Annual report of the Supervising Surgeon-General of the Marine Hospital Service of the United States (Volume 1897) online

:J^



^^1^^t^„.



:^-^^












4^^-^






^Jk



Columbia llnitoiittp
miht€\mtMt\ijfoxk




Srf^r^nr^ Slibrarg






»r






n^'f^Jf^-^'









^;^.^



Ife^^^^^i^.^^



.rJ^I^^SBt ';t*x






||^^'J^;



\r'i



:.1^^.



^^^
'M^




%'



f^-



1i#



â– ^-iktt



(- ^5B , , FT- '-



^'fea?/^



^M



'M.



<iff â–  \. Jlr-



>^Wv .



Digitized by tine Internet Arciiive

in 2010 with funding from

Open Knowledge Commons (for the Medical Heritage Library project)



http://www.archive.org/details/annualreportofsu1897unit



Treasury Department. Marine-Hospital Service.



ANNUAL EEPGHT



SUPERVISING SURGEON-GENERAL



MARINE-HOSPITAL SERVICE OF THE UNITED STATES



FISCAL YEAR 1897.



WASHINGTON:

GOVERNMENT PRINTING OFFICE.
1899.



Treasury Department,

Document No. 2121.

Office of U. S. Marine-Rospital Service.



OPERATIONS

OF THE

UNITED STATES MARINE-HOSPITAL SERVICE.

18 9 7.









280950



CONTENTS



I'age.

Report to the Secretary 11

Medical Corps 11

Boards convened for examination of applicants 11

Appointments and promotions 11

Resignations 11

Casnalties , 11

Death of Surg. W. H. H. Huttou 11

Death of P. A. Surg. W. D. Bratton 11

Officers on waiting orders for physical disability 15

Measures for the relief of the legal representatives of Asst. Surg. John W.

Branham, deceased 15

Cumulative leave for medical officers 15

Officers detailed to attend medical and public-health associations 15

Associations attended by the Surgeon-General — addresses and contribu-
tions 16

Report of Surgeon Bailhache on the meeting of the American Public

Health Association at Philadelphia, Pa 17

Report of Surgeon Sawtelle on meeting of Pan-American Medical Congress

at the City of Mexico 18

Report of P. A. Surg. J. J. Kinyoun on International Congress on Hygiene

of Railways and Vessels 20

Report of P. A. Surg. J. J. Kinyoun on International Leprosy Conference

at Berlin 25

Aid to other branches of the Government service 32

Life-Saving Service 32

Steamboat Inspection Service 33

Revenue-Cutter Service '. 33

Light-House Service 33

Immigration Service 33

Tennessee Centennial Exposition 33

Statement of character of exhibit 33

Revision of the Regulations 34

Official nomenclature of diseases 34

Hospital relief for officers and crews of the Revenue-Cutter Service 34

Regulations governing the same 34

New marine hospital for the port of New York 35

Advisory boards 35

Tonnage tax 36

Proclamation concerning German vessels 36

Provision made by Congress for shelter of deck crews on Western rivers 37

Revision of uniform regulations 37

Marine hospitals and relief furnished 37

Summary of patients treated 37

Stations discontinued and established 38

Statement, by stations, o f repairs made 38

Contracts for care of seamen — Department circular 42

7



8 CONTENTS.

Page.

Purveying division, report of 49

Equipment of hospitals 50

Necessity for new service ambulances 51

Steam disinfecting chambers for hospitals 51

Circular letters relating to administrative details 52

Examination of applicants for positions in civil service 52

Examination of candidates for appointment in Revenue-Cutter Service. . . 52

Examination of candidates for positions in Life-Saving Service 53

Reports of personnel for Biennial Register 53

Concerning leaves of absence 53

Financial statement 57

Reports of fatal cases with necropsies 63

Contributed articles 205

Addresses and report 208

International responsibility with regard to epidemic diseases, by the

Surgeon-General, Marine-Hospital Service 208

Report of international committee of Pan-American Medical Congress,
on international quarantine, presented by the Surgeon- General,

Marine-Hospital Service 221

Medical and surgical 225

Hemiplegia complicating enteric fever, by Surg. George W. Stoner.. . 225
Tubercular testes; inguinal hernia; urethral stricture. Operations.

