlow fever'? Ath\H'r-Yc.;, sir; I saw genuine ydlow fenr. I kul twdn; cm;e.; that originate<! lwre. I saw twenty-two eases in lll,Y owu practice. Qnl'i'tion-Did yon make nny post 1nr1rtcm cxaminatiou'.' AnswPr-Dr. :\Iettauer did, at tlte factory. There Wl'l'e tw.> pase.; t:IPI'e, and one tho doetor dill not nuke a pu81 1110rtcm examiwttion of. 'l'he post modem examination Waf' made at tlw n'(lllest or :uayor Hnii'. The nui.st of my ease.; were l.watr(l on the line of the SonthWl'c<tern Ibilro;td deput-tlwt b, oppr>.;ite-
and the :u. & B. H. H. depot, in tlw snm~ Ykinity wllPre Dr.
l\fdtanH's eases occurred. All the depots et>utn' nearly in the sanw phv:e.
Que:-;tion-1-Iavc you eYer lwd any experience 'vith epidemie yellow feYer'?
An~wer-I have practiced in five epidemies. In lSJi'-'S was the fir:-;t experience I had in it. I hall it myself, then. Then in the terrible epidemies of 1S.5:3-'i)4-'Ei0.
Qnestion-'l'hcse cases, tben, were genuine cases of yellow fever'? Answer-Yes, sir. Question-Dill you think all these eases eoulrll>e traec<l to direct infel'tion, bronght front other plaees-Sn \'ll!mail or Brun~wiek '? Answel'-il[y opinion was !hat I have gewndly lwl'll opposod to the doctrine of intro!luetion; hut from 'vh,tt I "aw here this ye:tr, llmve been emnpelled to llPlie\'e that it was introdtwed here, and it was by !he 1nenns of the railroad cars running from SaYHllnah, fastenetl up lPrfectly tight until they got here, and then thrown open, and tltis infceted air spreadi11g itself through the ncighborhood. All tl1ese cases oceurred in tile neighborhood of the freight depot. Que~tion-\Vhen or about what time did you see the first Pase? Answer-The ~lst of September. 'l'hc eases at the faetory were tbe first two cases. Question-Do you believe any of the eases oceUITetl here without being infectell witb SnYannah or Hrun,.;wick air'.' Answer- I think all of tbern were from inftdion. A eonple of perl'on,.; that came up from Savannah, brought their truJJks and eloth!s, all(] unpaekell them in the house of the fir~t one thnt died, UJHl wlwn she took it she heeame alarmed, aml would Bot let them stay there any longer, a11rl they went to the old Hutherford House, and one of them was taken ;;iek with the fe\er, and brought on premature laLor-as she was in the pre_::!;nant eomlition-aud tmned

APPENDIX.

LXV

perfectly yellow, and they ;,;ent for 111<". They thoug-ht she harl the janndice, hut after reviewing all the cases (thi~ is Uw en,e of :::\frs. S.), sinl'e then, I am of the opinion tlwt sh,, bad n gennin<' ca.~e of yellow fever. I fonncl that case~ that oteurre<l hPre W<re dlle to imnwdiatecommunication with pc~r.-;on~ that en me from F<:tv:nnwh, untl from that I believe ihe di~ea~e i~ infeetiou~nwlnot <'Ollla!,iou~.
(~ne~tion-have you ~een em~' ca~es here in previou~ ycar~ whi\:h appenrecl anything like these cases?
An~\Hr-}\~othing at all; I never saw any fever that had the hlaek vomit, hut the yellow fever. I dilnot nuke a }Jo.J mmtcm examiuation on any of these ease,,, hnt at the OJIU Dr. 'lfdtauer hacl I w:t~ present; there was black fluid in the stomn,h that I con~idered black \'omit, hut sonw of the pll~~ieian~ diffln'l. The liver was the true yellow fe~ver li\'<'c'; we lla<l a plate furni~lwd Ly Dr. c\rnol<l from casPs of Uw epidemic of ltl:-,c[, and thl'"e plates corre~powleci in e\'ery way with the liver of tlle party.
Qtwstiou-You evidently believe in the theory of infeetion, that the disease must start from a given point, and thns i'pread by means of the atmosphere?
Answer-Yes sir; but I don't believe the cli~ease eau spread in l\'l:aeon. I believe in its local origin in some place.
(~uestion-Is not the locality in whieh tllis fever occurred very unhealthy?
Answer-Yes, Rir; very much so. question- To what extent <lid the usual mabrial fevers ocenr this year in that part of the city'? AttSWL'r-Yery little; I beliPve that the city w:1s llllll,lmlly h''alth,v thi~ sumtner, exeept thef"J eases. X o other easl''' r><emTcd of any importance; bilious fevers were mteommouly rare C'omparetl with other seawns. There was very little sickncs~ in any part '>f the eity, except those (lose to the railroad. Question-\Vhat is t 11e llminag<" about the railroad? Amnver-I think it very bacl; there haH been a larg<" quantity of earth deposited along the line of Central Railroad, filling up about the tre:.;tle. It is new earth. Que~tion-Is there much stagnant water about the railroad? AnHwer-'fhere is a great deal of it. I think this hall influence upon the health of the~ eity. 'fhere was more walPr there this ;nmr than u~nal, it was new dirt, mul the water conltlnot gd away. The terrible epidemie in Katehez is attrilmted to the Hprentling of 11ew earth over the city. I believe that Uw disease \Ya~ brought from Savannah and Brunswick this year. f~uestion-vVould you advise quarantine between all the infected ports'?
Answer-As a general thing, I have been opposed to r1uamntine

l

LXVI

APPENDIX.

before, but it is my opinion now, where there is constant commu-

nication IJetween ports that are mfecte(l, it is the safest plan to

quarantine. I think there is no local cause here for the disea~e.

\\'e could see distinctly how it would spread from those cases

around the railroad; that part of the city became infeeted; to-

warcl the latter part of the season the street above was becoming

as badly nfieetecl as the other, and ha(l it not been for the cold

weather, I lmvc no (]oubt it would have been infected as badly.

Dr. Hall attended .Mr. Herring. .Mrs. Knight waited on him.,

and wlwn he dir~d ;;he went over to .Milledgeville, and in a few

days slle was taken down, and died with it; I attribute these cases

to infection; nev0r saw a person take it who attended it; I be-

lieve every ease is tracaule to infection brought here from Sa-

vannah aJl(l Brunswick, and tllat it continu0d to spread until the

cold weather.

Q.twstion-\Yell, doctor, what was the direction of the wind at

that time'?

Answ(r-It would be a hard matter to tell the direetion of the

wind at thnt time, but I tllink it was from the west and north

most of the time we had clear weather, and very little bad weather.

Question-Did you treat any case brought here from Savannah?

Answer-! treated ten cases ; the most of them were in East Macon.

.,

Question-In what direction is that from the eases that oeeurred

around the railroad?
Answer-About O) half mile from them to tile north. They

took the disease in Sanmnah; no other case occurred over there

that I could attribute to iilfeetion.

Question-Did any of the inhabitants have it?

Answer-Xo, sir.

Question-Do you know of any others near there?

