7L I Columbia 5ínítíetóítp THE LIBRARIES iHeíJítal Híbrarp ', 9, Digitized by the Internet Archive in 2010 with funding from Open Knowledge Commons http://www.archive.org/details/transactionsofseOOinte TRANSACTIONS OF THE SECOND INTERNA- TIONAL SANITARY CONVENTION OF THE AMERICAN REPUBLICS HELD AT THE NEW WILLARD HOTEL, WASHINGTON, D. C, OCTOBER 9, 10, 12, 13, and 14, 1905, UNDER THE AUSPICES OF THE GOVERNING BOARD OF THE INTERNATIONAL UNION OF THE AMERICAN REPUBLICS WASHINGTON, D. C. ■ - GOVERNMENT PRINTING OFFICE - - 1906 f 1-1 1^ Ob' OFFICERS OF THE CONVENTION. President, Surgeon-General Wyman, United States Public Health and Marine-HospitallService. Vice-presidents. Señor Don Eduardo Moore, M. D., Chile. Señor Don Juan J. Ulloa, M. D., Costa Rica. Señor IJmilio Joubert, Dominican Republic. Señor Don Serafín S. Whither, Ecuador. Señor Don JoAQmN Yela, M. D., Guatemala. Señor Don Eduardo Licéaga, M. D., Mexico. " Señor Don J. L. Medina, M. D., Nicaragua. Señor Don Daniel E. Lavorería, M. D., Peru. Mr. H. L. E. Johnson, M. D., United States. Señor Don Nicolás Veloz Goiticoa, Venezuela. Permanent secretary. Señor Don Juan J. Ulloa, M. D., Costa Rica. Advisory council. ^ Señor Don Eduardo Moore, M. D., ChUe, Chairman. Señor Don Eduardo Licéaga, M. D., Mexico. ^ . Asst. Surg. Gen. H. D. Geddings, United States. Maj. Walter D. McCaw, U. S. Army. ^ Señor Don Juan Guiteras, M. D., Cuba. ^ Dr. J. D. Gatewood, Surgeon, U. S. Navy. ^ 3 ^ •C 436628 CONVOCATION OP THE SECOND GENERAL INTERNATIONAL SANITARY CONVENTION. In accordance with the mode of procedure authorized by the Second International Conference of American States, held in the City of Mexico in 1901-2, the date of October 9, 1905, was fixed for the assembling of the Second General International Sanitary Convention in "Washington, D. C. The following official communications were promulgated as neces- sary preliminaries: Treasury Department, Washington, April 29, 1905. Mr. W. C. Fox, Director of tJie Bureau of the American Republics, Washington, D. C. Dear Sir: I inclose herewith a call for the Second General International Sanitary Con- vention of the American Eepublics, summoned, by direction of the International Sanitary Bureau, to meet in Washington, D. C, on October 9, 1805, at 11 o'clock a. m. This call is issued in accordance with the resolutions relating to international sanitary poUcy and sanitary conventions adopted by the Second International Conference of the American States, held in the City of Mexico October 22, 1901, to January 22, 1902. In accordance with paragraph 7 of said resolutions, I have to request that you will take such measures as you deem advisable to make announcement of this call. Respectfully, Walter Wtman, Surgeon-General, Chairman International Sanitary Bureau. Treasury Department, Washington, April 29, 1905. the second general international sanitary convention of the AMERICAN REPUBLICS. By direction of the International Sanitary Bureau, the Second General International Sanitary Convention of the American Republics will be held at the New Willard Hotel, Washington, D. C, on October 9, 1905, at 11 a. m. The programme for the meeting wiU be furnished in a short time, and announcements of any changes therein will appear from time to time in the Monthly Bulletin of the Bureau of the American Republics. Respectfully, Walter Wyman, Chairman, International Sanitary Bureau. In consequence of the foregoing, the Bureau of the American Republics caused the following to be transmitted to the accredited representatives in the United States of the countries composing the International Union of American Republics : I^Iay 1, 1905. Sir: I have the honor to transmit herewith copy of a letter received from Surg. Gen. Walter Wyman, chairman of the International Sanitary Bureau, forwarding a call for the Second General International Sanitary Convention of the American Eepublics to meet in Washington, D. C, on October 9, 1905, at 11 o'clock a. m. I am, sir, your obedient servant, Williams C. Fox, Director. b SECOND INTEKNATIONAL SANITARY CONVENTION. The programme submitted for the work of the convention was as follows : Secx)nd International Sanitary Convention of American Republics, Washington, D. C, October 9, 1905. scientific programme. 1. Reports by a delegate from each Republic. These reports should include (a) reports on prevaleúce of diseases, with special reference to plague, yellow fever, and malaria since January 1, 1904, being approximately the date" of adjournment of the last convention; (b) a summary of all quarantine and sanitary laws enacted since the first convention; (c) special sanitary work in progress or in contemplation. Tliese reports are to be rendered in behalf of each Republic, or each division of the subject may be committed to a delegate for presentation. A written report is requested for publication. 2. Plague: (a) Diagnosis; (b) Prophylaxis and therapeusis; (3) Maritime quarantine; (d) Land quarantine ; (e) Local measures for the eradication of the disease. 3. The mosquito in its relation to yellow fever and malarial fevers. Prevention of the spread of yellow fever and malarial fever by the destruction and elimination of the mosquito. 4. Discussions on sanitation of cities, with special reference to the ventilation of habita- tions and disposal of household wastes. TRANSACTIONS OF THE SECOND GENERAL INTERNATIONAL SANITARY CONVENTION OF THE AMERICAN REPUBLICS. FIRST DAY— MONDAY, OCTOBER 9. The convention was called to order by Surgeon-General Wyman, presiding, at 11.15 o'clock a. m. OPENING REMARKS BY SURG. GEN. WALTER WYMAN OF THE PUBLIC HEALTH AND MARINE-HOSPITAL SERVICE. Gentlemen : I have the honor of calling to order the Second Inter- national Sanitary Convention of the American Republics, convened pursuant to resolutions adopted by the Second International Confer- ence of the American States, City of Mexico, January 29, 1902. Three years ago next December the First Convention was held in this city, eleven Republics being represented by twenty-seven dele- gates. So far as I am at present informed there are twelve Republics represented in this convention. You will remember that it was decided to hold the Second Convention March 15, at Santiago de Chile, in accordance with the cordial invitation presented by the distinguished delegates from Chile. As the time approached it became evident that on account of a severe epidemic of yellow fever in certain portions of the United States and Mexico, and the necessity of precautionary measures for the ensuing year, it would be very difficult for delegates from these two Republics to absent themselves; therefore, the International Sanitary Bureau, with the kind concur- rence of the Chilean authorities, agreed to a postponement and finally determined upon this date and this city for the present convention. The good results of the First Convention have been made mani- fest in various ways, and the resolutions which were adopted have been of value certainly to the health authorities of the United States, and as I believe to "the authorities of the other Republics. I will review these resolutions, of which there were seven, giving their titles, but not attempting here to quote them in full. First, the convention to be governed by the resolutions of the con- ference in Mexico ; Second, resolutions relating to the time of detention and disinfec- tion at quarantine; Third, resolutions relating to yellow fever, mosquitoes, and quar- antine ; Fourth, resolution relating to the geographical distribution of the yellow-fever mosquito ; Fifth, resolution declaring the relation between lower animals, garbage, and disease; 7 8 SECOND INTERNATIONAL SANITARY CONVENTION. Sixth, resolution relating to typhoid fever and cholera, declaring the necessity of disinfection of discharges; Seventh, resolutions relating to the international Sanitary Bureau, its operations, and the collection of a fund for its use. The good results of the First Convention and the beneficial effect of the resolutions just enumerated, will, I am confident, be made to appear in tlie reports and remarks of the delegates to this Second Convention. I will here mention but one instance in illustration. After the yellow-fever epidemic in Mexico and in Texas in 1903, there was great apprehension of its recurrence in both countries in the following summer and fall of 1904, and it became evidently necessary that preventative measures similar in character and thoroughness should be adopted in both countries. Tlu"ough the International Sanitary Convention the way was paved for securing combined action through the highest authorities of both nations. A plan of operations having been prepared in the Bureau of the Public Health and Marine- Hospital Service, broad in character and definite in detail, approved by the President so far as expenditures from the appropriate fund were concerned, by the Secretary of the Treasury as to the application of the fund and the scope of the work to be undertaken, and by the Secretary of State as to its relations to a neighboring Republic, I had the honor of pajdng a visit in January, 1904, to our distinguished confrere. Doctor Licéaga, president of the superior board of health of Mexico. I was pleased to find that practically the same plan, both in scope and detail, had already been proclaimed by the Mexican authorities and there was no difficulty in determining upon conjoint and concurrent action. President Diaz expressed his interest and approval. As a result there was practically no yellow fever in either Republic during the ensuing season. A description of the methods employed will doubtless be given by the delegates from both countries. This incident is but one of many which might be . cited to show how effective may be the work of sanitation when carried on by friendly cooperation between two nations, each inspired by friendly feelings and a desire to protect the other as well as itself. This idea of sanitation by international agreement is but one of the evidences that all nations are to-day more nearly related than ever before in the world's history. Said a recent writer: Not only has the narrow ftith been practically abolished, but the wide ocean is traversed by passenger ships in five days and by thoughts put into words in a few seconds. All the world has become one neighborhood so far as relates to distances. In no manner has this been more strikingly shown than in the war- fare against contagious disease. But a few years ago a violent epi- demic of yellow fever in Cuba would excite no more than passing notice, while to-day the news of one or two cases anywhere on the lit- toral of our Western Hemisphere would be immediately communi- cated to the United States and other countries. A few cases of bubonic plague in the Orient which a few j^ears ago w^ould receive no attention are instantly reported and published and one case of cholera on a ship in the Mediterranean is telegraphed to the principal cities of the world. International congresses, conferences, and conventions are frequent, bringing the nations together as one family in the struo-prle against the common foe of mankind. SP:C0NU IN'I'KHNA'IIONAI, SANI'l'AKV (;(>iN V KN'IION. 'J We hear much at the ])resent thne of international peace confer- ■ences, and arbitration treaties. Is it too niucli to expect as a corol- lary, or as a parallel movement, that there should be ultimately a cooperation of all nations to eliminate connnunicable diseases? International sanitation might well be considered as an adjunct to the movement for universal peace. It miglit prove less diííicult of achievement than absolute arbitration or it might be made a power- ful influence in establishing the latter. A former President of the French Republic at the opening of the Hygienic Conference at Paris in 1894, gave expression to the following sentiments: The international principles which had their origin in the laboratory and are based on science are the only ones which bind nations togetlier with strong ties and establish equitable and immutable laws. This principle may be well considered by those who are seeking universal peace; and international responsil)ility with regard to disease is worthy of the attention of those who are interested in the development of international law. There is, I believe, no mention in the treatises on international law of the responsibilities of govern- ments to one another in matters of public health, but the time is ripe for adding a chapter on this subject. I quote from a recent writer: It seems that nations are beginning to develop a conscience and a sense of justice for the rights of other nations. As a whole the peace movement is another step toward the actual attainment of the ideal perfection of government. The thought of the writer of the foregoing quotation can find no better illustration than in the incidents connected with the treaty of peace recently effected at Portsmouth. With this growing sentiment of harmony and fraternity among the nations, there should be developed an international sentiment regard- ing sanitation and suppression of disease. If, as Tolstoi says, the only substitute for war is religion, international sanitation would be a pow- erful weapon in the hands of religion, if, indeed, it could not in itself be made a substitute for war. It surely would furnish a plane upon which nations might meet, and a more worth}^ object than war for the expenditure of energy and money. I have before given expression to some of these thoughts, but have deemed them particularl}" appropriate to this occasion. It remains for me only to express the hope that this Second Convention will be fruitful for good, that it will bring us still nearer together and make us all feel that the interest of one country is in realit}^ the interest of the others, most particularly in matters relating to the public health. The President (continuing). Gentlemen, we have with us the distinguished Secretar}^ of State, whom I liave the pleasure of intro- ducing to bid 3^ou a few words of welcome. I have the honor of introducing to you the Hon. Elihu Root. ADDRESS OF WELCOME BY THE HONORABLE SECRETARY OF STATE, ELIHU ROOT. Mr. President and gentlemen: It is a pleasure and an honor to wel- come you to Washington in behalf of the Government of the United States and to extend to you an expression of the good wishes of our Government for the success of all your deliberations. 10 SECOND INTERNATIONAL SANITARY CONVENTION. It is a matter of sincere satisfaction to the people of the United States that the soil of our country should be found a favorable place for all the agencies of peace, of justice, of humanity, that the atmos- phere which is breathed here should be one favorable to kindly feeling among all the peoples of the earth. We would rather contribute to the .saving of life than to the destruction of it. I do not know that we have any reason to believe that the individual intellect of man is any more powerfid now than it was 2,000 years ago; but there is rea- son to believe that the growth of organization among men is now fur- nishing to individual human intelligence a platform upon which it may stand and from which it may take its departure toward the accomplishment of results that were impossible to the men of past ages, however powerful their intelligence may have been. And there is reason to beheve also that the human intelligence is capable of far greater accomplishments under the magnetic influences of association with other minds alive to the same interests and seeking the same, end. That you may promote the great work of elevating the stand- ard from which you yourselves and your fellows and your successors may take new departures for the accomplishment of great things for humanity, that you may feel and may communicate this magnetic influence which tends to promote the successful activity of human intelligence is my sincere wish. I believe that almost all of the wars, the controversies, the bitter- ness between nations, result from a want of good understanding, from, the failure by the people of one nation to truly understand and appre- ciate the people of another nation; that the true cure and preventive of national controversy is acquaintance, personal good relation and friendship among the individual people of the two countries; and nothing, certainly, can contribute more to the good relations which ought to exist between all the peoples of the Western Hemisphere than to have the men who represent, as you represent, that humanity which is superior to all national interests, to all national divisions, know each other and understand each other. You have our very best wishes and our thanks for honoring us by your presence here in the interest of that common humanity for which we all join in the most sincere wishes and the most devout prayers. [Applause.] The President. As is well known, the Public Health and Marine- Hospital Service of the United States is a Bureau of the Treasury Department, and we have with us this morning the Acting Secretary of the Treasury, whom I have the pleasure of introducing to you — the Hon. Horace A. Taylor. [Applause.] REMARKS OF HON. HORACE A. TAYLOR, ASSISTANT SECRETARY OF THE TREASURY. Mr. President and gentlemen: As acting head of the Treasury Department, of which, as the Surgeon-General has told you, the Public Health and Marine-Hospital Service is one of the prominent bureaus, I join with the Secretary of State, who represents all the Government, in extending to you a cordial welcome to Washington. We have here, as many of you know, in this capital city a great many distinguished visitors every day and all the time, coming here' for business or for pleasure, and of late years this has come to be a SECOND INTP:RNAT1()NAL HANITAUY CONVKNTION. 11 popular place where many associations devoted to the diversified activities of life hold their conventions, and we are always ^lad to see them here whether they are citizens of our own country or whether there are, as is the case with this convention, other countries repre- sented. \ I trust, gentlemen, that this convention which you are about to hold will result as those which have preceded it have resulted — in doing great good. Your convention is not as large as many that assemble here, bijt there is none that has higher objects to attain than you have. The methods which you are to discuss, the questions that come before your consideration, are those which affect the very highest interests of the communit3^ Nothing is so dear to every man, woman, and child in all the earth, no matter from what country he comes or what tongue he speaks, as his health, and you are here as the result of the progress that has been made in medical science during the last few years. You are here not to consider questions of disease, but you are here to pre- vent disease, and certainly we all know, as the old adage says, that an ounce of prevention is worth a pound of cure. And so I am glad to know that the medical world and that men eminent in the profession, as you gentlemen before me are, are directing their attention not to curing people after they become ill so much as to prevent them from becoming ill. As Secretary Root well said, great results flow from organization. It is organization and association and discussion and agitation that are the most beneficent agencies in the world. Stagnation is forever the enemy of progress, just as in the natural world it is a menace to healthful existence. In nature and in society, in government and in business, in the sciences, professions, and all the activities of life, it is agitation that brings reform and safety. We are told, Mr. President, that there is but one sea in all the world w^hose waves are never break- ing on the shores. It is the Dead Sea. Its waters are forever still, and there you find stagnation and disease. It is after the storm, the thunder and lightning, and the gale that come the pure air and the sunshine and the song of the birds. I want to thank you for selecting one of the prominent officials of the Treasury Department, Surgeon-General Wyman, and honoring him with the presidency of this association. He has well earned the distinction, for those of us who come in official or personal contact with him know that he is forever wide-awake to every movement that has for its interest the promotion of the public health [applause] , and you well know in these very recent days, when a portion of our country has been scourged with the yellow-fever epidemic, his efforts for its suppression have met with notable success. We are glad to see you here and we hope you will have a good time. I assure you you will meet with the most cordial hospitality and the best wishes of all our citizens and they will unite with me in expressing the hope that your deliberations will result in adopt- ing such methods and in the establishment of such principles as when put into force will be of great benefit to the public health of the various countries and communities that you represent. [Applause.] The President. The Secretary of State and the Acting Secretary of the Treasury seem to think that when they delivered their speeches they might go. I wish to say for the benefit of the next speaker that we would like very much to have him remain, and I am sure 12 SECOND INTERNATIONAL 8ANTTARY CONVENTION. you will ao-ree with me when you know who he is. We have with us one of the board of directors of the Bureau of the American Eepub- lics, who on behalf of that very efficient and useful Bureau will o;ive us an address. I refer to the Hon. Gonzalo de Quesada, minister to the United States from Cuba, and I take great pleasure in intro- ducing him to you. REMARKS or MINISTER QUESADA, OF CUBA. ^Ir. President, gentlemen and ladies of the Second Pan-American Sanitary Conference: I thank your chairman heartily for this oppor- tunity lie gives me of addressing a few words to the delegates of the Second Pan-American Congress in the name of the governing board of the American Republics. It was tliis same liigh privilege wliich I enjoyed two years ago when you met for the first time, and the prophecies then made as to the result of the labors you then initiated have turned out gratifying realities. You have brought together by the better acquaintance of their sanitary conditions and understanding between their respective boards of health, by the tol- erance and sympathy in the common effort, the countries here repre- sented, in a most commendable and sincere spirit of mutual respect and confidence. In the past there might have been distrust in the methods pur- sued in various nations or a self-pride far from conducive to the high aim of scientists; to-day there is collaboration and friendship and the best of feeling among the distinguished physicians in whose hands is the care of the lives and interests of these free communities. Were this the only outcome of the happy idea of these confer- ences it would by itself constitute a glory for those who planned them and for those who have put in fruitful practice its inspirations. But more has been accomplished, the interchange of honest dif- ferences of opinion, their thorough discussion, and the subsequent publicity given your papers and transactions have undoubtedly con- tributed to the propagation of scientific sanitary measures and the actual adoption of prophylactic and preventive methods recommended by you. In this respect we have reasons for warm praise. The wise direc- tions of some members of this conference who are here present have caused changes worthy of the most cordial commendation, and I am sure I am only voicing the sentiments of all present with the same enthusiasm you showed before for my native country, when we ex- tend, our felicitations to the representatives of Mexico who have made such progress, since our last meeting, in the eradication of yellow fever in that progressive and beloved sister Republic. [Applause.] And the theories advocated by you have not only been practically tested there and in other places, but also during these last months in some points of the Southern States of this Union with the suffer- ings of which our hearts are in unison. Our vows are that s^iortly they shall cease to be sources of concern. But even in this mis- fortuné some consolation and useful purpose are to be found, for not only have the theories advocated by you been tested and found true, and important researches are being made by American inves- tigators wliicn we hope will contribute to increase our knowledge of RECOND INTIÍRNATIONAL SANITARY CONVENTION. 13 the disease, but we have seen the comforting spectacle of physicians from other countries come to share witli you the diííiculties of the struggle and to help in the magniiiceiit task assumed by your authori- ties, of which our cliairman is the illustrious head. An example of real human interest which were it to be followed in other phases of international relations would contribute to the attainment of the supreme ideal of mankind, universal brotherhood. Gentlemen, in that spirit and under the ever-conquering banner of science which knows of no frontiers, ra-ce, nationality, or time, but whioh has for adversaries only ignorance and error, let us com- mence this Second Pan-American Conference, assured beforehand that it can have onl}^ one end — the pursuit of truth and the advancement of the welfare of humanity. [Applause.] The President. I will request Doctor Ulloa, of Costa Rica, to act as temporary secretary of this convention and will request that he call the roll of Republics, and as the name of the Republic is called I will thank the delegates or one delegate to arise and announce the name of the delegate and leave a card with the secretary, or his credentials, which will be turned over to the advisory council. The Director of the Bureau of American Republics informs me that we have a book here in which at your leisure you are requested to register your names. (The same request and announcement were made in Spanish by Doctor Ulloa.) The President. Before proceeding with the roll call, I take the privilege of inviting the attendance upon this meeting,, he being here and interested in tliis work, a very distinguished representative from Japan; I would like to present to you Doctor Suzuki, surgeon-general of the navy of Japan. [Applause.] The acting secretary called the roll and the following delegates were present: Republic of Chile : Dr. Eduardo Moore. ' Republic of Costa Rica: Dr. Juan J. Ulloa. ^ Republic of Cuba: Dr. Juan Guiteras and Dr. Enrique B. Barnet.^ Dominican Republic: Sr. Emilio C. Joubert.^ Republic of Ecuador: Sr. Serafín S. Whither and Dr. Miguel H. Alcivar. . Republic of the United States of America: Dr. Walter Wyman; Dr. H. D. Geddings; Dr. J. F. Kennedy; Dr. John S. Fulton; Dr. Walter D. McCaw; Dr. J. D. Gatewood; Dr. H. L. E. Johnson. Republic of Guatemala: Dr. Joaquin Yela.v Republic of Mexico : Dr. Eduardo Licéaga. Republic of Nicaragua: Dr. J. L. Medina. Republic of Perú : Dr. Daniel Eduardo Lavorería. Republic of Uruguay: Sr. P. Requena Bermudez. Republic of Venezuela: Mr. Nicolás Veloz-Goiticoa. The President. Gentlemen, we have with us one who helped to make our last convention successful, whose interest in it was marked, and whose efficiency in the conduct of such conventions as this has been shown on many occasions, and one who is now heart and soul with us in our effort to make this an effective convention. I refer to the recently appointed Director of the Bureau of the American Republics, and I have the honor of introducing to you Mr. W. C. Fox, Director of the Bureau of the American Republics. [Applause.] 1-1 SECOND INTERNATIONAL SANITARY CONVENTION, REMARKS OF HON. W. C. FOX, DIRECTOR OF THE BUREAU OF THE AMERICAN REPUBLICS. Mr, President and gentlemen: I fully appreciate the distinguished honor of being called upon on this occasion. By sufferance of the honorable representatives of the International Union of the American Republics I, for the moment, fulfill the functions of Director of the International Bureau of the American Republics. While apparently the fabric which holds this union together is of such fine and delicate texture that one would tliink the slightest element of discord would tear it asunder, the very fact of its exist- ence under these conditions is an assurance of its permanency. If I understand the reasons for an International Union of American Republics aright, it is not to create harmony — but the union exists because there is harmony. That harmony is a fact for the reason that the distinguished men who control the destinies of the various Republics are in mutual accord; and I believe, without fear of con- tradiction, that this union is supported no more heartily than by the giant brain, the strong arm, and courageous heart of the President of the United States. Mr. President and gentlemen, we have come together here to again show our fealty and loyalty to the interests of the American continent. We are here carrying out in part the dictates of the First International Conference of the American Republics, held in this city in 1889, and those of the Second American Conference held in Mexico in 1901. We have already met together two years ago, and now are forging another link in the chain which binds the Ameri- can Republics so firmly together. I do not feel that I can add one word to what has already been said, except that it becomes my duty now to acquaint you with what in a modest way we have attempted to do for your comfort while you are with us here in Washington, and with your kind permission I will read the programme. Luncheon will be served to-day and every other day during the sessions of the convention, to which you are cordially invited. This afternoon at 3.30 o'clock we will meet here and take an automobile to visit the new filtration plant in connection with the water service of this city. On Wednesday, October 11, through the courtesy of the Secretary of the Treasury, an excursion w;ill be given on a revenue cutter down the Potomac River, The party will go to Indian Head and Mount Vernon, returning to the city before dusk. It -seems to me that it will be more practicable if we should meet in this room at 9.30 o'clock and proceed in a body to the wharf where the revenue cutter will be in waiting. The management of the Bankers' Convention, which is being held simultaneously with ours, have very courteously sent invitations to the delegates to attend the reception at the Corcoran Art Gallery on Wednesday evening and the general reception in this hotel on Friday evening next. Dr. H. L. E. Johnson, Mr, President, I move that the following physicians and others be entitled to the floor: Dr. George M. Kober, Washington, D. C. SECOND INTERNATIONAL SANITARY (¡ONVENTION. 15 Surg. Preston 11. Bailhache, Public Ilealth and Marine-Hospital Service. Dr. Reid Hunt, pharmacologist, Public Health and Marine-Hospital Service. The president of the Navy Medical School, Washington, D. C. The president of the Army Medical School, Washington, 1). C. The Surgeon-General, United States Navy. The Surgeon-General, United States Army. Surg. Gen. George M. Sternberg, U. S. Army (retired). Dr. Ch. Wardell Stiles, zoologist. Public Health and Marine-Hos- pital Service. Dr. William C. Woodward, health officer of the District of Columbia. Surgeon-General Suzuki, Imperial Japanese Navy. Prof. H. C. Wood, Philadelphia, Pa. The motion was seconded; and the question being taken, was unani- 'mously agreed to. The President. This afternoon we have an invitation to inspect the filtration plant here in Washington. I think it will be well worth our while, because it is a plant to purify the Potomac River water for drinking purposes ancf it is one of the most up-to-date works of that kind. I am sure it will be worth a visit. We are to start at half-past three, as Mr. Fox informs us, in automobiles from the New Willard Hotel. The only thing that remains to be done, so far as I can see and so far as I know your wishes, is to appoint a committee on organization to determine how this present convention shall be conducted, and if some gentleman will make a motion that such committee be appointed I will put it and the committee can be preparing their report between now and the meeting to-morrow morning. Dr. H. L. E. Johnson. I move that such a committee be ap- pointed by the chairman. The motion was numerously seconded; and the question being taken, it was agreed to. The Peesident. I appoint on that committee Doctor Liceaga, of Mexico; Doctor Moore, of Chile; Assistant Surgeon-General Ged- dings, of the Public Health and Marine-Hospital Service, and Major McCaw, of the Army, and I will ask these gentlemen to remain after the adjournment. Doctor GuiTERAS. Mr. President, I move that Dr. Juan J. Ulloabe made secretary of this convention. Several Delegates. I second the motion. The question was taken and Doctor Ulloa was elected secretary. The President. I wish to add Doctor Guiteras to that committee on organization, making five members in all. Tliis completes the programme for this morning, but if there is any delegate that has any particular matter to bring before the con- vention we will be glad to have him do so. Doctor Guiteras. I move we adjourn until 10 o'clock to morrow morning. The question was taken and the motion was agreed to. SECOND DAY— TUESDAY, OCTOBER 10. Morning Session. The convention was called to order by Dr. Eduardo Moore, pre- siding, at 10.20 o'clock a. m. Doctor Moore. As chairman of the advisory committee I will now call the convention to order, and I will ask Doctor Ulloa to read the resolutions adopted by the committee appointed yesterday. The resolutions were read by the secretary, as follows: (1) Resolved, That the name of Surgeon-General Wynian be presented to the convention as president for this meeting, and that the name of Dr. Eduardo Licéaga be presented to the convention as president of the next convention, and that Dr. Juan J. Ulloa be nominated as permanent secretary. (2) Resolved, That the convention be held every two years. (3) Resolved, That the next meeting be held in the City of Mexico in December, 1907, subject to the call of the International Sanitary Bureau. (4) Resolved, That immediately upon the completion of the organization the president recognize Dr. Eduardo Licéaga for a statement of general interest. (5) Resolved, That the committee suggest that reports of the Republics of great length should be abstracted for presentation to the convention. The full papers will be published in the transactions. Doctor GuiTERAS. Mr. Chairman, I move that these resolutions be taken up one by one and presented to the conference seriatim. The motion was seconded. The question was taken and the motion was agreed to. The Secretary. The first resolution is : Resolved, That the name of Surgeon-General Wjnnan be presented to the convention as president for this meeting, and that the name of Dr. Eduardo Licéaga be presented to the convention as president of the next convention, and that Dr. Juan J. Ulloa be nominated as permanent secretary. Doctor GuiTERAS. I move that this resolution be adopted. The motion was seconded. The question was taken and the motion was agreed to. The chair was here assumed by Surgeon-General Wyman. The President. Gentlemen, I wish to thank you for this renewed honor. Personally, it would have been more acceptable to me if some other delegate had been elected, and had been given this honor for this meeting. It seems, hovt^ever, that the presiding officer should be a native of the country in which the convention is held, and inas- much as he naturally has an oversight of the preparations for the meetings and is more intimately connected with the details of the programme than others could possibly be, on that account I am pleased to accept this great honor which you have again tendered me. The next resolution is : Resolved, That the convention be held everj'^ two years. Are you ready for the question ? The question was taken and the resolution was agreed to. 16 SECOND INTERN ATIONAL HANITAR\i CONVENTION. 17 The President. The third resolution is : Resolved, Tiiat tho next meeting of the convention be held in the City of Mexico in December, 1907, subject to tlie call of the International Sanitary Bureau. Are there any remarks on tliat? If not, we will vote upon it. The question was taken and the motion was af^reed to. Doctor Licéaga here addressed the convention in Spanish, his remarks being translated by the secretary. Doctor Ulloa. He thanked the conven- tion for the honor done his country in resolving to hold the next sanitary, convention in the City of Mexico. He confessed himself very highly pleased with this solution of the question, because the Second Pan American Congress was held at the City of Mexico, and there in that meeting resolutions were adopted, one of which was for the meeting of- the International Sanitary Congress. He extended his thanks for the courtesy and hoped that the success of this conven- tion would tend yearly to the strengthening of the ties that unite all the countries of this continent. He spoke very highly of the modern ways of uniting different countries and bringing them together in intellectual, social, and moral matters which he believed are the strongest means of accomplishing all those ends at which the highest motives of nations aim. The President. I will read the fifth resolution before the fourth. Resolved, That the committee suggest that reports of the Republics, of great length, should be abstracted for presentation to the convention. The full papers will be published in the transactions. The question was taken upon the resolution, and it was agreed to. The President. The fourth resolution is : Resolved, That immediately upon the completion of the organization, the president recognize Dr. Eduardo Licéaga for a statement of general interest. The question was taken upon the resolution, and it was agreed to. The President. The resolution was carried; we will now hear from Dr. Licéaga. Doctor Licéaga here read in Spanish his address. (See Appendix, page 111.) The President. Gentlemen, you have all heard tliis interesting paper of Doctor Licéaga, and the matter is now open for discussion. We will be very glad to hear from any member who wishes to speak on the subject. I would further say that if it meets with the approval of Doctor Licéaga, this matter, after discussion, will be referred to the advisory council, where it will be taken up in detail, and worked out and presented again to the convention. That was the order of procedure of last year, and I suppose it is agreeable to all that it should be the order this year; but we would like to have expressions, without any vote being taken, or any resolutions being offered just now. We would like to have expressions from any of the delegates who would like to speak on the subject to express their views. Doctor GuiTERAS. As you ask that an opinion be expressed, I would like to say that undoubtedly our colleague from Mexico is right when he says that we should begin as soon as possible, and that we should undertake» the getting up and iinisliing of sanitary regulations that should govern uniformly the Western Hemisphere. That is cer- tainly the object for which we have been sent here. At the same time 5610—06 2 18 SECOND INTERNATIONAL SANITARY CONVENTION. it appears to me that at the present moment v:e are not quite prepared to do that. It seems to me tliat we may prepare for that during the next year. We should have had presented, it seems to me, before this meeting, a sort of a plan of an organization or reglamento of that kind. It seems lo me we could act at the present meeting in tliis wa}^; that we might instruct the present committee on organization to present to the representatives of the different Republics at this convention the outline of the plan of such an arrangement between the different governments, and the present committee having pre- sented such a plan we would have one year to study it, and we would come to Mexico, to the next convention, prepared and ready to present sucli an agreement. Doctor Licéaga here addressed the convention in Spanish. Doctor GuiTERAS. I suppose that I should repeat what I haVe just said in Eiiglish to the Convention in Spanish, so that those who speak Spanish may 'understand the drift of what is being said. The President. Certainly. Doctor Guiteras here repeated in Spanish the last preceding remarks wliich were made in English. Doctor GuiTERAS. Doctor Licéaga has said that he objects to my remarks. He states that I seem not to have understood what he proposes to do. He does not think we are ready to come to a very definite conclusion or to establish a sanitary convention of science positively; but he tliinks that we should give more force to such things as we may have agreed upon at the last meeting, and may agree upon at this meeting. They seem to stand now in the air, but they are not enforced, although v/e have accepted them; and he thinks that we ought to give them validitj^ and weight in some way. The President. I beg leave to state that these resolutions which we adopted at the last convention have been carried out in practice by the United States Public Health and Marine Hospital Service. I can not sa.}^ that they have been carried out b}^ every State of the United States,- but we have lived up to them ourselves as faithfully as we could. And in this connection I think it would be interesting to hear from one of the delegates from the United States, who was a member of the international conference, with regard to plague, in Paris in 1903, where an agreement such as I think Doctor Licéaga has in liis mind was actually prepared, which agreement has been put in the shape of treaties, and has been confirmed by the several countries, or by a number of them, at any rate. I can not say at once whether all the countries who sent delegates to that conference have adopted formal treaties, or made formal treaties or not, or sub- scribed to this treaty; the United States has, I understand. There was some question about one detail, but it was arranged by the State Department, and the United States Government has been committed to it, with one exception. That agreement covers all the points with regard to quarantine, observation, detention and so forth, very perfectly, and yet in general terms so that it could be adopted by all the countries. I think that with your permission I vdll request Doctor Geddings, who has a translation of that con- vention, to bring it to the advisory council for consideration when we discuss tliis matter; and it might be that we might save our- selves a great deal of trouble, and practically cover these subjects SKUOND INTKKNA'J'IONAL HANITAUY OOxN VKNTION. 19 under discussion, by taking that up and making it a part of our agreement. I would like to call upon Assistant Surgeon-General Geddings to make a little statement as to that convention, as to what countries were represented and where it was held, and the final action taken as to its findings. Doctor Licéaga here asked leave of the president to make a short statement, wliich he did, in Spanish. Ilis statement was translated into English by the secretary. Doctor Ulloa. He said with refer- ence to what General Wyman had just said, that he wished to express the great satisfaction he had in acknowledging that the united States has really complied with all the resolutions taken in the pre- vious sanitary conference; but he intimated that the United States lias really fuliilled all the suggestions of the congress because it wanted to. He said that he would much prefer that a country should comply with the proper hygienic requirements, not because it wants to but because it is obliged to, and he would like to have those requirements complied with according to the resolutions taken at the previous m.eeting. Doctor Geddings. Mr. Chairman and gentlemen: In accordance with the request of the chairman, I would beg to outline as well as I can, from memory, and as briefly as the occasion requires, the results of the International Sanitary Conference of Paris of 1903, which assem- bled in Paris in October of that year and remained in continual session until December. This convention interested itself particularly mth the questions of plague and cholera. The members of that convention committed themselves to several important declarations. In regard to plague, they held the bold and perfectly justifiable conclusion that plague was transmissable only by the dejections, by the discharges, and by soiling of articles and of apartments with the secretions or excre- tions of those sick with the plague; that merchandise itself was incapable of conveying the plague and was only dangerous when it had served as a vehicle for plague-stricken animals, or was soiled by the discharges of those sick with plague. The same was held with regard to cholera; that a vessel, an apart- ment, or merchandise, was dangerous from the point of view of communicability of cholera only when soiled by the discharges of those previously sick with the disease. I would say that the convention lent itself very strongly to what was a practical abolition of quarantine, namely, they divided ves- sels into three categories — safe, suspected, and infected. To go into the definitions coming under those categories would take too long; but their regulations as to what constituted a suspected or infected vessel were in the main more lenient than we of the United States have been in the habit of holding. The quarantine measures pro- posed by the convention were efficacious, could they be carried out in their entirety; but their safet}^ depends upon the absolute integ- rity of the measures directed against a disease in question. The slightest slip, the slightest dereliction, the slightest neglect, would possibly produce a catastrophe. In view of this fact, the United States found itself bound to dissent from the findings of the conven- tion, and became signatory to the results, with tliis in its way. We can not under our laws and under our system recognize surveillance 20 SECOND INTERNATIONAL SANITAKY CONVENTION. as the equivalent of observation, surveillance meaning that the ves- sel arriving with those on board suspected of having the plague, or those on board who have had plague, and those who are exposed to the infection, those passengers should be allowed to proceed to their destination, and be observed there b}^ local authorities, or be obliged to report from time to time until the period of the incubation of the disease has, passed. As we understand observation, we direct our measures against a vessel, but detain the personnel and hold them under observation. The delegates for the United States dissented from the plan of surveillance, and the United States has since become signatory to the convention of Paris, with the exception that obser- vation must be substituted for surveillance wherever it occurs in the convention. In the matter of yellow fever, it is to be regretted^ that the representation of the Western Hemisphere was confined to* the United States, the Argentine Kepublic, and Brazil. There was a very determined efl'ort made to get the convention of Paris to commit itself definitely on the question of yellow fever. You will remember that this was two years ago. Were the convention to be held to-day the action might be different; but the convention declined to put itself on record or to formulate definite regulations as to yellow fever, and contented itself with the simple declaration that in the matter of yellow fever it was recommended to the powers interested to amend their regulations in accordance with the recent scientific discoveries on the subject. After considerable deliberation tlüs view^ was acceded to by the delegates of the Argentine Republic and Brazil. It is mj belief that the convention of Paris has adopted the firm and safe basis for a stable international agreement. I will take great pleasure, as directed by the chairman, in submit- ting to the committee on organization the text of the convention in print and a translation, which I made upon my return, into English, which I think will answer the purposes of the committee. The President. Are there any further remarks on this subject? The Secretary (Doctor Ulloa). With reference to the point in discussion about the petition of Doctor Licéaga, I have the honor to say that I agree fully w4th Doctor Licéaga. I agree with hini as to the fact that w^e are here not only to discuss different points in con- nection with sanitary science and to attend to this convention with the interest and with the pleasure which we always have in attend- ing scientific congresses, but to come to some agreement of a prac- tical nature. Oin- representation here is a combined one, if you will allow me to express it so. It is a scientific and a diplomatic one, as I would put it. I understand that the majority of us came to the previous convention, and also to this one, with full powers from our respective governments to sign ad referendum any agreement that w^e may come to. Our governments in sending us here have fidl confidence in us, and they have authorized us to come to agree- ments and to vote in accordance v/ith our judgment on the scientific problems to be discussed here. We are authorized to sign agree- ments on sanitary matters; but of course w^e have to submit them the approbation of our governments afterwards — that is to say, we are authorized to sign ad referendum. I agree with Doctor Licéaga and with Doctor Guiteras in the opin- ion that we might sign the resolutions which have been already taken, based on scientific facts which have been already demon- SECOND INTKUNATIONAL MANITARY (X)NVENTION. , 21 strated. The resolutions of the last sanitary convention cover, I believe, all the ground as far as yellow fever is concerned. Now we are going to discuss other important subjects, plague particularly, and I have no doubt that we shall, some of us, at least, learn a good deal from the discussions that will take place about said disease. I feel as if I was not justified yet in signing anything in regard to bubonic plague; but after I have heard your discussion of the sub- ject I will learn a good deal more about it, and I shall feel wholly empowered to sign any agreement that we may come to. (Applause.) Doctor Lavoreria here addressed the convention in Spanish, his remarks being translated by the secretary, Doctor Ulloa, into English. Doctor Lavoreria, after running over one by one the different clauses pointed out by Doctor Licéaga of the resolutions of the Second Pan-American Conference in Mexico, expressed the view that although Peru was not represented at the last sanitary conven- tion for reasons that he did not deem it necessary to enumerate, they have agreed in everything that was resolved at the last conference, and he said that several executive decrees have been dictated in Peru maldng lawful the different resolutions of the last sanitary congress. He said that they have the national board of health, which makes all the different rules and regulations in regard to hygiene, and that those regulations are obligatory in all sections of the country. He said that he accepts Doctor Licéaga' s propositions, and that one of the principal wishes of the Government of Peru is that we shall Come to some agreement by which all the different countries of the continent may be bound by uniform sanitary regulations. He said that there was a decree emitted binding Peru to all the different regu- lations, among which he mentioned the International Sanitary Bureau. He went into some details as to the resolutions cited by Doctor Licéaga, wliich have been read by all the members of the con- vention, and which it is not necessary to translate here. Mr. Withers addressed the convention in Spanish, his address being translated into English by the secretary. Doctor Ulloa. Mr. Withers agreed also with the proposition of Doctor Licéaga. He signified that the Republic of Ecuador had accepted the resolu- tions adopted by the First Sanitary Convention at Washington, and he believed in the full observance of all their provisions. He said that Ecuador had the good fortune of being free from the bubonic plague. He entirely agreed with Doctor Licéaga, and hoped in the name of his country that an agreement might be signed by tliis convention binding all the different countries of the continent. Doctor Alcivar addressed the covention in Spanish, his remarks being translated into English by the secretary. Doctor Alcivar expressed his opinion in entire accordance with Doctor Licéaga' s opinion. He said that he believed it Yevj impor- tant that all of the delegates here present should return to their countries carrying with them a signed agreement binding the difier- ent countries to the methods according to the resolutions of this congress. Doctor Medina agreed also with Doctor Licéaga' s proposition. Doctor Moore addressed the convention in Spanish, his remarks being translated into English hj the secretary. 22 _ SECOND INTERNATIONAL SANITARY CONVENTION. Doctor Moore said that he also agreed with Doctor Licéaga and stated that he beheved all the delegates to be in accord with this opinion. He said he believed that such opinion should form a part or the convention which should be signed at this meeting and sub- mitted to the respective governments. He said that he thought the discussion had been carried a little too far, and he believed that it would-be better to submit a resolution to the advisor}^ committee to the effect that a convention should be signed and then submitted to the respective governments. Doctor Licéaga here addressed the convention in Spanish, liis remarks being translated into English by the secretary. Doctor Licéaga said that he felt very fortunate and very happy in hearing the opinions expressed by the several delegates here pres- ent, and he remarked that he did not care what the governments might do ; but that he w^anted all who were here present and who might be convinced of the trutliñüness and effectiveness of the resolutions here taken to demonstrate it practicalh^ by signing their names to the resolutions and complj'ing with their duty in that way, and then he wanted them sent to their respective governments, and if the gov- ernments approved them, verj^ well, and if they did not, so much the worse; but the delegates would have complied with their duty. The President. Are there any more remarks on this subject? If not, before the closing of this matter I would request some gentleman to make a motion to the effect that the organizing committee which was appointed yesterday should be continued as the advisory coun- cil ; or if any other plan suggests itseli to anyone I would be pleased to hear from them. But otherwise we have not an advisory council to which to refer all papers, resolutions, and reports. Dr. H. L. E. Johnson. I move that all the matters arising before the convention be referred to the committee on organization ap- pointed j^esterday as the advisory council. The motion was seconded. The question was taken and the motion was agreed to. Doctor GuiTERAS. May I make a motion now? The President. Doctor Guiteras. Dr. Guiteras. I do not laiow whether this is the proper place, or whether I should bring this up before the advisory council, but I believe that at the last meeting we had vice-presidents appointed. The President. Yes, sir. Doctor Guiteras. And would it not be proper now to have vice- presidents appointed from the different Republics? The President. We shall consider Doctor Guiteras's motion as soon as the matter under discussion is disposed of. A resolution should be made referring Doctor Licéaga's paper to the advisory council. If there is no dissent this matter will be referred to the advisory council to be reported on. Is that agreeable to Doctor Licéaga ? The remarks of the president were translated into Spanish by the secretary, and Doctor Licéaga signified his assent. Doctor Guiteras. I move that vice-presidents be nominated. The President. In open meeting or by the committee? Doctor Guiteras. I move that it be referred to the committee. The President. I hear no objection, and therefore the motion is announced as nassed. SECOND INTERNATIONAL SANITARY CONVENTION. 23 The scieiitiiic program inc reads: 1. Reports ]>y a delegate from eacli Republic. Tlicse reports slioiild include (a) reports on prevalence of diseases, with special reference to plague, yellow fever, and malaria, since January 1, 1904, being appi'oximately the date of adjournment of tlie last convention ; (b) a summary of all quarantine and sanitary laws enacted since the first convention; (c) special sanitary work in progress or in contemplation. These reports are to be rendered in behalf of each Republic, or each division of the subject may be committed to a delegate for pres- entation. A written report is requested for publication. Ill accordance with this programme we will call upon the Republics by name, and request the delegates to malve verbal reports; or if they haVe briefs or written reports to present them, so that we may, during the day, hear from the Republics on the topics mentioned in this paragraph. In accordance with that, we will call fii'st upon Chile. Doctor GuiTEiiAS. I make the suggestion that perhaps it would be better tV) begin the hearing of these reports during the afternoon meeting, as the executive committee has to meet before lunch, and it will be difficult to find the time for the executive committee to meet if we prolong this session. I therefore move to adjourn, and to take up these different reports of the Republics in the afternoon session. The motion was seconded. The President. Before I put the motion to adjourn I would like to say that there are two or three announcements to make. The secretary will make these announcements. (The secretary here made announcements of various invitations extended to the members of the Sanitary Convention.) The President. We have here a number of copies of the revised edition of the report of Dr. L. O. Ploward on the prevalence of the Stegomyia mosquito in the United States, and the regions in wliich it prevails. It has been of great use to us in managing the 3?^ellow fever epidemic in the South this year. It shows where the Stegomyia mosquito prevails. Doctor Howard is chief entomologist of the United States Department of Agriculture, and is also consulting entomologist of the United States Public Health and Marine-Hospital Service, and for that reason I would like him to be present and to have the courtesy of the floor during our meetings. He may be able to give us some little talk on the yellow-fever mosquito. Doctor GuiTERAS. I move that the privilege of the floor be ex- tended to Doctor Howard and also to Dr. James Carroll. I do not think that this was done in regard to these two gentlemen yesterday. The motion was seconded. The question was taken, and the motion was agreed to. The President. It is carried, and I wall request the secretary to notify those gentlemen. In the absence of the Director of the Bureau of American Republics,' Mr. Fox, I wish to make an announcement in regard to to-morrow, so that it will be perfectly plain to you all. We are to meet here and about this neighborhood in the hotel, in this room or in the lobby of the entrance on F street, and we wiU start from that side of the hotel, because on Wednesday morning there will be a great many members of the American Bankers' Association in the hotel, that association meeting on that day, which will cause the other lobb}'' to be crowded. We will start from here at half past 9 and go to the wharf at the foot of Eleventh street. The steamer is expected to leave the wharf at 10 24 SECOND INTERNATIONAL SANITARY CONVENTION. o'clock, and we will be gone all day, -visiting various points down the Potomac River, ^.loiint Vernon, and other points. Of course, it is expected that all the delegates and the ladies and invited guests will be present. AVe expect to be gone all day, returning about dusk. If there is no other motion to put before the convention, the motion of Doctor Guiteras to adjourn, which has been seconded, will be put to you. The motion is to adjourn until 3 o'clock this after- noon. The question was taken, and the motion was agreed to. Thereupon the convention adjourned until 3 o'clock p. m. Afternoon Session. The convention was called to order by the president, Surgeon- General W3'Tiian. The President. The first order of business of this session will be the readmg of the minutes of the first meeting. (The minutes of the first meeting of the convention were read by the secretary.) Doctor Guiteras. I move that the minutes be adopted as just read. The President. Before that motion is seconded, or put, I want to say that I think there were one or two names left off of persons who were invited to the floor. Dr. J. F. Anderson was one. He is assist- ant director of the hygenic laboratory, United States Public Health and Marine Hospital Service. With the consent of the convention his name will be added to the official list of persons entitled to the privilege of the floor. You have heard the minutes, and it is moved and seconded that they be adopted as read. The question was taken, and the motion was agreed to. The President. Before proceeding further, I noticed when the minutes were being read that on the committee of organization, which you by resolution this morning have made the advisory council, there was one member omitted who ought, I think, in the broadened scope given to the committee to be included, and I think that his name should be added now, because we have two of the medical depart- ments of this Government represented, and it was by an oversight that one was not put on originally. With your assent I would like to add an officer of the United States Navy on that committee. Doc- tor Gatewood, who is the delegate from the Navy. Doctor Guiteras. I make the motion that Doctor Gatewood be included on the advisory council. The motion vv^as seconded, and the question was taken and the motion was agreed to. The President. I v/ish to say that our guests are expected to go with us when we have our social occasions, particularly on the excur- sion to-morrow down the river to Indian Head and Mount Vernon. Before we begin the proceedings of the afternoon, I might ask if any delegate has any special measure, or any special remarks that he wishes to make. If not, v.^e will begin with the call of the Republics, in accordance with the provisional programme. I suppose that every member has a copy of this provisional programme — the scientific programme — the first paragraph of which was read this morning, and SEOOND INTERN ATrON AL HANri'AKY CONVENTION. 