PROTOCOL No. 3.

SESSION OF JANUARY 24, 1881.

President, Mr. JOHN HAY.

The Conference met, pursuant to adjournment, in the hall of the Department of State.

Present:

Argentine Republic: Señor Don Julio Carrié.

Austria-Hungary: Count Bethlen.

Belgium Mr. Georges Neyt and Mr. Edouard Sève.

Chili: Señor Don Francisco Solano Asta-Buruaga.

China: Chen Lan Pin.

Denmark: Mr. Carl Steen Andersen de Bille.

Spain: Señor Don Felipe Mendez de Vigo and Dr. Rafael Cervera. United States: Mr. John Hay, Dr. James L. Cabell, Dr. Thomas J. Turner, J. Hubley Ashton, Esq.

France: Mr. Maxime Outrey.

Great Britain: Mr. Edward Mortimer Archibald, C. B., and Dr. J. C. Tache.

Hawaii: Mr. Elisha H. Allen.

Hayti: Mr. Stephen Preston.

Italy: Prince de Camporeale.

Japan: Jushie Yoshida Kiyonari.

Mexico: Señor Don Juan N. Navarro and Señor Don Ignacio Alvarado. Netherlands: Jonkheer Rudolph von Pestel and Dr. F. J. van Leent. Portugal: Viscount das Nogueiras and Professor José Joaquim da Silva Amado.

Russia: Mr. Michel Bartholomei.

Sweden and Norway: Count Carl Lewenhaupt.

Turkey: Grégoire Aristarchi Bey.

The Protocol of the last meeting (January 12) was submitted to the Conference and approved.

The Delegate of Great Britain (Mr. ARCHIBALD), on behalf of the Committee appointed at the last meeting of the Conference, presented their report.

He asked leave to say that, as he occupied the chair during the ses sions of the Committee, and had no opportunity of discussing or voting on the propositions presented, he reserved to himself the right of expressing, at the proper time, some views in regard to one or two points in which he did not agree with the Committee.

The report was read as follows:

The Committee appointed by the International Sanitary Conference, called by his Excellency the President of the United States, at its session of the 12th of January, 1881, "to consider and report to the Conference the result of their views respecting the propositions of the Delegates of the United States, and at the same time to consider and report upon the propositions contained in the paper of the delegate of Venezuela (Mr. CAMACHO), and any other propositions which might be laid before them by any of the delegates," beg leave to report that they have considered the subject-matter referred to them, and have adopted the following preamble and resolutions, which they respectfully submit for the consideration of the Conference.

The Committee append to this report a paper presented by Dr. IGNACIO ALVARADOS the special delegate of Mexico, as the expression of his views and opinions on the subject-matters in question.

PREAMBLE.

Nations have an inherent power to prevent, without any breach of their international obligations, the introduction into their territories of contagious or infectious diseases. But there is often an omission to exercise that power when there is real danger, or an unnecessary exercise of power to avert an imaginary danger. These mistakes arise from two principal sources: 1st, ignorance of the real state of the facts in the country where the danger lies; 2d, the omission to communicate to other countries the knowledge of facts actually ascertained.

Mr. SCHUMACHER dissenting.

FUNDAMENTAL PROPOSITIONS.

A. That this Committee recommend to the International Sanitary Conference that it be admitted as an international principle of sanitation that it is highly desirable to adopt an international system of notification concerning sanitary matters and the appearance and disappearance of contagious or infectious diseases.

B. That it is the opinion of this Committee that it would be highly advantageous to permit certain sanitary inspections to be made by foreign agents in ports of various nations, subject to such rules as are necessary for the safeguard of each country's sovereignty and of each country's commercial interests.

Mr. SCHUMACHER abstains from voting.

SPECIAL PROPOSITIONS.

1st. It is desirable that each government should obtain, as far as practicable, seasonable and accurate scientific information bearing upon the public health in its dominions.

Mr. SCHUMACHER abstains from voting.

2d. It is desirable that each government should communicate promptly its information to the other contracting parties.

Mr. SCHUMACHER abstains from voting.

3d. For the purpose of giving to international communications on the condition of the public health indispensable uniformity, each nation represented in the Conference should publish a weekly bulletin of the statistics of the mortality in its principal towns

and seaports.

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

Nays-Dr. TACHÉ, Dr. VAN LEENT.

4th. It is desirable that each government should promptly give to the consuls and accredited agents of the others at seaports and principal towns the information mentioned in propositians 1, 2, and 3.

