or guided by their natural instincts, desire to be free, and such persons have no special reason for concealing their name, their place of residence or their destination. They freely give us this information, and it is because of this that we have succeeded in discovering all the cases in all the places where yellow fever may spread. I thought it was of the utmost importance to advise you of these results, because I have felt that it might be useful for you to know what we do here, and as soon as we have exterminated yellow fever entirely these provisions may be put in practice generally in other countries, but I repeat, that these remarks made to you concerning the methods we follow, do not mean that we object to the articles relating to the matter of the Convention to which I have just referred. (Applause.) DR. GUITERAS. In the first place, I wish to state that the extraordinary success recently obtained in Mexico concerning yellow fever does not seem to me to be due to the manner of treating persons suspected of being afflicted with that disease coming from abroad, that is to say, that when Dr. Licéaga explained, as he has done, the method employed in this country in receiving passengers coming from countries where yellow fever prevails, the excellent results obtained here during the last two years seem to confirm his statements. But what I wish to say is that this way of receiving passengers has nothing to do with the brilliant results obtained, or, in other words, that it seems to me that the system followed in Mexico with regard to passengers coming from countries where yellow fever prevails has not yet been thoroughly tried. As a matter of fact, during the last few years Mexico has not been exposed to the introduction of yellow fever, except in a very remote way. I will mention the following example: There have been very few cases of yellow fever in Cuba, the disease having disappeared almost simultaneously in the ports of Mexico which have communication with the former country. So that what I simply wish to state is that I do not believe this process of admitting to the country, without previous inspection in a suitable place, the persons infected with yellow fever, has been properly tried. I fear if this country were exposed to a serious invasion of the disease, for instance to great epidemics on the Gulf of Mexico and on the south coast of the United States, I fear, I repeat, that the results obtained would not be so satisfactory. It seems to me that there is some danger in following this system. On the other hand, it should be borne in mind that in the Mexican Republic, like other countries exposed to the introduction of yellow fever, there is a large extent of territory to which the great current of immigration flows, and where, as Dr. Licéaga has informed us, yellow fever can not spread. I believe, therefore, that I am right when I say that the greater part of the immigrants who enter the Mexican Republic go to that section of the Republic, that is to say, to the Central Plateau, where it is impossible for yellow fever to spread On the other hand there are countries like Cuba, for instance, where there is not a single nook, where yellow fever does not prevail, and where the stegomya does not exist. So that, I still believe that the process explained by Dr. Licéaga would, in the case of a severe epidemic, it seems to me, be a failure. At least I fear it would be so. THE CHAIRMAN. I beg to make an explanation showing exactly the idea I meant to convey. Dr. Guiteras believes that I intended to say that one of the elements for preventing the spread of yellow fever, is the manner in which we rceive people from abroad. Now I simply state that, although we have not the restrictions in force in Cuba, yellow fever has not been introduced into our country by means of the system we employ. As to his second contention, I do not pretend that said system should be accepted in countries different from ours, but I simply stated what we do. It is true that a great number of people from abroad go to the Central Plateau, but it is also true that many persons remain at different places on the coast, to such an extent that all the work done on the plantations in those sections is done by immigrants, which places are most exposed to yellow fever. I should add that in Veracruz alone there are 10,000 persons who are not immune. DR. WYMAN. I feel that I should not allow this occasion to go by without saying a few words apropos of the subject under discussion. The discussion illustrates the fact that while general principles will hold good between countries, here are different conditions in each country which force themselves upon the sanitary authorities of the respective countries. The system adopted by Mexico is admirable, and is effective with regard to Mexico, and so far as its underlying principles are concerned, the same practice really prevails in the United States. For example, people coming from foreign countries infected with yellow fever are subject to no restriction or restraint; to no detention, at points north of the southern boundary of Maryland, that is to say in non-infectable territory. Just as you allow anybody from a foreign infected territory to land at Veracruz and come direct to Mexico, where the state of yellow fever does not exist, so would we allow anybody to come to Boston and pay no attention to them, even if there were a yellow fever epidemic in Havana or in Central American Republics. If a ship arrived, we would do no more than