The subjoined letter was sent the president of every railroad company entering the State of Pennsylvania: To the President of the Railroad Company: DEAR SIR: I am instructed by the State Board of Health of this Commonwealth to transmit to you the accompanying resolutions passed at its regular meeting at Harrisburg, November 9, 1887. The readiness which your company has always shown to coöperate in measures designed to protect the public health, leaves no room for doubt, that this request will meet with prompt and efficient compliance on your part. I have the honor to be, Yours very respectfully, BENJ. LEE, Secretary. Resolved, That this board respectfully requests the presidents of the railroad and transportation companies in this State to instruct their employés not to receive or transport any immigrant from an Italian port who has been under observation at the quarantine station of the port of New York without a certificate from the authorities of said station, declaring that his or her person, clothing and effects are free from danger of communicating Asiatic cholera. Courteous responses were received to this request in every instance, assuring the secretary of the desire of the companies to coöperate to the full extent of their ability in preventing the introduction of the contagion. The intelligent appreciation always shown by railroad officials of the necessity for sanitary precautions, their ready comprehension of sanitary problems and the attentive consideration with which they receive suggestions from sanitary authorities upon such matters, are as commendable as they are remarkable, and are in striking contrast to the supercilious neglect or undisguised resentment with which similar overtures are too often met by the petty magnates of country villages. The president of the Pennsylvania Railroad Company, having asked for additional suggestions in regard to precautions to be taken during an epidemic, the Secretary replied as follows: PHILADELPHIA, November 23, 1887. G. B. ROBERTS, Esq., President Pennsylvania Railroad Company: DEAR SIR: In reply to your favor of the 21st, in which you ask for suggestions from this Board in regard to possible precautions to be adopted in the event of the arrival of cholera-infected immigrants, I would say, first, that it would be well for the company to consider the expediency of selecting some point on each line which is likely to bring such persons into the State, not far from the State line, and as remote as possible from any center of population, provided with a good water supply, for the location of a temporary hospital, where passengers found sick or taken sick with suspicious symptoms, upon the train, could be sent for isolation and treatment. Secondly, an obvious means of spreading the disease would be the discharges of patients dropped from the car water closets on the tracks and thence washed by the rain into rivers and other sources of drinking water. Arrangements should therefore be made by which all emigrant cars could, at short notice, be provided with earth closets in place of the open closets. Indeed, I should look with great favor on the substitution of this form of closet on all trains and at all times. These are the only suggestions that occur to me in advance of the actual presence of an epidemic. I have the honor to be, Yours very respectfully, BENJ. LEE, Secretary. Simultaneously, with the note to the officers of railroad companies, the annexed communication was sent to the Quarantine Commissioners of New York: PHILADELPHIA, November 16, 1887. To the Honorable, the Quarantine Commissioners of the Port of New York. GENTLEMEN: I am instructed by the State Board of Health of Pennsylvania to transmit to your honorable board the accompanying reso lutions, adopted at its regular meeting, held at Harrisburg, November 9, 1887. I have the honor to be, Yours very respectfully, BENJ. LEE, Secretary. Resolved, That this Board respectfully requests the Quarantine Commissioners of the port of New York, First. To allow no immigrant now under observation at their quarantine station or who may hereafter arrive from a port in which or near which Asiatic cholera prevails, to leave without a certificate stating that his or her person, clothing and effects are free from danger of communicating the said disease, with the reasons for such belief. Second. To notify the Secretary of this Board whenever such immigrants leave the station with the intention of entering this State, in order that they may be kept under observation by the local health authorities; and Third. To notify the Secretary of this Board whenever a new case of the said disease arrives or develops at the station. The response to this communication came indirectly through the Secretary of the State Board of Health of New York, in the shape of the notification of the fact that one hundred and two immigrants from the steamship Alesia, who were destined for points in Pennsylvania, had been discharged with certificates of freedom from contagion. The name of each immigrant was given and the name of the place to which he was ticketed. The importance of such careful and specific information cannot be over estimated, and the incident affords a signal evidence of the value of coöperation between State boards of health. On the same day that this intelligence was received, the following circular letter in cyclostyle was sent to the authorities of the below named towns, giving the names of the immigrants who might be expected to arrive in each: COMMONWEALTH OF PENNSYLVANIA, STATE BOARD of Health, EXECUTIVE OFFICE, 1532 PINE STREET, PHILADELPHIA, November 21 1887. To the Health Officer or Burgess of: DEAR SIR: It is my duty to inform you that the following named persons who have been quarantined by the health authorities of the port of New York, on account of cholera, for several weeks past, have been discharged from quarantine, their destination being your The interests of the public health demand that they should be kept under observation for a considerable period. I have the honor to be, yours very respectfully. BENJ. LEE, Secretary. List of cities and towns to which the above notice of immigrants was sent: Balltown, Forest county, Bangor, Northampton county, Bloomsburg, Columbia county, Hazleton, Luzerne county, Mt. Tabor or Pierce, Armstrong county, New Castle, Lawrence county, New Cumberland, Cumberland county, Philadelphia, Philadelphia county, Pottsville, Schuylkill county. Wanamie, Luzerne county, Walston, Jefferson county. Fortunately the health officer of New York