Minutes

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'7

THIRD .iL._T_"F.:-%&,_?!OhU_._,_:_-,_._,>_;_._ .,u=t__,,,._.._IO't'T

l_e!d _t the _.ity of _ex=co, D_cember _ "_ 3rd _h _h

6th -_,,nd'?th) in the yes, r" 1907.

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_, -- " "N_ York CI%Z. ' --:,-...:_

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T

.ATI

T_IRD INTi_-_,?_ATIO__i SANITARY CONVJ-_t,{TION

of

A_I_ IC AN R:_2UBIlCS.

held .%t the City of _[exlco, December 2nd, 3rd, 4th_ 5th, x..

6th_ 7th_ 1907.

_m

Docember 2nd, (A. M=)

(After rer_arks of delegate from Ecuador insert:)

t j

SURGFX)N G_,_A._.WY_._AN: _r, Vice-President

of the Republic,(etc.) (_gr.Romero h%s CopY.)

(After Dr. Ulloa re_d_ llst of members whose ore-denti_!s have been examined by Co_muittee:)

_GEON G.,_.TERAI."_C#AN: Is that SUlOposed to be a

list of the deleg%tes who are here?..- _ _ ._ _

DR, D"_OA: l.istof the delegates whose: creden-tials have been examined,

_SURG_ON G_RA_. WYMAN: Is Dr. Owens here,?

DR. U.._OA: Hi_ n<ame is here, .-,_-_,,.,_ _._._*_" _..._-^ the

2 DR. JOI/_ISON: .Mr. President, I move you that the folio Ing gent!e_en b e invited r,o be present at the meeting s:

(

C

o

py iIst.)

(AFT]_ reading of r_ort by delegate from Chili, insert _eport of Surgeon General "_ym.an.)

December 3_ !l:O0 A. M°

(After Dr. Ulloa trees!ares from re.v_rks of re-r re-resen_ative from Salvador to the effect that tomorrow

he will have printed copy of his report in Engliah and in Spanish: )

Su_DRGXON G_F.,,.R_._u_AN: Mr. Presldent, we h_ve with us this morning the Secretary of the Bure_u of

/

Americ_u Republics, who has come from Washington to play

his part with us, _n_ to show _ho interest of the Bureau of ATerlc4n Republics in this Convention. I move y=u

Sl }_t th_ l)r'i'vil;goof the floor be grated to Mr, Yah e/s,,Secretary of th_ Bureau of Amerleu! Republics.

3

_TRGF_._ GF_ZRAI _J_N : ! feel t h_ I s_hould not _l!ow 1:hls occ_slon to _o by (e_c.)

('_r.Romero 9_s copy. )

Decca.bet 4th, 9:00 A. M.

{After Dr. Ullo_ spe_ks and delegate from Rout

-dot re_Is p_per:)

S_RGEON GT_ER_ WY_AN: _r. President and gen

-t!emen , I h_ve here an abstr_ from _ paper which I prepared _.t the reques_ of Secretary -Root for considera-tlon by the American Delegates to the Rio Conference in

1905, which embraces principles t_t I believe should go on the record of this Convention. I have first a s_rles

of p roposi _lons: -.

(Insert printed copy.)

Now, the following pages, Mr. President and

gen-t lem_u , I _ve an e!abor_tion of these l_ropositions

which I._ill,not_ e _zpthe t,lme" of,the Convention .in -";re_dlng now, but which I will hand in _o the seoro_ry

_'_So _hat riley may •appear in _he prooeed_ngs, _I thank '.._.._..

& (After Dr.Gulter_s spe_ks concerning Dr._iceaga's l_rol_ositlon as to the adoption of me_eure_ against ma

la-ria: )

DR. JOhnSON: _r. President, I would llke to Join the other gentlemen in congratulating Dr. _ice_g_ on the importance of _s pl_ns with re_rd to malaria.