inspect that ship and remove anybody that happened to be sick. But there is no detention. We would inspect the ship, inasmuch as the ship might afterwards go down to points on the southern coast which are in the infectable territory. So these principles are practically the same, but in their application. we have to give consideration to the special conditions existing in different parts of the country. Another thing: In Mexico you have on the Atlantic coast but two or three important seaports. We are obliged by our law to have uniformity of quarantine regulations otherwise it would not be fair to all, and we have in the United States a large number of ports in the infectable territory, and it is absolutely necessary for us to administer our quarantine regulations just as we do; but where feasible, as in the north, or in ports north of the southern boundary of Maryland, there is no particular restriction or restraint, excepting at the port of New York, where persons still in the incubative period of yellow fever, if they have been attacked with that disease before leaving an infected. foreign port, might pass right through New York and take a railroad train to the South and land in infectable territory before the period of incubation had passed, and thus develop the disease within infectable territory. Therefore, while there is apparently some difference in our viewpoint, I think that really we are all acting upon the same principles somewhat differently applied, according to the circumstances. DR. GONÇALVEZ CRUZ. In order to show the value of sanitary vigilance in the prophylaxis of yellow fever, I will for a moment call your attention to the city of Rio de Janeiro, in which there were places entirely free from yellow fever, and others where it did prevail. Even persons who were immune, residing in the foci of infection, were submitted to daily inspection as far as possible. This system was of undoubted advantage, and by means of it the spread of the disease was prevented, but it was necessary to immediately isolate all yellow fever patients in order to prevent infection by mosquitoes which exist in the city. THE CHAIRMAN. If there are no other remarks the meeting will adjourn. I beg to remind the delegates that today at 3 P. M. they will be received by the President of the Republic. I would request you to be there at that hour, because the President will be at the Palace at that time, and if he should not be there it will not be our fault. After that we will take an automobile ride, and then will take tea at the Chapultepec Cafe-a tea which is given in honor of the delegates and to which the ladies are also invited. I beg to remind the Secretary that all persons desiring that their reports be inserted in the minutes, must furnish extracts of the same at the end of the session. I now beg the delegates to kindly accompany me on a visit to the Post-Office Department. The session adjourned. THIRD DAY, WEDNESDAY, DECEMBER 4. Morning Session. The meeting was called to order by the Chairman, Dr. Licéaga, at 9 a. m., the following members being present: Doctors: Gonçalves Cruz, Payán, Roberts, Guiteras, Soza, Esteves, Wyman, Ezdorf, Straub, Gatewood, Rhett-Goode, Johnson, Ortega, Azurdia, Lazo Arriaga, Mendizabal, Gonzalez, and Secretary Ulloa. The minutes of the second and third days being open to discussion, Dr. Guiteras, representative of Cuba, was granted the floor, and said that the remarks he made in the previous session had been delivered by him in writing in a more comprehensive form than they appeared in the minutes just read. Secretary Ulloa stated that the remarks made by the delegates would appear in full in the minutes which would be published at the close of the Convention, and therein will be found in full the remarks made by the representative of Cuba. The representative of Brazil made the following explanation: The isolation of yellow fever patients in Rio de Janeiro is very rigorous, and medical vigilance constitutes an additional measure, and does not substitute the isolation as stated in the minutes. The minutes were approved. The Chairman granted the floor to Dr. Esteves, of Ecuador, to read his report, which was pending. DR. ESTEVES. Before reading my report, permit me to state that the bubonic plague, trachoma and beri-beri are unknown in Ecuador; we have yellow fever and malaria, and sometimes we have smallpox. Yellow fever is endemic in the country, but in certain seasons it becomes epidemic. Malaria occurs in different forms, and with regard to smallpox, it generally occurs only among persons who have not been vaccinated. He then read the report that appears on page 169 of Appendix. THE CHAIRMAN. The discussion which was to take place this morning relates to such measures of international police against yellow fever as are proposed in the papers or reports of the delegates, but since this was done in yesterday's session, the discussion on malaria belongs to this session, apropos of the same papers or reports. Dr. Wyman desires to call the attention of the delegates to a paper on measures of international prophylaxis in order that it may be referred to the Advisory Committee to be studied and acted upon. Dr. Wyman has the floor. DR. WYMAN read the following propositions: First. International Conference on health matters have heretofore considered only the management of epidemic diseases in their progress from one nation to another. Second. These diseases are simply the result of unhygienic conditions in the several countries. |