Answer-Two eases oceurred on Bridge road, this side of the

river. :\Irs. "H." came from Savannah, and brought all her

clothes; she took it on the way here, and died at her mother's ;

and her mother took it in aLout two weeks, an(l she died; her

sister hml it, and she got well. The Bridge road cases are in the

neighborhood of the Savannah cotton depot.

Question-Give me a case of what you consider typical of all

the rest.

Answer-'l'his l\Irs. "H." was a well marked cnse of yellow fever.

I was sent for in the evening about 8 o'clock, and when I got there

I found her witll a very high fever, with severe pain in the head

and \Jack, pains in her limbs, calves of her legs; she was suffering

the most exerueiating pain-twisting and turning on the bed like a

snake, and the family told me she was taken in the morning with

APPENDIX.

LXVII

a chill; she was sitting at the breakfast table, and said she never felt better; the chill lusted her about four hours; she was taken with a chill twelve hours previous to my culling, and tho family said they could not get her warm-nothing they could upply would warm her; she had symptoms us if she was freezing; and the cold sen~ation passed off, and a violent feyer came on, and this aehing in the head and back and limbs, and her pulse bounding so that it would almost throw my fingers off, it was so strong; the pulse is <1ifferent from any other pulse I eYer fl'lt in any other ldnd of fever. The foyer continued for about seventy-two hours, and nothing in the way of hot baths or teas, or anything that could be given her, brought about a pe1-spiration; her stomach was nauseated from the very commencement, at least from the first time I saw her, so that she could not retain a particle of nourislnnent or mc<licine; she could not retain a teaspoonful of water, and the only thing that we could get to stay at all was little pieces of ice; her stomach eontinucd in that condition, and she, without any perspiration, when her pulse began to fail, aJl(l about the fourth day she threw up black vomit, and died about the fifth day without fever-just gradually sunk away; and towanl the last, before she tlicd, a cold, clammy perspiration came on.
Question-Did her ki<lneys perform their functions? Answer-They acted but very little; they were almost locked up; she did not show any jaundice or yellow appearance, until she died, when she llcame as yellow as a piece of gold. Question-How do the symptoms in this case correspond with your previous experience with yellow fever? Answer-It corresponded very nearly, but cases that were curable didn't present so yiolent an appearance; nearly one-half turned yellow in the eases I attended of those that died. Quc~tion-,Vhen was 1\Irs. "H." attacked': Answer-20th of October. Question-\Yhen was the last case you had? Amnver-The last cast was taken on the 15th of November.
'l'he aboyc testimony, hastily taken down by a stenographer, expresRcs very imperfectly my views aiHllanguage. I will merely add that, in my opinion, the disease as described in Macon was inft>ctious, and not contagious. It is impos'lible to describe my views fully and satisfactorily in such an abbreviated testimony.
A. L. C. MAGRUDER, l\I.D.

MACON, GA., December 27, 1876. 'l'estimony of Dr. T. ,V. MASON: Question-Are you a practicing physician in this city? Answer-! am.

LXVIII

APPENDIX.

Question-Are you not city pllysician? Answer-I am. Question-Yfhat do you know about the existence of ycllow fen:r here this pastsummc>r all(I fall'? Auswer-I l>l'lieYe we had it. Question-Di1l yon b'C'<lt any case;,? Answer-I did; l trPnted ~ome ten or fifteen cases; p<ll't of them originated elsewhere-in ~UY<\Ilnah and Brunswick-awl were brought here. Question-How m:my did you treat that you ,;upposetl to lJc of local origin? Answer-'ren cases at least. QLH:f'tion-Tu what part of the city were those ten case" loeatetl '? Auswer-}Iost of them occurretl on Fourth awl Fifth ~treds; I did not see a case auove 'rhinl street, except two that oeeurretl at the fadory. Question-\Vere there any more than two cases at the factory? Answer-Xo, sir. Question-\Yere you present at a post mortem made by Dr. l\Iettauer '? Answer-! was. Question--,Vlmt was your rliagnosis of the case?
Auswer-My diagnosis of the case was, that it was purely yellow fever.
Quet<iiou-Have you Lad experience witb. yellow fever before thi~ .F~u '?
Answer-Yes, sir; I treated about one lmn<lred case:s in :\[outgomery, Ala., iu li05.':!.
Qut'stion-How long han~ you Lee'l practicing? Au.~wer-Nearly tbirty-tltree year~. Que~tion-Did you ~;ee these fnctory ca~es before tlwy died? Answer-I did. Que~tiou-Did you pronounce them genuine cases of yellow fever? Auswer-I did; they were like those I saw in .l\Iobile and J\Iontgomery. I would like to give you some f,lcts eonueeted with tbe yellow fever that I saw Lere. Ju jaunllic:e and tho,.;e forms of fever, tlte urine invariably eolors tlte linen; iu tlH'"e ea~es it did not. I tried it in three or four ca~es; I tested it. I took n piece of white eloth aml soaked it in it for some hours, aut! it did not color it. Question-Did you make any chemical analy:;is of the urine'? Answer-I did not. Question-\Vere any post mortems made other than tl!ose made at tlw factory?

APPENDIX.

LXI%

Atis\,el'-'l'hat wa<; the only post mortem, and they simply ex-

amined the li Yer. It was a elear box-wootl color; it could not luwc

\Jeenpaintetl1liecr. \Ye had Dr. Arnold's plates.

{2tw~tion-\Yas tllerc any blaek vmnit in these cases?

An~wer-Ye'l, sir, there was pure black vomit, such as l had seen

often before. Qm,~tion-'l'hese other t0n cases that yuu speak of, did t11ey pre-

sent all the symptoms of yellow fever'?



Answer-The eye was a Yery marked premonitory symptom;

uloodshotten1 witll a motley appearance, awl a yellowi>ih tingethe Rufl:"u~ion of the tears and pain in the back also.

Question-How long did the fever last?

Answer-Not exceeding seventy-two hours; I do not think there

was a fever that lasted over tilat time. '!'here was black vomit in

all the cases that died.

Question-It was your duty, as city phy~ician, by the order of

the .1\Iayor, to have a post mortem mmle on these cases?

AHswer-Yes, sir; and I was satisfied they were of local origin,

uml that they originated in that part of tlle city.

Question-\Vm; tllere any communication between these two

people that died antl the infeded clh;tricts '?

Ansv>er-Noue that I know of.

Question-How do yon suppose the cases you treated on Fourth
street received the disease 'l

APswer-I attrilmted it to the railroad. Dr. J\Ianderville, ofNew

Orleans, agreed with us on that subject.

Question-Httve you ever taken tlle trouble to inspect the lower

part of the city?
Answer-I have; it is in about as bact condition as it can be with

regard to all malarial diseases. That ii:; one of the poorest parts of

the city. Question-'Vhat has been your experience with regard to the

health of the city previous to the appearance of yellow fever?

An,;wer~Unusually good, Question-In your opinion, were there not special meteorologi-

cal causes for the production of malaria in an intensified form this

year? Answer-\Ve have had very little malarialfever here this year,

and up to tbe time of the epidemic it was particularly healthy.

Question-Did any of these cases that you attended antedate, so

far as you were informed, the epidemic of yellow fever in Savannah?

Answer-No, sir; they occurred some time afterwards.

Question-Are there any means which in your opinion could be

adopted to prevent these malignant types of fever that exist in the

southern and southeastern portions of the city?