By Surg. P. C. Kalloch 227

Enlarged prostate ; sarcomatous testicle. Removal of testicles. By

Surg. P. C. Kalloch 229

Formaldehyd gas in tuberculosis, by Surg. P. C. Kalloch 231

Yellow fever from a clinical and epidemiological point of view, and
its relation to the quarantine system of the United States, by

P. A. Surg. H. D. Geddings 233

Appendicitis, by P. A. Surg. J. C. Perry 244

Fracture of base of skull, by P. A. Surg. J. C. Perry 250

Malarial fevers of Memphis, Tenn., by P. A. Surg. George B. Young.. 253

Case of cocaine poisoning, by P. A. Surg. George B. Young 266

Sulphur hose at quarantine stations, by P. A. Surg. M. J. Rosenau.. . 268

Suggestions for guidance of nurses, by Asst. Surg. L. E. Cofer 270

Increase in cases of tuberculosis at St. Louis marine hospital, by

Asst. Surg. C.E. Decker 283

Considerations concerning hygienic administration of hospitals, by

Asst. Surg. C. E. Decker 289

Case of double infection — typhoid and malarial — by Asst. Surg. J. B.

Greene 296

Case of cocaine poisoning, by Hospital Interne George R. Gilbert 297

Historical sketches of several marine hospitals :

New Orleans, by Surgeon Sawtelle 299

Chicago, by Surgeon Carter 305

Cincinnati, by Surgeon Wheeler .. 307

Portland, Me., by Surgeon Banks 310

St. Louis, by Passed Assistant Surgeon Glennan 317

Memphis, by Passed Assistant Surgeon Young 324

Port Townsend, by Passed Assistant Surgeon Stimpson 327

Statistics, United States Marine-Hospital Service 331

PUBLIC HEALTH SERVICE.

Cholera 405

Annual history of, and table 405



CONTENTS. 9

Page.

Smallpox 407

Annual history of, and table 407

Plague 409

Annual history of, and table 409

Address on bubonic plague before the Medical Society of the District of

Columbia 411

Beri-beri 420

Inquiry concerning beri-beri at Gulf ports, by P. A. Surg. A. C. Smith (with

inclosures) 420

Report of case at South Atlantic quarantine, by Acting Asst. Surg. E. F.

Geddings 424

Eeport of cases at Brunswick quarantine, by Sanitary Inspector R. E. L.

Burford 425

Leprosy 426

Recommendations 426

Yellow fever 427

Annual history of, and table 427

Special measures to protect the United States during 1897 430

Outline of measures to protect the Florida coast 430

Recxuest for aid of special agents of the Treasury Department. . . 431

Instructions to officers commanding United States revenue cutters. 431
Instructions to officers of the United • States Marine-Hospital

Service, specially detailed 432

Circular letter to the United States consuls 433

National quarantine administration (foreign) 433

Sanitary inspectors 433

Inspection of Asiatic ports by an officer of the Marine-Hospital Service. . 433

Letter of detail and instructions 433

General report of inspection of Asiatic ports, by P. A. Surg. S. D.

Brooks 435

Special reports of inspections of ports in China, Japan, and Hawaii,

by P. A. Surg. S. D. Brooks 440

Reports on —

Hongkong 440

S watow 445

Amoy 446

Foochow 448

Shanghai 449

Tientsin 452

Chee Foo 455

Nagasaki 455

Kobe , 457

Yokohama 460

Honolulu 464

Report upon the sanitary condition of Vera Cruz, Mexico, by P. A. Surg.

