REPORTS AND RESOLUTIONS 
RELATING TO 
Sanitary Legislation 
PRESENTED TO THE AMERICAN PUBLIC HEALTH 
ASSOCIATION AT ITS MEETING IN 
RICHMOND, YA. 
November ig-22, 18/8. 
[Published by order of the Executive Committee.] 
CAMBRIDGE: 
snnteD at t\jc llitocEsitJc 
1878. REPORTS AND RESOLUTIONS 
RELATING TO 
Sanitary Legislation 
PRESENTED TO THE AMERICAN PUBLIC HEALTH 
ASSOCIATION AT ITS MEETING IN 
RICHMOND, YA. 
November I()-22, 1878. 
[Published by order of the Executive Committee.] 
CAMBRIDGE: 
Jdrintcfc at tljc ititosifcc 
1878. PEEFACE. 
When the meeting of the American Public Health Association at Rich- 
mond, Ya., November 19-22, 1878, was ordered by the Executive Com- 
mittee, it was supposed by the President and other members of the Associa- 
tion who had been consulted in regard to the organization and plan of work 
of the Yellow Fever Commission, that the report of that Commission would 
be submitted to the Association, at that meeting, and that the Association 
would then proceed, by means of special committees, carefully to consider 
the evidence and decide as to what should next be done. 
It was found, however, when the Association met, that the members of the 
Commission had not had time to prepare anything like a complete report, 
or even to examine to their own satisfaction the mass of evidence which 
they had collected, and it was also found that Dr. Woodworth did not pro- 
pose to turn over the control of the investigation to the Association, or to 
part with the reports and papers which had been collected; that he con- 
sidered the work as his work, and the report as his report, to be used and 
published in such manner as he thought proper; and that while he would be 
pleased to have any assistance which the Association chose to give, he pro- 
posed to edit the report himself. 
Under these circumstances, the Association could do little so far as the 
work of the Yellow Fever Commission was concerned, except through com- 
mittees to express a general opinion as to the merits of the plan pursued, 
since to have attempted to examine the evidence collected would have fore- 
stalled the work of the Commission itself. 
After some discussion and interchange of opinion, certain propositions 
were adopted by vote of the Association. These propositions should not 
be considered as deliberate conclusions from evidence submitted and from 
discussion, but as merely indicating the prevailing opinion among the mem- 
bers in the almost entire absence of such evidence. 
By a vote of the Association the Executive Committee was instructed to 
publish the transactions of the meeting with as little delay as possible; and 
immediately after the adjournment of the Association a special sub-com- 
mittee of three was appointed to take up this subject. Upon investigation 
by this sub-committee it was found that from the condition of the papers 
and reports, and from the state of funds of the Association, it would require 
several months to publish the transactions in full. In view of the great 
importance of promptly bringing to the attention of those interested in 
national legislation relating to the public health, and especially of the 4 
PREFACE. 
members of the advisory committee, and of those consulting with them, it 
was decided to print in pamphlet form certain documents of especial and 
immediate interest, and to defer for a time the publication of the addresses, 
reports of previous epidemics, etc., whose value would be much increased 
by being combined with other information with regard to yellow fever 
which the Executive Committee hoped to be able to obtain. REPORTS AND RESOLUTIONS RELATING TO 
SANITARY LEGISLATION. 
REPORT UPON THE WORK OF THE YELLOW FEVER 
COMMISSION. 
The committee to which was referred the general report of the Yellow 
Fever Commission has examined said report, and respectfully returns it to 
the Executive Committee with the following remarks : 
i. That it is evident that the Yellow Fever Commission has exercised 
great diligence in collecting data with regard to the late epidemic, and that 
its labors in this direction deserve the full approbation of the American 
Public Health Association. 
2. That the preliminary conclusions presented by the Commission are in 
accordance with the prevailing opinions of the medical profession of this 
and other countries, with the exception of that relating to disinfection. 
3. With regard to the method of investigation pursued by the Commission 
the committee consider it as satisfactory, and in fact the only one which, 
could have been employed, so far as the obtaining the history of this epi- 
demic is concerned. 
