« 이전계속 »
Case at Hanson City, near Kenner-At 1:10 p. m. Sunday, April 1, 1906, Dr. Gustine, Health Officer of Kenner (deceased), called up the office of the State Board of Health and reported a case of yellow fever at Hanson City, about one mile distant, saying that he had reported the case the previous day to the U. S. Marine Hospital Service in New Orleans, and that Dr. Corput, of that service, on his (Dr. Gustine's) invitation, had visited the patient that evening and had concurred in the diagnosis of yellow fever.
The President of the State Board immediately arranged to visit the case in company with experts. Of the several prominent physicians of New Orleans asked to serve in that capacity only Dr. E. L. McGehee, Sr., and Dr. L. G. Lebeuf, were able to attend on such short notice. The President therefore requested Dr. Veazie, one of the Medical Officers of the Board, to leave his duties in the city and form one of the committee of investigation.
On calling up the Marine Hospital to invite Drs. White and Corput, resident officers of that service, to accompany the committee, in accordance with the invariable practice of the State Board, the President was informed that those gentlemen were already at Hanson City, near which point they were met returning as the President and his committee were on their way from the Hanson City R. R. depot to the house where the patient was ill.
Drs. White and Corput were invited and urged by the President to return and see the case again in company with himself and the other physicians, but as Dr. White said they wished to catch a certain train back to New Orleans, and were afraid they might miss it, Dr. Gustine alone returned with the committee of the State Board to the bedside of the patient.
The patient was a ten-year-old boy of Italian parentage who had been taken sick Wednesday, March 28, and was first seen by Dr. Gustine on Friday, March 30. Though living at Hanson City for the previous three years, he was reported to have escaped the yellow fever which prevailed there extensively in 1905.
Without going into clinical details it may be stated that by a careful physical examination Drs. McGehee, Lebeuf and Veazie were enabled to demonstrate to Dr. Gustine the existence of a broncho-pneumonia, the obvious signs of which Dr. Gustine admitted, but without receding from his original diagnosis of yellow fever. He also admitted that an examination of the thorax had not been previously made.
The subsequent course of the case, with recovery after having the cough and other clinical phenomena of broncho-pneumonia sufficiently confirmed the diagnosis of that disease, and in the absence of any other suspicious cases or of any probable source of infection, may be held to have excluded yellow fever.
That case was unfortunately the subject of considerable newspaper controversy, causing the President of the State Board much regret that the reports of disagreements as to its diagnosis should have reached the public in such a sensational manner.
It was gratifying to the State Board to find that the verdict of its committee in this case was accepted with absolute confidence by the Surgeon General of the U. S. Public Health and Marine Hospital Service, and by the Health authorities of adjoining States, not one of whom sent any representative to make further investigations.
Case at Laplace --On July 7 a physician practicing in the Parish of St. John reported to Dr. L. T. Donaldson, Health Officer of that parish, that he had attended a genuine case of yellow fever at Laplace, La., stating that the patient had been taken ill June 25, was first seen by himself June 28, and was well at the time he made
Dr. Donaldson promptly notified the President of the State Board of Health of all the facts, adding that as the patient was already well he was unable to deny or verify the diagnosis but that he would act as if the case was one of undoubted yellow fever. He also stated that the house and neighborhood had no yellow fever during the previous year, so that it could not be an instance of recrudescence.
On the same day that this advice was received the President detailed Drs. Fred J. Mayer and C. Milo Brady, Medical Officers of the Board, to make a thorough investigation at Laplace. They were accompanied by Mr. L. F. Destrampes, chief of the Board's disinfecting force, for whose use in fumigating the suspected premises and neighborhood a large supply of sulphur was shipped that evening.
The investigation made by the officers of the Board included all the adjacent settlements, but failed to discover any source of infection or any other case at all suspicious, and Dr. Mayer's account of the history of the reported case, as gathered from the family, contraindicated yellow fever. The attending physician, however, adhered to his diagnosis, and on account of his failure to notify the Parish Health Officer until after the patient was well, in the meantime taking no precautions, steps were taken by the State Board to hold him accountable for such dereliction, as provided by the Sani
Here again the Health Officials of other States manifested entire confidence in the Louisiana Board, whose President sent out a frank statement of all the facts and of the result of the investigations made.
Case at New Iberia.—At 2:45 a. m., Saturday, Aug. 18, 1906, the President of the State Board received the following telegram:
New Iberia, La., Aug. 17, 1906. To the State Board of Health, New Orleans:
10:45 p. m. One suspicious case fever. Send expert.
A. Koch, Health Officer. In response to this appeal the President of the State Board requested Drs. Chas. Chassaignac and P. E. Archinard, of New Orleans, to examine and report upon the suspected case. They both promptly consented, and leaving by the first train for New Iberia saw the case in company with the local physicians at 5 p. m. that afternoon, Saturday, Aug. 18.
