Annual report of the Supervising Surgeon General of the Public Health and Marine-Hospital Service of the United States (Volume 1902) online

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OPERATIONS



OF THK



UNITED STATES PUBLIC HEALTH AND
MARINE-HOSPrrAL SERMCE.

1 9 O 2 .



I



cox '1^ E X T S



Page.

Secretary's letter of tranpmittal to ("onpreHS 11

Ke|>ort to the Seeretary — ^simiinary of uperatioiiH I;;

Aft elian<,'in>,' iiaim' of service ^ -j-j

Act retrulatinjj: s-ale of viruses, seruins, etc 2S

division of personnel aii<l accounts ;',]

Personnel of the Service ;;:{

Commissioned olhcers — promotions, resignations, and hoards con-
vened :i?,

Noncommissioned officers — acting assistant surgeons, sanitary inspect-
ors, medical inspectors, internes, and pharmacists ."{4

Hospital and quarantine attendants :55

Special details of commissioned medical officers :!")

In foreijrn jKjrts ;;,")

To investigate rumors of epidemic disease, etc ."Wi

To assist in the su]ii>ression of smallpox .",7

To rei)resent the Service at meetings of medical and puhlic health

associations ;;7

Report of Surg. P. H. Bailhache on meeting of American Puhlic

Health Association, Buffalo, X. Y., September It)- 20, 1901 :is

Report of Surg. P. H. Bailhache on fifty-third annual meeting of
the American Medical Association, Saratoga, N. Y., June 10-18,

1902 .S9

Report of Surg. G. AV. Stoner on meeting of American Congress

of Tuberculosis, Xe\\' York City, June 2-4, 1902 45

Report of Surg. Eugene Wasdin on meeting of American Public

Health Association, Buffalo, X. Y., September 10-20, 1901 48

Report of Surg. P. M. Carrington on fifty-third annual meeting of
the American Medical Association, Saratoga, X'. Y., June lO-K!,

1902 • 49

Report of Surg. R. M. Woodward on meeting of American l*ubli<-

Health Association, Buffalo, X. Y., September l(>-20, 1901 .lO

Report of P. A. Surg. H. D. (ieddings on conference of health

officials of Michigan, Ann Arbor, Mich., Xovember 21-22, 1901 . 51
Report of P. A. Surg. ^I. J. Rosenau on meeting of American
Public Health Association, Buffalo, X. Y., Septend)er 16-20,

1901 58

Report of P. A. Surg. M. J. Rosenau on meeting of New York
State Association of Railway Surgeons, Xew York Citv, Xovem-
ber 14-15, 1901 '. .' 54

Report of P. A. Surg. ^1. J. Rosenau on meeting of International
Conference of the American States, Mexico, Mexico, Decendier,

1901, to January, 1902 55

Report of P. A. Surg. ^I. J. Rosenau on meeting of Xew York

Academy of Medicine, Xew York City, February 20, 1902 (11

Report of P. A. Surg. ^l. J. Rosenau on meeting of .American

Medical Association, Saratoga, X. Y., June 10-1 ."J, W02 «>2

Report of P. A. Surg. C. P. Wertenbaker im meeting of As.socia-

tion of Military Surgeons, Washington, D. C, June 5-7, 1902.. 04
Report of Asst. Surg. Hill Hastings on meeting of Southern Cali-
fornia Medical Society, Idylhvild, Cal., ?klay 22-28, 1902 07

Report of A.^st. Surg. C. E. 1'. Lord on annual session of the State

Medical As.sociation of Texas, Dallas, Tex., May G-9, 1902 09

For quarantine duty in Hawau and the Philippme Islands 09

Accounts 69

\'ouchers passed for payment and settlement 09

Financial .statement 70

7



O CONTENTS.

Division of jtersonnel anfl accounts — Continued. Pag^.