25 I will not read it, over aj^ain, but I will procood to the call of delegates. I will ask the secretary to call tliein in alphabetical order. The Secketaky. Chile; Dr. Eduardo Moore. Doctor Moore here r<3ad his report as delegate from Chile, in Span- ish, and his remarks were translated by the secretary into English. (See Appendix, p. 115.) Mr. Withers moved that to save time all the reports from the dif- ferent Republics be handed to the secretary witliout reading them. The President. You have heard the motion that the papers should not be fead, but that each delegate should give a brief extempore abstract of what his paper contains, stating what it is about and what he shows. Doctor GuiTERAS. I understand that is what we had decided upon at the meeting of the council, or organization committee, that brief abstracts should be read. I do not think that will require much time. The President. That was passed by the convention, was it not? Doctor GuiTERAS. Yes, sir. The President. That will be the understanding, then. Next, we will have the report from Doctor Ulloa, the delegate from Costa Rica. Doctor Ulloa read his report in Enghsh. (See Appendix, p. 116.) The President. The secretary will now call on the delegate from Cuba. The Secretary. Cuba; Dr. Juan Guiteras. The report of the delegates from Cuba was read by Dr. E. B. Barnet, in Spanish. (See Appendix, p. 117.) The Secretary. The Dominican Republic; Señor Don Emilio C. Joubert. The President. Mr. Joubert requested to be excused to-da}^, say- ing that he would be very glad to make the report on Thursday, so that we will defer that report until Thursday. Doctor Joubert was here this afternoon, but was obliged to leave, and he will make his report later. (See Appendix, p. 191.) The Secretary. Ecuador. The report for Ecuador was read in Spanish by Dr. Miguel Alcivar. (See Appendix, p. 154.) The Secretary. Guatemala. The report for Guatemala was read in Spanish by Señor Dr. Don Joaquin Yela. (See Appendix, p. 158.) The Secretary. Mexico. The report for Mexico was read by the delegate, Dr. Eduardo Licéaga, m Spanish. (See Appendix, p. 160.) The Secretary. Nicaragua. The report for' Nicaragua was read by the delegate, Dr. J. L, Medina. (See Appendix, p. — .) The report for Peru was read by the delegate, Doctor Lavoreria, in Spanish. (See Appendix, p. 175.) The President. Dr. H. D. Geddings will speak for the National Government of the United States. Doctor Geddings addressed the convention in Enghsh. (See Ap- pendix, p. 192.) Dr. J. S. Fulton, of Maryland, addressed the convention in English. (See Appendix, p. 193.) 26 SECOND INTERNATIONAL SANITAEY CONVENTION. The President. The delegates from Uruguay and Venezuela have asked me to put before the convention their excuses for not present- mg reports for their respective countries. The delegate from Uruguay has not yet received all the data required for his report, and he expresses the opinion that he very likely will not present his report, but that he will accept anything that may be carried through in this convention, and that he will appear in the name of his countrj^ as a signatory to the resolutions here adopted. (See Appendix, p. 195.) The delegate from Venezuela could not present his report to-day, but he told me that he would present it in time to be printed in the proceedings of the congress. (See Appendix, p. 196.) I wish to read you a telegram which I have received ÍTom Dr. Rhett Goode, as follows : Mobile, Ala. To Gen. Walter Wyman, Chairman, International Sanitary Bureau, Washington, D. C: Supervision of existing quarantines prevent my attending convention. The most important points to be considered are the spread of yellow fever and the sanitation of cities. Please express to the members my sincere regret and ver}^ best wishes for a successful meeting. Rhett Goode, M. D., President Quarantine Board) Mobile, Ala. I wish also to announce that the President of the United States will receive this convention on Thursday at 12 o'clock. We will be in session then, and will start about a quarter of 12 to go over and pay our respects to the President. Doctor GuiTERAS. I move that we now adjourn to meet at 10 o'clock on Thursday morning. Doctor Medina. I second the motion. The question was taken and the motion was agreed to. Thereupon, at 5.20 o'clock p. m., the convention adjourned until Thursday, October 12, 1905, at 10 o'clock a. m. THIRD BAY -THURSDAY, OCTOBER 12. Morning Session. The convention was called to order by the President, Surgeon- General Wyman, at 10.30 o'clock a. m. The President. In order that there may be no misunderstanding I wish to announce that we will go to pay our respects to the Preisdent at a quarter before 12. It is desirable that we should have a full attendance at that time. The minutes of the previous meeting were read by the secretary. When the secretary had read the portion of the mmutes containing the remarks of Doctor Medina, Doctor Medina said: Mr. President, I wish to make a statement in regard to what occurred yesterday. My idea was not in any way to criticise the different boards of health in Central America. My idea was simply that they should be united under uniform rules. I did not mean to criticise anyone individually, but simply to express my opinion that if the system were put under uniform rules for all the Central American Republics, which are so close together, one port being only a few hours from another, there would be a possibility of carrying the undertaking to a better success. It would be far from me to criticise any of the Republics in reference to their ways of handling their boards of health. Each one has done what he has been able to do. Most of them are in prettA' good sanitary condition, and the only thing is, it seems to me, that they are working in different directions, without that uniformity which, it seems to me, would be very desirable, and I now wish to submit a paper relating to this subject, which I now hand to the secretary. The President. Do you wish to substitute this for what you said at the last meeting? Do you wish to amend the minutes to that effect ? Doctor Medina. Yes; I wish to withdraw the proposition which I made, and to substitute this. The President. If there be no objection tliis paper will be sub- stituted for the one Doctor Medina presented yesterday and it will be printed as a part of the transactions of yesterday. It will be inserted in place of the other. The secretary then translated the foregoing remarks into Spanish. The secretary, Doctor Ulloa, then spoke in English as follows: " I am very glad that my esteemed colleague from Nicaragua, Doctor Medina, has put things in their right place with reference to the unwarranted remarks he made at the last meetmg of tliis con- vention, and which showed me in a bad light, contradictmg in an indhect manner the statements that I had made with respect to the conditions of Costa Rica, which I have the honor to represent here, as far as sanitation and quarantine regulations are concerned. 27 28 SECOND INTERNATIONAL SANITARY CONVENTION. "The explanations given by Doctor Medina relieve me from the painful duty of protesting in strong terms against the injustice done to Costa Kica in this matter. We do not pretend to have as much in the sanitary line as other more advanced countries, but as I said in my report, we have done some effective work in this respect already, and we hope to go ahead, little b}^ little, and accomplish a good deal before long, as we want to keep abreast, as far as possible, with the progress of sanitary science, which we may say to-day has abolished quarantine in the sense of ignorant interpretation. Central America is a section which comprises five sovereign republics. Three of them have authorized representatives at this conference, and each one of these is the only one who has a right to speak for his respective country. As I am aware of the bad effect that some statements have about our countries, among peoples who unfortunately know very little about us, I beg to conclude by the following remarks, the authenticity of wliich can be vouched for by anybody who knows anything about my country. In Costa Rica we hold regular Presidential elections every four years, and we have there a complete independence of the different departments of the Government. We have never had in Costa Rica any coercive action of the sword or of unla^^^ul procedures in sanitary matters, and all our health officers are able professional men who perform their duties in a thoroughly consciencious manner, and whose dispositions are duly put in force by our sanitary police." Doctor Medina. I am pleased to hear the remarks of my friend, and I fully agree with him in what he has stated regarding the progress of Costa Rica. It is a little country, but one of the most progressive in Central America. He states that we come here to represent each of us but one country, and I understand him to sug- gest that we ought to confine ourselves only to the country we represent. I take a different view of that. I do not come here to speak for Costa Rica, because I have no right to speak for it; but being members of a sanitary international congress, if we think a measure could be adopted by which all that region could be benefited, I think we have a right to suggest such a proposition. Whether it be accepted or not is an entirely different question. My proposition is that in some way or other this conference should use its valuable efforts toward securing uniformity of action on the part of these five little republics, so that their boards of health, acting under uniform rules, may act in harmony, so that none of thern will destroy or impair the good that a country like Costa Rica is doing. If that can be done, we shall accomplish a great good. That is why I made the proposition I did make the other day. I wish to say that I fully agree with Doctor Ulloa in all his remarks as to the progress of Costa Rica. Doctor Ulloa. I consider the matter ended. Though we differ slightly as to the details, I consider the incident closed. Doctor Guiteras moved to dispense with the reading at length of the remarks of the other speakers. The motion was agreed to. The secretary resumed and completed the reading of the minutes. On motion, the minutes as read and amended were approved. láECOND INTKKNA'riONAI. SANI'I'AKY (JON V KNTION, 2'.J The President. I wish to read now a letter from Doctor Kennedy, one of the delegates from the United States. He says: I greatly regret to leave this a. m. I must stop off a couple of days in New York City, and nave some examinations at homo (Dcs Moines) next Wednesday. I have the press reports of our sessions as licld thus far. If you will kindly send mo copies containing 1 ater reports I will be greatly obliged. I have enjoyed and been benefited by our conference sessions thus far, and only wish 1 could stay to the finish.. I am, Very respectfully, yours, J. A. F. Kennedy. The PjiESiDENT. The secretary has some letters to read. The secretary read the following: Health Department of the District of Columbia, Washington, D. C, October 11, 1905. Dr. Juan Ulloa, Secretary International Sanitary Conference, The New Willard, Washington, D. C. Dear Sir : I have the honor to acknowledge the receipt of your letter of the 10th instant notifying me that at the meeting of the Second International Sanitary Conference I was accorded the privileges of the floor. I desire to express my appreciation of this courtesy, and to express, further, my great regret that the pressure of official business has rendered it impossible for me to attend all of the meetings of the convention. Very respectfully, yours, William C. Woodward, M. D., Health Officer. War Department, Office of the Surgeon-General, Army and Medical Museum and Library, Washington, October 11, 1905. Hon. Juan J. Ulloa, Secretary International Sanitary Conference, Washington, D. C. Dear Sir : I beg to acknowledge the receipt of your letter of the 10th instant conveying an invitation to be present at the meetings of the convention, and extending to me the privileges of the floor. I hasten to assure you of my deep appreciation of the honor, and acceptance of the same. Yours, very truly, James Carroll. The President. Gentlemen, in a very few moments it will be necessary for us to start to the White House to pay our respects to the President of the United States. Before leaving the convention hall for that purpose, I desire to make a short statement with regard to the interest which President Roosevelt has always expressed in the medical profession and in sanitation. Before starting to the White House I wish to assure you that you will have a cordial reception, and that you v/ill, without doubt, be greeted with words of encouragement as regards the objective aiiíis of this convention. I wish to state that no other President of the United States has publicly expressed so often and so eloquently an appreciation of the character and labors of the phj^sician in regard to his sacred relation to his patients, to his civic duties, and to his labors as a sanitarian. In his address before the Association of Military Surgeons ^of the United States, his address at the unveiling of the monument in Washington erected to the memor}' of Dr. Ben- jamm Rush, at the laying of the corner stone of the Naval Medical School, and very recently before the Association of Physicians of Long Island, his words were words of encouragement and wisdom. He has declared that in military life the surgeon, besides being a 30 SECO^'D INTKKNATIONAL SANITARY CONVENTION. surgeon, bears all the hardships of the soldier and the responsibilities of an administrator; he has declared that the doctor who stands high ill liis ])rofession in any city counts as one of the most valuable assets in that city's civic work, and that no doctor can be a good doctor or a good citizen unless he does his duty by the state, and that doctors must personally pa}" attention to their civic duties, because "everybody's business is nobody's business." "It must not be left to everybody, but individually the medical man should take an interest in State matters." He has sho\\n his appreciation of the sentiments that are so dear to us as ph^'sicians and sanitarians, namely, that our labors are highly essential to the welfare of the State as well as to the individual. In exemplification of this, he has expressed the greatest interest and confidence in the work of the sanitarians in the Isthmian Canal Zone, and has taken an initiative the good results of which are incalculable in the sanitary work which was begun and is still being conducted in New Orleans against the yellow-fever pestilence. In expressing this appreciation of our President I am only echoing the voluntary expressions which I have heard on many sides, and particularly at the recent meeting of the Great American Medical Association, in Portland, Oreg., where comments of the above nature were frequent, prompted solely by appreciation in the minds of the medical profession of the sentiments and support of our President in matters relating to individual and public health. The secretary translated the above remarks into Spanish. On motion of Doctor Guiteras, the convention adjourned to meet at 2.30 p. m. Afternoon Session. The convention was called to order by the president at 2.30 p. m. Doctor Guiteras. Mr. President, I have the honor of presenting the following resolution concerning the United States Pharmaco- poeia: Whereas the decennial edition of the United States Pharmacopoeia has just been pub- lished and issued by the board of tmstees of the convention of the United States Pharma- copoeia appointed by the American Pharmaceutical Association, and \\Tiereas this revised pharmacopoeia embraces many new forms of value, both for use in therapeusis and prevention of epidemic disease and represents the best thought and labor of experts on these matters: Tñerefore be it Resolved, That a translation of this United States Pharmacopcsia into the Spanish language would prove of great benefit to the medical profession and pharmacists in each of the republics represented in this convention; and further, Resolved, That the said pharmacoposia be referred to the several governments to report upon at the next meeting in Mexico, with a view to the adaption of an international phar- macopoeia for the American republics; and be it further Resolved, That the International Sanitary Bureau be requested to ascertain if it is pos- sible for the payment for such translation and publication of an edition of 5,000 copies to be made out of the fund provided for in section 7 of the resolutions adopted by the Second International Conference of American States, held in the City of Mexico in the wdnter of 1901-2; and be it further Resolved, Tliat if it is found the expense of this translation an(J publication can not be provided for from the fund provided hj said section 7, the matter to be referred to the Bureau of the ^imerican Republics, with the request that if possible the said translation and publication be provided for by the said Bureau. Doctor Guiteras then translated the above resolutions into Spanish. The President. You have heard the resolutions, and they will be referred to the advisory council. In the meantime, you will recall 8P:(J0ÍÍD INTERNATIONAL SANITARY: CONVENTION. 31 that by a vote we extended the courtesy of the floor to Dr. II. C. Wood, of Philadelphia. He is very much interested in this subject and has been invited especially to speak about it. J le is a gentleman whose name is known nationally and internationally, and he has paid groat attention to matters of materia medica and pharmacology and pharmacy, 'and I therefore beg leave to present to you J)r. 11. C. Wood, of l^hiladelphia, who will speak upon this subject. Doctor~Woor>. Gentlemen, in spite of the fact that nearly all of the members of this conference or convention are physicians, 1 will })egin my remai-ks by explahiing what a pharmacopoeia is. A pharmacopoeia is a list of medicines with tests for tluúr purity and with methods of making preparations from the crude drugs, these preparations to be used by the individual doctors. Tne pharmacopoeia has, however, a wider scope than the mere practice of medicine, because upon it are based many of the laws of the cus- toms of the various countries, and because upon it are based all the so-called pure-food bills, and because it comes continually into the courts as a legalized standard. In most countries the pharmacopoeia is produced directly by the Government. In Anglo-Saxon countries a need has frequently pro- duced popular means of meeting it, extra or without or beyond gov- ernmental supervision; precisely as in England the whole light-house system of Great Britain is in the hands of the Brothers of the Trinity and not under the direct control of the Government, because origi- nally it was the merchants of England who started the light-houses in Great Britian. So in the United States the Pharmacopoeia was produced by joint conventions of the two professions concerned and has so continued to be .produced, although it has become recognized by Government statutes as the law of the land. Before there is any pharmacopoeia in a country the practice of medicine in that country must be more or less chaotic. The apothecary has no official standard, and so if you want a tincture of a wine you get a preparation from the apothecary on one side of the street different in strength from that which the apothecary on the other side of the street gives you. Now, since the modern habit of travel has brought all nations into continual intercourse, the differ- ences in the different pharmacopceias have become serious in their practical results. So in 1902 there was called at the instance of the Belgian Governm_ent the so-called conference on heroic remedies, which was held at Brussels, where certain standards were agreed upon for the preparation of heroic or powerful drugs. The pharmacopoeia of the United States is the first national pharmacopoeia to conform with the international standard, and made, therefore, a great advance in the world's history in regard to the practice of medicijie. I hap- pened to be president of the United States Pharmacopoeia, so-called, and it is for this reason, I suppose, that I have been asked to appear before you. The movement for a Spanish edition of the United States pharmacopoeia did not originate with the pharmacopoeia con- vention of the United States at all. Long before the pharmacopoeia was published appeals were made from Cuba first, I believe, after- wards from Panama, later from the Philippmes, for a Spanish trans- lation of the work. The need of such a translation for the American possessions in the Spanish-speaking countries is of coufse imperative, 32 SECOND INTERNATIONAL SANITARY CONVENTION. and when we look at the condition of the South American repubhcs in general I think you will see that the need for some common stand- ard is no less imperative. Mexico is the only one of the republics, I believe, that has any official pharmacopoeia whatever. In Cuba three pharmacoposias are used, the United States, the Spanish, and the French, and there is perpetual confusion, and I suppose it was the result .of this confusion which led the Cubans hrst to ask for a Spanish edition of the United States Pharmacopoeia. In most of the Spanish spealdng countries the French Codex is employed. In Chile the German Pharmacopoeia is used. Now, the French Codex is of course not in the Spanish language. There is no Spanish edition of it, so that at present in none of the vast territories south of the United States and Mexico is there a pharmacopoeia in the language of the people recognized by the governments as a legal standard. If there be any underhung truth in the so-called Monroe Doctrine it is that the peoples of America shall not be only politically but scientifically and professionally independent: Under the present condition you can see that in the South American Republics this is not at all so. They draw their sustenance or their law from foreign countries, with reference to this subject. Now, the United States Pharmacopoeia is of course not an international pharmacopoeia, but it is hoped and expected that if the Spanish translation is made, and if it is, as will almost certainly be the case, more or less widely ex- ploited, it will lead finallj^ to our all coming, not under the United States Pharmacopoeia, but under some form of American or Pan- American pharmacopoeia if you please. There are several ways in which this can happen. It may be very well that there shall be appointed finally an internafional body which shall prepare a new Pharmacopoeia based upon that of the most complete that there is at present in the world. It may be verj well that the so-called conven- tion of the United States Pharmacopoeia shall be so modified in its nature that it shall become Pan-American by the reception of dele- gates from all parts of South America. Which of these two ways will work out in the future no one can know, but the present being merely the inception of a movement, it seems to me of the very greatest importance, which belongs strictly to the province of this convention, and which I hope you will see fit to support in your wisdom, and then in Mexico two years from now or in some other wa}^ we will certainly be able to bring about that which is most desirable thing, namely, a Pan-American pharmacopoeia.' Doctor LicÉAGA (translation). In Mexico there is a special board for the pharmacopoeia. They study the different pharmacopoeias and then make a special publication, or else accept some particular one and have it translated into Spanish with the official approbation of that country. Doctor Wood. I expressly excepted Liexico from my general state- ment, being well aware of the fact which Dr. Licéaga has just stated. Doctor LiCKAGA (translation). I. did not quite understand the statement of Doctor Wood in that respect. Doctor MooEE. In Chile they have accepted the German Pharma- copoeia and the national publication is almost a copy of the German one, being translated into Spanish. I agree entirely with the solution proposed by Doctor Guiteras and I consider it very important that there should \Je a pharmacopoeia of an international character for the SECOND INTERNA'I'IONAI. HANITAKY CON V I0NTÍON. Í33 American Republics. From the information I have received 1 know that the American pharmacopoeia is very much ahead of the others which have been in use in the Spanish-American Kepu})lics. Doctor Ulloa. As the representative of Costa Kica, I do not have much to ¿idd to what Doctor Moore has said. I adopt his words with the exception that we do not have a national pharmacopoeia and never had one. There are several pharmacopoeias in use in Costa Rica. We use, principally, the United States pharmacopíüia, because the majority or the doctors in Costa Rica were j^radiiated in the United States. We use that one, and also the German and the French pharmacopoeias-. I fully ataree with the statements of the previous speakers in reference to this matter and I will gladly give my assent to the proposition made by Doctor Guiteras. Doctor Barnett (translation). I agree to the expression made here. The Government of Cuba has appointed a special commis.sion with the purpose of preparing a national pharmacopfpia, t)ut after they held several meetings they found the task before them to be a very heavy one and that there were many difficulties to be encoun- tered,. so they decided after due discussion and consultation that the best plan would be to recommend the adoption of the United States pharmacopoeia, of course having it translated into Spanish. That idea having been agreed upon, it was decided that Doctor Guiteras in the name of Cuba should present at this conference the resolutions which he has presented to that effect. The President. Is there any other gentleman who desires to make remarks on this subject? If not, then the resolutions will be reported back from the advisory council at some future time during the sessions of this convention. I would like to ask the chairman of the advisor}^ council if there is anything to report from that council ? Doctor Moore (translation) : I wish to inform the congress that the advisor}^ council after discussing the subject, have decided to recom- mend the adoption of the convention of Paris of 1903, of course, omitting from said convention all those articles that do not relate to America. There are some articles relating to the Red Sea, and other subjects, that would not be of importance or interest on this side of the Atlantic. They also made an exception to the effect that pas- sengers should not be allowed to go free after the arrival of infected vessels, but that they be put under observation in proper quarters. Besides this, they have added to this convention all the articles referring to yellow fever 's^hich have been agreed upon in the last meeting of the same convention, and it is proposed to read, article by article, all the different articles of said convention, for the approval of this meeting. The Secretary. An official copy on parchment is to be made of this convention to be ready for the signatures of the delegates. Doctor Guiteras. The different articles must be approved before they are engrossed. Therefore we should read them section by section. The President. I understand we have an English version and a Spanish translation here. We will have the English article read first and then the Spanish translation read also, so that when all are read and agreed upon, they will be ready for our signatures to-morrow. Each article will be presented to the Convention to be voted upon 5610—06 3 ¿i-i SECOND INTERNATIONAL S.^NITAKY CONVENTION. before the delegates are called upon to sign. I will call ujion Doctor Guiteras to read the English version and Doctor Moore to read the Spanish. The preamble was first read in English and in Spanish. The President. The preamble as read, both in English and Span- ish is before the convention. Are there ñnj remarks to be made upon it? It has been suggested, and correctly, too, that this is the report of a committee which was to report to the advisory council, and the advisory council vras to report it to the convention. As nearly every- one connected with the advisory council has expressed the opinion that it should be presented now, I shall take it for granted, unless some one expresses himself to the contrary, that it is in order to be presented as coming from the advisory council for the action of the convention. If any member of the advisory council, all of whom are here present, has any objection to its coming before this convention, he may express that objection now. T'here are two members of the advisory council who have not been lieard from yet, being the repre- sentatives of the Army and Navy of the United States, Major McCaw and Doctor Gatewood. I would like to have them express themselves before proceeding further. Are both these gentlemen satisfied with course of procedure ? Major McCaw. I am perfectly satisfied. Doctor Gatewood. And so am I. Doctor Geddings. Among the names of the delegates from the United States there appears the name of Dr. A. H. Doty, of New York. Doctor Doty was regularly invited to represent the United States on this occasion, but owing to a stress of business at the port of New York he has been unable to attend. He therefore has never regularly qualified as a delegate on behalf of the United States, and I move, Mr. President, that wherever the name of Doctor Doty occurs it be stricken from the record. The motion was seconded. The President. Before putting this motion I wish to state that Doctor Doty has expressed great interest in this convention, and that he accepted the invitation to come here if it was possible for him to do so, that he has sent as many as three telegrams concerning it, expecting each day that he would be able to come, but finding that some pressing duty at his quarantine station has prevented it. So that this resolution is in no wise a reflection on Doctor Doty. In order to make it absolutely regular in every particular, it is proposed that this action be taken. Doctor Doty wished to express to the con- vention his great regret that he could not be here, and I have thought it best to make this explanation. (See Appendix, p. — .) The motion was agreed to. Doctor Barnett (translation) . This convention is to be signed by representatives of the Government of the United States, both the Army and the Navy. Inasmuch as the various States of the Ameri- can Union have different regulations on these subjects, it would be interesting to know in what situation these States will find themselves and what their attitude wdll be toward this agreement. The President. That is a most interesting question. Are there any further remarks ? If not the question is on the adoption of the preamble. The preamble was agreed to. SECOND INTERNATIONAL SANITARY CONVENTION. 35 Doctor Giiitoras read in English aru] I)o(;tor Moore in Spanish article 1. The President. Are there any remarks upon article l'{ Doctor GuiTERAS. I should like to look at the French copy. I think a wrong- word has been ein})]oyed in the vSpanish translation. The French word is ciiuivalent to the Knglish word " conlirni." The Spanish translation does not give that idea exactly. It says- "cases that have been found out," which gives a sort of indeñnite expression. The better word would be the Spanish equivalent for the English word "confirmed." Doctor Moore. We have changed that and have inserted the equiv- alent Spanish word. Article 1 was agreed to. Article 2 was read. Doctor Lavoreria. I wish to ])ropose that the different paragraphs of this article be taken up separately instead of the entire article all at once. The President. That suggestion is a very good one. The following paragraph was read : Article 2. The notification is to be accompanied or veiy promptly followed by the follow- ing circumstantial information: (1.) The neighborhood where the disease has appeared. The President. Are there any remarks on this paragraph? If not the question will be taken on its adoption. The paragraph was agreed to. The following was read : (2.) The date of its appearance, its origin, and its form. The President. You have heard the reading of the second para- graph; are there any remarks? Doctor Guiteras. The question is raised as to the difficulty some- times of tracing the orjgin of the disease. It is suggested that a request to give the origin can not always be compiled with. We have replied to that, that of course if the origin is not known then it can not be given. The paragraph was agreed to. The following was read: (3.) The number of established cases and the number of deaths. The paragraph was agreed to. The following was read: (4.) For plague, the existence among rats and mice of plague, or a pronounced mortaUty ; for yellow fever, the existence of Stegomyia fasciata. The paragraph was agreed to. The following was read: (5.) The measures immediately taken following the first appearance. The President. I hope, the English-speaking members here are paying particular attention to the' wording of this English version, because, as Doctor Guiteras states, this has been gotten up in a hurry and there may be errors in the English. Doctor Guiteras wished me to make that statement. The paragraph as read was agreed to. The President. Now, I think article 2 should be adopted as a whole. It has been read by paragraphs, but the question should be taken on its adoption as an entire article. 36 SECOND INTEKNATIOKAL SANITARY CONVENTION. The article as a whole was agreed to. The President. Is it the desire that the remaining articles shall be read by separate paragraphs'? Doctor GuiTEEAS. That request has been made. The following was read : Article 3. The notification and information prescribed in articles 1 and 2 are to be addressed to diplomatic and consular agents in the capital of the infected country. The Peesident. This is a A^ery important matter. I understand that there would be nothing in this to prevent, for instance, the presi- dent of the superior board of health of Mexico wiring to the Surgeon- General of the Public Health and Marine-Hospital Service or the United States. Doctor GuiTEEAS. I understand there is nothing to prevent him, but there is nothing mandatory compelling him to do it. Dr. H. L. E. Johnson. Could not that be amended so as to pro- vide that the information should be sent to the Public Health and Marine-Hospital Service of the United States instead of to the United "States State Department? The Peesident. We would get it through the State Department, and there is nothing to prevent its also being sent to the Service direct. For instance, I frequently cable to the president of íhe superior board of health of Cuba and also to President Licéaga, and both do the same to me. Doctor Baenett (translation). I move that a paragraph be inserted in that article embodjñng the statement which has just been made. Doctor Gatewood. I suggest that the proposed amendment be worded as follows: Article 3. The notification and information prescribed in articles 1 and 2 are to be addressed to diplomatic or consular agents in the capital of the infected country. This being construed as not preventing direct communication between officials charged with the public health of the several countries. I propose that, to overcome the objections which are made in regard to the slowness with which information comes through diplomatic channels. The President. You have heard the paragraph as amended. Are there any further remarks ? The paragraph as amended was agreed to. The following was read : For countries which are not thus represented, they are to be transmitted dhectly by telegraph to the Governments of such countries. The paragraph was agreed to. Doctor GuiTEEAS (reading) : Article 4. The notification and information prescribed in articles 1 and 2 are to be fol- lowed by further communications dispatched in the regular manner in order to keep the Governments informed of the progress of the epidemic. ■ These communications, which are to be made at least once a week, and which are to be as complete as possible, should indicate very particulaily the precautions taken to prevent the extension of the disease. They should set forth — 1. The prophylactic measures taken relative to sanitary or medical inspection, to isola- tion and disinfection, and 2. The measures taken upon the departure of vessels to prevent the exportation of the disease; and especially in the case mentioned by No. 4, of article 2, given above, the meas- ures taken against rats and mosquitoes. SECOND INTKKNATIONAL SANITARY CONVENTION. 'ó7 The above paragraph was here read in Spanish by Doctor Moore, The paragraph was agreed to. The President. Doctor Guitoras, will you kindly let me know if we have reached the end of that article? Doctor GuiTERAS. Yes; that is the end of article 4. The President. Article 4 lias been read to the convention in both Spanish and English, as amended. The question now is on the adoption of the article in toto. The article was agreed to. Doctor Moore here addressed the convention in Spanish, his remarks being translated into English by Doctor Ulloa. Doctor Moore said that there was nothing special in the different paragraphs of that article; that he thought the convention should go ahead and read the entire article, and then discuss the whole article at once. Doctor Guiteras here read article 5, as follows: Article 5. The prompt and honest accomplishment of the provisions which precede above is of the very first importance, the notifications only having real value if each Government is warned in time of cases of plague, cholera, or yellow fever, and of doubtful cases supervening in its territory. It can not then be too strongly recommended to the various Governments to make obligatory the declaration of cases of plague, cholera, or yellow fever, and of giving information upon all established unusual mortality of rats and mice. Doctor Gatewood. IVIr. President, it seems to me that you might substitute the word "frank" for "honest" and the word "execu- tion" for "accomplishment." Dr. H. L. E. Johnson. Had we not better use the words* agi'eed on ? How does that read ? Doctor Guiteras. It reads "the prompt and honest execution." That is better than " accomphshment," there is no doubt about that. Doctor Gatewood. "The prompt and faitliful execution?" Doctor Guiteras. Yes; "prompt and faitliful." The President. Does that correspond with the original ? Doctor Guiteras. It reads "the prompt and faithful execution of the provisions which precede above is of the very first importance." Then it reads "doubtful cases in its territory." The President. "Doubtful cases?" Doctor Guiteras. Yes; "doubtful cases." Doctor Gatewood. The word "suspicious" is better than "doubt- ful." Doctor Guiteras. Yes; it is. Doctor Gatewood. I would like to ask the force of the word "pro- nounced," in regard to the mortality? Would not the word "unus- ual" be better? Doctor Guiteras. Very well. Now it reads m tliis way: Article 5. The prompt and faithful execution of the provisions which precede above is of the very first importance, the notification only having real value if each Government is warned in time of plague, cholera, or yellow fever, and of suspicious cases supervening in its territory. It can not then be too strongly recommended to the various Governments to make obligatory the declaration of cases of plague, cholera, or yellow fever, and of giving information upon all unusual mortality of rats and mice, especially in ports. Article 5 was here read in Spanish by Doctor Moore. The President. Is that an entire article, or one paragraph of an article ? Doctor Guiteras. It is an entire article. That is article No. 5. I wish to speak on this article, Mr. President; simply as to the Spanish translation. 38 SECOND INTERNATIONAL SANITARY CONVENTION. Doctor Guiteras here addressed the convention in Spanish. Doctor Guiteras. That is all, Mr. President. I simply wanted to mention the verbal corrections. Doctor Moore here read article No. 5, as amended, in Spanish. The President. You have heard article No. 5. The question now is on the adoption of article No. 5. The article was agreed to. The President. Before proceeding further there is one question I would like to ask Doctor Guiteras, and that is how this convention is to be signed, whether on parchment or on a galley proof or on a type- written copy, because if it is to be on parchment, or printed, we will have to take some special measures to get it done promptly. It would take some time to prepare the parchment or the printed copy, and it may be advisable to give these sheets that we are going over into the hands of the ofRcial representative of the Bureau of the American Re- publics as they are finished to have them transcribed, so that we can get through to-morrow. I suppose all the delegates will want to sign that here before they go away, and it would be very difficult to prepare the copy for signatures before to-morrow evening. Doctor Guiteras. I have suggested that there should be here two gentlemen writing out these articles as they are approved, one writing them in English and another in Spanish ; but it seems to me that your suggestion should be accepted, and that the sheets should be handed over as they are approved. The President. Is it the wish of the convention that they should be on parchment? Doctor Guiteras. I do not think so. If it could be done on parch- ment it would be better, but I suppose that it could not be done. The President. It might be possible. Doctor Ulloa here addressed the convention. Doctor Licéaga addressed the convention in Spanish. The President. If acceptable, the Spanish copy and the English copy as finished, page by page, will be handed to the chief clerk of the Bureau of the American Republics for preparation on parchment. I think there are some of the sheets that have been finished and are ready now. Doctor Guiteras. Yes. The President (after informal conversation among the members). I will call upon Doctor Guiteras to make a suggestion as to the pre- liminary part of this paper as it shall be transmitted to the transcriber to be transcribed. I think this is very plain now. There is only one other subject to determine upon in regard to the mechanical part of it, and that is whether we shall have this prepared for our signatures upon parchment or upon typewritten copies. The remarks of the president were translated into Spanish by Doc- tor Guiteras, and informal conversation among the members followed. The President. You understand the subject, and it will not be nec- essary to put it to a vote. Unless there is some objection, that will be the procedure, that the first part of the document presented by the committee, having been edited in such manner as is satisfactory to the committee and in a proper manner for its transcription by the tran- scriber, the transcription shall be typewritten upon good heavy paper, and there shall be one copy in English and one m Spanish. Also that there will be a certificate as to the correctness of the transcription from one copy to the other. SECOND INTKRNATIONAL SANITARY CONVENTION. />.> The remarks of the president were translated into Spanish by Doc- tor Giiiteras. The President. Wo will now proceed with the reading of article 6. Doctor Guiteras read article 6, as follows: Article 6. It is imdorstood that neighboring oountrics rcHcrvc to thi'rnsclvfH tho right to make special arrangomonts with a viow of organizing a hi rvicc of din-ct infoiination between the chiefs of administration on the frontitrs. Article G was read in Spanish by Doctor Moore. Doctor Lavoreria here addressed the convention in Spanish. The paragraph was agreed to. Doctor Guiteras. We now come to section 2, a new section. The heading is, "Conditions permitting the consideration as contaminated or rendered healthy a given territorial area." That does not mean anything. Informal discussion among the members followed. Doctor Guiteras. We have made that read, "Conditions permit- ting a given territorial area to be considered as contaminated or as restored to health." Article 7. Information of a first case of plague or cholera or yellow fever does not entail against the territorial area where it may come to light the application of the measures pre- scribed in chapter 2, as hereinafter indicated. The President. The word "chapter" is used there, and that is the first time I have heard that word used. Doctor Gatewood. It is section 2 of chapter 1. Doctor Guiteras. Yes, that is it. I will read this again and con- tinue it: Article 7. Information of a first case of plague or cholera or yellow fever does not entail against the territorial area where it may come to light, the application of the measures pre- scribed in chapter 2, as hereinafter indicated. Upon the occurrence of several cases of plague or a nonimported case of yellow fever, or when cases of cholera form a focus, the area is to be declared inf jcted. Doctor Guiteras. Now, I wish to speak on this a moment. I want simply to have it brought out that we are here deciding that one case of nonimported yellow fever is going to declare that area infected. I am sorry to say that I have not a very positive opinion on this point, but I would like the conference to think of the matter and decide with a clear understanding that this is right. It is said that several cases of plague must exist before the place is declared infected. It is said that the cases of cholera must be sufficient to make a focus before a place is declared infected. Now, we are going to decide that a single case of yellow fever is enough to cause the place where it is to be declared contaminated. Certainly, if the modern theory of the transmission of yellow fever was generally understood and all were willing to carry out the measures to prevent the spread of yellow fever that our present knowledge indicates, I would oppose the calling of a place infected because there was one single case, not imported; but, as there is considerable doubt as to the application in some places of the modern doctrine of the trans- mission of yellow fever, I am rather inclined to favor the retaining of the provision that one single case of yellow fever shall be enough to make a place infected. I would like to hear Doctor Licéaga's opinion on that. The remarks of Doctor Guiteras were here repeated by him in Spanish. 40 SECOND INTERNATIONAL SANITARY CONVENTION. Doctor Liceaga here addressed the convention in Spanish, his remarks being translated by Doctor L'lloa. Doctor Liceaga said that he is in favor of the article just as it appears in the convention, because he is fully convinced of the truth- fulness of the doctrine of mosquito infection for yellow fever, and he believes that a single case of yellow fever is sufficient to infect enough mosquitoes to produce a good many cases of the disease. And, being determined, as we are to extinguish yellow fever ft'om the continent of America, he thought it was best that this article should be left as it is. The President. I understand that the extent of the area is not mentioned, or has not been mentioned yet, but that it is mentioned further on, and therefore for a thorough imderstanding of the point made I think it would be better to read what is said further on in regard to the extent of the infected area, and then come back to this proposition and vote upon it. Doctor GuiTERAS. It says here ''the territorial area." That is any territorial area, no matter what. The President. Does it mean a house, a block, or an acre? Doctor GuiTERAS. The next article defines it. I will read that. The President. Read what it says in the next article. Doctor GuiTERAS. That reads: By the word "area" is understood a well-determined portion of territory in the information which accompanies or follows the notiiicaticn. Thus, a p^o^^^ce, a state, a govermnent, a district, a department, a canton, an island, a commune, a city, a quarter of a city, a callage, a port, a polder, or a hamlet, whatever may be the extent of these portions of territory. The President. It is evident, then, from this clause as to the information of the infected area, that it is to be indicated and that the extent of the area shall be signified promptly. Have you fin- ished reading that article? Doctor GuiTERAS. We have discussed the question of whether one case of yellow fever shall be considered as sufficient reason for declar- ing an area contaminated, and the Spanish-speaking colleagues of the convention seem to be of the opinion that one case ought to be enough to cause the place to be declared infected. The President. I believe that the English-speaking delegates will concur in that. Doctor GuiTERAS. Then it stands as a whole. Article 7 reads as follows: Akticle 7. Information of a first case of plague or cholera or yellow fever does not entail against the territorial area where it may come to light, the application of the meas- ures prescribed in chapter 2, as hereinafter indicated. Upon the occurrence of several cases of plague or a nonimported case of yellow fever, or when cases of cholera form a focus, the area is to be declared infected. Article 7, as read by Doctor Guiteras, was here translated into Spanish by Doctor Moore. The President. The question will be put now on the adoption of this article. The question was taken and the article was agreed to. Doctor GuiTERAS. The next is article 8. Article 8. To limit the measures to the plague-stricken regions alone, governments should only apply them to those growing out of the infected or contaminated area. SECOND INTERNATIONAL SANITAKY (JON VKNTION. 41 The note heretofore read was here again read by Doctor Guiteras. Doctor Guiteras (reading) : But this restriction limited to the iiifrctcd area slioiild only Ijc accfptcd upon tfif; formal condition that the government oí the infected couiitiy should take tlie nicessaiy measures, first, to prevent, by means of preliniinary disinfectifjn, the ailicles named in aiiiclcs 1 and 2 of article 12 emanating from the infected area. Doctor Ulloa. What is that ? Doctor Guiteras. How can you prevent the articles emanating by means of disinfection? Doctor Ulloa. It means the prevention of the objects going from the contaminated area. Make it read "objects" instead of "ar- ticles. " Doctor Guiteras. Do you prevent them from emanating by dis- infection? No. It says to prevent them from emanating from the area by a preliminary disinfection. That is not right. And yet I see it is so in the French translation, too. It reads there "to pre- vent by a preliminary disinfection the importation of objects." That is very strange. It is certainly not right. Informal discussion among the members of the convention followed. Doctor Guiteras. We have made it read as follows: But this restriction, Umited to the infected area, should only be accepted upon the formal condition that the government of the infected coimtry should take the necessary precau- tions, first, to prevent, unless previously disinfected, the exportation of articles named in articles 1 and 2 of article 12 coming from the contaminated area. Then, also, further: And, second, measures to prevent the extension of the epidemic. And provided further, that there be no doubt that the sanitary authorities of the infected country have faithfully complied with article 1 of this convention. When an area is infected no restrictive measure is to be taken against departures from this area if these departures have occurred five days at least before the beginning of the epidemic. Article 8 was here read in Spanish by Doctor Moore. The foregoing article, article No. 8, was here again read from begin- ning to end by Doctor Guiteras in English, and w^as also again read in Spanish by Doctor Moore. The President. You have heard that article read in both Spanish and English. Are you ready for the question ? The question was taken, and the article was agreed to. Doctor Geddings. Mr. Chairman. The President. Doctor Geddings. Doctor Geddings. Mr. President and gentlemen, it is very evident that, owing to the haste with which this proposed convention has been prepared, it stands in serious need of editing in order to perfect it, and we are sacrificing the time of the whole convention by making corrections here on the floor of the convention which ought to be made in committee. I have the honor, therefore, sir, to move that the convention do now adjourn, and that the text of this convention ,be returned to the committee with mstructions to edit it overnight, and to present it in smooth shape to the convention on its reassem- bling in the morning. 42 SECOND INTERNATIONAL SANITARY CONVENTION. The motion of Doctor Geddings was translated into Spanish by Doctor I'lloa. Doctor Geddings. And I might add, Mr. President, that if it be convenient and agreeable to him, I would move that Dr. Eduardo Moore, the delegate from Chile, be added to that committee for this purpose. The additional motion of Doctor Geddings was translated into Spanish by Doctor Ulloa, and Doctor Moore signified his assent. The President. Are there any remarks on this motion made by Doctor Geddings? If not, I will put the motion. The question was taken and the motion was agreed to. Thereupon, at 5.25 o'clock p. m., the convention adjourned until to-morrow, October 13, 1905, at 9.30 o'clock a. m. FOUETH DAY— FRIDAY, OCTOBER 13. Morning Session. The convention was called to order by the president, Surgeon- General Wyman, at, 10. 30 o'clock a. m. The minutes of yesterday, October 12, 1905, were read by the secretary, and as read were agreed to. The President. I will call upon the chairman of the advisory council to make any report that he may have ready. The following was read : f The council recommends that the vice-presidents of the last convention be continued in oflBce, excepting when the representation to this convention is diil'erent, in which case the new delegates are to take the place of the previous ones. In the case of the Republics which were represented at the last convention and which are not represented at the present convention no vice-presidents shall be appointed; and the council recommends that the respective delegates from the countries which are repre- sented at this convention for the first time shall be appointed as vice-presidents also. 2. That the International Sanitary Bureau as constituted at the last meeting be continued. 3. That the resolutions presented by Doctor Guiteras concerning the printing of the 5j000 copies of the United States Pharmacopoeia be recommended for approval. Doctor Guiteras. The editing committee is now ready to report on the convention. The foregoing recommendation was here translated into Spanish by Doctor Moore. Doctor Barnett. I move that the report be adopted. The motion was seconded. The President. Are there any remarks. If not, I will put the motion. Doctor Guiteras. Mr. Chairman. The President. Doctor Guiteras. Doctor Guiteras. I have some resolutions to offer to the con- ference, as follows: Whereas the Republic of Mexico and the Panama Canal Zone, by the application of the mosquito doctrine to public sanitation, are nearing rapidly the desideratum of the final extinction of yellow fever; and Whereas the Republic of Cuba, by the application of the same methods has continued to maintain its territory free from yellow fever; and Whereas the lack of preparation for the thorough application of these methods 'has been the cause of the propagation of the disease in vai-ious territories; and Whereas in the city of NeW Orleans an epidemic which had been unfortunately allowed by the State authorities to take a firm foothold has been held in check and gradually reduced by the application of the said methods in the midst of the largest nonimmune population that was ever exposed to ji^ellow fever: Therefore be it Resolved, That this conference sees in these results a further confirmation of the view that yellow fever is naturally transmitted only by the bite of an infected mosquito. 2. That the conference is of opinion that an eflSicient plan of defense against the propa- gation of yellow fever at the beginning of an epidemic can be easily established upon the basis of this doctrine. 3. That the successful carrying out of such plan depends upon a thorough understanding of the mosquito doctrine by the people and upon the support that they may give to the prompt and frank reporting and the proper handling of the first cases and of all suspicious- cases. 43 44 SECOND INTEKNATIÜNAL SANITARY CONVENTION. 4. That all authorities who do not promptly report cases of yellow fever are worthy of the censure of this conference. 5. That the congratulations of the conference be extended to the Republics of Mexico and Cuba and to the Canal Zone of Panama for the success attained, and also to the Public Health and Marine-Hospital Service for the brilliant work done in New Orleans. And be it further Besolyed, That in the opinion of this conference all maritime quarantines and the manage- ment of all epidemics that threaten to extend to neighboring States and countries should be placed in the hands of the national health authorities. The President. Those resolutions will be referred to the advisory council. Is there any other matter to come before the convention before we proceed to the articles of agreement which were under consideration when we adjourned yesterday? Has any delegate any motion to make ? Doctor Ulloa translated the questions of the President into Spanish. The President. If there are no remarks, we will then proceed with the reading of the articles of the convention of Paris, wliich it is hoped we will all sign. I presume it would be pertinen,t to begin with the section following the last section which we adopted, and the pro- cedure will be the same as before, the articles of the convention being read in English and in Spanish. Doctor Guiteras. I move that it be so ordered. The President. If we are all ready, then, the next article is article 9. The following was read by Doctor Guiteras : Article 9. That an area should no longer be considered as infected, official proof must be furnished, first that there has been neither a death nor a new case of plague or cholera for five days after isolation, death, or cure of the last plague or cholera case. In the case of yellow fever the period shall be eighteen daj's, but each government may presei-ve the right to extend this period. Doctor Guiteras. There is a note here defining isolation, which reads as follows : Note. — The word "isolation" signifies isolation of the patient, of the persons who care for him constantly, and the forbidding of visits of all persons, the physician excepted. Mr. Chairman, I suppose that if I have any remarks to make explanatory of this, I may make them now ? The President. Yes. Doctor Guiteras. I may say in a general way that we have avoided adding anything that was not in the Paris convention, excepting in regard to yellow fever, which is distinctively American business ; but in this instance we have something to say in regard to these last words. It says, "the physician excepted." The definition given in this note in the Paris convention actually excludes the physician from visiting the sick, because it says "isolation of the patient, of the persons who care for him constantly, and the forbidding of visits of all persons." That would include in this exclusion the doctor, so that we have added the words, "the physician excepted." This reads further : 2. That all the measures of disinfection have been applied; in the case of plague that the precautions against rats have been observed and in the case of yellow fever that the meas- ures against mosc^uitoes have been executed. Doctor Moore here translated into Spanish what had been read by Doctor Guiteras. SKCOND INTKIÍNATIONAL HANITARY CONVENTION. 