The Secretary, Dr. T. J. TURNER, laid before the Conference the fol lowing letter from the honorable Secretary of State:

DEPARTMENT OF STATE,

Washington, February 1, 1881.

SIR: I have to inform you that, according to a note of the 30th ultimo from the Belgian Legation, M. le Baron A. D'ANETHAN, now in charge of that legation, will succeed Mr. NEYT as the Belgian representative at the Sanitary Conference.

I am, sir, your obedient servant,

THOS. J. TURNER, Esq.,

W. M. EVARTS.

Secretary of the International Sanitary Conference, Washington.

The protocols of the third and fourth days' proceedings were laid before the Conference.

On motion of the Delegate of Russia (Mr. BARTHOLOMEI) the ap proval of the protocols Nos. 3 and 4 was postponed until the next session of the Conference.

The PRESIDENT: "If any Delegate has any emendations to make in the protocols he will notify the secretaries."

The Delegate of Turkey (ARISTARCHI BEY): "Provided they are submitted at least twenty-four hours before the meeting."

The proviso of the Delegate of Turkey was agreed to.

The Delegate of France (Mr. OUTREY): "I suggest that instead of applying the word 'article' to the matters under discussion they be called 'propositions'-'First proposition,' 'Second,' 'Third,' &c. And then when the Conference has finished its work the various propositions can be arranged in articles and numbered consecutively, as Article 1, 2, 3, 4, &c."

There was no objection, and the suggestion of Mr. OUTREY was agreed to.

The Delegate of the United States (Dr. CABELL):

"Mr. PRESIDENT: As we have now reached a point in the consideration of the report of the committee that touches the very heart of the system which has been established by the legislation of this country, and which is now earnestly recommended to the Conference for adoption by all the powers here represented, I desire to say a few words.

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Unwilling to consume the time of the Conference except when essential principles were placed in jeopardy, I abstained from any participa tion in the discussion at the last meeting on the first four special propo sitions of the report of the committee (condensed into two articles by the decision of the Conference), although I was well aware that by my silence I exposed myself to the probable imputation of inconsistency in voting against an article couched in similar terms to those of a proposi tion to which I had given my assent in the committee. Two of these four propositions had been submitted by the delegates of the United States, but merely as preparatory and introductory to much more important and practical means of accomplishing the end for which the Conference was called. By a pure inadvertence they were at first ex

pressed in terms which implied a binding obligation on the contracting parties to collect and communicate information as to the sanitary condition of their respective ports. It was on my own motion in the committee that this phraseology was so amended as to express nothing more than it is desirable that each government should, as far as practicable, obtain such information and promptly communicate it to the other contracting parties. We consider it inexpedient to overload any international convention which might spring from the deliberations of this Conference with obligatory requirements not absolutely essential to the attainment of the main object in view, however ready we may be to give expression to a wish that all civilized governments should adopt certain features of maritime sanitary administration which have been recently established in our own country.

"It was merely in this latter view that I was induced to accede to the third proposition of the committee as offered by the distinguished Special Delegate from Portugal, whom I was more anxious to please because of a substantial identity between the regulations of the maritime sanitary code of his enlightened country and those of the United States. I had, however, some apprehension that the incorporation of this proposition in the report of the committee might be taken hold of as a concession that the establishment and distribution of a weekly bulletin of mortality statistics would be an adequate compliance with the requirements involved in the first two questions of Mr. Evarts' memorandum. This fear has been realized already. The proposition in question, conceived in a scientific spirit with reference to purely scientific results, has undergone a change by the skillful manipulation of experts in diplomacy. The change, it is true, is slight in appearance, but of ominous significance, being calculated and doubtless designed to forestall other practical measures which we consider to be absolutely essential to the attainment of the great end for which a system of notification is desired by our government. That end, as stated in Mr. Evarts' memorandum, is the prevention of the introduction into the United States of contagious and infectious diseases, especially yellow fever and cholera. Now, I affirm without fear of successful contradiction that a weekly bulletin of mortality statistics, whatever value it may have in other respects, is wholly unavailable to this end. The information, however reliable and trustworthy, would come too late to be of use. But there can be no guarantee that these statistics are trustworthy. In many instances they are misleading and even absolutely false, and are particularly liable to be so in just those cases where accurate information is most needed. The actual or apprehended injury to the commerce of a port consequent upon the publication of the existence of infectious disease within its limits furnishes a motive and, as many openly avow, an excuse for the suppression of the facts as long as such suppression is possible. To obtain the earliest information of threatened danger-and it is this which is needed for the efficient application of preventive S. Ex. 1-4

measures-it will be indispensable to employ agents who are independent of local influences, and who are responsible to the government to which the information is communicated. In a word, if a nation wants reliable and trustworthy information with regard to the sanitary condition of foreign ports with which it maintains commercial intercourse by sea, it must have its own agents, who will feel their responsibility in the matter, to collect such information and to certify to it.