Their first examination of the patient, a light mulatto boy twelve years old, ill in an isolated house on the outskirts of the town, did not enable them to arrive at a positive daignosis, but on the following morning they found conclusive evidence of yellow fever and so reported it to the State Board of Health, without, however, being able to trace the source of infection.
On receipt of this report the President of the State Board immediately sent the following telegram to the Southern Health Officials, to the Surgeon General of the U. S. P. H. & Marine Hospital Service, and to Dr. Carlos J. Finlay, Health Officer of Havana:
New Orleans, Aug. 19, 1906. One case of yellow fever at New Iberia, 125 miles from New Orleans. Am leaving to-night to take personal charge of the stiuation.
C. H. Irion, President Louisiana State Board of Health. With the perfect understanding existing, such was the confidence of the Health authorities of neighboring States in the ability of the Louisiana Board to handle the situation that no quarantine was declared.
Under orders from the State Board of Health the Southern Pacific Railway stopped the sale of tickets out of New Iberia, and trains were forbidden to stop at that point except for water.
The President of the Board completed all his preparations for taking charge at New Iberia the same day that the case reported to be yellow fever, and being unable to secure a special train on such short notice accepted the kind offer of Superintendent Cushing's private car for himself and party.
The car, carrying all the necessary apparatus and supplies, was attached to the fast mail train leaving New Orleans that evening, and was dropped at New Iberia, where the train was not permitted to make a regular stop.
Dr. Fred J. Mayer, Special Medical Inspector of the State Board, accompanied the President, and Dr. C. Milo Brady, Medical Inspector, followed the next morning to begin a thorough inspection of the territory adjacent to New Iberia.
Among those who went by the special car were a number of expert fumigators, under Mr. L. F. Destrampes, chief of that service, so that work was begun without any loss of time.
It was found to be impossible to trace the source of infection, and for this reason, as well as on account of the season of the year, it was decided to institute a sanitary campaign so thorough and sweeping that, with the rigid personal supervision to be kept up afterward, no chance should be left for further trouble.
This personal supervision consisted in making a daily house-tohouse census of the entire population of the suspected area, which procedure was kept up for twenty-one days.
This sort of a campaign meant also the fumigation of the whole town, including dwellings, stores and offices, with effective screening of cisterns, etc., etc., and naturally met with some opposition, but by combined firmness and persuasion thc work was carried out to a finish under the personal direction of the President of the State Board. So complete was the destruction of insect life by this thorough fumigation that the town was relieved of a plague of fies, with great resulting benefit as regards typhoid infection, which was very much in evidence.
The patient recovered and no other case of yellow fever occurred, adding one more instance to the scientific victories over our ancient enemy, the very name of which was recently so terrible to the people of New Iberia that in 1905 they practically quarantined against the world.
. The behavior of neighboring towns with reference to New Iberia in connection with this alarm of yellow fever was a very conclusive and gratifying testimonial of popular confidence in the State Board of Health, especially so in comparison with the appalling condition of chaos that prevailed in that section of the State in 1905.
Similar confidence was manifested by the authorities of neighboring States from start to finish.
Cases at Houma.—On Aug. 22, in response to a request received by the State Board of Health to send a Medical Inspector to investigate certain cases of fever at Houma, Terrebonne Parish, Dr. H. A. Veazie, of the State Board staff, was detailed for that duty. Finding four cases about which the local physicians still disagreed, Dr. Veazie telegraphed asking that a special committee of investigation be sent to aid in arriving at a diagnosis. Accordingly the President called upon Drs. P. E. Archinard and Arthur Nolte, of New Orleans, who reached Houma in the afternoon of Aug. 24, and after a thorough examination in company with Dr. Veazie and the attending physicians, found from microscopic examination of the blood and other indications that the fever was malarial.
From the foregoing account of cases reported to the State Board for investigation in 1906 it will be noted that the only one found to be yellow fever was the New Iberia case, which, as previously remarked, assumed special importance on account of occurring after the middle of August in a portion of the State, where infection had been so general in 1905 as to cause some fear of its recrudescence.
MARITIME QUARANTINE IN 1906.
By general consent among those charged with the duty of formulating Maritime Quarantine Regulations for 1906 it was decided to have the same go into effect March 15, instead of on April 1, as in the past few years.
At the regular quarterly meeting of Feb. 23 and 24, the Louisiana State Board of Health took action accordingly, as the result of which the following Proclamation of Quarantine and code of regulations were officially promulgated :
QUARANTINE PROCLAMATION FOR THE YEAR 1906.
STATE OF LOUISIANA,
Executive Department. At the request of the Board of Health of the State of Louisiana, embodied in a resolution adopted by that body at a regular meeting held February 23, 1906, and by virtue of the authority vested in