4. It is believed to be of great importance that the investigation thus 
commenced should be made as thorough and complete as possible, in ac- 
cordance with the methods of the Commission. 
But this committee think it proper to observe that the investigation should 
take a much wider range, since what is desired is to obtain, if possible, a 
knowledge of the cause of yellow fever, a knowledge which the most complete 
history of the epidemic which can be made toil I not be able to furnish. 
What is it that we hope to accomplish when we undertake to investigate 
the cause of a specific disease ? What will be accepted by the medical pro- 
fession and the scientific world at large as being a satisfactory demonstra- 
tion of the cause of yellow fever ? 
If yellow fever is, as we suppose, due to a specific material thing, some 
means is desired of recognizing the presence of that thing other than the 
fact of the occurrence of the specific disease in the human subject, some 
test which will enable us to say, for instance, Here is a jar containing a sub- 
stance which if inhaled or inoculated will produce yellow fever in a suscep- 
tible individual, and it will do this in any part of the country if applied 
under proper circumstances. 
To establish the fact that the material in the jar would do this would 
require numerous experimental verifications, which cannot be obtained upon 
human subjects, and hence one of the first things to be sought is some 
animal or organism in which it may be possible to produce either yellow 
fever, or some specific and recognizable effect of the yellow fever poison. 
In the accounts of yellow fever epidemics are various allusions to accom- 6 
THE WORK OF THE YELLOW FEVER COMMISSION. 
panying phenomena observed in animal life. For instance, it has been alleged 
that unacdimated animals at such times become sick; that certain insects 
are unusually prevalent; that insects do not annoy persons who have had 
the fever, etc. Certain analogies between the yellow fever and the Texas or 
Spanish cattle fever have been pointed out, etc., but as yet the test men- 
tioned has not only not been found, but it has not been methodically sought. 
It appears to us, however, that this is the first and most important step in 
the investigation, and that attempts to investigate the morphology, chem- 
istry, and biology of the poison will be largely wasted until we have some 
easily applicable test to inform us as to when we have really got the poison 
to investigate. 
Having such a test, the next step is easy. If the current theories about 
yellow fever are correct, the yellow fever poison may be developed by 
adding some one or more of the excretions or fluids of a person affected 
with yellow fever to decomposing organic matter under well-known condi- 
tions of temperature and moisture. We have then to carry out a process 
of elimination, to find out what constituents of the decaying filth are essen- 
tial and what non-essential, what secretions or excretions of the body are 
essential and what non-essential, to the production of the poison, and at the 
same time to seek chemical or microscopical means of recognizing the pres- 
ence of either the cause of the poison or the poison itself, in order to get 
rid, if possible, of the necessity of resorting to the physiological test of in- 
oculation to prove its presence. 
In this brief sketch of what would be considered a satisfactory demon- 
stration of the cause of yellow fever, but one provisional hypothesis, namely, 
the prevailing and popular one, has been mentioned. Several others must 
also be considered and tested by the experimental investigator, but in each 
and all the greatest and first desideratum is an easily applied test of the 
presence of the poison. 
It needs but a moment’s reflection to see that the period when an epidemic 
is raging is not the time to carry on such researches. 
They must be made when the disease is not prevalent, and yet there must 
be cases of the disease at hand in order to furnish the material for experi- 
ment. 
Probably the best place to carry on such an investigation would be at first 
the city of Havana. 
It must be clear to all that the necessary investigation will require much 
time and labor, and that its results should be presented accompanied by 
clear and convincing evidence. Such evidence will not be the opinions of 
any one, nor mere descriptions of microscopic appearances, nor even camera 
lucida drawings. Photographs, photomicrographs, the original prepara- 
tions, and similar evidence will be demanded. 
All of which is respectfully submitted. 
J. S. Billings, Surgeon U. S. Army, Chairman. 
J. Berrien Lindsley, M. D., Nashville. 
S. Oakley Vanderpoel, M. D., New York. 
J. G. Thomas, M. D., Savamiah. 
L. S. Joynes, M. D., Richmond. THE EXISTING QUARANTINE LAW. 
7 
COPY OF THE EXISTING QUARANTINE LAW. 