W. J.Pettus 467

Sanitary condition of Havana, Cuba, as to smallpox and yellow fever, by

P. A. Surg. J.J. Kinyoun 468

Yellow fever at Santiago de Cuba, by Sanitary Inspector H. S. Caminero. 473

National quarantine administration (domestic) 476

Circulars relating to quarantine regulations 476

Circular, November 21, 1896. Certificates of inspection 476

Circular, January 18, 1897. Regulations to jirevent the introduction

of plague 477

Circular, February 28, 1897. Bedding of steerage passengers and mat-
tress and pillow covers 477

Circular, August 5, 1897. Disinfection by formaldebyd gas 478



10 CONTENTS.

National quarantine administration (domestic) — Continued. Page.
Legality of the quarantine regulation requiring additional precautions at

ports south of the southern boundary of Maryland 479

Opin ion of the Attorney-General 479

Reports from national quarantine stations —

Camp Low, Sandy Hook 480

Eeedy Island 480

Delaware Breakwater 481

Cape Charles 484

Cape Fear 486

South Atlantic 1 489

Brunswick 492

Tortugas 494

Gulf 495

San Diego 497

San Francisco 501

PortTownsend 507

Relations with State and local quarantine authorities —

General coumients on 510

Transactions relating to CJulf quarantine station (national) at Ship

Island, Miss 512

Transactions relating to the quarantine function at San Francisco, Cal. 537
Transactions relating to the State quarantine station at Sabine Pass,

Tex 559

The yellow-fever epidemic during the fall of 1897 580

Chronological history of the disease and measures adopted 587

Report of sanitary work of United States Marine-Hospital Service in

southern Louisiana, by Surg. H. R. Carter 622

Report upon the detention camp at Fontainebleau, Miss., by P. A. Surg.

J.H.White .- 645

Report upon the detention camp at Avondale, La. (Camp Huttou), by

P. A. Surg. J. H. White 647

Report of operations of the Service in Alabama, by P. A. Surg. A. H.

Glennan 649

Report on train-inspection service, by P. A. Surg. G. B. Young 659

Report of measures taken at Atlanta, Ga., by Surg. H. W. Sawtelle 665

Report of yellow-fever cases at Cairo, 111., by Surg. P. C. Kalloch 668

Report of services at Cairo and Fontainebleau, and experiences with shot-
gun quarantines in Mississippi, by P. A. Surg. J. O. Cobb 669

Report of personal services as expert, by Acting Asst. Surg. John Guiteras. . 672

Expert commission to investigate the nature of yellow fever 676

Division of sanitary reports and statistics :

Publication of the weekly public health reports 678

Mortality statistics for the calendar year 1896 678

Tables 680

Inquiry concerning State and municipal laws and regulations concerning

tuberculosis "701

Hygienic laboratory :

Report of the acting director 709

Concluding remarks 779



REPORT TO THE/o^-feSlETARY.



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

November 1, 1897.
Hon. L. J. Gage,

Secretary of the Treasury.
Sir ; I have tlie honor to transmit herewith the report of the Marine-
Hosi^ital Service of the United States for the fiscal year ended June
30, 1897, being the twenty- sixth annual report of the Service and the
ninety-ninth year of its existence.

In addition to tlie statistical information pertaining to the fiscal
year, the operations of the Service to the present date, being near the
close of the quarantine season, are included.

MEDICAL CORPS.

One board has been convened for the examination of applicants for
admission into the Medical Corps. The number of applicants for per-
mission to appear before this board was 37. Thirty-one presented
themselves, 6 of whom passed successful examinations.

APPOINTMENTS AND PROMOTIONS.

During the fiscal year 5 successful candidates were appointed to the
grade of assistant surgeon and 4 assistant surgeons were promoted
after examination to the grade of passed assistant surgeon.

Two passed assistant surgeons were promoted after examination to
the grade of surgeon.

RESIGNATIONS.

One surgeon has resigned during the fiscal year.

CASUALTIES.

Since my last report the corps has lost by death one of its older sur-
geons, W. H. H. Huttou. A brief statement of his services is included
in the following announcement:

circula71 letter announcing the death of surg. w. h. h. hutton.

