Brazil deserve special mention as they are of sanitary as well as of commercial importance. The port of Santos is equipped with docks which enable vessels to moor alongside; the low marshy shores which formerly existed have been filled up and the city has been made completely sanitary by the construction of an excellent sewerage system and water works. The wharf of Santos will have, when completed, a total length of 4,726.88 meters. Active work is being done on the port works at Rio de Janeiro, 500 meters of wharf having already been opened to traffic.

The port works at Manáos are almost completed; 433 meters of wharf have already been built, there remaining only 158 meters for its completion.

Contracts have been made for the port works at Belém, Bahia and Rio Grande do Sul and the work of construction will shortly be begun, while improvement works are projected at the port of Victoria.

The Federal Government is planning a project to be submitted to the National Congress, for the complete sanitary organization of all the ports of Brazil. In accordance with this project, the Union will have charge of the maritime and land prophylaxis against all infectious diseases and all the ports of Brazil will be equipped with hospitals and disinfecting stations, the plans for which have already been made. This service will probably be organized within the coming year and will provide Brazil with a perfect and complete sanitary equipment. Twenty-four ports along the Brazilian coast will thus be equipped with a complete sanitary service.

WATER SUPPLY.

The new water works at Rio de Janeiro have been begun and the work of construction is being actively carried forward. When completed, the city will have a water supply of 360,000,000 liters per day, or an average of over 440 liters per inhabitant.

SEWERS.

The principal cities of Brazil are provided with sewerage systems. The Government is planning to substitute the chemical treatment of fecal waters now in use at Rio de Janeiro, by a biological treatment. For this purpose it has appointed a commission to make a study of this method, and it is now making careful experiments in a bed for observation installed for this purpose.

SANITATION OF HOUSES.

This service is rigorously carried out in accordance with the sanitary law of January 5, 1904, and sanitary regulations of March 8th, of the same year. It is already referred above to the aid which the Federal Government gives to the States in sanitary matters.

Brazil continues to be governed by the sanitary law of January 5, 1904, which was continued in force by a resolution of Congress of this year.

REPORT OF DRS. ERNESTO SOZA AND PEDRO LAUTARO FERRER, DELEGATES OF CHILE.

INFECTIOUS DISEASES IN CHILE.

The provisional programme of this Convention prescribes, in paragraph (a), that each delegate shall present a report on the existence of transmissible diseases which may prevail in the territory of the country represented by him, especially with reference to bubonic plague, yellow fever, cholera, malaria, beriberi, and trachoma, giving detailed information on the measures which have been adopted for the prevention or stamping out of any of the diseases above mentioned.

We can say that, of the diseases referred to, only the bubonic plague has invaded our territory. We will supplement this report by adding a few lines on other infectious diseases of a similar nature, and which threaten us, such, for instance, as the small-pox.

BUBONIC PLAGUE.

Chile has marked the ultimate geographic stop in the advance of this scourge, which has spread throughout all latitudes and climates of the earth.

After having been considered by many hygienists as one of the diseases whose extinction would be the result of the preventive measures of modern hygiene, it has reappeared with alarming characteristics in the civilized world. Its new and periodical sorties, from its four endemic foci in Asia, were initiated in 1893 by_invading Europe and the American continent.

In 1902 and 1903, San Francisco and San Diego, in California, Texas and Todos Santos and Mazatlan, in Mexico, received the first visits of the disease, it having invaded Peru immediately thereafter. The first case in the latter country was discovered in the Port of Pisco by Doctor Enrique Mestanza, whose diagnosis thereon was sent to Professor Doctor Ernesto Odriozola, of Lima, at a time when the epidemic was invading the port of Callao. Its next stop was Iquique, in Chile, attacking simultaneously Mollendo, Pacasmayo, Salavery, Tujillo, and several other localities of the Peruvian Republic.

In the Orient, Asuncion, the capital of Paraguay, was visited by the plague in 1899, invading thereafter Rosario de Santa Fe, and Buenos Aires, in the Argentine Republic, and appearing simultaneously in Santos and Rio de Janeiro, in Brazil, and in other northern ports of the southern hemisphere.