Administrative details — circular letters 72

Relative to .«en<lingr telegrams 72

Employment of attendants 72

Repairs and preservation of marine hospitals 73

Nomination of attendants 73

Leave of al^sence — when requested by wire 74

Monthly statement of expenditures 74

Division of marine hospitals and relief 75

Relief of seamen — summary r>f patient.« treated, etc 77

Aid to other branches of the Government service 77

Revenue-Cutter Service 77

Steamboat-Inspection Service 77

Life-vSavin^ Service 77

Coast and (Teo<letic Survey 77

Light-House Service 77

Naval colliers 77

Physical examinations of merchant seamen 78

Sanatorium for consumptives, Fort Stanton, N. Mex. — report of medical

officer in command 78

Limitation of spread of tuberculosis among seamen (Department circu-
lar) 80

Purveying depot at New York — report of medical purveyor 81

Supply table I 82

New hospitals at New York, Buffalo, Pittsburg, and Savannah 82

Contracts for care of seamen 83

-Monthly statement of expenditures 83

Reports of fatal cases, with necropsies 85

Contributed articles 187

Sanatorium treatment of tuberculosis, by Surg. P. M. Carrington 189

Nece.<^ity of disinfection, by P. A. Surtr. M. J. Rosenau 197

Statistics of marine hospitals and relief stations 201

Tables showing patients receiving medical and surgical treatment during

the year 203

Division of sanitary rei>ort« and statistics 267

United States 269

Public health reports, morbidity statistics, etc 269

Yellow fever ( none in the L'nitefl States ) 270

Plague in San Francisco — table 270

Smallpfjx 270

Table 271

Foreign and insular 293

Cholera 293

Table 294

Yellow fever 295

Table 295

Plague 296

Table 297

Smallpox 301

Table .301

Division of foreign and insular quarantine (embracing medical inspection of

immigrants ) 307

Cuba 309

Transfer of quarantine administratinn to the Cuban government .309

Recommendations of Surg. A. H. Glennan in regard to quarantine

management 312

Postponement of close quarantine against Cuba ( Department circu-
lar) 313

Reports from United States quarantine stations 314

Habana and subports 314

Matanza-s and subports - 321

Nuevitas 323

Santiago and subports - 324

Cienfuegos 327

Porto Rico 329

Reports from United Stales quarantme stations 329

San Juan and subports 329

Ponce 332



CONTENTS. 9

Division of foreign and insular *|iiaiaiitin(> — Continued. I'aK*-.

Mexico :i3*2

Kt'l>ort of trans^actions at Vera Cruz 's,y,i

H»'l)ort of transactions at Taiii|>ico ; 333

(Vntral and Soiitli America, I'niit-porl insjtection service 3.'i4

Assij:iiiiieMt of inspectors to fruit |)ort,«, sea-Mon <if 1902 'A'.U

Auiemiiuent to re^Milatious— detention of passenjjerH 334

Reports of transactious to June 30, l!l()2—

Tuerto Cortez, Honduras ;v,ih

I'ort Ijiuion, ('ostii Kica 335

Hocas del Toro, Colond>ia 336

(Viba, Honduras 337

Bluetieids, Nicaragua 338

lU'lize, British Honduras 339

Hawaii 339

Hei)ort of transactions at Honolulu and supports 340

Philipi)ine Islands :i46

Act providing for (iovernnient laboratories 346

Act establisiiin^ hoard of health 347

Report of transactions, Manila and suhports 349

Quarantine measures enforced on army transports at Manila 368

Correspondence relative to necessity for (piarantinintr V. S. Army

transports 369

.Japan 373

Report of transactions at Yokohama 373

Rei>ort of transactions at Kol>e 378

( 'hina 379

Report of transactions at Hongkong 379

England 383

Report of transactions at London 383

Report of transactions at Liverpool 384

Medical inspection of alien immigrants 387

United States 387

Cuba 388

Porto Rico 389

Hawaii 389

Quebec, Canatla 389

Medical inspection of emigrants at Naples and Palermo, Italy 392

Immigration and tuberculosis 395

Di visi( )n of domestic quarantine 399

Plague in San Francisco 401

Absence of yellow fever in the United States 406

Smalli)ox in the United States — assistance rendered State and local health

authorities 406

Craney Island 409

National quarantine stations 410

Care and preservation of quarantine steamers 410

Florida stations 410

Operations at domestic national quarantine stations of the United

States — sununary of transactions 411

Reports of transactions —

Portland, Me 411

Reedy Island 412

Delaware Breakwater 413

Alexandria, Va 413

Cape Charles . 414

Cape Fear 414

Savannah 415

South Atlantic 415

Brunswick 417

Cumberland Sound, Feruandina, i"la 417

St. Johns River inspection station, Mayport, Fla 418

Biscavne Bay quarantine, Miami, Fla 419

Key West ..." : 419

Boca (Trande, Punta Gorda, Fla 420

Tampa Bay 421

Cedar Keys 422

St. George Sound, Carrabeile, Fla 423



10 CONTENTS.

Division of domestic quarantine — Continued.
National (luaraiitiue stations — Continued.