45 The President. We agreed yesterday to tlie addition of something further to the deñiiition of isolation, which [^y an oversi<;ht has not been inchided in the English copy, and 1 wish to add it now. It refers especially to yellow fever. To the note defining isolation we add : By isolation, in the caso of yellow fever, is understood the isolation of the patient in an apartment ao screened as to prevent the access of mosquitoes. That has been read in the Spanish copy and we simply forgot yester- day to put it into the Englisli copy. The Pkesident. You have all heard this read in , Spanish and English. ' Are there any remarks ? Doctor Ulloa. I have to difl'er slightly ÍTom the article as it has been read, and I make a motion to the effect that, with regard to plague, the article should be left as it reads in the French copy, as it was agreed to by the Sanitary Congress in Paris. I believe in exclud- ing the physician from those visits because he may carry infection the same as anybody else. The President. Is the motion of Doctor Ulloa seconded? Doctor GuiTERAS. I will second his motion for purposes of dis- cussion. The convention was here addressed in Spanish by Doctor Guiteras and by Doctor Licéaga. The President. Doctor Ulloa will now interpret Doctor Licéaga's remarks into English. Doctor Ulloa. Doctor Licéaga said, in regard to my motion, that a doctor who visits a case of plague takes, of course, all the necessary precautions wliich we all know are taken with respect to infectious diseases, and Doctor Guiteras added that of course it would be better not to make the alteration that I proposed, because doctors are called in, and have to be called in, to make diagnoses of the plague in many cases, and of course they are admitted for doing so. I would say, in reply to these statements, that there must have been some reason why the convention of Paris left this as it is and I do not see w^hy we should alter that article. Of course I have great respect for the views of men like Doctor Guiteras and Doctor Licéaga, but in the case of plague I believe that, in order to have any practical effect in Spanish America, the cases must be well isolated and the phj^sician who attends them must stay v/ith the cases. In a case of isolation, of course, a doctor could come in and be disinfected before coming into contact with others. Doctor Guiteras. He could not come in at all, according to that •article. According to that he could not do that. That is w'hat we want to avoid, and according to the language here no visits could be allowed. The President. I would like to ask Doctor Geddings for his views upon this. He w^as present at the signing of the Paris con- vention. Doctor Geddings. I was present at the signing of this convention^ and I believe that the language used in that note, which is a mere footnote, was left as it is by a pure oversight. But, apart from that, as one interested in sanitary science, I object, and as a physician I protest, with all respect for our esteemed colleague, Doctor LHloa, against such a narrowing of the professional functions of a physician as is implied in Doctor Ulloa's amendment. For 3'ears and years, 46 SECOND INTERNATIONAL SANITARY CONVENTION. from tlie very beginning of medicine, physicians have regarded it not only as a sacred duty, but as a privilege, to visit the sick — sick with whatever disease it might be — and without fear for themselves, and, exercising reasonable precautions in regard to others, they have continued to give their ministrations; and I ask this convention, com})osed of men of experience, how many instances are known to them where the infection of any of the communicable diseases — small- pox, scarlet fever, plague, measles, and so on — has been conveyed to the public outside by the physician leaving the sick room? I sincerely hope that the convention — this conference — will adhere to the language of this footnote as ameiided bj'" the committee, and that they will not circumscribe the usefulness and the dignity and the effectiveness of the pltysician b}* demanding that each case of plague, of cholera, or of yellow fever should have its special medical attendant, vdio, once he has seen him, should share in the quarantine and isolation of that patient. The President. Ai'e there any other remarks upon this motion of Doctor Ulloa ? If not, are you ready for the question ? The question upon the motion of Doctor Ulloa was taken, and the motion was not agreed to. Doctor Barnett addressed the convention in Spanish, and his remarks were translated by the secretary. Doctor Ulloa. Doctor Barnett proposed that tliis note should be amended to the effect that the word "constantly" should be eliminated, and that there should be included in that any person affected with the plague, if it was only for a few hours, because the danger of infection would be incurred if the person was allowed to come out. The President. For the benefit of the stenographer I would like to have Doctor Guiteras translate and put into proper form the motion of Doctor Barnett. Doctor Guiteras. Doctor Barnett's motion is to the effect that instead of reading, "the word isolation signifies isolation of the patient or the persons who care for him constantly," and so on, that the word "constantly" should be stricken out. Doctor Guiteras. I second the motion of Doctor Barnett. The question was taken, and the motion was agreed to. The President. Are there any further remarks on this article ? Doctor Lavoreria here addressed the convention in Spanish. Doctor Guiteras. Doctor Lavoreria sa3^s that he does not rise to make an objection, but he wishes to have explained to him why we have fixed, in the case of yellow fever, the period of eighteen days. With 3^our permission I will explain that. The President. Doctor Guiteras will explain that. Doctor Guiteras here addressed the convention in Spanish. The President. We have, unfortunately, no Spanish stenogra- pher present at this meeting. Mr. Fox, the Director of the Bureau of the American Republics, tried very hard to get one, and we tried very hard — others of us — to get one, but we could not do so, and therefore those parts of the proceedings which are spoken in Spanish have to be translated into English. That is a very interesting expla- nation which Doctor Guiteras has just made, and I think that it ought to be translated and that it ought to appear in the record. Will you translate it into English, Doctor Guiteras ? SECOND INTERNATIONAL HANITAKY CONVENTION. 47 Doctor (JiTii'EiiAS. I fsliall try to he us biici as possible. The period of eighte(m days bas been fixed uj)or) as tlie number of days after which, witliout the presence of a new cas(i of yellow fever, the locality may be considered as free from the disease. That period has been fixed upon as scientiiically true, taking into consideration the extrinsic period of incubation and the intrinsic p(;riod of incubation; . that is, it takes twelve days after the inos(|uito has bitten the last person aillicted with yellow fever bc^fore it is ready to produce a new case. It bites the noninnnune individual, and it will take six days before tlmt develops in tliat individiuil. '^I'welve and six make eight- een. So that after the expiration of eight(ien days we should con- sider any place free from yellow fever. We are dealing witli a single locality, of course. Take, for instance, the case of Tampa, Fla. After eighteen days I considered Tampa to be free from yellow fever; we were sure, and there was' no doubt about it. Now, we have added here the provision that the authorities may extend that period of expectancy or waiting before declaring the place free from yellow fever; that they may extend it ad libitum, because we have considered that at certain places where yellow fever regularly prevails — that is, is endemic — the number of immune people is so great that there might be a large number or a quite consid- erable number of mosquitoes still lurking in that locality without invoking the yellow fever, because of the immunity of the inhab- itants, and we might be surprised at any time by a case of yellow fever. We have therefore allowed this freedom to the authorities to extend this period — to extend it the whole length of the yellow fever season, or the whole summer, if they desire. At any rate, we have given them the freedom to extend this period. The President. It seems to me this explanation is very clear. There is one question I would like to ask of Doctor Guiteras, and that is whether the matter of the appearance of frost is to be considered in this connection. As I understand it, you have a period prescribed here of eighteen days. It is customary in the United States, as soon as frost appears, to stop all precautionary measures. Doctor Guiteras. The time may be less, at the option of the authorities. It is left in that way. The President. Are there any further remarks upon this article? Does anyone wish to make a motion? If not, the article itself is before the convention for adoption. The article was agreed to. The President. The article is adopted. The next is chapter 2. Doctor Guiteras (reading): Chapter 2. Measures of defense by other countries against territories declared infected. Sec. 1. Publication of prescribed measuies. AiiTicLE 10. The Government of each country is obliged to immediately publish the measures which it believes necessary to take against departures, either from a country or from an infected territorial area. The said Government is to conunrmicate at once this publication to the diplomatic or consular agents of the infected country residing in its cap- ital, as well as to the International Sanitary Bureau. The Government shall be equally obliged to make known thi-ough the same channels a revocation of these measures, or modifications which may be made in them. In the default of a diplomatic or consular agency in the capital, communications are made directly to the Government of the country interested. The preceding article was here read in Spanish by Doctor Moore. The President. Are there any comments on this? Are you ready for the question as to adopting this article ? 48 SECOND INTERNATIONAL SANITARY COIS^VENTION. The article was agreed to. Doctor GuiTEKAS. The next is: Section 2. Merchandise, disinfection, importation, and transit; baggage. Article 11. Tlierc exists no merchandise which is of itself capable of transmitting plague, cholera, or yellow fever. It only becomes dangerous in case it is soiled by festous or chol- eraic products, or, in case of yellow fever, when such merchandise may harbor mosquitoes. Article 11 was here read in Spanish by Doctor Moore. The President. The article is now oefore the convention. Are there any further remarks? The article was agreed to. Doctor GuiTERAS (reading): Article 12. No merchandise or objects shall be subjected to disinfection on account of yellow fever, but in cases covered by the previous paragraph the vehicle of transportation may be subjected to fumigation to destroy mosquitoes. In the case of cholera and plague, disinfection should only be applied to merchandise and objects which the local sanitary- authority considers as infected. Doctor GuiTERAS. This article is rather important, and I shall ask that it be divided into paragraphs. I will read it again. The President. Verj^ well. Doctor GuiTERAS. This reads: In cases covered by the previous paragraph That is, that mosquitoes might be harbored the vehicle of transportation may be subjected to fumigation to destroy mosquitoes. In the case of cholera and plague, disinfection should only be applied to merchandise and objects which the local sanitary authority considers as infected. The above article was read in Spanish by Doctor Moore. The President. You have heard these two paragraphs read. Are there any remarks? If not, we will vote upon them. The two preceding paragraphs of article 12 were agreed to. Doctor GuiTERAS. The next reads.: Nevertheless, merchandise or objects enmnerated hereafter may be subjected to disin- fection or prohibited entr^' independently of all proof that they may or may not be infected. 1. Body linen, wearing apparel in use, clothing which has been worn, bedding already used. When these objects are transported as baggage or in the course of a change of resi- dence (household fm-niture) they should not be pTohibited, and are to be subjected to the regulations prescribed by article 19. Baggage left by soldiers and sailors and returned to their country after death are considered as objects comprised in the first paragraph of No. 1 of this article. 2. Rags and rags for making paper, with the exception as to cholera of rags which are transported as merchandise in large quantities, compressed in bales held together by hoops. New clippings coming directly from spinning mills, weaving mills, manufactories, or bleach- eries, shoddy, and clippings of new paper, should not be forbidden. The. above was read in Spanish by Doctor Moore. The President. That is the close of article 12? Doctor GuiTERAS. Yes, sir. ■ After discussion in Spanish, several verbal changes were made in the Spanish version, and the article was again read in Spanish, as altered, by Doctor Moore. The President. It has been read as amended, then? Doctor GuiTERAS. Yes, sir. The President. Are there any remarks? If not, I presume that you are ready for the question on the adoption of this article as read — as finally prepared here in Spanish and presented in English. The article was agreed to. RÍXJOND INTERNATIONAL BANÍTAKY (JONVKNTION. 49 Doctor GuiTERAS. Article 13 reads as follows: Article 13. In the case of cholera and plague there is no reason to forbid the transit through an infected district of merchandise, and the objects specified in Nos. 1 and 2 of the preceding article, if they are so baled that they can not have been exposed to infection in transit. In like manner, when merchandise or objects are so transported that in transit tliey can not corno in contact with soiled objects, their transit across an infected teiritorial area should not be an obstacle to their entry into the country of destination. Doctor Ulloa. I would suggest the changing of that word "baled" to "packed." They can not bale everything. Docttir GuiTEiiAS. Shall we substitute "packed"? What do you say, Doctor Geddings? Doctor Geddings. I should say the proper word was "packed," I thought so when it was being read. Doctor GuiTERAS. The committee will accept the suggestion of Doctor Ulloa, and change that to "packed." , The article as amended was agreed to. ■ Doctor GuiTERAS. I will read the next article: AnTicLE 14. The entry of merchandise and objects specified in Nos. 1 and 2 of article 12 should not be prohibited if it can be shown to the authorities of the country of destination that they were shipped at least five days before the beginning of the epidemic. Article 14 was agreed to. Doctor GuiTERAS. Article 15 reads as follows: Aeticle 15. The method and place of disinfection, as well as the measures to be employed for the destruction of rats, are to be fixed by authoritj' of the country of destination. These operations should be performed in such a manner as to cause the least possible injury to the objects. It devolves upon each State to determine questions relative to the payment of damages resulting from disinfection or from the destruction of rats. If taxes are levied by a sanitary authority, either directly or through the agency of any company or agent, to insure meas- ures for the destruction of rats on board ship, the amount of these taxes ought to be fixed by a tariff published in advance, and the result of these measures should not be a soiu-ce of profit for either State or sanitary authorities. The President. Are there any comments on this article as read? Discussion in Spanish between the members followed. Doctor GuiTERAS. I will translate the remarks made by the gen- tleman from Ecuador (Doctor Alcivar), who suggests the introduc- tion here of the word "mosquitoes." He suggests the addition of the words "and mosquitoes," so that it will read as follows: Ajiticle 15. The method and place of disinfection, as well as the measures to be employed ror the destruction of rats and mosquitoes, are to be fixed by authority of the country of destination. These operations should be performed in such a manner as to cause the least possible injury to the objects. The Preside-nt. As I understand, this is a resolution made by Doc- tor Alcivar that it should read in that way ? Doctor GuiTERAS. Doctor Alcivar makes that suggestion. He moves that the words "and mosquitoes" be introduced in connec- tion with the destruction of rats wherever those words occur, so as to make it read "rats and mosquitoes" in article 15, so that that article will read : The method and place of disinfection, as well as the measures to be employed for the destruction of rats and mosquitoes, are to be fixed by the authority of the country of des- tination upon arrival at said destination. These operations should be performed in such a manner as to cause the least possible injury to the merchandise. 5610—06 4 50 SECOND INTERNATIONAL SANITARY CONVENTION. It devolves upon each State to determine questions relative to the pajnnent of damages resulting from disinfection or from the destruction of rats or mosquitoes. If taxes are levied by a sanitary authority, either directly or through the agency of any company or agent, to insure measures for the destruction of rats and mosquitoes on board ship, the amount of these taxes ought to be fixed by a tariff publislied in advance, and the result of these measm-cs should not be a source of profit for either State or sanitary authorities. Article 15 was here read in Spanish by Doctor Moore. The President. Are you ready for the question ? Doctor Lavoreria here addressed the convention in Spanish, liis remarks being translated hj Doctor Ulloa. Doctor Lavoreria said that this was a question of translation, of fixing in clear terms the meanino- of the article in Spanish. He said that in Spanish two mterpretations could be given to that article. Some might understand that the country to which the merchandise was going might authorize the country from which the merchandise came to use certain disinfections, but the proper way would be for the country from which the merchandise comes to put in force the measures to disinfect those articles. He said that he thought it was chiefly a question of interpretation. Doctor GuiTERAS. The question is a delicate one, and to make it perfectly clear I will give you an example. Say, for example, that we understand that this means that if Peru has the plague, Chile should tell Peru how she should handle these tilings. The President. Is that your understanding? Doctor GuiTERAS. That is my understanding. It says : ''The place and method of disinfection, as well as the measures to be emploj^ed for the destruction of rats and mosquitoes are to be fixed by authority of the country of destination." In things coming from Cuba to the United States you will have to tell Cuba how she should disinfect, and I think that is right. You should object if Cuba is not disinfecting things properly. You will refuse to receive the things unless they are disinfected there accord- ing to your notion, and we will do the same thino- with you. If things are not being disinfected accordino- to our views, which are coming from the United States, we will object, and therefore we will force you to do the thing in the proper way. I am trying to make it clear. I am not discussing the q^uestion as yet. I am simply trjing to make it clear. I have not given an opinion, and I do not know whether I can give one. Discussion in Spanish, participated in by Doctors Licéaga. Medina, Guiteras, and Moore, followed at this point. The Secretary. Here I have a translation of this convention which says: "It rests with the authority of the country to which the arti- cles are consigned to decide in what manner and at what place the disinfection shah be carried out," etc. I tliink by simply adding the words "of this country" that will fix it. Doctor Guiteras. "On arrival." It means that the country that receives the goods will decide how it will manage them, and I think it is necessary to add "upon arrival." The President. Is there a motion before the convention? Doctor Guiteras. There is no motion.. Further discussion in Spanish followed. Doctor Guiteras here read article 15 in English as amended. Doctor Moore read the article in Spanish as amended. SECOND INTERNATIONAL SANITARY CONVENTION. 51 Doctor GuiTERAS. That is plain now. Article 15 was agreed to. Doctor GuiTERAS. Article 16 roads: AiiTiCLE 16. Lottors and correspondence, printed matter, books, newspapers, business papers, etc. (postal parcels not included), are not to be submitted to any restriction or disinfection. In case of yellow fever postal parcels are not to be subjected to any restric- tions or disinfection. Article 16 was read in Spanish by Doctor Moore. Ai'ticle 16 was agreed to. Doctpr GuiTERAS. The next article reads: Article 17. Merchandise arriving by land or by sea should not be retained at fron- tiers or in ports. Measures which it is permissible to prescribe with respect to them are specified in arti- cle 12. Nevertheless, when merchandise arriving by sea in bulk (vrac), or in defective bales, is contaminated by pest-stricken rats during the passage, and is incapable of being disin- fected, the destruction of the germs may be assured by putting said merchandise in a warehouse for a period to be decided by the sanitary autliorities of the port of arrival. It is to be understood that the application of this last measure should not entail delay upon any vessel nor extraordinary expeases resulting from the want of warehouses in ports. Article 17 was here read in Spanish by Doctor Moore. The President. Are there any comments or any resolutions to be offered on this article? Doctor Lavoreria addressed the convention in Spanish. Doctor GuiTERAS. Does anyone here know exactly what the term "vrack" means? In the Spanish translation they have copied it as it was in the French copy. Doctor Geddings. It means "in bulk." Doctor GuiTERAS. It says "in vrac, or imperfectly packed." Doctor Geddings. It means not packed, or imperfectly packed. Doctor GuiTERAS. In bulk, or in defective bales. Doctor Geddings. Defective packages, it ought to be. Doctor GuiTERAS (reading) : Article ¥7. Merchandise arriving by land or by sea should not be retained at frontiers or in ports. The President. May I interrupt you to ask the distinction between "detained" and "retained?" Doctor GuiTERAS. As I understand it, "retained" means per- manently, whereas "detained" means only temporarily. I do not know whether I am right on that. I do not know whether tliis is really so. We are using the French authority for it. They use "retinue;" but when they mean for a limited time they use the word "detinue." The President. That word is not a sufficient word in the English language, if that is the idea. Doctor Stiles remarks that in French that really means "embargo." , Doctor GuiTERAS. Shall we say "detained permanently," then? The President. I think that would be better. Doctor GuiTERAS. Very well, we will make it read "detained permanently." I will read it again. Article 17. Merchandise arriving by land or by sea should not be detained perma- nently at frontiers or in ports. Measures which it is permissible to prescribe with respect to them are specified in article 12. 52 SECOND IXTERNATl(i>JAL SANlTxVRY CONVENTiON. Xevcrtheless, when merchandise arriving by sea in bulk (vrac) or in defective packages is contaminated by pcst-stricken rats during the passage and is incapable ol' being disin- fected, the desti-uction of the germs may be assured by putting said merchandise in a warehouse for a period to be decided b}' the sanitary authorities of the poi-t of anival It is to be underetood that tlie application of this last measure should not entail delay upon any vessel nor extraordinary expenses resulting from the want of warehouses in ports. Article 17 was read in Spanish by Doctor Moore. Article 17 was agreed to. Doctor GuiTERAS. In the Spanish copy, in article 17 they have preserved the word, in brackets, "[vrac]," so that it shall be known to be the French. I wish to put it in. Article IS reads: Article i^. "Wlicn merchandise has been disinfected by the application of the measures prescribed in article 12 or put temporarily in warehouses in accordance with the third paragrp.ph of article 17, the owner or his representative has the right to demand from the sanitary authority which has ordered such disinfection a certificate setting forth the measures taken. Article 18 was read in Spanish by Doctor Moore. The President. You have heard the article read. If there are no remarks, we will vote upon it. Article 18 was agreed to. Doctor Geddings. Mr. Chairman, I would like to speak of this article 18. It says — When merchandise has been disinfected by the application of the measures prescribed in article 12 or put temporarily in warehouses in accordance with the third paragraph of article 12, the owner or his representative has the right to demand from the sanitary authority which has ordered such dismfection a certificate setting forth the measures taken. I suggest that it should read "such disinfection or deposit." Doctor GuiTERAS. "Which has ordered such disinfection or deposit." I find that this is in the Spanish version already. The question was taken upon the amendment proposed by Doctor Geddings, and it was agreed to. Doctor Guiteras here read article 19, as follows: Article 19. Baggage. In the case of soUed linen, bed clothing, clothing, and objects forming a part of baggage or furniture coming from a territorial area declared con- taminated, disinfection is only to be practiced in cases where the sanitary authority considers them as contaminated. There shall be no disinfection of baggage on account ofj yellow fever. ^ The President. Before the Spanish is read I would like to call the attention of Doctor Geddings, who is the representative of that committee, to the French translation — which is very good, by the way — where they use the word " local area." Doctor Gatewood. The word "area" is defined. Why not sub- stitute it for the words "territorial area?" Territorial area is not defined. Doctor Guiteras. It says "territorial area." The definition has said that an area was a territory. Doctor Gatewood. "Area" was defined. Doctor Guiteras. It was defined as a territory, an.area, a village, or any one of the tilings which it might be. Among the others "territory" was included. Doctor Gatewood. Why not use the word "area?" Doctor Guiteras. Shall I read it again? The President. Read it again. SECOND INTKUNATIONAL SANI'i'AKY CONVENTION. 58 Doctor GuiTERAs. It reads: In the case of soilod linon, bed clotliing, clothing, and oljjects forming a part of baggage or furniture coming from a territorial area decJarcd contaminated, disinfection is only to be practiced in cases when the sanitary authority considers them as contaminated. There shall be no disinfection of baggage on account of yellow fever. Article 19 was read in Spanish })y Doctor Moore. The PnESiDENT. I would like to ask Doctor Gcddings if he is satisfied with that in its present form? Doctor Geddings. I am satisfied with that — ''territorial area." Article 19 was agreed to. Doctor Guiteras read as follows: Section 3. Measures in ports and at maritime frontiers. Abticlb 20. Classification of ships. A ship is considered infected which has plague, cholera, or yellow fever on board, or which has presented one or more cases of plague or cholera within seven days or a case of yellow fever at any time during the voyage. The above was read in Spanish by Doctor Moore. Discussion in Spanish between the members of the convention followed. Doctor Guiteras. We have been discussing merely a verbal correction, which is understood in the Spanish. The above part of article 20 was again read by Doctor Moore in Spanish. The part of article 20 already read was agreed to. Doctor Guiteras read as f ollow^s : A ship is considered as suspected on board of which there has been a case or cases of plague or cholera at the time of departure or during the voyage, but no new case ■s\ñthin seven days; also such ships as have lain in such proximity to the' infected shore as to render them liable to the access of mosquitoes. The above, read by Doctor Guiteras, was here read in Spanish by Doctor Moore. That part of article 20 last read in English and Spanish was agreed to. Doctor Guiteras. The last paragraph of article 20 reads as follows : The ship is considered indemne which, although coming from an infected port, has had neither death *nor case of plague, cholera, nor yellow fever on board, either before ( departure, during the voyage, or at the time of arrival, and which in case of j-ellow fever has not lain in such proximity to the shore as to render it hable to the access of mosquitoes. I think that should read — i in such proximity to the shore as to render it Hable, in the opinion of the authorities, to the access of mosquitoes. Discussion in Spanish between the members of the convention followed. Doctor Guiteras. The gentleman from Ecuador objects to this last paragraph. That is, he desires to discuss it, in regard to mdemne ships. The President. Then it mil be necessary for him to make some motion. Doctor Guiteras. He asks for an explanation, and I am not able to give it. He asks whether a ship wall be considered indemne which has made a trip of, say, only one day from a port in Mexico to a port in Texas, or vice versa — very close across a frontier — after it has left an infected port. Would 5^ou consider that ship indemne because it has had no case or cases of cholera, yellow fever, or plague 54 SECOND INTERNATIONAL SANITARY CONVENTION. on board ? You see there will liave been but one day for "a case of ñnj disease to develop. The President. That evidently was not considered. Doctor GuiTERAS. It was not considered in the Paris conference, I should say. Discussion in Spanish followed. Doctor GuiTERAS. We are ready for a vote on the last paragraph of article 20. The last paragraph of article 20 was agreed to. The President. Article 20 being finished, we should now take a vote on the whole article, as read and adopted by paragraphs. Article 20 as a whole was agreed to. Doctor GuiTERAS. Article 21 reads: Akticle 21. Ships infected with plague are to be subjected to the following regulations': 1. Medical visit (inspection). 2. The sick are to be immediately disembarked and isolated. 3. Other persons should also be disembarked, if possible, and subjected to an observa- tion 1 which should not exceed five days, dating from the day of arrival. Then there is a footnote to explain what "observation" means, which reads as follows: Q) The word observation signifies isolation of the passengers either on board ship or at a sanitary station before being given free pratique. Article 21 continues: 4. Soiled linen, personal efl'ects in use, the belongings of crew^ and passengers which, in the opinion of the sanitary authorities, are considered as infected should be disinfected. Then there is a footnote explaining what the term "crew" means, which reads as follows : (2) The term crew is applied to persons who may make, or who have made, a part of the personnel of the vessel, and of the administration thereof, including stewards, waiters, "cafedii," etc. The word is to be construed in this sense wherever employed in the present convention. Then the balance of article 21 reads: 5. The parts of the ship which have been inhabited by those stricken with plague, and such others as, in the opinion of the sanitaiy authorities, are considered as infected should be disinfected. • 6. The destruction of rats on shipboard should be efl'ected before or after the discharge of cargo, as rapidly as possible, and in all cases with a maximum delaj^ of forty-eight hours, care being taken to avoid damage to meif;handise, the vessel, and its machineiy. For ships in ballast this operation should be performed immediately before taking on cargo. Discussion in Spanish followed. Article 21 was read in Spanish by Doctor Moore. Article 21 was agreed to. Article 22 was read by Doctor Guiteras, as follows : Article 22. Ships suspected of plague are to be subjected to the measures which are indicated in Nos. 1, 4, .5 of article 21. Further, the crew and passengers may be subjected to observation, which should not exceed five days, dating from the arrival of the ship. During the same time the disem- barkment of the crew may be forbidden, except for reasons of duty. The destruction of rats on shipboard is recommended. This destruction is to be efl'ected before or after the discharge of cargo, as quickly as possible, and in all cases with a maxi- mum delay of forty-eight hours, taking care to avoid damage to merchandise, ships, and their machinery. For ships in ballast this operation should be done, if done at all, as early as possible, and in all cases before taking on cargo. SECOND INTERNATIONAL HANITARY CONVENTION. 55 Article 22 was read in Spanish by Doctor Moore. , The article as read was agreed to. Doctor Gaiteras here read article 23 in exactly the form in which it appears in the convention. Article 23 was here read in Spanish by Doctor Moore. Discussion in Spanish followed. Doctor GuiTERAS. I have merely called attention to the fact that they have used "observation" here instead of "surveillance," and we thonght that we had agreed in this case that we might use "sur- veillance," because we were speaking of an indemne ship. Further discussion in Spanish followed. Doctor GuiTEKAS. We are ready to vote, Mr. President. Article 23 as read was agreed to. Doctor Guiterasread article 24^ as follows: Article 24. Wlien upon an indemne ship rats have been recogpzed as pest stricken as a result of bacteriological examination, or when marked mortality has been established among these rodents, the following measures should be applied: 1. Ships with plague-stricken rats: (a) Medical visit (hispection) . (b) Eats should be destroyed before or after the discharge of cargo, as rapidly as pos- sible, and in all cases with a delay not to exceed forty-eight hours ; the deterioration of mer- chandise, vessels, and machineiy to be avoided. Upon ships in ballast this operation should be performed as soon as possible, and in all cases before taking on cargo. (c) Such parts of the ship and such articles as the local sanitary authority regards aá infected shall be disinfected. (d) Passengers and crew may be submitted to observation the duration of which should not exceed five days, dating from the day of arrival, except in exceptional cases, where the sanitary authority may prolong the observation to a maximum of ten days. The above paragraph of article 24 was here read in Spanish by Doctor Moore. The Secretary. Here is the same difference again. In the Eng- lish copy they have used the word "observation" while in the Spanish copy it is "surveillance." That appears in paragraph (d). Doctor GuiTERAS. Yes. There is one correction to be made here, and one only. It is a verbal correction. Doctor McCaw suggests the substitution of the word "special" for "exceptional" in para- graph (d). We are now ready to vote on the first paragraph of article 24. Paragraph No. 1 of article 24 was agreed to. Doctor Guiteras here read paragraph 2 of article 24, as follows: 2. Ships where a marked mortality among rats is observed: (a) Medical visit (iospection) . (b) An examination of rats, with a view to determining the existence of plague, should be made as quickly as possible. (c) If the destruction of rats is judged necessary, it shall be accomplished imder the conditions indicated above in the case of ships with plague-stricken rats. (d) UntU all suspicion may be eliminated the passengers and crew may be submitted to observation, the duration of which should not exceed five days, counting from the date of arrival, except in special cases, when the sanitary authoiity may prolong the observation to a maximum of ten days. The second paragraph of article 24 was here read in Spanish by Doctor Moore. The second paragraph of the article was agreed to, The President. Now, the whole article should be agreed to. The entire article No. 24 was adopted. 56 SECOND INTERÍÍATIONAL SANITARY CONVENTION. Doctor Guiteras read article 25, as follows: Aeticle 25. The saiiitary authoiities of the port must deliver to the captain, the owner, or his agent, whenever a demand for it is made, a certificate setting forth that the meas- ures for the destruction of rats have been efficacious and the reasons why these measures have been appUed. Article 25 was read in Spanish by Doctor Moore. Article 25 was agreed to. Doctor Guiteras read article 26, as follows: Aeticle 26. Ships infected with cholera are to be subjected to the following regulations: 1. Medical visit (inspection). 2. The sick are to be immediately disembarked and isolated. 3. Other persons ought also to be disembarked, if possible, and subjected, dating from the arrival of the ship, to an observation, the duration of which will vary according to the sanitary condition of the ship and the date of the last case, without, however, exceeding five days. Doctor Guiteras. That is expressed in the Spanish copy, "the duration of which will vary according to the sanitary condition of the ship and the date of the last case." The President. Was that change made by our committee? As I understand it, we took that agreement that was passed in Paris, and we are to adapt it to our needs. If that has been changed by the committee it should be changed in the English as well as the Spanish. Doctor Guiteras. I have forgotten how the difference arose. The President. There is a discrepancy between the English and the Spanish texts. Was tliis done on purpose? Doctor Guiteras. In the Spanish ihej have eliminated ''varying with the sanitary condition." What is the use of telling them that when you saj that it will not exceed five days? We will eliminate that in the English copy, so as to make it agree. The President. Very well, do that, so that they may agree. Doctor Guiteras here continued the reading of article 26, as follows.: 3. Other persons ought also to be disembarked, if possible, and subjected, dating from the arrival of the ship, to an observation, the duration of which shall not exceed five days. 4. Soued linen, wearing apparel, and personal effects of crew and passengers which, in the opinion of the sanitary authority of the port, are considered as infected are to be dis- infected. 5. The parts of the ship which have been inhabited by persons sick with cholera, or which are considered by the sanitary authority as infected, are to be disinfected. 6. The bilge-water is to be discharged after disinfection. The sanitaiy authority may order the substitution of good potable water for that which is contained in the tanks on board. The discharge or throwing overboard into the water of a port of dejecta shall be for- bidden unless they have been previously disinfected. Article 26 was read in Spanish by Doctor Moore. Article 26 was agreed to. Doctor Guiteras read article 27, as follows: Article 27. Ships suspected of cholera are to be subjected to measures prescribed under Nos. 1, 4, 5, and 6 of article 26. The crew and passengers may be subjected to an obsei-vation which should not exceed five days, to date from the arrival of the ship. It is recommended during the same time to prevent the debarkation of the crew except for reasons of duty. Article 27 was read in Spanish by Doctor Moore. Article 27 was agreed to. HEOOND IN'J'KRNATIONAL HANITAKY CON VKNTION. -> ( Doctor Guiteras here read article 28, as follows: Article 28. Ships indemne of cholera are to 1)0 admitted to free pratique immediately, whatever may be the nature of their bill of health. The only regulations which the sanitary authorities of a port may prescribe in their case are the measures provided in Nos. 1, 4, and G of article 26. The crews and passengers may be submitted, in order to show their state of health, to an observation, which should not exceed five days, to be; computed from the date when the ship saued from the infected port. It is recommended that during the same time the debarkation of the crew be forbidden except for reasons of duty. Compct(^nt authority at the port of arrival may always demand, under oath, a certificate from the ship's surgeon, oi- in the absen(;e of a surgeon, from tlie captain, setting forth that there has not been a case of cholei'a upon the ship since sailing. Article 28 was read in Spanish by Doctor Moore. Article 28 was agreed to. Doctor Guiteras read article 29, as follows: Akticle 29. Competent authority will take account, in order to apply the measures indi- cated in articles 21 to 28, of the presence of a physician on board and a disinfecting apparatus in ships of the three categories mentioned above. In regard to plague, it will equally take accouat of the installation on board of apparatus for the destruction of rats. Sanitary authorities of such states where it may be convenient to make such regulations may dispense with the medical visit and other measures toward indemne .ships which have on board a physician specially conmiissioned by their country. Article 29 was read in Spanish by Doctor Moore. Article 29 was agreed to. Doctor Guiteras read article 30, as follows : Article 30. Special measures may be prescribed in regard to crowded ships, notably emigrant ships, or any other ship presenting bad hygienic conditions. Doctor GuiTSEAS. Is that correct, ''bad hygienic conditions?" Doctor Geddings. That is proper. Doctor Gatewood. Doctor Stiles suggests that you make it read ^'poor hygienic conditions,'' which sounds a little better. Doctor Geddings. What is the matter with ''unhygienic condi- tions?" Article 30 was read in Spanish by Doctor Moore. Article 30, as read in English by Doctor Guiteras, and in Spanish by Doctor Moore, was agreed to. Doctor Guiteras here read article 31, as follows: Akticle 31. Any ship not desiring to be subjected to the obligations imposed by the authority of the port in virtue of the stipulations of the present convention is ft-ee to proceed to sea. It may be authorized to disembark its cargo after the necessary precautions shaU have been taken, namel)^, fiist, isolation of the ship, its crew, and passengers; second, in regard to plague, demand for information relative to the existence of an unusual mortality among rats; third, in regard to cholera, the discharge of the bilge-water after disinfection and the substitution of a good potable water for that which is pro^'ided on board the ship. Authority may also be granted to disembark such passengers as may demand it, upon condition that these submit themselves to all measures prescribed by the local authorities. Article 31 was read in Spanish by Doctor Moore. Article 31 was agreed to. Doctor Guiteras read article 32, as follows: Article 32. Ships coming from a contaminated port, which have been disinfected and which may have been subjected to sanitary measm-es applied in an efficient manner, shall not undergo a second time the same measures upon their arrival at a new port, provided that no new case shall have appeared since the disinfection was practiced, and that the ships have not touched in the meantime ac an infected port. 58 SECOND INTERNATIO]N AL SANITARY CONVEINTION. When a ship only disembarks passengers and their baggage, or the mails, without having been in conununicatiou with term Jirma, it is not to be considered as having touched at a port, provided that in the case of yellow fever it has not approached sufhciently near the shore to permit the access of mosquitos. Ai'ticle 32 -was read in Spanish by Doctor Moore. Discussion in Spanish followed. The President. Has there been any change in the language? Doctor GuiTERAS. No; only a change in the wording. Article 32 was agreed to. Doctor Guiteras read article 33, as follows: Article 33. Passengers on an infected ship have the i-ight to demand of the sanitary authority of the port a certificate showing the date of their arrival and the measures to which they and their baggage have been subjected. Article 33 was read in Spanish by Doctor Moore. Article 33 was agreed to. Doctor Guiteras read article 34, as follows : Article 34. Packet boats shall be subjected to special regulations, to be established by mutual agreement between the countries in interest. Article 34 was read in Spanish by Doctor Moore. Article 34 was agreed to. Doctor Guiteras read article 35, as follows: Article 35. Without prejudice to the right which governments possess to agi'ee upon the organization of common sanitarj' stations, each country should provide at least one port upon each of its seaboards, with an organization and equipment sufficient to receive a vessel, whatever may be its sanitaiy condition. When an indenme vessel, coming ft-om an infected port, arrives in a large mercantile port, it is recommended that she be not sent to another port for the execution of the prescribed sanitary measures. In every country ports liable to the arrival of vessels from ports infected with plague, cholera, or yellow fever, should be equipped in such a, manner that indemne vessels may there undergo imediately upon their arrival the prescribed measures and not be sent for this pur- pose to another port. Governments should make declaration of the ports which are open in their territories to arrivals from ports infected with plague, cholera, or yeilow fever. Article 35 was read in Spanish by Doctor Moore. Discussion in Spanish follow^ed. Article 35 was agreed to. Doctor Guiteras read article 36, as follows: Article 36. It is recommended that in large seaports there be established: (a) A regular medical service and a permanent medical supervision of the sanitarj' condi- tions of crews and the inhabitants of the port. (b) Places set apart for the isolation of the sick and the observation of suspected persons. In the Stegomyia belt there must be a building or part of a building screened against mosqui- tos, and a launch and ambulance similarly screened. (c) The necessary installation for efficient disinfection and bacteriological laboratories. (d) A supply of potable water above suspicion, for the use of the port, and the installa- tion of a system of sewerage and drainage adequate for the removal of refuse. Article 36 was read in Spanish by Doctor Moore. • Article 36 was agreed to. Doctor Guiteras read as follows: Section 4. Measures upon land frontiers, travelers, railroads, frontier zones, river routes. Article 37. Land quarantines should no longer be established, but the governments reserve the right to establish camps of observation if they should be thought necessary for the temporary detention of suspects. Only persons presenting systems of plague, cholera, or yellow fever should be detained at frontiers. This principle does not exclude the right of each State to close a part of its frontier in case of necessity. SECOND INTERNATIONAL HANITAKY (J(;N V KNTK^N. 59 The President. Would you leave the word "State" in there? It might be interpreted to mean each State in the United States. Doctor GuiTERAs. Would you object to substituting the word "Government?" The President. No. A Delegate. Make it read "country." Doctor Guiteras. Country, yes. Then it will read: This principle does not exclude the right for each country to close a part of its frontier in case of necessity. Article 37 was here read in Spanish by Doctor Moore. Doctor Guiteras. Mr. Chairman, I move that the second para- graph of this article be omitted, namely, that part which reads: Only persons presenting symptoms of plague, cholera, or yellow fever should Vje detained at frontiers. Doctor Geddings. I second that motion. Doctor Guiteras. I make this motion because I take it that the second paragraph is in contradiction of the first paragraph of this article. The first paragraph of this article reads: Land quarantines should no longer be established, but the governments reverse the right to establish camps of observation if they should be thought necessary for the tempo- rary detention of suspects. Now, after saying that these camps of observation may be estab- lished if it is deemed necessary, it declares that only sick persons shall be detained, the language being "only persons exhibiting symptoms of plague, cholera, or yellow fever should be detained at frontiers." The President. Are you ready for the question on Doctor Gui- teras's motion? Doctor Medina. We would like to have it read again in Spanish. The article as amended was read in Spanish by Doctor Moore. Doctor Medina. That is all right. The amendment of Doctor Guiteras was agreed to. The President. The amendment is adopted. The question now is on the adoption of the article as read. Article 37 as amended was agreed to. Article 38 was read by Doctor Guiteras as follows: Article 38. It is important that travelers should be submitted to a surveillance on the part of the personnel of raikoads, to determine their condition of health. Article 38 was read in Spanish by Doctor Moore. Article 38 was agreed to. Doctor Guiteras here read article 39, as follows : Article 39. Medical intervention is limited to a visit (inspection) with the taking of temperature of travelers, and the succor to be given to those actually sick. If this visit is made, it shou.ld be combined as much as possible -with the custom-house inspection, to the end that travelers may be detained as short a time as possible. Only persons evidently sick should be subjected to a searching medical examination. Article 39 was read in Spanish by Doctor Moore. Discussion in Spanish followed, being participated in by Doctor Lavoreria, Doctor Licéaga, and Doctor Alcivar. Doctor Guiteras. The question is, Mr. President, on the taking of the temperature. Article 39 sa3'-s: "Medical intervention is lim- ited to a visit (inspection) with the taking of temperature of trav- elers, and the succor to be given to those actuallv sick." 60 SECOND INTERNATIONAL SANITARY CONVENTION. The gentleman from Peru would rather have the taking of the temperature limited — or, rather, when it is necessary. Doctor Licéaga insists that authority should be given to take the tempera- tures of ever3'body. I am in favor of reserving the authority to take temperatures. The. President. The physician can do it or not, if he pleases. Doctor GuiTERAS. Yes, sir; but he ought to have the authority to do it. Further discussion in Spanish followed. Doctor GuiTERAS. The amendment is withdrawn. We are ready for the vote. Article 39 was agreed to. Doctor Guiteras read article 40, as follows: Akticle 40. As soon as travelers coming from an infected locality shall have arrived at their destination, it would be of the greatest utility to submit them to a surveillance, which should not exceed ten or five days, counting from the date of departure, the time depending upon whether it is a question of plague or cholera. In case of yellow fcA'er the period should be six days. Article 40 was read in Spanish by Doctor Moore. Article 40 was agreed to. Doctor Guiteras read article 41, as follows: Aeticle 41. Governments may reserve to themselves the right to take particular measures in regard to certain classes of persons, notably vagabonds, emigrants, and persons travehng or passing the frontier in groups. Article 41 was read in Spanish by Doctor Moore. Doctor Gatewood. In groups? Doctor Ulloa. "Groups" is all right. Dr. H. L. E. Johnson. Is not that meant to apply to roving bands of gypsies and tramps ? Doctor Gatewood. Why not put it both ways — bands and groups ? The President. I will call upon Doctor Geddings to explain this. Doctor Geddings. This refers to vagabonds traveling in parties. It refers to tramps and gypsies and those who pass the frontier in troupes. Not in a military sense. The President. You mean theatrical troupes? Doctor Geddings. Yes, sir; theatrical troupes. A band or group, would be all right. Doctor Guiteras. It might be understood to be military — troops of cavalry, for instance. Doctor Ulloa. Put it groups, then. Doctor Guiteras. No; because groups may be very small. I think "bands" would be better. Doctor Geddings. I move to substitute "groups." Dr. H. L. E. Johnson. I would suggest that we cover both situa- tions by using both terms, and making it read "bands" or " groups." That would express it properly in English. I do not know how it would go in Spanish. Doctor Guiteras. I think that "groups" is so general that it might be applied to very small groups — a group, for instance, of five persons — and this certainly does not apply to such small numbers as that. It refers to such large bands as are difficult to handle and to discipline and to follow. But when it comes to small bands, I do not think it intends to interfere with them. A small group is a carload of people. Certainly you are not going to interfere with them. The word SECOND INTKKMaTIONAL KANITaTíY CONVENTION. 61 "bands" moans large groups moving without discipline. I do not see the necessity of using the term "groups." The President. There is a suggestion, and the motion is before us, that the word be changed from "groups" to "bands." 1 think J^octor Johnson has a suggestion to rjiake. Doctor Johnson. No, sir,- I withdraw that motion which I made. Tlie President. Then the question is on the motion of Doctor Geddings. The question was taken upon the motion of Doctor Geddings, and the motion was agreed to. Article 41 was agreed to. Doctor Guiteras read article 42, as follows: Akticle 42. Coaches intended for the transportation of passengers and mails should not be retained at frontiers. In order to avoid this retention a system of relays ought to be established at frontiers, with transfer of passengers, baggage, and mails. If one of these carriages be infected or shall have been occupied by a person suffering from plague, cholera, or yellow fever Doctor Guiteras. No; I do not accept yellow fever there. No, no. And yet, supposing a case of yellow fever on a train, should not that car be disinfected? Yes; a mosquito might have bitten the per- son. Yes; that is right. [Continuing reading] : If one of these carriages be infected, or shall have been occupied by a person suffering from plague, cholera, or yellow fever it shall be detached from the train for disinfection at the earliest possible moment. Article 42 was read in Spanish by Doctor Moore. Article 42 was agreed to. Doctor Guiteras read article 43 as follows : Article 43. Measures concerning the passing of frontiers by the personnel of railroads and of the post-oíñce are a matter for agreement by the interested administrations. These measm'es should be so arranged as not to hinder the service. Article 43 was read in Spanish, as above, by Doctor Moore. Article 43 was agreed to. ' Doctor Gatewood. What does the word "administrations" mean there? Does it mean the administration of the railroads, or of the countries ? Doctor Guiteras. It says "personnel of railroads, and of the post-office." Doctor Gatewood. If the railroads happen not to be under govern- mental control, the matter might be arranged by the railroads, then, according to that. Dr. H. L. E. Johnson. Would it not be better to say, "agreement of the countries interested?" The President. It shovdd be, really "the sanitary authorities." Dr. H. L. E. Johnson. It says "agreement by the interested administrations," whereas I think it should say "the countries interested." The Secretary. I think it should read "sanitary authorities.'' Doctor Guiteras. I will make it read, then, "sanitary authorities," "a matter for agreement of the sanitary authorities." The President. We have already adopted article 43 ^^ithout this amendment. Dr. H. L. E. Johnson. In order that we may consider that, I move that we reconsider the adoption of article 43. 62 SECOND INTEENATIONAL SANITARY CONVENTION. The motion was seconded. The question on the reconsideration of article 43 was taken and the motion was agreed to. The President. The motion for reconsideration of article 43 has been carried, and article 43 is now before you. Amendments are in order. Dr. H. L. E. Johnson. I move that article 43 be amended as agreed upon, and that the amendment as proposed here be read. Doctor Guiteras here read article 43, as amended, as follows: Akticle 43. Pleasures concerning the passing of frontiers by the personnel of railroads and of the post-office are a matter for agreement of the sanitary authorities. These meas- tures should be so arranged as not to hinder the service. Article 43 as amended was read in Spanish by Doctor Moore. Upon motion of Dr. H. L. E. Johnson, duly seconded, article 43 as amended was agreed to. Doctor Guiteras read article 44 as follows: Article 44. The regulation of frontier traffic, as well as the adoption of exceptional meas- ures of surveillance, should be left to special arrangement between contiguous states. The Secretary. The last word in that article should be changed to "countries." Doctor Guiteras. Yes. The President. Make it ''countries." Article 44, as amended, was read in Spanish by Doctor Moore. Article 44 was agreed to. Doctor Guiteras read article 45 as follows: Akticle 45. The power rests with governments of countries bordering upon rivers to regulate by special regulations the sanitaiy regime of river routes. Article 45 was read in Spanish by Doctor Moore. Ai'ticle 45 was agreed to. Doctor Guiteras. Mr. President, there is another article here which, I suppose, will raise no objection at all, but the question as to the title of that article is one that I wish to present. The President. We have finished all those articles which are ready and we will now adjourn until 3 o'clock p. m. Thereupon the convention took a recess until 3 o'clock p. m. Afternoon Session. The convention was called to order at the conclusion of the recess, at 3 o'clock p. m., by the president, Surgeon-General Wyman. The President. If it is agreeable to the convention, before we proceed again with these articles that we have almost finished, and pending the arrival of one or two members, Doctor Howard being present, we will hear from him now on the distribution of the Stego- myia mosquito. Doctor Howard. Mr. President and members of the convention, I realize that you are very busy and have a great many matters on hand, and I shall be as brief as I possibly can be. I wish to state that in the investigation of the yellow-fever mos- quito I have been assisted by many other men. M}^ own investiga- tions have led me to Mexico, where I have received the very greatest f)ossible courtesy at the hands of Doctor Licéaga, who has given me etters of introduction to the people I wanted to meet most in SECOND INTERN ATIONAJ. SANITARY (JONVKNTION. 08 Mexico and assisted me in every possi})le way. I wish also to render publicly my thanks to Doctor üuiteras for the opportunity of seeing everything in the ]jas Animas Hospital in Habana, and I think that it was probal)ly tlu'ough tlie kind words of Doctor Guiteras that I was able to land at all in Habana, because I arrived on a steamer from Veracruz, and no one was allowed to go off; but I gave my card to the medical inspector, and I said, "Give my card to J)octor Guiteras," and there were no more formalities, and I was the only person who was allowed to go ashore. In order to be as brief as possible, I think that I had f^etter read an abstract of what I intended to say, which is short, and, I hope, to the point. You will observe that I speak of myself in. this in the third person. Doctor Howard here read his abstract. (See Appendix, p. 214.) The President. We have on our programme a very short paper from Dr. II. L. E. Johnson, and we will be very glad to hear it now. Dr. H. L. E. Johnson read the paper referred to, in English. (vSee Appendix, p. 217.) The President. Doctor McCaw, of the United States Army, wishes to make the announcement to the convention that during the last year there have been published by the .Surgeon-General's Office the results of the investigations of the Board of Army Officers during the Spanish-American war on the spread of typhoid fever in camps. This book has been edited and gotten out finaíl37^ by the last surviving member of the board, Dr. Victor C. Vaughan. It is a very voluminous and heavy book, in two volumes, one volume consisting of an atlas and diagrams and the other volume being a book of statistics. The work is not of great value to the practitioner — it is too large for the ordinary library; but it is of great interest to those interested in public health. On behalf of the Surgeon-General of the Army I would say that I mil present to every member of this conference a copy of this work if they will give me the address to wliich they wish it sent. I can send it by mail to anyone in the United States, either to the legations or anywhere else. Í think perhaps if it were sent to South American countries it would be likely to be lost in the mail. I would be very glad if anyone who desires a copy would let me know. The announcement of Doctor McCaw was translated into Spanish by the secretary. Doctor Guiteras. I move that the thanks of the convention be transmitted to the Surgeon-General of the United States Army for this kind offer. The motion was seconded, and was agreed to. Doctor Guiteras. Is the paper of Doctor Howard open for dis- cussion, or can any remarks be made? The President. It would be very acceptable to have remarks made upon it. Doctor Guiteras. First, in respect to the biting of the Stegomyia late in the afternoon, or whether biting in the heated hours of the day, perhaps attracted by the odor of perspiration. There is a strong argument against admitting that view of one of the gentlemen quoted by Doctor Howard, and that is that the mosquitoes avoid negroes ; and if there is a strong odor of perspiration to be found any- where, it is that which is to be found in negroes. So that I do not believe that the odor of perspiration attracts mosquitoes. 64 SECOND INTERNATIONAL SANITARY CONVENTION. Relntive to the frequency of biting, undoubtedly tlie period given by one of the gentlemen, five or six da^^s, is too long. The other estimate, forty-eight hours, is correct. The female Stegomyia will bite every fortj-eight hours. But tlie question I am going to touch upon now is not mentioned in Doctor Howard's paper, but it is certainly intimately related to the question of the distribution of the Stegomyia. We want to know the geograpliical distribution of the Stegomyia and study it so thorouglily, because we suppose that the area over wliich the Stegomyia ranges ^\^ll correspond with the area over which the yellow fever is found, and therefore the conclusion can be drawn that yellow fever will not spread beyond that area. I want to make a statement that tliis is not so; that I believe there is j'-ellow fever in districts outside of the districts of the Stegomyia fasciata, at least outside of the ordinary distribution. I believe, in other words, that yellow fever may be spread and may be carried — perhaps not a large epidemic, but it may spread — where Stegomyia is not found. In other words, Stegomyia may be carried to such a place as Atlanta in the early spring and summer or even farther north, when it is warm enough for it to spread. Two or three females full of eggs may be carried in a sleeper to one of these places and they will breed sufficient mos- quitoes by the end of the summer — in August, for instance — to spread an epidemic of yellow fever. I believe such a thing happened in Madrid not long since, where a female mosquito was able to breed sufficiently to make a small epidemic. I believe that there is con- siderable danger in some of the ports of a small epidemic, and I think none of them are entirely free from the danger. I believe that such freedom is only relative, and I may add that Doctor Finlaj^ is of the same opinion. The Secretary. Just a few remarks in coniu-mation of what Doctor Guiteras has said. A few years ago there was an epidemic in Alajuela, about 12 miles outside of San José, in Costa Rica, a place which is not quite so high as San José, but nearly so. San José is 3,868 feet and Alajuela is 3,001 feet above the level of the sea. Of course, before the theory of the mosquito transmission of the dis- ease became a doctrine, we had the idea that yeUow fever could not develop in high altitudes, but nevertheless there was a very serious epidemic in the city of Alajuela, and the government had considerable trouble in eradicating it. And I believe, as Doctor Guiteras has stated, that the epidemic might have been due to some mosquitoes being brought from Punta Ai'enas, which is a port on the Pacific, during the summer season when they cart coffee from the interior to the port on the Pacific; and from there the carts or freight might have brought some of these mosquitoes. Some people came from the port ill and developed yellow fever in Alajuela, and the Stegomyia might have been found there and become contaminated, and in this manner started the epidemic. The President. Are there any other remarks? This is a very interesting and important subject. Doctor Medina. I would mention that I have information also that we had two cases in Managua, quite a distance from Corinto, some 150 miles away. We had two cases, but both those were of passengers who had come from Panama. The cases were developed, and they died in Managua; but the infection was not present, and those were the only two cases that we had. HEOOND INTERNATIONAL SANITARY CONVENTION. 