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Annual report of the Supervising Surgeon-General of the Marine Hospital Service of the United States (Volume 1898) online

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Treasury Department. Marine-Hospital Service.



CE]>^TE:sr>rj:AX; "t^ii/^R.



ANNUAL REPORT



OF THE



SUPERVISING SURGEON-GENERAL



OF THE



MARINE-HOSPITAL SERVICE OF THE UNITED STATES



FOE THE



FISC^^L YE^R 1898.



WASHINGTON:

GOVERNMENT PRINTING OFFICE.
1899.



Treasury Department,
Document No. 1449.

Office of U. S. Marine-Hospital Service.



OPERATIONS

OF THK

UNITED STATES MARINE-HOSPITAL SERVICE.

1 S 9 8.



><:






280465



CONTENTS



Page.

Report to the Secretary 15

Medical Corps:

Board convened for the examination of applicants. 15

Appointments and pi'omotions 15

Resignation 16

Casualties 16

Death of P. A. Surg. W. D. Bratton_ 16

Death of Asst. Surg. Emil Prochazka 16

Officer on waiting orders on account of physical disability 17

Act for the relief of the legal representatives of the late Asst. Surg.

John W. Branham, a^jproved June 15, 1898 17

Officers detailed to represent the Service at meetings of medical and

public health associations 18

Report of Surg. J. M. Gassaway on the meeting of the American

Public Health Association, Denver, Colo 18

Report of Surg. Charles E. Banks on the meeting of the Ninth
International Congress of Hygiene and Demography, Madrid,

Spain . ... 20

Report of Surg. Charles E. Banks on hospital equipment, ward
furniture, etc., in certain ho.spitals of Spain, France, and

England 23

Report of P. A. Surg. S. D. Brooks on the meeting of the Wash-
ington State Medical Society 27

Revision of the regiilations 27

Information for those desiring to enter the medical cori^s of the Marine-
Hospital Service - 27

Circular letter 27

Api^lication blank • 32

Specimen set of examination questions 82

Aid to other branches of the Government service:

United States Army and Navy 33

Correspondence relating thereto 34

Department circular approved by the President 35

Circular — rate of charge 36

Circular— Coast Signal Service (U. S. N. ) 36

Summary of relief furnished - . . 36

Acknowledgment of aid to Coast Signal Service (U. S. N.) 37

Aid to the United States Revenue-Cutter Service 38

Aid to the United States Life-Saving Service 38

Aid to the Inspection Service of Steam Vessels 38

Aid to the Immigration Service 38

Trans-Mississippi Exposition at Omaha - . 40

7



8 MARINE-HOSPITAL SERVICE.

Paga

Shelter for deck crews on Western rivers 40

Department circular calling attention to section 2, act of Congress

approved March 3, 1897, providing such shelter 40

Case of the steamer Anna B. Adams 41

Reports to be made of the deaths of foreign seamen 42

Circular issued by the Bureau of Navigation 43

Tonnage tax 42

President's proclamation discontinuing such tax in the case of vessels

arriving at United States ports direct from Copenhagen 43

Marine hospitals and relief furnished:

Summary of patients treated 44

Inspection of stations of the first, second, third, and fourth class

( blank forms) 44

Statement by stations of repairs and alterations made and needed ... 52

Contracts for the care of seamen — Department circular 60

Circular letters relative to administrative details ... 68

Leaves of absence for acting assistant surgeons 69

Promulgating certain paragraphs of the revised regulations 69

Employment of attendants under civil-service rules 70

Promulgating change in uniform regulations 70

Inquiry as to experience in the diagnosis and treatment of variola... 71

Accommodations for sick and wounded officers of the United States
Revenue-Cutter Service at stations where there is no United States

marine hospital 71

Concerning post-mortem examinations; specimens to be forwarded to

the hygienic laboratory 71

Report of the purveying division 72

Financial statement 77

Reports of fatal cases, with necropsies 83

Contributed articles:

Report on a case of Raynaud's disease. By P. A. Surg. P. C. Kalloch. 230

Location of bullet by X-ray. Rupture of traumatic aneurism; estab-
lishment of collateral circulation after double ligation of the main
artery of the limb; ultimate result in doubt. By P. A. Surg. R. M.

