After discussion, the question was taken and it was decided in the affirmative, yeas 5, nays 3, as follows:

Yeas-Dr. AMADO, Dr. CABELL, Mr. SÈVE, Mr. SCHUMACHER, and Dr. CERVERA-5.

Nays-Dr. TACHÉ, Dr. VAN LEENT, and Dr. ALVARADO-3.

Dr. ALVARADO stated the reason he voted against the proposition was because he did not consider the subject in proper time and order. The third United States proposition was then read, as follows:

Each government should bind itself to give to the consul or accredited agent of the others access to all hospitals and all the records of the public health.

Dr. VAN LEENT moved to strike out the proposition altogether, and submitted the following reasons:

Argum. I. I believe there will not be found one consul in the world who, respecting himself and his honorable position, will accept this mandate of visiting hospitals in order to see with his own eyes if there is or not contagious or infectious diseases treated in the hospitals and of what kind those diseases are. By accepting such a mandate he will find himself at once charged with a heavy burden of responsibility on matters that are not in his way, to regard, less to decide-in a word, a business totally strange to him. Nevertheless, on accepting the prerog. ative, he accepts at the same time the duties that it imposes. Here he is (supposing his admission to hospitals for these purposes) in the most difficult of all circumstances: on the one side to conceal his incompetence in the matter, on the other to look into affairs and to make a decision that he can by no possibility do. How will he make out if the cases that are before him are variola or varioloid, abdominal typhus or true typhus, typhus or acute miliary tuberculosis, cholera, or pernicious fever, bilious remittent fever, or yellow fever? I think he would compromise himself by entering into the medical business, and should at once refuse a mandate that no government should lay upon his shoulders. The honorable and honored-let me say sacred-position of the consuls and the respect for the governments ought to forbid them, it is my settled persuasion, to meddle with this business.

Argum. II. But suppose there would be found a consul willing to accept and execute this mandate. I doubt if he would find, from the authorities he has to communicate with, the necessary aid. I am cer tain that such an uncommon and till now unknown intervention in the household of hospitals will cause nothing but controversy. We must understand that there are so many hospitals where it will be, if not impossible, at least very difficult, to be admitted, where contagious and infectious diseases may declare themselves or be imported; p. exemp., the maternities, the women hospitals, the hospitals for special and specific diseases. Can the consul or the consuls (there may be twenty or thirty consular visits on one day) be admitted to such a hospital? The contagious diseases are not generally treated in special hospitals; but in their dependencies where there is a special building, sometimes a

barrack, sometimes a room particularly set apart for the treatment of contagious and infectious diseases. Now, that building, that room, that barrack, must and should be totally isolated, and no admittance allowed there. The visiting consuls are retained at the outer entrance by the imperative order, admission strictly forbidden.

Concerning the hospital registers or records, no medical chief of a hospital will open his register to any authority but the inspector of his service, acting in the name of the department to which he is related. Medical secrets ought not to be violated.

Argum. III. A third and last, though not least, argument against the article, is the want of confidence, the distrust, that it shows against the governments that bind themselves to the two articles precedent.

I am sure the governments will never agree to such control over their prompt and trustworthy notifications. Let the governments be responsible for the loyalty and truth of their information; and let us not support by our votes a measure that should be (I dare to say that I will not be alone of this opinion and persuasion) a serious obstacle to gov. ernments in giving adhesion to an INTERNATIONAL CONVENTION, the object of our Conference.

Mr. SCHUMACHER, Mr. ARCHIBALD and Dr. TACHÉ took substantially the same ground as Dr. VAN LEENT.

Mr. SÈVE thought that the consuls ought to have the power mentioned by the third United States proposition.

Dr. TURNER offered the following as a substitute for No. 3, which was read, considered, agreed to, Dr. VAN LEENT and Dr. TACHÉ accepting, except as to the third proposition:

It is desirable that each government should promptly give the consuls and accredited agents of the others at seaports and principal towns the information mentioned in propositions 1, 2, and 3.

The committee then adjourned until Saturday, January 15, at 11 o'clock a. m.

The chairman of the committee:

E. M. ARCHIBALD.

THOMAS J. TURNER.

The secretary of the committee:

ANNEX No. 9.

PROTOCOL No. IV OF COMMITTEE.

WASHINGTON, January 15, 1881. The committee met at 11 o'clock a. m. at the Department of State, pursuant to adjournment.

Present Mr. EDOUARD SÈVE, Dr. RAFAEL CERVERA, Dr. J. L. CABELL, Dr. T. J. TURNER, Mr. J. HUBLEY ASHTON, Mr. JAMES LOWNDES, HON. E. M. ARCHIBALD, Dr. J. C. TACHÉ, Dr. DON IGNACIO ALVARADO, Dr. F. J. VAN LEENT, and Prof. JOSÉ JOAQUIM DA SILVA AMADO.

The reading of the Protocols of the previous days was dispensed with. The committee then took up for consideration the projet submitted by the Delegates from the United States.

Dr. CERVERA offered the following:

Vessels ought to undergo, before and after their loading, an examination made by a physician of the country from which they sail; an examination in which the agent of the country of destination might assist, in order to be able better to attest its fidelity. Dr. AMADO offered the following as a substitute:

It is desirable that the consuls should be assisted by medical sanitarians, who will furnish them with all the information necessary. These medical men should belong to an international corps of sanitarians or épidémiologists residing in towns where such diseases prevail; the duty of these medical men being not only to assist the consuls, but to study scientifically the causes, the progress, the prevention, and the treatment of contagious diseases, and to inform the boards of health of the different nations of all that relates to the public health.