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

Washington, D. C, June 29, 1S97.
To the Medical Officers of the United States Marine- Hospital Service:

It is with regret I have to announce to the medical officers of the Service the death,
on the l-ith of this month, after a lingering illness, of Siirg. William Henry Harri-
son Hutton.

11



12 MARINE-HOSPITAL SERVICE.

Surgeon Hutton was bdrii ]n''5f0rk,''Jeffe^siJil Clounty, Ohio, February 28, 1838. At
the bej^inning of the late civil war he enlisted in Company K, Twentieth Regiment
Illinois Volunteers.' After about a yaa-r'ss ls&rvic:e with his regiment he was dis-
charged, and reeulisted jn .Oeiflijany D, One hundred and fourth Illinois Volunteers,
in which regiment he served, until, the .spring of 1864, when, in consequence of a
â– wound received at Pittsbu5rg Landing, ba was sent to Chicago, 111., and in a few
months recovered sufficiently to be placed m charge of the office of the Desmanes
Eye and Ear Hospital, under the United States Army, where he remained until
March 7, 186.5, when he was mustered out of the volunteer service. By his bravery
he won promotion at the battles of Chickamauga and Missionary Ridge.

He attended his first course of medical lectures at the Alabama Medical College,
at Mobile, and on March 16, 1875, was graduated from the Chicago Medical Col-
lege, Chicago, 111., receiving from this institution the first prize of the faculty for
the best graduating thesis.

He was appointed assistant surgeon in the Marine-Hospital Service May 8, 1875,
and was promoted to the grade of surgeon October 20, 1876. Surgeon Hutton, dur-
ing his connection with the Marine-Hospital Service, served as commanding officer
at the following stations: New York, Cincinnati, New Orleans, Detroit, Louisville,
Mobile, and Baltimore.

In addition to the above duties he rendered valuable service at Brunswick and
W^aycross, Ga., and Camp Perry, Florida, in 1888, in enforcing the quarantine and
other measures during the yellow-fever epidemic of that year, and again at Bruns-
wick, Ga., during the yellow-fever epidemic in 1893. At Camp Perry he installed
and was in command of the first detention camp, which proved so successful in the
management of the epidemic at that time raging in Jacksonville.

He was also placed in charge of the quarantine establishment at Sandy Hook,
New Jersey, during the cholera scare in 1892, and later in the same year rendered
efficient services in the establishment of the quarantine flotilla at Capo Charles. In
1894 ho was detailed to inspect the quarantine stations along the Florida coast, and
had temporary charge of the Gulf quarantine during a part of the same year. For
thirty-five years Surgeon Hutton has been serving his country in various capacities
in war and pestilence, and always with a conscientious devotion to its interests and
with a zeal worthy of emulation. He was ever ready to obey a summons to duty,
and oftentimes was a volunteer when epidemics threatened the country.

In his death the Service loses one of its oldest and most efficient officers.

Respectfully, yours,

Walter Wyman,

Snperinsing Surgeon-General M. S. S.

Another casualty occurred during the latter part of the yellow-fever
epidemic of 1897— the death from injuries of P. A. Surg, W. D. Bratton.
The sad circumstances of his untimely death are narrated in the fol-
lowing correspondence:

Sabine Pass, Tex., Octoler S, 1897.
Dear Sir : I am sorry to have to inform you that Dr. Bratton is dead. He died
to-day between 10 and 11 o'clock, from the eifects of a fall through the hatch of the
ship Albania, which happened late yesterday evening. He superintended the wash-
ing down of the vessel during the day. About 4 o'clock in the evening he came to
my room in the quarantine building and told mo that the work was finished, and
expressed his satisfaction with the work of my crew. After talking with me a few
minutes he remarked that he would go down and take another view of the hold of
the vessel and then get ready to go up (to town). I left the station a short time
after this interview. About 8 o'clock I was sent for to see him. It seems that he
went aboard the vessel and fell through a hole open for ventilation. He fell 12 or
14 feet, striking his head on an iron knee, cutting a gash about 3 inches deep to the



MARINE-HOSPITAL SERVICE. 13

skull. He was unconscious when they found him, and remained so until he died.
I could discover no fracture. The hemorrhage was considerable. It is thought by-
Mr. Allbright and others that it Avas at least two hours after his fiiU before he was
discovered, all thinking that he had gone to town, until the captain of his launch
made inquiries for him. Drs. Holliman, Clendenuing, and myself did everything we
could for him, and greatly regret the unfortunate accident.
Yours, respectfully

A. N. Perkins,

State Health Officer.
Dr. G. M. Magruder.

