New-York tribune., 1919-02-18
TO the Editor of The Tribune.

10 the Editor Of The Tribune.
GNlR: My attention has been directed to
article published in The Tribune
by Mr.. Kendrick Richard, presenting
the views of DR.. George e. Vincent with
respect to the necessity for national Sec
retary of Health, and especially to that
part of the interview touching on the pos
slbllity Of preventing the introduction of
influenza into this country by means of
adequate quarantine provisions
There is, to my mind, no question as to
the advisability of having strong national
health organization, and advocates of en-
largement of the Federal health service
should find ample argument in support
thereof without introducing such falaces
as presented in Dr. Nincent's interview.
Propaganda often serves most worthy
causes, but the proponents of a Depart
ment Of Health should rest their case on
its merits without resorting to unsound or
specious arguments
This criticism of alleged deficiency in
the public health agencies of the country
is well calculated to impair the confidence
Of the public in those agencies which should
protect the country against the invasion of
epidemic maladies wherever and whenever
preventive measures are possible. am
constrained however, to point out that the
opinions expressed in the interview are in
dicative Of a total lack of understanding of
the principles involved in the application
Of quarantine
Any argument for the enforcement of
non-ntercourse quarantine in this age and
generation seems too absurd to be treated
seriously, and yet, by his reference to the
non-ntercourse quarantine established at
Bethel, Me- DR.. Vincent would seem to
advocate the same procedure applicable
to the entire country. Modern quarantine
measures contemplate the application of
measures known and demonstrated to be of
practical value. In establishing a quaran-
tine, it is first necessary to have some def
mite standard by which disease can be
readily recognized either a clinical or a
meteorological standard. In the case of
influenza we have neither No sanitarian
of standing will contend that the causative
organism of influenza is known. Hence,
there can be no determination of what is
or what is not influenza by means of labo-
ratory methods AS to the determination
of the disease through clinical evidence,
it is we'll known that influenza varies ac-
cording to whether it is a mild or severe
type, and that in the absence of an epi-
demic of the disease, many cases at the
present time and in the past that have been
diagnosed influenza would ordinarily
have been diagnosed as a common "cold,"
bronchitis, pneumonia, or case of in
fluenza OF the "non-e epidemic" type
Another factor that would seriously in
terfere with the practical application of
quarantine measures is that of "carrers."
Although the virus of the disease has not
definitely been identified, there can be lit
tie doubt that certain percentage of trav-
ellers when exposed to the infection may
although themselves immune, carry the
virus in their person, and the same condi-
tion might we'll obtain among recovered
cases.
AS illustrative of practical quarantine
methods l may cite the procedure for the
prevention Of the Introduction Of cholera
In this disease we have definite diagnosis
through laboratory methods, and the sick
can be isolated until recovery. The employ
ment of laboratory methods demonstrates
beyond any doubt to whether person is
free from the cholera organism. Those in
contact with cholera can be readily
examined and proved to be either capable
of conveying the infection or not as the
case may be.
The same general principles obtain in re-
gard to yellow fever and to plague. In
those diseases preventive measures can be
applied which will assure almost absolute
prevention Of the spread of the disease
with practically no interference with COM
merce. 1t must necessarily be taken into
consideration that the stoppage of com
merce might we'll produce a condition of
affairs far worse than the actual introduc-
ton Of the disease. Non-intercourse quar-
antine-isolaton of a country from com
mercial relations with the rest of the
worlds not only impracticable, but it is
ndefensible, and under the conditions
which have obtained during the past two
years, it is, of course, unthinkable.
would DR.. Vincent suggest that during
august or september last year returning
troops from Europe be not allowed to land;
that ships carrying supplies essential to
the prosecution of the war be held in quar-
antlnc; that the crews be not allowed
ashore, nor any one from ashore be per-
mitted on board ship? Possibly it might
be argued that there WAS some practical
way by which the crews Of incoming ves-
sels might nave been confined TO the ships
and persons shore not permitted on
board such ships, and Mt the same time