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THE outbreak of the plague at Astrachan in the month of February last, and the alarm which naturally arose. throughout Europe, led the Author to consider what were the existing laws, not only in this country, but also in the British colonies, and throughout the whole world, which had for their end the protection of mankind from so terrible a visitation. While of the actual causes of the plague we are, in the opinion of the most eminent members of the medical profession, still profoundly ignorant, yet there seems to be a general consensus that it is transmissible, and such being the case, quarantine in some shape or other is, as a preventive, a logical consequence.
The complete suspension of all communication with an infected country, or even the isolation of suspected or infected persons at a reasonably remote distance, and during a sufficiently long period, together with a complete disinfection of all objects supposed to be tainted. with infection, has been generally recognized as a means of undoubted efficacy. This constitutes the ideal of "prophylactic quarantine." But in practice this ideal cannot be attained, for the suspension of all communication with an infected State is, strictly speaking, not applicable, except for the inhabitants of some secluded spot, such as an island, who do not of necessity communicate
with the country where the contagious disease is prevailing, and even this does not provide against dangerous communications, effected either clandestinely or through the medium of some other country. In fact absolute isolation is only practicable in a very restricted degree. A quarantine of long duration formerly constituted a practical method of protection, and was well suited to the slow and tardy commerce of the time. There was felt to be nothing disproportionate between the long and slow voyage and the lengthy quarantine. It certainly rendered great service, although its efficacy was not absolute. Complicated by all sorts of useless and barbarous processes, a long quarantine has now-a-days become a worthy object of criticism, and being, moreover, found to be a serious obstacle to the spirit of mercantile adventure, which has been increasing more and more, it has by degrees become obsolete, and has been replaced by milder regulations.
In practice, quarantine measures, be they what they may, can never give an absolute guarantee of safety; nevertheless they diminish more or less, according to the circumstances under which they are applied, and according to the vigour of the treatment with which they are enforced, the chances of an importation of infectious disease; in other words, quarantine can only give a relative guarantee. Must the conclusion then be as some would have it, that quarantine is useless? Must preventive measures be suppressed, because they cannot close every path against an importable and easily propagated infection? Such is not, however, the general experience of mankind, who, although aiming at perfection, are necessarily often content with a modicum of success. Shall we abolish the fire brigade, because a row of
houses are burnt down? Shall we dismiss the police force, because a dozen burglaries have occurred? Shall we denounce the system of railway signalling, because a false signal has caused a fatal catastrophe? No. In practice we must necessarily be content with the best relative certainty. In all cases it is sufficient for us if the means of prevention employed increase, in some reasonable degree, the chances of preservation and safety, and in such cases we consider those means of prevention advisable and worthy of adoption. Why should we require of quarantine that which we require of no other human institution?
Although quarantine does not constitute a certain. means of preservation, it affords a probability more or less great of preservation. Quarantine necessarily occasions a certain annoyance to those engaged in commerce and in shipping-two important interests clash together, viz., those of public health, and those of commerce— it becomes the problem for every State to determine on the happy mean in which quarantine may become advantageous for the interests of all, that is to say, that the benefits to be expected from a quarantine system should be commensurate with the burden which the system imposes. Every State experiences the difficulty of conciliating these two antagonistic interests.
The first consideration, viz., the public health, should be paramount, as concerning the great body of the people. It is particularly among the poorer classes that epidemics are most severe, and it is a first duty of every government to protect the interests of public health.
The laws of the United Kingdom are well calculated to meet all contingencies of disease, and to protect the sanitary interests of the kingdom, with the least practi
cable restraint on commerce. Owing, however, to a long continued exemption from imported contagion, these laws have somewhat fallen into desuetude, or even been lost sight of by those whose duty it would be to enforce them.
It would be out of place in a law-book to further discuss the aspect of the medical question, or to enter into political considerations connected with quarantine, but, perhaps, it may be permitted to state here that besides the well-known Great Plague of London of 1664–5, in which not less than 100,000 persons are computed to have perished in the course of one year, similar calamities have occurred in various parts of the United Kingdom much more frequently than is commonly supposed, as the following table will show :