Quarantine (It. quarantina, Fr. quarantaine, a space of 40 days), a police regulation for the exclusion of contagious diseases from a city or state. Sanitary laws are founded upon the assumption that certain diseases depend upon a specific contagion, and their professed ends are to prevent the exportation, importation, and spreading of contagious pestilential disease. For the first we have a process of purification, for the second quarantine and lazarettos, and for the third lines of circum-vallation and other modes of separation, seclusion, and restriction. The subjects of the sanitary code are epidemic and pestilential diseases generally, of which cholera, plague, yellow fever, smallpox, typhus, and dysentery are the principal; but its operations have chiefly been directed against the supposed contagions of plague and yellow fever, and of late years have formed a feature in the sanitary police of domestic animals. Moses prescribed (Lev. xiii.) the most stringent precautionary measures to prevent the spread of disease. He not only ordered the lepers to be set apart from the rest of the people, but required that their clothes should be purified, and even that the garments belonging to the more aggravated cases should be burned.
He gives explicit directions for the purification of the persons of those who have been cured of the disease, and also determines the time that the diseased shall dwell alone without the camp, as well as without their tent after being permitted to enter the camp. A peremptory sequestration of seven to fourteen days is also ordered for all those who had diseases of the skin. Long after Moses the religious laws were rigorously executed; and when the crusaders occupied Jerusalem, they established outside of the city an isolated place for the treatment of contagious diseases, called the hospital of St. Lazarus, whence the word lazaretto. Quarantine in Europe dates from the end of the 13th or the beginning of the 14th century, when leprosy prevailed in Italy and France. A military expedition returning from the Holy Land brought with it the Egyptian plague, which was looked upon as a new disease, and excited an unusual degree of attention from its great mortality and contagious character; it was soon discovered that those who avoided the sick escaped the disease.
The first quarantine regulation originated with Viscount Bernabo of Reggio in Italy, and is dated Jan. 17, 1374. Yet the authorities of Florence are said to have used occasional precautions as early as 1348, and we see in Fa-lasius that the emperors of the East had prescribed measures against those who arrived from places where plague prevailed, and it was at that time that the space of 40 days was fixed to observe them. The first quarantine regulations, founded on superstition and prejudice rather than reason and science, were most cruel and inhuman. The order of Bernabo required "every plague patient to be taken out of the city into the field, there to die or to recover." Their attendants were forbidden to associate with any one for ten days. Not only were these regulations strictly enforced, but in 1388 Bernabo forbade the admission of people from infected places into his territory, on pain of death. In course of time the benefits of these precautionary measures began to be understood and generally practised; but we have no account of any well defined legal code of regulations until about the middle of the 15th century, when the commerce of Venice was at its highest point.
Robertson says this city was not afflicted with plague while her commerce was limited or when it was dulled by the rivalries of the orientals; but when she had become strong enough to undertake conquests, when she covered the Mediterranean with her ships, and made commerce and war at the same time, she was invaded by a succession of plagues which originated in the Levant. In six centuries (from 901 to 1500) she had 63 epidemics. The Venetian senate in 1448 enacted a digest of laws known as the laws of quarantine. This system obliged all ships and individuals arriving from suspected places to undergo a term of probation before entering port and discharging their cargoes. The first organized lazaretto or pest house was erected in 1453 on the island of Sardinia, subsequently called il lazaretto vecchio; another was erected in 1468, called il lazaretto nuovo. All persons arriving from places where the existence of plague was suspected were detained there. The sick from the city laboring under the disease were sent with their families to the former station, and when cured were kept still 40 days longer in the latter. At a later period the republic of Venice established the first board of health, consisting of three nobles, who were appointed by the grand council.
They were called the council of health, and were ordered to investigate the best means for preserving health and for preventing the introduction of disease from abroad. The efforts of this council not being entirely successful, in 1504 they were invested with the power of life and death over those who violated the regulations for health, and there was no appeal from their sentence. During the prevalence of plague in Italy about 1527 bills of health were first introduced, and in 1665 they had become general. Quarantines and lazarettos began to multiply along the shores of the Adriatic, and other nations established similar laws. Though certain preventive regulations had existed in England from a very early period, no regular system of quarantine was enforced until about 1710, when plague was raging in the towns on the Baltic. During the dreadful plague at Marseilles in 1720 the government appointed the celebrated Dr. Richard Mead to draw up quarantine regulations. Parliament, approving his suggestions, repealed the act of 1710, and passed an act establishing quarantine throughout the commercial kingdom. Yellow fever visited Philadelphia in 1699, and in 1700 the general assembly enacted the first quarantine law in this country, imposing a fine of £100 for every unhealthy vessel that landed.