Passed Assistant Surgeon, M. H. S., Galveston, Tex.



U. S. Marine-Hospital Service,

District of the Gulf,
Sabine Pass, Tex,, Surgeon's Office, October 5, 1897.
Sir: In obedience to your telegraphic order of the 3d instant, I left Galveston for
Sabine Pass on the afternoon train of the same date. While waiting in Houston for
the east-bound train, I received iiotilication of Dr. Bratton's death, and immediately
procured a casket and secured the services of an undertaker. We arrived at Sabine
at 11 o'clock on the morning of the 4th instant, and the body, which had been kept
on ice pending my arrival, was embalmed, placed in a zinc-lined casket, which
was hermetically sealed, and forwarded by express ou the same afternoon to his
father at Winnsboro, S. C.

I had left Dr. Bratton at Sabine Pass only two days before, and at that time he
was in the best of spirits, much gratified at his being able to return to duty at a
time when all the officers of the corps were needed, having full confidence in the
complete restoration of his health after a year or two more in New Mexico, buoyant
at the pro.speot of soon visiting his friends in South Carolina, whom he had left a
year ago doubting whether he would ever return, and enthusiastic in the hope that his
darling scheme of bringing about in some way the establishment of a Government
hospital for the treatment of cases similar to his own, somewhere in the elevated
region of Albuquerque, would be gratified.

In view of the above, his sudden death seems doubly sad.
A'ery respectfully,

G. M. Magruder,
Passed Assistant Surf/eon.
The Supervising Surgeon-General,

Washington, D. C.

The followinj;- circular letter gives a brief summary of the life work
of this young officer :

CIRCULAR announcing DEATH OF P. A. SURG. W. D. BRATTON, UNITED STATES

marine- hospital service.

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

Washington, D. C, October 12, 1S97.
To the Medical Officers of the United States Marine-Rospital Service:

I have the painful duty of announcing to the officers of the Service the sudden
death of P. A. Surg. William D. Bratton, which occurred at Sabine Pass, Tex., on the
2d instant, under peculiarly distressing circumstances.

In the pressing need of medical officers for active work during the present yellow
fever epidemic in the South, Passed Assistant Surgeon Bratton, though an invalid,



14 MARINE-HOSPITAL SERVICE.

and therefore on waiting orders, promptly volunteered his services to meet the
emergency, and the tender was accepted in the spirit in which it was made. He
was ordered to Sabine Pass to assume charge of Service matters relating to the
quarantine service at that port, wliere he arriA^ed and reported himself on duty the
28th ultimo. On the Ist instant lie had been superintending the disinfection of a
vessel and returning to the ship to reassure himself upon the work done, he fell
through a ventilating hole, striking his head on an iron knee, producing concussion
of the ,brain. He remained undiscovered for several hours, and when found was
unconscious and remained so until death occurred, eighteen hours afler the unfor-
tunate accident.

William Du Bose Bratton was born in Fairfield County, S. C, June 23, 1860, the
son of Gen. John Bratton, of Winnsboro, in that State. His early education was
acquired in Mount Zion School, Winnsboro, and at Abbeville, S. C. In 1874 he was
matriculated at the Carolina Military Institute at Charlotte, N. C, remaining two
years, and then entered the University of the South at Sewanee, Tenn., where he
received the degree of B. S. in 1880, after a three years' course. He at once began
the study of medicine and was graduated at the Medical College of South Carolina
March 1, 1884, and for the year following was house surgeon at the Charleston City
Hospital.

