Plague : papers relating to the modern history and recent progress of Levantine plague / prepared from the time to time by direction of the president of the Local Government Board, with other papers ; sented to both House of Parliament by Command of Her Majesty.

Radcliffe, Netten.

Date:: 1879

Credit: Plague : papers relating to the modern history and recent progress of Levantine plague / prepared from the time to time by direction of the president of the Local Government Board, with other papers ; sented to both House of Parliament by Command of Her Majesty. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

77/82 (page 71)

$applied to three diseases only, all of them infectious diseases of foreign origin, viz. : plague, cholera, and yellow fever. Of plague there has been no question in English ports for the last 30 years or thereabouts. Against cholera, quarantine has not . been enforced since 1858, its futility as a precautionary measure in this country having then been abundantly manifesfe37 Yellow fever is the sole disease at present sub- jected to it in om^ ports, and this, as already stated, not from the medical necessity, but from the commercial exigency of the case. The only quarantine establishment now remaining in England—that at the Motherbank—is maintained in respect of this disease. Infectious diseases habitually current in this country, such as small-pox, scarlet fever, &c., notwithstanding that the phi-aseology of the Quarantine Act covers any infectious disease or distemper, have always been in practice exempt from quarantine, and dealt with under the general sanitary law of the kingdom. It appears to have been recognised that measures primarily designed to prevent the introduction into the country of diseases only coming to us from abroad, and which involved international considerations, would be misappKed if used for the purpose of preventing the importation of diseases ordinarily existing here, the limitation of which and not the exclusion could alone be in question. 3. The measures which have been substituted for quarantine against cholera—the only foreign epidemic which at present much concerns the health of this country— consists in this system of medical inspection, the details of which are set forth in the Order of the Local Grovernment Board dated the 17th July 1873. \8ee p. 74 of these papers.] This plan differs from quarantine in the following essential respects :— It affects only such ships as have been ascertained to be, or as there is reason- able ground to suspect of being, infected with cholera or choleraic diarrhoea (no vessel, according to the Order, being deemed infected unless there has been actual occurrence of cholera or of choleraic diarrhoea on board in the course of the voyage); (6.) It provides for the detention of the vessel only so long as is necessary for the requirements of a medical inspection, for dealing with the sick (if any) in the manner it prescribes, and for carrying out the processes of disinfection; (c.) It subjects the healthy on board to detention only for such length of time as admits of their state of health being determined by medical examination. The measures for dealing with the sick under this Order are but an adaptation to a particular exigency of the principles of sanitary administration with regard to infectious diseases which are in force under the general sanitary law of the kingdom. 4. But though quarantine lias no practical existence in this country, except a» regards yellow fever,^ird~aII bTh.er infectious diseases aredealt with either under the genefal~s'anifary law of the country, or such modification of it as has been just de- scribed with regard to cholera, the machinery which is maintained under the Quarantine Acts for obtaining information as to the existence of infectious diseases on board foreign-coming ships is made available for dealing with all diseases of that kind, whether they are quarantinable or not. The quarantine questions, as they are termed, which it is the duty of the Customs to put to the masters of all such vessels embrace all infectious diseases; and, in the event of any such disease not of a quarantinable kind being found to exist on board, or to have existed in the course of the voyage, the quarantine officer is required to detain the vessel and to forward the information with the least practicable delay to the sanitary authority of the port. In regard to cholera, moreover, both the Customs and the sanitary authority have certain powers of detain- ing the vessel specified in the Order of the Local Government Board above referred to. 5. The provisions under Articles 12, 13, and 14 of the Order of the Local Govern- ment Board as to the mode of dealing with persons who may arrive from abroad infected with cholera ^ill be better imderstood if a succinct statement be made of the ordinary provisions of the law with regard to infectious diseases in England. The authorities which have to administer that law, as now existing under the PubHc Health Act, 1875, are the urban, rural, and port sanitary authorities of the districts into which the whole kingdom is divided, and these authorities are empowered— (a.) To provide hospitals or temporary places for the reception of the sick (section 131); (6.) Where a hospital or place for such purpose is provided, to remove thither by order of any justice, on a certificate signed by a legally qualified medical practitioner, any person who is suffering from any dangerous infectious dis- order, and is without proper lodging or accommodation, or lodged in a room$