Al'l'ENOtX.
Answer-There is only one rem.edy, and that is to dtaln iL Question-'Ybat are your viewH with regard to the local origin of your ten cases ?
Answer-T an1 inclined t0 think that they originatcrl ::unong
parties who bad been in contact with persolJs who came from Savannah, and had the disease there. A bout those cases at tlw factory then~ were two parties that came here from 1:-'avannah; one of them bad the yellow fever; previous to theirtaking it they carried their baggage to the factory house, so they came in <li.reet ;ontact wi.th these pnrties. In the first case I saw (it was on 3rd street,) the case nf l\In;, Higgins. She left Savannah at 5 o'clock in tile afternoon, nrriving here about 1 or 2 o'clock in the morning, am! took the chill about 7 o'elock. She died on the third day with hlad;: vomit. Her mother, who nursed her, and had not been to 8nvanuah, from nursing her daughter tack it, and then ano ther daughter took it; tllere were two cases originating in that bouse from nursing ~Irs. H. Then there was a case on the hill on the line of Srll street, that of Mr. l'enog. He had been exposed to it in Savannah and took it. I treated him. His sister who visit eel him took thP. disease and died. I did not treat her; she died before he did. He lasted some two or three weeks. He did'nt take tlle black vomit, but had hemorrhage"l.
Question-Is it not likely that the infection came frorn the cars? Answer-Yes sir, it originated in that way, but others eontracted it from visiting ancluursing tllem. Mrs. Conrey, an old ladJ', took the disea~e from nursing those that had it. She was the worst case that I had to 1eeove1\ Question-Did not J\Irs. Higgins liYe very near the railroad '?
Answer-She lived on the corner of \Vahmt and 5th streets ; tpe
railroad runs below. There are no shops near there. Que:;tion-"'here did the majority of the ca:;es occur? Answer-'l'he moi't of the case~-: were right at the SJuth-\\'estern
Hailroad. 'rhen anothPr fact I learned was that the cars would go into Sanmnall and unload and be elosed up, anclnot opened until they got here.
'f. "\Y. J\IASOK, M.D.
]\fAf'ON, nA., December 27, 1876. Testimony of A. J'i. J3oAIW>IAN, Esq., city surveyor; Qtll'stioH-You are city surveyor'? An.~wer-I !lave no po,.;itionjust now, but was for a ;year <>rtwo, (~uestion-Are you familiar with tile general plan of the city'? Answer-I am. Question-\Vbat is the condition of the sewerage of the city? Answer-It rs very defective; th"re bas been uo plan followed

r

APl'ENDlX,

LXXI

in the sewerage. 'rhe only sev;ers that have been built have been the large ~ewen; on the branches that run through tl;p dty, and

other Hewers have been made running into them. QueHtion-"\Ylmt is the pre~ent population of the city of :\Jn.con ':

Ammer-The pPpulation of the city proper \YaH, H<i:!-an<l I don't think it has changed a great deal-1:3,10-!. That waH the la~t. census talien. Vineville and suburb~ wns G,200. I suppose now

we luwe 20,000 people in and around the city. Question-Do you consider a systern of sewerage for the city

necessary? Auswer--'l'o the proper drainage of the town it is necc~~ary.

(:ltwstion-"\Vlmt is the condition of that portion of the dty sur

roulHling the .:\lacon and. Brunswick railroad and the Central rail

road freight depots, with regard to tlle drainage? Answer-I think it bas nolle llut the natural drainage, alHl that
is very irnperfeet, beeau;;e it is very flat and lcYel. Tlwrc i~ a great.

deal of stagnant water and bog and ;:;wamp. (~uestion~"\Vhat relation doe;,; that portion of the city bear to

the level of the river'? Answcr~-It i.; al)()ut twenty feet above the ordinary loYd of the
river; the average through the park, and all that part of the Pwam~,

iR between fifteen and twenty feet above the onlinary l<!Ycl of the

river. 'rhat is below Sixth stred; lJetween Fourth and Sixth stred~ the ordinary level would be betwe'ln forty and fifty feet above the river. The court-houRe square is just fifty feet above the

ordinary surface of the water in the riYer. Q,uestion-"\Vhy is it, then, ~Ir. Bourdlllan, that that pcrtion sur

rounding the railroad depots in the southern and southeastern portiom; of the city is ~>O constantly covered with wat"r "? Jg that

not back water? Answer~'J'here is, in the time of freshets. The rca><on that the
water ordinarily stands there is because there if' ab~olutely no fall

from Se,enth street to the river; all the >lonthenstern l'ortion of the eity lie>:~ in a bend of the river. Frorn Seventh street clown to

the river, in a southeasterly direction, there is no fall to the land; it i>l a level swamp, ancl part of the ntiginal river ~'Yamp.

Question--'Vhat is the area of ncrlage embraced in Uwt section

you have just describt:d '?



An,;wer--It is all the rcserYe and ::"rapier's plantation, dmvn the

Brunswick railroad to the Brunswick bridge, fifteen miles beloW

here. It is seveml square miles. question--Doc~ the water ::;taml there during the wholo year? Auswc~r---~ot on the surface, only in ua;yous and lakes; it stands
in these bayous and lakes without any flow at all. 'l'he~e bnyous and
lakes are repleni'ihed by the overflows awl minB. The ~urfneq dn>in-

1

LXXtt

APPENDIX.

uge ofthe city flows into that portion of the swamp. There att" only

two ilrnHdws that carry the drainage of tbe cit,y into the rivt>r be

fore reat:lliug that s'"amp, awl the portimt of the town \Vhicb is

drain eel clircctly into the ri Yer. that dees not enter the swamp, may

l!c em !Jraced between Cotton a venue aml Forsyth street to the

river, ill a northPasterly d irel'tiotl. 'I' hat portion of the eity ~wltkb.

is draimcl directly into the river would not be over cme-c1uurter

of the area.

Qtw~tiun-'l'he drainage in that part of the city is ample and

sut-Jicient, at least for surface drainage?

Answer-The clminage is all right; but there are not sewers

enough. It has snflicient fall to drain itself into the river; all the

rest of the city i~ drained directly into the swamp.

Question-Then the drainage of the southwestern portion of the

city runs into the swamp also?

Amnnr-Yes.

Qtm~tion-How about that portion about the factory?

Answer-The drainage abou't the fautory is very deficient; there

is a p<.:at bog back of ami in front of the factory.

Q.ue~tion-Vvith regan! to the swamp before mentioned, ~Mr.

Boardman, what is the !Jest plan, in your opinion, for opening

the lagoons aud draining them into the river in order to seuure a

more uniformly dry surface?

AnswE-r-The best way, I think, to drain the swamp is to ditch

it thoroughly and have lateral ditches running into the larger

canals to carry off the water to the river. 'l'hat would insure for

the whole area, wlwre those dituhes were made and kept open,

dry ground, except when the dver wn.fl out of its banks. There

is no way to drain the wamv so that it would be permanently dry.

Question-\Vllat is the condition of the ground in the neighbor-

hood and on the other side of the river, in an easterly direction

from Ea,;t J\Iacon '?

Answer-It is a sandy loam, with strata of clay deposited through

it, and cousists, in a great degree, of decayed vegetation on the

surface.

1

Question-Is it in a better condition, so far as dryness IS con-

cerned, than on this side'?