AN ACT TO PREVENT THE INTRODUCTION OF CONTAGIOUS OR INFECTIOUS DISEASES 
[Public No. 41.] 
Be it enacted by the Senate and Hoiise of Representatives of the United States 
of America in Congress assembled, That no vessel or vehicle coming from any 
foreign port or country where any contagious or infectious disease may 
exist, and no vessel or vehicle conveying any person or persons, merchan- 
dise or animals, affected with any infectious or contagious disease, shall 
enter any port of the United States, or pass the boundary line between the 
United States and any foreign country, contrary to the quarantine laws of 
any one of said United States, into or through the jurisdiction of which said 
vessel or vehicle may pass, or to which it is destined, or except in the man- 
ner and subject to the regulations to be prescribed as hereinafter pro- 
vided. 
into the United States, 
Sec. 2. That whenever any infectious or contagious disease shall appear 
in any foreign port or- country, and whenever any vessel shall leave any 
infected foreign port, or, having on board goods or passengers coming from 
any place or district infected with cholera or yellow fever, shall leave any 
foreign port, bound for any port in the United States, the consular officer, 
or other representative of the United States, at or nearest such foreign port, 
shall immediately give information thereof to the Supervising Surgeon-gen- 
eral of the Marine Hospital Service, and shall report to him the name, the 
date of departure, and the port of destination of such vessel; and shall 
also make the same report to the health officer of the port of destination in 
the United States, and the consular officers of the United States shall make 
weekly reports to him of the sanitary condition of the ports at which they are 
respectively stationed ; and the said Surgeon-general of the Marine Hos- 
pital Service shall, under the direction of the Secretary of the Treasury, be 
charged with the execution of the provisions of this act, and shall frame all 
needful rules and regulations for that purpose, which rules and regulations 
shall be subject to the approval of the President, but such rules and regu- 
lations shall not conflict with or impair any sanitary or quarantine laws or 
regulations of any State or municipal authorities now existing, or which may 
hereafter be enacted. 
Sec. 3. That it shall be the duty of the medical officers of the Marine 
Hospital Service and of customs-officers to aid in the enforcement of the 
national quarantine rules and regulations established under the preceding 
section ; but no additional compensation shall be allowed said officers by 
reason of such services as they may be required to perform under this act, 
except actual and necessary traveling expenses. 
Sec. 4. That the Surgeon-general of the Marine Hospital Service shall, 
upon receipt of information of the departure of any vessel, goods, or pas- 
sengers from infected places to any port in the United States, immediately 
notify the proper state or municipal and United States officer or officers at 
the threatened port of destination of the vessel, and shall prepare and trans- 8 
HE CONSTITUTIONALITY OF QUARANTINE LAWS. 
Mit to th medical officers of the Marine Hospital Service, to collectors of 
customs, and to the State and municipal health authorities in the United 
States weekly abstracts of the consular sanitary reports and other pertinent 
information received by him. 
Sec. 5. That wherever, at any port of the United States, any State or 
municipal quarantine system may now or may hereafter exist, the officers 
or agents of such system shall, upon the application of the respective State 
or municipal authorities, be authorized and empowered to act as officers or 
agents of the national quarantine system, and shall be clothed with all the 
powers of United States officers for quarantine purposes, but shall receive 
no pay or emoluments from the United States. At all other ports where, in 
the opinion of the Secretary of the Treasury, it shall be deemed necessary 
to establish quarantine, the medical officers or other agents of the Marine 
Hospital Service shall perform such duties in the enforcement of the quaran- 
tine rules and regulations as may be assigned them by the Surgeon-General 
of that service under this act: Provided, That there shall be no interference 
in any mannei with any quarantine laws or regulations as they now exist or 
may hereafter be adopted under State laws. 
Sec. 6. That all acts or parts of acts inconsistent with this act be, and 
the same are hereby, repealed. 
Approved, April 29, 1878. 
OPINION OF HON. J. RANDOLPH TUCKER, M. C., OF VIRGINIA, 
UPON THE CONSTITUTIONALITY OF QUARANTINE LAWS. 
Lexington, Va., November 19, 1878. 
