NATURE 



25 



THURSDAY, NOVEMBER i: 



18S5 



THE INTERNATIONAL SANITARY 

 CONFERENCE OF ROME, 1885 



T' 



'HE first volume of the Proceedings of the Inter- 

 national Sanitary Conference of Rome has been 

 issued just at the time when the question of the re- 

 assembling of the Conference is a matter of diplomatic 

 discussion. The Roman Conference of this year was 

 brought together by the Italian Government because it 

 was felt that, after the cholera experience of 1883 in 

 Egypt and of 1884 in Southern Europe, advance might 

 be made in determining the bases of an International 

 Code as to quarantine or other preventive measures. The 

 previous Conference had been held at Vienna in 1874, 

 and the conclusions then arrived at had indicated sub- 

 stantial progress since the preceding meeting at Con- 

 stantinople in 1866. Under these circumstances nearly 

 all civilised Governments responded to the appeal of 

 Italy, and five delegates were deputed to represent this 

 country. Two of these. Sir W. Guyer Hunter and Dr. 

 Thome Thorne, acted with the British Ambassador at 

 Rome for Great Britain, and Sir Joseph Fayrer with Dr. 

 Timothy Lewis went as representatives of our Indian 

 Empire. Soon after the opening proceedings, a Technical 

 Commission, consisting of the medical delegates, was 

 formed, and it is essentially with the proceedings of that 

 Commission that the volume referred to has to do. 



With the ready assent of Dr. Koch, the Commission 

 decided at the onset not to discuss scientific questions 

 bearing upon etiology or otherwise, and the series of 

 resolutions arrived at deal almost exclusively with the 

 measures which are deemed necessary to prevent the 

 spread of cholera in Europe. Perusal of the proceedings 

 at once shows that the Powers bordering on the Medi- 

 terranean had one principal object in view. They were 

 convinced that shipping passing from India via the 

 Suez Canal constituted the great source of danger to 

 ports on the basin of the Mediterranean ; they knew 

 that the sanitary state of the majoiity of those ports 

 could not withstand the importation of infection ; hence, 

 cost what it might to other nations, they were de- 

 termined to place restrictions upon shipping passing 

 through the canal. It is true that the utter failure of 

 quarantine measures had once more been abundantly 

 shown during the 1884 epidemic, and for this reason the 

 Commission decided to drop the word quarantine alto- 

 gether ; and they proposed, instead of the ten days' 

 quarantine which had been sanctioned at Vienna, to 

 recjuire a detention of five days for the purposes of 

 " observation." But. as was pointed out by the English 

 delegates, this was quarantine pure and simple, for it 

 involved the disembarkation of all on board vessels which 

 might be regarded as infected by some internationally 

 appointed officer, and the detention of men, women, and 

 children in the filthy lazarets of the Red Sea shores for 

 as many consecutive periods of five days as the officer in 

 question might choose to dictate, so long as he could 

 regard any one amongst the persons thus isolated as 

 Vol. xxxiii.— No. 837 



having suffered from symptoms which in his opinion 

 resembled cholera. As regards European protection, it 

 was also contended that such a measure was unnecessary 

 in the case of British ships, and the Commission were 

 twice challenged to give a single instance in which 

 cholera had been brought into the continent of Europe 

 by means of a British ship coming from India. And if it 

 was unnecessary, it was contended that, provided British 

 ships touched at no ports on their way home, they should 

 be allowed the free passage of the Suez Canil as of an 

 ordinary arm of the sea. 



But quarantine restrictions were not only held to be 

 unnecessary, they were also shown to be distinctly mis- 

 chievous in so far as they led the inhabitants of threat- 

 ened countries to rely on Government measures of that 

 description instead of adopting measures of sanitation 

 which constituted the true remedy against cholera spread. 

 And here the experience of England was shown to be 

 strikingly opposed to quarantine. It is now some ten 

 years since England, adopting one of the alternative 

 measures sanctioned at Vienna, decided that since 

 quarantine must always fail, the country would place its 

 trust in an inspection of in-coming vessels, together with 

 the immediate isolation of the sick in hospital, and in 

 securing such improvement in the sanitary state of the 

 country as would tend to remove the conditions favour- 

 able to the diffusion of cholera if imported. And Dr. 

 Thorne Thorne, whilst pointing out in detail that during 

 that period of ten years our sanitary authorities had 

 spent some 27,250,000/. in large public health works and 

 that this had in truth been a remunerative expenditure by 

 reason of the saving of life which had followed it, asked 

 what country had shown a greater proof of the value it 

 set on human life than England had, and contended that 

 it would be an unfortunate day if we were to replace such 

 a system by the imposition of a five days' quarantine. 

 Indian statistics proving similar results were also brought 

 forward by Sir Joseph Fayrer, and they must be regarded 

 as unanswerable. 



In short, the English delegates contended that we must 

 look, above all, to improved sanitation in order to get rid 

 of the danger of cholera ; that countries which are taught 

 to rely on the false security of quarantine measures and 

 sanitary cordons will not at the same time spend their 

 money on sanitation ; and that the very countries which 

 had fitted themselves to resist cholera by making real 

 and substantial progress as regards sanitary improve- 

 ments, and had thus effected a saving in life from infec- 

 tious diseases, were those which had determined to place 

 little or no trust in measures of quarantine. 



Compared with the resolutions of the Vienna Con- 

 ference, the conclusions arrived at in Rome do in many 

 respects admittedly afford evidence of considerable 

 advance, but they are vitiated by the initial error of 

 trusting to ^.modified quarantine restrictions, instead of 

 boldly facing,the need for improved sanitation. As yet 

 these conclusions are those of the Technical Commission 

 only, and it remains to be seen whether, since the English 

 delegates are opposed to their colleagues on a matter of 

 such vital principle, any object will be gained by the 

 re-assembling of the Plenary Conference, to discuss the 

 recommendations made bv the Commission. 