Woodward _ _ 231

Anthrax oedema. By P. A. Surg. W. P. Mcintosh 233

Observations, comments, and statistics on the diagnosis, climatic
isolation, and future control of the consiimptive sailor. By P. A.

Surg. J. O. Cobb , 236

Fermoral hernia — Operation (Bassini's) — Recovery. By P. A. Surg.

J. B. Stoner 251

Cases from hospital practice. By P. A. Surg. George B. Young 253

A portable operating room (illustrated). ByAsst. Surg. L. E. Cofer. 260

Severe lacerated wound of the foot involving the bones of the foot,
metatarso-phalaugeal junction, etc. By Asst. Surg. J. H.Oakley.. 262

Toxic amaurosis — Recovery. By A.sst. Surg. J. B. Greene 263

Herniotomies. By Asst. Surg. H. S. Mathewson 264

The radical cure of hernia, with report of cases. By Acting Asst.

Surg. J. B. Eagleson 267

Reports on tuberculosis in Rio de Janeiro and on the etiology of beri-
beri. By Acting Sanitary Inspector W. Havelburg 280

Statistics of the Pasteur Institute at Rio de Janeiro aiid a report on
the Vaccination Institute in that city for the year 1897. By Acting
Sanitary Inspector W. Havelburg. 283



MARINE-HOSPITAL SERVICE.



Page.



Articles on yellow fever, its nature, diagnosis, treatment, and prophylaxis,
and quarantine regulations relating thereto:

Letter to the Secretary 287

Diagnosis of yellow fever:

Circular letter. By Surg. R. D. Murray 289

Diagnosis of yellow fever. By Acting Asst. Surg. John Guiteras. 296

Treatment of yellow fever:

The treatment of yellow fever. By Surg. R. D. Murray . 3pi

Therapeutic treatment of yellow fever. By P. A. Surg. H. D.

Geddings 313

Hygienic measures to be adopted by xiersons living within an area of
yellow fever infection:

By Surg. H. R. Carter 319

By P. A. Surg. Eugene Wasdin.... 330

By P. A. Surg. H. D. Geddings 333

By Sanitary Inspector W. F. Brunner 335

Prevention of the spread of yellow fever:

Measures to be adopted in towns infected with yellow fever. By

Surg. H. R. Carter 339

Measures to be adopted in a district threatened by yellow fever.

By Surg. H. R. Carter 358

Measures to be adopted in infected and noninfected towns. By

P. A. Surg. A. H. Glennan 361

Mea.sures to prevent the propagation of yellow fever fi-om an
infected to a noninfected locality. By Asst. Surg. Seaton

Norman 367

Regulation of traffic to, from, and through infected towns. By

P. A. Surg. J. H. White 370

Communication with an infected town. By Surg. H. R. Carter. 373

Detention camps and camps of obsei'\'ation. By P. A. Surg. J. H.

White ' 378

Train inspection service. By P. A. Surg. George B. Young 389

Synopsis of interstate quarantine regulations. By P. A. Surg.

J. H. White. :^ ' 412

Maritime quarantine against yellow fever:

Precis of United States quarantine regulations to prevent intro-
duction of yellow fever. By Surg. Preston H. Bailhache 415

A concise explanation of the maritime quarantine regulations of

the Treasury Department. By P. A. Surg. J. H. White 421

Post-epidemic disinfection:

Circular letters issued by the Marine-Hospital Bureau relating

thereto . . _ _ _ _ _ . 425

Present status of the bacteriology of yellow fever. By P. A. Surg.

E. K. Sprague ' 428

On the value of autopsic findings in cases that have died from sus-
pected yellow fever. By P. A. Surg. Eugene Wasdin. 432

Train inspection:

A contributed article by Surg. H. R. Carter, prepared at the close

of the epidemic of 1898 441

Statistics, United States Marine-Hospital Service 455

PUBLIC HEALTH SERVICE.

