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QUARANTINE
AND
PUELIC HEALTH REPORT
BY FREDERICK MONTI/AMBERT, M.D., F.R.C.S., D.C.L.
1889.
QUAER ANTINE.
3. No. 1.
ANNUAL REPORT ON THE ST, LAWRENCE QUARANTINE SERVICE.
GROSSE ISLE. •
(FREDERIC MonTIZAMBERT, M.D., F.R.C.S., D.C.L.)
Medical Superintendent.
SIR,--I have the honour to submit this my annual report for 1889.
The duties and responsibilities of the office which I hold have been enlarged
this season. The inspection of the mail and other steamers at Rimouski—hitherto
an independent service—was placed under my superintendence from the beginning of
the season. The whole St. Lawrence quarantine service is thus rendered uniform
as to administration under the one medical superintendence. This is in accordance
with the recommendations made by Provincial Boards of Health and the visiting
executive officers sent to inspect the service by the State Boards of Health of Michi-
gan, Illinois and Minnesota.
The inspection service at the Grosse Isle station has been continuously main-
tained. The number of vessels inspected there has been 122 in excess of the number
inspected last season. - -
Infectious disease was reported by or found upon the following incoming vessels
from abroad, named in the order of their arrival: Steamship “Montreal,” barque
“Premier,” steamships “Circassian,” “Lake Superior,” barque “Asia,” steamships
“Lake Winnipeg,” “Sardinian,” “Corean,” “Parisian,” ship “Lanarkshire”, barque
“Daggry,” steamships “Corean,” “Alberta,” “Siberian " and “Grecian.”
The diseases so reported or discovered were cholera, small-pox, typhus fever,
yellow fever and measles.
The season on the whole was a markedly healthy one. The admissions to the
quarantine hospitals numbered only 32, out of 50,879 persons inspected.
The steam tug “Champion” towed into the quarantine limits at Grosse Isle, on
the 23rd of July, the ship “Lanarkshire,” with small-pox on board. The tug left
her there and proceeded up the river without awaiting—as the law requires—the
visit and permit of the inspecting officer. A telegram to Quebec, however, caused
the “Champion ” to be met on reaching that city, and at once sent back to quaran-
tine. Then the amount and circumstances of the exposure of the crew to infection
from the “Lanarkshire’ were carefully investigated, and action taken accordingly.
This is in accord with the law for tow-boats which have communicated with vessels
liable to quarantine. As a rule it is carefully complied with by tow-boat captains and
agents. This failure of the “Champion ” in the endeavour to evade it will probably
prevent any recurrence of a similar attempt.
YELLOW FEVER.
The barques “Premier,” “Asia’’ and “Daggry,” allfrom South American ports,
arrived at the Grosse Isle station infected with yellow fever. They were fumigated
and disinfected.
The question is sometimes raised whether there is any danger from yellow fever
in this latitude and climate. An average temperature of 72° Fahr. is generally held
to be necessary for the development of that disease. The mean temperature during
the hot season in Quebec, and Montreal especially, during a “heated term,” is often
higher than that which has been registered as the mean, whilst an epidemic has been
at its acme in other places. In Spain and Portugal—which, like ourselves, have fre-
quent intercourse with West Indian ports—yellow fever epidemics prevail from time
to time. Thus Sternberg tells us that the city of Cadiz suffered in 1700, 1730–1,
1733–4, 1764, 1780, 1800, 1804, 1810, 1819–21. The epidemics of 1800, 1810 and 1819
were not limited to the city of Cadiz, but the disease extended to the interior, and
caused a considerable loss of life in the Provinces of Granada and Andalusia, and
also in some of the towns of Murcia and Catalonia, especially in Barcelona, from which
city the disease was conveyed to the Island of Majorca during the last epidemic.