Keporty of transactionw — Continued. I'agt-.

Santa Kosa, Penwacola, Fla 423

Pascagoula • 424

Gulf. \ 424

San Diego 425

Los Angeles 426

San Francisco 427

Eureka 428

Columbia Kiver 429

Hoquiam 429

Port Towuf^end. 429

Taconia 430

Port Angeles 431

Seattle 431

Texas-Mexican border quarantine 431

Reports of transactions —

Laredo, Tex 432

Eagle Pass, Tex 432

El Paso, Tex 432

Circular letter regarding discriminations in quarantine regulations 433

Amendments to quarantine regulations 433

Quarantine legislation 434

Division of scientific research 437

Organization and duties of the division 439

Yellow-fever institute 439

Hygienic laboratory — report of the director 440

Personnel 440

Plague 441

Special pathologic and bacteriologic reports 441

Examination of water supply of Birmingham, Ala 442

Service exhibits at Buffalo, IS'. Y., and Charleston, S. C 442

Tuberculosis 444

Disinfection and disinfectants 444

Car sanitation 444

The mosquito as a carrier of bacterial infection 444

Disinfection against mosquitoes 445

Malarial fevers 445

. Dengue 44H

' Vaccine virus 446

Dry |)()ints versus glycerinated virus, from a bacteriologic standjjoint. 446

Reports of conventions 44it

An organism resembling the bacillus pestis, By Asst. Surg. S. B.

Grubbs 45( i

A short description of the mosquito cycle of malaria, Bv Asst. Surg.

H. B. Parker ". 451

The Stegomyia fasciata. By P. A. Surg. H. B. Parker 452



Ll-TTER OF TRANSMITTAL.



Treasury Department,

WdshJiK/fon. December^, 1902.
Sir: In accordance with soction \) of the act of Congress approved
July 1. 15»()2, entitled '"An act to increase the efficiency and change
the name of lh(» Marine-Hospital Service."* 1 have the honor to trans-
mit herewith the annual rep(ut of the Surgeon-Cleneral of the Public
Health and ^larine-Hospital Service of the United States for the fiscal
year 11102.

Respectfully, L. M, Shaw,

'i'o the Speaker ok ihk House of Representatives.

11



ANNUM, RKPCJRT



SURGHC^N-GHNERAL PUBLIC HEALTH AND
MARINE-HOSPITAL SERVICE.



REPORT TO THE SHCRHTARY.



Treasury Depaktmext,
Bureau of Public Health and

Marine-Hospital Service,
Wa.s/un(/to7i, D. C. , Novemhei^ 1, 190'2.
Hon. Leslie M. Shaw,

Seeretary of the Treas^iry.
Sir: 1 have the honor to submit, for transmission to Congress, in
compliance with the act of July 1, 19(1:^, the following report of transac-
tions of the Public Health and Marine-Hospital Service of the United
States for the hscal year ended June 30, 1902. the same being the thirty-
tirst annual report of the Service, in the one hundred and fourth year
of its existence, and the tirst annual report under its new name (act of
Congress. July 1. VMYl).

In addition to the information pertaining to the tiscal year i!H»:^, the
operations of the Service in regard to quarantine and public-health
matters are narrated to the present date.

PERSONNEL.

At the close of the tiseal year the commissioned corps of the Service
consisted of 105 commissioned officers, including the Surgeon-General;
21) surgeons. 27 passed assistant surgeons, and -IS assistant surgeons.
During the year 1 surgeon resigned, 1 passed assistant surgeon was
promoted to the grade of surgeon, and 5 assistant surgeons were pro-
moted to the grade of passed assistant surgeon. At the close of the
tiseal 3'ear there were 181 acting assistant surgeons, 2 sanitary inspect-
ors, i'6 pharmacists, and 539 hospital and quarantine attendants.