Cholera:

Annual history of the prevalence of, and table showing the geo-
graphical distribution 527



10 MARINE-HOSPITAL SERVICE.

Yellow fever: Page.
In the United States —

Supplemental facts concerning the yellow fever epidemic of 1897 . _ 539

Origin of the epidemic of 1897 529

False reports against the United States quarantine
station at Ship Island, Mississippi, and refutation

thereof 529

Report of P. A. Surg. J. H. White, on the source of the

fever in 1897 at Ocean Springs, Miss 536

Post-e]»idemic disinfection throughout the South 539

Bureau orders relating thereto 540

Yellow fever outbreak in Louisiana and Mississippi in the sum-
mer 'and fall of 1898 544

The outbreak in McHenry, Miss 544

Resolution conveying thanks of Louisiana State Board of

Health :-..- 550

The epidemic in Franklin, La 550

Report of Surg. P. C. Kalloch 553

Spread of the fever in Louisiana and Mississippi 556

Weekly statement of spread and measures taken 558

General description of Service measures 565

Source of the yellow fever infection in Mississippi 570

Report of P. A. Surg. J. O. Cobb 570

In other countries —

Localities where present —

History of yellow fever in Rio de Janeiro since the year 1849,

with statistical tables 580

Table, yellow fever in foreign countries 583

Investigation by the United States Marine-Hospital Service of the

causes of yellow fever - 584

Preliminary report of yellow fever commission-
Report of Surg. Eugene Wasdin 587

■ Report of P. A. Surg. H. D. Geddings 590

Report of Surg. Eugene Wasdin on the antiamaryllTc serum of Pro-
fessor Sanarelli 593

Smallpox in the United States:

Annual hi.story of 598

Cooperation with State and local boards of health in the suppres-
sion of epidemics of smallpox during 1898 600

Report on the epidemic of smallpox at Birmingham, Ala.,

and vicinity 600

Report on the epidemic of smallpox at Middlesboro, Ky 613

Government aid to smallpox sufferers at Fair Oaks, Ark 622

Investigation and advisory aid at Charlotte, N. C 623

Investigation and advisory aid at Little Rock. Ark 624

Investigation and advisory aid at Columbia and Sumter, S. C. 625
Table showing geographical distribution of smallpox during the year

ending October 1 , 1898 628

Principles governing extension of aid in smallpox 630

Plague:

Reports on the plague in India ' 632

Epidemic in Bombay 632

Infection in other Indian cities 634



MARINE-HOSPITAL SERVICE. 11

Plague — Continiied. Page.
Eeport on the plague in Calcutta. By the United States consul-
general 635

Plague in other countries 685

Regulations to prevent introduction of plague into Morocco 638

Russian and French restrictions on the pilgrimages : 640

Strict enforcement of preventive measures urged iipon the Ottoman

Government 641

Haffkine's serum — preventive inociTlation 641

Leprosy:

Report on lei^rosy in Japan 643

Report on leprosy in the Kingdom of Denmark 644

Translation of certain laws on the subject of leprosy in force in

that country 644

Bill for the investigation of leprosy in the United States 646

National quarantine administration (foreign):

Foreign sanitary inspection service 649

Sanitary inspection at Habana. Cuba 649

Vaccination, at Habana. of persons departing for the United

States 650

Sanitary inspection at Santiago de Cuba 651

Sanitary inspection at Rio de Janeiro. Brazil 651

Statement of occurrence of yellow fever on shipping 651

Sanitary inspection at Yokohama. Japan 653

Report on inspection of vessels and passengers for the United

States during the fiscal year 1898 653

Report of epidemic dysentery 655

Sanitary inspection at Honolulu. Hawaiian Islands 655

Preliminarj' report of Surg. D. A. Carmichael 656

Method of inspection of emigrants at Naples, Italy 659

Report on the inspection of the William Head Quarantine Station,

British Columbia, by Surg. S. D. Brooks 667

National quarantine administration (domestic):