I wish to a d that in our section of tile count_j m_!aria is very potent _n intensifying the symptoms and the n_-ture and extent of o_her diseases. It is _herefore most i_al_ert_nt that this disease, which modifies so m_uy other dlse_ses, s_u!d be removed from ou_ midst, if t}_t be poBsible. In the l_aper which I read _t the Second

International Sanitary Convention, I dr_w _ttentlon _o wha_ appeared to me to be a valuable suggeation with

res-pect to this malady, _nd selecting _ n_e which would at the same time _ndlc_te the etiology. • suggested _herefore, that m_!arla should be known as anopheles

fever_ on the ground that if the public at large

under-stood the causation of this disease, it would greatly facilitate sanitary work in exterminating this dlse_se, an_ therefore they womld have the support of the public

5

_ug_e_ anopheles fever. In the world at large we be -lieved th' disease c_._e from b_d air. As a n_t_er of fact i_, e._ne from b_ wat._r and is c._rried about by the mosquito. Now, it is known to be propogated by the m es-quite. I would mlggest that it be known by the n_Ane anopheles f_ver.

(Dr, Ulloa _r_sl_es; Drs. _endizabal, Ul!ea,

_d Arrlaga _.)

DR. IOI_SON: I simply rise _o say that in my p_per at the l_st session I referred to that point, t.hat

it should he"mosqulto fever", "_noPheles fever" "s_ego -mya fever", indicating the kind of disease. Now,

as _e l_rogress, there seems to be the m:spicion that

other mosquitoes are engaged In other diseAseS -- for

o

instanc_.s dengue f_ver. I think iti_ well to use the

term "me,quite fever", _d indicate which particu1_r

kind is referred to. I ace_._t the _ugg_stion of Dr.

Ullo_, with theft mo_ificatlon.

6

(Dr. Ul!oa translates remarks of deleff_te from Brazil, )

SUR.-,GFONG_A'._ "_Y_AN: I would like to inq_ire

of the t_o gentlemen, Dr. Gulteras and Dr. Cruz, whether these _re species of the general class of anopheles or not .

DR. GUIT_RAS: Of the ano];helenas, yes. They belong to the anophelene fa_ily but they belong to dif -ferent genera,

DR. VON ]_ZDOP_: in llne with the proposition of

Dr. __iceaga to cormnence a crusade against malari_l fever i might add tha_ since we have acquired the quarantine stations in the south, _bile and New Orleans -- I c._n speak for New Orleans,- there we have been detaining all _assengers with m%larial fever comin_ from the Central

American and _exican ports, in fact from ".%11the gulf ports in the south. And the same condition has been ex -perienced in my station ._s with Dr. Gulteras: th%t all the osses proved to b_ m_lari%l fever with the exception Of ,twenty which were typhoid fever. I found the mlarial

parasite in all the cases, proving positively that they

were:_!arla. Nearly all of them proved to be the

V

great de%l of difficulty in _%_klng a definite diagnosis between yellow fever and rot!aria. I think it is an ex-cellent ides theft we should take _he "_{a,._(_itional prec_u-}''"

tlon to isolate _nd hold malari%l cases at quarantine

stations ttntil all doubts are removed as to their beln_ comp!ic%ted with yello_ fever.

The other c_ses,- the typhold cases, give us a gr_at deal cf trouble in making diagnoses, but the m_la

-ri_'A!seemed to b _ the most 10rominen_. I held all such oases of m_laria and typhoid fever at the quarantine, premitting the vessel to _roceed.

The point I wish to make is th%t 1_he indivldu_l with a feverj be it _larla or typhoid, w_s h_Id in

qua-rantine at my station for observation and treatment, thereby establishing a practice of quarantine for these diseases. I h_d no cases of yellow fever this year.

It is evident t._at my pr%ctice reduced the possibility of addins infection of malaria and typhoid fever In a oomm_mlty where the spread of these diseases was favored. X consider this practice is Justifiable and I favor the _rsco_men:!ation of Dr. lice_ga to isol_te m_larial fever

8

(Dr. Ulloa translates Surgeon General Wyman's propositions into Spanlsh,)

_URGEON w,_ _ _WAN. I beg leave to offer

the following resolution:

That the secretary be requested co include in the printed tr_nsactlons of _he Third Internatlon_l Sani

-tary Convention of the kneric_u Republics, a summary of all the form_l resolutions adopted successively by the First, the Second _id the Third Int,-_rna_ional Sanitary

Conventions.