Two boards were convened for the examination of officers for pro-
motion from the grade of assistant surgeon to that of passed assisttint
surgeon, and all officers ordered before said boards for promotion
passed successful examinations and Avere promoted.

One board was convened for the examination of such applicants as

13



14 PUBLIC HEALTH AND MARINE-HOSPITAL SERVICE.

might present themselves for admission to the mediciil corps as assistant
surgeons of the Service. The session of this hoard was not completed
at the close of the fiscal 3 ear ending June HO, 11H»2. 'rwent3^-four
boards were convened for the physical examination of line and engineei-
officers of the Revenue-Cutter Service and of the Coast and Geodetic
Survey.

ACCOUNTS,

The balance of the appropriation for the expenses of the Marine-
Hospital Serviceatthe commencementof the fiscal year was $720, 752. 74,
and the receipts from all sources were $U08,435..54. The net expendi-
tures were $95<),434.69, including expenditures for the improvements
of marine hospitals and grounds, and for repairs, heating apparatus,
furniture, fuel, light, and water, these items having ))een excluded by
Congress from participation in the annual appropriations and made
payable from the marine-hospital fund.

The amount available of the appropriation for preventing the spread
of epidemic diseases, July 1, 1901, was $799,561.81, and tiie expendi-
tures for the fiscal vear, $145, 47 1.71, leaving a net balance Julv 1, 1902,
of $654,090.10.

MARINE HOSPITALS AXD RELIEF.

During the fiscal year ended June 30, 1902, 56,310 sick and disabled
seamen of the merchant marine were treated, of which number 12,927
were treated in hospital.

The Service controls and operates 23 hospitals, of which 21 are
owned by the United States and 2 are leased buildings. In addition
to the hospitals there are 120 relief stations where seamen receive
hospital and dispensary treatment. Relief stations have been estab-
lished at Houghton, Mich., Hoquiam, Wash., and Sheboygan, Wis.

NEW HOSPITALS.

As recommended in the last i-eport of the Secretary of the Treasury,
provision was made by Congress for a marine hospital at New York,
N. y. , by an appropriation of $250,000 for the purchase of the site
and building now occupied, or purchase of a new site and erection of a
building. Negotiations are now in progress for carrying out the
intent of this provision.

Congress also authorized and mad(^ appropriations foi- marine hos-
pitals at Buffalo, Pittsburg, and Savannah, and measurcNs have been
taken toward selecting sites and erecting ])uildings for the same.

SANATOKICM FOR TUBERCULOUS PATIENTS, KORT STANTON, N. MEX.

The relief transactions of the sanatorium for consumptives at Fort
Stanton, N. Mex., have markedly increased, 212 patients having been
treated during the year, an excess of 60 over the previous year. The
repair of the buildings is proceeding as rapidly as possible, and it is
expected that under the present system of cattle raising and farming
in a short time the greater portion, if not all, of the meats, vegetables,
and fruits consumed at the station will he produced on the reservation.

As a further measure to limit the spread of tuberculosis among
seamen, instructions have been issued to officers of the Servxe to



PUBLIC HKALTH AND MARINK-HOSPITAL SERVICE. 15

disinfect, wlienovcr prjiclicabic the t|itiirtci-s on sliiphoard which h:i\('
h«'eii occupied hy seamen seeking" relict" on account of puhnonarv
c(>nsuin|)tion. It is believed that sueii infected (piartcrs are responsihle
for a considerable proportion of cases of this disease occurring anionj^
merchant seamen.

I would ur*i(Mitly r(>comnien(l as a sanitary and i^rophylactic measure
the expedieiu-y of receixine- ui)on the lar^c; reservation now at the
disposal of the Service at Fort Stanton such cases of tubei'culosis as
mav be sent there by State health authorities foi- treatment, upon the
pavnuMit of a i)er diem i"ate, to be based upon the cost of maintenance.
This measure would result in the cure of many ill with a disease
incurable under general conditions of enviromuent, and would diminish
centers of infection estal)lished l)v these patients in their homes, and
such a provision would materially aid in tlie various and well-directed
etlorts now bein*;- made for the suppression of the disease in the
I'nited States.