"When the authorities of France aimed to put a stop to the frequently recurring introduction of cholera by way of the Red Sea into the Mediterranean ports, they did not ask the governments of Turkey and Egypt to establish and give the 'greatest publicity possible' to a weekly bulletin of the deaths from that disease in Mecca, Medina, and the Red Sea ports. They resorted to very different and much more practical means of securing the desired end, and by their success won the applause and gratitude of all Europe. Let us hear the exposition of this system as found in a report made by the minister of commerce and agriculture to the then President of the republic in 1849.

"This minister said:

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"The ordinance of 1847 very materially modified the sanitary code of our country. It not only reduced the duration of quarantines and abolished them under certain conditions, on arrivals from Turkey and Egypt, when these countries were free from any pestilential epidemic, but it also established (and it is this which gives the act a peculiar importance) upon rational data the new system of precautionary measures which it prescribed. Hitherto all defensive measures against the invasion of the disease had been organized merely on the sea-coast. It was now deemed to be both more simple and more logical to extend the surveillance over the countries themselves where the disease took its origin. This was done by the nomination of resident physicians by our government (that of France) in Turkey and Egypt, to examine into the sanitary condition of those countries, and to fix the bills of health to be given to vessels on their departure, a measure that was the more useful as it provided for the more or less speedy introduction of important modifications into the régime of sanitary superintendence.

"I beg the Conference to observe how a measure primarily designed to protect the public health of Europe against the invasions of infectious disease, in effecting that end also promoted the interests of commerce by superseding the necessity of quarantine restrictions at the ports of arrival.

"The brilliant success of this system was the subject of remark and commendation at the International Sanitary Conference at Paris in 1851-22, and at Vienna in 1874, where it was suggested that similar measures should be adopted along the line of the approach of cholera from Persia by way of the Caspian Sea.

"What France has thus accomplished for Europe in respect to cholera we desire to effect for all nations wherever a similar exigency exists, by means similar in all essential features, though with certain differences in accordance with differences of local circumstances.

"In general, when any particular country is constantly or frequently in danger of importing infection from a given foreign port, it will, for

its own safety, maintain a competent physician at such port to assist its consul, but until it becomes apparent that the exigency exists, or is near at hand, it is not to be expected that governments will be willing to incur the expense of sending medical officers to reside at all the ports at which an infectious disease may possibly exist at some future day, and yet it will be important to have the earliest notice of the first cases, if any should occur. For this reason we proposed, in an original project, that each government should bind itself to give to the consul or other accredited agent of the others access to all hospitals, and to the records of public health, a proposition which assumes, by necessary implication, that the consul is to be the certifying authority to his government as to the sanitary condition of the ports of departure.

"Section 2 of the act to prevent the introduction of contagious or infectious diseases into the United States,' provides that—

"All vessels sailing from any foreign port where any contagious or infectious disease exists shall obtain from the consul, vice-consul, or other consular officer of the United States at the port of departure, or from the medical officer, where such officer has been detailed by the President for that purpose, a certificate, in duplicate, setting forth the sanitary history of said vessel, and that it has in all respects complied with the rules and regulations in such cases prescribed for securing the best sanitary condition of the said vessel, its cargo, passengers, and crew; and said consular or medical officer is required, before granting such certificate, to be satisfied that the matters and things therein stated are true.

"A part of section 3 reads:

"The Board of Health shall make such rules and regulations as are authorized by the laws of the United States, and necesssary to be observed by vessels at the port of departure and on the voyage, where such vessels sail from any foreign port or place at which contagious or infectious disease exists to any port or place in the United States, to secure the best sanitary condition of such vessel, her cargo, passengers, and crew, and when said rules and regulations have been approved by the President they shall be published and communicated to, and enforced by, the consular officers of the United States: Provided, That none of the penalties herein imposed shall attach to any vessel, or any owner or officer thereof, till the acts and the rules and regulations made in pursuance thereof shall have been officially promulgated for at least ten days in the port from which said vessel sailed.