05 The secretary here translated into Spanish the substance of the preceding remarks upon this subject. Doctor Licéaga adclressed the convention in Spanish. The Secretary. Doctor Licéaga has said tliat he desires to make the following explanation on the point under discussion : He says that in a high altitude in Mexico, about 2,000 feet, where the City of Mexico is situated, they made the following experiment: They brought some mosquitoes from Veracruz, which has been, as we all know, a great focus for yellow fever for a good many years back, and they succeeded in breeding through three generations the mosquitoes of the Stegomyia fasciata, and the only difierence they found was that the mosquitoes bred in Mexico did not last as long as those bred in Veracruz. Doctor Licéaga concluded by saying, very wisely, that this illus- trates the possibility of yellow fever developing in a city at that altitude if the authorities were not careful enough in the treatment they accord to our friends the Stegomyia. Doctor Licéaga said that he wants to thank Doctor Howard kindly for his expressions concerning the treatment he received in Mexico. He extends his thanks to you. Doctor. Doctor Howard. May I say a word in reply? The President. Doctor Howard. Doctor Howard. I am particularly interested in the instances given by Doctor Ulloa and by Doctor Licéaga, and by the generalization made by Doctor Guiteras. The subject is covered pretty fully on page 4 of this pamphlet, which I understand was distributed among the members of the convention during the sessions of the first day, and I speak there of the danger of these mosquitoes coming up the Mississippi River and the Ohio River, and being carried in steamboats and in trains, and of the likelihood of epidemics being caused in that way. During the trip of which I have already spoken, on which my labors were so facilitated by Doctor Licéaga's kindness, the highest point at which I found the Stegomyia breeding — I was there in May, but it could have been carried up there — was at Orizaba, w^liich is at an elevation of 4,500 feet above sea level, and it was not an original denizen there, as it was at the coast. But when the railroad was built up into the country at Mexico, it was carried up farther, and then it died down a little bit, but it finally established itself at Cordova, and then finally at Orizaba. The first cases in Orizaba were all of persons living in a small radius, close around the railroad station. In the next epidemic they spread out a few hundred yards farther and took in another block of houses a little farther off from the railroad station as a center, and it may be that in course of time thev will establish themselves permanently a little farther ofl' from the railroad station. But at any rate that point, at Orizaba, is the highest point where I found the Stegomyia mosquito permanently breeding in the country of Mexico. The secretary translated the remarks of Doctor Howard in Spanish. The President. Are there any further remarks on Doctor How- ard's paper? Doctor Lavoreria addressed the convention in Spanish, his remarks being translated into English by the secretary. 5610—06 5 66 SECOND INTERNATIONAL SANITAEY CONVENTION. The Secretary. Doctor Lavoreria says that m Peru they have not yellow fever, and they do not have any form that refers to this disease, and consequently they do not Ivnow much about the Stegomyia fasciata, and they would like to know about what temperature is requisite for the development of the Stegomyia. Doctor Howard. Will jou ask him if it is not known in Callao ? The secretary here addressed the question in Spanish to Doctor Lavoreria. The Secretary. He says that he does not know. He says that they have it on the coast, but that they have not had any yellow fever since 1868. The President. If there is no objection, we will now continue with the articles of the convention. Doctor GuiTERAS. The last article is to be designated 'Hransitorj disposition," if that title is approved. This term is official, and it is used in treaties officially, so that we have adopted it for this last article. This reads as follows: TBANSITORT DISPOSITION. The Governments which may not have signed the present convention are to be admitted to adherence thereto upon demand; notice of this adherence to be given through diplomatic channels to the Government of the United States of America, and by the latter to the other signatory Governments. The above clause was read in Spanish by Doctor Moore. The clause was agreed to. Doctor Guiteras read as follows: Made and signed in the city of Washington on the 14th day of the month of October, nineteen hundred and five, in two copies, in English and Spanish respectively, which shall be deposited in the State Department of the Government of the United States of America, in order that certified copies thereof, in both English and Spanish may be made, to transmit them through diplomatic channels to each one of the signatory countries. Doctor Guiteras. Should we not add here at the end of this that in case of doubt or disagreement the English text should be consid- ered as the standard? The President. Doctor Geddings, do you remember any such wording ? Doctor Geddings. No, sir. Doctor Guiteras. The word has been used in connection with the French language. It was said that in case of disagreement between the two versions the French text should be considered as the standard. Since we have two languages, we must use one or the other, and the committee has agreed to choose the English. Discussion followed. The transitory disposition was again read by Doctor Guiteras in English, and was then read by Doctor Moore in Spanish. The transitory disposition was agreed to. Doctor Moore made some remarks in Spanish upon the wording of the transitory disposition. The Secretary. Doctor Moore proposes that the convention should be signed to-day instead of to-morrow. Doctor Guiteras. Then the date should be the 13th instead of the 14th. SECOND INTERNATIONAL SANITARY CONVENTION. 67 The President. I think that it would be, excellent if we could sign it to-day, but whether we can or not depends on the typewriters. It depends on whether they can complete the typewriting to-day. Doctor Moore here addressed the convention in Spanish. The Secretary. Doctor Moore says that in the committee it was agreed that the convention should be signed to-day, and of course if it is impossible through mechanical difficulties, it can not be done, but he suggests that the date might be left the 13th, although we do not sign it until to-morrow. I am sorry, for Doctor Moore's sake, that this can not be done, because the treaty to be signed is an inter- national convention, and it must be done exactly as it is stated. We can not sign it to-morrow saying that it was signed to-day, because that might invalidate the treaty. You may finish the con- sideration of the document, and agree upon it entirely; but if you can not actually sign it to-day, you can not say in the convention that it is signed to-day. Doctor Moore here made a remark in Spanish. The Secretary. Doctor Moore says that his motion is withdrawn. The President. The objection being withdrawn, if you are ready we will have the question. The question was taken and the transitory disposition was agreed to. The President. It has been suggested that a motion ought to be made to have an editor for the English copy and one for the Spanish copy, to compare these two documents, one in English and one in Spanish, and that the editors should be authorized to make such verbal changes as will make the convention plain, without altering the meaning. Doctor GuiTERAS. So that it would all have to be written over again ? The President. No, not necessarily. Doctor GuiTERAS. I move that a committee of two be appointed to finally revise these two copies, compare them, and make any verbal arrangement that they may deem necessary. The I^resident. Any verbal what ? Doctor GuiTERAS. Verbal change. The President. Without altering the sense? Doctor GuiTERAS. Yes, sir. ' Without altering the sense. The President. You hear the motion. Is there a second? The motion was seconded. The motion was translated into Spanish by Doctor Ulloa. The question was taken and the motion was agreed to. The President. The motion is carried. How shall this commit- tee be appointed? Several Members. By the President. The President. I will appoint Doctor Lavoreria, the delegate from Peru, and Doctor Gatewood, of the United States Navy, respectively, as the Spanish and English editors, members of tms committee. Doctor Gatewood. Mr. President, I would like to say that inas- much as the person to whom I shall be a companion in this matter does not speak English, under the circumstances it would be almost impossible for us to compare the Spanish and English copies, the 6y SECONI) INTERNATIONAL SANITARY CONVENTION. committee consisting of two members, one of whom speaks only English and the other sj^eaks only Spanish. The Secretary. Is not the object really to compare the two copies? It is simply to read them and make some slight changes, without changing the sense of an}^ article. Doctor Gatewood. The motion for the appointment of the com- mittee said ''to compare." It seems to me that there ought to be at least another person on tliis committee who speaks both lan- guages. Would not Doctor Guiteras serve? Doctor Guiteras. Very well, sir, I will change my motion and make it that the committee should be composed of three members. The motion was seconded, and it was agreed to. The President. I will appoint Doctor Guiteras as the tliird mem- ber of that committee. Informal discussion among the members followed. The President. Is there any other business to come before the convention tliis afternoon? Doctor Guiteras. The continuation of the programme is the only business we have now. The President. The provisional programme has been largel^^ gone into in connection with this convention. There is the matter of diagnosis of maritime quarantine, and of land quarantine, and of local measures for the eradication of disease. Then the third and fourth headings are still untouched. They read as follows: 3. The mosquito in its relation to yellow fever and malarial fevers. Prevention of the spread of yellow fever by the destruction and elimination of the mosquito. 4. Discussions on sanitation of cities ■with special reference to the A^entilation of habita- tions and disposal of household wastes. I would suggest that if your committee might be with the type- writers while they are working on the transcription of this conven- tion it might go very much faster. Doctor Guiteras. There are some papers in connection with plague and yellow fever. The end of the programme concerns itself with yellow fever and its transmission by the mosquito. The President. Then we will have those papers. We will pro- ceed with the programme as far as we may. This is merely a provi-^ sional programme, a tentative programme, and we have broken into the order of it pretty extensively. Doctor Medina. I wish to present a resolution before the conven- tion that, as the Republics of San Salvador and Honduras are not represented here, a copy of our convention shall be sent to each one of these Governments, expressing at the same time the pleasure of this convention if they would join with us in making effective the measures prescribed. I explained that to my friend Doctor Ulloa, and also to the representative of Guatemala, and they were in favor of it. Those Republics are not represented, and according to our treaty copies are to be sent only to the countries that have signed, so that they will not receive copies except under some such special provision as this, and I make the motion that copies of the conven- tion be sent to San Salvador and Honduras, and also that this con- vention should express the pleasure that they would have if those two countries w^ould adhere to our convention. The Secretary. I desire to make just a few remarks about the intention of Doctor Medina, as he expressed it to me. Although it SECOND INTKIÍNATIONAL SANITAKY (CONVENTION. 69 does not seem to me necessary that an exception should be made in these cases, nevertheless the intentions of Doctor Medina are very good, as he explained them to me. As these countries are so near to us, and as Ilonduras is on the (iulf of Mexico and Salvador is wedged right in between Guatemala and Nicaragua, if thi)se two countries sliould not follow the regulations agreed upon they might be a great drawback to the carrying out of the measures by the other countries of Central America, as they are all connected by the same lines of steamers; and Doctor Medina said he thought that unless an exception was made with regard to those Republics they might not really have a good understanding of what had been done, and that they might not sign as quickly as is desired by this conven- tion. When he explained it to me in that light I agreed with him. Of course it is for the convention to say whether it deems it proper. Doctor GuiTERAS. I present an amendment to that motion, tnat when the transactions of this convention are published a copy be sent to all the countries of the western continent. I do not under- stand why we should pick out two countries and present to them especially the reports of this convention and not to the other Republics. The President. That is, not the transactions; it is the convention which we adopt. Doctor GuiTERAS. Even at that, I do not see why it should be sent to these two Republics and not to the others. There are nine Republics which are not represented here. Doctor Medina. My idea in mentioning those two only was that they were concerned more than the others, as being right in the middle of Central America, it was especially important that they should have these copies. If the other Republics do not accept it I should be very sorry, but not so much so as in the case of these two Republics, because all our efforts would be in vain unless they did accept. Doctor GuiTERAS. I make the motion that the convention be sent to all the countries of the western continent. I make that motion as an amendment. The motion of Doctor Guiteras was translated by the secretary. Doctor Medina. I accept that amendment. The Secretary. The motion is that a cop}^ of this convention be sent to each of the countries which are not represented at this con- vention. Doctor Gatewood. Are there not other countries concerned besides the Republics of South America? There are the West India islands that might be mterested. The President. This is a convention of the American Republics. Doctor Gatewood. I understand that; but would there be any objection to sending the convention to the other countries? The President. If you wish to make a motion to amend, you may do so. Doctor Gatewood. I do not wish to make a motion if it is alto- gether out of the question. Doctor Medina. I thmk it would be impracticable to send copies to those islands of the West Indies. They belong to foreign countries, to the other Government, and the proper thing would be to send it 70 SECOND INTERNATIONAL SANITARY CONVENTION. just to the American Republics, it seems to me. They are the only- ones interested. The President. The question is on the motion of Doctor Medina, with the amendment of Doctor Guiteras. Doctor Medina. I will change that motion, and say, instead of the two Republics, to all the Republics not represented here, and that we shall say to them that we would see with pleasure their adherence to our convention. The President. Perhaps you had better read it as amended. Doctor Medina. It will read in this way, in English: "Doctor Medina, the representative from Nicaragua, presents a motion, amended by Doctor Guiteras, in the following way. That this con- ference should address officially all the governments not repre- " sented at this convention and send a copy of our convention to them, at the same time letting them know that we would receive with pleasure their adherence to our treaty here, or would join with us." The Secretary. I think it would be better that that motion should go to the advisory council and be presented to-morrow. Doctor Medina. Very well. The President. Is there any other motion to be offered, or is there any paper to be read ? Doctor Guiteras. The plague came first, but if there is no paper to be read on the plague, I will read a paper on yellow fever in Cuba. Doctor Licéaga addressed the convention in Spanish. The Secretary. Doctor Licéaga wants me to explain to the delegates that they need not be afraid about the length of his paper — which has been printed and copies of which you all have in your hands — on the plague, because he is only going to make a few remarks about it, instead of reading the paper. Doctor. Licéaga here addressed the convention in Spanish, extem- pore, upon the subject of the plague. Doctor Lavoreria addressed the convention in Spanish. Doctor Licéaga responded to Doctor Lavoreria. Doctor Guiteras. I would ask that, as unfortunately we have no Spanish stenographer, Doctor Lavoreria be requested to present in writing his remarks to be printed in the transactions. Doctor Licéaga, of course, has his paper printed in both Spanish and English form, but we have nothing left of Doctor Lavoreria's remarks unless he will present them in writing. The President. Will Doctor Lavoreria write out his remarks and send them to the secretary ? Doctor Lavoreria here addressed the convention in Spanish. Doctor Guiteras. I will withdraw my motion. Doctor Lavoreria says that he has presented a report already from his country, and his remarks, or the substance of them, are included in that report. The President. Doctor Moore, have you anything to say on this subject? Doctor Moore addressed the convention in Spanish. The President. Will you write out your remarks and send them in, Doctor Moore? Doctor Moore (speaking in English). I will write them out. The President. Are there any further remarks upon this subject of the plague? If not. Doctor Guiteras has a paper upon yellow fever. SECOND INTERNATIONAL SANITARY CONVENTION. 71 Doctor GuiTERAS. I have here a report on the yellow fever in Cuba since the last meeting. I am sorry that I have had to arrange this report in the shape of an argument in support of the view that yellow fever is transmitted only by mosquitoes. Of course this con- vention has accepted it as a fact, but as there are countries and por- tions of countries in America where this has not been attempted, and where certain of the people are still not prepared to accept it, I have been glad of the opportunity to repeat the arguments in favor of such a view. Doctor Guiteras here read his paper, in English (see Appendix, p. 217). The President. I am sure we are all very much indebted to Doctor Guiteras for that very interesting paper. I consider it a very valuable paper. Are there any remarks upon this subject? Doctor Gatewood. I move that we adjourn. Thereupon, at 6 o'clock p.m., the convention adjourned until to-morrow, Saturday, October 14, 1905, at 10.30 o'clock a. m. FIFTH DAY— SATURDAY, OCTOBER 14. Morning Session. The convention was called to order at 10.30 o'clock a. m. by "the president, Surgeon-General Wyman. The President. The minutes of yesterday will be read by the secretary. The minutes were read by the secretary. .The Secretary. This, of course, is only an abstract of the minutes of the convention. The minutes will be transcribed in fidl, and will be published in full. This is only an outline, to comply with the con- ditions of the convention. It was moved and seconded that the minutes be approved, and the motion was agreed to. The President. The next order of business will be the report of the advisory council on the resolutions of Doctor Medina as they were to be put in shape. Doctor GuiTERAS. In the name of the council, I report that the resolution presented by Doctor Medina is recommended to the asso- ciation, with the understanding that the Bureau of American Repub- lics will send copies of the convention to the governments of all the American Republics. The President. You hear the resolution as presented by the advisory council, to the effect that the convention which we are now preparing regarding quarantine and epidemic diseases shall be trans- mitted through the Bureau of American Republics to all the South American and Central American republics, whether they are repre- sented in this convention or not. Are there any remarks? The resolution was agreed to. The President. Some of the delegates who are very much inter- ested in the matters that are to come up in completing our agreement are not as yet present this morning, and I therefore recognize Doctor Geddings, who has a few brief remarks to make and a resolution to present. Doctor Geddings. Mr. President, it has been bi;ought to the atten- tion of this convention that in the Comptes Rendus, Société de Bio- logic de Paris for, I think, August, 1905, there is a claim by Messrs. Marchoux and Simon of the French Commission of the Pasteur Insti- tute of Paris, whose work in Rio de Janerio has received wide notice, that they have demonstrated that the infected Stegomyia produces infected offspring. Such a claim as this is startling, although a similar announcement was foreshadowed in the daily press of New Orleans as a possible explanation of the occurrence of mild cases in that city. I have had the pleasure of speaking to our esteemed contemporary, Doctor Guiteras, to whom we all look up to in this matter, and if it meets his views, and the views of the convention, I think it would be of decided benefit to us here to beg the privilege of a few remarks from Doctor Guiteras on the point, to elicit his opinion, if he is ready to express one on this doctrine, and begging him to foreshadow in the 72 SECOND INTKHNA^riONAL HANITARY iJONVKNTION. 73 deep thought he has given to these matters the effect upon the integ- rity of the doctrine of mosquito transmission of yellow fever and its possible effect upon public health measures; and J tiierefore beg to move that, if agreeable to J)octor Guiteras and to the c(jnvention, he should address us on these lines. The motion of Doctor Geddings was translated into Spanish by tiie secretary. Doctor Guiteras. I woidd be very glad indeed if anything that I may say will assist in the work that we are all so much interested in. I was avvare of the announcement made by the PVench Commission of the Pasteur Institute of this discovery. In their recent report thev suggest that they have found two new methods of transmission of yel- low fever, to which they l)elieve importance should be attached. These new methods are the infection of the eggs of infected Stego- Tuyias, and the transmission of yellow fever through extremely mild cases in the natives of the yellow-fever countries. I must say that I called attention to these suggestions and announcements of Marchoux and Simon at the meetings of the New Orleans Paris Medical Society during my recent visit in that city. The announcement as to the trans- mission through the eggs of the infected Stegomyia is certainly a matter of grave importance ; but it seems to me that everything points to the probability of an error of judgment, or of facts, in this announcement made by those gentlemen. I have read their original publication, and they themselves admit that they have only a single case — an experi- ment — which was of this character. They raised eggs from infected Stegomyias in the twelfth day of their infection — and this is a very interesting point, and they insist upon that point, that the eggs must be laid when the mother mosquito is actively infected ; that is, is already capable of producing the disease by its bite — that is, on the twelfth day after having bitten a patient infected with yellow fever. Therefore the eggs used in their experiment were gathered, or were laid, on the twelfth day after biting a yellow-fever patient, and then mosquitoes were raised from those eggs, and from several experiments tried they succeeded in producing one single case of yellow fever with the mos- quitoes raised from those eggs. Now, to begin with, this is a single case. Of course in the experiments of this kind one case does not count for much, especially when the experiments were being carried out in an infected locality — in Rio de Janerio — and when the infection might have come about through the bite of an infected mosquito. They themselves admit this, or consent that it weakens very much their point; that they have only one case to present. Furthermore, I have to object to this supposed new method of transmission of yellow fever on other grounds, from experiments made in Habana. I am sorry to say that these experiments are not care- fully recorded experiments that will stand close scientific investiga- tion, but they certainly have some weight, and I hope that Doctor Car- roll, who has the privilege of the ñoor, will state his part of the experi- ments that I am about to mention. I say that we have in Habana experiments performed which contradicted this statement of Mar- choux. My experiments at Las Animas contradicted this new view in this wise. As a matter of fact, all the mosquitoes that we have used in our experimental station in Habana from the beginning, all of them, proceeded from infected mosquitoes — that is, we started with a cer- tain number of mosquitoes that we fed upon yellow-fever patients, and 74 SECOND INTERNATIONAL SANITAEY CONVENTION. we infected them, and those mosquitoes kept laying eggs, and in that way we kept up our breed of mosquitoes at Las Animas Hospital. Now, these mosquitoes were always fed by nonimmunes. There were two of them that were constantly putting their arms into the jar con- taining these mosquitoes, so that they would be fed, and would lay eggs. So that we were constantly making the experiment without taking speci-al note of the experiment. But on two occasions I remem- ber calling the attention of several gentlemen to this and saying, "There is a mosquito raised from infected mosquitoes, fed by nonim- munes, raised from eggs laid by infected females, and yet they are not going to contract the disease." Therefore it is not transmitted in the case of Stegomyia as it is in the case of Texas fever with the tick. I called the attention several times of visitors and friends to this, although we did not take any note of it. I believe the same thing will be stated to you by Doctor Carroll. I believe they did the same thing; that they saw several times nonimmunes being bitten by mos- quitoes raised from the eggs of infected mosquitoes — such mosquitoes' as are mentioned by Marchoux and Simon. And finally it seems to me that if this were true — that the infection of yellow fever could be transmitted from the mother mosquito to the eggs — that it would have been absolutely impossible to cause the disappearance of yellow fever from Habana, as we have done. I would certainly give up all hope of eradicating yellow fever from the earth, which I now entertain in a lively manner, if that were possible. It seems to me impossible to combat the disease if you have such an active way of propagation of the disease, which lies entirely beyond your control, as the innumerable eggs that misquotoes lay during their lives — eggs that should all, according to this view, be capable of pro- ducing infected mosquitoes. There is another point that is implied in this statement of Mar- choux — at least I think it is implied — as to the yellow fever transmit- ted in this manner, that is transmitted by mosquitoes raised from supposed infected eggs, and that is that the yellow fever so transmit- ted IS a mild type of the disease. Now, it seems to me this is a funda- mental error. If the yellow fever transmitted in that manner would be a mild form of the disease, I think yellow fever would have died out over the earth long ago of itself. There would have been a proc- ess of natural vaccination of the disease; because I believe all of you will admit that the cases produced from such eggs ought to be much more numerous than those produced directly from the infected mothers, because a mother can only produce in her life of 150 days, biting every three days, 50 cases of yellow fever, whereas that mos- quito will lay 400 or 500 eggs — perhaps several hundred eggs — from which several hundred mosquitoes would arise, which would all of them produce mild vaccinating cases of yellow fever, so that we would have the mother mosquito producing only 50 cases and we would have this constant process of vaccination with mild cases going on tln-ough the human race, and the disease would have died out through vaccination in nature. These are the objections that I raise against the statement made by Marchoux and Simon. Doctor Guiteras here repeated his remarks in Spanish. The President. We would like to hear from Doctor Carroll, of the United States Army. SECOND INTERNATIONAL SANITARY CONVENTION. 75 Doctor Carroll. I agree most heartily with what Doctor Guiteras has said on this subject. I do not think it is safe to accept the state- ment of these gentlemen upon one unconfirmed experiment, because we can bring forward an experiment made for the purpose of deter- mining that very point. Alter we had about completed our work in one ot these places we placed a number of mosquitoes, hatched out from the eggs laid by infected insects, in a jar, and we had a nonim- mune place his hand in this jar, and he was bitten by 30 or 40 insects. We did not expect any result, and no result followed. Our insects were not obtained in quite the way Doctor Guiteras has indicated. Our stock was obtained from insects obtained on the outside. Our first stock was obtained from those insects which we ^ot from Doctor Finlay . Our second stock was largely obtained from insects at Santa Clara Barracks. Doctor Guiteras, And it is quite possible that among those there ought to have been infected mosquitoes'? Doctor Carroll. Yes; I am willing to admit that. Doctor Guiteras. It is probable. Doctor Carroll. These insects were hatched out and raised in the post laboratory, and it was only afterwards that they were taken to the special laboratory where our infected mosquitoes were kept, and, once infected, their progeny were kept in the mosquito house; that is, the house kept specially for the infected mosquitoes. I think this experiment to which Doctor Guiteras refers is like many others in the scientific world. We can not accept them until we receive confirmation. It is evident that the fullest precautions were not taken, and it is unsafe to accept them. And then, as Doctor Guiteras says, if we were to accept the possi- bility of infection of the progeny of infected mosquitoes it is quite evi- dent that the disinfection of infected dwellings will not stamp out the disease as fully as it was stamped out in Habana. I think Doctor Liceaga might give us some interesting remarks on that question, resulting from his experience in Mexico. Doctor Guiteras. I will try to put briefly in Spanish the substance of this, as this is a question in which some of our Latin American col- leagues may assist us with their opinions. Doctor Guiteras here translated into Spanish the preceding remarks of himself and Doctor Carroll. Doctor Liceaga addressed the convention in Spanish. The Secretary. The remarks of Doctor Liceaga are to the effect that he congratulates Doctor Guiteras for the excellent explanation that he has given of the subject in question, w^hich he considers not only as a contradiction of the information given by Marchoux and Simon, of the commission to Brazil, but he goes a little further and says that it should not only be called a contradiction, but that the expres- sions of Doctor Guiteras have really given the lie to these gentlemen for having affirmed something based only on one case. He put the question as to the effect, and on that he says that to his knowledge there is no acute disease whose infection is transmitted by the off- spring or b}^ the eggs of insects. He confirms the opinion of Doctor Guiteras that if the opinion of Doctors Simon and Marchoux were true the disappearance of yellow fever from Habana in such an effect- ive manner as it took place would have been utterly impossible. He says that the experiments and the opinions of Doctors Guiteras and 76 SECOND INTERNATIONAL SANITARY CONVENTION. Carroll are enough, in his estimation, to convince us of the fallacy of the opinion manifested by the doctors of the Brazil commission. He insisted upon this other ])oint. He says that one argument that might be used against this opinion is the admission of Doctors Marchoux and Simon to the eft'ect that they consider their point rather weak because they only had one case out of their experiments, and besides, that they could not say to a certainty that the mosquito infected had conveyed the disease; that, as Doctor Guiteras said, the experiment was conducted in a place infected with yellow fever, where the biting b}^ a mosquito infected was an easy matter. Doctor Licéaga finished by remarking that this weak point in the announcement of Doctor Marchoux and Doctor Simon was in very plain contradiction to the points assured by the work of Doctor Car- roll, Doctor Guiteras, Doctor Reed, and all the other gentlemen who experimented in Habana, and who, while at the beginning the}" could not .state the facts with certainty, yet through experiments, thorough and long continued, and resulting in the prevention of yellow fever, had established their opinions as a certainty. The President. We have with us the head of the medical depart- ment of the Marine-Hospital Service, and I would like to ask his opin- ion on this. Doctor Stiles. I agree thoroughly with Doctor Guiteras and Doctor Carroll that there is no reason why we should become fright- ened at this announcement in Paris. But, in justice to our French colleagues, w^e should recall one very important statement in their article, namely, that such a method of transmission is exceptional. That is their claim. They do not set this forth as being a regular method of transmission, but they merely say that such a method of transmission is exceptional, and in tliis claim I see nothing contra- dictory to the statements brought forward by our good friends. Doctor Carroll and Doctor Guiteras. It is perfectly possible that they may have made fifty or one hundred experiments in Cuba of tliis kind, and have had them all negative, but that is negative evidence. Now, we must bear in mind the fact that we have had at least half a dozen diseases which may be transmitted from one generation to the next through insects. I am by no means of the opinion that we should immediately accept these statements that have just reached us from Paris, but I believe we should hold our minds open for further proof. It is a little dangerous to condemn a statement offhand like this. Take, for instance, malaria. It, is now, according to Schau- dinn, demonstrated that malaria may be transmitted from one gen- eration of mosquitoes to another. Pehrin disease is hereditary in the silkworm. We have the fiagellat diseases in flies so transmitted. We have two diseases in an owl of Germany which, it is claimed, may be hereditary in the intermediate host, namely, Culex. Now, until we know just what the parasite of yellow fever is, it seems to me difli- cult to make any definite statement that this can not be hereditary in the mosquito. It seems to me not improbable that the parasite of yellow fever will turn out eventually to be an organism more or less closely allied to the parasites of the same general class of diseases as those that I have mentioned, namely, an organism belonging some- where in between the flagellats and the sporozoa. I might also refer to Texas fever in cattle and hemoglobinuria in dogs — the canine plasmosis — in way of comparison. SECOND IN'I'KRNATIONAi. SANI'J'AKY (JON VKNTION. 77 In view of the fact that we know a number of diseases are trans- mitted by heredity in the intermediate host, I bcHeve it is too early to come down too heavily on this French announcement. We should simply hold our minds ojxui, in a receptive mood, and if our col- leagues can demonstrate h(>rodity in this disease, as has been dismon- strated in other diseases, let us do thcjn the justice to recall tiiat they do not state that this is a common method of transmission. They state it distinctly to bo an exce])tional method. The remarks of Doctor vStiles were translated into Sj)anis]) by the secretary. The Secretary. Several of the members inquire. Doctor Stiles, if you said that malaria belonged to the diseases transmissible by heredity in the intermediate host. Doctor Stiles. Yoís; the parasite of malaria is claimed by Schau- dinn to be transmissible from the female mosquito to the next gener- ation. That was published in 1894 by the Imperial Health Office of Germany. The parasite has been found passing from one generation to the next. There were no clinical cases based on such heredity, but the parasite was found passing through the egg. The President. Doctor Guiteras has an important matter to bring before the convention. Doctor Guiteras. Mr. Chairman, I wish to introduce a series of articles, to be added to the convention already agreed upon at our last meeting, which articles should be numbered 28a, 28b, 28c, and 28d, so as not to break the order of the numbers as they are found in the French edition and in order that they may not be placed at tlie end, ^s I had at first thought of doing, where they will appear very awk- wardly. I would place them in the midst of the articles where they properly belong, following article 28, and call them ''28a," ''28b," " 28c," and " 28d." There are four of these articles. The Secretary. You had better call them additional articles. That is the only way to do it. Discussion in Spanish followed. Doctor Guiteras. I move that the following additional articles be introduced, following the last article agreed upon at our previous meeting. The last article was numbered 45, so tha,t these four articles will be numbered 46. The President. They are headed "Additional articles relating to yellow fever? " Doctor Guiteras. They are headed that way- — "Additional articles relating to yellow fever." The President. I will ask Doctor Moore to take the Spanish copy of these additional articles, as he did with the first part of the conven- tion, and read them in Spanish as we proceed. Doctor Guiteras read as follows: Article 46. Ships infected with yellow fever are to be subjected to the following regulations : 1. Medical visit (inspection). 2. The sick are to be immediately disembarked, protected by netting against the access of mosquitoes, and transferred to ühe place of isolation in an ambulance or a litter similarly screened. The above part of article 46 was read in Spanish by Doctor Moore. The President. Shall we vote on this by paragraphs, or shall we have the whole article read all through? Al short discussion followed. 78 SECOND INTERNATIONAL SANITABY CONVENTION. The President. We will read this article through, paragraph b paragraph, and anyone who has any question to ask will please as it at the time, or it anj^one has any objection to make or anj'^ motion to make, after it has been read in English and Spanish, let him make it, or if there are any comments to be made they can be made. We will go on and read every paragraph until we have finished the article, and then we will vote on the article. The remarks of the president were translated into Spanish by Doctor Ulloa. Doctor Guiteras continued the reading of the article, 46 as follows: 3. Other persons should also be disembarked, if possible, and subjected to an observation of six days, dating from the day of arrival. The above was read in Spanish by Doctor Moore. The President. It should be borne in mind now that if there is any alteration in phraseology, either in the Spanish or the English language, attention should be called to it at the present time, other- wise the copies as read will go to the transcribers. The secretary translated the remarks of the president into Spanish; Doctor Guiteras continued the reading of article 46, as follows: 4. In the place set apart for observation there shall be screened apartments or cages where anyone presenting an elevation of temperature above 37.6° C. shall be screened until he may be carried in the manner indicated above to the place of isolation. 5. The ship shall be moored at least 600 feet from the inhabited shore. Doctor Barnet addressed the convention in Spanish. Doctor Guiteras. Doctor Barnet suggested that in the Spanish copy we state 200 meters, as the metric system is used in Latin countries, and 200 meters is the equivalent of 600 feet. Doctor Geddings. I would suggest making it 200 meters in both languages, because 600 feet is not the exact equivalent, though it is approximately so, of 200 meters. Doctor Guiteras. It is not any less Doctor Geddings. No, sir; it is rather more. The President. We wiU substitute ^'200 meters" for "600 feet," then. Doctor Guiteras. Then it will read: 5. The ship shall be moored at least 200 meters from the inhabited shore. Doctor Guiteras continued the reading of article 46, as follows: 6. The ship shall be fumigated for the destruction of mosquitoes before the discharge of cargo, if possible. If a fumigation be not possible before the discharge of the cargo, the health authorities shall order, either — (a) The employment of immune persons for discharging the cargo, or (b) If nonimmunes be employed they shall be kept under observation during the dis- charging of cargo and for six days, to date from the last day of exposure on board. The President. We will now vote on article 46 as a whole. This is to be article 46, in lieu of the closing formal article of the conven- tion as we had it yesterday, and the closing article will have to be changed to another number. Article 46 was agreed to. - Doctor Guiteras read article 47, as foUows: Article 47. Ships suspected of yellow fever are to be subjected to the measures which are indicated in Nos. 1, 3, and 5 of the preceding article; and if not fumigated the cargo shaU be discharged as directed under subparagraph (a) or (b) of the same article. SECOND INTERNATIONAL HANITAKY CONVENTION. 79 The above was read by Doctor Moore in S¡)ani.sh. Doctor Barnett addressed the convention in Spanish, his remarks not being translated. Article 47 was agreed to. Doctor Guiteras read article 48, as follows : Article 48. Ships immune from yellow fever, cominji from an infected port, after the medical visit (inspection), shall bo admitted to free pratique, provided the duration of the trip has exceeded six days. If the trip be shorter, the ship shall be considered as suspected until the completion of a period of six days, dating from the day of departure. If a casa of yellow fever develop during the period of observation, the ship shall be considered as infected. . The President. In the first line of this article, as I have it before me here, the term ''indemne" is .used instead of ''immune." Doctor Guiteras. I have it "indemne" in my copy. The President. You read it "immune." Doctor Guiteras. Certainly we would call a ship "indemne" that came from an infected port and had nothing to do with yellow fever, would we not? We would not call a ship coming from the St. Law- rence River, for instance, from the north, a suspected vessel. That Would be an indemne vessel, coming from an uninfected port. Doctor Geddings. It is the ship coming from an infected port, not having had cases at the port of departure, or en route, which is meant here. Doctor Guiteras. What do we call a ship that is entirely free ? It is not in the convention, anyway. The President. It is just a ship. [Laughter.] Doctor Guiteras here again read article 48, as above, changing the word "immune" to "indemne." Article 48 was read in Spanish by Doctor Moore. Article 48 was agreed to. Doctor Guiteras read article 49, as follows : Article 49. All persons who can prove their immunity to yellow fever to the satisfac- tion of the health authorities shall be permitted to land at once. Article 49 was read in Spanish by Doctor Moore. Article 49 was agreed to. The President. The typewritten copies of the agreement which we have just voted upon, article by article, are now ready. I will ask Doctor Gatewood to read the copy in the English language and Doctor Lavoreria to read the copy in Spanish, article by article, the idea being that if there is any technical flaw in either copy, or if there is anything obscure in the phraseology, or anything ungram- matical in the language, attention should be called to it immediately, and let it be corrected on the floor of the convention, because this will be the final copy which will be signed by us. In this way it is obvious that the greatest care will have been exercised that the unaltered copies in Spanish and English are actually signed by the members of this convention. The work of typewTiting the copies is nearly completed, and we can commence with the first pages of the copies in both Spanish and English, and the last pages will be finished so that we will not be delayed. The remarks of the president were translated into Spanish by the secretary. The preamble was here read in English by Doctor Gatewood. 80 SECOND INTERNATIONAL SANITARY CONVENTION. Dr. H. L. E. Johnson having been designated in the preamble of the convention as "a member of the American Medical Association," Doctor Johnson requested that this might be changed to '' a member of the Board of Directors of the American Medical Association." The above alteration was agreed to. The reading of the final draft of the convention was continued by Doctor Gatewood in English and Doctor Lavoreria in Spanish until 1.20 p. m., when the convention took a recess until 2.30 o'clock p. m. Afternoon Session, The convention met, pursuant to adjournment, Surgeon-General Wyman, the president, in the chair. The President. The convention will come to order and we will continue with the reading of the articles. We are now on article 8. The reading of t]p.e convention in English and Spanish was con- tinued. The President. There is an inquiry with regard to the "Inter- national Sanitary Councils," mentioned in article 10. This conven- tion has an international sanitary bureau, but whether that term ''councils" is intended to be more broad and to relate to any othef councils, or rather to the several national councils, I do not know. Doctor Geddings. The International Sanitary Councils mentioned in that convention are the International Sanitary Council of Con- stantinople, and the Quarantine and Sanitary Council of Egypt. The President. Then it includes also our International Sanitary Bureau ? Doctor Guiteras. Yes, sir. Doctor Geddings. We left it in advisedly, believing that these notifications should be made in this way to the Central and South American Republics, and to the United States, and the International . Sanitary Bureau. The President. We are not dealing with the foreign countries. Doctor Geddings, is that your understanding? Doctor Geddings. That was my understanding — that it was simply left in order not to change the text, but the International Sanitary Bureau of this convention was included within the meaning of that paragraph. The President. There is nowhere else, in this convention, so far as it has been read, where reference is made to "International Sani- tary Councils" other than those of the American Republics. Doctor Geddings. That is correct. The President. Then why should we bring it in here? It is a little confusing. I do not know how that appeals to the other mem- bers of the convention, but I think it is a point that ought to be considered — whether we shall change it to " International Sanitary Bureau" or not. Doctor Geddings. I move that we change it in that way. The motion was seconded. The President. It is moved and seconded that the words "Inter- national Sanitary Bureau," meaning the bureau established by this convention, be substituted for the words " International Sanitary Councils." The question was taken, and the motion was agreed to. SECOND INTERNATIONAL SANITARY (JONV KNTION. 81 The reading of the convention, article })y article, in French and Spanish, was continued down to the end of article 21, when Doctor Licéaga addressed the convention in Spanish, his remarks heing translated by Doctor Ulloa. Doctor Liceaga said that it having been determined in the former session that a distance of 200 meters should be inserted, the last part of article 20, whicli leaves it to the sanitary authorities to fix the distance that a ship sliould be com- pelled to anchor from the shore, should })e clianged. Doctor Medina. It was placed at the minimum, so that any larger distance could be settled by the authorities. Discussion in Spanish between Doctor Liceaga, Doctor Medina, and Doctor Moore followed. The Secretary. It says ''at least 200 meters." Doctor Liceaga is satisfied with that. Doctor Gatewood. In this footnote, in regard to the word "crew," is that provision in the Spanish copy to the effect that the word is to be construed ^n the manner defined in this note wherever it occurs in the present convention? The Secretary. Yes; it is in the Spanish copy. That is all right. The reading of the convention in English and Spanish was con- tinued down to the end of article 33. The President. There is one point I want cleared up — about a ship not being subject to a second disinfection? I would like to know whether that interferes with our disinfection of what we call ''via" vessels? Does that section relate to all diseases, or only to some ? Article 33 was again fead by Doctor Gatewood in English. The President. Would not that prevent the redisinfection of a vessel in a southern port? Discussions in English and Spanish followed. The President. Very well; go on. Doctor Gatewood here read article 34 in English. A Delegate. I would like to ask what is the definition of the word "packet." The President. That is a term taken from the Paris convention. Was that discussed there? Doctor Geddings can tell us. Doctor Geddings. For example, those boats which ply between ports of British America and northern ports of the United States, which we exempt by our regulations from ineasures relative to bills of health, are packet boats. There are packet boats which ply across the lakes. Doctor Gatewood. And packet boats across the English Channel, from Calais to Dover. If you will look in the dictionary you will find some such definition as this: "Packet boat. Originally, a vessel employed by government to carry dispatches or mails, and therefore having a military or naval signification; hence, applied to any boats carrying materials that have a regular day of sailing." The trans- Atlantic liners would come under that. Doctor Ulloa. Here is the definition in Webster's Dictionary: Packet. Originally, a vessel employed by government to convey dispatches and mails; hence, a vessel employed in carrying mails, passengers, and goods; a mail boat. 5610—06 6 82 SECOND INTERNATIONAL SANITARY CONVENTION. Doctor Gatewood. There you have it. The President. Is there any harm in leaving it in there, with that understanding? Doctor Gatewood. Packets are mail boats. The President. That is evidently intended to apply to ports not distant from one another. Doctor Gatewood. My idea is that a packet is a boat that makes one or two trips a day, and therefore runs within a small radius of the place of departure. But a ferryboat, not carrying mails and not carrying dispatches, would not come under that definition. The Secretary. We call them " barcos de cabotaje " in Spanish. They make communication between different ports of the same country. Doctor Gatewood. If it is between different ports of the same countr}^, why do you put this in here: "Packet boats shall be sub- jected to special regulations, to be established by mutual agreement between the countries in interest?" • The Secretary. That is so. The President. It seems to me you might leave it as it is. Doctor Gatewood here read article 35 in English. Doctor Lavoreria here read article 35 in Spanish. A discussion in Spanish followed between Doctor Moore and Doctor Guiteras, which was not translated into English. The reading of the convention in Spanish and English was con- tinued down to the end of article 41. Doctor Gatewood read in English as follows : Article 42. Coaches intended for the transportation of passengers and mails should not be retained at frontiers. The President. That word "retained " was changed to " detained," was it not? Doctor Geddings. No, no; it was left ''retained," after a discus- sion. We decided to leave it in that way. The reading of the convention in English and Spanish was con- tinued down to the end of article 48. Doctor Geddings. In regard to the second paragraph of article 48, the section before us states: Ships indemne from yellow fever, coming from an infected port, after the medical visit (inspection), shall be admitted to free pratique, provided the duration of the trip has exceeded six days. The quarantine regulations of the United States cover the same idea, but go further, that if the duration of a trip exceeds five days, and i& less than ten days, the same procedure would obtain; but if the voyage is more than ten dsLjs the sliip shall be disinfected and held under observation. That rule of conduct is based upon the fact that if a mild case of yellow fever occurs on board, it may have sufficiently recovered to permit the individual to pass a satisfactory medical inspection, but the case may have infected Stegomyia mosquitoes which are on board and give rise to further trouble. It was suggested when this article was in course of consideration this morning that some such provision should be put in, but there appeared to be reasons why it should not be done, and without any wish to make a reserve on the part of the United States, I think it is only fair to state that in cases coming under that category the United SECOND INTERNATIONAL SANITARY CONVENTION. 88 States will have to fall back upon or take refuge in a general pro- vision of the convention allowing sjiecial regulations to be made to meet special circumstances, in the discretion of the sanitary authorities. Doctor Gate WOOD. Can you do that when that is a specific state- ment there? Doctor GuiTERAS. With respect to the fact of the necessity of disinfection in these cases, it must be remembered that the action taken by the United States evidently does not refer to what we have defined here as "indemne ships," in connection with yellow fever. We have made a special definition of indemne ships in connection with yellow fever, in which definition it is stated that the shin has not been in such proximity to the shore as to make it possible for mosquitoes to have access to the said ship. Therefore there can be no mosquitoes in an indemne ship such as we have defined. The ships that are treated on the tenth or twelfth day by the United States authorities, very properly — I mean by fumigation — -are not the indemne ships that we have defined here. There are ships that may have infected mosquitoes. But these can not have them, because it says definitely that they must have anchored a sufficient distance from the shore not to have received infected mosquitoes. So that I do not see that the United States need change in the least its present policy in respect to such ships. The President. Is that satisfactory. Doctor Geddings ? Doctor Geddings. With that explanation the paragraph mil be perfectly satisfactory. Doctor GuiTERAS. This explanation goes on record, I suppose. The President. It goes on the record. The stenographer is taking everything in full. All that has been said goes in the minutes. The reading of the convention article by article in English and Spanish was resumed by Doctor Gatewood and Doctor Lavoreria and was completed to the end of the "transitory disposition." Discussion in Spanish between Doctor Barnet and Doctor Lavo- reria followed. The Secretary. Doctor Lavoreria has made a motion that instead of sa5ring there that a copy should be sent to each country repre- sented, it should be put that copies in both English and Spanish should be sent to each of the signatory countries to this convention. Doctor Barnet (speaking in English). Because the English is the the standard one. The President. Yes; that is right. Discussion in Spanish followed. Doctor GuiTERAS. Doctor Licéaga has made a motion which I will translate into English. Doctor Licéaga moved that instead of saying that the English copy may or shall serve as the base or — what is it ? Doctor Geddings. The standard. Doctor GuiTERAS. Yes; the standard; that we say that in case of doubt the English mterpretation shall stand, or be the standard. The Secretary. No, no; that the English copj^ shall prevail — that the interpretation of the English copy shall prevail. Doctor GuiTERAS. Yes; that the interpretation of the English copy shall prevail. 84 SECOND INTERNATIONAL SANITARY CONVENTION. Doctor Gatewood. Then it will read: Artici^e 50. It is agreed that in the event of a diü'erence of interpretation of the Enghsh and Spanish text the interpretation of the Enghsh text ^\■ill prevail. Doctor GuiTERAS. That is right. The President. If there is no objection, that change will be made. Then I think the words ''in both English and Spanish" should be inserted in the last clause of the transitory disposition, so that it will read — in order that certified copies thereof, in both Enghsh and Spanish, may be made to transmit them through diplomatic channels to each one of the signatory couuti'ies. Is that agreed? The President. That is agreed to. There was no objection and there is none. I believe that the convention as now prepared, in both the Spanish and the English languages, has been read and approved, article by article. It now becomes necessary to adopt the convention in its entirety. I await a motion to that effect. Doctor Johnson. I move you, Mr. President, that the convention as read and adopted, article b}^ article, m English and Spanish be adopted by the convention in its entirety. Doctor GuiTERAS. I second the motion. The secretary translated the motion in Spanish. The convention was agreed to in its entirety. The President. It is adopted. [Great applause.l Doctor Medina addressed the convention in Spanish. The Secretary. Doctor Medina makes a motion to the effect that this convention shall be published and copies thereof sent to the different delegates. I have the pleasure to inform Doctor Medina that its publication has already been decided and that we are going to have copies ready for the delegates as soon as it can be done, and as the majority of the delegates are going to New York they may call at my office or send to my address and I will remit them as many copies as they like — about ten each, if they desire it. The President. Does Mr. Fox wish the privilege of the floor? Mr. Fox. Mr. Chairman, I think as the Bureau of the American Republics exists for the purpose of carrying out the wishes of the convention of the American Republics, we would much rather be the medium of transmitting these copies and also seeing that they are printed and arranged. The Secretary. Of course they shall print the copies. My sug- gestion was meant simply for the convenience of the delegates. Doctor Licéaga addressed the convention in Spanish. The Secretary. Doctor Licéaga says that the object is not to procure the official copies. Official copies will be sent by the Bureau of the American Republics. I have no desire to interfere with the Bvireau of the American Republics; but my idea was simply to accommodate the different representatives, so that they might formulate their reports to the different countries. Mr. Fox. I assure you that the Bureau will take it up immediately and have them printed. The Secretary. This is simply to accommodate the delegates, because they are going away very soon and they wish to formulate their reports to their respective governments. SECOND INTERNATIONAL HANITARY CONVKNTION. 85 Mr. Fox. I understand, then. The President. There are now some resolutions whieh have been reported to the advisory council, and Doctor Moore will read thism. The resolutions in question were read in vSpanish by Doct()r Moore. The resolutions were then read in English by Doctor Guiteras, as follows : Whereas tlie Republic of Mexico and the Panama Canal Zone, by tlie a])plicati()n of the mosquito doctrine to public sanitation, are nearing rapidly the dcsidcratuni of the final extinction of yellow fever; and Whereas tlie Republic of Cuba, by the application of the same methods, has continued to maintain its territory free from yellow fevei- ; and Whereas as through lack of preparation to apply these methods the spread of yellow fever has been permitted in certain countries; and Whereas in the city of New Orleans an epidemic which had been unfortunately allowed by the State authorities to take a firm foothold lias been held in check, and has been gradu- ally reduced by the application of the said methods in the midst of the largest nonimmune population that was ever exposed to yellow fever: Therefore be it Resolved, That this convention sees in these results a liirthor confirmation of the view that yellow fever is naturally transmitted only by the bite of infected mosquitoes. 2. That the convention is of opinion that an efficient plan of defense against the propaga- tion of yellow fever at the beginning of an epidemic can be easily established upon the basis of this doctrine. 3. That the successful carrying out of such plan depends upon a thorough understanding of 'the mosquito doctrine by the people, and upon the support that they may give to the prompt and frank reporting and the proper handling of the first cases, and of all suspicious cases. 4. That the convention expresses its censure of the sanitary authorities that do not report in due time the presence of yellow fever in their territory. 