given by Drs. Janeway, Edson, Biggs, and Prudden of their explorations of Hoffman and Swinburne islands, and of the defects in the plant of those islands, and the difficulty, if not impossibility, of providing adequate shelter, classification, and disinfection of immigrants suffering from or subject to infectious diseases.

On November 15th, 1887, the committee again met, having been called together on receipt of a communication from the President of the Board of Health, enclosing notes from his Honor, the Mayor, and the Health Officer of the port. His Honor, the Mayor, having heard of the appointment by the Academy of Medicine of the Conference Committee, requested such committee "to make an early examination of the quarantine establishment; to point out its defects and its requirements, in order to bring it up to the highest ideal standard of modern scientific and medical knowledge; to estimate the amount which will be required to be appropriated by the State in order to complete the necessary improvements, and generally to suggest whether the city of New York should provide any further temporary hospitals, in case there should be an outbreak of cholera in our midst."

In view of the emergency made by the note of his Honor, the Mayor, the following telegram had been sent previously to the meeting by the chairman :

46

"NOVEMBER 16, 1887.

'Dr. William M. Smith, Health Officer, Quarantine Station, Staten Island.

"The Conference Committee, Academy of Medicine, desires to inspect quarantine with you to-morrow, Thursday. Name hour, and whence."

Reply:

"QUARANTINE, November 16, 1887.

Pleased to meet you at Clifton Station to-morrow morning at any hour you please to name.

"WILLIAM M. SMITH, Health Officer."

Owing to conflicting professional duties, some of the committee could not go on Thursday the 17th. On Saturday the 19th the committee did make its visit of inspection, being

conveyed to quarantine on the steamboat Edson of the Health Department. All the members of the committee were present except Dr. Stephen Smith, who declined to go because he had recently visited quarantine. There were also present, by invi tation of the committee, the President of the New York Board of Health, Mr. J. C. Bayles; Mr. Elnathan Sweet, State Engineer; Dr. H. M. Biggs, Pathologist of the Carnegie Laboratory, Bellevue Hospital College; Dr. T. Mitchell Prudden, Pathologist of the College of Physicians and Surgeons, New York, and Mr. Frederick N. Owen, engineer, Columbia College. Dr. Biggs and Dr. Prudden were added by vote of the committee to its membership at a meeting held on the return of the committee from its tour of inspection.

The first point reached in the exploration was Hoffman Island. It should be remembered that the quarantine establishment, port of New York, consists of the landing station at Clifton, Staten Island, where vessels arriving receive the official inspection of the Health Officer; and two miles below this station, in the Lower Bay, two islands artificially made of riprap and sand filling. The more northern of these islands, called Hoffman, is about two acres in extent. The more southern, nearly a mile distant from the former, is two acres and a half in size.* Hoffman Island, in the system of quarantine, is the place of detention. Off it detained vessels are anchored in the roadstead, and exposed there to heavy sea when the wind is on the coast. To this island passengers and their luggage are taken from detained vessels by a small steam tug, when, in the opinion of the Health Officer, their deten

* Hoffman Island is two and seven eighths and Swinburne Island two acres, superficial area.-A. N. B.

tion is made necessary by prevalence among them of infectious diseases, or when such diseases shall have existed on the ships in which they have arrived. The sick are sent immediately to Swinburne Island to the hospital buildings which exist there.

It is proper here to say that the quarantine property, land, buildings and plant, generally, owned by the State of New York is in the custody of a body called the Commissioners of Quarantine, appointed by the State and responsible to it. The Health Officer of the port, appointed by the Governor of the State and confirmed by its Senate, has no other control of the property and stations than that of police. He may use it without addition or modification, and so far only as may be necessary to enable him to discharge his duties in preventing the introduction into the port of New York of contagious diseases or infectious substances.

In regard to the question whether quarantine property and affairs should be under the jurisdiction of a National Government rather than a State Government, as now, the committee is not called upon to express an opinion. The committee deems its business to be to point out such defects of the quarantine establishment as are plainly apparent and easily remedied; to advocate such improvements in the plant at quarantine as would render it a sufficient safeguard for the port of New York and the country at large, if administered in a scientific manner.

As a related matter we would allude to the possible effect produced upon the business interests of New York and the country at large, if cholera were permitted to invade the dense population of the city. It is estimated that about one hundred thousand dollars a day are received by those hotels in the city of New York, from which people would flee if an alarm of cholera existed there. The amount of money received over the counters of shops from those who frequent the city to buy its innumerable wares cannot be estimated. It is millions. Hundreds of millions of dollars are annually produced in values in our various factories. To disturb the peace and industrial interests of the city, by permitting the irruption of cholera through defects in quarantine, would inflict an injury upon business beyond computation.

The time consumed in reaching San Francisco by railroad is

about that of the possible maximum period of incubation of cholera. The germs of any of the contagious diseases admitted into the port of New York by inadequate quarantine might be conveyed to any portion of the United States, fructifying as they went. Every citizen of the United States and British Provinces has, therefore, a personal interest in the condition of the New York quarantine. The existence of cholera in New York would cause the entire country to quarantine against the city. In this way interstate commerce would be paralyzed or seriously embarrassed. As regards the effect upon the health and death-rate of the people we cannot even surmise, as that question would turn on the efficiency of sanitary police. The law of cholera, its propagation, limitation, and extinction are so well understood that the disease may be said without presumption to be subject to scientific prevention or control.

With these few preliminary considerations, your committee would now in a cursory way call attention to some of the manifest defects in the quarantine establishment. In so doing they expect only to prepare the way for a thorough study of the subject. Thus steps may be taken to induce the Legislature, under appropriate law, to grant money enough to make quarantine what it should be. The plans to do this should be speedily prepared by the State officers. If there is neglect in this matter, and cholera, which has threatened to invade our port for more than three years, and has recently been brought to quarantine, should appear in the spring, and, favored by warm weather, pass an imperfect quarantine and reach New York City or Brooklyn, or possibly extend beyond

to near and remote places, public opinion would seek out the blameworthy and visit them with a condemnation which no. seclusion would be deep enough to smother or mitigate.

The ground is soft, uneven, full of recesses in which water, refuse, etc., will be retained without any chance of their being cleaned. The wood walks are in the worst possible conditioninterrupted, broken, rotten. The riprap of only one half of the island is now supported by an inside wall of cement.

The present buildings used for the residence of the people quarantined are badly adapted for their purpose. They should be razed or remodelled.

There is now almost no adequate separation of ages, sexes,