advisory supervision of vital and mortuary statistics and sanitary measures, should directly control a properly devised maratime quarantine, which should be so framed as to act with and in support of State quarantines.

In an opinion read before the American Public Health Association at Richmond, by the Hon. J. Randolph Tucker, of Virginia, the question of the relation of the national and State governments in regard to sanitation, is so plainly set out that I will be excused for a somewhat lengthy quotation.

"The States have, undoubtedly," says he, "reserved to themselves the power to protect the lives and health of their people. The power delegated to Congress 'to regulate commerce with foreign nations and among the several States,' cannot be constitutionally exercised if thereby the introduction of disease into any State is either licensed or permitted. Unless this reserved power of the State to protect the people, by quarantine and other health laws, be upheld in full force, the commercial regulations of Congress might fill the avenues of trade with disease and death. The commercial power is inter-national and inter-State, external and federative in its nature, for the regulation of which a general government is best fitted. The health power is local, domestic, and internal in its nature; operates within the State and guards the homes of the people, and is best exercised by the State government. Chief Justice Marshall, in the case of Gibbons vs. Ogden, 9 Wheaton, 1, states the question with clearness and force in the following language: "The acts of Congress in 1796 and 1799, empowering and directing the officers of the general government to conform to and assist in execution of the quarantine and health laws of a State, proceed, it is said, upon the idea that these laws are constitutional. It is undoubtedly true that they do proceed upon this idea; and the constitutionality of such laws, so far as we are informed, has never been denied. But they do not imply an acknowledgement that a State may rightfully reg

ulate commerce with foreign nations, or among the States; for they do not imply that such laws are an exercise of that power, or enacted with a view to it. On the contrary, they are treated as quarantine and health laws, are so denominated in the acts of Congress, and are considered as flowing from the acknowledged power of a State to provide for the health of its citizens.'

But as it was apparent that some of the provisions made for this purpose, and in virtue of this power, might interfere with and be affected by the laws of the United States made for the regulation of commerce, Congress, in that spirit of harmony and conciliation which ought always to characterize the conduct of governments standing in the relation which that of the Union and those of the States bear to each other, has directed its officers to aid in the execution of these State laws, and has, in some measure, adopted its own legislation to this object by making provisions in aid of those of the State."

Granting, then, the power of Congress to regulate commerce, we have a practical solution of the difficulty, in the position maintained by Chief Justice Marshall, that Congress should sustain the health laws of the States, and make provisions in support of them, but not against them,' or contrary to their purpose."

In this view, it becomes a matter of the first importance that the States should, through co-operation with the National Public Health Board, adopt and recommend to Congress such a uniform system of quarantine and sanitation as will enable Congress, in accordance with the principles already stated—and in the past acted upon by the general government to make laws in aid of the State laws of health. In this way, the conflicting elements may be harmonized and the public health promoted.

"For it cannot be," says the opinion already quoted from, "the interest of any State to obstruct its own commerce by needless and adverse health laws, nor can it be the policy of

Congress to foster commerce by the sacrifice of the lives or health of the people of the States."

The propriety and necessity of quarantines in our seaboard cities, against yellow fever, are generally admitted They are only objected to by a few who believe that yellow fever is endemic in our Southern seaports, or that, being once exotic, it has become naturalized. The possibility of failure in these, however, renders an inner cordon necessary, in the form of inland quarantines.

These have met with greater opposition as interfering, in many instances, with inter-State commerce, and have been harshly denounced by those whose views of humanity are confined to the protection of the citizens of seaboard cities, or whose views of the privileges of commerce outweigh their consideration for the protection of human life. By such, they have been denounced as unwise, inhuman, impracticable, and unconstitutional.

The same principles apply here as in the relation of State and general government. Every community has the inherent right to protect itself against threatened disease, and when this right is exercised by municipal authorities, county or village, under the provisions of the State Board of Health, and by its authority, they become part and parcel of the State laws of health, and, as such, are entitled to the same considerate recognition and aid from the State and general government as are the more general State laws of health. And if they should, in some measure, interfere with inter-State commerce-as may the State health laws with foreign commerce-they are none the less constitutional, and none the less worthy of proper consideration, both by general government and seaboard cities. These inland quarantines of absolute non-intercourse, which have been derisively denominated "shot-gun quarantines," are the legitimate results of a populace aroused to a sense of their danger, and are but the counterparts of the military cordons of European sovereigns, which have so successfully held at bay the Asiatic

plague, in its late threatened invasion of Europe. And if the cities of our Southern coasts do not see to it, through a rigid enforcement of their quarantines, that yellow fever is not permitted to enter their gates, they must expect that these inland cordons will be even more rigid than heretofore; and while they may attempt to hold open the gates of importation to commerce, the doors of consumption will be closed against them, and their commodities must rot on their hands.

"The dangers to health arise from the privileges of commerce," and those who would reap these privileges, must also provide against the dangers; and while the Shylocks of commerce may demand their pound of flesh, they must not, in taking it, shed one drop of the blood of life.

Their practicability is a question to be decided only by a fair trial. In support of this, I may refer to the exemption of Natchez, Selma, Montgomery, Forest, and Livingston, last fall, which each had its strict quarantine, while many other places less exposed than these, in the absence of efficient quarantines, were devastated by the fever.

I have presented this point more at length than I desired, but its importance demands at our hands the most serious consideration. I would suggest that the Association devise some general system of county and municipal quarantines, to be carried out by the County Boards, so as not to leave them to be improvised under excitement, and thus be subject to the defects of hasty action, by which important provisions may be omitted, or unnecessary restrictions imposed.

LOCAL SANITARY MEASURES.

There is a second factor-local sanitary measures-to which I must refer.

Those who believe in the endemic nature of yellow fever, would rely solely upon this. While I cannot believe this is a correct or safe position, I fear there is danger of overlooking the importance and necessity of the most careful local

sanitary measures. The history of yellow fever in former visitations shows that it requires a certain epidemic condition of the air in order that the disease may propagate itself when the germ is introduced into a community; and there are not wanting facts to show-though it would not seem wholly dependent upon this-that this epidemic condition of a place may be dependent upon its local sanitary condition. A remarkable instance of this was seen at Huntsville during the late epidemic, which was constantly exposed to the fever, by the unrestricted introduction of imported cases into the city from August until frost, and yet not a case originated in the city. This exemption was attributed by Dr. Dement, the health officer, to the good sanitary condition of the place.

Another similar instance was mentioned by Dr. Bemis, in his report to the American Public Health Association, of a village near Memphis-name not now remembered-near which a camp was established, to which about three hundred of the citizens were removed after the fever was epidemic in the town, and daily communication kept up between the camp and the town; and yet not a case originated at the camp, though it continued to prevail fearfully in the town.

But while these facts are not to be denied or overlooked, it is equally clear that we are unable to determine, in the present state of knowledge, when this foul or epidemic condition of the air exists, and hence the only safe rule is a well regulated system of quarantines, while, at the same time, we do not neglect local sanitary measures.

To sum up, the prevention of this exotic disease is encompassed in two factors, viz.:

(1) Through local sanitary measures, and

(2) A well devised system of co-operative quarantines, national, State and municipal; and let it be remembered, that quarantine, to be effectual, should be under the rigid and unbending supervision of the most advanced measures pointed out by sanitary science, or, in the absence of these,