Evening star. [volume] (Washington, D.C.) 1854-1972, 1903-02-02
PLAGUE IN FRISCO
REVIEW BY THE MARINE HOSPI-
TAI SERVICE.
Cases Up to December
IL Last-Eighty-Nine Of
Them Fatal.

The marine hospital service makes a care
full review of the existence of the plague
in San Francisco. The memorandum was
prepared by Assistant Surgeon D. NJ. Cur
RE. The review says:
"Ninety-three cases of plague have oc-
Cured within the city of San Francisco De-
tween the dates Of March 6, 1900, and De-
cember II, 1902. Six of these were whites
four Japanese and the remainder Chinese
Six have been pneumonia. of which TWO
were purely pneumonia. The others prob
ably secondarily pneumonic-that Is, sec
ondary to bubonic. Two have been purely
tonsillar; four have recovered; eighty-nine
proved fatal. In eight cases the claim was
made that they had come from other parts
Of the state.
In the Chinese Quarter.
"All were taken sick in the Chinese quar-
ter with the exception Of five-one japanese
and four whites, the former almost certain
ly being infected in the Chinese quarter.
One Of these whites was a woman whose
husband was a teamster for the Chinese,
and she herself lived within block Of the
Chinese quarter. Another, trained nurse,
was infected from a Chinese patient. An
other, a white sailor, who denied having
been in Chinatown for a year and half,
4
to have gone on sprees, and therefore
whose movements were doubtful, to say the
least. The longest lapse that has occurred
between cases Is ninety-two days, during
which time Chinatown was being cleansed
by the state board of health. the next long
est .seventy-two days, which ended Febru-
airy %. 1902.
There have been three lapses Of fifty days.
All the cases occurring in the Chinese quar-
ter beginning March 6, 1900. up to date have
been about equally distributed through
out, although taking given month they
are frequently found to have occurred in
comparatively localized area. So far as Is
known, there have not been over five cases
that are even probably contacts, and to
one or two of these the connection is
doubtful as to whether it was contag1on
from one to the other or from a common
source. 1t Is probable that all the dead in
Chinatown are seen. We have had some
evidence from Chinese sources in several
cases that sick have been removed in order
to avoid necropsy. In these particular
cases we have been unable to find out
whether it was true. If cases were re-
moved from the city, from what we have
observed here-namely, that few or no con-
facts contract the disease-it is probable
that no spread of the disease would take
place.
Except from the certificates of the at
tending physicians, we have no means of
ascertaining whether the whites in differ
ent parts of the city dying are infected
with plague.
High Mortality.
1.-THE city board of health says that after
the population of Chinatown is taken, ex-
elusive Of Japanese, the mortality runs 30
per 1000, which is high, considering there
are very few children. But these statistics
are based on the dead which we see, the
great majority of which are not plague
The method by which we see the sick is
as follows: 1t is known to the Chinese that
all cases which have been seen by us dur
ing life and found not to be plague will be
passed without necropsy.
Therefore, a certain per cent Of the pop
ulation report their sick to US for the sole
purpose of avoiding necropsy in case Of
death. This, as will be readily seen, per-
mits US to visit only those sick who the
Chinese believe are going to die. We have
repeatedly, through the Six Companies, and
directly, urged the Chinese to report even
trivial cases to us, assuring them that their
interests would not be injured thereby but
up to the present time, possibly owing to
contrary influences brought to bear against
us by the agents of the state board of
health, we have been unable to secure their
full confidence and cooperation.
LAS a rule, the Chinese 1aymen and ply
s1c1ans strongly suspect plague even at an
early stage of the disease; but, on the
other hand, any acute febrile illness they
regard in about the same light. In short,
differentiation between acute febrile cases.
The cases which occur with well-marked
buboes they recognize as readily as do the
trained white physicians. If the Chinese
believe the case to be one of plague they
rarely report it to this office because their
whole fear is the quarantine and the necrop-
sy of the body. All they can hope to gain
by reporting is the prevention of the necrop-
sy of the body, and therefore they have no
tnducement in this case to report"