had done his work so thoroughly that no single case of cholera developed from any one of the many hundred immigrants who spread themselves broadcast through the land. The second of the contagious diseases above named, variola, has made its appearance in five different localities: Chester; Lowhill, Lehigh county; Philadelphia; Bentleysville, Washington county, and in a lumber camp near Horton City. It was introduced into Chester by a colored woman who had been visiting friends in Wilmington. In that city its origin was clearly traced by the health officer to the " Augus tine" paper mill. The Secretary made an attempt to discover from the owners of the mill what the source of the rags which produced the infection was, but as usual in such establishments a know-nothing policy was strictly observed. The Chester authorities took prompt and efficient measures to stamp out the infection and confined it to four cases. Their experience, however, naturally made them feel anxious when it was rumored that there was a possibility of the removal of the small-pox hospital of Philadelphia to the Lazaretto, which is but a comparatively short distance outside of their city limits. A series of resolutions remonstrating against the continuance of quarantine at that point was passed by their board of trade and forwarded to the Secretary. Together with his reply they will be found spread upon the minutes of the ninth regular meeting. The origin of the disease at Lowhill was kindly traced by Dr. P. L. Reichart, the health officer of Allentown, who, in the absence of an inspector for that district, was requested to assume control there temporarily. It is somewhat curious. The keeper of a cheap hotel in Catasauqua, finding old clothing constantly left on his premises, instead of adopting the plan of the Pennsylvania Railroad Company and promptly burning it, in a spirit of false economy sent it to his son-in-law at Lowhill to be used by his grandchildren. The garments proved veritable tunics of Nessus, infecting not only the children and immediate family, but a good woman from Slatington who helped to sort them, and who took back the disease with her to her home. The hotel was promptly closed and fumigated, the neighborhood vaccinated and the pestilence stayed. The board of health of Philadelphia was not so fortunate in its management of the disease in that immense center of population. From the report of the Sanitary Committee to the Board, the following facts are gleamed with regard to its origin: An Englishman, arriving on the steamship Lord Clive, February 2, coming from a house in England in which there was small-pox, developed the disease after his arrival in so light a form as not to require the attendance of a physician. Two weeks after his departure, the nature of his illness not having been suspected by the other inmates of the boardinghouse, three of them were taken sick. Unfortunately, the disease was not recognized by the attending physician for several days, and then there was unnecessary delay in reporting it to the Board. Opportunity was thus given for the exposure of a considerable number of persons, and it was taken abundant advantage of. After a stubborn fight, in which vaccination and disinfection were freely employed, but isolation was not insisted upon as rigorously as could have been desired, at the end of eight months the sanitary authorities have, it is hoped, destroyed the contagion, with a record of three hundred and seventy-six cases, and a sacrifice of eighty lives, to which must be added another, that of a man who contracted the disease in Philadelphia and carried it to Bentleysville, Washington county, where the case was at once taken charge of by Inspector Hunter, of the State Board, and where the patient died without communicating the disease. During this period small-pox has prevailed throughout the entire country. By means of the admirable system of interstate notification, now adopted by the State Boards through the medium of their annual conference, the Secretary has been kept constantly informed of its occurrence and progress in seventeen States and Provinces. The widespread existence of the infection is plainly due to European importation, and the lines of steamships bringing immigrants to this country owe it to us to adopt more stringent regulations to prevent this transportation of the means of death. It is infinitely more terrible than the transportation of dynamite and infernal machines, which they are charged with conveying in the opposite direction. During the prevalence of a contagious disease, such as had existed for a year previous to our own outbreak, in England, not only should the strictest precautions have been taken in regard to vaccination, but no passenger should have been admitted into the steerage who could not show a certificate from a local health officer that he had not been exposed to the contagion for at least a month previous to presenting himself for embarkation. It should also be made a misdemeanor, punishable both by fine and imprisonment, for any individual to suffer from an acute eruptive disease without obtaining the opinion of a respectable physician as to its nature, or for any landlord to harbor such individual, or for any parent to attempt to treat such an acute eruptive disease in a child without obtaining such opinion. Had the landlord in this instance insisted on a physician being called when the eruption appeared on his guest, the entire epidemic would have been prevented and eighty-one persons now in their graves might still be in the enjoyment of life and health. In addition to this let it not be forgotten that the average value of a human life, taking the average of all ages, has been estimated by careful political economists to be not less than $1,500, and we have a loss to the wealth of the city of $120,000 in lives alone. Instances have fallen under the notice of the Secretary and probably of every medical member of this Board, in which mothers have attempted to treat what they ignorantly supposed to be measles, without "sending for a doctor," and have been the unintentional, though not innocent, means of sending scarlet fever forth on its errand of death to many a home. Much difficulty was experienced in a number of cases during this outbreak in inducing the friends or family of patients to allow them to be removed to the Municipal hospital, when in the judgment of the officers of the board of health of the city, public safety demanded it. In order to settle the question of the right of the Board to enforce |