In explanatlon of this I would state that there are _ number of very v_luabls resolutions relating to

sanitary _%tters that should not be lost sight of and

I think __ _.would be advisable _o have a review of them in the prlnted _ransactlons of this session.

I wish also to invite the attention particularly of the corms!trees on trachoma and on yellow fever to the recent treatises on these two subjects which have been published by the PubtiC Health Service of the United

Shares. One is on tr_cho_: _ud is a very valuable

ad-! ,

dltion to our k_owledge of the m_bject. It is a review of all the late_t scientific ideas concerning that d

9

In the di_gnos_s of the disease a.._dpa_ticularlF useful

in the efforts to keep tr%chom_% oases from e_tering the

country f_om %nether count_'y. The second is _ ve'_j

val-uable practlc.%l work on Fellow fever,- its etlology, symptoms and _lagnoeis, wh_ ch was ._.-epar_d par_iculaFly for use by physicisns who actually come in contac_ with

these cases of y_ilow foyer and with doubtful cases. 3:00 P, M.

(Insert .afs_rDr. liceaga's re_arks following re_dlng of report by delegate from Uruguay.)

DR. V0N _ZD0W_ " : In ordsr t.ba_ some of the pro -positions presented this mo:n!ng in relation to malaria may become more effective i wi,_h Zo pr_sen,= the follow

-ing resolution:

RF_0_V_: That the permanent S_nltarF Bureau at

Washlngton be instm_cted to distribute regularly informa

-tlo_ concerning the existence of malaria in their several

important oltles. ," ,: " :

lO

_egal Society, etc.)

EURGF_N G_EWA_ wlr_._N: I did not qui_e _utde_'

-stand the purport of the circulars t_t were re_d. Are

we invited to n_e delegates to their convention, or

have they 8en_ delegates to this convention?

DR. U_.0A: They have appointed delegates in a very peculiar manner from their }_norary vice-presldents to this eonventlon, but I have not myself received any communication from them, although I _m one of those .u_med and I suppose the same is the _'_se with the other gen

-tlement named here.

December 5th, (6:0G P° M.}

(After_Dr. Ulloa translates Dr. liceaga's speech on tuberculosis and Dr. Hugo Roberts speaks.)

DR. VO_ _DOR_: My idea on the subject of

tuberculosis on Vessels is that we c_unot t_ke any par-ticularly ex_raordlna_y measures agalns_ tuberculosis _n the traveling puBlle; 1_ut one measure I think we should

ber-11

zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

--

zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

c u l 0 s l . s .

zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

As

for

the

o t h e r

zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

m e a ~ u r e e ,

o f

courw

there

are

.

alwaye

aome

laws

or

reeulatfons

adopted

prohAblt

exo

I

p c t o r s t i a n

zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

in

puhlia

p&oes

plrraes

where

people

con-

gragate,

and

there

should

always

bet

r e g u l a t i o n s

of

t h t

kind

on

~ e s s s l .

There

have been a

number

o f

zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

t i o n 8

made

in

t h i s

connection

one

that

I

b v e

thought

& m i l d

b e

appllokbte

is

t h e

of'

paraffine

paper

spit

oupe

thxt

a o u l d

b e

made

in

a

very

chexp form

and

mielit

even

be distributed

by mesna

of

s l o t

rnachfnee,

where

o o u l d

them

for

probably

a

penny

or

penniea,

with

prfnted

d i r e c t l o n s

on

the

maohine

how

t o

u m

the

cup'

and

directions for

i t s

dispositfon

after

it

ha8

bean

used

for

time,

Provision

could

bet

for

tho

dastructlon

of

t h e

e m e c t o r a t i o n

the

cnp

at

one

tfne

.

b y

f i r e , which

l a

t h e

best

dieinfeat

l n f a o t s d

ex-

p o t o r a t i o n .