5. That the congratulations of the convention be extended to the Republics of Mexico and Cuba and to the Canal Zone of Panama for the success attained, and also to the Public Health and Marine-Hospital Service for the brilliant work done in New Orleans; and be it further 6. Resolved, That in the opinion of this convention all maritime quarantine and the man- agement of all epidemics that threaten to extend to, neighboring States and countries should be placed in the hands of the national health authorities. The President. This is reported favorably by the advisor}^ council. Dr. H. L. E. Johnson. I move the adoption of the resolution that has been read, as reported. Discussion in Spanish followed, participated in b}^ Doctor Lavor- eria, Doctor Moore, Doctor Guiteras, Doctor Medina, and Doctor Ulloa. Doctor Guiteras. Mr. Chairman, the gentleman who has been addressing the convention in Spanish is in favor of softening the expressions made use of in this resolution respecting New Orleans. It is stated in the resolution : Whereas in the city of New Orleans an epidemic which has been unfortunately allowed by the State authorities to take a firm foothold, etc. He believes that that should not be made so harsh. I claim that this is no direct accusation and it has no effect of censure passed spe- cifically against the city of New Orleans, but it is simply the statement of a fact, that the authorities in New Orleans allowed this epidemic to spread as it has spread. And anyone who has traveled through that southern country, who has seen all those towns in the State of Louisiana, who has seen the towns in the State of Florida infected by yellow fever because the people went into the city of New Orleans on excursions to enjoy life there and came back with the infection of yellow fever, certainly will not feel like softening this declaration in any way. 86 SECOND INTERNATIONAL SANITARY CONVENTION. The Secretary. The point raised is a veiy dehcate one, reall}^. Several of us who are delegates to tliis convention have offices of a diplomatic nature in tliis countiy, and we must be careful in emit- ting any opinion that might be construed as censuring the authori- ties of any part of the country where we represent our countries. Although from a scientific point of view I am entirely in accordance with Doctor Guiteras, I should like, as the delegate from Costa Rica, to try to put this as mildly as possible, because New Orleans is a part of the United States. Although the point is covered by the congratulations extended to the Marine-Hospital Service, which really in tliis matter represents the National Government, still the authorities of New Orleans might take note of these resolutions and consider that tliis was a reflection on them. I should like to con- sider this a little more and see if we can not resolve something that would put us in a good light. I would suggest the following amend- ment. It reads here — r ■ '^^ Wliei'eas in the city of New Orleans an epidemic, which had been unfortunately allowed by the State authorities to take a firm foothold. I should strike out the words "allowed by the State authorities," and would propose the following wording: Whereas in the city of New Orleans an epidemic unfortunately took a firm foothold, etc. In that way we cover the same ground without mjuring anybody. Doctor GuiTERAS. You will have to word it in this way, "which unfortunately took a foothold?" The Secretary. Yes. The secretary here translated into Spanish the preceding remarks in English. The President. I believe the motion to amend has been made plain in Spanish and English? The Secretary. Yes, sir. The President. The convention is oi^en to remarks upon that resolution. Doctor Barnet addressed the convention in Spanish. Doctor Lavoreria addressed the convention iii Spanish. The Secretary. Doctor Barnet adds a strengthening argument to the proposition of the committee, mentioning the fact that on account of bubonic plague in San Francisco the local authorities of San Fran- cisco were very strongly censured by the meeting held at New Haven, Conn., and that the censure there was a great deal stronger than that proposed here to-daj^. Doctor Lavoreria has answered Doctor Barnet in a manner which I take as mj own also, and I will try to convey to you his idea fully, because it conveys my own also. It is true that the censure was a very strong one at that Connecti- cut conference, but we must also remember that that conference was held in the United States and by physicians of the United States. That is so, is it not? The President. Yes; that is true. The Secretary. And it was not an official conference. Here it is different. We come here representing foreign countries — different countries — and we do not want to reflect on the United States in any way. We have to treat with the United States, and we want to treat with them as courteously as possible. SECOND INTERNATIONAL HANITAKY CONVENTION. 87 Doctor Gatewood. I move an amendment to the amendment offered by the representative from Costa Rica, tliat the wording be put in this way: • Whereas in the city of New Orleans an epidemic, which obtained a footliohl under local authority, has been liekl in check, etc. The Secretary. I am sorry not to agree to accept the amend- ment. I should hke to put my amendment as I proposed it before the convention. The majority will decide this question, and of course it may not adopt my amendment; but I will say that I will not vote in any other way. Doctor Gatewood. The way I have put it it will simply say that an epidemic existed there under local authority. The President. How does Doctor Ulloa's motion read ? Doctor Gatewood. He leaves out the word ''unfortunately" only. Doctor Ulloa. This is the amendment as I propose it: Whereas in the city of New Orleans an epidemic unfortunately took a fmn footholdj etc. That is the amendment that I propose. The President. Doctor Ulloa's amendment has not been seconded, I believe. Dr. H. L. E. Johnson. I will second the motion of Doctor Ulloa. I see the propriety of it. The President. Doctor Ulloa's motion has now been seconded. Doctor Gatewood has suggested an amendment to that amend- ment, and Doctor Gatewood' s amendment has not been accepted by Doctor Ulloa. Doctor Gatewood. My amendment is simply to strike out the word "unfortunately" and to say "obtained a foothold in New Orleans." I will leave that out then. The President. Then the motion before the house is on the adop- tion of the amendment of Doctor Ulloa. Doctor Ulloa translated the precedmg discussion into Spanish. Doctor Ulloa. Doctor Moore now has the idea, and has put it into the Spanish version. Doctor Moore here read the part of the resolutions in question, with Doctor Ulloa's amendment in Spanish. Doctor Ulloa. That is right. Doctor Ulloa's amendment was agreed to. The President. The question is now on the adoption of the reso- lutions, on motion of Doctor Johnson, seconded by Doctor Medina, I believe. The remarks of the president were translated into Spanish by the secretary. The resolutions were adopted. Doctor Moore addressed the convention in Spanish. Doctor Guiteras. Doctor Moore, the president of the advisory council, asks me to translate a resolution presented by the council which is to the effect that the thanks of the convention be extended to Doctor Ulloa for his uniform courtesy and his assistance to the delegates, both on the floor of the convention and during the visit to the President of the United States. The President. You have heard the motion. As president of the convention, I add my testimony as to the kindness and unfailing ho SECOND INTERNATIONAL SANITARY CONVENTION. courtesy and accuracy of Doctor Ulloa's services, and I would sug- gest that those who are in favor of this resolution will signify it by rising.» The members of the convention unanimously arose. [Applause.] The Secretary. Gentlemen, I thank j^ou from the bottom of my heart for this great honor jo\i have conferred upon me. I have tried my best to .comply with the duties that j^ou put upon my shoul- ders when you elected me your secretar}-. I do not care how much I work, and I reall}" do not care if I really had had to work five times as much as I have, when I experience the great satisfaction that you have given me to-day. That is the best price for all my work, and nothing would pay me more than to see you satisfied witli the little I have done. ^ I have the honor to submit to the consideration of my esteemed colleagues of this sanitary convention the following resolutions: Resolved, That a vote of thanks be extended by the International Sanitary^ Convention of the American Kepublics to His Excellencj' Theodore Koosevelt, the President of the United States of America, for his valued cooperation to the success of this conference and for the high meaning of the expressions of the cordial address with which he greeted the delegates to this convention at the reception he accorded to them at the White House on the 12th instant. Resolved, That a vote of thanks be extended to the honorable the Secretary of State, and to the honorable the Acting Secretary of the Treasury, for their addresses of welcome at the inauguration of this convention. Resolved, That a vote of thanks be extended to the Hon. Gonzalo de Quesada, minister plenipotentiary ft-om Cuba. Resolved, That a vote of thanks be extended to Director Fox, as representing the Bureau of the American Kepublics, for his attentions to the delegates and for the arrangements made for their entertainment. Resolved, That an expression of our sincere appreciation be given to our highly esteemed president, Surgeon-General Wyman, for his kind treatment and for the eificient manner in which he has complied with his official duties. Resolved, That a vote of thanks be extended to the Cosmos Club and to the press of the city of Washington for the courteous manner in which they have treated us during our stay at this capital. Resolved, That a vote of thanks be extended in the name of the delegates from the Spanish American Republics to the delegates from the United States for their hospitality and excel- lent fellowship. The President. Who presents those resolutions? The Secretary. Myself. And I will have to act, if you will allow me, as chairman at this moment, because Surgeon-General Wyman does not like to put them before you, as one refers to himself. Doctor Lavoreria addressed the convention in Spanish. The Secretary. Doctor Lavoreria suggests that these resolutions be not discussed, but that they be adopted by acclamation. Doctor Guiteras. By a rising vote? The Secretary. Yes; by a rising vote. Doctor Barnet addressed the convention in Spanish. The Secretary. Doctor Barnet makes a suggestion which I accept most heartily, and which will correct w^hat was reall}^ an involuntary omission on my part, namely, to include in the vote of thanks the Bankers' Association of the District of Columbia. The resolutions were agreed to. The President. We will now begin the formal signing of the con- vention. Two copies have been prepared, one in English and one in Spanish, and the delegates from each one of the Republics will be expected to sign. The roll of the Republics will be called in alpha- SECOND ÍNTEKNATIONAL SANITARY CONVENTION. 89 betical order, and it is the understanding that each delegate will sign his name and say "From such and such a.Repul)lic." Doctor GuiTERAs. Will the roll be called alphabetically according to the English or the Spanish names of the Jíepublics'í Jt will make a considerable diiference in the order in wliich the liepu})lics come. The Seceetary. Doctor Guiteras makes a very important sug- gestion. In English the United States comes in one of tne last places on the roll, while in Spanish the name of the United States begins with the letter E. It was moved by Dr. H. L. E. Johnson that the States be called ac- cording to the alphabetical order in each language; that is, that for the signatures to the English version the names of the Republics be called in English, and for the signatures to the Spanish version the names should be called in the order of the names in Spanish. The Secretary translated the suggestion into Spanish. The President. It has been suggested by Doctor Geddings, who is somewhat familiar with these procedures, that it is not necessary to put in the name of the Republic at all. I presume that is what Doctor Johnson was about to suggest. The names are already in there as those of the delegates from the respective Republics, and all we have to do is to sign our respective names. The remarks of the president were translated into Spanish by the secretary. Dr. H. L. E. Johnson. I am going to supplement your suggestion by adding that they sign in the order in which they appear in the pre- amble. The names are mentioned there, one after another, and it would be better to have them appear as they appear there. The Spanish corresponds to the English,, and the English is to be the standard. Upon examination it was found that the order of the Republics was the same in both the Spanish and the English copies. The signing of the convention by the delegates was now commenced and concluded. The President. The convention will come to order. There are three delegates who have not affixed theis names to this agreement. They are the delegates from Uruguay and Venezuela, and one dele- gate from the United States, Doctor Kennedy, who was obliged to leave the city, as he said the other day he thought he would very likely be obliged to do. But it seems very desirable that we should eventually have the signatures of these three delegates to the con- vention, and your president awaits an expression of the wish of the convention as to the method to be pursued to secure these signatures. Has anybody a motion to make as to how thej should be secured ? The Secretary. I make a motion to the effect that we leave tliis document in charge of Mr. Fox, Director of the Bureau of American Republics, to secure the signatures of these tlii-ee delegates to the document, and as soon as he secures them to forward the document to the Secretary of State, as agreed upon by this convention. Doctor Ulloa here translated this motion into Spanish. The motion was seconded. The motion was agreed to. The President. I wish to say that the copies of this agreement will be printed for the use of the delegates as speedily as possible. The work will be begun Monday morning, and we expect to be able 90 SECOND INTERNATIONAL SANITARY CONVENTION. to furnish you with copies in the Enghsh and Spanish both; but these copies are not. to be considered as official copies. They are simply copies for your indi^adual use. The official copies will be printed later on and furnished to you. The remarks of the president were translated by the secretary into Spanish. The President. Gentlemen, the work for which this convention was assembled is about completed. Before parting it will be agree- able to aU, I have no doubt, that we should hear from each delegate to the convention a short word of congratulation or expression of the pleasure that has been experienced or any comments that may seem pertinent to the individual who makes the address. We pro- pose to call on each delegate, according to the alphabetical order of the Republics, as named in the agreement. The remarks of the president were translated by the secretary into Spanish. The President. I will first call upon Dr. Eduardo O. Moore, the delegate from Chile. Doctor Moore addressed the convention in Spanish. [Applause.] The Secretary. I am requested to give an interpretation of the very well-put remarks of Doctor Moore, of Chile. I will make an extract of it, and I request him to tell me if I leave anything out. Doctor Moore expressed his astonishment at the results obtained at this convention. He says that he never expected to do so much work, and of such an efficient nature as we have done. He says that when he came from his country he thought that he was coming to a congress or a convention the same as the last one we had in Washing- ton, but in this one we have achieved very high results, and of a very important nature, and the signing of this convention is a great step toward the accomplishment of the object of these meetings. He says that he has never signed any document of this sort that has pleased him more than the present one, and he hopes that we may meet again soon; and he hopes every one of us will be at Mexico during the next convention, with the certainty that we will have a splendid time, and a very cordial reception, such as it is customary for the Mexicans to afford. [Applause.] The President. We will next hear from the Republic of Costa Rica, represented by our distinguished secretary. Dr. D. Juan J. Ulloa, ex-vice-president, ex-minister of the interior of Costa Rica, and ex-president of the medical faculty of Costa Rica. Doctor Ulloa. Mr. President and members, it gives me the greatest pleasure to express to you, in a few words, my high appre- ciation of your merits as scientific men and of your qualities as fellow- men. I never was prouder myself before, and I am proud of myself now because I am here among you. I am proud of myself because when I leave Washington to-night — or to-morrow, or whenever I do leave — I will be authorized to say that I was a member of the Second International Convention of the American Republics, and that I was one of those who signed the convention which is going to be of such high meaning to all our Republics, the convention which in the esti- mation of anyone who thinks rightly means the greatest achievement that we could attain. It means security to health, it means facility to commerce, and it means destruction to unwarranted and ignorant SECOND INTERNATIONAL HANITAKY CONVENTION. 91 quarantine measures. It means pro^-ess of the twentieth century, and it means death to if^norance in matters relating to public health. Gentlemen, in the name of Costa Kica, J tjiank all of you for your cooperation. I thank, sincerely, my distinjiuished friend Doctor Wyman, all the delegates from the United vStates, and all the other delegates from the Spanish-American Jief)ublics. In parting, I do not want to say good-bye; 1 want to emV^race you all and say ''Au revoir." And I second the words of Doctor Moore, hoping that nothing will stand in our way so as to meet again in the country- of our beloved friend. Doctor Licéaga. I know that after the very fine time that we have had here, even if we have worked a little hard, we are going to have a lovely time also in Mexico, and I only hope that these two years that are to come will hurry up and pass away so as to go to Mexico City quickly. [Applause.] The President. The next is the Republic of Cuba. I hardly know what to say in introducing our great and good friend. Doctor Guiteras, whose name is international in regard to all the matters that have been before tliis convention. His kindly personality, his great scientific achievements, his great interest in all these matters, has been a powerful influence in this convention, and I call upon Dr. D. Juan Guiteras for remarks. Doctor Guiteras. Mr. President, I thank you very much, and I have only to sa}^ that I am proud also, like Doctor Moore, to have been able to put my signature to this document, and I think as the years go on every one of us will feel more and more proud of the work that we have done. I congratulate the convention for the effort they have made to bring this task to a successful termination. [Applause.] y Doctor Guiteras repeated his remarks in Spanish. [Applause.] The President. Will Doctor Guiteras kindly explain to those who speak English only, the substance of what Doctor Ulloa said in English, briefly? I think they would be glad to hear it. Not in full, but briefly. Doctor Guiteras. I wish I had thought of doing so while he was delivering it. It impressed me very, very deeply, and I am usually better at saying things for other people than for myself. The preceding response of Doctor Ulloa was here translated into Spanish by Doctor Guiteras. The secretary addressed the convention in Spanish. The Secretary. Concerning the resolutions that have been offered, thanking those who have shown us courtesies, I have just had the honor to make the motion in Spanish, extending those thanks also to Mr. Fox, of the Bureau of American Republics. The President. We would like also to hear from the distinguished representative of the cliief executive of the sanitary department of Habana, Dr. Henry B. Barnet. Doctor Barnet addressed the convention in Spanish. [Applause.] The President. The Republic of Ecuador; Dr. Miguel Alcivar. Doctor Alcivar will excuse me if I do not get the Spanish just right, but we all know who you are, no matter how I pronounce your name. Doctor Alcivar here addressed the convention in Spanish. His remarks were not translated. The President We are fortunate in having vdih us at tliis con- vention the minister from the Dominican Repubhc, who is also a 92 SECOND INTERNATIONAL SANITARY CONVENTION. delegate to this convention, and we would like to hear from him. Señor Don Emilio Joubert. Señor Joubert here addressed the convention in Spanish. His remarks were not translated. (See Appendix, p. 192.) The President. I am sure we are all glad to hear from Mr. Joubert, and I take this occasion to say that when the call of the Republics was held he was not present, but he afterwards informed me that he would present a report in accordance with the reports from the other Republics as to sanitary conditions, and later on promised that he would send it in in writing, and I am sure we would be very glad to receive it, as well as his remarks which he has just made, if lie will put them in writing. And I hope that it will be understood, broadly, by those who speak in Spanish, that we will be glad to have them transmit their remarks to the Director of the Bureau of American Republics, and that they will be printed in the proceedings of to-day in both English and Spanish. Director Fox, I am sure, will have them translated for us. I next call upon the United States. I will make my few remarks at the close, as I bid you good-bye, and I will call now upon Asst. Surg. Gen. H. D. Geddings. Doctor Geddings. Mr. President and gentlemen, I am sure that I would voice the sentiments of the delegates of the United States in say- ing that the recollection of this convention must ever be a source of pride and pleasure, when we remember that the work on which we have been engaged all this week, and which we have brought to a conclu- sion tliis evening, is one that marks a new departure on the Western Continent. And it would be impossible to part without saying how much gratification has been given me by the good spirit, the fraternal feeling, and the spirit, to use an Americanism, of give and take, which has characterized the transactions of this congress. To have met so many distinguished men from various countries has been a source of unspeakable pleasure, and I voice — I reecho — the sentiments of Doctor Ulloa, whom we have all learned to esteem so highly, in saying that the years that intervene between now and the meeting in the Republic of Mexico, under the protection and patronage of Doctor Licéaga, can not roll around too rapidly. Good-bye is always a hard word to say, but the good feelings of the delegates from the United States accompany those gentlemen who return to homes foreign to us. [Applause.] The President. I will call now upon a representative of our great United States Army — of the Medical Department of it^ — Dr. Walter D. McCaw, major, surgeon in the United States Army. Doctor McCaw. Mr. President and gentlemen, as a member of the United States Army I feel a particular pride in having been permitted to take a part in such an important convention as this. Our little military force is so much of the people and for the people that it is interested, of course, as all other citizens, in the questions of public health of this and the neighboring countries. I know that they will be pleased that even a humble representative of their body has had the privilege of putting his signature to the important articles of this convention adopted to-day. I would like to say, with the others, that I look forward over the intervening years to the time of the meeting which will take place in Mexico; but I am afraid that the prospects of the pleasurable stay SECOND intí:knati<>nal sanitary convention. 93 in that city will be so ^reat ainon^ the members of the Army that I shall find many formidable competitors for the position. 1 only hope that I shall win in tbe race. A few of us have taken in the past an important part in the sanita- tion of the American Continent. We liope to do sometbirif^ in the future when called upon. In the meantime, we stand by and look with applause at theniagtiiiicant work that is beinN V KN'IION. 1)5. Doctor Medina. Mr. President, first I will thank you for your kind words. Secondly, I will Aay in the name oí" the Republic of Nicaragua, which I have the honor to represent, that I am sure my colleagues will receive with delight the words of this convention, and not only will the action of the convention be accepted, but we will do all that is in our power to carry on the practical work to a successful and faithñil realization. Next I will thank all my fellows in this convention. It has been a pleasure to me for us to be all together here, all working with such a brotherly feeling, which really makes us forget all the harshness that an American man has to go through in life. It is not often that we have the opportunity to meet such a company of fellows with such a friendly feeling as that which has been exhibited here and in which this convention has discharoed its duties. I hope that we will soon meet again, as all of my colleagues have expressed the hope of meeting in Mexico. There may be some people who think that we have overestimated the work of this convention and who may have criticised it. I think that the work of this convention will he fully appreciated in this matter, but not to-day. The work of this week of this convention here I am sure will be a monument in days to come, because others will follow, will improve it, and will carry on to success that which may be out of our reach to-day. I hope to meet you all in Mexico, and in closing I wish only to express my sincerest respect for Doctor Licéaga, who really has been the shining member of this convention. [Applause.] The President. I am sure we were all very much pleased to learn that we had a delegate from Peru at this convention. You will remember that Peru was not represented at the first convention, and when I received a call from Doctor Lavoreria I was very much delighted, because I had heard of him from some of my ofíicers in Panama and I laiew of his high reputation in his own country, and I was delighted to know that Peru was to be represented, particu- larly as the relations between Peru and the other Republics, and especially the United States, are becoming more intimate. Our relatio'ns are becoming closer; we are being drawn nearer together in these matters and are dependent more upon one another than we were formerly, and I wish to say that the authorities of Peru have shown their disposition to do everything that is possible in the elimination of plague and the other epidemic diseases. In other words, they are in the ÍTont rank, and I call upon the distinguished representative, Doctor Lavoreria. [Applause.] Doctor Lavoreria addressed the convention in Spanish. [Ap- plause.] Doctor Lavoreria' s remarks were not translated. • The President. We have had with us during the convention the genial presence of the charge d' aft'aires of Uruguay and we would liJie to hear from him. I am informed that he is not here at the present time. The representative of the Republic of Venezuela is not here with us at the present time, although he has been in the hall a number of times. We have with us two distinguished gentlemen who have been invited to the privileges of the floor, and I would like to call upon Doctor Carroll, of the United States Army. 96 SECOND INTERNATIONAL SANITARY CONVENTION. Doctor Carroll. Mr. President and gentlemen of the convention, I beg to be permitted to express ni}" sincere thanks for the great honor and privilege that has been accorded me of being present at the proceedings of this convention. I assure you that I have found them both interesting and instructive, and their results are so far- reaching that we can onl}^ conjecture the ultimate outcome. I rejoice with you in the results that have been accomplished so far, and I rejoice particularly because I feel that we can look forward now with almost absolute certainty to the accomplishment in the near future of the absolute extinction of the yellow fever from the North American continent and later from the whole continent, which means practically the universe. The time has flown so rapidly, and it is now so late, that it would not be proper for me to detain you any longer. I desire again to express my great appreciation of the honor that has been conferred upon me. [Applause.] The President. I will call now upon Doctor Stiles, the medical zoologist of the Public Health and Marine-Hospital Service. Doctor Stiles. jVIt. President and gentlemen, I am sure I voice the sentiments of my colleagues in the hygienic laboratory, to whom you extended the courtesies of the floor, when I thank you very much for the instructive time that we have had in these meetings here during tliis week. It has been instructive to us from various points of view. In a laboratory we naturally work primarily upon theoretical grounds, and it is of great value to us to come into con- tact with the class of men whose experience leads them into the broader lines of administrative work. It is a great satisfaction to us, further, to see practical deductions from our laboratory works put upon paper by a class of men capable of understanding their bearing upon the public health. Such deductions can be utilized only by men who have a very broad view of administrative work, combined with a deep insight into the theoretical work of the laboratory. Speaking personally, I have had another great satisfaction in being here — -namely, not as a physician, but as a zoologist. It has been my conviction for a ^ood many years past thai there are a number of problems in medicine which should be attacked from the zoological standpoint. Already a number of diseases have been cleared up, or partially cleared up, by working on zoological lines. Curiously enough, it has not been, as a rule, the zoologists who have brought out these facts, but the physicians have invaded the zoolog- ical field and have discovered the zoological principles and zoological facts •which zoologists themselves had overlooked. It is always, therefore, a great pleasure for a professional zoologist to acknowledge the debt that zoology owes to medicine in showing the zoologist just how important zoology is to medicine. Personally, also, I have had great satisfaction in attending these meetings from an entirely different point of view — nsuneij, the inspiration which a young man receives from personal association with men so much his seniors in experience, in years, and in practical work accomplished. And, finally, there is one other example that has been set to_ me here. Some of us in the laboratory are sometimes a little anxious about working too hard in one week, for fear we may lose too much 8EC0ND INTEKNATIONAL HANITAKY CO» VENTION. 97 of our flesh. As I look around the room I think how hard the mem- bers of this conference have worked, and yet I do not note that there has been any groat reduction in the circumference of my good friend, Dr. II. L. E. Johnson, or of my good friend from the Army, or of our worthy president. I wish to thank you very much indeed for having extended the courtesies of the floor to me, and in the absence of my colleagues, Doctor Anderson and Doctor Hunt, I will speak in their names also. [Applause.] The President. Gentlemen, there is one more gentleman whom I wish to address this convention for as long as he likes — one to whom we are greatly indebted for the preparation for and assistance in the conduct of this convention. He stands there now, on guard over that sacred document which we have just signed. [Laughter.] Although, literally speaking, he is sitting, he is still on guard, and I am sure we will all be glad to hear from the Hon. W. C. Fox, Director of the Bureau of the American Republics. Mr. Fox. Mr. President and gentlemen, the hour is really so late that I do not think I should detain you, but I wish to extend my sincere thanks and the thanks of the Bureau for the courteous remarks that have been made about us, and to assure you further that what we have done has been only a duty, and one which we have been but too glad to perform. The Bureau has certain func- tions, and I believe this occasion has demonstrated that these functions are worthy. I recall that when, upon the opening day of this convention I had the honor of escorting the honorable Secretary of State down to this hall, in coming down in the carriage he talked over a few matters, and I said to him then that I did not know what practical results would come out of this convention nor did I know what practical results would come out of the work of the Bureau. He said to me, "Do not worry about that. You are a good deal in the position of a lawyer making an argument to the court. The argument may be very good or it may be indifi^erent, but as long as you are making that argument you keep the court's attention on the case." And I think that is what you are doing; and I am very glad that I have had opportunity, in a small way, to have been of some little assistance to you distinguished gentlemen in completing this magnificent piece of work. [Applause.] The President. The minutes of this meeting of to-day will have to be approved by some one after the final adjournment of the convention, and before adjourning it would be competent for some one to make a motion that the president and the secretary be author- ized to approve the minutes, or to make some provision, in any manner that seems fit and proper to the convention, for the approv- ing of the minutes of to-day. Dr. H. L. E. Johnson. I move you, sir, that the minutes be referred to the president and secretary for their approval and that their approval be the approval of the convention. The motion was seconded. The question was taken, and the motion was agreed to. The President. Gentlemen of the convention [Applause], the moment has arrived when we are about to adjourn, to meet again in the Third International Sanitary Convention of the American Republics in the City of Mexico two years hence. A valedictory is 5610—06 7 98 SECOND INTERNATIONAL SANITARY CONVENTION. supposed to be an address carefully thought out, carefully prepared. As you are aware, the business of this convention has been so serious, so engaging, that it has been practically impossible for me to pre- pare an address which I think would be worthy of tliis occasion. So I am simply about to bid you adieu with the expression of the thoughts that come into my mind at the moment. And, reviewing the work of the past week, I feel that there is much with regard to which congratulations are in order to each and every member of this convention. We have made one another's acquaintance in a way in which it has never been made before. Now, when we see the papers or read the journals or magazines of the different coun- tries represented by this convention the thoughts of each one of us will revert to the faces that are here now. We will each associate the others with the countries which they represent, and we will therefore have a deeper and more personal reeling toward the nations which are represented here. I feel that we have had a very successful time, judged from the standpoint of social intercourse. We have learned to know one another, we have learned to appreciate the high attainments of the individual members of this convention, and we have learned to appreciate the kindly thoughts and the kindly expressions which have been so constant thi'oughout the past week. We are also to be congratulated upon the evidences of scientific attainment which have been so manifest in the proceedings of this convention. I do not know whether it has occurred to you, as it has occurred to me, that one of the reasons that we have met with such success in our deliberations and our conclusions is the fact that the Republics taking part in this convention are represented by men of high education — finished, cultivated gentlemen. That fact has made it comparatively easy for us to agree upon these great principles which we have put into form and which we hope to emphasize by administration. Again, we are to be congratulated upon the great international effect of such a convention as we have held. Aside from medicine and sanitation, such conventions as this bring nations nearer together, which is one of the aims and is the great trend of modern thought. Peru and Chile no longer seem as far off as they did ten years ago to us, and I trust the Uinted States does not appear as far off to you gentlemen as it used to. So that we are an element in the progress of civilization, in the establishment of the brotherhood of m.an, which I think is the highest aim that can be sought by any organization or by individuals working in a convention or working individually. Personally I wish to extend to each and every one of you my thanks for your very courteous treatment of your president. There has not been one ripple of unpleasantness throughout the whole week. I have felt that in my efforts to conduct the convention I have had the sympathetic support — the sympathy and the support — of every one of you, for without both the convention could not have been a success so far as my presidency was concerned; and I want to renew my thanks and to express my great appreciation of the fact that I was reelected to the presidency of this Second Inter- national Sanitary Convention of the American Republics, a con- vention which I believe will go into history as the beginning of great SECOND INTERN A.TION AL SANITARY ' CONVENTION. 99 things for the Western Hemisphere, great advances in the Western Hemisphere, advances in sanitation, advances in relieving commerce of many of its unduly restrictive measures, advances in good sani- tation, which adds so much to the public health and prosperity of nations. I will now wish you all a fond farewell. By "fond farewell" I mean that in going away you carry with you the loving thoughts of the American delegates and of myself ; that we look forward to the third convention in the City of Mexico with the greatest of pleasure. And we sympathize with the remark that was made by one of the delegates, to the effect that he wished that the time might be short between this convention and the next. With these few remarks I bid you farewell, and I declare the Second General International Sanitary Convention of the American Republics at an end. [Applause.] APPENDIX. 101 APPENDIX. SECOND GENERAL INTERNATIONAL SANITARY CONVENTION. CONVENTION AD REFERENDUM CONCLUDED AT THE SECOND GENERAL INTERNATIONAL SANITARY CONVENTION OF THE AMERICAN REPUBLICS, IN WASHINGTON, ON OCTOBER 14, 1905. The Presidents of the Republics of Chile, Costa Rica, Cuba, Dominican Republic, Ecuador, Guatemala, Mexico, Nicaragua, Peru, United States of America, and Venezuela, having found that it is useful and convenient to codify all the measures destined* to guard the pub- lic health against the invasion and propagation of yellow fever, plague, and cholera, have designated as their delegates, to wit: Republic of Chile, Señor Dr. D. Eduardo Moore, professor of the medical faculty, hos- pital physician; Republic of Costa Rica, Señor Dr. D. Juan J. Ulloa, ex-vice-president, ex-minister of the interior of Costa Rica, ex-president of the medical faculty of Costa Rica; Republic of Cuba, Señor Dr. D. Juan Guiteras, member of the superior board of health of Cuba, director of the "Las Animas" Hospital, professor of general pathology and trop- ical medicine of the University of Habana, and Señor Dr. D. Enrique B. Barnet, executive chief of the health department of Habana, member and secretary of the superior board of health of Cuba ; Republic of Ecuador, Señor Dr. D. Serafín S. Wither, charge d'affaires and consul-general of Ecuador in New York, and Señor Dr. D. lliguel H. Alcivar, member of the superior board of health of Guayaquil, professor of the medical faculty and surgeon of the General Hospital of Guayaquil; Republic of the United States of America, Dr. Walter Wyman, Surgeon-General of the Public Health and Marine-Hospital Service of the United States; Dr. H. D. Geddings, Assistant Surgeon-General of the Public Health and Marine-Hospital Service of the United States and representative of the United States at the sanitary convention of Paris; Dr. J. F. Kennedy, secretary of the board of health of the State of Iowa; Dr. John S. Fulton, secretary of the board of health of the State of Maryland; Dr. Walter D. McCaw, major, surgeon in the United States Army; Dr. J. D. Gatewood, surgeon in the United States Navy; Dr. H. L. E. Johnson, member of the American Medical Association (member of the board of ti-ustees) ; Republic of Guatemala, Señor Dr. D. Joaquin Yela, consul-general of Guatemala in New York; Republic of Mexico, Señor Dr. D. Eduardo Licéaga, president of the superior council of health of Mexico, director and professor of the National School of Medicine, member of the Academy of Medicine; Republic of Nicaragua, Señor Dr. D. J. L. Medina, member of the Second Pan-American Medical Congress of the city of Habana in 1901 ; Republic of Peru, Señor Dr. D. Daniel Eduardo Lavorería, professor of the medical fac- ulty, member of the National Academy of Medicine, physician of the "Dos de Mayo" Hospital, chief of the division of hygiene of the ministry of fomento ; Dominican Republic, Señor D. Emilio C. Joubert, minister resident in Washington; Republic of Venezuela, Señor D. Nicolás Veloz-Goiticoa, charge d'affaires of Venezuela, Who, having made an interchange of their powers and found them good, have agreed to adopt, ad i ef erendum, the following propositions : 103 104 SECOND INTERNATIONAL SANITARY CONVENTION. CHAPTER I. REGULATIONS TO BE OBSERVED BY THE POWERS SIGNATORY TO THE CONVENTION AS SOON AS PLAGUE, CHOLERA, OR YELLOW FEVER MAY APPEAR IN THEIR TERRITORY. Section I. — Notification and subsequent communications to other countries. Article I. Each Government should immediately notify other Governments of the first appearance in its territory of authentic cases of plague, cholera, or yellow fever. Art. II. This notification is to be accompanied, or very promptly followed, by the fol- lo^ving additional information: 1. The neighborhood where the disease has appeared. 2. The date of its appearance, its origin, and its form. 3. The number of established cases and the number of deaths. 4. For plague — the existence among rats or mice of plague, or of an unusual mortality; for yellow fever — the existence of Siegomyia fasciata in the locality. 5. The measures taken immediately after the first appearance. Art. III. The notification and the information prescribed in Articles I and II are to be addressed to diplomatic and consular agents in the capital of the infected country; but this is to be construed as not preventing direct communication between officials charged with the public health of the several countries. For countries which are not thus represented, they are to be transmitted directly by tele- graph to the Governments of such countries. Art. IV. The notification and the information prescribed in Articles I and II are to be followed bj^ further communications dispatched in a regular manner in order to keep the Governments informed of the progress of the epidemic. These communications, which are to be made at least once a week, and which are to be as complete as possible, should indicate in detail the precautions taken to prevent the extension of the disease. They should set forth, first, the prophylactic measures taken relative to sanitary or med- ical inspection, to isolation, and disinfection; second, the measures taken relative to depart- ing vessels to prevent the exportation of the disease, and, especially under the circumstances mentioned in paragraph 4 of Article II of this section, the measures taken against rats and mosquitoes. Art. V. The prompt and faithful execution of the preceding provisions is of the very first importance. The notifications only have a real value if each Government is warned in time of cases of plague, cholera, or yellow fever and of suspicious cases of those diseases supervening in its territory. It can not, then, be too strongly recommended to the various Governments to make obligatory the declaration of cases of plague, cholera, or yellow fever, and of giving information of all unusual mortality of rats and mice, especially in ports. Art. VI. It is understood that neighboring countries reserve to themselves the right to make special arrangements with a view of organizing a service of direct information between the chiefs of administration upon the frontiers. Section II. — Conditions showing a given territorial area to be infected or to have been freed from infection. Art. VII. Information of a first case of plague, cholera, or yellow fever does not justify against a territorial area where it may appear the application of the measures prescribed in Chapter II, as hereinafter indicated. Upon the occurrence of several nonimported cases of plague or a nonimported case of yellow fever or when cases of cholera form a focus the area is to be declared infected. Art. VIII. To limit the measures to the affected regions alone, Governments should only apply them to persons and articles proceeding from the contaminated or infected areas. By the word "area" is understood a well-determined portion of territory described in the information which accompanies or follows notification; thus, a province, a state, "a gov- ernment," a district, a department, a canton, an island, a conmaune, a city, a quarter of a city, a village, a port, a "polder," a hamlet, etc., whatever may be the extent and popula- tion of these portions of territorj'. But this restriction, limited to the infected area, should only be accepted upon the formal condition that the Government of the infected country shall take the necessary measures, 1, to prevent, unless previously disinfected, the exportation of articles named in 1 and 2 of Article XII coming from the contaminated area; and 2, measures to prevent the extension of the epidemic; and provided further, that there be no doubt that the sanitaiy authori- ties of the infected country have faithfully complied with Article I of this convention. SECOND INTERNATIONAL SANITAKY CONVENTION. 105 When an area is infected, no restrictive measure is to be taken against departures from this area if these departures have occurred five days, at least, before the beginning of the epidemic. Art. IX. That an area should no longer be considered as infected, oificial proof must be furnished : First, that there has been neither a death nor a new case of plague or cholera for five days after isolation,^ death, or cure of the last plague or cholera case. In the case of yellow fever the period shall be eighteen days, but each Government may reserve the right to extend this period. Second, that all the measures of disinfection have been applied; in the case of plague, that the precautions against rats have been observed, and in the case of yellow fever that the measures against mosquitoes have been executed. CHAPTER II. MEASURES OF DEFENSE BY OTHER COUNTRIES AGAINST TERRITORIES DECLARED TO BE INFECTED. Section I. — Publication of prescribed measures. Art. X. The Government of each country is obliged to immediately publish the meas- ures which it believes necessary to take against departures either from a country or from an infected territorial area. The said Government is to communicate at once this publication to the diplomatic or consular agent of the infected country residing in its capital, as well as to the International Sanitary Bureau. The Government shall be equally obliged to make known through the same channels the revocation of these measures or modifications which may be made in them. In default of a diplomatic or consular agency in the capital, communications are made directly to the Government of the country interested. Section II. — Merchandise — Disinfection — Importation and transit — Baggage. Art. XL There exists no merchandise which is of itself capable of transmitting plague, cholera, or yeUow fever. It only becomes dangerous in case it is soiled by pestous or choleraic products, or, in the case of yeUow fever, when such merchandise may harbor mosquitoes. Art. XII. No merchandise or objects shall be subjected to disinfection on account of yellow fever, but in cases covered by the previous article the vehicle of transportation may be subjected to fumigation to destroy mosquitoes. In the case of cholera and plague dis- infection should only be apphed to merchandise and objects which the local sanitary authority considers as infected. Nevertheless, merchandise or objects enumerated hereafter may be subjected to disin- fection or prohibited entry, independently of all proof that they may or may not be infected: 1. Body linen, wearing apparel in use, clothing which has been worn, bedding already used. When these objects are transported as baggage, or in the course of a change of residence (household furniture), they should not be prohibited, and are to be subjected to the regula- tions prescribed by Article XIX. Baggage left by soldiers and sailors and returned to their country after death are con- sidered as objects comprised in the first paragraph of No. 1 of this article. 2. Rags, and rags for making paper, with the exception, as to cholera, of rags which are transported as merchandise in large quantities compressed in bales held together by hoops. New chppings coming directly from spinning mills, weaving mills, manufactories or bleacheries, shoddy, and clippings of new paper, should not be forbidden. Art. XIII. In the case of cholera and plague there is no reason to forbid the transit through an infected district of merchandise and the objects specified in Nos. 1 and 2 of the preceding article if they are so packed that they can not have been exposed to infection in transit. In like manner, when merchandise or objects are so transported that in transit they can not come in contact with soiled objects, their transit across an infected territorial area should not be an obstacle to their entry into the country of destination. o The word "isolation" signifies isolation of the patient, of the persons who care for him, and the forbidding of visits of all other persons, the physician excepted. By isolation in the case of yellow fever is understood the isolation of the patient in an apartment so screened as to prevent the access of mosquitoes. 106 SECOND INTERNATIONAL SANITARY CONVENTION. Art. XrV'. The entry of merchandise and objects specified in Nos. 1 and 2 of Aiiicle XII should not be prohibited if it can be sliown to the authorities of the country of destination that thev were shipped at least five days before the beginning of the epidemic. Art. XV. The method and place of disinfection, as well as the measures to be employed for the destruction of rats and mosquitoes, are to be fixed by authority of the country of destination, upon arrival at said destination. These operations should be performed in such a manner as to cause the least possible injury to the merchandise. It devolves upon each country to determine questions relative to the payment of damages resulting from disinfection or from the destruction of rats or mosquitoes. If taxes are levied by a sanitary authority, either directly or through the agency of any company or agent, to insure measiires for the destruction of rats and mosquitoes on board ships, the amount of these taxes ought to be fixed by a tarifl" published in advance, and the result of these measures should not be a soiu-ce of profit for either State or sanitary authorities. Art. XVI. Letters and correspondence, printed matter, books, newspapers, business papers, etc. (postal parcels not included), are not to be submitted to any restriction or dis- infection. In case of yellow fever postal parcels are not to be subjected to any restrictions or disinfection. Art. XVII. Merchandise arriving by land or by sea should not be detained perma- nently at frontiers or in ports. Measures which it is permissible to prescribe with respect to them are specified in Article XII. Nevertheless, when merchandise, arriving by sea in bulk (vrac) or in defective packages, is contaminated by pest-stricken rats during the passage and is incapable of being disin- fected, the destruction of the germs may be assured by putting said merchandise in a ware- house for a period to be decided by the sanitary authorities of the port of arrival. It is to be understood that the apphcation of this last measure should not entail delay upon any vessel nor extraordinary expenses resulting from the want of warehouses in ports. Art. XVIII. When merchandise has been disinfected by the apphcation of the meas- ures prescribed in Article XII, or put temporarily in warehouses in accordance with the third paragraph of Ai'ticle XVII, the ovraer or his representative has the right to demand from the sanitaiy authority which has ordered such disinfection or storage a certificate setting forth the measures taken. Art. XEX. Baggage. In the case of soiled linen, bed clothing, clothing, and objects fornaing a part of baggage or furniture coming ft'om a territorial area declared contaminated, disinfection is only to be practiced in cases where the sanitary authority considers them as contaminated. There shaU be no disinfection of baggage on account of yellow fever. Section III. — Measures in ports and at maritime frontiers. Art. XX. Classification of ships. A ship is considered as infected which has plague, cholera, or yellow fever on board, or which has presented one or more cases of plague or cholera within seven days or a case of yellow fever at any time during the voyage. A ship is considered as suspected on board of which there have been a case or cases of plague or cholera at the time of departure or during the voyage, but no new case within seven days; also such ships as have lain in such proximity to the infected shore as to render them liable to the access of mosquitoes. The ship is considered indemne which, although coming from an infected port, has had neither death nor case of plague, cholera, or yellow fever on board, either before departure, during the voyage, or at the time of arrival, and which in the case of yellow fever has not lain in such proximity to the shore as to render it liable, in the opinion of the sanite"' authorities, to the access of mosquitoes. Art. XXI. Ships infected with plague are to be subjected to the following regulations: 1. Medical visit (inspection). 2. The sick are to be immediately disembarked and isolated. 3. Other persons should also be disembarked, if possible, and subjected to an observation,» which should not exceed five days dating from the day of arrival. 4. Soiled linen, personal effects in use, the belongings of crew i> and passengers which, in the opinion of the sanitary authorities are considered as infected, should be disinfected. o The word "observation" signifies isolation of the passengers, either on board ship or at a sanijtary station, before being given free pratique. 6 The term "crew" is applied to persons who may make or who have made a part of the personnel of the vessel and of the administration thereof, including stewards, waiters, " cafedji," etc. The word is to be construed in this sense wherever employed in the present convention. SECOND INTERNATIONAL HANITAKY CONVENTION. 107 5. The parts of the ship which have been inhabited by those stricken with plague, and such others as, in the opinion of the sanitary authorities are considered as infected, should be disinfected. 6. The destruction of rats on shipboard should be effected before or after the discharge of cargo as rapidly as possible, and in all cases with a maximum delay of forty-eight hours, care being taken to avoid damage of merchandise, the vessel and its machinery. For ships in ballast this operation should be performed immediately before taking on cargo. Ab,t. XXII. Ships suspected of plague are to be subjected to the measures which are indicated in Nos. 1, 4, and 5 of Article XXI. Further, the crew and passengers may be subjected to observation, which should not exceed five days, dating from the arrival of the ship. During the same time the diserabark- ment of the crew may be forbidden, except for reasons of duty. The destruction of rats on shipboard is recommended. This destruction is to be effected before or after the discharge of cargo, as quickly as possible, and in all cases with a maximum delay of forty-eight hours, taking care to avoid damage to merchandise, ships and their machinery. For ships in ballast this operation should be done, if done at all, as early as possible, and in all cases before taking on cargo. Art. XXIII. Ships indemne from plague are to be admitted to free pratique immediately, whatever may be the nature of their bill of health. The only regulation which the sanitary authorities at a port of arrival may prescribe for them consists of the following measures: 1. Medical visit (inspection). 2. Disinfection of soiled linen, articles of wearing apparel, and the other personal effects of the crew and passengers, but only in exceptional cases, when the sanitary authorities have special reason to believe them infected. 3. Without demanding it as a genéfal rule, the sanitary authorities may subject ships coming from an infected port to a process for the destruction of the rats on board before or after the discharge of cargo. This operation should be done as soon as possible, and in all cases should not last more than twenty-four hours, care being taken to avoid damaging merchandise, ships and their machinery, and without interfering with the passing of passengers and crew between the ship and the shore. For ships in ballast this procedure, if practiced, should be put in operation as soon as possible, and in aU cases before taking on cargo. When a ship coming from an infected port has been subjected to a process for the destruc- tion of rats, this process should only be repeated if the ship has touched meanwhile at an infected port and has been alongside a quay in such port, or if the presence of sick or dead rats on board is proven. The crew and passengers may be subjected to a surveillance, which should not exceed five days, to be computed from the date when the ship sailed from the infected port. The landing of the crew may also, during the same time, be forbidden except for reasons of duty. Competent authority at the port of arrival may always demand, under oath, a certifi- cate of the ship's physician, or in default of a physician, of the captain, setting forth that there has not been a case of plague on board since departure and that no marked mortality among the rats has been observed. Akt. XXIV. When upon an indemne ship rats have been recognized as pest stricken as a result of bacteriological examination, or when a marked mortality has been established among these rodents, the following measures should be applied: 1. Ships with plague-stricken rats : (a) Medical visit (inspection). (6) Rats should be destroyed before or after the discharge of cargo as rapidly as possible, and in aU cases with a delay not to exceed forty-eight hours : the deterioration of merchan- dise, vessels and machinery to be avoided. Upon ships in ballast, this operation should be performed as soon as possible, and in all cases before taking on cargo. (c) Such parts of the ship and such articles as the local sanitary authority regards as infected shall be disinfected. (d) Passengers and crew may be submitted to observation, the duration of which should not exceed five days, dating from the day of arrival, except in special cases, where the sanitary authority may prolong the obsei-vation to a maximum of ten days. 2. Ships where a marked mortality among rats is obsei-ved : (a) Medical visit (inspection). (6) An examination of rats, with a view to determining the existence of plague, should be made as quickly as possible. (c) If the destruction of rats is judged necessary, it shall be accomplished under the conditions indicated above in the case of ships with plague-stricken rats. {d) Until all suspicion may be eliminated, the passengers and crew may be submitted to observation, the duration of which should not exceed five days, counting from the date of lUb SEC02ÍD IKTEENATIONAL SANITARY CONVENTION. arrival, except in special cases, when the sanitary authority may prolong the observation to a maximum of ten days. Art. XXV. The sanitary authorities of the port must deliver to the captain, the owner, or his agent, whenever a demand for it is made, a certificate setting forth that the measures for the destioiction of rats have been efficacious and indicating the reasons why these measures have been applied. Art. XXVI. Ships infected wnth cholera are to be subjected to the following regulations: 1. Medical visit (inspection). 2. The sick are to be immediately disembarked and isolated. 3. Other persons ought also to be disembarked, if possible, and subjected, dating from the arrival of the ship, to an observation the duration of which shall not exceed five days. 4. Soiled linen, wearing apparel, and personal ell'ects of crew and passengers which, in the opinion of the sanitary authority of the port, are considered as infected, are to be disinfected. 5. The parts of the ship which have been inhabited by pei-sons sick with cholera, or which are considered by the sanitaiy authority as infected, are to be disinfected. 