NATGORE 
THURSDAY, JULY 9, 1885 
THE INTERNATIONAL SANITARY 
CONFERENCE [N ROME 
HE late Conference in Rome, which for some un- 
known reason stands adjourned for the present to 
reassemble again in November, has arrived at certain 
results, the details of which are not published yet, and 
until the full and authenticated report is at hand it would 
be unjustifiable to subject them to criticism. But as far as 
the gross results achieved and the methods followed by 
that Conference have already become known through the 
reports sent to the daily papers, there is no reason for 
viewing those results with any peculiar satisfaction. As 
far as we can follow the proceedings of the Conference, 
its achievements cannot be considered an advance on 
those of its predecessors held in Constantinople in 1866 
and in Vienna in 1874. 
During the present century Europe has been visited six 
times by cholera, and after the second visitation (1847-50) 
the first International Sanitary Conference was convened | 
to Paris in 1851, in order to arrive at some common 
understanding as to quarantine, and to discuss various 
questions of hygiene, as well as the etiology of the 
disease. 
Between 1852-56 Europe was again visited by cholera 
(England in 1853-4), and very important knowledge was 
then gained as to the intimate relations existing between | 
| what lesson has the late Conference in Rome learned 
general insanitary conditions and the spread and severity 
of the disease. After the next visitation of Europe by 
cholera (in 1865-6) the second International Sanitary | 
Conference met at Constantinople (in 1866). The results 
of the deliberations of this Conference have been in many 
respects important. The Conference agreed, with few 
dissentients, that cholera has for its starting-point India ; 
that its invasion into other countries is effected by human ; 
| from Bombay arrive under favourable conditions off 
intercourse, including linen and wearing apparel; that 
its spread depends in a great measure on general in- 
sanitary conditions of habitation, air, water, and food. In 
order to avert and check the invasion of Europe by the 
disease, the Conference agreed to a certain complicated 
system of quarantine both by land and sea, which em- 
bodied and enlarged on the scheme laid down by the 
preceding Conference of 1851, but which had been found 
incapable to avert the introduction of the disease in 
1865-6. 
Next cholera appeared in Europe in various countries 
between 1869-73, and after the epidemic came to an end 
another International Conference assembled in Vienna in 
1874. This Conference, while confirming the results of 
the deliberations of its predecessors, arrived at certain 
important conclusions as to the value of disinfection and 
quarantine. As regards the latter the Conference 
agreed that all measures of quarantine, as far as they are 
practicable, are fallacious and incapable of averting or 
checking the introduction and spread of the disease ; that 
all measures of land quarantine are to be condemned ; 
and that maritime quarantine is to be replaced by com- 
petent medical inspection. Cholera appeared next in 
| cations with Egypt, Italy, and Spain. 
Egypt in 1883, and from here was introduced into | 
VOL. XXxII.—NOo. 819 
217 
Marseilles, where it assumed, in July 1884, alarming propor- 
tions ; thence it spread into Toulon, the south and north 
of France, into Italy and Spain, raging everywhere with 
great severity. If at any time land and maritime quaran- 
tine had a fair trial it was in 1884 in France, Italy, and 
Spain. Every one remembers the dictum of M. Fauvel, 
then at the head of medical affairs in France, that the 
disease that broke out in 1884 in Marseilles and spread 
thence into Toulon and other parts of France could 
not be Asiatic cholera, because quarantine, after the 
appearance of cholera in Egypt in 1883, had been very 
perfect and had been carried out in French maritime 
ports with great rigour. Every one remembers also that, 
in spite of all the measures of land quarantine practised 
in France, Italy, and Spain in 1884—and at the present 
moment practised in Spain—its lazarettos, fumigations, 
and military cordons with its attendant troubles, miseries, 
and cruelties, cholera spread and raged with great severity 
in France and Italy, and is at the present moment assum- 
ing alarming proportions in the eastern and south-eastern 
parts of Spain ; while, on the other hand, this country, 
without any maritime or land quarantine, but with an 
efficient and competent medical inspection of all shipping 
in its maritime ports, has remained free from cholera in 
1884 and hitherto, notwithstanding its vast communi- 
Maritime and 
land quarantine have had a repeated and fair trial, but 
have been found utterly wanting, and countries like 
France, Italy, and Spain placing the utmost faith in them 
have dearly paid for it. Now, what lesson is to be 
learned from all this, and let us ask at the same time 
from this ? 
The Conference of Constantinople (in 1866) had adopted 
ten days as the furthest limit of the period of incubation— 
that is to say, if any ship coming from an infected part 
had been at sea for ten days and no case of cholera has 
appeared on board, the ship is to be considered “clean ” 
and is to receive free Pratigue. Now, steamers sailing 
Suez on the eleventh day, and therefore if no cholera 
has appeared during the whole of the voyage, the ship 
ought, according to the above, receive free Jracvzgue. But 
instead of this every ship is detained and kept under 
“inspection ” for at least twenty-four hours at Suez, at the 
instance of the Egyptian authorities acting under the 
instructions of the General Board of Health. The majority 
of the medical members of the late Conference at Rome 
carried this still further in recommending that all ships 
coming from India should be detained and kept under in- 
spection at Suez for five days, some delegates even for ten 
days. Another still more iniquitous recommendation, and 
one which, if carried into practice, is likely to have serious 
consequences for Egypt and Europe, is this: that if any 
“suspected” ship—the decision as to this “suspicion ” 
resting with an Egyptian official of self-estimated com- 
petency—arrive off Suez, the passengers and crew are to 
be turned out into lazarettos, kept there under observation, 
disinfected, &c. Now, the Conference, in order to esta- 
blish a permanent focus of cholera from which the disease 
might, and in all probability would, spread into Egypt 
and the adjoining countries, the Mediterranean Basin and 
Europe. could not have recommended any arrangement 
L 