Local outbreaks as a result of importation from the West Indies occurred in Gibraltar
in 1828, Barcelona in 1870, and Madrid in 1878. An epidemic of the disease was
inaugurated at Lisbon in 1856, and during the following year developed into a
devastating Scourge, which extended to the towns of Belem, Olivaes and Almada.
According to Hirsch, yellow fever prevailed to a limited extent at Quebec in 1805,
and at Halifax in 1861. Vessels arriving infected with yellow fever have caused
limited outbreaks of that disease in the ports of Plymouth and of Southampton. The
same thing occurred at Brest in 1856, at St. Nazaire in 1861, and at Swansea (Wales)
in 1864. The mean temperature of this last city at the time was only 67° Fahr.
Coming down to this year (1889) an epidemic has occurred at Vigo, in Spain. In that
city and the neighbouring coast cities nearly 1,000 persons were attacked. From 10
to 12 per cent. Of these persons are officially acknowledged to have died.
From such facts as these it would appear that, whilst there may not be much
danger of an epidemic of yellow fever in Canada, yet to allow our ship labourers to
enter and work in the hold of a veseel infected with that disease, in any of our sea-
ports in summer, might readily lead to at least a localised outbreak. So might also
the landing, of infected clothing, &c. Acting on this belief, I do not allow any vessel
with yellow fever cases on board, sick or convalescent, or reporting the occurrence
of the disease on board, to pass the quarantine station until the atmosphere of
her hold has been driven out by our steam fan, and she has been thoroughly fumi-
gated and disinfected.
CHOLERA.
Asiatic cholera was reported by the S.S. “Alberta,” from Iloilo, Philippine
Islands, with sugar for Montreal. She reached the Grosse Isle station on the 16th
September. She had had two fatal cases of Asiatic cholera, and six cases of chol-
eraic diarrhoea at Iloilo.
As several vessels arrive annually in the St. Lawrence, and possibly others also
at other ports, both of our Atlantic and Pacific seaboard, from Iloilo, Manilla and
other Philippine ports, it may be mentioned that the Siglo Medico says, that
between August, 1888, and July, 1889, 60,385 persons died of cholera in the Philippine
Islands. The statistics being official, are pretty sure not to err on the side of
€ XCGSS.
This same disease has also, this summer, spread from its East Indian home
westward into Persia and Mesopotamia. At this present writing it is stated to be
rather abating in the regions of the Tigris and the Euphrates, but still tending to
spread westward. The number of choleraic deaths in the new region it has
attacked registered from the end of July, the beginning of the epidemic, to October
25, reached 6,867.
The following resolution referring to this matter was adopted at the recent
annual meeting of the American Public Health Association, held at Brooklyn, in Octo-
ber: “Whereas Asiatic cholera leaving its usual restricted bounds threatens to
advance by the same lines that it has followed in the last four epidemics: be it
Fesolved,—That the American Public Health Association desires to call renewed
attention to this fact, and to urge that quarantine authorities on the Atlantic and
Pacific seaboards and Boards of Health throughout the country make every effort to
prepare for this threatening danger.”
INFLUENZA.
In this connection the epidemic of influenza, which is prevailing at present in
Europe may be referred to, and the theory to which currency has been given in the
telegrams from St. Petersburg, that epidemic influenza is a forerunner of cholera need
only be mentioned in order that it may be condemned as unfounded. It is true that
an infiuenza epidemic has on several occasions been closely followed by a visitation
of cholera. But it is also true that there have been epidemics of influenza with no
cholera following, just as there have been epidemics of cholera with no influenza pre-
ceding. The two diseases are so dissimilar in causation and method of spread as to
make any such sequence all but impossible. Any occasional instances of their simul-
taneous appearance must be regarded as a mere coincidence with no deeper signi-
ficance. Epidemic influenza seems to spread by the atmosphere, either by some
peculiar condition of the air itself or possibly by micro-organisms carried in it and
breathed into the lungs. It is thus that it can sweep over a country with such
marvellous rapidity, and strike in one city 100,000 persons within twenty-four hours,
as it is stated, to have done in Paris this autumn. Cholera, on the contrary—
although the micro-organisms freed from dried excreta may be carried on the wind—
spreads mainly by infected water, infected persons, infected things. It follows always
along the lines of human travel. Against influenza spreading through the atmos-
phere quarantines are useless. But cholera has never been brought to the American
continent except on, and by, a ship. It therefore should be, and is, one of the dis-
eases from which a country can be protected with certainty by efficient maritime
Sanitation.