Dr. J. L. Cabell : 
My dear Sir,— In submitting my views, at the request of the Executive 
Committee of the American Public Health Association, upon the powers of 
the General Government to prevent diseases in the States, I must, for want 
of time for full consideration, be brief, and avoid any elaborate discussion 
of the question. It is one which is delicate and difficult; and we must take 
care to reach no conclusion which, while seeming to do good in the relief 
of our country from the recurrence of the dreadful pestilence which has 
recently afflicted the South, may disturb the just equilibrium established by 
the Constitution between Federal and State power. 
The States have undoubtedl}7 reserved to themselves the power to protect 
the lives and health of their people. The power, delegated to Congress, 
“to regulate commerce with foreign nations, and among the several States,” 
cannot be constitutionally exercised, if thereby the introduction of disease 
into any State is either licensed or permitted. Unless this reserved power 
of the State to protect its people by quarantine and other health laws be 
upheld in full force, the commercial regulations of Congress might fill the 
avenues of trade with disease and death. 
The commercial power is inter-national and inter-state,—external and 
federative in its nature, for the regulation of which a general government THE CONSTITUTIONALITY OF QUARANTINE LAWS. 
9 
is best fitted. The health power is local, domestic, and internal in its na- 
ture ; operates within the State, and guards the homes of its people ; and is 
best exercised by the State governments. As long as Congress regulates 
commerce, including in this term, if you please, navigation, and the instru- 
ments, machinery, and agents of intercourse with foreigners and among the 
States, it is legitimate and constitutional. But when it transcends the bar- 
riers which the States have reared to protect the lives and health of their 
people, it is without authority and unconstitutional. No State could safely 
leave to the central government the health regulations of the places within 
its borders. If the States have any exclusive power, it is here,—in the pres- 
ervation of the health, physical and moral, of the homes of its citizens. 
If the question be asked, Where is there any limit to the power of Con- 
gress over commerce, I answer, “ In the terras of the Constitution itself.” 
Commerce must be regulated by law. Congress can only pass such laws as 
are “necessary and proper” for the regulation of commerce. No law can 
be necessary, none can be proper, that is not, as Judge Story defines the 
word, “ bond, fide appropriate to that end,” or which impairs one of the 
clearest of the domestic powers reserved to the States. No commercial 
regulation can be constitutional, therefore, which would abate in any degree 
the undoubted right of the State to preserve the lives and health of its 
people. 
On this subject, the decisions of the Supreme Court are uniform, begin- 
ning with the case of Gibbons v. Ogden, 9 Wheaton, 1. 
In that leading case, Marshall, Ch. Justice, speaking of the acts of Con- 
gress, which had recognized in their establishment of commercial regula- 
tions the quarantine laws of the States “as flowing from the acknowledged 
power of a State to provide for the health of its citizens,” states the question 
with clearness and force in the following language : 
“The acts of Congress, passed in 1796 and 1799, empowering and direct- 
ing the officers of the General Government to conform to and assist in the 
execution of the quarantine and health laws of a State, proceed, it is said, 
upon the idea that these laws are constitutional. It is undoubtedly true 
that they do proceed upon that idea; and the constitutionality of such laws 
has never, so far as we are informed, been denied. But they do not imply 
an acknowledgment that a State may rightfully regulate commerce with 
foreign nations, or among the States ; for they do not imply that such laws 
are an exercise of that power, or enacted with a view to it. On the con- 
trary, they are treated as quarantine and health laws, are so denominated 
in the acts of Congress, and are considered as flowing from the acknowl- 
edged power of a State to provide for the health of its citizens. But as it 
was apparent that some of the provisions made for this purpose, and in 
virtue of this power, might interfere with and be affected by the laws of the 
United States made for the regulation of commerce, Congress, in that 
spirit of harmony and conciliation which ought always to characterize the 
conduct of governments standing in the relation which that of the Union 
and those of the States bear to each other, has directed its officers to aid in 
the execution of these laws, and has, in some measure, adapted its own THE CONSTITUTIONALITY OF QUARANTINE LAWS. 
legislation to this object by making provisions in aid of those of the States. 
But in making these provisions, the opinion is unequivocally manifested 
that Congress may control the State laws, so far as it may be necessary to 
control them, for the regulation of commerce.” 