Iquique. This port, situated on the 20° 12′ south latitude, and 70° 11' west longitude, was infected in May, 1903.

On the 25th of the same month, the first bacteriological diagnosis of the plague in Iquique was made, which confirmed the reports made to the authorities by physicians, based upon clinic diagnosis carried out some days previous.

The epidemic lasted until the 24th of September, 1903, causing the following number of cases: total, 214 (125 men, and 89 women); deaths, 135.

Of this mortality, 38 died within the first twenty-four hours after the cases were taken into the lazaretto, and 58 died in their respective houses without receiving the serotherapic treatment. The accompanying map shows the principal foci of the epidemic (Annex I).

The danger caused by this epidemic to the commercial life of the nitrate region, compelled the authorities to take energetic measures for protection against the scourge. A committee of physicians, presided over by the Director of the Institute of Hygiene, and composed of bacteriologists and hygienists (among whom were physicians that had been sent by the Chilean Government to study the plague in Rosario de Santa Fe in 1899), was sent to the north, with the necessary powers to organize, conjointly with the Intendente of the province and the representative of the Executive, the necessary sanitary services. Under this committee several branches were operated, such as the Sanitary Inspection, the bacteriological laboratory, the public disinfecting station, the isolation house, the lazaretto, the sanitary commissariats, the sanitary police, etc., etc., as well as all services related to the transit of passengers, transportation of cargo and baggage, and the general movement of the port.

The Maritime Sanitary Regulations of 1895 were rigidly enforced. The issuance of sanitary passports was prescribed, and the disinfection of certain packages considered as suspicious, such as bed clothing, clothes, rags, sacks, leather articles, etc., was required. The port physicians were placed in charge of this work, in accordance with the provisions of the Ordinance of Navigation and Maritime Health.

One of the efficient measures that facilitated to a great extent sanitary investigations and disinfections, and, consequently, the abatement of the disease, was the strict enforcement of the law compelling physicians to report all cases of infectious diseases; this law, promulgated on the 7th of February, 1899, provides, under penalty of a fine, that the following diseases shall be reported within twenty-four hours after the diagnosis, certain or probable, has been made: Cholera morbus; yellow fever; bubonic plague; diphtheria; smallpox; typhoid fever; scarlet fever, and leprosy.

The Superior Council of Public Health, which has the power of prescribing the general measures of prophylaxis, insisted, before the Central Government, upon the necessity of the establishment of a Sanitary station in the northern part of the Republic, for otherwise it would have been necessary to suspend the commercial relations with the countries threatened with an invasion of the disease. The establishment of another sanitary station in the extreme southern

section of the country, in Agua Fresca, near Punta Arenas in the Strait of Magellan, was also requested to protect the country against the epidemics of the Atlantic.

The Superior Council of Public Health requested that the law of Sanitary Police be put in force; this law gives the civil and sanitary authorities full powers to enforce measures of defense against epidemics, and authorizes the President of the Republic to close infected or suspicious ports; to prescribe quarantines; to establish sanitary cordons; to declare as infected, towns where any cases of contagious diseases may have occurred; to issue sanitary ordinances; to prescribe penalties for violations thereof; and to adopt such sanitary measures as he may deem best for the protection of public health.

After four months of struggle, we succeeded in stamping out the first epidemic at Iquique.

In February, 1904, the plague reappeared in a port further south, Antofagasta, situated on the 23° 38′ south latitude, and 70° 22′ west longitude.

Within the period of five months, there were recorded in Antofagasta 185 known cases, the number of concealed cases being estimated at about 35 per cent. The lazaretto had the following movement: Total number of cases treated, 83; deaths, 23. Besides, 20 cadavers of plague-stricken persons were found. These cases were concealed by the families.

Valparaiso.-The first cases that occurred in this port were caused by infection imported from Callao, in 1903, by the S. S. "Colombia," and in 1904, by the S. S. "Limari." A few cases were recorded in May of the current year.

It has been fully proven that the infection was caused by the captains and a physician of the two mentioned steamers, who had concealed cases of plague that had occurred on board the vessels, thus violating the Maritime Health Regulations, and the elementary principles of morality, for the sake of commercial interests.