In 1701 a health law partly quarantine was enacted in Massachusetts. The first law on the subject in New York was passed by the colonial legislature in 1758. Congress passed "an act respecting quarantines and health laws," approved Feb. 25, 1799, which still stands upon the statutes. In 1831 cholera rode over all quarantine restraints; and these barriers being deemed antiquated, reforms were suggested. On Aug. 18, 1847, a royal ordinance of France declared the first recognition of the truth, based upon the opinions of medical men, that many of the restrictions of quarantine were unnecessarily burdensome, and therefore they were abolished. Still other reforms were established by decrees of Aug. 10, 1849, and Dec. 24, 1850. Dupeyron suggested the idea of a sanitary congress. A convention of delegates from the principal countries in Europe met in Paris in 1851, and after a long discussion proposed an international code of quarantine laws, which was ratified by the nations represented. On the approach of cholera in 1865 the French government called an international sanitary conference at Constantinople. Since this discussion quarantine has been established on a scientific basis, and more in accordance with modern notions of liberty and justice. - Reviewing the history of quarantine, several periods may be distinguished.
At first people, seized with terror, became panic-stricken; they wanted to be protected at any price. During this first period of superstition and terror, plague-stricken cities were burned; the sick were left alone to die; the shipwrecked from a suspected port were refused assistance; and physicians, afraid to appproach their patients, threw bistouries at them from a distance in order to open their buboes. The second may be called the period of reaction. The atmosphere was considered as the vehicle of epidemics, and was supposed to transmit diseases to a great distance. Going to the opposite extreme, quarantines were declared useless. The cholera of 1830 furnished new arms to the adversaries of restrictive measures. The severe quarantines and cordons organized on a vast scale in Russia and Prussia, and other parts of central Europe, applied in the midst of dense populations, became mere propagating agents. With the conference of Constantinople the question enters on the third or scientific period, when the true principles of international hygiene became established. Why the term of 40 days was fixed upon as a proof whether people were infected, is not very clear.
Some say it was chosen merely from superstitious notions, because people were accustomed to it in Lent; others that it arose from the doctrine of physicians in regard to the critical days of many diseases. - Communication with a country where a contagious disease exists may be interdicted by lines of troops or detachments posted from place to place. Some happy results may be cited in favor of these sanitary cordons applied at an opportune time and rigorously observed. Forts and villages in Orenburg and Astrakhan have been preserved from cholera by this means, as well as other towns in Russia, and also in Palestine and Arabia. The original lazaretto at Venice was the model for most of those forming part of the quarantine estab-ment in nearly all European ports. The old lazarettos are more dangerous than useful; those of Ancona and the Dardanelles gave ample proof of this during the cholera epidemic of 1865. At the present day temporary-lazarettos are considered the most desirable. Floating ones have lately been used in New York. In England there is no such thing as a lazaretto, though the quarantine act of July 28 1800, provided for the erection of a lazaret on Chetney hill, in the county of Kent. - A rigorous quarantine consists in the sequestration and isolation of both ships and persons for a determined time, with disinfection of everything susceptible of concealing morbific germs.
A quarantine of observation holds ship, crew, etc, under surveillance for a certain number of days; it may be enforced against a ship from a suspected port, or a ship in a filthy or unhealthy condition, although there may be no case of actual sickness on board. "When a ship is about to sail, she is furnished by the consul of her country or other competent authority with a bill of health, which is her passport. It shows the sanitary state of the place of departure and of the points at which she has put in. A foul bill is delivered in a port where cholera, plague, or yellow fever prevails; a clean bill, where none of these diseases exist. The duration of quarantine is regulated by the nature of these documents. The declaration of the captain or master of the vessel, upon all incidents of the voyage having reference to the public health, is an act in certain circumstances of high importance. In 1865, upon false declarations made at Suez and at Constantinople, two captains obtained free entry into two ports; and the terrible consequences of these lying declarations are well known.
Several countries where the cattle plague is regarded as exotic have enacted laws to prevent its spread; and an act of parliament is believed to have prevented its spread in Great Britain. Legal enactments of the same nature, only more stringent, prevail in France and Holland, and by the Ottoman government peste bovine is equally regarded with the plague, cholera, and yellow fever. An act of congress "to prevent the spread of foreign diseases among the cattle of the United States" was approved Dec. 18, 1865, and an act amending this, March 6, 1866. Cattle plague appeared simultaneously a few years ago in England and France, and the most rigorous methods were taken to strike at the root of the evil. In France it sufficed to kill 100 head of cattle to put an end to the progress of the epidemic. In England, owing to difference of opinion and insufficiency of legislation, things were allowed to take their natural course, and as many as 300,000 head of cattle were lost. - In the United States quarantine is exceedingly defective. Each state has laws of its own, which in many cases are absurd and conflict with one another.
The law deserving most attention is that of the legislature of New York, Jan. 22, 1873, entitled "An act establishing a quarantine, and defining the qualifications, duties, and powers of the health officer for the harbor and port of New York." The quarantine establishment for the port of New York consists of warehouses, docks, and wharves, anchorage for vessels, a floating hospital, boarding station, burying ground, and residence for officers and men. Merchants are afforded facilities for overhauling and refitting vessels while in quarantine. Connected with the warehouses are apartments with appliances for special disinfection by forced ventilation, refrigeration, high steam, dry heat, and chemical disinfection. The boarding station for suspected vessels, arriving between the first day of April and the first day of November, is in the lower bay below the Narrows. Vessels are boarded as soon as practicable after their arrival, between sunrise and sunset. The anchorage for vessels under quarantine is in the lower bay, two miles from shore, and within an area designated by buoys. Quarantine applies against yellow fever, cholera, typhus or ship fever, and smallpox, and any new disease of a contagious, infectious, or pestilential nature.