IM KVKVINC IJKPOT AT \K\V VnKK.



L)urino- the year ♦>(i2 requi.sitions were filled by the pui-veyino- dej)oi
in New York City, and supplies were furnished to marine hospitals
and to quarantine stsitions of the Service in the United States and its
insular possessions. Through this depot medical supplies have been
purveyed for the Immioration Service, and for vessels of the Revenue-
Cutter Service and of the Coast and (Jeodetic Survey.

AID TO OTHER SKRVICKS.

During the year the Service has extended aid to other liranches of
the Government, as follows : To the Revenue-Cutter Service in the
physical examination of 800 applicants for enlistment, 145 of whom
were rejected; to the Steamboat Inspection Service in the examination
as to visual capacity of 1,759 pilots, of whom 85 were rejected; to the
Life-Saving Service in the physical examination of 1,045 surf men, of
whom 58 were rejected: to the Immigration Service in the medical
inspection of 74H,2HT immigrants arriving at the various ports of the
United States and Cuba; to the C'oast and Geodetic vSurvey and Light-
llouse Service in the physical examination of 27 applicants for enlist-
ment, of whom 1 was rejected.

SANITARY REPORTS AND STATISTICS.

The Bureau has issued, in accordance with law, weekly public health
reports, containing all availal)le sanitarv information and vital statis-
tics. These reports are sent to the quarantines and to State and
municipal health ofticials. United States consuls, and others, and are
relied upon as the chief source of information upon the important and
.specific topics therein included.



YELLOW FEVKK.



There has been no yellow fever reported in the United States during
the past year. Reports have been received of the existence of the dis-
ease in Brazil. United States of Colombia, Costa Rica, Cuba. Dutch
West Indies, Haiti, Mexico, and Salvador. Mexico has furnish(>d a
large proportion of the cases reported, and Cuba, which has heretofore



16 PUBLIC HEALTH AND MARINE-HOSPITAL SERVICE.

reported a large number of cases every 3^ear, has reported only 61
cases and 14 deaths for the six months ended December 31, 1901, and
l)ut 1 case and no death for the six months ended June 30, 11)02, and
this single case was an imported one.



In the United States (San Francisco, CaL), since November 1, 1901,
the date of my last report, 39 cases of plague have been reported, all
])utoneof which resulted in death. This disease has been reported as
existent during the fiscal 3 ear 1902 in the following-named countries:
Australia, Brazil, British South Africa, China, Egypt, P^ngland,
France, Hawaiian Islands, India, Ital}^ Japan, Madagascar, Mau-
ritius, Mozambique, Paraguay, Philippine Islands, Russia, Scotland,
Spain, Straits Settlements, and Turkey.

SMALLPOX.

During the 3'ear smallpox has been reported as occurring in 14
States and Territories of the Union. The number of cases reported
for the 3^ear ended June 30, 1902, was 55,8.57; deaths, 1,852; a mor-
tality of 3.31 per cent, as compared with 38,506 cases and 689 deaths
during the year ended June 30, 1901.

FOREKJN AND INSULAR QUARANTINE AND IMMIGRATION.

Maritime quarantine has been conducted in Cuba, Porto Rico,
Hawaii, and the Philippines.

PHILIPPINEJS.

The severe outbreak of cholera in the island of Luzon has necessi-
tated the maintenance of a stringent quarantine on outgoing vessels
from Manila to the uninfected ports of the Philippines, as well as to
those of the United States and its insular possessions. The station
recently fitted up at Mariveles, across the bay from Manila, has been
of the greatest assistance for the detention and disinfection and obser-
vation of the personnel of vessels on which cholera has appeared. A
quarantine of five da\"s has been imposed on army transports before^
they sail for the United States, as an outbreak of cholera on a crowded
troop-ship at sea would be a most serious occurrence. Acting assistant
surgeons are stationed at Iloilo and Cel)u.