Valparaiso, the commercial emporium of the Republic, was compelled to take stringent prophylactic measures in order to stamp out the scourge. The Superior Council of Public Health and the Departmental Council of Valparaiso suggested to the authorities the necessary emergency measures that were taken.

Arica and Tacna.-In 1904, these two ports were also visited by the plague, a few cases being recorded. In October and November, 28 cases, with 9 deaths, occurred in Arica, and in Tacna, from December, 1904, to March, 1905, 9 cases with 6 deaths.

Pisagua. The Chilean town that has suffered most on account of the plague is that of Pisagua, north of Iquique, and it is the northernmost nitrate port of Chile. It has a population of from 3,000 to 4,000 inhabitants, varying in accordance with the increase or decrease of commercial exports. In order to estimate the seriousness of these exotic invasions, it must be taken into consideration that from Pisagua, situated at 19° 34' south latitude and 70° 11' west longitude, to Taltal, situated at 25° 25' south latitude and 70° 34' west longitude-which is the zone ordinarily threatened by the scourge there is a population of 150,000 inhabitants, exporting annually 30,000,000 quintals of nitrate (1 quintal= 100 pounds); this region produces, besides, a great amount of minerals and salts of various kinds. In this zone are included, from south to north, the ports of Taltal, Antofagasta, Mejillones, Tocopilla, Iquique, Pisagua, Coloso, Caleta Buena, and Junin.

The first invasion of bubonic plague in the Port of Pisagua took place in the year 1905, and caused 310 cases in two months. The rapidity with which the epidemic spread out, and the violence of the attack caused a great panic among the inhabitants, who abandoned their homes in large masses. This migration left the city with only the local, military, and sanitary authorities. The inhabitants took refuge in the plains, where the infection has never penetrated. The following table shows the movement of this epidemic:

Statistical Resumé of the Epidemic of Bubonic Plague in Pisagua, from January 27, 1905, to March 31, 1905:

The total number of cases is distributed between the two sexes as follows: Men..

Women.

The distribution by ages is as follows:

308

72, or 23.37%.

...199 with 44 deaths (22.11%)
..109 with 28 deaths (25.68%)

.36.36%

15.90%

.13.63%

.11.36%

9.09%

From. 21 to 30 years.

From 31 to 40 years.
From 51 to 60 years.
Under 10 years.
From II to 20 years.

From 41 to 50 years.

Over 61 years...

The number of cases treated in the lazaretto was.

Treated in private houses...

In this resumé are not included two plague-stricken bodies that were found in private houses.

Distribution by nationalities:

Valparaiso and Viña del Mar.-The plague made its reappearance in 1906, causing 23 victims in the latter city, and a few isolated cases in the former. The Superior Council of Hygiene sent a sanitary inspector, who, with the consent of the local authorities and the Departmental Council of Valparaiso, was able to enforce prophylactic measures and to quench the disease in its incipiency. At the same time, in the northern section of the country, new isolated cases had appeared, in this instance with greater tenacity than in the Port of Taltal, taking the proportions of an epidemic in the early part of the current year, to such an extent that the presence of the Director of the Institute of Hygiene was required. This officer brought with him the necessary elements to organize the defense and to establish a Bureau of Hygiene.

Santiago. In January of the present year, the Asiatic plague made its appearance in our capital.

The Superior Council of Public Health and the Institute of Hygiene were ready for the defense from the beginning; their sanitary inspectors were duly authorized to proceed with the work. The Supreme Government created a Central Sanitary Board composed of the Intendente of the province, the First Alcalde (Mayor) of the city and the President of the Superior Council of Health, and assisted by the sanitary inspectors for the enforcement of its resolutions. Although the Law of Sanitary Police was not put in force, which law authorizes the adoption of extraordinary measures in these cases, this Board took, however, energetic and stringent measures of prevention, which, if they had been termed as "dictatorial" by the press adverse to such actions, were, nevertheless, crowned with success, inasmuch as the infection was checked and the number of cases reduced. Only 24 were recorded during the period from January to April, 1907. These cases did not constitute a focus, and it is interesting to note that they were scattered throughout the city, as may be seen in the accompanying map (Annex II).