I

have

one o t h e r

propoeltfon which I think

would

be

a

one,

and

that

I s

the

screening of a16 the

l i v -

l n c

q u a r t e r a

zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

of

v e a s e l .

1

b e l i e v e t h i s

c a b l e .

I t

would

protect

the

vePrlssl

a g ~ i n s t

---I.,.--,

-

q u e n t l y

warm

mlth

fliers, a??d

I

have

an

idea

if

. . . .

flies come in contact with infected expectoratio_ they

my deposit some of the organisms or some of this matter in the food or the milk, or In _ny of the edibles, a_udI

I"

believe theft is one _ray by which t_erculosis may be

spread. I therefore consider t_hat the screening of

all living quarters is advisable on board a vessel. I h&d some other points on this subject which I

intended to present; I did net know it wo,:Id be taken u_ this afternoon.

December 6th (9 A. _.)

(After Dr. 8oza's and Dr. l!ce_a's remarks.}

OR. yon EZ_0EF: _I _ou!d llke to conclude what i had to say in regard to _he transmis_on of tube rcu-losis fror_ individuals on board vessels. I mentioned yesterday the advisability of hav_ong parafflne paper cups provided on board ship, and also the screening of

the vessel, as practical measures.

13

and others that simply re%try cabin passengers, first _nd second class passengers. We a_so h_ve ships which make only alert voyages, and other ships that make long voyages, so tb_t we _%ve to discuss each one of these

sepa r_ rely.

Now in regard to pers,%us on board the ship that

is c_rrying _ large number of passengers: I think one

of the first measures th%t we h_ve to consider is _hat

they sho_l_ be educated to understand that the practice of expector_tlng prom±scuous!y in pl_ces frequented by

others may be da_£ero_sto t_b_ir fellow-men. I

think everyone will agree to th%t_ tha_, expectoration

is _% f_.l*h,,_,hablt. The second rroFosit!on is that all

!persons s}_n!d be euco_r_ged to use individual drinking cups, _nd _I_o che_p paraffine paper cups might be pro

-vided for use as exDec_or_ting c_ps--individual cups.

No_ a point that I wish to make in regard to the

whomDr.I third cless p_ssenzers, or steerage passengers,

)

Roberts referred to as being the mos_ dangerous Indlvi- I duals on board the vessel and morelikely than the other

/

Classe_ to_ ihfe_ the living quarters, because of lack

-14

vision we co,_ld _ke in reg_rd to those passenge_4s is to endeavor _o hav_ tber_under_tand t}_t they must not expectorate anywhere except in the plac_s provided for

that p_rpose t _nd one of the most pbactlcal m_-_sures that I think could be adopted on board _hlp I g the use of tP_ parafflne paper cup already mentioned, to be placed folded into a tin form which might h_g along

the sldes of the bunks. As we know, these large

steerage pas_engervessels are very crowded, and the

p_ssenger_ are in bunks one over the other, sometimes In tiers of three. These cups can be used In case of 8easlckness and for all ordin_ry expectoration. I

think that i_ all we can possibly do with regard to that c!a_s of _assengers.

These cups co,_Id be destroyed by flre or, at :sea, thrown ove_bo_-d. That is practicable for any vessel, whether a long-trlp or _ short-trlp vessel.

B_t w lth regard to a isng-tr!p vesselwhere the

15

With regard %o the s_rt-trlp vessels, where the

passengers are in these steerage b_-racks for only two

or three or four days, I think that periodical disin-fection woul._ be quite sufficient.

Whatever measures we wlsh to adopt should be

practical and easy of application, and these have

occurred to me as the most practical and easily

under-stood by the steerage passen_rs tl_ t we have to deal

with. _,

As far as the cabin passen_rs are concerned, I

thlmk they can understand instructions, wherever they man

"ee placed in printed form about the cabins.