6. The bilge water is to be discharged after disinfection. The sanitary authority may order the substitution of good potable water for that which is contained in the tanks on board. The discharge or thromng overboard into the water of a port, of dejecta, shall be forbid- den unless they have been previously disinfected. Art. XXVII. Ships suspected of cholera are to be subjected to measures prescribed under Nos. 1, 4, 5, and 6 of Article XXVI. The crew and passengers may be subjected to an observation, which should not exceed five days, to date from the arrival of the ship. It is i-ecommended during the same time to prevent the debarkation of the crew except for reasons of duty. Art. XXVIII. Ships indemne of cholera are to be admitted to free pratique immediately, whatever may be the nature of their biU of health. The only regulations which the sanitary authorities of a port may prescribe in their case are the measures provided in Nos. 1, 4, and 6 of Article XXVI. The crews and passengers may be submitted, in order to show their state of health, to an observation, which should not exceed five days, to be computed from the date when the ship sailed from the infected port. It is recommended that during the same time the debarkation of the crew be forbidden except for reasons of duty. Competent authority at the port of arrival may always demand, under oath, a certificate from the ship's surgeon, or, in the absence of a surgeon, from the captain, setting forth that there has not been a case of cholera upon the ship since sailing. Art. XXIX. Competent authority will take account, in order to apply the measures indicated in Articles XXI to XXVIII, of the presence of a physician on board and a disin- fecting apparatus in ships of the three categories mentioned above. In regard to plague, it will equally take account of the installation on board of apparatus for the destruction of rats. Sanitary authorities of such countries, where it may be convenient to make such regula- tions, may dispense mth the medical visit and other measures toward indemne ships which have on board a physician specially conomissioned by their country. Art. XXX. Special measures may be prescribed in regard to crowded ships, notably emigrant ships, or any other ship presenting bad hygienic conditions. Art. XXXI. Any ship not desiring to be subjected to the obligations imposed by the authority of the port in virtue of the stipulations of the present convention is free to pro- ceed to sea. It may be authorized to disembark its cargo after the necessary precautions shall have been taken, namely, first, isolation of the ship, its crew and passengers; second, in regard to plague, demand for information relative to the existence of an unusual mortality among rats; third, in regard to cholera, the discharge of the bilge water after disinfection and the substitution of a good potable water for that which is provided on board the ship. ' Authority may also be granted to disembark such passengers as may demand it, upon condition that these submit themselves to all measures prescribed by the local authorities. Ajrt. XXXII. Ships coming from a contaminated port, which have been disinfected and which may have have been subjected to sanitary measures applied in an efficient manner, shall not undergo a second time the same measures upon their arrival at a new port, provided that no new case shall have appeared since the disinfection was practiced and that the ships have not touched in the meantime at an infected port. When a ship only disembarks passengers and their baggage, or the mails, without having been in communication with terra firma, it is not to be considered as having touched at a port, provided that in the case of yeUow fever it has not approached sufficiently near the shore to permit the access of mosquitoes. SECOND INTERNATIONAL SANITAKY CONVENTION. 109 Abt. XXXIIT. Pa.sHongei'H arriving; on an inlVictod siiip have t?if! right to demand of the sanitaiy authority of tlie port a certiiicato sliowing tlic date of their arrival and the meas- ures to which tiiey and their baggage liave l)een suljjeoted. Art. XXXIV. Pacitet boats shall be Hul)je(;ted to special regulations, to be established by mutual agreement between the countries in interest. Art. XXXV. Without prejudice to the right which governments possess to agree upon the organization of common sanitary stations, each country should provide at least one port upon cacli of its seaboards, with an organization and equipment suííicient to receive a vessel, whatever may be its sanitaiy condition. When an indemne vessel, coming from an infected port, arrives at a large; mercantile port, it is recommended that she be not sent to another port for the execution of the prescribed sanitaiy measures. In ever countiy ports liable to the arrival of vessels from ports infected with plague, cholera, or yellow fever should be equipped in such a manner that indemne ve.ssels may there undergo, immediately upon their arrival, the prescribed measures, and not be sent for this purpose to another port. Governments should make declaration of the ports which are open in their territories to arrivals from ports infected with plague, cholera, or yellow fever. Art. XXXVI. It is recommended that in large seaports there be established: (a) A regular medical sei-vice and a permanent medical supervision of the sanitary condi- tions of crews and the inhabitants of the port. (b) Places set apart for the isolation of the sick and the observation of suspected persons. In the Stegomyia belt there must be a building or part of a building screened against mosqui- toes, and a launch and ambulance similarly screened. (c) The necessaiy installation for efficient disinfection and bacteriological laboratories. (d) A supply of potable water above suspicion, for the use of the port, and the installa- tion of a system of sewerage and drainage adequate for the removal of refuse. Section 1Y.— -Measures upon land frontiers — Travelers — Railroads — Frontier zones — River routes. Art. XXXVII. Land quarantines should no longer be established, but the governments reserve the right to establish camps of observation, if they should be thought necessary, for the temporary detention of suspects. This principle does not exclude the right for each country to close a part of its frontier in case of necessity. Art. XXXVIII. It is important that travelers should be submitted to a surveillance on the part of the personnel of railroads, to determine their condition of health. Art. XXXIX. Medical intervention is limited to a visit (inspection), with the taking of temperature of travelers and the succor to be given to those actually sick. If this visit is made, it should be combined as much as possible with the custom-house inspection, to the end that travelers may be detained as short a time as possible. Only persons evi- dently sick should be subjected to a searching medical examination. Art. XL. As soon as travelers coming from an infected locality shall have arrived at their destination, it would be of the greatest utility to submit them to a surveillance, which should not exceed ten or five days, counting from the date of departure, the time depending upon whether it is a question of plague or cholera. In case of yellow fever the period should be six days. ^ Art. XLI. Governments may reserve to themselves the right to take particular measures in regard to certain classes of persons, notably vagabonds, emigrants, and persons traveling or passing the frontier in bands. Art. XLII. Coaches intended for the transportation of passengers and maus shoiild not be retained at frontiers. In order to avoid this retention, a system of relays ought to be established at frontiers, with transfer of passengers, baggage, and mails. If one of these carriages be infected or shall have been occupied by a person suffering from plague, cholera, or yellow fever, it shall be detached from the train for disinfection at the earliest possible moment. Art. XLIII. Measures concerning the passing of frontiers by the personnel of raüroads and of the post-office are a matter for agreement of the sanitary authorities concerned. These measures should be so arranged as not to hinder the service. Art. XLIV. The regulation of frontier traffic, as well as the adoption of exceptional measures of surveillance, should be left to special arrangement between contiguous countries. Art. XLV. The power rests with governments of countries bordering upon rivers to regulate by special arrangement the sanitary regime of river routes. lio SECOND INTEKNATIONAL SANITARY CONVENTION. ARTICLES RELATING TO YELLOW FEVER. Art. XLVI. Ships infected with yellow fever are to be subjected to the following regulations: 1. ^ledical visit (inspection). 2. The sick are to be immediately disembarked, protected by netting against the access of mosquitoes, and transferred to the place of isolation in an ambulance or a litter similarly screened. 3. Other persons should also be disembarked, if possible, and subjected to an obserration of six days, dating from the day of arrival. 4. In the place set apart for obsei-vation there shall be screened apartments or cages where anyone presenting an elevation of temperature above 37.6° C. shall be screened imtil he may be carried in the manner indicated above to the place of isolation. 5. The ship shall be moored at least 200 meters from the inhabited shore. 6. The ship shall be fumigated for the desti-uction of mosquitoes before the discharge of cargo, if possible. If a fumigation be not possible before the discharge of the cargo, the health authorities shall order, either (a) The employment of immune persons for discharging the cargo; or (b) If nonimmunes be employed they shall be kept under observation during the discharg- ing of cargo and for six days, to date from the last day of exposure on board. Ajrt. XLVII. Ships suspected of yellow fever are to be subjected to the measures which are indicated in Nos. 1,3, and 5 of the preceding article; and if not fumigated, the cargo shall be discharged as directed under subparagraph (a) or (&) of the same article. Art. XLVIII. Ships indemne from yellow fever, coming from an infected port, after the medical visit (inspection) shall be admitted to free pratique, provided the duration of the trip has exceeded six days. If the trip be shorter, the ship shall be considered as suspected until the completion of a period of six days, dating from the day of departure. If a case of yellow fever develop during the period of observation, the ship shall be con- sidered as infected. Art. XLES. All persons who can prove their immunity to yellow fever, to the satisfaction of the health authorities, shall be permitted to land at once. Art. L. It is agreed that, in the event of a difference of interpretation of the English and Spanish texts, the interpretation of the English text shall prevail. TRANSITORY DISPOSITION. The governments which may not have signed the present convention are to be admitted to adherence thereto upon demand, notice of this adherence to be given through diplomatic channels to the Government of the United States of America and by the latter to the other signatory governments. Made and signed in the city of Washington on the 14th day of the month of October, 1905, in two copies, in English and Spanish respectively, which shall be deposited in the State Department of the Government of the United States of America, in order that certi- fied copies thereof, in both English and Spanish, may be made to transmit them thrgugh diplomatic channels to each one of the signatory countries. j Dr. Eduardo Moore. -^ Juan J. Ulloa. • Juan Guiteras. E. B. Barnet. Emilio C. Joubert. M. H. Alcivar. Walter Wyman. H. D. Geddings. John S. Fulton. Walter D. McCaw. J. D. Gatewood. H. L. E. Johnson, M. D. Joaquin Yela. " E. LiCÉAGA. " J. L. Medina, M. D. Daniel Edo. Lavorería. N. Veloz-Goiticoa. SECOND INTERNATIONAL SANITARY CONVENTION. Ill PAPER READ BY DR. E. LICÉAGA IN ACCORDANCE WITH THE SCIENTIFIC PROGRAMME. [From tmnslation fumishod by Doctor Licéaga.] Gentlemen: Allow me that, before our attention is occupied with the subjects which form the subject-matter of the sciontiiic progi-anmio, I direct same for a few moments toward another particular which interests us as a preliminaiy question now, as it will be afterwards the capital question. This question, gentlemen, is the one which refers to the primordial object of our reunion; and so as to establish same conveniently, I trust that you will gi'ant me the peimiasion to remind you of its antecedents. During the last months of the year 1901 and first month of 1902 the vSccond International American Conference met in Mexico, to which assisted representatives of seventeen of the Kepublics of the occidental hemisphere so as to promote all that which could increase the moral and material well-being of the respective countries. By virtue of their full powers those delegates accepted and signed, on the 29th of January, 1902, some resolutions upon "international sanitary police," which contents I ask you permission to extract: The first one of those resolutions proposes: That all the measures upon international sanitary police remain under the dependency of the national government. The second asks: That the detention which is to be exacted from the vessels in the ports be of two kinds, one of observation and inspection and the other of disinfection. The third clause has for object: To suppress the quarantine upon the merchandises and manufactured articles which have not had occasion of getting contaminated upon their passing through an infected country. The fourth clause proposes: That the Govermnents lend their cooperation to the pro- vincial and municipal authorities, with the object that they better the sanitary conditions of the places which need it. That clause asks in addition: That the declaration of the infectious sicknesses should be made obligatory from one country to the other. The fifth clause I permit myself to transcribe integrally, because it is the one which refers directly to the object of our convention. It reads: 5. The second international conference of the American States further recommends, in the interest of the mutual benefit that would be derived therefrom by each of the American Republics, and that they may more readily and effectively cooperate one with the other in all matters appertaining to the subjects mentioned in the above resolutions, that a general convention of representatives of the health organizations of the difl'erent American Repub- lics shall be called by the governing board of the International Union of American Republics to meet at Washington, D. C, within one year from the date of the adoption of these resolu- tions by this conference; that each Government represented in this conference shall des- ignate one or more delegates to attend such convention; that authority shall be conferred by each Government upon its delegates to enable them to join delegates from the other Republics in the conclusion of such sanitary agreements and regulations as in the judg- ment of said convention may be in the best interests of all the Republics represented therein; that voting in said convention shall be by Republics, each Republic represented therein to have one vote; that said convention shall provide for the holding of subsequent sanitary conventions at such regular times and at such places as may be deemed best by the con- vention, and that it shall designate a permanent executive board of not less than five members, who shall hold ofíice until the next subsequent convention, at which time the board shall be appointed with a chairman to be elected by ballot by the convention, the said executive board to be known as the "International Sanitary Bureau," with perma- nent headquarters at Washington, D. C. Gentlemen, allow me to call your attention upon these facts: First. In conformity with the clause which I have just read, the Fii'st International Sanitary Convention met from the 2d to the 5th of December, 1902. Second. In conformity vsdth same a new reunion was fixed to take place at Santiago, in Chile, in April of 1904. Third. In obedience vrith the same an executive commission was named, which should act permanently between one convention and the following. Fourth. This executive commission or board, which was denominated "International Sanitary Office," resolved: That the convention which could not meet in Santiago, Chile, in April of 1904, should meet on the 9th of October, 1905, in Washington, D. C. Fifth and last. This same International Sanitary OflBce has convoked us in this capital and by virtue of this convocation we are here congregated. Gentlemen, all the facts which I have just mentioned and our presence here prove to the certainty that the resolutions which were signed on the 29th of January, 1902, by the representatives of the Republics here represented are in full force. 112 SECOND INTERNATIONAL SANITARY CONVENTION. The facts demonstrate equally, geutlenien delegates, that the most part of the preventions contained in clause fifth have been faiUilled, but the nonsigning a convention in 1902 shows also that the principal has not been fulfilled. And I say the principal because this is the final object, the conclusive, and for the same reason the more important of the dispositions, which literallj' says: That each one of the Governments represented in this conference appoint one or more delegates, so that they assist to the mentioned convention, giving them the necessary authoritj-, so that they may, together with the other delegates of the other Republics, celebrate the sanitary conventions and enact the regulations which in their judgment may prove more beneficial to the interests of all the countries which may be represented in the same, and with this prevention we have not fulfilled. Gentlemen delegates, allow me to ask you: Is there in all the resolutions which I have transcribed an}' precept more concrete, better defined, more clearly expressed Í Is there any possible doubt that it contains the final object of the convention? The answer is not doubtful. This precept is the capital one: The convention has for object to take to the practice all the resolutions of the conference which met in Mexico, relating to the international sanitary police, but veiy specifically that of "celebrating sanitaiy agree- ments and to enact regulations which in the judgment of the same convention should be more beneficial to the interests of all the countries which would be represented in the same." Gentlemen, have we fulfilled this capital precept in the convention of 1902? Evidently not. But this is explainable. That convention, being the first, was the explorating one of the intentions of the Governments whom accepted to concur to the same. It was des- tined to fix the extent of the scientific problems, to formulate them, to approve them, if this was possible. All this was done in that convention; the problems were presented; ' they were concretely formulated: thej^ were definitely resolved, those which were the more important. This means that the preparatory meeting, the preliminary, the one of scientific order, is already ended; that of those subjects the first convention occupied itself. That one fulfilled its duties. It has passed. Gentlemen, let us possess ourselves of the part which we are to perform in the actual convention. We do not come only with the character which is given to us by our oflacial position of technical advisers in subjects of hj^giene; as representatives of the advisory boards; we come now in the name of our Governments, provided with the data which the sanitary science has reached up to the actual moment ; bearing on the experience that each one of us has been able to acquire in his respective country, and sufficiently authorized to sign a sanitary convention between the Republics which are represented here. This is our mission; for this we have come. Let us make, gentlemen, from this first moment the agreement and a solemn one of not separating ourselves before signing those agreements; to enact those regulations, mentioned by the fifth clause, and only then we will have fulfilled with our duties. Think, gentlemen, in the responsibility which we will incur with our Governments if we return to our homes without having fulfilled the commission which has been confided to us ! I ask you again, gentlemen delegates, that we should not separate without having signed a sanitary convention. Gentlemen, I have occupied myself exclusively of the legal question because it is the one which obligates us. With intention I did not want to treat the questions of conveniences and utility because these are indubitable. That the quarantines subsisted in past times, one can conceive and explain, because it rested only on a practical knowledge. This practical knowledge is that the epidemical sicknesses are transmitted by the men, by their means of transportation, by their clothes, and by the merchandises. This is the brutal fact, but it was the one which was used to dictate the precautionary measures. The men bring us the sickness; well, let us detain the men. The vessels transported the sicknesses; let us detain the vessels. The goods some time conduct the sickness; let us stop the entrance of the merchandise. All this are facts of observation, but badly observed. During how much time will we detain the men and the vessels? Upon resolving this question conunenced the difference of opinions. Differ- ence of opinion that had for base the observation also, but incomplete of the facts observed. The vessels used to be detained seven days, ten days, twenty days, forty days, two months as was done at Panama in the year 1892, when the cholera which had invaded Spain threatened. But to the fear as adviser in hygiene, we commence to substitute the reason: Already England observes that in the disinfected and cleaned cities the transmissible sicknesses do not become epidemic, and they clean the ports, investing in same enormous sums, and since then they separate the sick men, clean the vessels, and let them in. After comes the admirable, transcendental discoveries of Pasteur; and at once, as if a veil had been rent, it is discovered that the sicknesses which form the group of the trans- missibles depended of difl'erent causes of live germs. And after Pasteur come the Kochs, the Pfeiffers, the Rouxs, the Yersins, the Kitassatos, and show us that one is the germ of the SECOND INTERNATIONAL SANITARY CONVENTION. 113 cholera, and another that of tlio turberculosis, and another that of the diphtheria, and another different the one of tiio bubonic phi^e. And in possosnion of thi.s knowlodi^o, tliis m to say, that the germs of those sicknesses are live beings, it is founfl out the phwc they occupy in tlie series; natural history is studied, where are found tlieir conditions to live, how tlicy live, iiow they develo}), what means favor their multiplication and which are unfavorable and in which other their lives arc annihilated ; and of this detailed and individual knowledge for each germ, of each sickness, logically, necessarily are taken the means to combat them. But there are transmissible sicknesses, death-dealing ones, which cause the ruin of terri- tories and whole populations and which germ is not yet known. It is true, Imt then appear the fine, delicate, memorable experiments of Kced, of Carroll, of Agi'amonte, giving form, color, and life to the discovery made by the genius of Finlay, and they discover, what? The germ; of the yellow fever? No. Well, what do they discover? They discover the way that the sickness transmits itself. There was a scientific curiosity only known of the naturalists, and it was this, that there are live beings, that there are organisms, that to complete their evolutions, to reach the objects of their life, need to pass through two organisms, and here come the Italian and English doctors to demonstrate that the plasmodia discovered by Laveran in the blood of the paludals is one of those organisms that need to pass through two other live beings, one the man and the other the body of a mosquito Anopheles; and for once is confirmed the admirable discovery of Laveran, the etiology of the malaria is completed and its way of transmission is known. Here are, gentlemen, the data that the science has put to our disposal to transform in scientific, the measures, up to now empirical, employed to defend us from the sicknesses which are transmissible. After knowing that each of the sickness of those which the man can take with him from a port to another is originated by a different germ and that this germ has diverse conditions of existence, and when we know the transmissive agent of the plague, that of the malaria, that of the yellow fever, can we detain m front of a port the vessel with the man which he brings on board and the animals which perhaps continue to produce the sickness in the very vessel? But let us analyze the fact after the light of the actual knowledge. Is the vessel all a danger? Ai-e all the men that are on the vessel dangerous? Are all the animals which accidentally are in the same offensive, from the point of view of the transmission of the sicknesses ? Of the vessel there is only dangerous the part which has been soiled by the dejections of a choleric, by the sputum of a tuberculous and those of a pestered. There is not a more dangerous place than the one where there are rats infected of plague, or mosquitoes anapheles which carry the germ of the malaria, or Stegomyias, infected of the yellow fever. Therefore if it is in our power to disinfect the place of the vessel which has been soiled with the dejec- tions of the choleric, with the sputum of the tuberculous or of the pestered ; if it is possible for us to destroy the rats and mice sick with plague and the mosquitoes infected with the yellow fever or which cany the germ of the malaria, let us direct our doings upon those places or against those animals ; let us change the water from the bilge which might contain larvae of the insects; let us cover the drinking-water tanks so that the mosquitoes may not lay their eggs in the same; and as soon as these operations are done, let us free the vessel. It is not dangerous any more ; let us free it, and not impose on same a quarantine of detention, for it is useless; and if it is useless for our defense it is prejudicial to the interests of the commerce. Let us study the question of the man, the awe-inspiring man, to whom quarantine was imposed. Thereupon not all the men that come in a vessel are sick. Let us inspect them, to dis- cover those which are so. There are sick ones; let us separate them from the others, because they are dangerous for their innocent companions on board; but there are others which, without being surely attacked of such sickness, are suspected of having same. Let us separate them likewise and let us have them in observation, but out of the vessel. There they would be dangerous if they have already the sickness, and they would be victims if they did not have it. Let us separate them, then. The inspection has allowed us to dis- cover that the other passengers are healthy. Then let us free them; but we might be told some of these passengers who seem to be healthy may take with them or have incubated the sickness. Yes; it is true. But would it be convenient to leave them in a narrow place, little ventilated, in the staterooms, and where there is accumulation? Would it not be better to take them away and watch them outside of the vessel, and only for the number of days that the incubation lasts, and in a special place and spacious, where there is a personnel intelligent who watches them? Well, let us do it so; but by all means let us empty the ves- sel, so as to disinfect the same of the germs which may be on its floor and of the infected mosquitoes which may be on its ceilings. 5610—06 S 114 SECOND INTERNATIONAL SANITARY CONVENTION. Therefore it is in our possibility to separate and isolate separately the sick and suspected ones and watch those which might take in germ the sickness ; let us free all the others who will not fear the rigor of the quarantine, and will not deceive us upon the state of their health, because it is of no utility to them to deceive us. The vessel empty, then we can disinfect the same and in turn let him free. How are the inspections to be made for the crew and passengers : how is the disinfection of the vessels to be made as to each one of the sicknesses which germ is different and which means of transmission is also different? This I explained carefullj' in the discourse which I made in the previous convention, and I proposed a series of resolutions on the subject of yellow fever, the cholera, and the plague, and another general resolution which contained all of them — resolutions which, in my opinion, can serv^e as a base for discussion. If the gentlemen delegates wish it so, the secretary of the convention can read the resolutions and the considerations which caused the same. Gentlemen, after the exposition which I have just made, can there be any doubt of the convenience and of the utility to suppress the cjuarantincs as they were made a century ago, and to make them as it is claimed by our state of civilization, as it is exacted by the precise knowledge upon each sickness, as we are obliged to do it by jointly the interests of the conuiierce and the free communication of men? But there are ideas, gentlemen, which, united to an expression, to a word, is so identified with it, that as long as that expression exists, also that word, there is no way to separate them from the idea to which it was associated centuries ago. Gentlemen, let us make the sacrifice of the word quarantine, let us strike it out of our actual vocabulaiy , and then it will not be hard work for us to accept the measures which I am proposing: but, what will be more, we shall not fear then to accept, in the name of our govcnmients, the resolutions adopted in the previous convention, which was only the scientific preamble of the one which has made us meet in this hospitable country, the cradle of so many innovations; in the midst of this nation which has broken all the conventional ties which still binds many nations with the preoccupations of tlie past, with the traditions of such a thiiig vvhich is not useful nor practical; a nation which has declared the same its political independence as its indus- trial; the same the scientific as the artistic; that has separated itself from the trivial paths in war and in the diplomacy. To you, gentlemen delegates, who represent here in your respective nations the future of the Latin race in the world of Colon; to you w^ho are the banner bearers of the advanced ideas of the Republics who have sent you, I address myself, asking that these young nations, fill] of life and of noble aspirations, go into the new ways with frank and resolved steps. Let us leave, gentlemen, the ancient preoccupations; let us forget what the word quar- antine signified; let us substitute that antiquated phrase by another which represents the actual aspirations about public hygiene. Let us adopt a new flag for the battle against the transmissible sicknesses; let us inscribe on same the motto, "To safeguard the interests of the public health without impairing, or impairing the least possible, the interests of the commerce and of the free communication of men," and, affiliated to the scientific doctrine and basing our sanitaiy laws upon that sublime maxim, "Do not do to others what you do not like to have done to yourself," let us reduce the exigency against our neighbors to those which we would wish them to impose on us. If we sign a convention which on one side is founded on science and on another on justice, we wiff have celebrated a compact which will prove that the nations of the Latin America are meritorious to inherit the civili- zation of those who in the Old World gave them life, and that the tree which was rooted two thousand years ago in the place of birth of Lacio comes now to deposit its products, but already ripe, on the other side of the Atlantic, effacing the inscription which was engraved at the outlet of the Mediterranean, "Non plus ultra." Let us prove, gentlemen, that we have science and justice on our side to wrest from its place that old inscription, remembering that actually the science and justice ignore the frontier of the nations, the nationality of the different languages, and that if we have to invoke the past it will be only to bring to your memory its glory to which we should aspire. When the North American nation calls us unto its own house, places at our disposition the conquests of its sons made by them in the sanitary sciences; when it has assembled us here, with sufficient authorization from our respective governments to make and sign agreements and regulations, to give unity to the measures which may secure at the same time the interests of the public health, without impairing, or impairing the least possible, the interests of the commerce, can we be satisfied, as the past time, with making studies of scientific character, as if we assisted to an academy, without fulfilling the obligations which are imposed on us by the fifth clause of the international Pan-American conference, this is to say, without applying to the practice what science has taught us? No; it is not possible. This is not in accord with the legitimate aspirations of the governments who have sent us here to give a solution, the best solution, to a problem which, if we do not resolve at once, wül defer the urgent realization of a great progress in benefit of the hygiene and of the commerce, and the occasion to bind with a new tie of reciprocal interests the friend- ship of the nations of the occidental hemisphere. SECOND INTERNATIONAL SANITARY CONVENTION. 115 Gentlemen delegates, in the name of the progresses of the sanitary science, in name of the civilization, in name of the interests well understood of humanity, I pray you to adjust an International Sanitary (Jonvontion of the Kopubliiis roproHisntod \)csy our Government, which realizes the importance of its betterment. Not wishing to occupy your attention with other matters that are really foreign to the object of this convention I end ray report heic. REPORT FROM THE DELEGATE FROM CUBA, DR. E. B. BARNET. Mr. President and gentlemen of the convention: As the delegate from the liepublic of Cuba I have the honor to submit before this convention tiio sanitary ordinances agreed upon by the superior board of health of the island of Cuba for the sanitary management of the municipalities of the Republic, in accordance with the provisions of military order No. 159, series of 1902, of the former government of intervention of the United States. The organic sanitary law which is in force at present is said order No. 1 59, which pre- scribes that there shall be enacted by the superior board of health general rules for the sani- tary service of all towns of the Eepublic, and said rules are the ordinances which I now deliver, and which as soon as they are enacted by the Cuban Government will immediately be put in force for the purposes to which they are designated. As prescribed by order No. 159 these ordinances will only be of a general character. After their enactment each municipahty, within the period to be designated by the Executive, shall modify them to adapt the local conditions, subject to the approval of the superior board of health. There are at present in the Republic of Cuba 82 municipalities; but when these ordinances were drafted the importance of a city such as Havana was taken into consideration, leaving to the discretion of each municipality the power to propose the amend- ments which I have mentioned. These ordinances are a work of selection and adaptation. Sanitary regulations, ordi- nances, provisions, codes, etc., of other countries were had in view when it was being carried out, because in sanitary matters, particularly in sanitary legislation, it is impossible to try to make original or new provisions, but one must be guided by what practice and experience have demonstrated in other countries. These ordinances are divided into three parts. The first part consists of four chapters, and is a sort of a regulation derived from order No. 159, above mentioned. This part con- tains general provisions and refers to local sanitary boards, local sanitary chiefs, and inspectors. It contains instructions rather than provisions. The second part is the one which really contains provisions, and has 27 chapters, all of them regarding the sanitary matters of a community. The third part concerns violations and penalities. The former are classified in minor and grave offenses according to the sanitary importance, and gives the correctional court jurisdiction over them for the imposition of the proper penalty. Courts of justice are given jurisdiction over violations which constitute crimes against public health. As a whole these ordinances have 635 sections. As every human work, and having been carried out in a new country, which has just been born to the life of freedom, and where matters of public health were formerly unknown in practice, perhaps these ordinances contain many errors and deficiencies. Time and expe- rience will amend and improve them. And, undoubtedly, these ordinances will help Cuba in maintaining the high sanitary reputation which she has among her sister Republics of America. Ordinances of the Superior Board of Health of the Island of Cuba, for the Sanitary Administration of the Ayuntamientos of the Republic. Chapter I. In accordance with the provisions of paragraphs 7 (k) and (b) of sections 1, 2, and 4, respectively, of order No. 159, series of 1902, the Superior Sanitary Board has passed the following ordinances, which, upon approval by the Executive, shall regulate the sanitary service of the ayuntamientos of the Republic. In compliance with paragraph (b), section 4, of said order, these regulations may be modified to conform to the local conditions of each ayuntamiento upon a request from the local sanitary board, approved by the alcalde and forwarded to the Superior Sanitary Board, whose action thereon shall be final. In accordance with the provisions of the Presidential decree No. 11, of May 20, 1902, the chief sanitary officer shall himself or through the secretary of the board dispose of the business of the board together with the secretary of the interior or the Department of Havana, when it is so required by reason of the importance of a particular case. 118 SECOND INTERNATIONAL SANITARY CONVENTION. SANITARY ADMNISTRATION. Chapter II. LOCAL SANITARY BOARDS. Section 1. The sanitary administration in each ayuntamiento shall be controlled by a local sanitary board, which shall be constituted and empowered in accordance with para- graphs (a) and (c) of section 4 of order No. 159. In municipalities where there is no quar- antine oflicer of" the port or chief of the section of special hygiene one of the members shall be a pharmacist, a veterinarian, an engineer, an architect, or some other professional man, if practicable. The members shall qualify as soon as their appointment has been approved by the Superior Board. Sec. 2. The local sanitary board shall prepare the rules and regulations for its interior management, to be submitted to the approval of the Superior Board. Sec. 3. The local sanitary board, by virtue of the powers with which it is vested, shall take special care of all matters relating to the sanitation of its respective municipal district and shall see that all sanitary laws and regulations in force and the orders or instructions of the Superior Sanitar^^ Board in each special case are strictly complied with, subject to the provisions of these ordinances. Sec. 4. The local sanitary boards shall be considered as deputies of the Superior Sanitary Board for the faitliful execution, under a uniform system, of the functions with which they are intrusted in regard to the maintenance of public health. Sec. 5. The local sanitary board shall have charge, under the supervision of the Superior Board, notwithstanding the provisions of paragraph (e) of section 2 of order No. 159, of the services of sanitation and hygiene within its mifnicipal district; of the prophylactic vaccination and inoculation; of cemeteries, interments, disintennents, embalming, and of the removal of cadavers; of the inspection of the medical attendance in private houses, sanitariums, asylums, barracks, fortresses, etc., and of the sanitation of all such institutions. Sec. 6. The local sanitary board shall publish such instructions as it may deem proper to prevent the spread of diseases, submitting said instructions previously to the approval of the Superior Board. Sec. 7. The local sanitary board shall make frequent inspection of the schools and shall order the removal of teachers and pupils which it may find suffering from any infectious disease, prohibiting their return to the school until aU danger of infection shall have disappeared. Ssc. 8. It shall see that proper hygienic methods are followed in hospitals, particularly in all that concerns the isolation of persons having contagious diseases. Sec. 9. It shall see that all tenement houses, hotels, boarding houses, cafés, etc., comply with the sanitary provisions in force, holding the manager, owner, or tenant, as the case may be, responsible for the violation. Sec. 10. it shall instruct the head of the family in which there is a case of infectious disease concerning the precautions which he must take, and shall notify the principal of the school v, ho are the pupils living in the infected house and who must not be admitted to the school until said house be disinfected after the termination of the case or any other which might follow it. Sec. 11. If the local sanitary board should not have the proper means with which to perfonn a bacteriological analysis, it shall send to the Superior Sanitarj' Board samples of the sputimi, blood, defecation, or other pathological matter which the physicians may furnish for the purpose of diagnosis. As soon as the board shall receive the result of the analysis it shall notify the interested parties thereof. Sec. 12. The local sanitarj' board shall send three samples of each beverage or food prod- uct suspected of falsification or adulteration, the receptacles of which shall be strapped, sealed, and signed in the presence of the interested party, in order that it shall not be possi- ble to substitute the contents thereof without leaving traces of such substitution, and it shall deliver to the seller a sample similarly 'strapped, sealed, and signed, retaining one and sending the remaining sample to the Superior Board, with the minutes and the respective report, for the necessary analysis. Sec. 13. Whenever necessary it shall make domiciliary inspections, house by house, making report upon each one of them in the form prescribed for the purpose, which report shall state chiefly: The number of persons hving in the house; whether there is in it a case of a contagious disease or if any has occurred therein within a year prior to the date of the report; sanitary conditions of the house, water-closets, drains, etc. Sec. 14. It shall order owners of houses, in writing, what alterations they must carry out in their respective houses within a definite period, which may be extended for justifiable reasons, provided that it shall not unreasonably delay the execution of the work. SECOND INTERNATIONAL 8ANITARY CONVKNTION. iV,) Sec. 15. It shall give the respective court infonnation of all violations which should be punished, sending in the record of each case and authorizing one of its members or employ- ees to prosecute the oiTonder. Sec. 16. It shall servo notice to all those who refii-se to obey the order or who delay the execution of the work that they shall be brought before the couit if they do not comply therewith within the designated period. Sec. 17. Houses, buildings, etc., which constitute a menace to public health or safety shall bo declared uninhabitable and ordered closed by tlio local sanitary board, and if nec- essary it shall request the ayuntamiento to have the same demolish(!d. The inspection of the municipal architect shall be necessary previous to tlie demolition. ' Sec. 18. it shall recommend to the ayuntamiento the vvoiks which it deems necessary for the sanitation of its municipal district and which the i(!sid('./il,s are not compelled by law to carry out, such as the sanitation of swamps in public lands, drainage of jjool.s, cleaning of streets, etc., sanitation of slaughterhouses and cemeteries, and all other necessary works in public places. Sec. 19. When the sanitation recommended constitutes an urgent necessity and the ayuntamiento refuses to perform the work in due time, the local sanitary board shall notify tiae fact to the Superior Board of Health for the pui-poses stated in paragraph (e) of section 3 of order No. 159. Sec. 20. It shall inform the Superior Board what works of sanitation must be carried out by the province or the government within its respective municipality. Sec. 21. The local sanitary board shall submit to the Superior Board of Health an annual estimate of the expenses required for the maintenance of the sanitation of the ayuntamiento, and which must be stated in the municipal appropriations. Sec. 22. It shall keep, besides the minutes of proceedings, a record of all its transactions, as well as a register of the physicians, phannacists, dentists, midv^-ives, and veterinarians within its municipal jurisdiction, in the fonn prescribed and furnished by the Superior Board. Sec. 23. It shall make an annual report to the Superior Board of Health, within the month of January, on forms furnished by said Superior Board, upon the sanitary conditions and necessities of the municipality; the method of transacting its business; infectious diseases and epidemics and their interesting characteristics;. other events, and all data which the Superior Board may require. • Sec. 24. When requested by the Superior Board, it shall furnish the same with sanitary and demographic statistics made on forms prescribed for the purpose. Sec. 25. It shall report to the Superior Board the permanent causes of the diseases which may prevail iu its jurisdiction, stating what measures it deems advisable for the suppression thereof. Sec. 26. It shall see that no disinfecting materials are lacking in its district, and that drug stores are always provided with antiseptic substances and have the same for sale at reasonable prices ; anything to the contrary shall be notified to the Superior Board. Sec. 27. It shall prepai-e or be provided with exact and detailed maps of its municipahty in order to make upon them graphic representation of the diseases and other subjects worthy of note. Sec. 28. It shall send to the Superior Sanitary Board a monthly extract of aU resolutions passed during the previous month. Sec. 29. It shall furnish the inspectors of the Superior Board of Health with aU infor- mation and data which they may require for the accurate performance of their duties. Sec. 30. The oiHce of member of the local sanitary board is incompatible with that of councilor or employee of the ayuntamiento. Sec. 31. The secretary shall be selected by the board from among its members; he may employ a clerk under his supervision for the dispatch of business. Chapter III. THE LOCAL SANITARY CHEEP. Sec. 32. The local sanitary chief shall be an experienced and competent physician, appointed and paid by the ayuntamiento, subject to the approval of the Superior Sanitary Board. In case the first and second nominations of the ayuntamiento be rejected by the Superior Sanitary Board, the latter shall appoint the person which it deems capable for the position. Sec. 33. The local sanitary chief shall be the president of the board and its executive officer. Sec. 34. He shall submit to the approval of the Superior Board the appointment and removal of the employees of the local board. 120 SECOND INTEENATIONAL SAT^ITARY CONVENTION. Sec. 35. He shall make the reports, statistical data, documents, etc., that the superior sanitar}^ chief may require in regard to the sanitation of his respective municipal district. Sec. 36. In the performance of his duties as local sanitaiy chief, he shall comply with the instructions which the superior sanitaiy chief may give him. Sec. 37. He shall issue orders for the detention and isolation of any person suflering from an infectious disease until the period of his liabihty to spread the disease is passed, in accordance with the provisions of paragraph (f) of section 3 of order No. 159. Sec. 3S. He shall make monthly and annual reports of his trar sections to the local sani- tary board. , . Chapter IV. INSPECTORS. Sec. 39. Sanitary inspectors shall be considered as the deputies of the chief sanitary officer; they shall devote the service hours exclusively to the performance of their duties, and shall always be ready to execute the orders which are given them. Sec 40. The inspector shall be provided with credentials and a badge of oflBce, and shall wear a uniform if the Superior Sanitary Board so orders it. By virtue of his office, he shall be respectful and polite to all persons with whom he may come in contact in the perform- ance of his duties; he must always avoid discussion, and shall submit his reports in writing. Sec 41. He shall make in his reports, which must be specific, accurate and reliable, the reconmaendations which he may deem necessary to prevent the violations which may come under his observation; he shall not give any direct information or order, verbally, or in writing, to the interested parties. Sec. 42. He shall endeavor to be well informed in all that concerns the sanitary condi- tions of his district, so that he may at any time furnish any information which the board or the local sanitary chief may request of him. Sec 43. He shall be correctly dressed, and avoid all places of disrepute during the sers^ice hours. Sec. 44. He shall remain in his district during the service hours, unless he receives express orders to the contrary, and he shaU not engage in any private business during said houre. « Sec 45. Before entering a house he shall announce his office and the object of his visit, and he shall make the inspection with careful attention and minuteness of detail, so that the orders which may result therefrom shall not have to be modified because of deficiencies, errors, or inaccuracies therein. Sec. 46. If he should meet with unreasonable resistance on the part of the owner or ten- ant of a house to allow him to make the inspection, he shall notify the fact to the sanitary chief, in order that through him the aid of the police it may be secured, after all persuasive means have been exhausted. Sec 47. He shall exercise the greatest prudence and reserve in regard to anything that he may obser^^e in the houses by him inspected: he shall not exercise the powers of his office with malicious intention to injure or benefit a third person, or on behalf of his own private interests or his relatives. Sec. 48. He shall request the leave of the local sanitary board when it be necessary for him to absent himself temporarily on account of illness or other private cause. SANITARY ORDINANCES. Chapter I. WATER SUPPLY. Sec. 49. The local sanitary board shall take particular care of the supply of water in its locality, respecting the quantity and the biochemical qualities as well, obtained either from aqueducts, springs, streams, wells, cisterns, or any other natural or artificial source; and it shall prescribe the measures necessary for the preservation of the purity and salu- brity of the water intended for drinking and other domestic purposes. Sec. 50. In towns where there are acqueducts that furnish drinkable water in sufficient quantities, and where the service is well regulated and reasonable in price, the installation of independent pipes in all houses, buildings, and upon all floors in the same that are to be rented separately, and the suppression of all wells, cisterns, and other receptacles shall be ordered unless they are used for industrial purposes, in which case the interested party shall be required to apply for the written consent of the board, which may grant the request or not, in its discretion. Sec 51. It shall be compulsory for the managers of aqueducts to make the water reach the highest places of the town during the daytime. SECOND INTERNATIONAL HANITARY CONVENTION. 121 Sec. 52. When the requirements of the case shall demand it, the use of filters or other means oí puriíication shall be ordered for the amelioration of water used in schools, asylums, cafés, and other public places. Sec. 53. In towns where, on account of the lack of aqueducts, the use of wells and cis- terns is permitted, said wells and cisterns must be provided with lids and impermeable walls, and their openings must be protected by wiie gauze against the access of mosquitoes; the water conduits must also be impermeable and the entrance of the first rain water must be prevented. The well and cistern walls mu.st be at a distance of at least 10 meters from any cesspool, sewer, etc. No cultivation of any sort shall be permitted upon cisterns and wells. Sec. 54. The extraction of water from wells and cisterns, although they be covered, shall be made only by means of pumps, in order to prevent effectively the access of mos- quitoes. Sec. 55. In towns where it is absolutely necessary, to avail of river water for domestic consumption, a place in the I'iver where the water can not be easily infected, shall be selected, and bathing, washing, and the drainage of latrines, sewers, distilleries, sugar mills, slaughter- houses, cemeteries, etc., shall be prohibited in any part from the head of the river to the place selected for the extraction of water. Sec. 56. Any public sale of water for domestic consumption must be authorized by the local sanitary board, which shall regulate and inspect the service assiduously, and shall require that the receptacles be well covered and composed of materials proper for the clean- ing, such as glass, iron, or clay coated with porcelain or glass. Sec. 57. Only drinkable water shall be permitted for public consumption for drinking purposes. Sec. 58. Only water pei-fectly purified shall be used in the manufacture of ice and aer- ated waters, and all operations of the factory shall be perfoimed with strict cleanliness. Ice intended for domestic consumption must be pure, without any taste, and free from all danger of transmitting infection. Sec. 59. Soiling or in any way injm-ing a river or stream, thus making its water unhealth- ful or improper for consumption, is prohibited. Sec. 60. He who, directly or indirectly, makes water intended for consumption danger- ous to health, shall be held criminally responsible. Sec. 61. When, on account of the appearance of a disease, the local sanitary board, sus- pects that an aqueduct, or a well, cistern, stream, etc., is infected, it shall cause an analy- sis of the water to be made immediately, and pi^escribe the measures showing the manner in which to continue its use without danger, or prohibit the use of such water, as the case may be. Chapter II. FOOD products AND BEVERAGES. Sec. 62. Food products or beverages imported or intended for sale in a town must be pure or fresh, ripe or preserved, and their component materials and character must always correspond with the name under which they are sold, clearly stated on the labels of their receptacles or packages. Sec. 63. When a food substance, or a beverage, contains one or more materials foreign to its known and accepted natural composition, it shall be considered as adulterated; it shall also be so considered when any or several of its component materials have been extracted from it, or do not correspond in nature, quality, or composition to the name under which the product or beverage is sold. Sec. 64. Ajiy substance shall be considered as noxious or detrimental to health, and its mixture with any food or beverage being therefore illegal, when it has been shown that it is hurtful to the human body, and when there is any doubt as to its innocuousness, either in its immediate or subsequent effects. Sec. 65. Any food or beverage shall be considered adulterated when — (1) It is in a state of decomposition. (2) It has become acid, decayed, or rancid, or has undergone any alteration which might change its taste or its nutritive qualities, or which would render it detrimental to health. Sec. 66. Adulterated or falsified food products or beverages, as well as those that have substituted for others, or may prove to be difi'erent from what is stated on the label, must be seized and deposited, or disposed of in such a manner as the nature of the ordinance requires it; the manufacturer or seller shall be held personally responsible. Sec. 67. The sale of any food product or beverage, from which the constituent of nutri- tive value shall have been extracted in part or in whole, or that shall have been mixed with other substances, if its composition be not stated on the label and be made known to the purchaser, is prohibited. 122 SECOND INTERNATIONAL SANITAEY CONVENTION. Sec. 6S. The sale, importation, or storage of meat, fish, pouUry, game, fruits, vegetables, milk, beverages, wines, liquors, etc., which are not found in perfect condition for consump- tion, and also of canned goods the receptacles of which are damaged or opened, is prohibited. Sec. 69. The sale in public streets of meat, fish, pies, candies, etc., unless they be prop- erly covered and protected against dust, insects, and hands, is prohibited; and likewise the sale of pies, candies, viands, etc., in establishments, unless they be kept in closed show cases ; the use of proper instruments for handling said articles is recommended instead of the use of hands. Sec. 70. The lisc of mineral colors in which composition lead, antimony, copper, chro- mium, arsenic, or mercury, form a part; of organic colore, such as gum gutta and aconite; of coloring materials derived from bitumen, and, in general, of all materials, which might be injurious to health, is proliil)ited in the coloration of an)^ food product. As an exception, the use of colors derived from bitumen for the coloration of food prod- ucts is permitted, provided said colors do not contain antimon}^, arsenic, barium, lead, cad- mium, chromium, copper, mercury, uranium, zinc, tin, gum gutta, coralline, or picric acid. Sec. 71. The use of leaden tin foil for wrapping fruits, candies, chocolate, cheese, and any other food products, is prohibited. Tin foil intended for such purpose must be composed of an alloy containing at least 97 per cent of tin immersed in metastannic acid. This alloy must not contain more than a half of 1 per cent of lead and to o o o of arsenic. Sec. 72. Likewise, timiing of vases and kitchen utensils is prohibited unless the solution contains a similar alloy to that prescribed in the preceding section. The use of tin vases and utensils intended for containing or preparing food products is prohibited if said vases and utensils be manufactured ^vith an alloy containing more than 10 per cent of lead or other metals which are ordinarily found alloyed with tin; such alloys should not contain more than x^oo o of arsenic. Sec. 73. Objects of metal or alloys, the nature of which niight.be injurious to health, must not be mixed with bonbons, candies, and, in general, any food product. Metallic foil used in gilding or silver-plating bonbons and pastilles must be of fine gold or silver. Sec. 74. It shall be the duty of any peison having information of the existence of un- wholesome or decaj^ed food products for sale to notify the fact to the local sanitary chief. Sec. 75. It is prohibited to manufacture, sell, or give away, or to authorize the manu- facture, sale, or giving away of food products or beverages injurious to health, whether their toxic or noxious efl'ect be immediate or tardy. Sec. 76. All establishments engaged in the sale or deposit of food products or beverages must be kept perfectly ventilated and clean — floors, walls, counters, kitchens, water-closets, seweis, etc., particularly. Sec. 77. The use of poisonous substances, or substances prejudicial to health, for dyeing, painting, or coloring food products or beverages, or paper for wrapping the same, is prohib- ited; and also the use of said poisonous or noxious substances for painting, varnishing, tinning, or coating receptacles of any kind which might infect the food products or bever- ages; toys and other articles for children are included in this prohibition. The use of colore in the composition of which lead, antimony, copper, chromium, areenic, mercury, gum-gutta, or aconite form part, is prohibited in the preparation of paper, paste- board, or other materials for packing food products. Sec. 78. Wine is defined to be the liquid resulting from the femientation of grape juice, without addition of substances foreign to the composition of said juice. Sec. 79. Artificial mne is that which is not derived from the fennentation of grape juice. Sec. 80. The use of the following substances in the manufacture of all kinds of alcoholic liquors, and the addition of the same to wines, is prohibited: (1) Metallic salts, mineral or organic acids, pernirnes, ethere, and essences. (2) AH antiseptic substances. (3) Aiiy other substances foreign to the natural composition by fermentation of wines and alcoholic liquors. Sec. 81. Wines and alcoholic liquore containing any of the following substances shall be considered as adulterated, and noxious or not, as the case may be: (1) More than two grams of sulphate of potash per liter. (2) More than one gram of sodium chloride per liter. (3) Excess of water or alcohol. (4) Coloring substances foreign to the composition, whatever their origin may be. Sec. 82. Alcoholic liquors obtained by fermentation must not contain foreign coloring matter. Sec. 83. Persons selling adulterated or artificial wines not detrimental to health shall incur the penalty of seizure and payment of the cost of analysis and the fine. Those selling adulterated or artificial wines detrimental to health shall be brought before the courts of justice. SECOND INTERNATIONAL H ANITA K Y (JONVKNTION. 