Annual report of the Supervising Surgeon-General of the Marine Hospital Service of the United States (Volume 1901) online

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Treasury Department,

Document No. '2'.\'2'2.

Office of U. S. Marine-Huspitul Service.




353366



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OPERATIONS

OP THE

UNITED STATES MARINE-HOSPITAL SERVICE.

1 9 O 1.



COl^TEl^TS,



Page.

Report to the Secretary 11

Division of personnel and accounts 19

Personnel of the Service —

Commissioned Medical Corps promotions, resignations, and boards

convened 21

Noncommissioned officers, acting assistant surgeons, and hospital

stewards 21

Hospital and quarantine attendants 22

Special details and appointments of commissioned and noncommis-
sioned officers, chronologically arranged 23

Appointment of commission for investigation of plague in San

Francisco 24

Officers detailed to assist State and local authorities in the suppres-
sion of smallpox : . _ ._ 24

Officers detailed to represent the Service at meetings of medical

and public health associations 25

Report on meeting of Association of Military Surgeons and

American Medical Association, by Surg. G. T. Vaughan 25

Report on the proceedings of the Thirteenth International Con-
gress of Medicine, Paris, France, August 2-9, 1900, by P. A.

Surg. M. J. Rosenau 26

Report on the proceedings of the commission charged with the
revision of the nomenclature of causes of death . Paris, France,

August 18-21, 1900, by P. A. Surg. M. J. Rosenau 34

Report on the proceedings of the Tenth International Congress
of Hygiene. Vienna, Austria, October 13, 1900, by P. A. Surg.

M. J. Rosenau 70

Report on the twenty-eighth annual meeting of the American
Public Health Association, Indianapolis, October 22-26, 1900,

by Asst. Surg. D. H. Currie 73

Accounts —

Vouchers passed for payment and settlement ^ 74

Financial statement , 74

Administrative details, circular letters^ —

Requisitions for supi^lies 79

Issue of new requisition blanks 79

Treatment of infected wards 79

Treatise on Military Hygiene to be furnished officers 80

Division of marine hospitals and relief . - - 81

Summary of patients treated 83

Aid to other branches of the Government service, physical examina-
tions —

Revenue- Cutter Service 83

Steamboat- Inspection Service 83

Life-Saving Service 83

Light-House Service 83

Coast and Geodetic Survey 83

Navy Department 83

Other examinations . 83

New relief stations 83

Seamen employed on Navy colliers entitled to relief. 84

Handbook for ship's medicine chest _ 85

Purveying depot at New York, Report of medical purveyor 85

Sanatorium for consumptives, Fort Stanton, N. Mex. , report of medi-
cal officer in command 87

7



CONTENTS.



Report of fatal rases, with necropsies 93

Contrilinted articles 221

Observations of surgical c-linics. By Surg. G. T. Vauglian 223

The United States Marin^-Hospitjil Service. By P. A. Surg. M. J.

Rosenau 230

A case of appendicitis, with operation. By Acting Asst. Snrg. Robert C.

Craig - 237

A case of appendicitis, with operation. Bv Acting Asst. Snrg. Robert C.

Craig â–  238

Appendiceal abscess— operation — recovery. By Acting Asst. Surg. Rol)-

ert C. Craig . . 235)

Statistics of the Marine-Hospital Service . . 241

Tables showing patients receiving medical and surgical treatment dur-
ing the year 243

Division of sanitary reports and statistics 31")

Public health reports '517

United States .. 317

Plague in San Francisco — table . . . 318

Tuberculosis 318

Smallpox - 318

Table 319

Foreign and insular 337

Cholera 337

Table 337

Yellow fever - 338

Table ..- 338

Plague - 339

Table 340

Smallpox • 344

Table 1 344

Division of insular and foreign quarantine and immigration _ 34!)

Cuba . 35!