AMERICAN PUBLIC HEALTH Association.
At the meeting of the American Public Health Association above referred to, I
had the honour to be present as your representative and delegate. Many valuable
papers were read at this meeting, and the discussions on them, and on other sanitary
subjects, were full of interest. The Association is a growing one. The importance
of conjoint and co-ordinate work and protection against exotic disease by all parts of
the continent is fully recognized by it. The following resolution was adopted at this
meeting: “Resolved, that in view of the rapidly increasing commercial intercourse
and trade between this country and Mexico, Cuba and the Central American States,
and the consequent growing importance of establishing and cultivating the most
friendly relations between the health authorities of our own and those of the
countries above named, a cordial invitation be extended to the sanitary authorities
of Mexico, Cuba and the Central American States to send representatives to future
meetings of this Association; that the Secretary be instructed to open correspon-
dence with the proper authorities looking to this end.”
LEPROSY.
The resolution urging preparations in case of the continuance of the present
westward march of cholera has been already quoted. Another resolution was
adopted requesting “Maritime quarantine officers to use the same vigilance and to
hereafter enforce the same regulations regarding leprosy as are now pursued
towards small-pox, yellow fever, &c.”
OTHER QUARANTINEs.
At the same meeting the reading of a paper by Dr. Wm. M. Smith upon
“Improvements at the New York Quarantine Station ” was followed by the visit of
the Association to the inspecting station and the quarantine islands in New York
harbour. There, at Hoffman Island we had pointed out to us the new and com-
modious dock, the new boiler house, kitchen, lavatories, dining rooms, dormitories,
&c., and the, as yet unfinished, rooms for disinfecting by super heated steam, and
at Swinburne Island the hospitals, officers' quarters, mortuary, and a crematory
recently erected for the cremation of the bodies of those dying from infectious dis-
ease. I was infomed that $150,000 have been expended upon these various works
during the last season, and that about as much more would be required for their
completion,
The State of Touisiana is laying out and fitting up a new and enlarged quaran-
time station on the Mississippi below New Orleans. It is to have a wharf with a
frontage of 400 feet, with a minimum depth of water of 28 feet. On this wharf
the cylinders for superheated steam, the tanks of mercuric chloride solution, and
g
-
the fans, furnaces, &c., for fumigation with sulphur dioxyde, are to be placed.
The last named appliance they find it well to take off their tug, even in the
smooth waters of their narrow river.
Charleston, South Carolina, has this season refitted her quarantine station with
deep water wharf, with all the most modern appliances upon it.
The Congress of the United States is now spending five hundred and forty-two
thousand five hundred dollars ($542,500) in fitting up national refuge quarantine
stations on the Atlantic and Pacific coasts with the newest appliances.
Dr. Smith, the health officer of New York Harbour, in a report dated 1st Feb-
ruary, 1889, says: “It is believed that the repairs and improvements of the quaran-
tine establishment” (of New York) “now in progress and contemplated will
supply all the conditions necessary to secure the country from any possibility of
an epidemic of infectious or contagious diseases which approach by the sea.” This
assurance from Dr. Smith is encouraging. '.
An expenditure by the Dominion of Canada of one-half the sum that is being
spent by New York would enable me to give a similar assurance as to the St. Law-
rence. But as I have been reporting in season and out of season for the last twenty
years, no such assurance can be given until the quarantine station at Gross? Isle is
provided with a deep water wharf, upon which the modern appliances for prompt and
scientific disinfection could be placed, and to which infected vessels could be brought
for such prompt and scientific disinfection.
