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to preserve for future reference documents which are already of historical value, we respectfully recommend the publication, in connection with our report, and as a part of it, the following named monographs and papers, namely:

(1). The Conclusions of the Board of Experts appointed by Congress to investigate the Yellow Fever Epidemic of 1878.

(2). The Harris Quarantine Bill.

(3). The McGowan Quarantine Bill.

(4). The Quarantine Bill of the National Board of Health.

(5). The Memorandum of the Executive Committee of the American Public Health Association.

(6). The Report upon the Work of the Yellow Fever Commission, by the Committee of the American Public Health Association.

(7). Report on Propositions Relating to Yellow Fever, by the Committee of the American Public Health Association.

(8). Opinion of Hon. Randolph Tucker, M. C. of Virginia, upon the Constitutionality of Quarantine Laws.

(9). The Law of National Quarantine, by the Hon. F. G. Bromberg, of Mobile.

CONCLUSIONS OF THE BOARD OF EXPERTS AU

THORIZED BY CONGRESS TO INVESTIGATE THE YELLOW FEVER EPIDEMIC OF 1878.

Being in Reply to Questions of the Committees of the Senate and House of Representatives of the Congress of the United States, upon the Subject of Epidemic Diseases.

WASHINGTON, January 29, 1879.

To the Committees of the Senate and House of Representatives of the Congress of the United States, upon the subject of Epidemic Diseases:

The Board of Experts, "appointed to investigate the causes and method of preventing yellow fever and cholera," received the following letter, on the 26th of December, 1878:

MEMPHIS, TENN., December 26, 1878.

Dr. John M. Woodworth, Surgeon General, having by resolution of the joint committee of the Senate and House of Representatives (appointed to investigate the causes and method of preventing yellow fever and cholera) been constituted President ex-officio of the Board of Experts provided for by resolution of Congress, he will proceed to organize the same and direct them to investigate the following points of inquiry, viz :

1st. The origin, cause, and distinctive features of yellow fever and cholera; whether or not they are indigenous to any part of the United States; if not, how they are brought to this country, and the localities from which they come; and if found to be indigenous and also imported, in what proportion and to what extent has their presence in the United States been owing to importation.

2d. The season of the year and atmospheric conditions, when and in which they may be propagated.

3d. The means to be adopted by which their introduction into this country from other localities may be prevented.

4th. The method of preventing its propagation and spread, when once introduced into any part of the United States.

5th. The number of deaths that have occurred in the United States during the present year; the expenditure and the injury to business resulting therefrom.

The foregoing is the order of the committees in joint session, and the experts will confine themselves to it as nearly as possible.

ISHAM G. HARRIS,

Chairman Senate Committee.. STANLEY MATTHEWS,

Of Senate Sub-Committee.

CASEY YOUNG,

Chairman House Committee.

In compliance with the foregoing instructions, an organization of the Board of Experts was completed by electing Dr. Chaille, secretary, and adopting a plan of operations for continuing the investigation which had been commenced by the Yellow Fever Commission, in October last. For the details of the plan, reference is respectfully made to the accompanying record of the proceedings of the Board of Experts at its meeting for organization, held in Memphis, December 26th, 27th, and 28th, 1875. Upon adjournment of the Board, in Memphis, the members entered immediately upon the work assigned to them.

Including the thirty-four infected cities and towns visited by the Yellow Fever Commission which was merged into the present Board, more than fifty localities were carefully and personally examined previous to the 15th instant, on which day the Board convened in the city of Washington, in accordance with instructions. A great number of facts have been gathered respecting the history of the late epidemic of yellow fever, which have guided the Board in arriving at the conclusions which are respectfully submitted in reply to the questions of the Congressional Committees on Epidemic Diseases.

It should be borne in mind that these conclusions are based upon the evidence of a necessarily incomplete investigation of the epidemic-incomplete because of the urgent demands for public health legislation during the present session of Congress; otherwise the Board might not be held excusable for the seeming haste in dealing with this great subject. For among the most difficult questions which confront us are those which relate to the prevention of disease and untimely death; and this is especially true in respect to yellow fever and cholera, the mysterious and elusive causes of which become associated with man in his travels and traffic.