Report of chief quarantine officer, including report of transactions

at Habana and subports, first quarantine district 351

Rejiorts of transactions at other ports —

Matanzas and suVjports, second (piarantine district . 302

Nuevitas and subports. third (piarantine district 377

Santiago and subports, fourth (quarantine district 381

Cienfuegos and subports, fifth quarantine district 389

Porto Rico 394

Appointment of chief quarantine officer and organization of the

service 394

Status of Miratiores Island . San Juan 39.")

Rei)orts of transactions —

San Juan and subports 397

Ponce - 400

Mexico - - 401

Changes in assignment of officers at various ports 401

Instructions to officer at Vera Cruz 402

Repf)rts ( f transactions —

Vera Cruz ^ '. 402

Progresso ...'.....-. _ 404

Tampico 405

Central and South America, Iruit port-inspection service 400

Final reports, season of 1900—

Ceiba 400

Belize iOO

Bocas del Toro . . - . - - - 107

Lim )U •- 107

Livingston - - - - 409

Bluefields - 409

Puerto Cortez . 409

Season of 1 901 , reestablishment of fruit port inspection 410

Regulations for government ( >f fruit vessels 410

Re])orts of transactions —

Ceiba :: ......:...::.... 411

Belize - - 412



CONTENTS.



Division of insular and foreign quarantine and immigration — Cont'd.
Central and Sontli America, fruit port-inspection service — Cont'd.
Reports of transactions — Continued.

Bocas del Toro 413

Limon . . 415

Livingston 417

Bluefields 418

Puerto Cortez 419

Hawaii 420

Detail of chief quarantine officer for the Territory of Hawaii 420

Installation of disinfecting machinery at Honolulu 420

Report of transactions, Honolulu and s abports 420

Inspection of Hilo as site for quarantine station 427

Philippine Islands ^^ . 430

Detail of chief quarantine officer 430

Report of transactions, Manila and subports 431

Japan . _ . 442

Death of Acting Asst. Surg. Eldridge at Yokohama . 442

Report of transactions at Kobe 4 12

China 415

Hongkong , 445

Vise of food products from noninfected regions 445

Vise of freight bound for Honolulu . . 445

Report of transactions , . 445

Europe . 449

Recall and transfer of officers at certain European ports 449

Reports of transactions —

Paris ..., 449

Liverpool .. 451

London 452

Berlin 456

Medical inspection of alien inamigrants 457

United States 457

Cuba 458

Porto Rico .. _ 459

Quebec , Canada 459

Emigration inspection at foreign ports 460

Liverpool. England 460

Naples. Italy 464

Division of domestic quarantine 469

Operations at domestic national quarantine stations of the United

States — summary of transactions 471

Reports of transactions —

Reedy Island quarantine . . 471

Delaware Breakwater quarantine 472

Alexandria. Va. , inspection station 472

Cape Charles quarantine . ._. 472

Washington. N. C , inspection station 473

Newbern, N. C. . inspection station 473

Cape Fear quarantine 473

Savannah quarantine 473

South Atlantic quarantine 475

Brunswick quarantine 476

Gulf quarantine 476

Pascagoula. Miss. . inspection station 477

San Diego quarantine 477

Los Angeles, Cal. . inspection station 477

San Pedro. Cal. , inspection station 478

San Francisco quarantine 478

Eureka, Cal. , inspecition station 479

Columbia River quarantine 479

Hoquiam. Wash. . inspection station 480

Port Townsend quarantine 481

Tacoma. Wash. , inspection station 481

Seattle, Wash. , inspection station 481

Port Angeles. Wash. . insj)ection station 482

Dutch Harbor, Alaska, quarantine 482

Nome, Alaska, inspection station^ 482



10 CONTENTS.

Division of domestic qnarantine — Continiicd. Vano.