He was commissioned as assistant surgeon April 1, 1885, and assigned to duty at
New York. His subsequent stations while in that grade were San Francisco, Cal.,
as medical officer of revenue cutter Corwin for service in Alaskan waters, aud then
for temporary duty at Port Townsend, Wash. He was commissioned a passed assist-
ant surgeon April 2, 1888, and again assigned to duty as medical ofiticer ou the rev-
enue cutter Bear for service in Alaskan waters. In May, 1889, he was ordered to
duty in command of the Service at Portland, Oreg., where he remained two years,
and was then assigned to duty at Chicago, 111. In 1893 he was placed in command
of the Service at Buffalo, N. Y., where he remained till January 9, 1894.

In the fall of 1893 he first became aware of a condition of his health which grad-
ually disclosed a tuberculous character, and after the Bureau had been officially
informed of it he was sent to Wilmington, N. C, for its favorable climate, where he
remained several months, doing meanwhile temporary service at Delaware Break-
water Quarantine; but later he was placed on ''waiting orders" (January 1, 1895),
taking up his residence in Arizona, and finally at Albuquerque, N. Mes., to obtain
the advantages of the Southwestern arid region. After a two years' residence there,
he reported, in March, 1897, his gradual return to a state of health which justified
him in asking for an early restoration to active duty, but further delay was advised
in order that he might have the benefit of a longer residence, and, if j)ossible, a
permanent cure.

Passed Assistant Surgeon Bratton, during the period of "waiting orders," became
much interested in the climatic treatment of consumptives, and wrote several reports
on the arid region of the Southwest as the best locality for such work, recommend-
ing the establishment of a sanitarium in that section for the treatment of patients of
this Service sufi'ering from the disease.

His literary and scientific attainments were of a high order, and his studious
habits aud keen faculties enabled him to maintain in the Service a reputation for
unusual professional knowledge and skill in practice. Officially, devotion to duty
was always a paramount consideration with him, and his conscientiousness in
respect thereto was a marked characteristic of his work.

Personally, he was of modest and reserved manner, yet frank and manly iu his
demeanor, and actuated by a high sense of honor iuall relations with his associates.
He was in every respect a noble officer.

Respectfully, yours, Walter Wyjian,

Supervising Surgeon-General, M. H. S.



MARINE-HOSPITAL SERVICE, 15

The passed assistant surgeon reported in the hist Annual Report as
being upon waiting orders because of tuberculosis has since died from
injuries incurred in the line of duty, as previously detailed.

Of the two assistant surgeons incapacitated by the same disease one,
who had been on waiting orders since April 1, 1894, reported himself
sufficiently improved to take active service, and was reassigned to duty
July 21, 1896; the other, who had been on waiting orders since Decem-
ber 1, 1895, also asked for active service, and was placed on duty Jan-
uary 11, 1897. Both have continued on the active list ever since the
last-mentioned dates.

MEASURES FOR THE RELIEF OF THE LEGAL REPRESENTATIVES OF
ASST. SURG. JOHN W. BRANHAM (DECEASED).

Referring to the comments in my last Annual Report upon the above-
named measure, it is gratifying to be able to announce that a bill has
passed the Senate and has been favorably reported from the Commit-
tee on Commerce of the House of Representatives, and it is hoped that
during the coming session of Congress the bill will be passed by the
House.

CUMULATIVE LEAVE FOR MEDICAL OFFICERS.

The i)ropriety of granting cumulative leave to medical officers was
referred to in my last Annual Report, and the draft of a bill for the con-
sideration of Congress was given in connection with other documents
on the subject. This measure, somewhat modified verbally, but retain-
ing the substance of the original draft, passed both Houses and received
the approval of the President February 19, 1897. The text of the law
is as follows :

That the Secretary of the Treasury is hereby authorized, in his discretion, to grant
to the medical officers of the Marine-Hospital Service, commissioned by the Presi-