689 



And as Rutli Masters stated two years later : 



Today there are few spheres of governmental activity in 

 which states so readily agree to pool experience, to render 

 each other assistance, to harmonize their administrative 

 practices, and to share their knowledge freely, as in that of 

 public health/ 



But even in public health, today's level of international coopera- 

 tion was not easily achieved nor is it easily sustained. Historically, 

 the cycles of pestilence were accepted as a fact of life. There was a 

 series of di^ase invasions beginning with the Christian era, running 

 on through the fall of Rome, and climaxing in the Black Death of the 

 fourteenth century. Most of this was probably plague, but typhus 

 came into the early picture too and it is now known that "more cru- 

 saders were slaughtered by typhus and plague at the gates of Antioch 

 and Jerusalem than by the infidel." Much laiter it was thought in the 

 developed countries that the scourges of plague and cholera could be 

 kept awuy by sanitary practices at home. The fact is, however, that 

 many infectious diseases can threaten advanced countries. It was not 

 cholera or plague which took the lives of twenty million people in 

 1918-1919, but rather a particularly virulent strain of influenza in 

 pandemic — twice the number of casualties produced by World War I 

 itself. These casualties occurred in the developed world where death 

 re<5ords were kept; uncounted additional deaths occurred elsewhere." 



In the early deliberations (1850-1900) of nations on public health 

 there occurred the )iow well-known phenomenon of scientific dispute. 

 The paucity and uncertainty of scientific knowledge about health and 

 medicine left much room for debate, and the doctors could more easily 

 align themselves with views held vital to the national interest- of their 

 countries. The quarrel between French and British doctors about how 

 to control the spread of international disease was intensified and em- 

 bittered by traditional Anglo-French political rivalry. The German 

 members of the International Sanitary Council of Constantinople 

 made decisions of little consequence to disease but calculated to expand 

 the political dominance of Germany in one instance and to weaken 

 British commercial dominance in the other.^ According to Masters, 

 Turkey rarely observed sanitary rules, holding that the whole system 

 was a tool of imperialist power politics rather than a system for the 

 protection of Europe against epidemic invasions.^ British physicians, 

 even with French scientists ridiculing their logic, had little difficulty 

 in supporting British foreign shipping interests by downgrading the 

 importance of quarantine restrictions. 



The "medical plank" which most of the British doctors were sup- 

 porting is described in the 1849 British Report on Quarantine, which 

 concluded "that the only real security against epidemic disease is an 

 abundant and constant supply of pure air * * * and that ventilation 



«Ruth D. Masters. "International Organization in the Field of Public Health," (Wash- 

 ington, D.C., 1947). page 2. ^^. ^ 



sihld., p .^1. Onlv recently, as the instrnmentR of war have reache'' the capacity of high 

 kill, have their (toll In casualties exceeded that of disease. Not until World War II did more 

 soldiers die from bullets than from disease. As for the great World War I Influenza i^n- 

 demic, it must be stated in all fairness that the deaths were low compared with the 700,- 

 000.000 people who came down with the disease. There were hardly that many soldiers or 

 civilians exposed to bullets, gas. or any other deliberate weaponry. So, while the deaths were 

 relatively low, the casualties were enormoun. Then as now the primary enemies of man 

 were diBeaf^e and disease-producing organisms. 



•Ihld., page .S8. 



' Ibid., pages 7-8. 