VISIT OF PROVINCIAL BOARD.
The Provincial Board of Health of Quebec paid an official visit to the Grosse Isle
station on the 26th of September. The members present were Dr. Lachapelle
President; Drs. Demieux, Garneau, Paquet, Craik, and the Secretary, Dr. Pelletier.
They made a thorough examination of the Station and its appliances and workings.
They were able to estimate the difficulties and delays caused by our present make-
shift method of endeavouring to take the disinfecting appliances out on a steam yacht
to an infected vessel in the offing. One vessel, I may here remark, was this season
delayed for three days lying off the station. She was promptly inspected upon
arrival, but had to wait for three days until the smaller disinfecting steamer could
be used alongside of her for her fumigation.
The Provincial Board subsequently issued in print a report of their visit. From
that report I now submit a translation of some of its paragraphs: “The council is
more and more convinced that the prolongation of the wharf, as it has already
recommended to the Federal Government, is absolutely necessary, not for the
inspection of vessels, which would continue to be done in midstream, but for cases
where, after inspection, the entire vessel requires to be disinfected. Were this wharf
built, vessels would be spared the long detention caused by landing passengers and
their effects by means of yachts, as is now done. Moreover, the appliance Sfor dis-
infection being then installed upon the wharf, and not on a yacht as at present, the
disinfection would be performed more easily and more thoroughly, especially when
the sea is high.” “The prolongation of the wharf, the installation upon that wharf
of the appliances for generating sulphurous acid, as well as a large reservoir con-
taining always in readiness corrosive sublimate in solution, and lastly, the con-
struction upon, or close to the wharf, of an apparatus for disinfection by steam, are
the great improvements which will make it possible to reduce the detention of vessels
to a minimum, whilst ensuring the efficiency of the St. Lawrence quarantine; and
the Provincial Council hopes that the Federal Government will recognize the urgency
which exists of immediately supplying them at Grosse Isle.”
|RIMOUSKI SERVICE.
The Provincial Board also express in this report their satisfaction at finding that
the inspection of the mail steamships at Rimouski has been placed under my super-
intendence, and they add, “Recommendation que le Conseil Provincial avait déjà faite
.au Gouvernement Fédéral.”
Rimouski is the lowest point to which the Intercolonial Railway follows the
bank of the River St. Lawrence. It is 180 miles below Quebec, and therefore about
150 miles below Grosse Isle. There the mail steamers and some extra steamers
touch to land the mails, the passengers for the Maritime Provinces, and any others
who may elect to continue their journey by rail. A Government medical officer
boards steamships touching there. Thirty-seven steamships were so boarded this
season. If the vessel is reported “all well” he allows the landing of the mails, and
of such passengers as desire to disembark there, and gives the vessel a discharge from
quarantine by a permit which exempts her from subsequently reporting at the
Grosse Isle station further up the river, and which is in itself sufficient to procure
her Customs' entry at Quebec or Montreal. If she be not “all well” he uses his dis-
cretion as to the landing of anybody or anything at Rimouski. He may withhold a
permit and send the vessel to Grosse Isle to be examined and dealt with there. The
medical officer at Rimouski goes off to vessels in the mail tender. As that tender
leaves again for the shore the moment the mails are transferred from the steamship
to her, he has to depend very much upon the statement of the ship's surgeon, and
has not time enough to thoroughly check that statement by personal examination.