Dr. CERVERA withdrew his proposition and accepted that of Dr.

AMADO.

The question was taken, and Dr. AMADO'S proposition adopted.
Dr. TACHÉ dissented.

The fourth proposition was read, as follows:

Each government consents that its ships, before and after taking in cargo, may be subjected to an examination in port by the agent of the country of destination to meet the sanitary requirements of the country of destination.

Dr. TACHÉ offered the following as a substitute:

It is desirable that each government should consent that its ships, before and after taking in cargo, may be subjected to adequate sanitary examination in all ports by

the agent of the country of destination, under such rules as may be laid down by inter national agreement or treaty.

The question was taken, and decided in the affirmative; Drs. ALVARADO and CERVERA abstaining from voting.

The committee then took a recess until 24 o'clock.

AFTER RECESS.

The committee reassembled, pursuant to adjournmenttaken, and resumed the consideration of the propositions submitted by the Delegates of the United States.

The fifth proposition was read, as follows:

No clearance shall be granted without a bill of health signed by the agent of the country of destination in the accompanying form. In case of no such agency in any port of clearance, or non-attendance or disability of such agent, the absence of such bill of health to work no injury in the country of destination.

After discussion, Dr. TURNER offered the following as a substitute: It is desirable that each government should consent to require its ships to carry an international bill of health in the accompanying form, signed by the accredited agent of the country of destination, upon an examination provided in the 4th resolution. In case of no such agency in any port of clearance, or non-attendance or disability of such agent, the absence of such bill of health to work no injury to the ship in the country of destination.

The question was taken upon the substitute offered by Dr. TURNER, and was decided in the affirmative; Drs. ALVARADO and CERVERA abstaining from voting.

Dr. CABELL offered the following resolution, which was read, considered, and disagreed to:

Resolved, That the accredited agent of the country of destination granting the bill of health as provided for by the last proposition shall have authority to collect such additional information to that communicated by the local authorities of the port as provided by article 2, as may, in his judgment, be necessary to satisfy the requirements of the sanitary authorities at the port of destination.

Dr. ALVARADO declined to vote on the above resolution.

Dr. ALVARADO submitted the following, the consideration of which the committee decided to defer until all the propositions submitted by the United States had been disposed of:

The propositions are as follows:

The questions which the Government of the United States intended to submit to the examination of the several powers, and with which object this Conference has been instituted, are clear and expressly specified in the memorandum of the 29th of July, 1880, annex No. 2 of the Protocol No. I. Consequently the Conference has to consider them in all points of view, as also the other questions which may strictly spring therefrom or may lead to their satisfactory solution.

The questions alluded to are these:

A.-The establishment of a reliable and satisfactory international system of notification as to the existence of contagious and infectious diseases, more especially chol- ́ era and yellow fever.

B.-The establishment of a uniform and satisfactory system of bills of health, the

statements in which shall be trustworthy as to the sanitary condition of the port of departure, and as to the condition of the vessel at the time of sailing.

The undersigned believes that the best system of international noti fication could be obtained by means of scientific agents, appointed ad hoc, and not by any other means, in view of the considerations deduced from the perusal of the present document. The agents ought to be two, viz, a physician, appointed by the power the sanitary state of whose port it is desired to know, and another physician, appointed by the power interested in ascertaining that state.

The scientific character of said agents is an indispensable condition, as physicians are the only persons who, by reason of their profession, are in a position to appreciate most accurately the sanitary state of a locality. Any other person, however learned he may be, cannot make these observations, as such an one lacks in medical knowledge.

To develop and make this idea feasible it will be necessary to create a system of international scientific boards, subject in their fundamental proceedings to general regulations uniform to all the boards.

To this end each one of the signatory powers of the final Protocol can appoint a physician for such ports or cities they may think proper, who will reside in the place designated for him. The meeting of a majority of the physicians of several powers residing in a locality and presided over by the highest civil authority of the same will constitute the international sanitary board of that place.

The civil authority will transmit to each board all the information the board may ask for, and which may lead to the fulfillment of its mission, such as the daily entries in the civil and military hospitals, with specification of the diseases, &c.; these documents could be authenticated by a committee of the same board whenever it may be thought proper. This is the simplest, the most accurate, practicable, and trustworthy way which can be employed in order that each power may ascertain, through its delegates, the sanitary state of any place whatever; besides the guarantee obtained by the public faith given to the authority of the place, it has the honesty and knowledge of its delegate, who, as has been said above, can ultimately verify the accuracy of the official data.

On proceeding to the organization of the boards, the questions relative to bills of health and to all the other matters derived from the adoption of an international system of sanitary notification have naturally to be referred to such boards.

Although when the obligations and duties of international boards of health are defined-everything that refers to them will be properly subject to regulations-it is necessary, in order that I may complete my idea, to put forward a certain general basis to which said boards should conform their proceedings.

A. All the official acts of the boards which may have for their final object the making known to a foreign government the sanitary state of a locality, such as visiting the vessels at the time of sailing, issuing