Answer-I think it is; it is more generally cultivated. But there

are swamps on the east side of the river which are almost impasse

al.lle, about a mile from the city. 'l'hey partake of the same char-

acter of the river swamp. 'l'here is \Valnut Creek swamp and

Rocky Branch swamp.

Question-Is the swamp land very thickly covered with the

growth of wood?

Answer-It is pretty thickly covered.

,....

APPE~DIX.

LXXIII

Question-Ho\V about that portion of the C"ity in the neighborhooll of the ~warnp that yon have just descriued '?
An~wcr-It is generally cleared up. Que~tion---How long has it been cleared? Ani<W(er-Thirty or forty years. 'fhat is Napier's plantation; there is a helt of timuer Letween thi,; and the city. 'l'hat is the city re~ervc, which extencls some half mile from 7th street, and iu a southeasterly direction; that is entirely wooded. Question-Then there is a belt of trees almost encircling that portion of the city'? Ani:-iwer-Yes; but it is still a portion of the river swamp. There is a portion of the river swamp which is still he~wily tilnbered, lying between 7th street and the Napier p~antation, about half a mile wide. Question-! want to ask you with regard to the water supply of
the city'? Answer-It is very inadequate. Question-In what way is the water obtained'? Ans\\-er-Aimost exclusively from wells. Hydrant water is
suppliell lJy the gas company to about sixty consumers. That water is taken frmn the college spring, on :Hagnolia street.
Question--In the lower portion of the town, what is the usual depth of wells to obtain water?
Answer-AlJout twenty feet. Que~tion-You consider that surface water, do you not? Answer-Pretty nearly; the supply is almost entirely from surface filtrations. The town is situated so near a granite outcrop running through the city, that is, througll the cemetery in the northern portion of the city, that we can get no water lJut from surface filtration. Question-Do you know anything of the plan adopted in the city for the disposition of human excreta? Answer-I do not know of any plan at all, except by privies, sinks and wells. Each man has got rid of his own. I will state that there are pulJlic privies on most of the lJranches and sewers. The water closets at the Brown House, and all that section of town, are emptied into the sewer which runs down Poplar street, anu empties directly into the swamp by the l\Iacon and Augusta Railroad freight depot. Question-What becomes of it then? Answer-It spreads over the land. It flows into the swamp, and there remains. There is a stream, but it is so sluggish that it will not carry off anything except during heavy rains. Question-"\Vhere is that sewer, and where does it empty?
Ga

LXXIV

APPENDIX.

..

Answer-That sewer is in the city limits, and opens on Sixth street and runs clown through the city re~ervc. 'fhe sewer proper ends between Fourth and Fifth streets; after that it h; JJIJthing but an open lJraneh. There are a great many people liYing dose to this Lranch. It is in the immediate ncighLorhood of tlle Central Railroad freight yard, where trains are made up. 'l'he freight de]Jots of the Southwestern, Central, and l\Iacon & \Yestern railroads, lie between the two branches which carry off the llrainngc of three-fourths of the city. 'l'he l\Iacon clv Brunswick Hailroad freight depot lies ncar the southermost of these branvh~s. All the ueighborlwod of the ::\lacon armory property, is drainetl by one of these branches; also, the Macon cotton factory, Schull's tan ncry, the suap factory, and a large portion of the nwst populous part of the city.
Question-\Vhere are the branches described in Dr. Hnmmond's testimony'?
Answer-'l'hey meet directly southeast of the freight depots. These Lranehes are the ones that flow down Poplar l'treet, and back of the :Macon cotton fadory. 'l'hese bnmehes meet about one-fourth of a mile ~ouiheast of the freight depots, and the river backs up there at every fre,;bet, and dP}JO~its silt. In the time of a freshet tlJe ri\er water backs up as far as old Camp Ogldhorpe, within about three hundred yards of the freight depot. "\VhPn the water goes otr, it does not go ofr fm;t enough to .carry thi:,; silt witl1 it. This iiilt is deposited to the (kpth of a quarter of an inch. 'l'his is the washings of a large portion of country. I will state, further, that within the last three ytar:s the gas works have changed the uircction of their waste ~;o that now it goes direct to the river, through Sixth street, whereas, formerly it WPnt down vValnut street through tlw City Park, and spread over the swamp in the city reserve. 'l'be ga;; works here make their gas of wood, and the tar, which is here allowed to run to wa;;te, l1as a great deal of creo~ote ami earbolic acid in it, while coal ta1l1as not nearly so mueh. \Yc have no wlplmr wnstes.
Question-Are you ptepared to give me a ~tatement re~pecting the meteorological conditions of this city during tbe past year, in a geueral way'?
Answcr-I could not giYe it now, but I haYe it at my olfice. I have the temperature and rainftlll for every montll in tbe year; but I can give some information here. Ju the spring of this year, -I think in Apri!-;ve had the hcavie:lt freshet in the ri1er that we have had since the "Harrison freshet," and nlmo~t the "Whole of tlmt portion of the swamp was et1tirely coyered with water, to an extent that it bad not Lcen bPfore or since tlw "Harrison freshet." Then >Ye had a very hot June and July, with thunder

AfPEXDlX.

LXXV

,.,hoWei."s frequently. In August it was wa1'm, but drier, and in

September it was dry, and very warm; in October it was very dry

and warm, and inNovember1 exceedingly dry. I will state, further, that the prevailing wind i.'l from the northwest.

Question-\Vhat was it during the summer aml fall, about the

time of the epidemic of fever here?

Answer-I think it was varialJle. During the summer we had

some easterly winds and south"easterly winds during the equinoc-

tial; however, when we have a lengthy storm, the wind is usually

from the east.

Question-How was it September and October?

Answer-I do not know of my own knowledge.

The '\'ind blowing from the southeast and east, would pass di-

rectly over the swamp regions that you have been speaking of?

Answer-Yes.

A. G. BOARDMAN, C. E.

MAcox, GA., December 20th, 18i6. Testimony of :Dr. H. A. ~1ettauer;
Question-Are you a resident pllysician of Macon? Answer-Yes sir. Question-Are you a practicing physician? Answer-! am, 'Question-vVhat do you know about the existence of yellow feVer here this summer? Answer~! llave certainly treated twenty-three cases of yellow feVer; five of these cases were among refugees from Savannah and
Brunswick, taken witll the disease immediately after their arrival in Macon.
Question-Did you have any cases that you could trace to pre viously infected districts in :\[aeon'?
Answet-I Could not trace the origin of thlsdisPase to any other cause thr,u by the in:'lportation of atmosplle1e fron1 Savannall.
Question-Do you know that ~nyof ihcs~ caRes were in commu nication with the trains o1 uny other means by which infection could occur ?
Answer-1rhe eighte-en ca;;es which occurred among our citi;~,ens who did not visit Savannah or I3rtmsWick, occurretl on .Jth street opposite the freight depot \rllerc oYer a hundred thouhand cubic feet of Savannall atmosphere was thrown out of tltc cars daily from empty cars brought from Savannah closed; the air iru pris oned in tlle empty cars.
Question-\Vere any of these previously employed on the road? Amm'er-One watchman, who remained at the deJ:JOt every night. Question-\Vas that a genuine case of yellow fevt~r?

'1

LXXVI

APPENDIX.