It was found that under this system infectious disease was, from time to time
admitted into the country. -
The placing of the whole quarantine system of the St. Lawrence under my
superintendence was, as I have stated above, urged upon the Government by the
Brovincial Boards of Health, and by the executive officers who were sent by the State
Boards of Health of some of the western States to inspect that system. This has
been carried out this season, and I have assumed, by your direction, these new duties
and responsibilities. They entail, amongst other things, my going down by rail to
Rimouski from time to time, and my coming up from that place on the mail steamers,
inspecting them thoroughly between that place and Grosse Isle, an interval of about
ten hours. My assumption of the medical superintendence of the whole St. Lawrence
quarantine system ensures two beneficial results. First, there is uniformity of
administration and method, and of the treatment of passengers and vessels throughout
the service, and secondly, ship surgeons now never know on what incoming voyage
they will find me coming off at Rimouski with the local inspector, to accompany
them for the remainder of the voyage up the river, thoroughly investigating the
exactness of their reports and the actual condition of the vessel whilst doing so.
SHIPS SURGEONs. cº'
Some ship surgeons are doubtless thoroughly reliable. But the status, remuner-
ation, quarters, &c., and the fact that with few exceptions they have no tenure of office
beyond the voyage, deter the better class of medical men, as a rule, from taking the
position. My experience of this season has proved that where, from the necessarily
hurried nature of the medical visit they alone expected at Rimouski, detection seemed
improbable, some amongst them thought the saving of trouble to themselves and
possible delay to the vessel of more importance than even the sanctity of an oath.
For instance, in the case of one of the mail steamers I came up on, her surgeon took
and signed the oath before Dr. Gauvreau and myself off Rimouski to the truth of his
written statement that each of the steerage passengers on board had signs of having
“been vaccinated within seven years, or of having had the small pox within that
period.” After leaving Rimouski I made a personal examination of the steerage
passengers, working in the steerage all day as the vessel continued her way up the
river to Quebec. I found and vaccinated 198 persons not protected as the law above
quoted requires. A large proportion of these were adults who made no pretence of
having been re-vaccinated since their infancy; and seven were children, from four
months to four years old, who had never been vaccinated at all.
On several other mail steamers a similar condition of affairs was found to exist
in varying numbers. Eight hundred and eighty persons in all were thus vºcinated
; ~
between Rimouski and Grosse Isle. '',
I was further enabled by the detailed inspection thus secured to detect some
cases of infectious disease in addition to those reported, and to carefully examine
and suggest some needed improvements in some of the hospitals on these vessels.
AA
***
The effect of my extension of duty was quickly apparent. On the second and
subsequent voyages I found that the ship's surgeons, not knowing on which occasion
they might find me awaiting them at Rimouski, had performed their duties carefully
and well. 3;
There is every reason, therefore, to conclude that this extension of my duties has
been productive of much benefit, and has removed what was a weakness and defect
in the quarantine service. *}
WACCINATION.
The regulations as to vaccination were, on the whole much better obeyed by
ships' surgeons this season. This was especially the case on vessels which had learnt
by experience last year that these regulations would be faithfully enforced at the
quarantine station. Only 1,059 vaccinations had to be performed at Grosse Isle this
season, a marked reduction in number from the 4,000 of last year. The further
number of 880 vaccinated on the mail steamers after passing Rimouski has already
been given above.
Passengers were vaccinated this year in varying numbers on the following
vessels by your quarantine officers: S.S. “Parisian,” “Lake Winnipeg,” “Geo-
graphique,” “Assyrian * “Henri IV,” “Nautique,” “Siberian,” “Grecian,” “Wan-
couver’’ “Lake Huron " “Sardinian,” “Prussian,” “Carthaginian * “Dominion,”
“Erik,” “Sarnia,” “Oregon,” “Lake Superior,” “Corean,” “Toronto,” “Lake
Winnipeg,” “Canadian,” “Toronto,” “Norwegian,” “Nautique,” Corean,” and
“Texas,” ship “Lanarkshire,” barque “Romulus,” and towboat “Champion.”
Amongst these vessels the following were instances where individuals who had
refused vaccination by the ships' surgeon, were induced by your quarantine officers
to submit to it from our hands S.S. “Parisian,” “Lake Winnipeg,” “Assyrian”
“Circassian,” “Lake Winnipeg,” “Canadian,” “Toronto” and “Norwegian.”