(After Dr. Ulloa translates Dr. Soza's remarks)

DR. JO}_SON: Yr. President and membmes of the

Convention: In :accordance with t_be preliminary pro-gramme, I have the following comments to make with

respect thereto. •

'(._r. Ro1_erohas copy. ) _ . :_"

(After']_r. yon Ezdorf seconds moticn to combine all recommendations made to prevent spread of _uberculosis " and Dr. l_errerspeaks:)

:_'-._. ... '... j: ".,, ,

16

EURGF,0N-GFN_AL _WY_gA_-_: I have a resolution to

offer--not on this subject, however. I would llke to inquire if it is pertinent or the proper time to introduce it.

(Copy in resolution.)

_z. Ulioa translates into Spanish.)

DR. GATEW00D: _[r. President, ! desire to present the following resolution, with a request for reference

to the Advisory Committee: (Copy in resolution.) (Dr. Ulloa translates.)

j ,.

SURGE_-G}}_,_.Sj. _%_[A}I: I beg leave to present to

the Convention a report from Dr. A _{. Doty of New York, in compliance with some of the features of the prelim -inary programme, and he has also transmitted photographs oft}_ work that h_s been going on in Staten Island for the e_mlnation of mosquitos by drainage _ of swamps. I

will turn this in to th% Secretary for such use as he _s_y be able to rake of the illustrations or of the articles

17

might be left on th_ tables

for

ez_ine

.

I also wish, Mr. President, to invite attention to some very !nt_reztlng papers that have been transmit-ted by Dr. Samuel G. Dixon, Commissioner of T_blie Health

of the State of Pennsylvania. They have come to me since my arrival in Mexico and I have placed them on the tabls.

They sho_ the operations of the Department of Health of the Sta_e of Pennsylvania in it_ several divisions, with

a number of p_togr_phlc illustr_tions.

Dr. Dixon asked me to kindly transfer these to

Dr. lleeaga as l_resid_'nt of the Superior Board of Health

af* =ey have been exa_uined by the m_mbers of this Convention, and I _st theft Dr. Liceaga, as President of the Super!or Board of Health, will kindly acce.pt them from Dr. Dixon.

(After Dr. Ulloa's translation of Dr. Liceaga's

reply :)

_,_, L W_D_N: I move that the reading

"of t.hat roport be dispensed with at the present time. I

think it would take quite a long while, and _t can be included in the pz0ceeding_s.

(After Dr, _.Ioeaga resplles to offer of resolu

18

DR. GOODE: Mr. President, I would like to offer this resolution. It is possible, however, that it may hav_ been covered in so_ of the resolutions already of-fered:

(Copy in resolution.)

(After Dr. Ul!oa translates resolution Of Dr. _endizabal copy in recommendation of Dr, _ohnson,),,

December 7th, 9:30 A. M.

(After Dr. U!loa transl_tes:)

DR, _AT_VOOD: In re_d to th_ matter of this

resolution t_t h.a.3Just been read toust I did not alto -5

gether tt_der.sta_dhow _he..Vrenoh fan,aRgo c_me into this and I did not he_r anything about the English l_

-_uage in connection _ith it.

DR. UIIOA: Allow me to correct t]_.t to "Spanish ]_ngllsh and Portuguese."

(After colloquy between Dr. Ulloa and Dr, Gate

-w

o

o

d

:

)

8

UR

O

_ON G_£

W

Y

I_AN

: I

h

ave t_o reso

lu

tions

19

be considered by the Advisory Council and be reported on this _fternoon, or they could be adopted by the Conven

-tion right now. Are we to have ,_nother report from the Adbl sor'I Council?

DR. Lw.__OA: The President requests you to leave

those propcsitlons to be _bmitted to _he consideration

of the Convention until we h.%ve discussed these recom-mend%t ion_.

(After Dr, Roberts speaks and Dr. Gulteras ft.- n-slates: )

ErG_,GEONG_A'... W_D/AN: Yes; I thi_k that t.hose should be referred hack _o the Advisory Council for amending a_ reque_ed.