There are five fully ecj nipped quarantine stations in Cuba — at Habana.
Matanzas, Nuevita.s, Santiago, and Cienfuegos. There were fourteen
inspecting stations in Cuba, which were operated by acting assistant
surgeons until May 20, 1902, when the United States formally trans-
ferred the government of Cuba to the Cuban officials. Since this date
the accredited medical officers of the Service have been attached to thr
consulates at their respective ports. While the quarantine inspection
of incoming vessels has been turned over to the Cuban authorities at
these five ports since May 20, 1902, all vessels departing for the United
States are still inspected and certified to by medical officers of the
Service.



rUHLIC ]IJ<:ALT11 and IMAllINJvllO.sriTAL 8KKVICK. 17



I'oIMu liic



Tlu> (luaiuiitiiu' scr\ict' in J*ort() Kico lias been coiiducti'd upon tlic
sumo linos iis lor tho last tiscal 3'oar. Tlio disinfoctiri}^ barj^o Ar(/u>f
has boon sont to I'onoo, vvlicrc slio is nioorod in tho harbor, to bo used
for tho disinfoction of vcssols. Mirafloros Island, at San Juan, I'orto
Kico, has rociMitly ])oon transfcM'rod by Kxi'cutivo order lo the. Soi\ico
and is now usod as a (juarantino station.



During the year a question was raised as to the validity of the title
of tho Service to tho quarantine island at Honolulu, but infoi-niation
has boon roceivod from tho United States district attorney at Hono-
lulu that the (juestion has been finally settled, and u])on receipt of tho
proper papers the necessary repairs to th(^ buildings und extension of
tho plant, delayed while the matter was in liti<;ation, will be proceeded
with.

FOKKKiN I'OKTS.

M(>dical officers have lioon stationed at the ports f)f I>ondon, Liver-
pool, and Naj)les, at Quebec, Canada, and Halifax, Nova Scotia.
Durinj^ the active (|uai"antine season medical officers have been sta-
tioned at seven fruit ports of Central and South America to inspect
fruit vessels departing- for United States ports. Officers have been
detailed for duty at Yokohama and Kobe, Japan; Hongkong, China;
Rio do Janeiro, Brazil; and Vera Cruz, Progreso, and Tampico,
Mexico; and one has recently been sent to Shanghai, China. There is
also a sanitary inspector at Nagasaki, Japan.

MEDICAL INSPECTION OF IMMIGRANTS.

The medical inspection of arriving immigrants was performed at
thirty-two ports during the j'ear by medical officers of the Service
detailed for the purpose; also, at tho ports of the islands of Porto
Rico and Hawaii. Immigrants wore also inspected at Quebec, Canada,
and Halifax, Nova Scotia. Emigrants leaving Naples and Palei'mo for
the United States are inspected by a medical officer whose post of duty
is at the former place.

DOMESTIC QUARANTINE.

During the year 5,828 vessels were inspected at national quarantine
stations, and -±20 vessels were detained and disinfected. At tho close
of the fiscal year, June 30, 1U02, the Service owned 19 complete mari-
time (luarantine stations, and in addition operated 18 stations where
inspections of incoming vessels were conducted by officers of the Serv-
ice, thus making a total of 37 stations. In addition to these stations
there are 8 others completely equipped, and 12 inspection stations con-
ducted by States and municipalities within the boundaries of the United
States.

In January, 1902, the quarantine functions at Portland, Me., were
transferred to and accepted by the Service under the provisions of the
act of Congress approved February 15, 1893, as in like manner the
quarantine station and functions at Savannah, Ga., had ])oen acquired
in April, 1899, and the quarantine stations of Florida in August, 1901.

5836—03 2



18 PUBLIC HKALTH AND MAKIXE-IIOSPITAL SP:RVICE.

Provision was made in the sunrliT civil ))ill. approved June 28, 1902,
for tiie purchase of the Florida (|uaiantine stations thus ti'ansferred.

TEXAS-MEXICAN BORDER QCARANTINE.

With a view to the prevention of the introduction of 3ellow fever,
siiialli)ox. and typhus fever from the Republic of Mexico, land quar-
antines were ujaintained at ¥A l*aso, P^acrle Pass, and Laredo, Tex., and
these stations have been operated with the cooperation of the United
States inspectors of innnigration. Over 5(J,000 passengers have been
inspected, and 25 were detained for observation and the disinfection of