In another part of the same opinion, the great Chief Justice speaks of 
“ quarantine laws, health laws of every description,” as “ component parts 
of an immense mass of legislation,” “ not surrendered to a general govern- 
ment, all of which can be most advantageously exercised by the States 
themselves.” And this is quoted with the sanction of the same court in the 
case of Gilman v. Philadelphia, 3 Wallace, 726, decided in 1865. 
It is true that in some of the late cases it has been hinted by some of 
the judges of that court that the legislation on all such matters by Congress 
would be more satisfactory (see Henderson v. Mayer, 2 Otto, 259}; but 
the question has never been before that court for decision, nor has any 
judicial sanction been given to a departure from the doctrines stated by 
Chief Justice Marshall in the case of Gibbons v. Ogden. 
And it is well to remember that Judge Marshall cannot be suspected of 
any strained interpretation of the Constitution in behalf of the reserved 
powers of the States. On the contrary, his opinions have always been con- 
sidered as favoring a liberal construction of the Constitution in respect to 
the powers of the Federal Government. 
But in his definition of the boundary between the commercial powers of 
Congress and the health powers of the States I think he was right,—and I 
would not recede from the position he has sanctioned: that health laws are 
not parts of the commercial power, but are an acknowledged part of the 
reserved powers of the States; and that every commercial regulation of 
Congress must respect and defer to the health laws of each State, passed 
for the protection of the citizen from disease. To deny this absolute power 
to the States, and yield it to the general government, to be exercised or not 
at its pleasure and by its own methods, would not only be obnoxious to 
sound constitutional principles, but be perilous to the well-being of the 
people of the States. 
But while I hold these views, I think we may find a practical solution of 
the question in the language of Judge Marshall: 
You observe, he says, that Congress “has directed its officers to aid in 
the execution of these laws ” (of the States), “ and has, in some measure, 
adapted its own legislation to this object by making provisions in aid of those 
of the States.''1 In other words, Congress should sustain the health laws of 
the States, and may make provisions in aid of them, but not against them, 
or contrary to their purpose. 
As, therefore, Congress in its commercial rules has conformed to and as- 
sisted in the execution of the health laws of the States in previous legisla- 
tion, it should do so in all future acts ; and there is no reason why it 
should not, in its commercial regulations, embody such provisions for vessels 
and other instruments of inter-national and inter-state intercourse as in its 
judgment would promote the ends the States have in view, in preventing the 
introduction and spread of disease. Such laws, though not “ necessary ” for THE CONSTITUTIONALITY OF QUARANTINE LAWS. 
regulating commerce, would be eminently “ proper ” (in the constitutional 
sense), because while they would be needful rules for commerce and for the 
good of the States ; they would prevent the agencies of commerce, operating 
under congressional sanction, from invading the reserved authority of the 
States, and cursing, with the scourge of pestilence, the people upon whom 
they should bestow the blessings of commercial prosperity. 
If therefore your Association could induce the States to adopt some uni- 
form system of health regulations, it would accomplish much good. Nor 
can I see why such a result is not probable. Then, let Congress in its 
commercial regulations respect the health laws of the States, and wherein 
they seem deficient engraft upon the commercial rules it establishes such 
limitations upon trade as will conserve the health of the people by prevent- 
ing the ingress or spread of disease. It is the privileges of commerce which 
create the danger to health. It is thus the power which grants these privi- 
leges that menaces the power which protects the health of the people. 
Congress, by limiting commercial privileges by its own rules, which will 
prevent the ingress or spread of disease, and respecting the health regula- 
tions of each State, will do all for commerce it should do consistently with 
the welfare of the people. In this way, it seems to me, the two systems of 
government under our federal system may constitutionally and harmoni- 
ously cobperate for the promotion of our commerce and for the security of 
the health of our people. 
For it cannot be the interest of any State to obstruct its own commerce 
by needless and adverse health laws, nor can it be the policy of Congress 
to foster commerce by the sacrifice of the lives or health of the people of 
the State. Why may not both Congress and the States harmonize in 
concurrent action, within their respective constitutional functions, in the 
adoption of a wise policy, under the sagacious suggestions of the eminent 
medical and scientific men of the country ? I confess I can see no con- 
stitutional difficulty to the adoption of a system of commercial and health 
laws in perfect harmony with each other, made legal by the sanction of the 
Federal and State governments. 