Occasional passengers who preferred a quarantine of observation to vaccination
were landed at the quarantine station from the S.S. “Oregon,” “Circassian” and
“Parisian.”
In the majority of instances under the last two paragraphs the objections were
stated to me to be to the manner of procedure of the ships' surgeon rather than to
vaccination itself.
j
WACCINATION REGULATIONs.
With regard to the vaccination regulations in our quarantine laws, my experi-
ence of their working during the last two seasons they have now been in force
confirms the opinion I have already had the honour to submit, namely, that the
great object to strive for is the securing of the vaccinal protection of passengers
before the vessel leaves her port of departure.
There is no general compulsory vaccination or re-vaccination law in Canada.
Under these regulations the alternative of a quarantine of observation may be
chosen. .
It would seem, therefore, that the prevention of the introduction into Canada of
vaccinally unprotected persons (who may contract small-pox after arrival) how-
ever desirable it may be in itself is not the main object of the quarantine laws on this
subject.
The regulations requiring vaccination within a period of seven years, or a quar-
antine of observation, have for their main object—as it would appear—the prevention
of the entrance into Canada of any vaccinally unprotected person who may have
been exposed to the infection of small-pox shortly before sailing for this country, or
upon shipboard during the voyage, Lin other words who may have small-pox incu
bating in his system.
They are, I presume, founded upon some such considerations as the following:—
(a). The period between the contracting of small pox and the falling ill with
the decease—the period of incubation—is, as a rule, about twelve to fourteen days. That
is longer by some days than the average steamship voyage from Europe to Canada
A passenger may therefore take the Small-pox at his home on the continent or in
England, on his way to the port of departure, or whilst there awaiting to embark,
and yet remain apparently well during the voyage, and only fall ill with the
developed disease after he has reached his inland destination on this side. An
instance of this which occurred last year may be cited as an example. A passenger
by the S.S. “Parisian * arrived at Quebec apparently quite well, yet, she was in the
incubating stage of small pox, contracted in Norway or England, which developed
in her a few days later in Minnesota, causing an outbreak of that disease.
(b). The period of incubation of the protective vaccination is less than that of
small-pox. A vaccination usually “takes’’ on the third or fourth day. By the
eighth day the vaccine vesicle is completely developed, with its areola, the “Zone of
safety.” --
(c). When this stage of the vaccine vesicle can be reached before the termination
of the period of incubation of small-pox the attack of that disease, otherwise about
to declare itself, may be averted.
(d). Even when this stage of the vaccine vesicle is only reached after the actual
appearance of the eruption of small-pox the attack of that disease may be modified
or aborted.
It is evident, therefore, that the earlier we can secure the vaccination of passen-
gers, the more complete will be the protection for them and for this country.
Vaccination during the voyage cannot be depended upon to prevent the develop-
ment of small-pox from reception of its infection shortly before embarkation, unless
it be performed the first day or two after sailing. If postponed by the ships' surgeon
on account of other duties, or to allow the passengers to get over their sea-sickness,
if only done late in the voyage, just to enable the ships-surgeon to make oath truth-
fully that it has been done, or a fortiori if only done at quarantine at the port of
arrival, it may modify the severity of the attack, but it cannot be counted upon to
prevent its occurrence.