Dr. TACHÉ and Dr. VAN LEENT assenting, except as it refers to the 3d proposition. 5th. It is desirable that consuls should be assisted by medical sanitarians, who should furnish them with all necessary information.

These medical men should belong to an international corps of sanitarians and epidemiologists, residing in towns where endemies or epidemics 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. Yeas-Dr. AMADO, Dr. VAN LEENT, Dr. CERVERA, Mr. SÈVE-4. Nays-Dr. TACHÉ, Dr. CABELL-2.

Dr. ALVARADO abstains from voting-1.

6th. It is desirable that each government should consent that its ships, before and after taking in cargo, should 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 international agreement or treaty.

Dr. CERVERA and Dr. ALVARADO abstain from voting.

7th. It is desirable that each country should consent that its ships shall carry an international bill of health in the accompanying form, signed by the accredited agent of the country of destination, after the examination provided for in the 6th resolution. In case of no such agency in any port of clearance, or non-attendance or disability of the agent, the absence of such bill of health shall work no injury to the ship in the country of destination.

Dr. ALVARADO and Dr. CERVERA abstain from voting.

8th. In those towns where there are sanitary physicians belonging to the international body, they should have the right to examine everything that can help them to form an accurate idea of the sanitary condition of the country.

Yeas-Dr. ALVARADO, Dr. AMADO, Dr. CABELL, Dr. Cervera, Dr. VAN LEENT, Mr. SÈVE-6.

Nay-Dr. TACHÉ—1.

9th. The appearance and the existence of any epidemic disease in cities and ports cannot be well known and attested but by physicians, so that the authority that should certify to the sanitary condition of cities and ports ought to be a physician responsible for his acts, but in case another administrative agent deliver a bill of heath to the vessel leaving the port, he should be provided with official information supplied by medical authority; without this information it will be impossible for him to certify to the health of the vessel, and as the examination of the sanitary condition of a vessel properly belongs to a medical man it is desirable that the officer in charge of inspecting vessels and delivering bills of health be a physician, and such physician should be attached to the consulate.

Dr. TACHÉ dissenting.

10th. As the permanency of a scientific organization has been approved by this Committee, it is desirable that a permanent commission should be established.

Dr. TACHÉ dissenting.

11th. It is desirable that the bill of health issued in compliance with international rules should be issued gratis.

Drs. ALVARADO, AMADO, and CERVERA abstain from voting.

12th. It is desirable that the bill of health issued in compliance with international rules shall be considered evidence of the health of the ship at the port and time of departure.

Adopted unanimously.

I,

port of

INTERNATIONAL BILL OF HEALTH.

(consul, consular agent, or other officer empowered to sign), at the do hereby state that the vessel hereinafter named clears from this port

2. Sanitary condition of vessel (before and after reception of cargo, with note of any decayed wood). Note disinfection of vessel,

3. Sanitary condition of cargo,

4. Sanitary condition of crew,

5. Sanitary condition of passengers,

6. Sanitary condition of clothing, food, water, air-space, and ventilation,

PORT.

1. Sanitary condition of port and adjacent country

a. Prevailing disease (if any).

b. Number of cases of and deaths from yellow fever, Asiatic cholera, plague, smallpox, or typhus fever during the week preceding—

d. Total deaths from all causes during the preceding month,

2. Any circumstances affecting the public health existing in the port of departure to be here stated.

I certify that the foregoing statements are made by who has personally inspected said vessels; that I am satisfied that the said statements are correct; and I do further certify that the said vessel leaves this port, bound for, in In witness whereof I have hereunto set my hand and the seal of office, at the port this day of

of

[SEAL.]

Unanimously agreed to.

The Secretary of the Committee,

THOMAS J. TURNER.

188-,

o'clock.

The Chairman of the Committee:

Consul.

E. M. ARCHIBALD.

THE PROPOSITIONS OF DR. IGNACIO ALVARADO, SPECIAL DELEGATE FROM MEXICO.

The questions which the Government of the United States have submitted to the examination of the representatives of the several Powers, and for which object this Conference has been called, are clear and expressly specified in the memorandum of the 29th of July, 1880. Consequently, the Conference has to consider them from every point of view, as also the other questions which may strictly spring therefrom or may lead to their satisfactory solution.

The questions alluded to are as follows:

"A. The establishment of a reliable and satisfactory international system of notification as to the existence of contagious and infectious diseases, more especially cholera 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 notification 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 docu

ment.

These 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 supposed to 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 as 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 fulfilment 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 bills of health, or other analogous work, will be