"The rules and regulations made by the Board of Health, in conformity with the provisions of the act I have cited, having been officially approved by the President, have the force of law. Among them I cite the fifth rule:

"Each consul, vice-consul, consular officer, or medical officer of the United States in a foreign port shall keep himself thoroughly acquainted with the sanitary condition of the port and its vicinity, especially with regard to the existence of infectious or contagious diseases or epidemics, and shall, upon request of the owner, agent, or master, make or cause to be made an inspection of any ship or vessel bound for any port in the United States, and give the bill of health required by these regulations. Vessels carrying a foreign flag shall be inspected, when practicable, in company with the consul or consular agent of the nation to which the vessel belongs.

"The principles involved in these regulations did not originate with us. I am glad to render homage to the enlightened government of Portugal for giving prominence to these principles in its admirable 'Règle

ment général de santé maritime,' published in 1874. Under Titre III a very comprehensive article thus prescribes some of the duties of the Portuguese consuls in connection with this subject:

"ART. 6. Il appartient aux fonctionnaires consulaires de Portugal, par eux et par leurs subordonnés :

"10. S'informer constamment de l'état sanitaire, non seulement des localités où ils résident mais de tous leurs districts consulaires, tâchant de savoir s'il y a des cas de peste, de fièvre jaune ou de choléra morbus, et encore même de petite vérole, etc. Ils doivent, en conséquence, maintenir des rapports étroits avec les administrations des hôpitaux civils et militaires, avec les départements de santé publique, et avec les médecins jouissant de la meilleure réputation, etc.

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"40. Communiquer au gouvernement, par la voie la plus prompte, et sans perdre un moment, l'apparition de quelque cas de peste, de fièvre jaune ou de choléra-morbus, à terre ou à bord des navires mouillés dans les ports respectifs, et aussi quelque cas d'épizootie, marquant le jour ou les jours de la présentation des cas, quand même ils n'auront pas été fatals.

"8. Fournir au gouvernement, en cas de manifestation dans leurs districts de maladies contagieuses et épidémiques ou d'épizooties, tous les éclaircissements qu'ils pourront obtenir par rapport au caractère des maladies, informant, sur l'origine de l'infection, la statisque des attaqués et des morts, la propagation dans les lieux voisins et les mesures adoptées; ils devront, dans ce cas, indiquer les ports du pays, ainsi que ceux de l'étranger, avec lesquels les points infectés maintiennent de plus fréquentes et immédiates relations commerciales.

"9°. Adresser aux capitaines ou commandants de navires qui demanderont une patente de santé, et aux équipages respectifs et passagers à bord, toutes les demandes qu'ils jugeront à propos de leur faire par rapport à l'hygiène des embarcations, tåchant de les visiter et de les inspecter, et mettre, si on lui en fait la réquisition, le timbre du bureau sur les écoutilles qui fermeront la cargaison des navires.

"110. Signer et expédier des patentes de santé avec le sceau du consulat remplis sant les déclarations du modèle No. 1, qui fait partie du présent règlement, etc.

"Art. 7°. Dans l'absence ou l'empêchement des consuls et vice-consuls portugais et des employés qui les substitueront légalement, les patentes de santé et les visas pourront être délivrés par les employés consulaires de France, d'Angleterre, d'Espagne, et d'Italie, etc.

"According to Sir Sherston Baker (Laws of Quarantine, London, 1879), bills of health are given by Italian consuls to vessels of all flags, according to a prescribed form, one item of which is the 'sanitary state of the vessel.' He cites a decree of the 20th of November, 1870, of the Italian Government, which requires all vessels leaving the ports of the United Kingdom of Great Britain for Italy to provide themselves with a bill of health from Italian consular authorities, under pain of the penalties imposed by the ministerial decree of 29th of April, 1867. The suspension of pratique, however, is limited to 24 hours in the case of vessels provided with any other bill of health.

"Austria requires that bills of health from foreign ports shall be given by the local sanitary authorities or by the Austrian consul. With regard to this I have only to say that if the choice between these alternatives be left, not to the captain of the vessel, but to the government of the country of destination, we should not object to the terms of the Austrian regulation. We have no desire to make it obligatory on any nation to require bills of health to be given by the consuls, or in