Transfer of Florida (inarantiiies to the National (rovernnient 48'i

Agreement bi-twcen United States Treasury Department and State

authorities of Florida 483

Texas-Mexican border (inarantine - 4y5

Reports of transactions —

El Paso, Tex - . 486

Eagle Pass, Tex 487

Laredo, Tex 487

Qnarantine decisions regarding Chinese food prodiicts 487

Dnl )( )nic plague at San Francisco, Cal . . . _ - 4!) 1

List of cases 41)1

Correspondence and measures taken —

October, 11)00 492

November, 1900 . _ 494

December. 1900 49.1

Detail of Surg. J. H. White r)00

January. 1 901 - r.Ol

Ci nnmission of expert diagnosticians appointed .10.")^

Suspicious pneumonia at Bakersfield 508

February. 1901 510

* Correspondence with the governor of California. 514

March, 1901 533

Report of commission of expert diagnosticians 533

Agreement for cooperation with representatives of Califor-
nia and San Francisco . 535

Results of commission's investigation communicated to

health officers and others 537

Surveillance of Chinese in Pacific coast towns 543

April. 1901 ' - 546

Disease at Bakersfield apparently acute lobar pneumonia. . 547

Mav, 19(M â– . 554

June l-October VA. 1901 559

Report of Surg. J. H. White on work in Chinatown 563

Smallpox in t h;^ United States 578

Summary of prevalence and mortality, 1 SO.I-1 901 578

Assistance rendered State and local health authorities . . 579

Smallpox in Alaska 579

Report of officer detailed to investigate 579

Aid rendered by the Revenue-Cutter Service '. 583

Yellow fever (none reported in the United States) . 583

Proposed plan for international agreement of American republics —

sanitation of yellow- fever seaports - 583

Yellow-fever institute 583

Hygienic; laboratory 587

Assistants in the laboratory — class work 589

Yellow fever - - - 590

Insects as factors in the conveyance of disease 593

Bubonic plague 592

Disinfection experiments 594

Daiiyz â–  s A-irus and the destruction of rats _ 594

Pollution and purification of water siipplies 596

Portable laboratories of the Service 596

New lalKtratory building 597

Appendix No. 1— Search for the bacillus icteroides. by Asst. Surg. D. H.

Ciu-rie f^iOl

Appendix No. 2— Filtration of water supplies — comparison of slow sand

and mechanical processes, by P. A. Surg. H. D. Geddings 610



ANNUAL REPORT



SUPERVISING SURGEON-GENERAL MARINE-HOSPITAL SERVICE.



REPORT TO THE SECRETARY.



Treasury Department,
Office of the Supervising Surgeon-General

Marine-Hospital Service,
Washington, D. C, November 1, 1901.
Hon. L. J. Gage,

Secreta7-y of the Treasury.
Sir: I have the honor to submit the following report of transac-
tions of the Marine-Hospital Service of the United States for the fiscal
year ended June 30, 1901, the same being the thirtieth annual report
of the Service and the one hundred and third year of its existence.

While the major portion of this report includes only those transac-
tions i^rior to July 1, 1901, the officer in charge of the division of
Insular and foreign quarantine and immigration has embodied in his
report sui^plemental reports from certain stations showing the work
to September 15, 1901, and both in his report and in the report of the
domestic quarantine division the operations of the Service, in several
instances where it was deemed necessary to complete the narration,
are I'eported up to the present date.

Full reports of the Service operations, in detail, by officers in charge
of the different divisions of the Bureau follow, but I will give here
a review of the work of the Service since November 1, 1900, in brief.

PERSONNEL.

The commissioned corps at the close of the fiscal year consisted of
106 officers, including the Surgeon-General, 29 surgeons, 23 passed
assistant surgeons, and 53 assistant surgeons. Noncommissioned offi-
cers — 188 acting assistant surgeons, which includes all officers of this
grade in Cuba and the insular possessions, and 49 hospital stewards.
Hospital and quarantine attendants, 646. One officer, Asst. Surg.
W, R. Edson, resigned September 22, 1900.

ACCOUNTS.

The balance of the marine-hospital fund available at the commence-
ment of the fiscal year was $773,313.42. The expenditures on account
of the Marine-Hospital Service were $956,805.46. The amount avail-
able July 1, 1901, was $726,752.74. The expenditures from this fund

11



12 MAUIIS'K-IIOSI'ITAL SEKVKK.

have beoii lav.tror than usual on accounl of the growtli of the Service
and the increased reli<'f fnrnislied, and because Congress puri)osely
excluded marine hosi)itals fi-oni i)ar1 icipation in the annual appropri-
ations for repaii's, furniture, fuel, liirht, and water, and from special
appropriations lor iniproNcnienls Ihese items heinij i)ayal)le from this
fund.