123 Sec. 84. The sale of wine vinegars containing less than 5 per pent of acctio acid is pro- hibited. Seo. 85. Vinegars derived from alcohol, beer, cider, etc., may be 'sold, provided the label on their receptacles show the product from whi(;h they are derived. None of tluae vinegars shall contain less than 3 per cent of acetic acid. Seo. 86. Vinegars containing sulwtances foreign to their natural composition shall be considered as adulterated. Sec. 87. The addition of any substance to wheat flour for tlie purpo.se of increasing its natural weight or volume is prohibited. Sec. 88. Ordinary bread, intended for sale, must bo manufactured with wheat flour with- out any mixture whatsoever, and well kneaded and baked The use of any substance foreign to^the natural and known composition of bread is proliibited. ' Sec. 89. Any other kind of biead which is not exclusively made of wheat flour, leaven, salt, and water may be sold provided its composition is made known to the purchaser. Sec. 90. Bakeries must be established in places with good light and the ventilation necessary for their perfect cleanliness. Flooi's, walls, kneading troughs, etc., must be kept absolutely clean. No bedrooms, water-closets, stables, animals, etc., shall be permitted in the premises of any bakery or in direct communication with the same. Persons suffering from cutaneous or infectious diseases are prohibited from intervening personally in the confection, sale, etc., of bread. The transportation of bread shall be made with absolute cleanliness and protection against dust, insects, and hands. Sec. 91. The use of wood and other fuel that has been painted, undergone any chemical process or been saturated with substances noxious to health, for the heating of furnaces in bakeries, confectioneries, etc., is prohibited. Sec. 92. The kind of flour used in the confection of soup pastes shall be stated on the label of the package. Sec. 93. Only pure saffron and annatto may be used in coloring soup pastes. Sec. 94. The sale of spices intended for food or condiments, such as cinnamon, saffron, clove, etc., that have been adulterated or the natural weight, volume, or composition of which has been increased, is prohibited, unless it be done in accordance with the provisions of section 67 of these ordinances. Sec. 95. Products exclusively manufactured with milk, or cream derived from milk, or with both, with or without salt and coloring substances, and in the composition of which there is more than 15 per cent of water, is prohibited from being sold as or termed " butter." Sec. 96. Any food product which, on account of its appearance or flavor might be taken for butter, or which is prepared for the same use, shall not be sold except under the name of "oleomargarine," if such be the case; in other cases the provisions of section 67 of these ordinances shall be complied with in the sale, under penalty of seizure and fine if the viola- tion does not constitute crime. Sec. 97. Packages, boxes, cans, paper, and packing of any kind, containing oleomarga- rine for sale or deposit in large or small quantities, must have printed thereon in Spanish and in conspicuous roman letters, of a half a square inch at least, the word " Oleomargarine." The sale of such product without the above or other specification shall be understood to be of butter, for the purposes of sanitary inspection. Sec. 98. Merchants or dealers selling products, which, not being pure pork lard, are similar thereto, or which might be taken for it on account of their flavor or appearance, under the name of "lard" or "compound lard," are hereby compelled to inform the pur- chaser or consumer, at the time of the sale, that said substances are not "pork lard," and to put on the receptacles thereof labels with the words "Artificial lard" printed in Spanish, with intelligible letters a half a square inch long; these labels- shall be placed on the most conspicuous part of the receptacles. Sec. 99. The only oil that shall be sold under the name of "olive oil" is that extracted from olives, free from any mixture. Other oils intended for table use and which are not noxious may be sold, provided that the labels on their receptacles state in roman letters, in Spanish, and in an intelligible and durable way, their nature or origin. The sale of adulterated or rancid oils of any kind for table use is prohibited. Sec. 100. The manufacture of all kinds of beverages must be made with ingredients of good quality, using for the purpose clean vessels which are not made of copper or other material that might make them prejudicial to health. Sec. 101. The use of saccharine in beverages and food products is prohibited. Sec. 102. The sale of watered, skimmed, or otherwise adulterated milk, and that derived from sick animals, or animals that have been fed with industrial refuse in fermentation, is prohibited. Sec. 103. For the purpose of these ordinances, the following shall be considered as adulterated milk: 124 SECOND INTERNATIONAL SANITARY CONVENTION. (1) Milk containing more than 18.5 per cent of water, less than 11.5 per cent of solid materials, and less than 2.7 per cent of grease, or containing any substance foreign to its natural composition. ; (2) Milk obtained fifteen days before or eight days after the parturition of the animals. (3) Milk derived from sick animals, or animals that have been fed with waste materials and products in a state of fermentation. (4) Milk from which the cream has been totally or partially skimmed. (5) Milk obtained from animals kept in narrow or unhealtliful places. (6) Milk to which water, other liquid, condensed milk, or any other foreign substance has been added, or curdled or otherwise spoiled milk. ^ (7) Milk coming from places where scarlet fever, cholera, typhus, typhoid fever, diph- theria, or other contagious diseases prevail. (8) Milk extracted from animals tliat have been fed with poisonous plants or that have taken toxic substances. Sec. 104. For purposes of inspection, milk the density of which is less than 25° (1025), ascertained by the Qucvenne lactometer at a temperature of 15° centigrade approximately shall be considered as suspicious. Sec. 105. Milk intended for sale shall not be kept on places used as bedrooms or for any other purposes. Milk shall not be drawn off in the public streets, trains, or railway stations except when it is to be delivered to the purchaser. Sec. 106. The sale of milk intended for public consumption shall be permitted only when the bottles, flasks, or other vessels which contain it have undergone the following treatment: (1) Bottles, flasks, and vessels, before being filled with milk, shall be washed first with a hot solution of soap, lye, or other alkaline substance, and afterwards with hot water. (2) Milk must be bottled in places which are not used for habitations, bedrooms, or other domestic purposes, and which are not near any stables. (3) Vessels containing mük intended for sale must be provided with an adequate. cover to protect it against dust and other impurities. Sec. 107. Vessels used as receptacles for milk must be very clean, and their joints must be smooth and not rusty. Vessels made of untinned copper, brass, lead-coated metal, or unevenly varnished porcelain, are prohibited. Sec. 108. If it be not desirable to cover the milk while it is in the stable or dairy, a fine cloth shall be placed upon the mouth of the vessel containing it. Cleaning of vessels shall be done immediately after they shall have been emptied, with boiling water, soap, and brush; they shall be rewashed with boUed water only and put to dry in the sun, mouth downward, but not upon the ground. Sec. 109. Milk stored for sale must always be deposited in a refrigerator or ice box. Sec. 110. Ice boxes must be washed twice a week, at least, with hot lye water. Sec. 111. The drain pipe of an ice box must not be directly connected with sewers or gutters. Sec. 112. Measures and other utensils used for measuring milk in dairies and other places where milk is sold, must be carefully washed after the sale with boiling water to which lye shall have been added in a proportion of one tablespoonful per liter. Sec. 113. Milk must be properly stirred in the vessel before sale, in order that the last portions extracted shall contain as much cream as the first. Sec. 114. Ice must not be put into the milk, as a means of preserving it; milk must be kept in the ice box. Sec. 115. Wagons assigned to the transportation of milk must be made of waterproof materials or oil-painted wood, and always kept perfectly clean. The use to which it is assigned shall be stated in the exterior of each wagon in permanent and intelligible letters, as well as its number and the place from which it comes. Milk dealers on horseback, or availing themselves of other means of transportation, must keep the panniers, saddlebags, etc., perfectly clean. The transpoitation in wagons, panniers, saddlebags, etc., assigned to the delivery of milk, of other products or substances except fresh cheese, butter, and similar dairy products, is prohibited. Milk dealers must carry with them during the ■ sale hours their respective licenses, which they must exhibit to the sanitary inspectors whenever requested to do so. Sec. 116. Vehicles and horses assigned to the transportation of milk shall be registered in the records kept for this purpose by the local sanitary board. Sec. 117. Persons engaged in the traflic, transportation, and handling of mük intended for sale shall provide themselves with a certificate from the local sanitary officer guaran- teeing the hygienic condition of the milk. These certificates shall be renewed from year to year. SECOND INTERNATIONAL HANITAKY CONVENTION. 125 Sec. 118. Milk dealers shall be provided, besides tlie industrial HccriHO that inay be required by the municipal laws, with a copy of tiio rcf^ulationsof these Ordinances regarding the sale of milk, whicli copy shall be furnished by tlie local sanitary board. Sec. 119. Buildings intended for milch-cow stables must have 30 cubic meters at least of space for each animal; good light and ventilation; properly canalized pavements; and must be well roofed and provided with pure and fresh water and all that is nojcessary for the maintenance of cows and other milch animals in good condition of liealth and hygiene, in accordance with the special regulations in icgard to dairies. Such stables must be located outside of the city limits, and no other industry or business shall be conducted therein. Seo. 120. Owners or managers of stables for cows or other milch animals must keep the f)remises,of their establishments perfectly clean, and take the cows to the pasture grounds rom 4 p'. m. to 8 p. m., and shall not put them in the stables but from 4 to of ¿lie next morning. Sec. 121. Persons suffering from cutaneous or contagious diseases, or those that. have come in contact with them, are prohibited from milking cows or other animals, selling milk, handling vessels, measures, and other milk receptacles, or helping in any such operations, until their liability to spread the disease has disappeared. Persons engaged in dairy opera- tions must be clean and free from filth of any kind. Seo. 122. Milk derived from sick cows must not be sold, used in the confection of food products, or mixed with other milk. Likewise, its use for any other purpo.se, even if it were for feeding other animals, is prohibited. Sec. 123. The importation, sale, or storage of adulterated condensed milk is prohibited. For the purposes of these ordinances "condensed milk" is understood to be pure milk from which a part of its water has been extracted, or from which a part of water has been extracted and sugar added. The term "adulterated," in the last case cited, refers to condensed milk in which the quantity of grease is less than 25 per cent of the solid substances contained in it, and to which any foreign substance, except sugar, has been added as a means of preserving it. Seo. 124. Milk intended for sale shall be subject, at any time and place, and under all circumstances, to the vigilance of sanitary inspectors, who are hereby authorized to take samples in quantities not exceeding a half a liter per vessel, in order to submit them to analysis. Before taking samples the milk must be sufficiently shaken, in order that the small particles of grease be equally distributed in the liquid. Sec. 125. Inspectors shall use the Quevenne lactometer in order to ascertain the specific weight of milk, and shall keep a record of all samples tested. Sec. 126. As soon as there are suspicions that a certain milk is adulterated, an inspection of the dairy, stable, or place from whence it came, shall be ordered, and it is left to the discre- tion of the inspector to require or not the exhibition of the cows from which the milk in question was extracted. Sec. 127. Milk dealers who do not comply strictly with the regulations prescribed for the sale of this article shall be subject to fine and subsequent seizure ; if the violation constitute a crime the inspector shall notify the fact to the local sanitary chief for proper action. Sec. 128. Dairies and cow stables must be well ventilated and kept in perfect cleanliness, and their pavements shall be scrubbed daily. In the stable each animal shall have a manger and a trough, general mangers and troughs being prohibited. Sec. 129. No sick cows shall be allowed in the stables, and the sound ones should be separated from each other, well fed, given fresh and pure water, and bathed daily. Sec. 130. The premises of stables should be well ventilated and the pavement sprinkled before milking the cows in order to avoid the falling of dust into the milk. Sec. 131. Milking must be done with perfect cleanliness; before the operation the milker should wash his hands and also the udder of the animal that is to be milked, drying them with a clean piece of cloth; he shall avoid the falling into the milk of hair or any other substance that might soil it. Sec. 132. It is prohibited to milk cows or other animals the udders of which have any «ruptibn, inflammation, or other disease. Sec. 133. If, during the operation of milking, the milk turns out to be bloody, yellowish, or, in general, of a color and a flavor different from the natural ones, it shall be thrown away, carefully cleaning the vessel that contained it, suspending the operation of milking, and placing the cow under observation until the condition of its health has been ascertained and the sanitary inspector authorized the milking anew. Sec. 134. If, for any cause, should the milk be soiled, it shall not be collated, but thrown away, washing the vessel that contained it immediate^ after. Sec. 135. Farm dairies engaged in the extraction of milk for sale, manufacture of cheese, etc., must compty with the preceding provisions as much as possible, and shall be subject to frequent inspection by the local sanitary board. 126 SECOND INTERNATIONAL SANITARY CONVENTION. Sec. 136. OwTiers of stables and dairies are compelled to have posted in a conspicuous place thereof a printed copj'^ of the special regulations regarding the trade, to be furnished by the local sanitary board. Sec. 137. The use of " presers'ing " substances in milk, as well as in other food products, is prohibited. Sec. 138. The manufacture of pot cheese should be made with cream or milk of good quality and derived from sound animals, and the manufacturer shall take proper hygienic precautions approved by the local sanitary chief. The sale of cteam or pot cheese by peddlers, or others who do not keep the article in a refrigerator and protected against dust in order to avoid its decomposition and the produc- tion of poisonous substances, is prohibited. Sec. 139. Organic substances susceptible of easy decomposition, intended for food products, shall be preserved in a refrigerator. Sec. 140. Grains or powders sold.under the name of "coffee" must be exclusively com- posed of this substance. The sale of coffee mixed with foreign substances, as well as the sale of "powder coffee," deprived, by the infusion thereof into water, of the constituents which give it its perfume, flavor, and peculiar qualities, is prohibited. Sec. 141. Products prepared and sold under the name of "chocolate" shall be obtained only from cacao seeds, pulverized and mixed with sugar, aromatized or not. The maximum proportion of sugar shall be of 60 per cent; proportions exceeding this number shall be expressly and clearly stated on the label of the package containing the article. Sec. 142. Owners or managers of grocery stores must permit the visits of the sanitary inspector; failure to complj^ with this provision shall be punished by fine for the first offense, and with the penalties that the court might deem proper in case of a repetition of the offense. Chapter III. construction of buildings within city limits — ventilation— drainage and sanitary plumbing. Sec. 143. Lands on which houses or buildings are to be constructed should be previously drained ; if it be necessary to fill the land before the construction, the filling shall be done with materials which are not noxious. Before commencing an excavation or removal of earth or materials, the local sanitary chief shall be notified in order that he may issue the necessary orders for the disinfection of the land. Sec. 144. The building should be based on a firm ground, upon a bed of cement or other proper material. Ground-floor rooms should be isolated from the earth by a bed of asphalt or cement of a minimum depth of 15 centimeters. In order to prevent the ascension of humidity through the walls the same should be isolated with coating of cement, asphalt, slate, or other impermeable material. This insulat- ing coat shall be placed at about 15 centimeters under the level of the floor. Sec. 145. If stables or storerooms for salt or other corrosive substances are to be built against a wall, a distance of 15 centimeters at least should be left between the wall and the intended construction. Sec. 146. Glass or other material roofs are prohibited upon interior courts or yards above the stanchion of the ground floor, unless said roof be removable or be provided with venti- lators of vertical faces, which openings should not be smaller than one-third of the surface of the yard or court, and have a height of 50 centimeters. Sec. 1 17. Each house or building in streets where there are no sewers, and while these are being constructed shall have a cesspool for the deposit of fecal matter exclusively; but as soon as the construction of the general sewers in the streets be completed the property owners shall be compelled to construct the outlets to the general sewers and to fill the cess- pools. ■ Owners of houses or buildings in streets where there are sewers shall proceed to construct the outlets to the same within the six months following the pubMcation of these rules. Sec. 148. The construction, reconstruction, or alteration, partially or totally, for any purpose, of a house or building, which construction, reconstruction, or alteration might constitute a danger to public health and safety, on account of lack of substantiability ventilation, light, drainage, sanitary plumbing, or other similar requisites, shall be pro- hibited. Sec. 149. The permission from the ayuntamiento must be previously secured for the construction, reconstruction, or alteration, partial or total, of a house or building, and to make or change the sanitary plumbing in the same, and the works shall be carried out subject to the restrictions prescribed by the ordinances regulating constructions and to the specifications of the department of engineering, or of the municipal architect in places where there be no such department of engineering. Before granting the Ucense the ayunta- miento shall submit the apphcation to the local sanitary board for its opinion, which shall be based on these ordinances, and if such opinion be unfavorable it shall point out, within SECOND intí:rnational sanitary convention. 127 twenly days, the defects and the proper way to corrcet them. An appeal against the decision of the local sanitary board may be taken before the Superior Board for final action. If the decision of the local sanitary Ijo'ard be favorable, the license sball be irrariled at the earliest possible convenience, unless other lepal ie(|uisites have not Ijr'cn iullilled. Sec. 150. Before a nevi^or partially or tolaliy rebuilt or altered housfi, or Ijuildinjí, is occu- pied, rented, or in any other way availed of, it shall he inspected, a favorable certificate of the inspection from the local sanitary board bcinfi necessary. Tlie inspection shall t>e limited to verifying the fulfillment of the prescriptions required by the approved plan and specifi- cations. An appeal against the decision of the local sanitary board may be taken to the Superior Board, whose action shall be final. Sec. 151. No house, building, or part thereof, shall be used for living purposes unless it has all proper conditions of capacity, water service, ventilation, light, drainage, and other indispensable requisites of cleanliness and sanitation. Sec. 152. New houses or buildings shall be constructed leaving 15 per cent at least of the built area for uncovered surface or interior courts or yards, in order that all rooms shall have good hght and ventilation. Sec. 153. Existing houses or buildings used as residences, which have not the conditions prescribed in the preceding section, shall be provided with air shafts, or, if these be impracticable, supplemental ventilation. Sec. 154. All rooms shall have doors and windows overlooking directly the street, garden, court, or open passage. Doors shall have transoms, protected or not by glass frames. Sec. 155. All rooms should have a capacity of at least 36 cubic meters, and a surface in doors and windows of not less than 3 square meters, increasing this space in a proportion of 1^ square meters for every 30 meters of cubic contents. Sec. 156. The pavement of ground-floor rooms shall be higher than that of courts, and the latter higher than the street level. No other exceptions shall be made outside of those expressly authorized in wi-iting by the local sanitary board, when the requisites prescribed by the same shall have been complied with in each case, subject to these ordinances. Sec. 157. The pavement of ground-floor rooms, as well as that of courts, shall be made of cement, compressed cement tiles, or other impermeable materials. Sec. 158. Walls of houses or buildings shall be so constructed as to prevent the impreg- nation of the humidity from the ground, employing for the purpose impermeable materials. Sec. 159. In houses or buildings, in places where the use of wooden pavements for gi-ound floors is permitted, the space between the ground and the floor shall have ventOation. Sec. 160. No cesspools shah be constructed under the floor of any room. Such deposits shall be located in the most central part of courts or gardens, ventilated and exposed to the sun. Sec. 161. Water-closets shall be located in courts, passages, corridors, or other places with good light and ventilation, but never in bedrooms, and should be isolated from living rooms, kitchens, pantries, etc., by solid walls. Sec. 162. Drainpipes from roofs, water-closets, etc., should be made of cast iron and must not be set into the walls, but placed outside of them. Sec. 163. Each house or building shaU have one water-closet for every twenty persons, with all necessary requisites to prevent emanations and infiltrations. Sec. 164. The owner, agent, manager, or representative of a house, building, or residence shall always be primarily held responsible for the maintenance in good condition of the sani- tary plumbing of the property, irrespective of the action which might be properly taken against the tenants, as the case may be. Sec. 165. Outbuildings should have the required conditions of ventilation, light, and water, and their own water-closets and sewers; if not, the o-Roier shall be compelled to allow the tenants the use of the water-closets and sewers of the main building, in the pre- scribed proportion to the number of persons. Sec. 166. Outbuildings used for the sale of meat, milk, candies, etc., shall have the sani- tary service completely separated fi'om the store; they shall not be in direct communication with the main building; they shall have in the upper part of the door a transom 40 to 50 centimeters high by whatever the width of the door may be. Only the pei'sons in charge of their custody, and in no case any family, shall be permitted to sleep therein, but in adjoining rooms. Sec. 167. Owners of houses in towns where there are aqueducts and water pipes from the same in the streets are obliged to place in the houses faucets in proportion to the num- ber of tenants, and an independent water service for each floor that is to be rented sepa- rately. Sec. 168. The construction of wells, cisterns, or other deposits for water in new houses which streets have water pipes from the aqueduct shall not be permitted, except when they are to be assigned to industrial pm'poses, in which case the permission ft-om the local sanitary board shall be necessary, and the use of such weUs and cisterns shaU be subject to the requisites that said board may prescribe. Pools for domestic purposes are excepted from this prohibition if they have the conditions prescribed by the local sanitary board. 128 SECONU INTERNATIONAL SANITARY CONVENTION, Sec. 169. Cesspools, in towns where they are permitted, shall be located at a distance of not less than 10 meters from wells, cisterns, springs, or other water sources. This provi- sion shall apply to deposits for refuse, garbage, etc. Sec. 170. The installation of water pipes through sewers, drains, etc., is prohibited. Sec. 171. The construction or opening of churches, theaters, circusis, foundling asylimis, hotels, hospitals, asylums, and other public places shall not h^ permitted except upon favor- able report of the local sanitary board after the examination of the plans, specifications, etc. Sec. .172. Theaters, circuses, churches, hotels, lodging hous:^s, asylums, etc., shall have, besides the general requisites, the following special ones: (a) SufBcient ventilation; (b) fire extinguishers "and escapes; (c) abundant suppty of water, and proportionate number of water-closots and urinals; and (d) perfect cleanliness in all outbuildings. Sec. 173. No barracks and jails shall be constructed except upon favorable report of the Superior Sanitary Board. Sec. 174. Persons having knowledge of the commission of an act or the carrying out of a work in a building dangerous or detrimental to public health shall report the fact to the local sanitary chief. Chapter IV. HOTELS, LODGING HOUSES, BOARDING HOUSES, CAFÉS, RESTAURANTS, AND INNS. Sec. 175. No hotel, lodging house, boarding house, café, restaurant, inn, or bar shall be established unless the owner subjects the establishment to the conditions prescribed by the sanitary chief in a written license. Owners of hotels, lodging houses, etc., which are in operation at pres'^nt are hereby granted a maximum period of six months from the publica- tion of these ordinances, within which time they shall make the required improvements, under penalty of fine and closing of the establishinent. Sec. 176. Hotels, lodging houses, and boarding houses shall keep a book where the name, place of origin, date of arrival and departure, and number of the room, of each guest shall be recorded, and also the names of persons employed in the establishment. Sec. 177. It is hereby prohibited to lodge in hotels, boarding houses, lodging houses, and inns a larger number of persons than that corresponding to the capacity of the rooms, in a proportion of 20 cubic meters of space for each person. Sec. 178. Every room or chamber shall be numbered with permanent figures. Sec. 179. A larger number of beds than that corresponding to the above-mentioned pro- portion shall not be permitted in rooms or chambers uidess there be other proper means for more ventilation, approved by the local sanitary board and by license in writing, in which the number of beds permitted shall be stated. Sec. 180. Every bedroom shall have 40 cubic meters capacity at least, and the neces- sary doors and windows, the latter being not less than 1 square meter, so that it shaU have communication with the exterior air, unless other adequate means to furnish good ventila- tion be employed. Sec. 181. Every room shall always be kept perfectly clean, as well as the furniture, uten- sils, bed clothing, etc. The walls shall be whitewashed once a year at least. Sec. 182. Garbage and refuse shall be deposited in receptacles of zinc or other imperme- able material in accordance with the model prescribed by the local sanitary board, and shall be collected daily. Sec. 183. Hotels, lodging houses, boarding houses, and inns should have the urinals, water-closets, sculleries, sewers, pipes, etc., kept perfectly clean and in good serviceable condition. There shall be one bathroom and one water-closet for every twenty persons. Water-closets shall be located in places of sufficient capacity, well ventilated, and with enough light, natural or artificial, during day and night. The walls must be impermeable to a height of at least 1 meter. The pavement of bathrooms, water-closets, urinals, sewers, etc., must be impermeable, and shall always be kept perfectly clean. Sec. 184. The above-mentioned establishments shall be provided with water supply sufficient to furnish at least 100 liters daily for each person. Sec. 185. Cafés, restaurants, bars, etc., shall be provided with sanitary water-closets, urinals, and washstands for the pubhc service, all of them in good serviceable and clean condition, in number proportionate to the importance of the establishment; said water- closets, etc., shall be subject to the approval of the local sanitary board, and installed in accordance with the plan and system prescribed by the board. Sec. 186. The establishments referred to in the three preceding sections shall be provided with cuspidors, in the proportion of one for every twenty persons, in corridore, passages, etc., of the model and with the disinfecting solution to be prescribed by the local sanitary board. In cafés the number of cuspidors shall be equal to that of tables in use. Sec. 187. It is the duty of the keeper or owner of an hotel, lodging house, or boarding house to report to the sanitary chief any case of disease on the premises which may be found to be without medical attendance; cases of infectious diseases shall be reported as well. SECOND TNTERNATTOKAL SANITARY CONVENTION. 129 Seo. 188. Any person suffering from a contagious disease who is lodged in a iiotel, lodging house, or boarding house, etc., shall be removed to an isolated hospital when the sanitary chief shall deem it nccessaiy. Seo. 189. The owner or keciper of a hotel, lodging house, inn, n^staurant, or bar who shall fail to comply with the provisions of this chaptisr shall be held responsible for the offense. Should he find resistance on the part of any of the lodgers to comply with said provisions, or should any of such lodgers have violated the same, lie shall notify the fact at once to the sanitary chief. Chapter V. TENEMENT HOUSES. Seo. IQO. For the purposes of these ordinances it shall be understood by the term "tene- ment house " any building or part thereof assigned as residence of three or more families who live independently from one another, with general right to use the passages, courts, bathrooms, or water-closets, and with separate kitchens. Seo. 191. Every tenement house shall have a person in charge of it, who shall be held primarily responsible for the fulfillment of the following duties, irrespective of the action that may be brought against the owner. Sec. 192. He shall keep a register, where the name, place of birth, age, place of origin, date of arrival, and number of rooms of each tenant shall be stated, as well as the changes of rooms which might take place within the building, or the date on which any of such rooms may be left vacant. Seo. 193. He shall notify the sanitary chief whenever there is a sick person in the building without medical attendance. Seo. 194. He shall ask the physician attending a sick person in the building whether the disease is contagious or not; if the answer be affirmative, he shall immediately notify the fact to the sanitary chief. Seo. 195. He shall compel the tenants to deposit the garbage and refuse in galvanized- iron receptacles, to be furnished by the owner of the building and made in accordance with the model and number prescribed by the sanitary board. Seo. 196. He shall see that all courts, yards, and corridors are always kept perfectly clean, and for this purpose he shall not allow garbage or dirty water to be thrown in said courts, yards, or corridors. Seo. 197. He shall not permit the deposit in the building of furniture or articles not in use. Seo. 198. He shall see that the inlets to sinks are supplied with water and properly covered. He shall inspect the same frequently to see that they are in good condition, as well as the faucets, traps, sinks, washstands, and other sanitary plumbing. Sec. 199. He shall see that water-closets and urinals are always kept clean and in good serviceable condition, and that no urine or other filthy substances are deposited on the floors thereof. Seo. 200. He shall inspect all rooms in the building in order to see that they are kept clean. Should he find any room in an unsanitary condition he shall admonish the tenant, and if such tenant refuses to comply vñth the notice he shall report the fact to the sanitary chief. Sec. 201. He shall keep the courts or yards in such a condition that no puddles can be formed, and he shall see that the wells, cisterns, tanks, and other receptacles for water are properly protected v/ith covers of wire gauze against the access of mosquitoes. Sec. 202. He shall not allow in any room overnight a greater number of persons than that corresponding to its capacity as prescribed by the sanitary board, which number shall be posted in every room. Sec. 203. Inxmediately after a room is left vacant he shall clean it thoroughly before it is rented again, keeping it closed in the meanwhile. If a case of any disease the report of which is compulsory should have occurred in the room, he shall notify the fact to the local sanitary chief for the necessary disinfection. Seo. 204. Every tenement house shall be provided with cuspidors in the proportion of one to every 20 persons, which cuspidors shall be placed upon stands 1 meter high, in courts, passages, and corridors, and it shall be the duty of the person in charge of the building to keep them clean and supplied with the antiseptic solution prescribed by the board. Sec. 205. Every tenement house shall be provided with one water-closet, one bathroom, and one sink for every 20 persons; the floors and walls of such water-closets and bathrooms shall be impermeable, and also the walls to a height of IJ meters, at least. Sec. 206. All tenement houses shall be provided with water supply sufficient to furnish at least 100 liters daily for each person. Sec. 207. Roofs, walls, doors, and windows of tenement houses shall be kept clean, white- washed and painted, and without clefts. The walls shall be whitewashed at least once a year. 5610—06 9 18U SECOND INTERNATIONAL SANITARY CONVENTION. Sec. 20S. The placing of cloth or paper over holes or small windows of rooms in such manner as to obstruct the access of light or air, is prohibited. Sec. 203. Wash tubs, or other receptables for washing purposes, should have metal hoops, and props for stands, and not barrels, cases, or other such devices. Walls, in places assigned to washing purposes, should be covered with impermeable material to a height of at least li meters. Sec. 210. Washing or coolting in dwelling rooms is prohibited. All newly constructed tenement houses shall be provided with special compartments, uninliabited and for general use, one for the washing place and the other for the kitchen. Sec. 211. Dividing of rooms by means of thin walls, whatever be the material employed for the purpose, is hereby prohibited. Sec. 212. The smallest room in a tenement house should not be less than 9 square meters in area and 4 meters high. Sec. 213. Industrial or commercial establishments in tenement houses arc prohibited; therefore, no shops of any kind can be conducted wñthin the piemises of said buildings, except in those higher than one story, the entrance and sanitary service being independent from the part assigned to living purposes, all with the consent of the sanitary board. Sec. 214. No stables shall be permitted in tenement houses, nor can animals of enxy kind be kept therein, except birds in cages. Sec. 215. Any person sud'ering from a contagious disease in a tenement house shall be removed to an isolation hospital whenever the sanitary chief shall deem it nccessan,'. Sec. 216- Should the person in charge of a tenement house encounter resistance on the part of tenant to comply with the provisions of these ordinances, or should any tenant violate any of said provisions, it shall be his duty to report the fact immediately to the sanitary chief. Sec. 217. Newly constructed buildings shall not be used as tenement houses imtil the plans thereof shall have been approved by the sanitary board; nor shall buildings already existing be used for like purposes without the previous consent of the sanitary board. Sec. 218. It shall be the duty of persons in charge of tenement houses to furnish the sanitary inspector anji^ information in regard to said buildings, and also to accompany them upon their inspection visits. Sec. 219. Printed copies of the rules contained in this chapter shall be posted at the entrance of every tenement house, said copies to be furnished by the local sanitary board. Chapter VI. PRIVATE HOUSES AND BUILDINGS JN GENERAL. Sec. 220. All houses, buildings, constructions, etc., are hereby made subject to sanitary inspection by the local sanitary board, and their owners, keepers, agents, lessees, tenants, inhabitants, "etc., shall allow and facilitate any inspection by the officers or agents duly authorized by the local sanitary board, and also carry out, or permit the carrying lOut of, the sanitary works in the house which might have been ordered as a consequence of the inspection. Sec. 221. Every house or dwelling shall be provided with all the necessary hygienic con- ditions, so that it shall not constitute a danger or menace to the health or life of its inhab- itants and neighbors. Sec. 222. Every house, or floor thereof rented separately, shall be provided with water supply sufficient for the domestic necessities of its inhabitants, at the rate of 100 liters, at least, per day for each person. Sec. 223. Owners or tenants, as the case may be, shall take the necessary precautions to prevent the sewers, sinks, water-closets, etc., from exhaling emanations or other annoying odors. Sec. '224. Drainpipes should be sufBciently ventilated and have all the necessary' require- ments to facilitate the discharge of refuse matter, prevent nitrations through walls and pave- ments, and permit the escape of gases in such- a manner that they shall not be detrimental to the health of tenants end neighbors; to this end the construction, installation, or altera- tion of the same shall conform with the engineering specifications prescribed in the respec- tive permit. Similar specifications are required in the case of water-closets, cesspools, scul- leries, sinks, and other sanitary plumbing. Sec. 225. The consti-uction of drainpipes, ventilating tubes, or smokestacks which may annoy or damage the neighboring houses, or that in which the same are intended to be con- structed, is prohibited. The provisions of this section shall be applied to such drainpipes, etc., that are already constructed. Sec. 226. Houses in towns where there are aqueducts and sewers shall be provided with water-closets of the system adopted by the Superior Sanitary Board, exclusive of any other system. Houses in towns where there are no aqueducts or sewers shall be provided with SECOND INTERNATIONAL SANITARY CONVENTION. 131 cesspools, constructed in accordiance with the proper engineering specifications and at a distance of not Joss than 10 meters from wells, cisterns, rooms, anrl kitchens, nnless the sanitary l)oar(i should adopt otiiei' system for tl](! collfiction and (ixtniction of feed matter. Sko. 227. Cesspools and dumps sliall he constructed in such a manner aa to prevent the overflow on account of rains. Seo. 22S. The construction or existence of cesspools and sinks in houses shall only be per- mitted in streets whore there are no sewers. Sec. 229. The owner or tenant of every house shaJl pour into cesspools and sinks unslaked lime, sulphate of iron, creohne, or other disinfecting substancies, when so ordered by the sani- tary boai'd for special reasons. Sec. 230. Pavements of water-closets, bathrooms, washing places, sculleries, etc., shall be made of inj^permeable material, and the walls shall be covered with the same material, if they are made of sto.?e, to a height of 1^ meters, at least, and oil painted if they are wooden. Sec. 231. Owners of houses shall sec that cesspools and sinks are never filled up nor allowed to overflow, ordering the cleaning of the same whenever necessary. In ca.se they shall fail to do so, the sanitary board shall cause such cleaning to be made by the public service of cleaning at the expense of the owner of the house, irrespective of the fine wliich may be imposed on him for the oil'ense. Sec. 232. Wells, cisterns, tanks, or other receptacles for water shall be so arranged that no dampness from the same can be communicated to rooms, and that no iiltrations be received by the same from cesspools and sinks, and they shall always be protected with wire-gauze covers against the access of mosquitos. Only fountains constantly operating with running water shall be permitted. Sec. 233. No deposit of refuse, garbage, or offal, stanched water, or any other matter dele- terious to health shall be permitted within the premises of any house. Sec. 234. Receptacles used for containing garbage and refuse shall be placed as distantly as possible from the rooms of the house and must not have holes. Sec. 235. Breeding or fattening of pigs within city limits is prohibited; and it shall only be permitted at a distance of 200 meters from said boundaries. Sec. 236. Rooms used as kitchens, or permanent stoves or furnaces, should be provided with mantles or chimneys to facilitate the escape of gases and smoke generated by com- bustion, so built that they shall not injure the health of tenants and neighbors. Portable furnaces shall be placed, when in use, in places where they shall not be annoying to tenants or dwellers. Sec. 237. All rooms, outbuildings, courts, roofs, and sanitary plmnbing of a house shall always be kept perfectly clean. Walls must be kept in good condition and properly painted, as well as doors and windows ; pavements and roofs must be kept in good condition in order to prevent humidity in rooms, and for this purpose, wherever necessary, the construction of drainpipes and conduits shall be required. Sec. 238. Stables shall only be permitted in perfectly ventilated places, with impermeable pavements and walls, and all the requirements prescribed by the special regulations for stables. Sec. 239. The use of cellars and semisubterraneous places for sleeping or dwelling piir- poses is hereby prohibited, and no door or opening communicating a cellar with a bedroom shall be permitted. This prohibition shall be applicable to ground floors if the height of the same be less than 2J meters and if they are not provided with windows to furnish suffi- cient ventilation. Sec. 240. The accumulation of domestic animals, such as dogs, cats, rabbits, poultry, pigeons, birds, etc., in rooms shall not be permitted. Sec. 241. If a house or a part thereof be declared unhealthy, as a result of the inspection, the sanitary chief shall notify the fact to the owner or tenant, as the case may be, giving him sufficient time within which he may make the works, repairs, or improvements that he might have been ordered to carry out. At the expiration of the time allowed a reinspection of the building shall be made for the purpose of ascertaining whether the order has been complied with or not. If not, and if the justifiable and unavoidable causes that prevented the carrying out the works ordered have not been stated in writing, a complaint shall be filed before the proper court for the imposition of the penalty fixed by law, and further period of time shall again be granted for like purpose. If after the third time the works have not been carried out the house or part thereof, as the case may be, shall be declared uninliabitable and the police shall proceed to dislodge it and close it within thirty days. It shall remain closed until the worl¿ ordered shaU have been carried out. Sec. 242. A house or building, or part thereof, used for dwelling, sleeping, manufacturing, or other purposes, which constitutes a permanent danger to health or Hfe, and which can not be placed in proper hygienic conditions, shall be declared uninhabitable or dangerous after proper investigation and shall be dislodged and closed upon order of the sanitary chief by the police within thirty days. 132 SECOND INTERNATIONAL SANITARY CONVENTION. Chapter VII. schools and colleges. Sec. 243. No school or college shall be established without the favorable report of the local sanitary board in regard to location, hygienic conditions, sanitary plumbing, and capacity of the building in proportion to the number of pupils and school furniture. Sec. 244. Lecture halls must be dry, with good sufficient ventilation, and an area in proportion to the nmuber of pupils at the rate of 1^ meters per person. Sec. 245. School and college buildings shall be pro^•ided with one water-closet for every 30 pupils at least and as many urinals as it is deemed necessary. Sec. 246. Sanitary plumbing of schools and colleges shall always be kept perfectly clean, ■as well as the outbuildings, courts, floors, walls, etc. Sec. 247. Schools and colleges are subject to inspection by the local sanitary board regarding the buildings as well as the condition of the health of professors and pupils. Sec. 248. Every pupil in a school or college shall be vaccinated and the parents, guardians, ■etc., shall be responsible for violation of this provision, as well as tlie director and professor, as the case may be. The same provision is applicable to the director, teachers, and other ^subordinate employees. Sec. 249. When the director of a school or college finds that a pupil, teacher, servant, etc., lives in a place where a contagious disease prevails, he shall dismiss such person ft-om the school temporarily and give notice of the fact to the sanitary chief within twenty-four hours. Sec. 250. No pupil, teacher, servant, etc., so dismissed shall be readmitted to the school or college without the proper authorization from the sanitary chief. The provisions of this and the preceding section shall also be applicable to night and Sunday schools. Sec. 251. The permanent or temporary closing of a school or college on account of the -prevalence therein of a contagious disease or of the unhealthy condition of the building shall be ordered by the local sanitary board. Sec. 252. Persons suffering from chronic contagious diseases shall not be permitted to discharge any office or position in a school or college. Chapter VIII. FACTORIES AND WORKSHOPS. Sec. 253. Before a permit for the installation of a factory or workshop is issued, the favorable report of the sanitary board is necessary. Said report shall be prepared upon the statement submitted to the board expressing the nature of the establishment, its location, technical conditions, proper for its industrial purposes, safety, stability, light, ventilation, capacity, kind and maximum munber of machines and apparatus to be operated, and number of laborers and other employees. Sec. 254. Every factory or workshop shall have an area of 2 square meters per person and a cubic volume of at least 12 meters. Sec. 255. Workshops shall be located in dry places, with good light and ventilation and ■other hygienic requirements necessary for the health and life of laborers and employees. Sec. 256. Factories or workshops in which, due to the nature of the works, gases, dust, or liquid refuse, annoying or noxious to laborers, employees or neighbors, are indispensably produced, shall be provided with the proper means of gathering and distributing said gases, -dust, or liquid refuse, without constituting any danger, by the process deemed necessary and approved by the local sanitary board. Sec. 257. Owners of factories, workshops, establishments, houses, etc., where smoke- stacks are to be or have been already placed, shall construct or modify them, as the case may be, in such a manner that the smoke can not have access into neighboring houses or rooms. Sec. 258. The discharge of refuse matter from workshops, factories, or industrial estab- lishments into streams, canals, rivers, etc., the waters of which ai'e used for fishing, drinking, qr other purposes is prohibited, unless such refuse matter be previously purified by means of proper process approved by the Superior Board. Sec. 259. No child under the age of 14 years shall be employed in any factory or work- shop. Minors under 18 years of age shall not be employed for the handling of dangerous machines or apparatus. Sec. 260. Factories or workshops where there are machines, or where dangerous sub- stances are manufactured, and the number of laborers exceeds 200, shall have a permanent physician during the labor hours ready to render his assistance in case of accident. Sec. 261. Every factory or workshop shall be provided with cuspidors in proportion to the nmnber of laborers. Said cuspidors shall be kept perfectly clean and washed daily with boiling water or some disinfecting solution. The sanitary board shall prescribe the SECOND INTERNATIONAL SANITARY CONVENTION. 133 model and number of said cuspidors, and tlio disinfecting solution wJiich tlie same shall contain and that with which they shall be washed. Seo. 262. Factories and workshops shall bo provided with sufficient number of water- closets in a proportion of at least 5 per cent of persons, and urinals and washstands, all of which shall be kept perfectly clean and in good serviceable condition. Seo. 263. Owners or managers of factories or workshops shall not permit therein any laborer or employee suffering from a contagious disease. Seo. 264. (Jigar factories shall be subject to the following provisions: (a) Working tables shall be so arranged that the laborers shall not sit facing each other. (b) Each table shall be provided with a small receptacle made of enameled iron, for the water and paste to be used in the confection of cigars. The use of saliva and the teeth in such coijfection shall not be permitted. (c) Every table shall be provided with a receptacle for the waste of materials employed in manufacturing cigars. (d) Walls and tables shall be cleansed once a week, at least. (e) Cloth used in tables for gathering waste matter shall be kept clean. (f) Spitting on floors shall be prohibited. (g) There shall be a cuspidor for every laborer, (h) Pavements shall be washed daily. (i) They shall be so kept that no cracks may be found thereon. (j) Windows of workrooms shall be so airanged that the upper part thereof shall remain open. (k) There shall be in workrooms a space of 20 cubic meters for every laborer. (1) The manufacture of cigars, etc., in bedrooms is prohibited. (m) The sale of tobacco refuse which shall have fallen upon floors shall not be permitted. (n) Water which shall have been used in the confection of cigars must be thrown away before it decomposes. Seo. 265. Factories, workshops, and industrial establishments in general, where machin- ery, apparatus, etc., are employed, shall have the same mounted in such manner that the parts thereon which by their movement or other cause constitute a danger, shall be covered or protected with wire gauze or other material. Steam boilers or other means of generat- ing motive power shall be kept in the best condition of safety and must be explosion proof ; all buildings pertaining to an industrial establishment shall be so constructed as to prevent danger of lives. Wells, traps, holes, etc. , shall be kept closed. The foregoing provisions are also applicable to theaters, circuses, stores, and other estab- lishments where mechanical apparatus are emplo3'^ed. Chapter LX. dangerous, unhealthful or annoying factories, industries and establishments. Sec. 266. Dangerous, unhealthful or annoying factories, industries, and establishments shall not be permitted hereafter except in accordance with the following requirements as to their location the respective classiñcation and the prescriptions of the regulations con- cerning the same : (a) They shall be located far from dwellings, streets, and roads. (b) They may be located in the suburbs of towns. (c) They may be located in any part of the city, but subject to frequent inspection and governmental prescriptions. Sec. 267. Besides the requirements of -construction, engineering, etc. , prescribed by the ayuntamiento, no permit shall be granted for the installation of any of such factories or estab- lishments, without the favorable report of the local sanitary board; and it shall not be operated until after it has been demonstrated to the board that all sanitary requirements prescribed in the permit have been complied with. An appeal from the decision of the local board may be taken to the Superior Board. Sec. 268. The kind of products sought to be manufactured in the factory or establish- ment shall be stated in the permit or license for the installation and operation thereof, as well as the process of manufacture to be followed and the maximum amount of goods that the warehouses or storerooms can contain. Sec. 269. When a factory or industrial establishment shall have suspended its operations for more than a year, or has to be removed to another location, it shall have to fill the same requirements as if it were a new one. Sec. 270. When the interest of public health shall so demand it, the removal of any establishment may be compelled through due process of law. Sec. 271. Departments in factories or industrial establishments, where organic sub- stances susceptible of easy decomposition are manufactured, shall be provided with per- fectly impermeable pavements, and sufficient supply of water for frequent washing. 13-4 SECOND INTERNATIONAL SANITARY CONVENTION. Sec. 272. No organic substances shall be stored in a factory or industrial establishment over twenty-four hours, unless they be protected against decompositioa. Waste matter and reñise shall be collected eveiy day from such establishments. Sec. 273. The preparation or cooking of animal refuse, for industrial or commercial pur- poses, within city limits, is prohibited as well as the grinding or trituration of bones or shells, and other industrial operations producing fetid odors, or which might endanger public health. Sec. 274. Renting or ceding rooms for dwelling or sleeping purposes in houses or buildings where there are dangerous or unliealthful establishments or factories, is prohibited. The connection of such establishments or factories with tenement houses is likewise prohibited. Sec. 275. No laundiy shall be established in a house, unless said house b^ previously inspected by the sanitary board and a favorable report from tlie same be secured for the purpose. Sec. 276. In laundries where steam is not used, the clothes shall be immersed in boiling water for at least an hour. Sec. 277. The local sanitary board shall prescribe in each case the requirements which the sanitaiy .service in laundries must have (cemented tanks, drainage, etc.). Sec. 278. Stables for all kinds of animals shall be considered as unhealthful establish- ments, subject to special regulations, and shall be located in the suburbs. Sec. 279. No license shall be granted for the installation and operation of stables without the favorable report of the local sanitary board. Sec. 280. The sanitary conditions required for the granting of such licenses, and to which all existing stables shall be subject, are as follows: (a) Stables shall be located outside of the city limits. (b) Buildings for stables shall be made of stone, brick or iron, 5 or 6 meters high, and shall be provided with ventilating holes, one for every 4 animals. (c) The stables shall be in galleries 4 meters high at least. (d) Galleries having only one manger adhered to the wall shall not be less than 4 meters wide in all its longitude. (e) The walls shall be covered with cement or other impermeable material. (f1 The racks for forage shall be made of iron ; the mangers may be made of wood. (g) The pavements shall be made of cement, with an inclination of at least 200 per cent. (h) The sewers shall be constructed with a bottom of an elhptical shape, and shall be perfectly polished. (i) In order to prevent the animals from slipping, or catching cold when lying down on the pavement, the same shall be covered with wooden boards about 2 inches thick, said boards to be removable and placed in such a manner that sufficient space be left between the boards and the pavement. (j) Each animal shall be separated one from the other by a proper distance. The stables shall be provided with proper divisions of a space 1^ meters wide. (k) Racks for forage of all kinds shall be made of stone, brick, or iron. (1) Stables shall have an infirmary, which shall be independent from the rest of the premises, and where only the sick animals affected with diseases not transmissible to man- kind, shall be lodged. (m) In case there be no general sewer system in the place where a stable is located, the excreta shall be deposited in a dumping place of the capacity prescribed in each case; such dumping place shall be made of impermeable materials, and must be emptied whenever necessary, the contents being removed to the general dumping places of the city. (n) Stable buildings shall be provided with the necessary number of ventilators or win- dows. (o) The drinking troughs shall be made of impermeable materials and so arranged that they may be easily cleaned. There shall be one drinking trough for each animal. Sec. 281. Dwellings in stables are prohibited, except those exclusively assigned to employees thereof; establishments having no connection whatever with stables are like- wise prohibited therein. Sec. 282. Stables shall be provided with water supply sufficient to furnish the necessary amount of water for the general cleaning, which shall be made twice a day at least. Sec. 283. Garbage and excrement shall be removed from stables eveiy day and taken to the general dumping places in the manner prescribed for the public collection and disposal of garbage. Sec. 284. The excreta shall be deposited in metal receptacles which shall be cleansed and disinfected daily. Sec. 285. Pavements of yards, workshops, and other compartments for the storage of outfits, etc. , shall be perfectly filled \vith stone or macadam. Sec. 286. Sick animals shall not be employed in any kind of work. Sec. 287. It shall be the duty of owners of stables to engage the services of a veterinarian who shall inspect the cattle once a week at least. dECOND INTERNATIONAL SANITARY CONVKNTION. 1Í55 Sec. 288. Whenever the municipal veterinarian, or sanitary inspectors, make an inspection of stables they shall record the inspection in a book kept for the purpose in every stable. Sioc. 2S9. Whenever tluu'c is an animal suircsring from a disease transmi.ssible to mankind, the veterinary attending such animal, or, in his st(!ad, the owner thereof or other interested person, shall report the casci to the local sanitary chief. Sec. 290. When an animal suffering fi-om an infectious disease is removed from the stables the municipal veterinarian shall see that a thorough disinfection is made in the place con- sidered infected, and, in cases of glanders, that the harness used on such animal has been also disinfected. Sec. 291. Stables in houses and private establishments .shall l)e sul^ject to the provisions herein contained as regards the construction and sanitation thereof. Sec. 29^. Stables in towns where there is no sewer system sliall be provided with outlets to dumping places of sufficient capacity. , Sec. 293. Stables which are not provided with open sheds must have ventilating tubes projecting 2 meters out of the ceiling. Said tubes may be provided with registers to regulate the current of air. Sec. 294. Stable utensils, such as pails, or water receptacles, sponges, forage racks, etc., shall always be kept clean. Sec. 295. Stables shall be washed twice a day. Sec. 296. Animals in stables shall be subjected to the test of "maleina." Sec. 297. Dangerous or annoying estabhshments, deposits, or factories must always be kept perfectly clean, so that the operations therein shall not be detrimental to public health. Chapter X. SLAUGHTERHOUSES AND SLAUGHTERING. Sec. 298. No slaughterhouse shall be constructed without the favorable report of the local sanitary board, approved by the Superior Sanitary Board, after consideration of the plans, specifications, and other documents. Sec. 299. Rooms for dwelling purposes in slaughterhouses are prohibited except when specially permitted in writing by the Superior Board. Sec. 300. Every ayuntamiento shall have a public slaughterhouse with the necessary departments, personnel, sanitary service, etc. Sec. 301. Private slaughtering for the consumption of meat in farms or factories is pro- hibited, unless it shall be duly authorized and made in accordance with provisions prescribed by the local sanitary board. Sec. 302. Slaughterhouses shall be managed by special regulations, to be approved by the Superior Sanitary Board, as regards the sanitary service therein. Sec. 303. Slaughtering of animals for public consumption shall be made in the official slaughterhouses of municipalities only. Sec. 304. Slaughtering in courts or yards of houses within city limits is prohibited. Slaughtering in country houses or houses in towns of lesser importance is prohibited unless it be intended for private consumption: a favorable certificate of the examination of the animal by a competent official shall be necessary therefor. Sec. 305. Animals intended for public consumption shall be examined before and after the slaughter by the veterinarian or by a physician if there be no veterinarian. If the exami- nation shows that the animal is not completely healthy it shall be condemned. Sec. 306. Animals that are to be slaughtered must be perfectly clean and kept in the slaughterhouse corral during six hours before they are slaughtered. The corrals shall be thoroughly cleaned every twenty-four hours ; their capacity shall be in proportion with the number of animals ; said corrals must be well ventilated and provided with sufficient water and drinking troughs and other requirements which may be deemed necassary. Sec. 307. Persons in charge of corrals shall notify to the respective veterinarian the exist- ence therein of any animal suspected of being sick. Sec. 308. Slaughtering of thin, pregnant, beaten, suffocated, or wounded animals or of animals sufl'ering from ulcers, fever, or other disease which in the discretion of the veteri- narian may render them unfit for consumption, shall not be permitted. Sec. 309. Animals that are to be slaughtered must be able to go to the slaughterhouse on their own feet, except those which on account of their excessive fatness can not walk. Sec. 310. Slaughterhouses shall be kept thoroughly clean and ventilated, and all offal, blood, refuse, and other filthy matter shall be removed after the slaughtering. All refuse matter shall be destroyed or removed to places where it can not be detrimental to pubhc health. Sec. 311. The transportation of meat to the places where it shall be sold must be made in the best condition of cleanliness and in oil-painted wagons, the inside of which shaU be cov- ered with tin or galvanized iron ; they shall be provided with hooks where the meat shall be hanged. The transportation in any other way whatever shall not be permitted. 