Quarantine Beyond Contagion: The View from the Water's Edge

Based on the everyday practice of quarantine at Philadelphia’s Lazaretto (1801-1895) as reported in the minutes of the Board of Health, as well as on published accounts of quarantine policy elsewhere, this paper claims that during the nineteenth century, the institution of quarantine was not premised on the contagiousness of epidemic diseases.  Rather, it was based on a loosely articulated but firmly held conviction that foul or contaminated air could be imported from overseas in vessels and goods, and in certain conditions could spark deadly disease outbreaks. 

 To be sure, patients admitted to the Lazaretto hospital were treated in relative isolation, and strict regulations governed access to and from the quarantine station, particularly when vessels were undergoing quarantine.  However, vessels were often detained based strictly on the nature or condition of their cargo, even when all aboard were healthy and without any report of disease in the port of departure.  In fact, cargo was often the dominant factor in the difficult and highly fraught quarantine decision, and passengers were frequently allowed to proceed to the city while their vessels and cargo remained at the Lazaretto for disinfection.

Contagion, which had provoked such vehement debate in Philadelphia during the yellow fever epidemics of the 1790s, became anathema among mainstream American physicians after about 1815.  Indignant and sarcastic protestations against the contagionist doctrine continued to proliferate for decades more, with few arguments made on the other side. Still, although  mainstream physicians regularly denounced quarantine as ineffective and oppressively burdensome to commerce, most stopped short of calling for its outright abolition.  I suggest that the danger that actually underlay the practice of quarantine in the nineteenth century was not contagion but a pre-bacteriological notion of “infection,” a protean term designating some kind of importable, disease-causing contamination.