The floating hospital, with a capacity sufficient to accommodate 100 patients, is anchored in the lower bay from the first of May to the first of November; at other times it is anchored in some more secure place. The hospital at West bank, when so required, is used exclusively for yellow fever and cholera patients. The buildings on Hoffman island are used as a place of reception and temporary detention of persons who have been exposed to contagious or infectious diseases, but who are not actuallv sick. The health officer is the custodian of the quarantine establishment; his jurisdiction extends within the limits of the city and county of New York. In ascertaining the sanitary condition of a vessel he is authorized to examine under oath the captain, crew, and passengers, and to inspect the bill of health, manifest, log book, cargo, etc. Vessels liable to quarantine are required to discharge in quarantine, and be detained long enough thereafter for disinfection and aeration, such detention not to exceed ten days unless the disease occurs or reappears during that interval, in which event the time is extended ten days. But no vessel or cargo which has been in quarantine is allowed to proceed to New York or Brooklyn without the approval of the mayor or board of health of those cities respectively.
Filthy or unhealth-ful vessels are subject to quarantine for purification, not exceeding ten days. On infected or suspected vessels all clothing, personal baggage, cotton, hemp, rags, paper, hides, skins, feathers, hair, woollens, and other articles of animal origin, are subjected to an obligatory quarantine and purification. Molasses, sugar, and live and healthy cattle are subjected to quarantine at the option of the health officer. All other merchandise is exempted from quarantine and admitted without delay. The effects of persons who die in quarantine are taken in charge by the health officer, and if not claimed by the rightful heir within three months are delivered to the public administrator of the city of New York. All persons who have died are interred without delay in the quarantine burying ground at Seguin's point. A vessel has the right to put to sea before breaking bulk, in preference to going into quarantine; but the health officer in such case indorses on her bill of health the circumstances under which she leaves port, the length of her detention, and her actual condition, and sends to the quarantine hospital such sick as may desire to remain. All passengers on board of vessels under quarantine are provided for by the master of the vessel.
Any person violating the quarantine regulations, or who shall oppose or obstruct the health officer or any of his employees in the performance of their duties, is guilty of misdemeanor and punishable by a fine of not less than $100, or by imprisonment not less than three nor more than six months, or by both such fine and imprisonment. Any person aggrieved by any decision of the health officer may appeal therefrom to the commissioners of quarantine, who constitute a board of appeal. - On June 6, 1872, congress passed a joint resolution providing for a more effective system of quarantine on the southern and gulf coasts. Dr. Harvey E. Brown of the army, being detailed in obedience to the resolution, made a thorough report, on the strength of which a national quarantine was proposed, and "An act to prevent the introduction of contagious or infectious diseases into the United States" passed the house of representatives, but did not become a law. Quarantine in France, under the new organization of 1850, founded upon the departmental division, comprises two elements: the one, active and responsible, representing authority; the other simply consultative, and representing the locality.
The first is personified in an agent appointed directly by the minister, called director of health or principal agent, according as his duties are more or less circumscribed. The second is formed of a reunion of small functionaries and citizens taken from certain competent categories, and in particular from among the members of the council of hygiene and board of health. This organization is that of the large ports, which alone have a director and a special agent. In the others the service, reduced for economy to the strictest necessity, is done by secondary agents, principally employees of the custom house, who perform this service concurrently with their other functions. In India only limited measures have been taken to prevent the exportation of cholera. The "natives passenger act," promulgated by the government of India in 1858, only applies to the hygienic conditions and navigability of ships. The Dutch government, with a view to reducing the constantly increasing number of pilgrims who go from its possessions to Mecca, has established a regulation which may be beneficial in the future. - Many intelligent scientific observers have not only suggested sweeping and radical reforms in quarantine, but have questioned its utility and recommended its entire abrogation.
In England, the general board of health, after close investigation, propose the entire discontinuance of quarantines, substituting for them a strict code of international hygienic regulations, and they unhesitatingly assert that quarantines are no public security. The doctrine of a specific contagion, so universally received when quarantines were first established, has lately undergone almost an entire revolution. Objections to new and more comprehensive measures of protection on the part of the general government of the United States cannot now be raised, as in the days of Jefferson, who in 1804, in a communication to congress on the state of the Union, protested against the adoption of a code of laws to prevent the introduction of yellow fever. The conference at Constantinople, although establishing the true principles of international hygiene, was occupied exclusively with their application to cholera. It is proposed that any resolutions adopted by a future convention should have for their common end the preservation of the healthy individual, and be founded upon a different principle: to regulate the isolation and sequestration of the human species, and to systematize the destruction of animals.