102 



SCIENCE, 



[YoL. YL, No. 131. 



itar}^ axioms, is of the greatest importance. 

 For it is onl}^ under the stimulus of a recent 

 epidemic, or the fear of one in tlie near future, 

 that those who devote their liA^es to sanitary 

 science can secure the attention of legislators, 

 and of the public generally, to the truth of 

 these axioms, and to the fact that cholera and 

 3'ellow-fever are, to a great extent, preventable 

 diseases. 



Upon two things the sanitarians assembled 

 at Rome, with two or three exceptions, were 

 agreed : Firsts that cholera invades countries 

 at a distance from that part of India where it 

 exists as an endemic disease, not by de novo 

 development, nor by any independent power of 

 extension, but as a result of human intercourse. 

 In other words, that new centres of infection 

 are established b}^ the transportation of germs 

 from previously infected localities, either by 

 fomites, or b}' means of the dejections of the 

 sick. Second, that certain insanitarj^ local 

 conditions are essential for the development of 

 an epidemic when cholera-germs are intro- 

 duced ; and that in a city which has a pure 

 water-supply, and which is in a perfect sanitary 

 condition, cholera cannot establish itself. So 

 thoroughl}' are the English delegates to the 

 sanitar}' conference convinced of the truth of 

 this latter proposition, and so well are they 

 satisfied with the present sanitar^^ condition of 

 their country, that the}' are willing to trust 

 entirely to local sanitation, disinfection, and 

 isolation of the sick, and insist that quaran- 

 tine restrictions of an}' kind are unnecessary. 

 In proof of this they point to the fact, that, 

 for years, there has been unrestricted commu- 

 nication between the cholera-districts of India 

 and England ; and that, nevertheless, the dis- 

 ease has not been introduced into the latter 

 country. 



Other countries of Europe, however, are not 

 wiUing to trust alone to local sanitation. 

 They say. We admit that with plenty of money, 

 a city may in time be made cholera-proof, es- 

 pecially if its inhabitants have been educated 

 in ways of cleanliness, and if it is not located 

 too near the tropics. But the cities and towns 

 of southern Europe are not in this condition, 



and it is hopeless to think of effecting such 

 radical sanitary reforms on short notice. We 

 therefore demand the establishment of bar- 

 riers for the arrest of the infectious principle, 

 or germ, which comes to us from your Indian 

 possessions, and most frequently by way of 

 the Red Sea and Suez Canal. In addition to 

 this, we propose to guard our ports of entry, 

 and to depend rather upon the exclusion of 

 cholera-germs than upon the hopeless task of 

 effecting such sanitary reforms as will make 

 it safe to open the doors for their unrestricted 

 introduction. 



England replies, through her delegates to 

 the conference at Rome, Guard your ports as 

 closely as you please, but leave us free to pur- 

 sue such methods as we have heretofore found 

 efficient ; and don't interfere with our commerce 

 by detaining ships which are sailing directly 

 from India to English ports by way of the 

 Suez Canal. 



As to the quarantine restrictions necessary, 

 there is the widest range of opinion among the 

 delegates to the conference at Rome. Some 

 insist upon the old-fashioned arbitrary quaran- 

 tine of detention for all ships and persons com- 

 ing from infected ports, and differ only as to 

 the time of detention. For these, from seven 

 to ten days after arrival is the shortest time 

 which can with safety be admitted. In this 

 old quarantine party are the delegates from 

 Turkey, Spain, Brazil, Greece, Roumania, and 

 one or two other second or third rate powers. 

 On the other hand, the delegates from France, 

 Germany, Italy, Austria, Russia, the United 

 States, and several other nations, advocated a 

 more flexible system, which should take into 

 account the sanitary condition of the vessel, 

 the time she has been at sea since leaving an 

 infected port, or since the last case of cholera 

 occurred on board, etc. This system, com- 

 monly spoken of as the system of ' medical 

 inspection,' includes the isolation of the sick; 

 disinfection of soiled clothing, excreta, and of 

 locahties exposed to infection, including ships ; 

 and detention of the well for observation for a 

 limited period — three to five days — if they 

 have been recently exposed to infection. 