Answer-The attending physic-ian said so; this is not {ncluded in the eighteen cases; it was not my case. A~ a proof that the di.-;c:a~e occurred in that way in 1804, the depot was 011 the East l'lide of the river; when the epidemic was raging in Savannah, about one humlrecl cascs of fevcr re~embling yellow fever in every resjJl'd occurred near the depot that year. Since that time the depot h:\s been remoYecl to this Hicle of the river, and the same tiling ocenrrecl in the neighborhood of it this year.
Que~tion-"\Vhat was the time you saw the fir:;t case? Answer-The Sth of September. Question-Do you know of any caseil seen before that time by any other physician '? Answer-I saw two cases at tho factory about the last of August I did'nt think thcywere yellow feverfrom certttin circumstances connected with the cases. Question-Did you perform a post mortem examination on any case'! Answer-I performed a post mortem examination on a case at the fac-tory. Question-Did that case have a box-wood liver? Answer-The liver was the same as any jaundice liver. Question-Did any of the eighteen cases con1e from Savannah? Answer-No sir; as before stated, these eighteen cases occurred among our citizens; the disease originating here. Four of the number died, all that died had the black vomit, and three others that got well hat! it. All that died died between the 5th and 7th days ancl in every instance without a death sweat, the body almost dry. Question-Did any case occur outside of this immediate neighborhood? Answer-A few cases occurred on 4th street after a three days east wind, which blew the infected atmosphere further into the city. Question-"\Vere these cases similar to the factory cases? Answer-I ditl'nt see them until after death. Question-Have you known cases to occur here in previous years similar to those that died on 4th and 5th streets? Answer-None except genuine yellow fever which I saw years ago. Question-"\Vbat do you think was the origin of the fever? Answer-I think it depended wholly for its origin on the daily supply of infected Savannah atmosphere, which was brought here imprisoned in the empty cars, these cars being opened at the depot opposite the locality where these cases occurred. I don't think there is any local cause for the disea3"e.

APPENDIX.

LXXVII

Question-You have-never seen anything sitnilnr to these eases wllid1 "-ere urought here from Sanmnah, awl those whieh occurred here?
Answer-I have never seen anything in this place cxeeptgenuino yellow feve1, tlmt re~emblcd it at all. llwvehad but little experience in the treatment of yellow [(Yer until this year. In the case of John Fouglmcr, 1 have no doubt but that he got the <lisease by rceeiving erates of cabbage a!Hl fruits from Savannah, and opening them in his house. He slept tlwre with his family. He died of the dbease, and one of !lis children took it after bb death. I cannot account for these eases in tlll_'.' other way.
Question-\Vhat part of the eity did he live in'.' Answer-Opposite the guard-house, on Fourth "treet. Q.uestion-Did you know any per8o!ls that tool> it, who hall been in communication with Savannah eases you attnHle<l? Answer-I di<l not. From what I luwe ;.;e<c>n, ther<c> is no eontugion about the disea~e. Those who kept away from it were the ones that had it, provided they JiYed on Fifth tsircet. 1 don't think. there it; any local eause llere for the yellow fever-that is, no terrestrial cause. Every case that I have seen is traeeable to Savannah atmosphere importe<l here into our city. Que8tion-Did you make a post mortGJn examination iu any of the eighteen cases? Answer-None. Question-\Yere there ttny more than ei~hteen ea8ets in your praetiee? An:-<wer-No; and 1 <lid not preeipitnte an opinion that I was convineed that J was treating yellow feYer. 'l'he ensr:~ ha(\ all the symptoms of yellow fevPr, aud tlw;,;e tlmt died had it, with the hlal'l{ vomit; and those that were admitted to be yellow fevPr imported eases from Savannah, were exactly similar to those in all resp~cts. 'rhere is a pec-uliar ()(lor aoout the !Jinck vomit, whkh I reeogni~etl both in the imported ea-;es and tlw~c originating here. Question-\Ylmt proportion of !leaths were there to those that were among the cases supposed to he yellow fever? AnBwer-Four die!l out of the eighteen ea~es originating among onr citi;.~eHs, am\ two of the five imported ea~es. Question-In case any future c>pidemic of yellow feyer should occur in Charleston, Savannah or Brunswiek, or along the coast, where it usually prevail~, do you think it a safe plan to allow refugee,; to be quartered in this city "? Answer--Perfectly. I think quarantine would be eruel. 'l'ho only restrietion I would place, would be to bring the ears !Jack from Savannah and Brunswiek open, so as to let this atmosphere blow .out. And it would be the safest to compel the railroad authorities

LXXVIII

APPENDIX.

..

to run all the trains open the whole length of the track, so as ~ thorough ventilation can be effecte<l. I do not think that any sleeping car should be allowed on the road during the epidemic, from the fact that I have known several cases who bad not visited Sanmnab or Brunswick, but contracted the disease in sleeping curs.
Question--Do you think the atmospheric or meteorological conditions were favorable to its production?
AnRwer-I could not say. It bas been proven that epidemics occur here after a long Rpell or protracted seasons of dry weather, follmved by \Yet and heat; that is the supposition, and wheneYer they luwe that condition in Savannah, we have it here. \Ve have had the yellow fever three times since I have been in Macon, and it neyer has been known to spread far from the railroad depot.
Question-How long have you been practicing in Macon? Answcr-'fwenty-two years. Question-Did you, in the course of yom practice, notice any of the severe typeo,; of the ordinary malarial fever? Answer-No, sir. I saw a few cases of very mild intermittent and remittent fevers. Qne~tion-What had been the health of the city previous to the epidemic? Answer-Unusually good. Question-Do yon believe there was sufficient air brought from SaYannah to have produced such a number of cases? Answer-'fhere were 150 ears brought here each day, discharging their imprisoned air at the depot, amounting to over 100,000 cubic feet. QmHtion-Name some particular case that you think originated from the depot. Ans;ver-I think l\Ir. O'Brien took it by passing the depot, which he did every night and morning, and he often went to the depot on bu~iness, aml I l!nve no doubt that he got it in this way. Question-IVere there a great many employees about the depot? Answer-Yes, sir; but they did not remain there during tbe night. Question-Did l\Ir. O'Brie-n go to the depot at night? Answer-He passed there eYery night. Question-If there is anything el~e that you can think of, in the way ot a SIJggestion, the board will be glad to have it; whether yon advise quarantine to be e~tablished, further than what you haH\ already stated. Answer-To be perfecctly safe, every trunk brought on the roads from those cities where the disease may exist ::;houlcl he, at a point on the road between them and this city, 1epacked, and every bo.x, vr



APPENDIX.