Yellow fever precauticms in the spring and summer of 1898:

Inspectors 670

Special regulations for naval war vessels 670

Correspondence with Navy Department 671

Navy requested to intercept small craft and refugees from

Cuba __,. 671

Navy Department to forbid transportation of refugees or
effects from Cuba and to require observance of usiial quar-
antine regulations on part of prize vessels and auxiliary

vessels . - 673

Correspondence ^^^th War Department in. re transports — not to
bring refugees, clothing, or baggage, and to submit to regular

quarantine regulations, May 31, 1898 — reply July 16 673

Efforts to prevent landing of sick and wounded and refugees

from Cuba at southern ports 674

Letter to Surgeon-General Sternberg, U. S. A 674

Protest of Portsmouth, Va. , board of health 675

Protest from Port Tampa, Fla. — letter to Secretary of War.. 675

Orders to collector of customs. Port Tampa 676

Quarantine authorities sustained notwithstanding war meas-
ures — letter to state health officer of Florida 676



12 MARINE-HOSPITAL SERVICE.

National quarantine administration (domestic) — Continued. Page.
Yellow fever precautions in the spring and summer of 1S98 — Cont'd.

Detention Camp at Egmont Key 677

Disinfection of the steamer Nictheroy — afterwards U. S. criiiser

Buffalo 682

Detail of board to report on sanitary condition of vessel 683

Report of board 684

Correspondence with the Navy Department 685

Precautions recommended regarding return of troops from Santi-
ago to Montauk Point 686

Telegraphic orders issiied by the War Department 689

United States maritime quarantine at Montauk Point 690

Army transport and port inspection service 693

Correspondence with Secretary of War 693

Official orders — War Department 694

Officers of the Marine-Hospital Service detailed to serve on

Government transports ., 694

Instructions 605

Reports of Asst. Surg. A. R. Thomas on Obdam 696

Report of Asst. Surg. C. H. Lavinder on Manitoba 700

Report of Asst. Surg. Sherrard R. Tabb on Manitoba 703

Report of Asst. Surg. John McMullen on Mississippi 705

Reports of Asst. Surg. S. B. Grubbs on Chester 707

Report of Asst. Siirg. H. B. Parker on Minnewaska 713

Report of Acting Asst. Surg. J. S. Hough on Roumanian 714

Texas border inspectors and guards. 716

Treatise on yellow fever 716

Investigation of reported cases of yellow fever at Key West, Fla.;
Tampa. Fla.: Fort Point (near Galveston), Tex.; Portsmouth,

N. H.; Fort Monroe, Va.; Brownsville. Tes.,and Varner, La.. 716

No yellow fever admitted to the United States during 1898 718

Amendments to quarantine regulations — ciuarantine circulars 718

Addition to regiilations —

Disinfection by f ormaldehyd gas 718

Special regulations relating to naval vessels 719

Consular bills of health 719

Inspection of certain vessels and baggage on and after April 1

and until November 15 720

Vessels from infected ports, bound for Apalachicola, Fla., to proceed

first to a disinfecting station 720

Reports from the national quarantine stations — transactions, repairs,
and improvements during the fiscal year 1898 —

Reedy Island Quarantine 721

Delaware Breakwater Quarantine 722

Cape Charles Quarantine 723

Cape Fear Quarantine 725

South Atlantic Quarantine 726

Brunswick Quarantine 728

Tortugas Quarantine - 728

Gulf Island Quarantine 730

San Diego Quarantine - 735

San Francisco Quarantine 737

Port Townsend Quarantine 739



MARINE-HOSPITAL SERVICE. 13

National quarantine administration (domestic) — Continued. Page.
Report on the establishment of a national quarantine station at Asto-
ria. Oreg - . . 740

Detail of board for selection of site 741

Floating quarantine plant Protector . - - 741

Relations with State and local health authorities:

Relations harmonious 745

Replies to criticism 745

Letters of appreciation from State authorities 745

National quarantine legislation:

Senate bill 2680 and House bill 4363 — genesis and history of. 745

Bureau of public health bill — genesis and history of . 747

Mobile and Atlanta conventions 748

Service attitude toward conventions and associations 748

Legislation needed 748

Increase of clerical force in Bureau 749

Senate bill 2680 in full as reported 749

Report on by Senate Committee on Public Health and National

Quarantine - - - 752

House bill 4363 as reported 757

Letter of Secretary of Treasury 760

Statement of Surgeon-General relating thereto . . 761

Report of Committee on Interstate and Foreign Commerce of

the House of Representatives 766

Minority report •. - - 771

Division of sanitary reports and statistics

Public health reports 773

Table of yearly mortality, cities of the United States, 1897 776

Transjwrtation of dead bodies in the United States 801

National regulations relating thereto 801

Inquiry into the rules and regulations of the several State boards of

health in regard to the transportation of dead bodies 802

Circular letter addressed to State boards of health 803

Abstracts of replies received 802

Report of the hygienic laboratory:

Special investigations _ 808

Infections caused by the pneumococcus 808

Pseudo-diphtheria bacillus 808

Bacillus typhosus 809

Etiology of variola .-. 809

Bacteriological examination of the Potomac water supply. 809

Laboratory instruction to officers of the Service 824

Car sanitation. 824

Measures to obtain material for pathological instruction 825

Microscopical and chemical examinations 825

Prospectxis of laboratory work during 1899 826

Recommendations 826

Report on the best method of disinfecting mail matter 826

Acknowledgments 828



CENTENNIAL YEAR.



EEPORT TO THE SECEETARY.



Treasury Department,
Office Supervising Surgeon-General M. H. S.,

November 1, 1898.
Hon. L. J. Gage,

Secretary of the Treasury.

Sir : I have the honor to herewith transmit the report of the Marine-
Hospital Service of the United States for the fiscal j'ear ended June
30, 1898, being the twenty-seventh annual report of the Service and
the one hundredth year of its existence.

In addition to the information pertaining to the fiscal j'ear 1808,
the operations of the Service as regards quarantine and public health
matters are included to the present date.

It had been the intention to include in this report a history of the
development of the Service, together with a full description of its
present legal status, its functions, and personnel; and the preparation
of a complete article had been begun when the exigencies caused by
the outbreak of hostilities with Spain and the Service work in con-
nection with yellow fever in the South demanded so close attention
to more active duties that the historical summary was necessarily
deferred until the next annual report, when it will be equally appro-
priate.

MEDICAL CORPS.

One board has been convened during the year for the examination
of candidates for admission to the Marine-Hospital Service as assistant
surgeons. The number of applications to appear before this board
was 32. Thirty applicants presented themselves, of whom 5 attained
the required standard.

APPOINTMENTS AND PROMOTIONS.

During the year 6 successful candidates were appointed to the grade

of and commissioned assistant surgeons, and one passed assistant

surgeon, after examination, was promoted and commissioned as

surgeon.

15



16 ,', MARINE-UOSPITAL SERVICE.

, ..... RESIGNATION.

One assistant snrgeoli resigned his commission on June 22, 1898.

CASUALTIES.

During the year ended June 30, 1898, there have been two deaths
among the medical ofi&cers of the Service. One of these deaths was,
although occurring on October 2, 1897, the subject of mention at
some lengtli in my last annual report, as the circumstances of his
demise, occurring while performing quarantine work and while barely
recovered from a long illness, appeared to warrant notice at that time
without waiting for the next issue of my annual report to you. I refer
to P. A. Surg. W. T>. Bratton, who died from injuries sustained by
falling into the hold of a vessel which was undergoing disinfection at
the quarantine station at Sabine Pass, Tex.

The second fatality was that of Asst. Surg. Emil Prochazka, who,
on account of tuberculosis of the lungs, had been placed on waiting
orders in the spring of 1897. His death occurred from this disease on
April 1, 1898.

circular letter announcing the death of asst. surg. emil prochazka.