The balance of the appropriation " Prevent inti: the spread of epi-
demic diseases,'' available .Inly 1, I'JOO, was >^4r>8,581.!i<i; tlie appro-
priation act of jNlai-ch o, I'lOl," *o(K),()0(); and repayments, *(i,L*:j;3.20,
making a total available dui-ini; t he year of .S'.»74,S15.22. The expend-
itures were 1175,253.41, and the balance July 1, irMil,was ^799,501. 81.

MARINE HOSPITALS AND RELIEF.

Fifty-six thousand three hundred and eij::hty-one sick and disabled
seamen of the merchant marine were treated during: the fiscal year,
being 2,020 in excess of the number treated in previous j'ears. There
were 13, oil treated in hospital, the remainder being treated as dis-
pensary" i^atients.

There were 1,309 important sui-gical operations i)ei-formed iTMpiir-
ing the use of anaesthetics.

The Service owns and operates 21 marine hospitals, and oi)erates
two additional hosi)itals in leased buildings (New York, N. 1'., and
Dutch Harbor, Alaska). There are besides 115 relief stations wliere
patients receive hospital or dispens;ury ti-eatment. Three relief sta-
tions of the second class have been established during the year at the
ports of Honolulu, II. I., San Juan, P. Jl., and Ponce, P. R., and
three others at the close of the last fiscal year.

HOSPITALS NKEDED AT XEW YORK AND BUFFALO.

I have to lenew my recommendation that the hospital and grounds
at Stapleton, N. Y., now rented for the care of patients of the Serv^-
ice, be purchased by the Government for this Service, and that Con-
gress be requested to appropriate a sum sufficient iov this purpose.

A marine hospital is also needed at the jwrt of Buffalo, N. Y., and
I have to recommend that Congress be requested also to make appro-
priation for purchase of site and erection of a hospital building at
that ]iort.

SANATORIUM FOR CONSUMPTIVES, FORT STANTON, N. MEX.

The equipment of this Station is now nearing completion, and the
repair of the buildings and the improvement of the reservation have
proceeded as rapidly as possil)le.

Tuberculous patients admitted to liospital at other relief stations
have been transferred as promptly as their condition would pernut,
with resulting benefit to the individual transferred and diminution
of the risk ot" infecting other beneficiaries of the Service. The sta-
tion has been su[)plied"with modern sterilizing apparatus with a view
to preventing the infection of the sanatorium itself.

There were l()5])atients adnuttedio the sanatorium during the year.
Eighteen wcie discharged cured, 42 improved, 3 not improved, and 17
died.

rURVEYlNG DEPOT, NEW YORK.

The marine hospitals and quarantiiK' stations in the United States,
Hawaii, Cuba, ]\)rto Rico, and the Philippines receive their supplies



MARIISrE-HOSPlTAL SERVICE. 13

through the purveying depot. The Immigration and Revenue-Cutter
services, and Coast and Geodetic Survey, also receive some of tlieir
supplies through the depot. Nine hundred and seventy-three requi-
sitions were filled during the year.

AID TO OTHER SERVICES.

Aid was extended to other branches of the Governmen"^ service dur-
ing the fiscal year as follows :

To the Life-Saving Service, in the physical examination of 1,445
surfmen, of whom si were rejected, and the examination of 420 claims
of surfmen for the benefits x)rovided by tho act of May 4, 1 882 ; to the
Revenue-Cutter Service, in the examination of 932 applicants for
enlistment, of whom 155 were rejected; to the Steamboat-Inspection
Service, in the examination of 1,(344 applicants for pilots' licenses, of
whom 04 were rejected ; to the Coast Survey and Light-House Estab-
lishment, in the examination of 40 applicants for enlistment, of Avhom
11 were rejected; and to the Immigration Service, in the medical
inspection of 472,111 immigrants, the inspection of immigrants being
conducted by officers of tlie Service at 20 i^orts of the United States.