LXXIX

anything that contains air, and every article thorougly aired. I don't think there could be a particle of infection conveyed to us, if thnt were done.
Question-You say in 18.5-1 there were cases in East ~lacon, and all could he trace<l to tlte infected atmosphere brought up from Savnnnah in the cars?
Au>-wer--1 do not know about that; but all the cases occurred in the llPif;hl!mhood of .the f:eight depot. lam certain tlmt the ca~e~ oeeurring here this year were produced in tllis way.
Qupstioa--\Vhat b::tR been the health of that neighborhood sincp the frdght depot has b<c~n rern.oved?
Answer--Perf<,ctly healthy. Question-How about the surroundings? Answ<:r Tiley are considered healthy. Q.tw:otion-Is there not a great deal of fever of different types there'? Answer-'rhat part of tllc city has a great deal of malarial lever. It is remarl.:aule that, in the most malarial part of the city, no <.'ase" of this kver oecurred. Que. -tion-How do you aCf')}Ullt for the immunity? Answer-Because all tho freight depot'> are nearly together. Question-You say a tew cases were to be attributed to infection brought from Brunswick? Answer-A few cases came from Brunswick with the disease. Question-How long did the fever continue here? Aui<wer- From the 5th of l:'leptember till the J..lth of N ovem her, indwling the imported. 'l'lw first that originatNl here, that I lmow nuything about, occurred ahout the 8th of October; tho last case was .Fouglmer's, about tlw 14th of November. Question-\Vere there otlwr cases in the city, besides those you attended? Answer- I visite1l several cases that were not my patients. I didn't regard the discase epidemic here. lllon't think a di,;ease can be culleJ epidemie, when it is r:online<l to iiO small a district of a town. Question-And in no instance could you trace t.he recent case to commtmicnlion of the partie~"? Answc'r-Xo, sir; even those w.ho staid with the sick night and day, <1 itl not take it. QtW>;tion-Give rile a typical case. Answer-There was more uniformity in tho appearance of these ~:ases than ttny disease I ever treated. In the first instance a very slight chill, head-ache, pain in the litnus and back, and tlte pain in tile llm bs respmlJlell very much that symptom in the disease known .as dengue; after the chill passes ofi", the Jever comes on, witlt a

,

LXXX

APPENDIX.

very rapid pulse, broatl am! bounding. It is in this ~tago that the
pain in tlw hcad is greatest. The puhe rang<'H from n;, (o 140 per
minute. The eye bce,tme red and injeetetl, t!Je lO!li-','U<e not n~ dry as would 1>'! the ear;e with otlter fevers. Thb fevcr la~ts (\H> days without any remi~siou, and til en vel'~' ~n<ldenly ,;ub~idP~, the pulse bceoming almost natural, and a YPry ~light degree or nau.-Pa, was all the unpleasant symptom that rem:linet1. The ''kin w:ts hot nnd dry. 'l'he patient imagines he is nearly well. 8inte tht fever commenced, thPrc has not been the slighte~t appearnuet ofptrspiration, HOI' has there been any ~lePp. In the eour"e of a fuw hours after the ,.;nb,;i<l<"lleu of tlw fevcr, lw comnH'IWetl to til row up a hlnd: matter from the stomach (!Jlrtck 'Vomit!, an<l the pnlse eontinnc<l to sin];: aftc,r this, until on the flftlt day the patient died. 'l'lw puhe is ycry dif!ereut from the pube in onliuary nmittent and inL:lmiltent fevers, :mel it is a eharaetNi~tie uf tlw diseasP, in rn) opmwn. 'l'aken in cmu1ertion with a long-continut'tl fever, as ~<>Oil as the first portiou of the black Yomit ~was ejected from the stomach, the throat became very sore, so as to rewler swallowing tliffieult and painful. (And this 1 have obseryed in all eaRes where, immediately after the patient bPgins to throw up hlaek vomit, a krnall quantity fell on the child's bosom and nrnnined 2-! houri', aml when it was wiptd ntra blister was found umlt;r it.)
Question-You eonsider the clescriptioll applieable to all the other cases you bad '!
Answer-Yery nearly; to all that died. A!ter the appearanee of black vomit, there is Yery great depression, and tlw pul~c wcakcns, and the patieut ~ink~ until he tlil~, but not in enry instanee llm\'e seen tilrt'l' eace,.; that had the bl:lek \'omit and neon'red. 'l'lw ea~t-; that I tre,tte,J, im.portt(l fmm s,tvannall, (the di~ea~e contr:1detl in Ravaunah,) wen~ exaetly similar to tlloH' eighteen eases that oecurred on Fifth ~treed, Ill en;ry respeet. H tbl' live cases that I treated, tllat came from Ravannah, were yPllow feHr ca~l!s, the eighteen were also yellow fever.
H. A . .i'.IE'l'TAUH, :H. D.

l\IAcox, GA., Dec. 2:2, lSiG.
T;stimony of Dr. \V. n. Burgess.
Question--Are you a practicing phy;;ieian in this eity .
Answer-I am. Question--For llow long? An,;wer-Sinee .June '(ili; n little over ten years. Question--Did any cases resemuling yellow fever come under
your notiee this fall'? Answer-I attended some that I think resemLled yellow fever.

APPENDIX.

LXXXI

Question-Dill you make any po.st mortem examination upon any of the cases .
An,.;wer-I was present at tho exnmination made on one who die(\ at the fadory.
t~ucstion-,Yhat was your (\iagnosis of the case; Answer-:\[y diagnosis was not very po~itive. I f(lt that it wa,; just such a form of di~ease as I had seen here hel(ne; 'l'hl'tlwr yellow f("cr or not, I do not preteJl(\ to say. If yl'llow fever, it was something not new to certain bcalitie~ in :\!aeon. Question-How many cases di(\ you see that resemble(\ yellow fever? AnswN-I saw some six or eight natiye cases; these occurred among tlw inlmbitants. Qne~tion-\Yhnt part of the city (]i(l tho~c cn>-.(\~ o!cm in? A ll'''H'r .lt ,Ia,; not confined to the lJomHis of the, faetory, but all on the b(ln\urs of the town. 'l'wo of the1n W<'l'l' L1tal ea~es> that occurrc(1 on the lower ell<l of \\'alnut street, lwhncn the railroad tracks, ns you go to the Fair Uround, going lJJ\(lcr the two railroads, in a hou~e to tho left, in a basin formed lJy dirt l.Jeing thrown th(re to f-ill up h0tween the railroads, nml in thnt basin was a filthy, muddy sluice all the summer. I Raw two fatal eases there, motlwr and ehild, both white. I saw a mulatto boy in \Valnut t<tr<>et, jnst l.Jack of Captain Carnes' hou~e; that ca~e recoYerod. It had all the charaeteristicK of tho otlwr ca.~e:.;, sueh as throwing up this black, inky vomit, intense hea<lnelw, ~npraorbitnl Jmin.~. Another ease wns on 5th street, below tlw ~ontil western Railro:Hl shops, tho <hught<>r of a man by tlw name of Bryant, an engine<-r. 'l'hat ('HSe recovere(l, but T ielt almost hopclc"' of it for ~OilloJ (by,;. Jt had aJl tJJU symptulllS of this fever, whether ydloW fever, ""~amp fever, or what else; at any rate lt \\as the smne type of fever. Que~tion-1n the two cases whkh recovered in the neighborhood of the Fair Ground, could you trnee tho clisease to :m~ (lhec:t infection, which might haYe been urought by car:; directly from Savannah or Brunswiek? An~wer-Nono at all; it is my judgment that it was strictly local. Question-How far from tlw railroad is this? Answer-Eight under it. Qtwstinu-Coul<l there have been any co1nmunication between the ears nn(1 the house?
AnswPr-Xono, sir; that is a mere po:;sibility. Que~tion-'l'lmt immediate neighborhod is a malarial one, is it not? Answer-Quite so,

LXXXII

APPENniX.

Question-Have you seen in previous years cases resembling

those you have just described?