The Board is unanimous in the opinion that the investigation of the late epidemic should be completed, and that the study of the natural history of yellow fever should be systematically pursued, and especially that the inquiries should embrace the perpetually infected ports of the West Indies, whose fields give greatest promise of practical results, as the reward of faithful scientific

inquiry. It is accordingly recommended that two or three skilled experts be charged with the completion of the study of the late epidemic, which can be concluded in a few months, and that at least two such experts be authorized to proceed to the West Indies, there to make a more thorough study of yellow fever than has ever yet been undertaken, and that they be accompanied by an experienced microscopist. It is further recommended that the necessary steps be taken by Congress to secure the co-operation of the Spanish and other foreign Governments, through an Interrational Commission, or otherwise, in an earnest effort to ascertain the cause, or causes, which perpetuate the yellow fever from year to year in the West India Islands, and to devise ways to remove the cause, or causes, or to lessen the chances of transporting the poison to the United States or other countries.

Yellow fever should be dealt with as an enemy which imperils life and cripples commerce and industry. To no other great nation of the earth is yellow fever so calamitons as to the United States of America. In a single season more than a hundred thousand of our people were stricken in their homes, and twenty thousand lives sacrificed by this preventable disease. Systematic, scientific study should be unceasingly directed against this subtle enemy until our weapons are so perfected as to destroy or to surely hold it in check. In the benefits flowing from scientific research, America has received from Europeau nations more than she has bestowed, but the opportunity is now offered to pay a part of the debt by continuing to completion, so far as human skill will permit, the work which has been begun.

In the light of scientific experience, and of such facts as have been obtained, the Board has given careful consideration to the outlines of a system of observation of yellow fever and cholera; and, as connected therewith, to shipping in foreign ports, to the interchange of information, and to the inspection and sanitation of infected vessels and persons outside of our ports and after their arrival; together with the supervision of inter-State travel and traffic in times of epidemic within our borders.

The object aimed at, is to present the outlines of a system of quarantine, which may afford the greatest attainable degree of protection against the introduction and spread of infectious epidemic diseases; and at the same time inflict only a minimum of injury and inconvenience upon commerce. Two classes of medical officers are suggested: First. Medical officers of health to serve in foreign ports from which we receive importations of yellow fever and cholera. Secondly. Medical officers of health to have charge of quarantine stations, and to supervise inter-State travel and traffic from infected places in times of epidemic.

The two classes of Medical officers suggested are considered indispensable to any method of quarantine which does not involve complete suspension of intercourse with infected ports. The Board regards it to be especially important that the selection of these officers should be made from men skilled in medicine and sanitary science. The success of any modified quarantine scheme depends almost entirely upon the competency and fidelity of its medi

cal officers. One of the difficulities which has confronted the Board in considering the subject of quarantine is the lack of definite knowledge respecting the duration of life or virulence of the poisons of yellow fever and cholera. It is now known that the poison of neither is susceptible of long vitality when exposed to the open air; but it is not yet determined how long its infectious properties may be preserved in closely shut chambers or in compartments of vessels, or when confined in the folds of clothing or goods. It consequently follows that ships are especially dangerous carriers of these diseases, and also that they remain sources of infection for months after having been infected with the poison.

Another difficulty arises from the imperfect state of scientific knowledge respecting disinfection as applied to the destruction of the poison of yellow tever. It is deemed of great importance that the means may be provided by Con gress for obtaining trustworthy information by telegraph in respect to the outbreak and progress of cholera, yellow fever, and other epidemic diseases in all parts of the world, and the departure of vessels from infected ports bound for ports in the United States. The diffusion of trustworthy information among the people respecting the existence and progress of preventable diseases, at home and abroad, should be encouraged, as tending to avert the evils of panic, and to promote measures of prevention.

The carrying into effect of an efficient system of quarantine contemplates a central authority or Health Department. It is considered important that such a department should be so organized as to gain strength from, and give strength to, State and municipal health organizations. In view of the diversity of circumstances attending vessels arriving from infected ports, the difference exhibited by different ports in respect to their liability to infection; and the difference in such liability in the same port at different seasons and under varying circumstances; it is desirable that matters of detail should not be fixed by law, but should be left to regulations to be prepared under proper restrictions. The great interests which such regulations would guard, and the necessity for changes in them from time to time, as increased experience or knowledge, or other causes, might indicate, warrant the recommendation for the establishment of an advisory Board of Health, to be composed of men eminent in sanitary matters, who, together with the chief officer of the Health Department, shall frame all needful rules and regulations for carrying into effect, subject to the approval of the President, such National public health laws as may be enacted.

THE ORIGIN, CAUSE AND DISTINCTIVE FEATURES OF YELLOW FEVER AND CHOLERA.

FIRST QUESTION. -"The origin, cause, and distinctive features of Yellow Fever and Cholera; whether or not they are indigenous to any part of the United States; if not, how they are brought to this country, and the localities from which they come, and if found to be indigenous and also imported, in what proportion and to what extent has their presence in the United States been owing to importation."

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