SANITARY REPORTS AND STATISTICS.

The Public Health Reports, which are intended for collectors of
customs, health officers, and other sanitarians, have now a circulation
of 2,250. Reports were received during the year from 1,447 cities and
towns of the United States, with an aggregate population of 20,920,738,
and from 110 of the principal foreign cities.

In addition to publishing the mortality tables and tables of epidemic
diseases as reported from the various cities and to^^^ls of the world,
reports are published from the officers of the Service and consular ofli-
ceis relative to the health conditions of tlie countries in which they are
stationed. The Public Health Reports for the calendar year ended
December 31, 1900, contained 3,183 pages, and were bound in two
volumes.

INSULAR AND FOREIGN QUARANTINE.

During the year the Marine-HosiDital Service has conducted mari-
time quarantine in Cuba, Porto Rico, Hawaii, and the Philippines.

Floating disinfecting plants are now stationed at Havana, Matan-
zas, Santiago, and Cienfuegos, an.d a x^lant is now in course of con-
struction at the ]3ortof Havana for use at Nuevitas. A floating pla,iit
has been stationed at San Juan, P. R., and another plant is now
completed for use at the port of Ponce, P. R.

Disinfecting machinery has been installed on the channel wharf at
Honolulu, Hawaii, and extensive repairs are under way at the quar-
antine station at Mauliola Island, in tlie harbor of Honolulu. Inspec-
tion stations are also operated at Hilo, Kahului, and Kihei. Repedrs
and improvements have been made at Mariveles Quarantine Station,
near Manila, P. I., including the construction of a wharf, with disin-
fecting machinery installed thereon, rendering this one of the best
equipped quarantine stations under the control of the Service.

Medical officers have been on duty at the ports of London, Liver-
pool, and Naples, in Europe; also at Quebec, Canada, for inspection
of aliens coming to the L^nited States.

The inspection of the seven fruit ports of Central and South



14



MAKlNK-lloSl'lTAL SERVICE.



Ani(M-ic;i, namely, IJclizc, I5iitisli IIoikIiiius; Livitiirstoii, (Guatemala;
Puerto C'ortcz, Honduras; I.a('('il)a, lloiidiuas; IJIudields, Nicarai^ua;
I'oit Liiiion, Costa Rica, an<l Hocas del Toi'o, C()l()iid)ia, lias been
reestablished for the pucpose of inspect iiisj: all v<'ssels bound fi'oin
said ports to ports in the Unite«l States, with a view to facilitat int; the
transportation of fruit, without endan^eriiiLC the public healtli.

Followiuii is a list showing- the number of ollicers at naticuial (piar-
antiue stations in our insular possessions:



Hawaii

Porto Rico .
Philippines
Cuba




Ai-ting
assistant
surtjeons.



Hospital

stewards.



Officers have also been on duty at the ports of Vera Cruz, Proj2:reso,
and Tamijico, ]\Iexico; Kio Janeiro, I'.razil; Iloni^konu', China; Yoko-
hama and Kobe, Jajjan, lor the ins[)ectiou and cerlificatiou of vessels
and passengers leaving for the I'nited States.

DOMESTIC QUARANTINE.

There were dui-ing the year 4,720 vessels inspected and 366 vessels
disinfected at national quarantine stations. At the close of the fiscal
year the .Alarine-llospital Service owned lo coinj)lete mai'ilinu' ([uar-
antine stations and conti-oUed 2i stations whej-e inspection of incoming
vessels is conducted by ofticers of the Service.

FLORIDA QUARANTINE TRANSFERRED TO THE GOVERNMENT.

August 1, lOOl, the State authorities of Florida transferred their
quarantine stations and functions to the ]Marine-IIosi)ital Service.
They were accepted under the provision of section 8 of t Intact of Con-
gress approved Febi'uary 15, 189.'5, in like manner as the quarantine
at Savannah, (xa., was accepted in lOOO.