Answer-I have, sir. I do not know that I could safdy sny

e\'ery year, but certainly in the majority of years. During tlw

fall season I think I have seen identically the same ca~Ps occurring

in the swampy borders of the town.

Question-You had no eases of your own in the immediate

neighborhood of the Central Railroad, or :Macon & Brunswick

Railroad, excepting the case of l\Ir. Bryant's daughter?

Aw;wcr-'l'hat is the only one. Other cases occurred on 4th and

5th streets of the s~une kin<l. At the time I treated Mr. Bryaut's

daughter every 'member of the hom;ehold was sick, except oue

daughter; but the cases referred to resembled simply our climatic

fevcrs-intermittant and remittant fevers. I saw another case of

this malignant fever in a family.

Qut>stion-Have you given the matter of infection or contagion

of the disease any thought?

Answer-! have.

Question-How do you suppose these cases which you think re-

sembled yellow feYer were produced'?

Answer-I think they were produced by local cam;es. I base

this opinion upon the fact that I have seen just such cases llere

...

before, where there was no introduction of foreigners with yellow

fever. I do not get my own consent that this \vas yellow fever.

Truly and sincerely I do not think it was yellow fever. I think it

a more malignant type than yellow fever. According to tlw history

of yellow fever in its malignant form, not more than ten per cent.

die, while in this fever that prevailed here during the fall months

I think at least fifty per cent. of the cases clied, and that under

treatment by those who claimed to be familiar with yclltnv fpver.

Question--Doctor, be kind enough to give me, in ae systematic

way as you can, a description of one of your case>J, tlmt is, one of

the cases above mentioned?

A nswer-I will give you the de~cription of the motlwr that died

in 'Walnut street nenr the railroad, Mrs. Bridges. She was auout

six mouths advanced in pregnancy; she was taken with severe

chill; her child having previously died with this fever, she was

apprehensi \e that it might be the snme thing, and she immedi-

ately took a mustard b:tth, wrapped herself up and \V("nt to bed,

and sent for me immediately. I saw her about 9 or 10 o'clock in

the morning'; she had then a very high fever and inten,.;ely hot

skin, but ~weating profuHely; I thought it was yellow fever symp-

toms, and I kept her under such treatment as was recommended

by physician~ of Xew Orleans and Savannah. She W<lS given

salts, and see!ned to purge, and then kept on diaphoretic doses of

J

APPENDIX.

LXXXIII

snake root, with five-grain doses of quinine every five hours, so as to give her fifteen grains in twelve hours. 'l'his fever continued unabated, notwithstanding she ha<l an eye to the importance of keeping up a perspiration aml keeping the kidneys active, and rapidly the skin began to assume a ye1lo~-reddish tinge, the eye very mueh inflamed, almost blood-shotten; the fever continued unabated for about seventy-two hours, then a state of collapse came on, and she died. Tbat is, I think, alJout the history of the case.
Qnestion-Did she have any blaC'k vomit? Answer-Yes, sir; that occurred on the third day of the fever, and the feYer remained unabated until she sank into a state of collapse ; the heat of the skin remained at a temperature of from 103 to 100. QuEstion-How long did she live in this condition? Answer-About ten hours. Question-\Vhat was the condition of the surface of the skin when the collapse came? Answer-It was cold and clammy. Question- In your opinion, did her pregnant condition have anything to do with the fatal reRnlt? Answlc'r-I had no reason to suppose it did; there was no abortion.
Question-Your other six cases, they were very similar to this? Answer- Yes, sir; I sav,r some genuine yellow feYer from Savannah nncl Brunswick, and in no instance did the black vomit resemble the black matter that was emitted by our local cases. Que~tion--In what respect did the vomit differ from the yellow fever eases? Answer-In those cases brough here from Savannah and Brunswick, the vomit corresponded very closely with my knowledge and general reading of a yellow fever vomit, it being dark, brownish, coffee colored, with mucous jloculii through it, while in our local cases it was simply like black water, inky, or rather like soot and water mixed together; no granular appearance, no mucmts jloculii. (~uestion-Was that a local symptom? Answer--No, sir; I had ouly those eases of this peculiar type of fever, aml two of them who had the black vomit recovered. Question-In the case of the mulatto man mentioned, could be have had any communication with Savannah or Brunswick, either directly or by means of ears. Answer-Possibly by means of the cars; he was fifteen or sixteen yenrs old, and spent a good portion of his time in the lower end of tlw town, and I account for it in that way; there was no

....

LXXXIV

APPENDIX.

local cause, for usually very little malarial fever exisb there ;

this boy ha([ frequented the lower part of the city dnv mHl night

not sleeping there, but tlwrc at all hour,.; of the night.

Question-Some of tho phy,.;icians in the dty thinl;:, th,lt the

~ases \d1ieL1 occurred in tlte neighborhood of the freight dPpots

were due to infeeted atmosphere brought from s,wantwll nnll

llrunswiek, and that tlll'y were not dne to local cause.~; have you

given t!mt wutter any thougltt '?

Answlr-I have.

Question-\Vhat is your opinion upon that u:mtttr '? Do you

think that the eases were likely to have received infection, or, in

a measure, to have been due to local causes'?

Answer--AH l:-;tate(l before, I have never been at all disposcd to go

ahroud for the origin of my cases. I think that every sin~ll ca~e

that I have seen may be traced to local causes, ami I han! never

given any ercdence to the thought that tlJe freight t!Pput had any

special agcney in the production of the~e ca:-;es. '!'here is thi:s well

known fact to physicians, when an epidemic ii1 any torm of a dis-

eai'\e makes it:s appearance, di~ea:se,; of tlJat peculiar family are

very apt to partake of its nature throughout the country; and a

peculiar circnm:;tance letvling to tlJe development of thiH foYer in

Savanna~, in my opinion, existed in ::\Iaconand elsewhere, and

.

led to this participation in our Lilious fever:> here to this t(wlency

to assume a malignant form simulating yellow fever.

Question--Do you think that the atmo~plwric condition whieh

exists during the fall and summer in thi:-; city favomblc to the

prc,pagation of yellow fever infcction?

An~wer-I do, that portion of the city bel0w 3!l street, but par-

ticularly below 4th street; aud I think it pos~ible that the atmos-

phere might be infected with yellow fever pohmn, by the introduc-

tion of the disease from abroad.

(~uestion--I asked several gentlemen their opinion with regard

to the advisability of (1uarantine in future ;;hould an epidemic

occur along the coast; what are your views with regard to that?

Answer-! think that where there is possibility of danger, pre-

cautionary measures are necess,ny, aud I think there is a pos.~i

bility of danger to the lower part of the towu, but I (lon't know

that this possibility, and it is a bare possibility, ia my judgment,

would justify the shutting out of refugees from an iufede!l home

seeking an asylum in our midst, wllere there is so little danger.

I am honestly convinced from my past knowledge of yelluw fever,

but more particularly from the experienee of the past few months,

that above 2d street, and particularly the hill portion of our city,

cannot, under any circumstance~, be infected by yellow fever. I

Jwow a number of instances where yellow fever patients from Sa-

APPENDix.