(After Dr. _agen spe_ks')

8URGEO_ GE_/F/_S.'_Y_AN: _r. ]_resident, 1%hlnk _hat is a resolution auch as may be sent to the Advlso._j

Council. I have no obJeotlon to a vote, but I think we _d better retain the form.

(Dr. Oulteras tr_usl,_tes,)

_%W/RGEONGFN_A_ WY_AN:, I have a resolution here

whlc_ als_ _ul_ go'to th, Advisory Council, on

Interna-#

-(Copy reso lut ion. ) (Dr. Gulteras tr_nslates,)

S_IRGF_qN G_,_AI _,_AN: I have one more, _r. President, concerning the re!a-_ions between the Inter

-nation_tl S_qitary Bureau and the Bureau of American Re

-p_blios:

(Copy, re_olution. )

I will say in submi_,tlnz these resolutions that

I h_%veprepared them in conjunction with Mr, Yanes who represents the Bureau of American Republics here, and that they meet with his approval.

(Dr. Ulloa translates.)

SURGFX)N G,.,_Lw_A_I._f_,_AN:Mr. President t I have received a telegram this morning from Rome_ Italy, from th_ American represent_tlve in Rome, appointed by the Government of the United St_tes to meet the other re-present_tlves from other countrles in order to form the

International Sanitary Bureau of Paris.

The International Sanitary Convention agreed to at Paris provided that later delegates should be sent to

Rome to organi_e the International Sanitary Bureau of Paris.. Among _the_delega_es .sent _o the same was_one sent

_A

his instructions I directed _dm informally to convey to

the members present at _h_ conference the resolutions

pa_sed at Rio concerning the interoomr_m_ications between

the lnte_1_tion_l Sanitary Bureau of Washington _.nd the

International 8_nitary Bureau _,t P_ris. I have _

tele-gram from _0r. _cl_._gh!in which I wou_d like to re._d, show

ing that evidently the President of the Internation_l

_anit_ry Bur_u of P_.ris is in hearty accord with the

idea of intercommunication between the t_0 Bureaus.

(Copy telegr_. )

D_. UI_',OA: The P_'esiden_ desires to know if

thi_ conference is in Besslen yet _t Rome.

SURG_ON G_RA_ "_: They ar_ me,tAng this month to form the Interr_tlonal S_n_ry Bureau. They are

probably in session now.

(After delegate from Brazil s_eakB on President Diaz' compliments to Dr. _,_iceaga,copy in Surgeon General Wyman's _peech. Mr. Remote has copy.)

_I00P.M.

22

_J_G_0N G_'RAI X_3._AN: Gentle_n of the Conven

-tion, I move tb_ _hese resolutions be adopted by accl a-mation.

(So adopted.)

(After Dr. iiceaga thanks Dr. Espiro! for

reso-lu_ ion. )

_%_/RGEONG_NERA_. WI_AN: I wish also to th_nk the gentleman, I having held the position of Chairman of

the Internation_! _anitary Bureau, _nd express my

grate-ful appreciation of his suggestion.

(After Dr. Soza and Dr. idceaga speak.)

SITRGEON G,"-Ni-_AL ._x_,_._T. I move that that be the sense of the Cenw;ntion.

DR. ff0Tr:,_0N:I second that motion.

(After Dr. Azurdia's farewell address copy in

that of _urgeon Gener_l Wyman. Er. Remote has copy.)

DR. GOODE: Mr. President, while our represen -tative, Dr, Wyman, has spoken so well and has left but

little for the other delegates to say, we are so appre-ciative of wh_ has been done that we would like to add

one little drop to it.

... We have experienced gre_t pleasure in our brief

_S

modest womenl the kind and Intelli_ent men th%t we h_ve h_d _he hono_ _nd pleasure of meeting, evidence the hi_Jnest mark of Americ._n citizenship. Gre_t good _o

humanity will resul_ from the work of the Third Interna -tional Sanit:%r_jConvention, and _o our Presi,_ent, Dr. lice_z_ ",_e%re in_ebted for noz only the sumcess of

this meeting, but the happiness _hleh we .h_ve ,_II so muoh enJoyed.