If these views only avail to-suggest some action for your Association which 
shall result in the good we all desire, I shall be gratified. I submit them 
with that hope, and with deference and respect for the opinions of others 
upon a subject on which there has been much discussion, but no judicial 
decision, I am, with sincere regard, 
Your friend, 
J. R. Tucker. 12 
RESOLUTIONS RELATING TO YELLOW FEVER, ETC. 
RESOLUTIONS RELATING TO YELLOW FEVER AND TO 
SANITARY LEGISLATION, OFFERED AT THE MEETING OF 
THE AMERICAN PUBLIC HEALTH ASSOCIATION AT RICH- 
MOND, VA., NOVEMBER 19-22, 1878. 
Resolved: That a committee of members be appointed to prepare and 
recommend measures for the more efficient management and control of 
future epidemics, especially for the training, selection, and employment of 
skillful and trustworthy nurses. 
MAJOR W. T. WALTHALL, OF MOBILE. 
REV. DR. J. K. MARSHALL, OF VICKSBURG. 
i. Resolved: That we respectfully urge upon the General Government of 
the United States the appointment of a commission of competent citizens, 
who shall be authorized to visit Havana for the purpose of investigating the 
rise and progress of the yellow fever • and that they shall be required to 
investigate what may be done, if anything, toward the purifying of ships 
leaving that port during their voyages, and what further may be done, in 
addition to the present methods in use, for the farther improvement of the 
practical workings of an improved and general quarantine system. 
2. Resolved: That the government be urged to set apart a sum of money 
sufficient for the full and untrammeled employment of all the time and ener- 
gies of such commission ; and that such commission be composed of phy- 
sicians, scientists, and laymen, who shall enter upon their work with as little 
delay as possible. 
Resolved: That it be earnestly urged upon the President of the United 
States to confer with the Spanish government, and request the appointment 
of an international commission, who shall study yellow fever at Havana, its 
principal place of endemicite, with a view of adopting measures which shall 
eradicate it or prevent its spread in that city. 
DR. S. O. VANDERPOEL, OF NEW YORK. 
DR. W. H. BEATTY, OF MOBILE. 
Resolved: That a resident physician at each point where yellow fever 
prevailed be requested by this Association to give it such information as 
they may be able to collect as to the origin and mode of spread of the late 
visitation, together with the mode of treatment found most successful. 
Resolved: That it is the opinion of this Association that the body does 
reproduce the poison of yellow fever, and that without this poison being 
thrown off from the body of a yellow fever patient, the clothing, bedding, and 
rooms of such patients would not be infected, and therefore could not infect 
persons or things ; but we recognize from its history and mode of spread- 
DR. GREENSVILLE DOWELL, OF GALVESTON. RESOLUTIONS RELATING TO YELLOW FEVER, ETC. 
13 
ing that if this poison is thrown off in an open and pure air, it will be de- 
stroyed, or so diluted that it will not always affect persons in the same room 
or even sleeping in the same bed. 
Recognizing the necessity of uniformity of action in all the States of the 
Union upon matters concerning the public health, and fully appreciating 
that the machinery necessary to move a whole nation would be cumbersome, 
and could better be done by the separate action of the States represented in 
this Association, be it hereby 
DR. THOMAS F. WOOD, OF WILMINGTON, N. C. 
1. Resolved: That we hold it to be very important that Boards of Health 
be established in each State ; that to be effective these boards should be 
properly empowered to act, and that money should be placed at their disposal 
to further the steady and vigorous prosecution of the measures which the 
advance of sanitary art and acience may point out as best for the further- 
ance of the public health. 
2. Resolved: That a copy of these resolutions be sent to the Executive 
Department of every State in the Union, with a request that they be 
brought to the attention of the Legislature. 
Whereas, It is confessed by all that every present known means of disin- 
fection against yellow fever has proved a failure, and 
DR. JAMES B. MCCAW, OF RICHMOND. 