My experience of the two years now last past, during which these regulations
have been in force, has proved the well nigh invariable usage of ship'ssurgeons alike
on our mail, and other passenger steamships to be the postponement of the exami-
nation, and of such vaccination as they may do, until the steamship is in the com-
paratively quiet waters of the Gulf—that is to say, until a day or two before the
vessel is due at the quarantine inspecting point, the excuse usually given being
that the recovery of the passengers from their sea-sickness had to be awaited. Per-
Sonal observation has shown me that a very similar usage obtains on some at least
of the principal steamships running to New York, and I am told by ships' surgeons
generally, that it is practically the rule for all vessels bringing passengers from
Europe to all ports on this side. The difficulty of examining and vaccinating a
number of passengers suffering from sea-sickness, with all its attendant disturbance
of mind and body, needs only to be mentioned to be believed in ; but it can scarcely
be even approximately realized without having been experienced,
It may be assumed, then, that this cause of the tardy examination makes the carry-
ing out of the vaccinal protection during the first day or two of the voyage, practi-
cally beyond the power of the ship's surgeon ; and, as before stated, when postponed
until later, the vaccination cannot be depended upon to prevent the developºment of
small-pox contracted before embarkation. -
To secure the protection for Canada sought for by these vaccination regulations,
every proposed passenger should be examined, and protection in accordance with
them established or ensured, prior to admission to the vessel, or before she leaves
the calm waters of the port of departure.
The Government of England recognizes a duty to passengers leaving her shores,
and to the countries for which they are so leaving her. In paragraphs 44 and 45 of
the Imperial “Aet to amend the Law relating to the Carriage of Passengers by Sea,”
it is enacted that, “No passenger ship, except as hereinafter provided (that is, where
no medical man can be obtained), shall clear out or proceed to sea until some medical
practitioner, to be appointed by the emigration officer, shall be satisfied that none
of the passengers or crew appear, by reason of any bodily or mental disease, unfit to
10
proceed, or likely to endanger the health or safety of the other persons about to pro-
ceed in such vessel. Such medical inspection of the passengers shall take place either
on board the vessel or, at the discretion of the said emigration officer, at such con-
venient place on shore before embarkation as he may appoint; and the master,
owner, or charterer of the ship shall pay to such emigration officer a sum at the
rate of twenty shillings for every hundred persons so examined.
“If the emigration officer at any port shall be satisfied that any person on board
or about to proceed in any passenger ship is, by reason of sickness, unfit to proceed,
or is, for that or for any other reason likely to endanger the health or safety of the
other persons on board, the said emigration officer shall prohibit the embarkation
of such person, or if embarked, shall require him to be e-landed.”
A person in the stage of incubation of small-pox is certainly “likely to endanger
the health or safety of the persons on board.” Every vaccinally unprotected person
embarking may be in that stage from recent exposure, consciously or unconsciously,
to the infection, yet there being nothing is his appearance to betray his condition,
it would not be discovered by this medical inspection.
The enlargement of such medical inspection to include the examination as to the
vaccinal protection of intended passengers, and the vaccination at that time—by the
Government medical officer, by medical men employed for the purpose, or by the
ship's surgeon—of all passengers who may not demonstrate previous protection
within the required limit, would be the best means, and indeed the only possible and
effectual means that I can see, of protecting this country from the developément
after landing here of small-pox contracted before sailing.
An occasional case might still occur on shipboard, where the person only embarked
at a late stage of the period of incubation, but even here the vaccination if
performed before sailing might modify or abort the attack. And from the protection
of all others having been already secured, there would be no danger of the disease
spreading on the vessels.
Whilst by thus making sure of the vaccinal protection of all persons before
sailing the great majority of the cases of small-pox now occurring on shipboard, and
all those now occurring on, or just after, arrival at this side, would be prevented.
I beg to most earnestly recommend this subject, and the expediency of endea-
vouring to secure such vaccinal protection of passengers before sailing, to your
favourable consideration. -
RAG-WORKERs.
. This disease, small-pox, is one of those to which rag-workers are exposed. In
connection with this fact and referring to the difficulties so far experienced—as I
have reported to you from time to time—in devising a mean of disinfecting rags in
the bale, I may be permitted to cite here the rules issued by the Legislature of the
State of Maine in a law entitled : “An Act to provide against the danger of the spread
of Small-pox from Paper Mills.”