One station, Mullet Key, was purchased under act of Congress .June
6, l'.)00. The othei- stations were leased for a period of three years.
Of the stations thus accpiired, G arc equipped for disinfection, and
are located at Fernandina, Miami, Key \Vest, Mullet Ke}^ Carabelle,
and Pensacola. The other stations, 5 in all, ai"e for inspection only.
The Department has agreed to recommend to Congress legislation
necessary for the purchase of the stations, and estimates have accord-
ingly been included in the Book of Estimates for 1!M)3.

In the in-eliminary measures looking to the ultimate transfer of the
Florida ([uarantines to the National Goveriunent credit is due to
Sui'g. A. IF. (41en!ian, who acted as the representative of the Jiureau
and of the I)e!)artmeiit, both in biiiiging about an enfenfe cordidJr
with the Florida State health authorities and at Tallahassee in making
known the i'e«[uiivments of the I)e])ai'1ment with i-egard to the neces-
sary legislation to be enacted by the legislature of Florida.



TEXAS-JIEXICAN BORDER QUARANTINE.



On account of the continued pievalence of yellow fever and snuill-
pox in the Republic of Mexico, the land quarantine at El Paso, Eagle



MARINE-HOSPITAL SEEVICE. 15

Pass, and Laredo, Tex. , have been maintained as in previous years,
and the officers stationed there have exercised supervision over the
entr}^ into Texas of all persons from Mexico, and have cooperated in
this work with the United States Immigration Service and with the
State health authorities. There were 1,104 trains inspected, carry-
ing 77,074 passengers, 186 of whom were detained for observation.

SMALLPOX.

During the year smallpox has been reported in every State and
Territory of the Union, with the exception of Arizona, from which no
reports have been received.

The number of cases reported for the six months ended December
31, 1900, was 7,796, with 137 deaths, a mortality of 1.75 per cent.

For the six months ended June 30, 1901, 30,710 cases were reported
with 553 deaths, a mortality of 1.70 per cent.

For the whole year the number of cases was 38,506 and deaths 689,
•mortality 1.77 per cent, as comjDared with 15,053 cases and 735 deaths
during the year ended June 30, 1900, a mortality of -4.8 per cent.

Thus it is seen that while more than twice as many cases have been
reiiorted during the year just ended, the mortality has been less than
half what it was in the preceding year. This is probably to be
explained by the fact that cases as well as deaths were more fully
reported during the year just ended, while in the preceding year,
although most of the deaths from smallpox were reiDorted, there is no
doubt that a great many cases of the disease, for various reasons,
were not reported. According to this explanation the lower figures,
1.77, are nearer the correct mortality, and even this may be a little
excessive as deaths are more apt to be reported than cases.

As in previous years the 5larinc-IIospital Service has rendered
assistance to State and local boards of health by furnishing advice
and detailing officers to make investigations and assist the State
authorities in putting into execution proper regulations. The detail
of officers made last year to Cape ]^ome and Dutch Harbor, under
authoritj' of an Executive order, was renewed this year, and in the
spring of 1901 an officer was sent to make a careful investigation of
smallpox conditions in southeastern Alaska. His report showed a
widespread dissemination of smallpox in that region.

In view of the unusual prevalence of smallpox throughout the
United States, and to aid in a way the supj)ression of it, two pam-
phlets relating to the diagnosis, prevention, and suppression of the
disease, which were prepared by ofiicers of the Service, were mailed
to the health officers or other interested persons in towns where small-
pox was reported to be present. In this manner these pamphlets were
sent to 3,100 towns, and into every State and Territory of the United
States, except one.

PLAGUE IN SAN FRANCISCO.

The existence of bubonic plague in San Francisco, which was first
officially reported on INIarch 7, 1900, and of which mention was made
in my last report, was conclusively confirmed by a commission
appointed by the Department, consisting of three bacteriologists of
the highest reputation, and with no previous connection with Govern-
ment service, who reached San Francisco in the latter part of January,
1901, and, after an exhaustive investigation, rendered a report so con-
clusive in its nature as to result in measures being taken to cleanse