First Half of 1907.-During this period the plague reappeared in the northern part of the Republic. The statistics, which are given in detail in another section of this report, show a total of 695 cases with 302 deaths, or 43 per cent of mortality.

The commonest clinic form of the plague is the bubonic form proper in 75 per cent of the cases. The order of the inflammation of the ganglions has been manifested as follows: Ganglions of the right and of the left inguens; of the crural and inguinal regions; of both inguens; of the neck; of the axillas, and of combined regions. The septicemic or intestinal form was presented in 5 or 6 per cent of the cases; the pneumonic form in 1 or 2 per cent, and the rest of the cases were mild or ambulatory. In Annex III is given a table containing the statistics referred to above, and which was furnished us by Dr. R. Davila Boza, Director of the Institute of Hygiene at Santiago.

Yellow fever, cholera, malaria, beri-beri, and trachoma.-As we have already stated, yellow fever does not exist in Chile.

In 1868, the year in which the great invasion of this disease took place in Callao and Lima, it spread to Tacna, Arica, and Iquique in Chile, but in a milder form. Twelve patients from the north took refuge in Valparaiso, but they were cured and did nothing but cause alarm and panic.

In 1904, three yellow fever patients arrived in Punta Arenas by the S. S. "Oropesa" from Rio de Janeiro. This steamer left said port on the 23d of April; the first case occurred four days thereafter, and the next two, two days later. One of the patients died. The "Oropesa" did not accept the quarantine imposed on her and left for Coronel, where she again refused to be subjected to quarantine, and, sailing for Valparaiso, arrived at that port on the 9th day of May.

It seems, therefore, that our country, which has always remained immune from the infections caused by the Stegomya Fasciata, is not a field for yellow fever.

In 1906 the S. S. "Luxor," of the Kosmos Line, arrived from Callao infected with yellow fever. This steamer started from Guayaquil, had a crew of 61 members, carried 2 first-class and 6 second-class passengers; the number of cases that occurred during the trip was five, three of which died.

This steamer was fumigated in Callao; the bilge water was bacteriologically examined, and the provision was changed; all living plants on the steamer were thrown overboard, but in spite of all these measures, the disease still continued. In view thereof, she was ordered on the 11th of April to sail for the south without touching any port of the Peruvian coast. On April 15th she arrived in Arica where she was disinfected and subjected to quarantine until the 18th day of the same month, far from the coast; the members of the crew and the passengers were inspected daily.

No new cases occurred, and the steamer was, therefore, given free pratique. Malaria is unknown in the country. Beri-beri is likewise unknown. In August of 1904, the ship "Talborg," from the Fiji Islands, was stranded on the coast of Itata, Southern Chile, having on board some patients who were considered by the local authorities as cases of bubonic plague. A sanitary_inspector of the Superior Council found that they were cases of beri-beri. The entire crew perished on account of the small epidemic, except two of its members, the cook and a young boy.

Trachoma was imported in 1892 by Spanish immigrants. The diagnosis was made by Doctor Maximo Cienfuegos, Professor of Ophthalmology, who informed the Government of the dangers which this new disease could bring to the country.

Arabian and Turkish immigrants imported new cases of granulous conjunctivitis. In a statistical table of the ophthalmological clinic, it is shown that trachoma is credit with only 0.14 per cent in 17,000 known cases of various forms of conjunctivitis.

Other infectious diseases; small pox; vaccination.

Smallpox is the scourge that in other times made the greatest number of victims in Chilean territory.

Its history covers many gloomy pages. The disease made its first appearance in Chile in the year 1561, imported by the ships of Governor Don Francisco de Villagra. Natives and conquerors alike, by thousands, paid their tribute to this scourge. Inoculation, or the method of provoking a similar but milder disease by means of the introduction into the dermis of the smallpox pus, diminished the damages caused by the epidemic. This system was first used in Chile in the latter part of the XVIII century by Father Pedro Manuel Chaparro, a creole and eminent physician, who as has been verified in our historic archives, was ignorant of the fact that the use of this therapeutic process had been general