Treasury Department,
Office of the Supervising Surgeon-General M. H. S.,

Washington, D. C, April 9, 1898.

To the Medical Officers of the United States Marine-Hospital Service:

It is my painful duty to announce to the officers of the Service the death of
Asst. Surg. Emil Prochazka, which occurred on the 1st instant, at Silver City,
N. Mex., from tuberculosis of the lungs.

Emil Prochazka was born in Manitowoc, Wis.. April 9. 1864. His education
began in the graded public schools of Manitowoc, where he graduated from the
high school in 1880. subsequently entering the State University at Madison, where
he pursued a special course for two years, devoting particular attention to higher
mathematics, chemistry, and languages. He began the study of medicine in 1882
in the office of Dr. J. S. Pritchard at Manitowoc, entered Rush Medical College
the following year, graduating in March, 1885. After graduation he entered pri-
vate practice in Plymouth, Wis., and continued as a general practitioner in that
place until 1890, which year he spent in Europe, doing special work at Prague,
Vienna, and other cities. Returning to America in 1891, he resumed the practice
of his profession in Beatrice, Nebr., leaving there in August, 1892, to enter the
United States Indian Service as physician to the Indian agency at Nez Perces,
Idaho.

He was commissioned as assistant surgeon in the Marine-Hospital Service April
19, 1893, and assigned to duty at the immigration depot, Ellis Island, N. Y., sub-
sequently serving at United States marine hospitals at Stapleton, Louisville, and
Cleveland until September, 1894, when he was assigned to duty at Detroit, Mich.,
remaining there until September, 1896, During this time, however, he served
temporarily at Evansville, Cleveland, Charleston, Cairo, Buffalo, and Chicago.
From this time iintil July 11, 1897, when he was placed on waiting orders, he
served at Reedy Island and Delaware Breakwater quarantine stations.

In the fall of 1895 he became aware of the existence of a lung trouble, which
in June, 1896, was definitely determined to be tuberculosis, but he manfully



MARINE-HOSPITAL SERVICE. 17

continued on diity until the spring of 1897, when, being ordei'ed to examination
for promotion and feeling assured that he could not pass the i-equired physical
examination, he reported the fact to the Bureau, and was, after being physically
examined, placed on waiting orders, as already mentioned. The last nine months
of his life were spent at health resorts in Colorado and New Mexico.

Dr. Prochazka was unmarried, but leaves an aged father and devoted sister to
mourn his loss.

Assistant Surgeon Prochazka was an officer of more than ordinary professional
ability, having made excellent use of very superior advantages. Personally he
was modest, reserved, and devoted to study and scientific research: honorable in
all intercourse with his associates, by whom he was held in high esteem as a man
and an officer.

Respectfully, yours, Walter Wyman,

Supervising Surgeon-General M. H. S.

Of the two medical officers of the Service reiDorted in thj last
annual report to be incapacitated from duty on account of tubercu-
losis one has died during the year, as above narrated, while the other,
after returning to duty and so remaining for some months, has again
been placed on waiting orders.

MEASURES FOR THE RELIEF OP THE LEGAL REPRESENTATIVES OF THE
LATE ASST. SURG. JOHN W. BRANHAM.

Referring to the comments in my last annual report upon the above-
named measure, it is gratifjdng to be enabled to report that during
the last session of Congress the bill for the relief of the heirs of Assist-
ant Surgeon Branham passed the House of Representatives and the
act authorizing the payment to the heirs the sum of $4,100 — the
amount of salary and allowances for an assistant surgeon for two
j^ears at the date of the death of Dr. Branham — was approved by the
President June 15, 1898. The bill passed the Senate May 20, 1896.

The circumstances of his death, while in the j)erformance of his
duty, are set forth in your letter to the President of the United States,
transmitting the bill to him, and stating your opinion that the meas-
ure was a meritorious one, of which the following is a copy:



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