Whereas, We know that a temperature below the freezing point will kill 
the germ of the disease, therefore, be it 
Resolved: That a committee of shall be appointed to devise an 
effective and simple method of producing artificial cold, to be applied to 
the disinfection of clothing, baggage, and other movable property which 
may have been exposed to the yellow fever contagion. 
RESOLUTIONS REPORTED BY THE COMMITTEE ON RESOLUTIONS TO THE COM- 
MITTEE ON LEGISLATION. 
i. Resolved: That the American Public Health Association very respect- 
fully but earnestly urge the President of the United States to confer with 
the Spanish Government with a view to securing the appointment of an in- 
ternational commission of competent experts to investigate the cause of 
yellow fever at Havana, the principal place of its endemic prevalence, and 
to recommend measures for its prevention. 
2. Resolved: That they respectfully petition Congress to appropriate a suf- 
ficient sum of money to conduct such an inquiry, on the part of the United 
States, in a thorough and exhaustive manner. 
3, Resolved: That the President of the American Public Health Associa- 
tion for the ensuing year, and two other members to be appointed by him, 
constitute a committee to act in behalf of the Association, to present these 
resolutions to the President and Congress, and to urge upon them the adop- 
tion of measures, by both governments in cooperation, for the prevention of 
the occurrence of epidemics of yellow fever, so far as is possible, or at least 
its importation into the United States. 14 
RESOLUTIONS RELATING TO SANITARY LEGISLATION. 
i. Resolved: That in the deliberate judgment of this Association, it is the 
duty of every State to establish and adequately maintain an efficient State 
Board of Health, and in as great an extent as practicable to contribute to 
the protection of the public health within its own commonwealth, and by 
all suitable means to that of the whole country. 
RESOLUTIONS REPORTED BY EXECUTIVE COMMITTEE, 
2. Resolved: That the powers and duties of the State Boards of Health 
should be so well defined by law, and so fully provided for in the polity of 
State administration, that the sanitary interests and protection of all places 
in the State should be secured. 
3. Resolved: That a copy of these resolutions, with a suitable official 
memorandum as a basis of correspondence, shall be transmitted to each 
State Board of Health and each Governor in our country, to the health 
officers of ports, and to the government of each State and port that may 
be concerned in the duties of such mutual efforts for sanitary protection. 
4. Resolved: That in the efforts to obtain the aid or interposition of the 
Federal Government for any general and specific kinds of sanitary protec- 
tion of the United States against pestilential and infectious diseases, the 
State authorities should have effectual and prompt methods of united ac- 
tion to insure sanitary protection and improvement, whether or not the 
national agencies lead or assist in or simply impart unity and effectiveness 
to the sanitary service of the States. 
5. Resolved: That a committee be appointed to advise with the Execu- 
tive Committee of this Association with regard to matters of legislation com- 
ing before Congress during the next session which relate to the subjects of 
public health, and that this committee be composed as follows: namely, one 
member from each State represented in the Association, the chief medical 
officer in the Army, in the Navy, in the Marine Hospital Service, the Com- 
missioner of Education, or such officers in these respective services as they 
may designate; and that to this committee be referred all resolutions and 
motions relating to the subject matter of the resolutions which have been or 
may be presented to this Association, having reference to such legislation ; 
the members of this committee to be appointed by the Executive Commit- 
tee of this Association, after consultation as far as possible with the repre- 
sentatives of each State and the District of Columbia in this Association, 
and they shall report to the Executive Committee any advice which they 
may have to present. And this Association instructs the Executive Com- 
mittee to exert its influence to secure such legislation as will best protect 
the public health of the whole country. 
The following resolution, proposed by Dr, Choppin, of New Orleans, was 
reported by the Committee on Resolutions as follows ; “ Generally approved, 
but the objects desired will be reached by the contemplated change in the 
Constitution of the American Public Health Association.” 
“ Whereas, It has been found that the present administration of quaran- 
tine by different State authorities lacks such uniformity and efficiency as are RESOLUTIONS RELATING TO SANITARY LEGISLATION. 
15 
necessary to protect an extended coast-line from invasion by such exotic 
pestilences as cholera and yellow fever. 