136 SECOND INTERNATIONAL SANITARY CONVENTION. Sec. 312. Persons employed in the transportation of meat must be cleanly dressed and shall not be permitted to work unless they wear impermeable overcoats. Sec. 313. The transportation or conveyance of refuse matter from slaughterhouses thi-ough the streets shall not be permitted unless it be done in the manner prescribed by the sanitary board. Sec. 314. The insufflation of the skin of dead animals in order to facilitate the operation of flaying shall be made by means of apparatus fit for the purpose; such insuflflation by means of the mouth is prohibited. Sec. 315. The' use, even though temporary, of the premises of a slaughterhouse for any other purposes than that to which it is assigned is prohibited. Chapter XI. Sec. 316. No market shall be built or altered without the favorable report of the local sanitary board after consideration of the plans and other documents. Sec. 317. The capacity of a market shaU be in proportion with the commercial necessi- ties of the locality; every market shall be supplied with abundant quantity of water; the pavements thereof shall be made of impermeable material and with the necessary declivity in order to prevent stagnation; the pillars shall be sufficiently high and distant from each other to furnish good ventilation; the roofs shall be provided with ventilating holes, and if they be made of metal sheets they shall be sufficiently separated from the waUs in order to prevent excesfeive heat. Sec. 318. Premises of markets which may be constructed hereafter shall not be used for dwelling or sleeping purposes, and the construction of dwellings therein shall not be permit- ted. In markets already in existence wherein dwellings are permitted and to which the provisions of this article can not be applied on account of special circumstances, such dwell- ings shall be subject to the necessary conditions required by public health and sanitation. Sec. 319. The rules which the local sanitary board may prescribe for the sanitary man- agement of markets shall be included in the special regulations for the administration of the same. Sellers shall comply with all provisions in regard to the keeping of their stands in the best of hygienic conditions. Sec. 320. The sale in markets of cooked food products of any kind is prohibited except feet and intestines, boiled only and without any other preparation whatever; the use of braziers, furnaces, stoves, etc., within markets shall not be permitted. Sec. 321. Meat or fish remaining from the daily sale can be sold only when preserved on ice or salted. Sec. 322. Stands where meat is sold shaU have the following requirements: (1) They shall be provided with an iron or steel bar, perfectly polished and clean, for hanging the meat. (2) In towns where it be practicable to do so a water cock of suflScient gauge shall be placed upon the sink, which wiU be connected by means of a pipe with the market sewerage system. (3) A sink inlet with hydraulic plug. (4) The stands must be oil painted and kept perfectly clean. (5) They shall be provided with wire gauze doors and covers to prevent the access of mosquitoes. (6) There shall be in every stand a marble counter and a table of the same material. (7) The meats shall be so placed that the customers and other persons can not touch them. Sec. 323. The use of hatchets and wooden blocks for chopping meat is prohibited; the meat and bones must be cut with knives and saws respectively, the handles of which must be made of metal. Sec. 324. Meat and fish seUers shall wear during the sale hours a clean white apron. WaUs, counters, etc., of stands shall be washed after the sale hours. Sec. 325. The sale of meat shall be discontinued at 11 a. m. Meat remaining from the sale of the day must be placed in the refrigerator or shall be salted; if said meat be kept otherwise it shall not be sold the next day. The use of preserving substances other than common salt (sodium chloride) is prohibited. Sec. 326. The giblets shall be placed in the refrigerator as soon as they are received from the slaughterhouse. Sec. 327. The sale of fish or mollusks shall be discontinued at 10 a. m. during the summer and at 11 a. m. during the winter. The remnants from the sale shall be salted or placed in the refrigerator. Sec. 328. Crabs, lobsters, and other crustaceans must be sold alive, precisely. Sec. 329. The sale of oysters during the months of May and August, inclusive, is pro- hibited, and oysters in a decaying condition shall be thrown away immediately. SECOND intí:rnational manitary convention. 137 Seo. 330. The sale of scaled, flayed, beheaded, or in any other way mutilated fish, is pro- hibited, except fish which is usually sold in round slices. Seo. 331. The sale of fishes which are liable to cause ciguatera (kind of jaundice) is pro- hibited. Seo. 332. Fish sellers must be cleanly dressed and wear a white apron during the sale hours; they shall wash the counters, tables, etc., every day. Seo. 333. Vessels used for washing vegetables, etc., must be made of enameled iron or other impermeable material. Seo. 334. The sale of decayed or noxious fruits is prohibited. Seo. 335. The sale of dead domestic rabbits is prohibited. Sec. 336. Dead poultry and game must be disemboweled and perfectly fresh, it being the duty of the sellers to preserve said poultry and game in refrigerators. Seo. 337. Other animals for public consumption, such as suckling pigs, kidlings, rabbits, etc., must be perfectly healthy, fat, and clean. Seo. 338. Throwing refuse matter on the floors is prohibited. All refuse matter shall be deposited in galvanized-iron receptacles provided with lids; said receptacles shall be placed in the stands and marked with the corresponding number. When the cleaning of a stand has been completed, said receptacles shall be placed at the entrance in order that they may be collected by the persons in charge of the service. Seo. 339. The sewers shall be kept covered, and every market, in towns where it be {)racticable, shall be provided with sanitary water-closets and urinals approved by the ocal sanitary board. Seo. 340. The general cleaning of a market shall be made twice a day and at the hour prescribed in the administrative regulations of the market. The persons in charge of the cleaning shaU collect the garbage from each stand, washing the receptacles and putting them back in their places. They shall also clean the water-closets and urinals, every night, as well as the sink inlets, disinfecting all of them with hme, creoUne, etc. Seo. 341. Wooden walls and other wooden constructions shall not be permitted in stands. Seo. 342. There shall be in each market a place where, during the hours of cleaning, all articles which may have been seized, on account of being unfit for consumption, shall be deposited in order that they may be thrown away or destroyed together with the garbage and refuse. Seo. 343. The inspection of markets shall be made daily and at different hours. Seo. 344. The existence of cellars, cafés, establishments, etc., is prohibited within markets. Seo. 345. It shall be the duty of inspectors: (a) To examine carefully all stands; (b) to report to the sanitary chief whatever they may deem necessary for the cleaning and main- tenance of the premises of markets; (c) to inspect meats, fish, poidtry, and other animal products; (d) to order the withdrawal from sale of all articles unfit for consumption, notifj^ing the sanitary chief immediately; (e) to take samples of all articles which may be considered suspicious, in bad condition, or adulterated, giving the interested party a receipt specifying the article from which the sample is taken, in order to avoid doubts or discus- sions; (f) to examine the water-closets, urinals, and inlets to sewers, reporting to the sanitary chief any violations which they may observe. Chapter XII. MEAT MARKETS AND SALE OF MEATS. Sec. 346. Before a meat market is opened the favorable report of the local sanitary board shall be necessary in regard to its proper sanitary conditions. Seo. 347. Meat markets, besides being well ventilated and kept in a cleanly condition, shall have the following requirements: (a) White marble counters, well poHshed. (b) Marble or cement pavements. (c) Smooth ceilings. (d) The walls must be covered with glaze tiles to height of 2 meters. (e) The stanchion therein must be 4 or 5 meters high, except in those already existing and which have sufficient ventilation. (f) They shall be provided with abundant water supply. (g) They shall be provided with refrigerators or ice boxes of suflBcient capacity in accord- ance with the importance of each establisliment. (h) They shall be provided with iron-grating doors facing the street. (i) The meat must be hung on steel hooks. Said hooks must be beyond the reach of hands of purchasers and attached to a steel bar, all of which shall be kept pohshed. (j) The sanitary plumbing therein shall be adapted to the prescriptions of the sanitary board. No water-closets shall be permitted in meat markets. 138 SECOND INTERNATIONAL SANITARV CONVENTION. (k) The premises must be kept in the best cleanly condition ; the pavements must be washed one or more times daily, and the walls, etc., oil painted whenever necessarj'-. (1) No other industry or commerce sliall be conducted in meat markets; bones, refuse, garbage, etc., must not be deposited therein; meat markets must be separated from other establishments by complete stone walls. Sec. 348. Meat and fish remaining ft-om the daily sale shall be placed in the refrigerators or ice boxes of the model prescribed by the local sanitary board. Sec. 3+9. The sellers must wear a white clean apron. Sec. 350. No aneat market shall be permitted in wooden buildings, except when, on account of special circumstances of location, the consent in ^vl■iting of the local sanitary board be secured. Sec. 351. Meat markets already established and which have not the requirements pre- scribed by these ordinances shall be allowed a period of six months from the date in which these ordinances shall go into effect. Meat markets which shall not have complied with said requirements shall be closed. Sec. 352. Premises of meat markets shall not be used for dwelling or sleeping purposes. Sec. 353. Meats shall be kept hanging outside or inside of the refrigerator from the time of their arrival to the establishment until 10 o'clock in the morning; after that time they shall be placed in the refrigerator, which shall be provided with sufficient amount of ice. Sec. 354. The use of hatches and wooden blocks for chopping meat is prohibited; the meat and bones must be cut with knives and saws, respectively, the handles of which must be made of metal. Sec. 355. The sale of meat from animals which shall not have been slaughtered expressly for consumption, in slaughterhouses, is prohibited. Sec. 356. When the owner of a meat market suspects that the meat which he has is derived from a diseased animal, he shall suspend the sale of said meat and immediately report the fact to ihe sanitary chief. Sec. 357. AU utensils used in meat markets shall always be kept perfectly clean. Sec. 358. No meat other than pork or beef, nor other salt than sodium chloride, shall be employed in the confection of sausages, and utensils made of other material than wood, ii'on, or stone must not be used for said purpose, which utensils shall be kept perfectly clean. Sec. 359. The importation of meat from one town into another shall not be permitted unless such meat is marked with the stamp of the slaughterhouse, and accompanied with a certificate from the veterinarian thereof, approved by the alcalde. Sec. 360. Meats not proceeding ft'om authorized slaughterhouses, or which have not been examined by the inspectors, shall be considered as clandestine, and be seized. Such meats shall at once be sent to the respective officer for sanitary examination. Sec. 361. The tanning of hides or the preparation of tallow in meat markets or other places within city limits, without the written consent of the local sanitary board, is prohibited. Sec. 362. The delivery ft-om house to house of meats, bones, giblets, lard, etc., shall be done in boards made of polished metal or wood covered with metal foil, which boards shall be kept clean; they shall be provided with covers in order to prevent dust, insects, or hands from coming in contact with them. Sec. 363. The use of preserving substances other than common salt (sodium chloride) for the preservation of meats is prohibited. Chapter XIII. GABBAGE AND REFUSE. Sec. 364. In houses where the service of transportation of garbage to sea shall not have been established, the garbage and refuse shall be deposited in dumping places located at a distance of not less than 1 kilometer from the city limits and in places where they can not be detrimental to public health. "V\1ien crematories for garbage and refuse shall have been established, the garbage and refuse shall be transported to the same. Sec. 365. Each ayuntamiento, when the servics is not provided for by the Government, shall establish a pubhc service for the collection of filthy water, garbage, and refuse of streets, squares, and houses in the manner prescribed by the sanitary board. Sec. 366. House refuse and garbage shall be deposited in metal receptacles, which shall be placed in the streets near the sidewalk a few moments before the wagon for the collection of such refuse and garbage passes by; if the service be made during the day time, it shall be early in the morning; if it be at night, after 10 o'clock. In places where there is no organized service for the collection of house refuse, and when it can not be transported outside the city limits, it shall be cremated in the yards of the respective houses eveiy forty-eight hours, or before if necessaiy to prevent decom- position. SECOND INTERNATIONAL SANITARY OONVKNTION. 139 Seo. 307. Tenants must be provided with a suflicicnt numbur of waterproof receptacles, made of metal, or interiorly covered with nict-al foil, of a capacity sufficient ti> contain all garbaf^e, refuse, etc., wliieli may have Ixcn aecuuiulated ihjrir:^^ the day. Jn places where there a7'(i no stiwers, (svery occupant of a hous(? shall be providtsd with vchhcIh to contain the waste lic(ai<]s, in the same conditions as garbage, lie shall seo that the recep- tacles ar(^ witlidi'awn fr'om tlie street as soon as they have í)een emptiísd. Sec. 368. Passers-by must not shake, scatter, or ivniove the contents of sucfi receptacles or take possession of the latter. Sec. 309. In places where there is no public service of ckianing, garbagf; and refuse from industrial and commercial establishments shall bi; transported to th(i dumping places at the expense of the owners. Sec. 37Q, The throwing of fecal matter and dead animals into dumping places is pro- hibited. Sec. 371. The ayuntamientos shall pi-escrilx' that the garbage and refus(! thrown into dumping places be cremated or destroyed by the contractors when the service is made by contract; in case the removal of garbage, artick's, or materials from dumping places for industrial purposes shall be permitted, they shall be previously disinfected, and with the consent of the sanitary board. Sec. 372. Accumulating or depositing garbage, rcfaise, bones, or other matter susceptible of decomposition, or which may be annoying to neighbors, or produce fetid odors, in rooms, cellars, yards, etc., is prohibited. Chapter XIV. TRANSPORTATION OF GARBAGE AND MANURE. Sec. 373. The transportation of garbage and manure from stables within city limits is prohibited, unless it be made in special wagons built for the purpose and in accordance with the model prescribed by the sanitary board. Sec. 374. The wagons for the transportation of manure and garbage shall be loaded inside the stables or in the yards therein, and in no case in the street. The contents shall be so transported that no fetid odors can be produced. Sec. 375. The manure and refuse to be transported shall be so placed that no portion thereof shall fall out of the wagon. Sec. 376. Unloading garbage, manure, or refuse at a distance of less than 1 meter from an inhabited place is prohibited. Garbage and refuse shall not be kept over twenty-four hours in stables. Sec. 377. The construction or use of vaults or cellars for the deposit of garbage, etc., is prohibited, unless the sanitary board shall give its consent in writing on account of special reasons. Sec. 378. The transportation by railroad of garbage or manure shall be made subject to the following requirements : (a) The transportation shall be made in covered and inclosed wagons. (b) The wagon must be kept closed while containing such garbage and manure, and immediately after it has been emptied it shall be mechanically washed by means of water flowing under pressure. It shall be left open until loaded again. (c) If it is not practicable to wash the wagon upon being emptied, it shall be kept closed until it can be washed. The washing of such wagons must not be omitted before reloading the same. (d) Wagons assigned to the transportation of garbage and manure must not be used for any other purpose whatever, and the word "Garbage" shall be printed on both sides of the wagon in types visible from afar. (e) The operation of loading apd unloading shall be made from wagon to wagon and at a distance of not less than 100 meters from inhabited places. (f) The pavements of premises assigned exclusively to the loading and unloading of garbage must be impermeable. (g) Loading and unloading of garbage shall be made during the nighttime. (h) The same proAásions regarding the loading and unloading shall be followed whenever garbage is to be used for fertilizing purposes. (i) Lighters, barges, etc., assigned to the transportation of garbage, when loaded, shall not be permitted to be anchored in wharves for over twelve hours. They shall be frequently disinfected. Chapter XV. cleaning of privies and CESSPOOLS. Sec. 379. Before granting the permit for the establishment of a plant for the cleaning of cesspools and privies, the favorable report of the local sanitary board shall be necessary. 140 SECOND INTERNATIONAL SANITARY CONVENTION. Sec. 380. Such establishments or plants shall be located outside of the town, and it shall be the duty of the o\vners thereof to file their names and addi'esses with the local sanitary board. Sec. 3S1. Owners of plants for the cleaning of cesspools and privies shall send to the sanitary chief a daily report of the pri\'ies and cesspools cleaned during the previous night, stating the street and number of the house, name of its owner, his residence, number of wagons, and capacity and condition of each cesspool or privy cleaned. Sec. 382. Partial cleaning of privies and cesspools is prohibited. If the operation of cleaning be interrupted, it shall be continued the next night. Privies and cesspools shall be duly disinfected with iron sulphate and lime twelve hours before the cleaning. They shall also be disinfected after the operation and totally emptied. Sec. 383. When the suppression of cesspools, sinks, gutters, etc., be ordered, they shall be filled after having been cleaned and disinfected. The material to be employed in the filling shall be mixed with lime. Sec. 384. The cleaning of cesspools and privies shall be done from 11 p. m. to 5 a. m. A green light shall be placed in the door of the house where the cleaning is being carried out. Sec. 385. The person in charge of the cleaning of a privy or cesspool which on accoimt of the conditions of its constmction might cause accidents due to the escape of gases shall take the necessary precautions in order to prevent mishaps. Sec. 386. In towns where the service is not made with modern apparatus, the matter extracted, after being duty disinfected, shall be placed in air-tight receptacles, which shall be transported in wagons provided with a green light to the places assigned for the purpose outside of the town limits and where such matter can not be detrimental to pubhc health. Sec. 387. Wagons assigned to these purposes shall not be permitted in the streets outside of the hours prescribed for the cleaning, even though they be empty. Wagons and utensils used in the operation of cleaning shall be duly disinfected and kept outside of the town. Sec. 388. The wagons above referred to shall be of solid construction and so conveyed in the streets as to prevent the contents from leaking. The receptacles shall be tightly covered. Sec. 389. The persons employed in the cleaning of a privy or cesspool shall, after the operation, wash, scrub, and clean all places in the house which might have been soiled on account of the operation. Sec. 390. In case the contents of a wagon or receptacle should, on account of an accident, be poured out partially or totally, the conductors shall gather such contents at once and wash the soiled places thoroughly well. Sec. 391. The wagons shall always be kept clean in order to prevent the emanation of fetid odors. Sec. 392. The throwing into cesspools and privies of garbage, refuse, dead animals, decayed vegetables, or other matter foreign to the purpose for which they were constructed is prohibited. Sec. 393. It shall be the duty of owners or tenants, as the case may be, to keep all receptacles of refuse or sewage of the house in the best condition and perfectly clean. Sec. 394. No fecal or other filthy matter shall be thrown into rivers, harbors, bays, streams, lakes, etc. Chapter XVI. RAILROADS, STREET CARS, AND OMNIBUSES. Sec. 395. All vehicles for the transportation of persons must be well painted, washed, cleaned, and free from insects. Sec. 396. The thromng out of refuse, ashes, and other similar waste matter from railroads, tramways, or omnibuses within city limits is prohibited, excepting the sand usually employed between the rails and wheels of engines. Sec. 397. All vehicles for the transportation of passengers shall have sufficient ventilation. Sec. 398. Soiled linen or other similar material shall not be pennitted in the places assigned to passengers, but only in front platforms of cars or in the tops of omnibuses. Sec. 399. All railroad cars shall be provided Avith water-closets for both sexes, constructed with impermeable materials and kept perfectly clean. Omnibuses, tramways, and railway coaches shall be provided with a sufficient number of cuspidors containing a disinfecting solutjon and shall be cleaned every day. Sec. 400. Stations and outbuildings thereof shall also be kept perfectly clean; the walls, doors, and windows shall be whitewashed or painted whenever necessary; there shall be a sufficient number of cuspidors containing a disinfecting solution and which shall be cleaned every day; there shall also be water-closets in perfect sersáceable and clean condition. Sec. 401. Spitting upon floors of cars and stations is prohibited. Signs with this prohi- bition shall be posted in cars and stations. SECOND INTERNATIONAL SANITARY OONVKN'IION. 141 Seo. 402. Station yards shall be kept clean and in good condition, as well as the gutters and drains. Sec. 403. Railroad companies shall be compelled to cany, with the passenger coaches and at the rate prescribed by the committee on railroads, a special car, the property of the Superior Sanitary Board, for the transportation of persons suirering from transmissible diseases. Said cars shall be disinfected at the expense of the sanitaiy board whenever used and shall be kept in one of the central stations. Chapter XVII. STREETS AND OTHER PUBLIC PLACES. Sec. 404. No garbage, refuse, offal, filthy or fetid liquids shall be thrown upon the streets, squares, avenues, yards, etc. Sec. 405. No other matter or liquid than rain water shall be permitted to flow out through drain pipes discharging in streets. Sec. 406. No garbage, animal or vegetable refuse, or other matter liable to decomposition shall be used in the filling up of streets, lands, etc. Sec. 407. Street's, squares, avenues, etc., shall be so kept as to prevent water from forming puddles thereon, and no grass shall be permitted to grow except in the places where it is necessary for ornamental purposes. Sec. 408. It shall be the duty of tenants to keep the sidewalks and conduits in a per- fectly clean condition. Sec. 409. Personal voidances in streets, etc., shall not be permitted. Sec. 410. In towns where there is no public service of sprinltling the streets the residents shall sprinkle the same once a day during the dry season. Sec. 411. It shall be the duty of the contractor in charge of the service to collect the dead animals found in the streets. Sec. 412. It shall be the duty of street sweepers to collect all refuse matter found in the streets. Sec. 413. Shaking and beating carpets, etc., in streets is prohibited. Sec. 414. Hitching or turning loose pigs, horses, or other animals in the streets or public places is prohibited. The owners or persons in charge of the animals shall be responsible for the violation of this article. Sec. 415. Unloading of cattle in public places shall not be permitted until after 10 p. m. and before 5 a. m. Cattle shall be taken to their point of destination through the remotest streets of the town, and in such a manner that it shall not be dangerous to the health or life of the residents. Sec. 416. The transit of milch cows through the streets shall not be permitted without the consent in writing of the sanitary board. Sec. 417. Persons in charge of the cleaning of streets shall, before sweeping the same, moisten them in order to prevent the dust from scattering. Chapter XVIII. HOSPITALS, SANITARIUMS, AND INFIRMARIES. Sec. 418. Public or private hospitals, sanitariums, infirmaries, etc., shall be established outside of towns. This prohibition shall not apply to such institutions as are already established. Sec. 419. No hospital, sanitarium, etc., shall be built, enlarged, or removed without the advice and consent of the Superior Sanitary Board, to which the specifications, plans, etc., of the building sought to be constructed or enlarged shall be submitted. Sec. 420. Hospitals, lazarettos, sanitariums, etc., which may be established hereafter for the isolation and attendance of persons suffering from contagious diseases shall be sepa- rated from other buildings by a distance of not less than 30 meters and shall be surrounded by trees and gardens. Sec. 421. There shall be in every hospital, sanitarium, etc., one or more places provided with double doors and windows protected with wire gauze against the access of mosquitoes, the interior of which places shall be properly arranged for the isolation of cases of any of the following diseases: Measles, diphtheria, croup, yellow fever, scarlet fever, smallpox, Asiatic cholera, exanthematous typhus, bubonic plague, whooping cough, leprosy, puerperal fever, phylariasis, and malaria. Sec. 422. Hospitals, etc., shaU be provided with apparatus and places for disinfection. Sec. 423. Any case of the diseases mentioned in section 421 shall be isolated immediately after its appearance, and the director of the institution shall notify the sanitaiy chief , at once. 142 SECOND INTERNATIONAL SANITARY CONVENTION. Sec. 424. Persons suffering from infectious diseases shall not be admitted or attended to in general hospitals. Such persons shall be removed to isolation hospitals or buildings with the necessary precautions. Sec. 425. Hospitals, sanitariums, etc., shall disinfect frequentlj^ the wards assigned to infectious diseases. Sec. 426. Convalescents from infectious diseases and the persons who have attended them shall be disinfected before leaving the hospital. Sec. 427. Public or private liospitals, sanitariums, lazarettos, etc., shall be subject to inspection hj the sanitary board. Sec. 428. Sañitariimis shall be established and governed in accordance with the pro- visions contained in the follo\\Ting sections. Sec. 429. Sanitarium is an establishment, maintained by a company or person, where medical attendance is given to patients at rates agreed to by the interested parties. Sec. 430. Buildings used for sanitariums must have good conditions of height, sufBcient ventilation and capacity, and shall be located in dry places, far from streams, lakes, swamps, and deposits for organic substances in state of decomposition. Sec. 431. Companies or persons owning this kind of establishments must keep them constantly and perfectly clean, beautify them as much as possible, and provide them with all necessary requirements for the best attendance and comfort of patients. Said estab- lishments shall also be provided with one water-closet, one washstand, and one bathroom for every 20 persons, and shall have gardens and yards. Sec. 432. No license shall be granted for the establishment of a sanitarium without the favorable report of the local sanitary board, duly approved by the Superior Sanitary Board. Said report shall be made upon the sanitaiy conditions of the building, its construction, capacity, and other particulars which the board may deem proper to insert. The municipal architect shall report upon the conditions of solidity, etc., of the building. Sec. 433. Together with the application for such license plans and specifications of the building shall be fiJed, stating in detail the number of bathrooms, water-closets, wells, water supply, etc., sought to be installed. A copy of the regulations for the management of the sanitarium shall also be filed with the application, where the kind of professional services sought to be rendered and rates to be charged for the same shall be stated. Sec. 434. The application shall be filed with the alcalde, who shall forward it to the local sanitary board for its report. After the local sanitary board shall have submitted its report the municipal architect shall make a report upon the conditions of safety of the building. Both reports must be favorable and approved by the Superior Sanitary Board. Sec. 435. The regulations for the management of a sanitarium after being approved shall be printed, and the manager of the institution shall distribute copies thereof to the interested persons. Sec. 436. All sanitariums shall be provided with a sufficient number of boarding physi- cians, nurses, and attendants. The nurses must be graduates of the University of Habana. A period of three years from the date of the enactment of these ordinances is granted for the compliance of this requirement. Sec. 437. There shall be in each sanitarimn one attending physician for eveiy twenty patients, and three boarding physicians for every two hundred patients, in order that the service be eflicient. Sec. 438. Pharmacies of sanitariums shall be placed in charge of professional pharma- cists. Sec. 439. Directors of sanitariums shall send a daily report to the local sanitary board of the cases of contagious diseases admitted therein, as well as of the patients discharged or dead. For the purposes of section 423, a dailj" record shall be kept where the date of admit- tance, disharge, and attendance of patients, and the diagnosis of the disease in each case shall be registered. Said record shall be inspected by the local sanitary chief, or his deputy, whenever he shall deem it necessary. Sec. 440. Every sanitarium shall be provided with two independent pavilions for the isolation of infectious diseases, one of which pavilions shall be assigned to diseases trans- missible by mosquitoes, and the other to those transmissible by contagion. Sec. 441. The first of said pavilions shall be provided with doors and windows protected with wire gauze against the access of mosquitoes. The door of said pavilion shall be double. Sec. 442. The pavilion for diseases transmissible by contagion shall be divided into two or more wards for the dift'erent diseases and to prevent the infection by a patient of a disease different from that with which he may be affected. Sec. 443. The wards shall be divided into small rooms, in each of which not more than two beds shall be allowed. There shall be, besides, one pavilion or special ward for persons suffering from tubercu- losis, said pavilion to be at a sufficient distance from the rest of the patients and provided with all the necessary precautions to prevent the spread of said disease. Sec. 444. Nurses and attendants in wards of contagious diseases shall by no means come in contact with the rest of the personnel of the institution. SECOND INTERNATIONAL HANITAHY CONVKNTION. 143 Seo. 445. Phywicians, nurses, and attendants in said wards sfjall wear wranpei-s, the collars and cuil's of which must be perfectly adjustable; they shall take oil' saitl wrappers before leaving the wards. Sec. 446. The excreta from patients must Im! duly disinfected. The vessels, bed clothing, and other articles which might have come in contact with patients shall also be disinfected. Every patient, as soon as ho is admitted in a sanitarium, shall deliver his clothing for its disinfection, and must w(iar the clothing assigned to him. Sec. 447. Sanitary plumbing of saiiit.ai-iiuns in towns where there are sewer and water systems shall be installed in accordance witli the provisions contained in these ordinances. Sec. 448. Sanitariums in towns where there is no sewer system .shall be provided with a sufficient number of cesspools, tlie bottom and walls of which shall be cemented and which shall have, other requirements whicli the local sanitary board may prescribe. Sec. 449; Cesspools shall be located as far as po.ssible from the building occupied by the patients, and shall be disinfected daily with crude petroleum and a solution of iron sulphate. Sec. 450. Patients who, on account of their condition of health, are not able to go in person to the water-closet, may make their evacuations in porcelain vessels which shall be provided with lids, and be taken out of the wards and disinfected immediately after they have been used. Sec. 451. There shall be in every sanitarium an isolated place where cadavers .shall be deposited until their burial. Said place must be disinfected whenever it shall have been occupied by a cadaver. Sec. 452. The sanitariums shall be inspected by the local sanitary board, and the sanitary chief or his deputy. Sec. 453. Sanitariums established without the prescribed provisions shall be immediately closed, and the responsible person shall be punished accordingly. Sec. 454. Hospitals, sanitariums, etc., shall furnish the local sanitary board such data from their private statistics and such other information as it may require. Sec. 455. The provisions prescribed for sanitariums shall be equally applicable to hos- pitals, infirmaries, etc. Chapter XIX. ANEMALS AND LIVE STOCK. Sec. 456. No animal affected with a disease transmissible to ±ankind, or which shall have been in contact with other animals suffering from contagious diseases, shall be brought or kept in a town. The owner or person in charge of animals, and aU veterinarians must notify the local sanitary chief of all cases coming under their observation. Sec. 457. Animals suffering from contagious diseases shall be isolated in the places designated by the local sanitary board. The appearance in the Province of Habana of a case of glanders or bovine tuberculosis shall be reported to the committee created by order 66, series of 1901, for the adoption of the measm-es therein prescribed. In other provinces the provisions of these ordinances shall be followed. Sec. 458. Stables, yards, corrals, etc., where any diseased animals may have been, must not be used again until they have been thoroughly disinfected, and the consent of the local sanitary board secured for the purpose. Sec. 459. The owner, person in charge, or veterinarian who shall notice in an animal symptoms of glanders or scrofula shall notify the case to the sanitary chief immediately. Sec. 460. Diseased or iU-treated animals found in the streets or other public places shall be immediately taken by the police to the place assigned for the purpose. Sec. 461. The transportation of animals suff'ering from transmissible diseases, or of cadavers thereof, shall be so made that it shaU not constitute a danger to public health. Wagons assigned to said transportation must be covered and inclosed and disinfected immediately after being used. Sec. 462. The burial of dead animals within the city limits is prohibited; they shall be transported before becoming decomposed to the place designated for their interment or cremation as the case may be. Sec. 463. Dogs shall not be permitted loose in the streets, if without muzzles. Dogs found otherwise shall be seized by the municipal employees in charge of the service, and who shall take them to the respectiA^e pound. Sec. 464. Whenever a person shall have been bitten by a dog or other animal, the local sanitary chief shall be notified, which officer shall cause the animal to be placed xmder observation, and if it turns out to be hydrophobic he shall direct the measures which he may deem proper. Sec. 465. Animals suspected of hydi-ophobia shall be captured and isolated, and the fact shall be reported to the sanitary chief. Sec. 466. Kennels must be kept perfectly clean always, and must be provided with drinking water. 144 SECOND INTERNATIONAL SANITARY CONVENTION. Sec. 467. Domestic animals must be kept clean always as well as the places assigned to them. Sec. 468. Breeding or fattening live stock of any kind in dung yards, muck hills, or other places where animal and other refuse is deposited is prohibited. Sec. 469. The removal of diseased animals from one district to another, or from one place to another in the same district, where pereons or animals may be infected thereby, is pro- hibited. Sec. 470. As soon as the local sanitary chief or the cattle owners have knowledge of the appearance of a case of epidemic disease (such as rinderpest) among live stock, they shall report the fact immediately to the superior sanitary chief, who shall at once enforce the measures prescribed in the circular of the secretary of the interior, in regard to rinderpest, of February 17, 1903, published in the Official Gazette of the 19th of the same month and year, the provisions of which are hereby ratified and confirmed. Sec. 471. Parts of animals dead of infectious diseases must not be availed for any pur- poses whatever. Sec. 472. Animals dead of infectious diseases must be completely cremated, and those dead of other diseases may be buried. Sec. 473. No hospital or stables for animals affected with diseases transmissible to mankind shall be permitted within the limits of any municipality. Chapter XX. COUNTRY OE RURAL SANITATION. Sec. 474. Coimtry residences shall be constructed far from swamps and swampy lands; high and dry lands must be selected for such residences. Sec 475. Owners of country houses shall fill and drain the swamps and puddles which may exist therein, and if it can not be done on account of the expense, they shall pour into the same sufficient quantities of petroleum every two weeks in order to prevent the pro- creation of mosquitoes. Sec 476. Country houses must have, as much as possible, similar sanitary conditions to those of other houses. Sec. 477. The crops shall not be deposited in dwelling places, and the keeping of domestic or other animals therein shall not be permitted. Sec. 478. Stables, pigpens, poultry yards, and other places where animals are kept must be separated from dwelling places and must be kept clean always. Sec. 479. Muck hills and cesspools must be situated in the remotest places from dwell- ings, wells, cisterns, streams, and rivers. Chapter XXT. transmissible diseases. Sec. 480. It shall be compulsory for physicians to report to the local sanitary chief all cases of any of the following diseases: Actinomycosis, anquilostomiasis, or unnicariasis, beriberi, gangrenous tumors, Asiatic cholera, cholera nostras, diphtheria and croup, epidemic dysentery, enteritis (any kind), erysipelas, scarlet fever, yellow fever, Malta fever, miliary fever, typhoid fever, phylariasis, grippe, leprosy, epidemic cerehro-spinal meningitis, glanders, pneumonia, granulous and puru- lent ophthalmia, malaria (all kinds), mmnps (epidemic parotiditis), bubonic plague, rabies, measles, puerperal septicemia and other puerperal diseases, tetanus neonatorum, exanthe- matic typhus, favus, whooping cough, tuberculosis (all kinds), varicella, and smallpox. The report of suspected cases of quarantinable diseases is also compulsory. For the purposes of these ordinances, transmissible diseases are those printed in italic in the preceding list, and quarantinable diseases are bubonic plague, Asiatic cholera, exan- thematic typhus, smallpox, yellow fever, and leprosy. The provisions of this section are apphcable to private as well as to official and municipal physicians. Sec. 481. When there be doubt as to the diagnosis, the physicians shall send to the local sanitary board samples of the sputum, blood, excreta, etc., for the purpose of ascer- taining the nature of the disease. The local sanitary board shall promptly consider all consultations submitted to it, and its decision shall at once be notified to the physician. Sec. 482. Physicians shall inform the local sanitary board whether there are any chil- dren in the house where a case of transmissible disease has occurred. The same information shall be given to the principal of the school attended by said children. Sec. 483. The local sanitary chief shall send a report to the superior sanitary chief of all cases of yellow fever, smallpox, bubonic plague, and Asiatic cholera which shall have been reported to them. _ SFXJOND INTERN /VTION AL SANITARY (!i>N VKNTKjN. 145 Sec. 484. The Superior Siuiitnry Jioard is hereby authorized to add the narne.s oí other diseases to the list coritiiincd in section 480, giving due publication to such additions as it may make for the information of all concerned. Sko. 485. The report presciibed in section 480 siialj be made in writing within twenty- four hours after the first visit or consultation, or immediately after if the case be, suspected or coirlinned, of Asiatic cholera, yellow fever, scarlet fever, measles, hubonic plague, diph- theria oi' croup, glanders, or tetanus nconatoium. Said report shall be made on printed blanli forms furnished by the sanitary boajxl. Sec. 486. Physicians tittending or visiting cases of transmissible diseases shall send to the local sanitary chief a certificate of the result of each case. Sec. 487; The attention of physicians is paiticulai'ly brought to the fact that they must report all cftses of tuberculosis attended by them, even if such cases may have been attended previously by other physicians. Sec. 488. It shall be the duty of persons affected with tuberculosis, as well as of their relatives and attendants, and of private and public institutions, to comply with and enforce all regulations and measures presci'ibcd, in ordei- to prevent the spiead of the di.sease. Sec. 489. When two or more physicians have visited in consultation a case of trans- missible disease, the one taking charge of the attendance, or, if none of them take charge of it, the one who shall have visited or examined the patient fh'st, shall report, the case. Sec. 490. Physicians shall likewise report all cases of transmissible diseases the patients of which go to their offices in consultation, stating this fact in the report, as well as the name, residence, etc., of the patient. Sec. 491. Owners or managers of boarding houses, hotels, lodging houses, colleges, fac- tories, and other places where many persons dwell or sleep shall also report to the sanitary chief within twenty-four hours, all cases of any of the diseases mentioned in section 480 which may occur in their respective establishments. Sec. 492. The sanitary chief, the medical health inspector, or the committee on infec- tious diseases shall have the right to visit any case, suspected or confirmed, of transmis- sible disease. Sec. 493. Directors of hospitals, sanitariums, etc., shall state in their reports the resi- dence of the patient or the place where it be supposed he contracted the disease. Sec. 494. Any person having knowledge of the existence of a case of transmissible dis- ease, or of a death caused therefrom, without medical attendance, must report the same to the sanitary chief. Se^. 495. Any physician attending a case of transmissible disease shall advise the head of the family, or the person in charge thereof, as to what measures should be taken to pre- vent contagion and the spread of the disease. Sec. 496. All cases of diseases easily transmitted shall be isolated upon order of the sanitary chief, either in the patient's house, if there be eflBcient means for the isolation, or in hospital, lazaretto, or other isolated place. Sec. 497. According to the nature of the disease, the isolation may include the entire house inhabited by the patient. The sanitary chief may, at his discretion, order the iso- lation of all or some of the persons residing in said house, or of the persons coming in con- tact with the patient. Such persons shall be subject, after the isolation, to the observation requirements which the sanitary chief may prescribe. Sec. 498. Flags and placards shall be placed in a conspicuous position or positions upon houses where there are cases of cholera, yellow fever, bubonic plague, exanthematic typhus, smallpox, scarlet fever, and diphtheria or croup. It shall be unlawful to hinder or obstruct the placing of said flags or placards, or, when placed, to deface, obliterate, or in any man- ner conceal the same. Sec. 499. The attendance of persons suiTering from cholera, yellow fever, typhus, typhoid fever, smallpox, scarlet fever, measles, or diphtheria shall not be permitted in colleges, hotels, boarding houses, factories, workshops, barracks, prisons, and other places where a large number of persons dwell or gather, except when such places are provided with a suit- able location for the isolation of transmissible diseases, the conditions of which are satis- factory to the sanitary chief. Sec. 500. Every municipality shall be provided with a special hospital or lazaretto properly fitted for the isolation of cases of transmissible diseases. Sec. 501. Physicians, nurses, and other persons attending patients of transmissible dis- eases must not come in contact with other per-sous unless they have previously disinfected themselves in the mamier prescribed by the local sanitary board. Sec. 502. When the circumstances of the case shall so demand it. a sanitary watchman shall be stationed in houses the isolation of which may have been ordered for the purposes of securing compliance with these ordinances. The persons in charge of such buildings sliall be held responsible for the violations committed by the persoimel under them. Sec. 503. Persons escaping vigilance or breaking the isolation shall be punished accord- ingly- 5610—06 10 146 SECOND INTERNATIONAL SANITARY CONVENTION. Sec. 504. No pereou shall, without the wi-ittcn corsent of the local sanitaiy chief, cany or remove, or cause to be carried or removed, from place to place any person suffering from uuj' transmissible disease. No person shall expose himself while sulfering from any transmissible disease. This prohibition includes nurses and other persons who have been exposed to such disease, until they have secured the consent of the local sanitaiy chief, who, before granting it, shall cause all necessaiy precautions to prevent contagion to lie taken. Sec. 505. The transportation of persons suffering from transmissible diseases shall be eflfected in suitable ambulances, which must be disinfected after having been used. In towns where there be no such vehicles the transportation may be made in caniages, which must also be disinfected in the manner prescribed by the local sanitaiy chief. The ownei^s or conductors of said carriages, as the case may be, shall be held responsible for the noncompliance with this provision. Sec. 506. It shall be unlawful to cany or transport in tiamways or omnibuses persons suffering from transmissible diseases. Such transportation may be made in railroad cars, provided they are properly fitted for it and isolated. The consent of the local sanitary chief, approved by the superior sanitaiy chief, must be previously secured therefor. Cars used in the transportation aforementioned must be thoroughly disinfected before being used again. Persons violating the provisions of this section shall be punished accordingly. Sec. 507. BacteriologicaUy confirmed cases of leprosy which are not properly isolated and cared for shall be confined in the San Lázaro Hospital of Habana or of Santa Clara, in accordance with the provisions relating thereto. Sec. 508. Any physician attending on or visiting a case of transmissible disease shall send to the local sanitaiy chief a certificate signed by him certifying to the recovery of case as soon as he becomes aware of such recoveiy. No person who has sufl'ered from anj' transmissible disease shall be pennitted to go out until he shall have secured an official certificate of recovery. Sec. 509. Children suffering from transmissible diseases, or children living in houses where cases of such diseases exist, shaU not be admitted in schools, colleges, workshops, etc. This prohibition includes laborers or employees therein. Teachers and foremen sbaU report to the sanitaiy chief any case of transmissible disease which they may notice. Parents, guardians, teachers, and foremen shall be held responsible for the violations of this section. Sec. 510. The person in charge of the house in which there is a case of transmissible dis- ease must strictly comply with the special instmctions given him by the sanitaiy chief in regard to the patient, his room, etc. Sec. 511. No house, room, etc., in which a case of transmissible disease has been shall be used again until properly disinfected. Sec. 512. Local sanitary chiefs shall notify the superior sanitary chief as soon as they become aware of the appearance of any case of acute quarantinable disease (yellow fever, Asiatic cholera, smallpox, bubonic plague, exanthematic' typhus) and shall immediately enforce the necessaiy preventive measm-es. Sec. 513. Besides the enforcement of the provisions of these ordinances, in regard to trans- missible diseases, the local sanitary board shall, as soon as it shall become aware of the appearance in its locality of any case of quarantinable disease (yellow fever, bubonic plague, smallpox, Asiatic cholera, exanthematic typhus), secure the strict compliance of the preventive measures prescribed by the Superior Sanitary Board in each case, such as the isolation of cases, and, if practicable, it shall order the removal of the patients to a place properly fitted for the absolute isolation and suitable attendance. If the focuses of any of such diseases be several, it shall secure the isolation of the cases in places distant from the inhabited parts of the town. It shall request the competent authorities to order the closure of schools, theaters, etc., and to prohibit sick persons, or persons suspected of being sick, from going out of the town. The local sanitary board shall send to the Superior Sanitary Board a daily repoit of all measures prescribed by it, as well as of the necessities which require prompt attention. The official announcement of the existence of an epidemic in any place of the Republic shaU be made only by the Chief Executive after hearing the superior sanitaiy chief. Sec. 514. The local sanitary boards of other municipalities shall exercise the gieatest care in watching o^'er the means of communication with the municipality where an epidemic prevails, disinfecting everything that comes therefrom, and exercising a careful inspection over persons coming also therefrom. If the enforcement of more vigorous measures be necessary, the question shall be submitted to the Superior Board. Sec. 515. While an epidemic prevails the local sanitary board shaU order the disinfec- tion of all premises where cases of the disease have occurred. Sec. 516. All articles in use in the loom or rooms of persons sufl'ering fi'om transmissible diseases .shall be disinfected, as well as all other articles which have been exposed to infection, and school books and supplies to be taken by children to the school. SECOND INTKKNATIONAL SANITARY rONV KNTION. 147 Sec. 517. Clothing used by siidi sick porsoiis inu.sfc not Ix! tukcn to liiuriflrics unlcs.s the same have been previously (lisinrectcd and tlus consent of the sanitary chiiif therefor been secured. Tiio same prohibition is applicable to furniture, utensils, and other articles from an infected house. Sec. 518. It shall be the duty of tiu^ pe/.son in charge of an inívcXcá Iiímjsc to carry out, within the time prescribed by the .sanitary bf)ai(i, the works or niea,sures which at the dis- cretion of the latter are necessary for the suppression of the unhf^althful conditions of the promises. Sec. 519. The sanitary board may order thocn embalmed. Seo. 547. No disintei-ment shall be made witliout the wi'itten consent of the local sanitary board, wiiere it shall be stated that such disinterment will not constitute a danger to public health. Sec. 548. Disinterments shall be made in the presence of a physician authorized by the sanitary board to represent it ; said physician shall take the greatest precautions to prevent any danger to jjublic health, ordering the disinfection of the grave, the coilin, and the cadaver or its remains. Seo. 549. In no caso shall a giave be opened in which has been buried the body of any {)erson wHo has died of bubonic plague, Asiatic cholera, diphtheria, smallpox, scailet fever, eprosy, or glanders, within five years after the burial. The consent of the local sanitary board shall be necessai-y therefor. Chapter XXIII. AUTOPSIES, EMBALMINGS, ETC. Seo. 550. No autopsy shall be performed outside of hospitals, morgues, cemeteries, and medical schools. No autopsy shall be made within twelve hours after the death. It shall be unlawÍTil to embalm, mummify, or petrify any cadaver within twelve hours after the death. It is likewise prohibited to mold the face, neck, or any part of a cadaver within twelve hours after the death and without the consent of the local sanitary chief. Such operation shall never be permitted in cadavers of persons who have died of smallpox, measles, scarlet fever, bubonic plague, or leprosy. Sec. 551. The following requirements shall be necessary for the carrying out of any of the operations referred to in the preceding section: (a) The consent of relatives of the deceased person, (b) the death certificate, and (c) the presence of the local sanitary chief or of a physician authorized by him to represent him. The presence of this officer shall not be necessary in autopsies. Sec. 552. The local sanitary board may order the carrying out of any of such operations whenever the interests of public health shall so demand it. Seo. 553. The operations above referred to nuist be performed by professors of surgery or medicine exclusively. Sec. 554. The local sanitary chief, his deputy, or the professors performing the operation shall diaw up and execute a certificate, to be signed by him or them and two ^vitnesses, in which the contents of the death certificate, the hour and day of the operation, the process employed for the embalming, mummifying, etc., and the composition of the liquids injected into the cadaver, or used otherwise, shall be stated. Sec. 555. The death certificate and the certificate referred to in the preceding section shall be sent by the local sanitary chief to the Superior Sanitary Board, in which oflBce the same shall be filed. Sec. 556. No embalmed cadaver shall be deposited in a house or church for more than twenty-four hours after it has been embalmed, except with the consent of the local sanitary chief. During said time the cadaver shall be under the custody of the physician who wit- nessed the operation of embalming. Sec. 557. The provisions of this chapter may be suspended or amended by the health authorities in time of epidemic. Chapter XXIV. conveyance of cadavers. Sec. 558. No cadaver of a person who has died of smallpox or bubonic plague shall be conveyed from one municipality, town, or province to another. Sec. 559. The conveyance of cadavers of persons who have died from typhoid fever, tuberculosis, Asiatic cholera, yeUow fever, exanthemalic typhus, diphtheria or croup, scarlet fever, measles, erysipelas, puerperal fever, glanders, anthi-ax, or leprosy shall cnly be permitted after such cadavers have been prepared therefor and disinfected in the following manner: (a) Arterial and capilliary injection of an eflncient antiseptic solution, (b) disin- fection and tamponage with absorbent cotton of all orifices, and (c) exterior washing of the body. These operations shall be performed by a physician and with the consent of the local sanitary chief. Sec. 560. After the cadaver has been disinfected in the manner prescribed in the pre- ceding section it shall be enveloped, fii'st, in a cotton coating thi-ee centimeters thick, and then with a sheet perfectly adjusted; then it shall be placed on a case made of zinc, tin, 150 SECOND INTERNATIONAL SANITARY CONVENTION. copper, or iron, and which shall be hermetically sealed. This case shall be inclosed in a wooden box. , Sec. 561. Cadavers of persons who have died ft-om diseases different from those mentioned in the preceding sections may be conveyed to places thau can be reached within thirty hours after the death. Sucli cadavers shall be inclosed in hermetically sealed metallic cases, which shall be placed in wooden boxes. If the place of destination can not be reached within the time prescribed, the same requirements pi-escribed in the preceding section shall be followed. Sec. 562. No person who has been exposed to infection shall be permitted to attend the funeral of the cadaver of a person who has died of any of the diseases mentioned in section 559, except with the consent of the sanitary chief certifjing that said person has been properly disinfected. Station masters shall carefully examine the permit for the conveyance of the cadaver, in which the names of the person in charge of the conveyance, and of those authorized to attend the funeral shall be stated. Sec. 563. The local sanitary chief shall notify, by telegi'am, the local chief of the place where the cadaver is to be convej^ed, stating in the notice the name of the disease, the date, hour, train, or steamer by which it is sent, and the station or wharf at which it shall arrive. Sec. 564. Every cadaver transported must be accompanied by a person who shall carry with him the permit from the local sanitary chief, and of a copy of the death certificate. It shall be stated in said permit whether the disease is transmissible or not, the place of des- tination, and the names of the persons authorized to attend the funeral. Sec. 565. A certificate ft-om the embalmer as to the manner in which the cadaver has been prepared for the transportation shall also be necessary. A copy of this certificate shall be attached to the exterior case. Sec. 566. The permit for the conveyance of a cadaver shall be made in duplicate and shall be signed by the attending physician, the local sanitary chiei, and the embalmer. One of the copies shall be| delivered to the person in charge of the cadaver and the other shall be sent to the superior sanitary chief. Sec. 567. The exterior case shall be provided with four handles, at least. Sec. 568. The transportation of cadavers by express shall be made in accordance with the provisions of sections 559, 560, 561, 563, 564, 566, and 567. The documents mentioned in said sections shall be sent to the agent in the place of destination. Sec. 569. Disinterred cadavers, whatever the cause of death may have been, shall be considered as infectious and dangerous to pubhc health ; the consent of the Superior Board of Health and the favorable report of the local sanitary board shall be necessary for the removal thereof. Such cadavers, or parts thereof, or the boxes containing them, shall be enveloped in a woolen blanket saturated with a solution of hydrargyric bychloride at 1 per 1000 and inclosed in a metallic case which shall be hermetically sealed. Sec. 570. Cadavers which have been embalmed and prepared in the manner prescribed, and which have been temporarily deposited in a vault, shall not be considered as disinterred if the transportation be made within thirty days after the death, and it shall not be neces- sary to secure the permit of the local sanitary chief of the place of destination. Chapter XXV. BARBER SHOPS. Sec. 571. Metallic instruments used in barber shops, such as razors, combs, scissors, as well as shaving brushes, immediately after being used shall be sterilized by being immersed in boiling water, which shall be changed every time, and to which 50 grams of carbonate of sodium shall be added. Sec. -572. Onl}^ metallic combs and razors with metallic handles shall be used, so that the same maj' be properly disinfected. Sec. 573. The strop must not be used until the razor has been previously disinfected. The razor must be cleansed with a new piece of paper whenever used, or wth a rubber devise which must be disinfected in the same manner as other utensils. Sec. 574. The use of powder puffs and sponges is prohibited; cotton, to be renewed every time, shall be substituted therefor. No alum or other material shall be used to stop the flow of blood unless the same be used in powder or liquid form. Sec. 575. No barber shall permit any person to use the head rest of any barber's chair under his control until after the head rest has been covered with a towel that has been washed since having been used before, or by clean, new paper. Sec. 576. Every barber shall cleanse his hands thoroughly with brush and soap inmie- diately before serving each customer. No barber shall use for the service of a customer any towel or wash cloth that has not been boiled or laundered since last used. SECOND INTERNATIONAL HANfTARY CONVENTION. 151 Sec. 577. No person sunVring from a corniriunicablc, disease shall be permitted to act aa barber. -No services shall be rendered to persons suffering from a similar disease, unless such persons be provided with their own uten.^ils. Sec. 578. Every manag(ir of a barber shof) shall keep said shop and all furniture, tools, appliances, and other equipments used tlieivin at all times in a cleanly condition. Sjoc. .')7!). Tin ownei' or miUia