L:XXXV

Vunimh nud Hmns\dck were qnartererr in families; some eYen as

low down as between Bd ::til(\ -!th Btncts in front of the Isaac's

Hou~e, were sick, and in mo~t instances died, being HUrKcd by the

familie~, some at boarding houses where numbers of pcr:;ons were

exposed, ant\ uot in one single instance did a case of fever occur

from them; thus proving rnost unmistakably that yellow fever is

not contagious from one person to another, at lea;.;t in this atmos

phere.

(~.no~tion-Do you think any of the cases that you had were

cou tagious?

Answer- I don't; any more than the bilious fevers are con

tagious.

Question-Have you any reliable information of any disease

exiHting in the surrounding country which corresponds with those

cases you have described?

Answer- I have nothing beyond the information that we have

of the fever prevailiug in the lower part of Georgia, known as

"Lee coun'.Y yellow fc,Jer," and I think that the fever we had in

l'llacon was precisely such a fever, and is more malignant, a hun

dred per cent., than yellow fever proper.



Que,;tion- Are there any measures which can, in your opinion,

be adopted, any hygienic measure, to prevent this malignant type

of fever'?

Answer- I think such measures as we would adopt to arrest

intermittent or rernittent fever; I believe that the production of

this peculiar type of fever results, in a great mea:mre. from ex

treme heat after a wet season.

'Vl\I. R. BURGESS, M.D.

MACoN, GA., December 20th, 1876. Testimony ofDR. ,V. F. HoLT:
Question-Are you a practicing physician? Answer-! am. Question-For bow long have you been practicing? An,;wer-Nineteen years. Question-Did you sec any yellow fever cases here last summer? Answer-I saw some that were purported to be yellow fever; one of these I saw in articulo mortis, and another 12 hours before she died. Question-Did you have a post mortem examination of those cases'? Answer-Yes, sir; Dr. Mettauer made a post mortem. Question-'Vhat was your opinion of the cases? Answer-'fhat they were not yellow fLVet. I was invited to see

LXXXVI

AP:PENDIX.

another case that was said to be a marked case of yellow fever1 originating here ; but that case got well.
Question-\Yhere was this first case located? Answer-In what is called the Fctctory Row, in tbe ~outhwestern part of the city. Question-Is that locality considered a healthy one? Answer-It is a malarial district. Question-\Vhat time was it you saw these ca8es ,you !'!peak of? Amswer-I think it was in September. Question-\Vhat part of September'? Answer-I don't remember, but think it was irt the early part of September. Question-Do you know nothing of the cases of yellow fever upon which the post mortem was p<'rformed more than what you saw at the examination? Answer-Yes) sit; I saw one in artictl,[omorti'J and the other d~ed l:l hours after I saw her. It is my opinion that neither of these case~ were yellow fever. Question-State as near as you can the post mortem appearance? Answer-'fhe liver resemuled the yellow fever liver more than it did the bronze liver of ui.liouo; fever. The liver wa>l not yellow fQVel' liver. Question-Did. you ever treat a case of yellow fever? Answer-I ne,er did, and n-ever saw any. Question-Did you make any comparisons of the liver with plates or descriptions. Answer-I had no means ofcomparing the liver except theoret
ically, (~uestion-You consider that that case originated in that part of
the city'? Answer-It is my opinion tllat it did.. I don'tthinl> the parties
live anywhere else. A niece of this party, it was said, came from Savannah; she renuined in the house two nigllts and a day. I went directly from thifl factory ease to see the niece who had left the house, thinking that I could trace the comwction. I found that r:;be hnd not been sick, and she was not taken sick afterwardH. I examined her clothing and trunk, the only baggage she carried to the house of her aunt, the old lady who died. 'l'here was a woman lying confined in the house.
Question-\Vhat do you considf)r the condition of that part of the city surrounding the freight depot.
Answer-It is a malarial di!>trict; it is the sickliest portion of Macon; uilious, remittent and intermittent fevers and what is called pernicious, have prevailed there. I consider tlle :-;outheaste

APPENDIX.

LXXXVII

ern portion of the city favorable to the development of malarial diseascs, a large swamp being in close proximity.
Que:oiiun-"\rc there any other portions of the city, besides that SUlTOUJHling tlJe freight depot, considered to be malarial'?
Alls\ver~I uelievt' ull the surroundings are malarial, and to the east of Fifth street, towards the swamp.
Question-Did you treat any cases of yellow fever that came here frmn Savannah?
Answer-I did not. (~uestion-\Vlmt other purported cases of yellow fever did you
know of at tlw time '?
Answer-I was invited to see a case that was said to be a well marked case, on Pine street, uetween Third and Fourth stleets, l\ly diaguo~i~ wml that it was not yellow fever. The attending physician said that it was a well marked case. 'fhe patientrecov ered.
Queetion-\Vere there other eases of fever in town, that you heard of?
Answer-A number of them; but it so happened th:tt I was not called to see tllem.
(htestion-Have you studied the matter of contagion or non contagion '?
Answer- Yes, sir. I did not consider these fever;.; to be the re sult ot contagion. I don't believe yellow fever is contagious. It will have to ue a peculiar eondition of the atmosphere to propa gate yellow fever. I don't co11Sider this atmosphere fttvorau!e to tlle propagution of yellow fever.
Qnebtion-'l'hese otller ease;; you heard of were in the ndgllbor hood of Fourth and Fifth streets?
Answer-\"es, sir; uy tlle Brunswick railroad. Que~tion-\Vhat are your views in regard to quarantine of train>'! and indiYiduals "? Answer- I have no expc;rienc>e with that. QneHtiou- What do you think of tlle advisability of establi~lling a quarantine wh<;n tile epidemic occurs in our sister eitie>:1'~ An:,;wer-1 vonld lle totally opposed to quarantine.
Qw,~tiou-1 would like for you particularly to put yom~elf on reeord, wiLh regard to tl1e pofit mortem examination of the cne of yellow fever ttt the factory.
An~wer-I ~t<y it. wa>; not n ca:,;e of yellow fever. Que~tion-\Vhat was the eondition of tile city with r!.'gard to healtil at that time'? An;;wer-It never has ucen better at that seaBon of the year for nineteen year~ !Jack. l.c~ue~tlon-After the occurrence of the cases of fever, near tb~,J

LXXXVIII

APPENDIX.

depot, whnt was the health, during September, through the re

maining portion of the city'!

Answer-Good. Intermittent fevers prevailed, "ith no malig

nant types.

Question-Do you consider the city of Macon etricUy in a sani-

tary condition'?

Answer-Not etrietly so.

Question-In what respect do you consider it deficient?

Ans,ver-Defecti ,.e sewerage,

Question-~What is the general plan of sewerage in the city?

Answer-'J'here are not enough sewers, and they are not large

enough, and the manner of disposing of human excreta is very

defective. It i>-l disposed of by means of wells and sinks.

Question-Are there any houses in the city containing water

closets?

An'3Wer-A few. The proportion is very small. Some use the

dry-earth system, some the \Vakefield closets. !{ine-tenths of

them arc open privies, out~ide of the house.

Question--\Vhat is the system~ of water supply'?

Answer--There is no s,ystem, except cisterns for fire-engines;

and there is 110 hydrant water, except in a few houses.

Question~-Has there been much typhoid fever pervading tlle

city this year?

...

Answer--A few cases. Macon never was in so llealthy a condi-

tion since I have been llere, as our mortuary reports will abund

antly corroborate.

'V111. :F. Hovr.