“Section 1. No owner, agent, or superintendent of any paper mill, where domestic
or foreign rags are used in manufacturing paper, shall hire or admit any persou to
work in or about said mill who has not been successfully vaccinated or re-vaccinated
within two years, or to the satisfaction of the local board of health.
“Sec. 2. No person shall work in or about any paper mill where rags are used
who has not been successfully vaccinated or re-vaccinated within two years, or to the
satisfaction of the local board of health.”
Sec. 3. The owner, agent, and superintendent in every paper mill where rags
are used shall, every year, in the months of February and September, make out and
deliver to the local board of health a list containing the names, ages, kind of work,
and places of residence of all persons employed in or about said mill.
“Sec. 4. In the months of March and October, annually, each and every person
who is employed in a paper mill shall be examined by the local board of health as
to whether he or she is successfully and sufficiently protected by vaccination, and the
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local board of healthshall, in all cases, be the judges of the sufficiency of the protection
by vaccination.”
The violation of these provisions is made a misdemeanor punishable by fine.
AMBULANCE.
A new and very commodious and useful ambulance has this season been supplied
to the quarantine station, Grosse Isle. It is used to convey sick from the wharf
where they are landed, or from the western division, where “suspects” undergo quar-
antine of observation, to the hosiptal. It replaces a worn-out ambulance waggón of
obsolete pattern. It is a great improvement upon it in every way. It combines all
the best features of the English, Scotch and continental models, with certain modifica-
tions to meet the local and peculiar requirements of the station service. s
SEARCH LIGHT.
An electric search light for the inspecting steamer is much required. Wessels
have to be boarded off Grosse Isle on arrival by night as well as by day. On dark
and stormy nights this is often a matter of difficulty, not to say danger. On such
nights the want of a search light has been much felt. The addition of such a light
would greatly facilitate the prompt recognition and the boarding of vessels at night.
It would also lessen the risk of injury by collision, or striking between the vessels.
Such injury, for instance, as was mutually inflicted by your steamer “Challenger"
and a Norwegian barque I was endeavouring to board in the gale of the 1st of June
last. Moreover, amongst other advantages, the same engine and dynamo could sup-
ply incandescent lights throughout the steamer, obviating the present ever-existing
danger of fire from the coal oil lamps. For these latter reasons the small expenditure
for this purpose would seem desirable, if only as a matter of insurance against the
possible heavy expenditure to follow injury or loss.
With regard to the steel cylinders required for disinfection by superheated steam,
and other works and improvements of less importance at the station, I have had the
honour already to submit recommendations for your consideration.
DEEP WATER WHARF.
The great deficiency and requirement of the quarantine station of Grosse Isle
continues to be that of a deep water wharf. A wharf to which infected vessels could
be brought to land their passengers and effects for disinfection; and on which could
be placed the steel cylinders for the prompt and scientifically approved disinfection
of clothing and effects by superheated steam, the elevated tanks for drenching with
the mercuric chloride solution, and the steam fans, furnaces, etc., for changing the
atmosphere in the holds and steerages and replacing it by one charged with sulphur
dioxyde. I have already in this report quoted the opinion on this subject, officially
published by the Board of Health of the Province of Quebec. And I have cited an
example of three days lost to a vessel from the imperfect nature of our present make-
shift appliances for want of a wharf.
I can only repeat as I have done upon every possible occasion, that the deep-
water wharf at Grosse Isle is the one essential, all-important, ever-pressing need of
the St Lawrence quarantine service.
Until that is supplied, and fully equipped as above, the service cannot be
depended upon, nor be expected to protect the country from the invasion of epidemic
disease. g
I have the honour to be, Sir,
Your obedient servant,
F. MONTIZAMBERT, M.D., F.R.C.S., D.C.L.
Medical Superintendent.
The Honourable
The Minister of Agriculture,
Ottawa.
UNIVERSITY OF MICHIGAN