The Birmingham age-herald., 1911-08-06
QUARANTINE OF OLD

Cabin Passengers Are Rarely De-
 tained Because Diseases Thrive
 Principally in the Crowd
 ed Steerage
 From the New York Evening Post.
 That yellow flag which flies from the stay between foremast and funnel of in coming steamships from foreign ports is the worldwide emblem of quarantine. l. IS the shipmaster's warning against in- truders, and his signal to the health of fcer to come aboard Revenue cutters, mail boats, newspaper tugs. and all units of the mosquito fleet that extend wei. come to new arrivals give heed to the yellow flag and seaway to the noisy lit tie tug that carries the boarding doctor, and rubs her insignificant fenders against the steel side of the liner. Cnly the health officer has power to lower the flag, and until it is hauled down, nc one except attaches of his department is per mitted to board the ship The lowering of the flag signifies that the ship mas received pratiaue-the health officers term fo- elearance-and then the customs and mall boats can range alongside while the ship gets under way for her pier.
 In these days of cholera carriers. guar antine regulations necessarily stinen, par ticularly with regard to ships that come from the infected Mediterranean ports, and the medical examination of an imml- grant vessel calls for more than ordinary care. Every ship Is obliged to carry among her papers B so-ealled bill of health. which purperts to give the sani- tary conditions existing at her sailing port These are merely formal documents and 1t Is doubtful whether, at the prea- ent time. they approximate the truth, so far as Italian ports are concerned. at least. Apparently, there has been a ter- dency on the part of the Italian govern ment to suppress facts relating to the area of cholera infection; and only with ils the last few weeks has the public be- gun to realize that the disease is likely tc travel westward with almost every Mediterranean snip.
 Have Watched Course of Disease
 Not so with Dr. AIvah H. Doty, New York's health officer, whose station is et
 
 United States Marine Hospital Service The federal government agents and Dr. Doty's correspondents in foreign cities long ago began to trace the course cf cholera in Europe. and as a consequence the ports guardians nave watched iu- coming ships carefully for well-defined cases and the dangerous carriers-per- sons who hold the cholera organism In their system. but show no signs of ill.,
 
 al the citys gateway is due 10 the meth eds of inspection and observation prac- tice6 at quarantine. When the doctors hoard a ship they line up the steerage passengers. with hats of for a visual in- spectiou which frequently results in the detection of infectious diseases. Positive cases that have been isolated by the ships surgeon. and passengers who have been treated h transit, but apparently have rc- covered. undergo close scrutiny. The character of the examination depend largely on the sanitary conditions exist ing at the port Of departure, the general health of the ships company. length nf tlme occupied by the voyage. and other factors. At the present time the port doctors are deToting their energies prin- cipaily toward discovering mild ambu- latory. or conyalescent cases that may pass unrecognized in the visual test. They use their clinical thermometers freely, and the slightest elevation in the tenn perature Of a passenger is sufficient cause for his removal to the detention station.
 Their most effiicent safeguari is a bac- astrological examination of cultures taken from the suspected passengers. and this as resulted in the discovery of cholera carriers, which. in the opinion Of sani- tarians, are calculated to spread the dis ease If permitted to pass unrecognizef. A dose of saline solution Is usually suffl- oient to light up," as doctors say, the latent organism in a carrier. and the case almost immediately becomes positive.
 The Quarantine of Old
 In former days, when a quarantine lit orally meant detention of 40 days, and sanitary science was in it's infancy, the loss to commerce was tremendous through the enforced idleness of ships in various ports. With the discarding of the the- ory that cargoes well the clothing of healthy passengers are mediums Of in- lection. and cooperation of ships doc tors with port health authorities, loss of time through detention has been reduced to a minimum. It is to the advantage of steamship companies 70 stimulate their doctors to discover cases of infection early in the voyage, and some even go SC far as to give bonuses to surgeons WHO nave dOEe SOOu WOfk lfl lSDlallnG pd- tients, and thus reducing or perhaps eliminating the annoyance and expense of detainng passengers at New York.
 A few modern liners are equipped with isolation wards, which have no connec ton with the ships general hospital, and on these vessels the surgeon is able to remove patients from compartments where they are a source of danger to their fellow travellers On ships which do not have isolation wards, the surgeon sometimes puts an infectious case in a single room, although this is not always practicable. At all events he IS required to keep a careful medical history of all cases developed in transit, so that the quarantine doctor may have frst-hand information.
 One of the principal factors m determin- ing the necessary length of deyention is the period of incubation. In cholera cases this is said to vary, and last week it wae decided 10 hold infected ships at quar- antine for ten days instead of five. The presence of cholera carriers indicated that the public would be better protected