“ And Whereas, The Constitution of the United States does not confer 
upon the general government any authority relative to sanitary matters, 
“Resolved: That this Association recommends the formation of a sanitary 
congress, to be composed of one or more delegates from each State Board 
of Health, giving to each State Board equal representation ; this congress 
to assemble once annually, or oftener, at its discretion, for the purpose of 
adopting measures of cooperation in carrying out a system of quarantine 
which shall be equitable in all its features, and uniform so far as varying 
conditions, climatic and otherwise, may allow.” 
The Committee on Resolutions submitted the following report: 
The Committee on Resolutions respectfully report that they have duly 
considered the inclosed resolutions, presented by Dr. Henry B. Baker, of 
Michigan, in relation to obtaining legislation by Congress on several sub- 
jects pertaining to the public health. 
While the committee cordially approves of the subject matter of these 
resolutions, it still deems it inexpedient and unwise to commit the Associa- 
tion at this critical period of public agitation of kindred topics to any 
definite form of organization of a public health service. In our opinion, 
the objects sought can best be attained by the appointment of a suitable 
Committee on Legislation by the Association, which shall be empowered to 
secure the legislation necessary to the organization of an adequate public 
health service connected with the General Government. The committee 
would suggest that in the organization of a legislative committee, each 
State represented in the Association should have a member, and that the 
chief medical officer of the Army, of the Navy, and of the Marine Hospital 
Service, and the Commissioner of Education, or such officer in their respec- 
tive services as they may designate, shall be members, together with the 
President of the association. This committee should have an Executive 
Committee conveniently located to act together during the session of Con- 
gress. To this legislative committee should be referred all resolutions or 
matters pertaining to congressional action. 
All of which is respectfully submitted 
Edwin M. Snow, Chairman. 
The following are the resolutions of Dr. Henry B. Baker referred to in 
the above report: 
1. Resolved: That this Association heartily approves and earnestly recom- 
mends the adoption of the proposition of Surgeon J. S. Billings, U. S. Army, 
as set forth in a communication dated October 15, 1878, from J. K. Barnes, 
Surgeon-general U. S. Army, to the Hon. S. S. Cox, M. C., Chairman of the 
Committee on Census of 1880, and which proposition is, that statements of 
certain specified facts relating to the health of the people shall be collected 
in the coming census. 
2. Resolved: That the Secretary of this Association be directed to transmit 16 
RESOLUTIONS RELATING TO SANITARY LEGISLATION. 
a memorial to Congress, or a respectful communication to the Hon. S. S. 
Cox, M. C., Chairman of the Committee on Census of 1880, or to the proper 
officers who shall be charged with the control of the U, S. Census of xSBo, 
setting forth the importance of having the statistics relating to the sickness 
and deaths, and all other vital statistics of the inhabitants which may be 
collected by the census, collated, digested, and compiled under the super- 
vision of an expert in vital statistics and sanitary science; to the end that 
statistics collected at such cost and which are of such vital importance to 
the people shall not be made valueless by reason of unskillful compilation, 
but as useful as they can be made by a practical statistician familiar with 
the sanitary problems of the day. 
3'. Resolved: That, in the interests of public health and the prosperity of 
this country, it is desirable and important that the facts and data bearing 
upon public health subjects which are collected by the census, and con- 
stantly being collected by the several departments of the General Govern- 
ment at Washington, shall be systematically utilized and made practically 
available as aids to all proper efforts by Congress, Legislatures, Boards of 
Health, associations, and individuals, for the better protection of the lives, 
health, happiness, and prosperity of the people of the United States. 
4. Resolved: That, for the accomplishment of the purpose suggested in the 
preceding resolution, this Association approves of the proposition for the 
formation of a permanent “United States Public Health Commission/’ 
charged with the duty of collating and utilizing all such information directly 
or indirectly relating to the public health as shall be gathered in the several 
departments of the general government of the United States ; this com- 
mission to make to the President or to Congress an annual report which 
shall embody such facts and information relating to public health as may be 
collected and be considered important to be included in such report, and 
otherwise to collect and disseminate useful information relating to public 
health in such manner as shall best advance the interests of the people of 
the United States, the amount of money appropriated for such purposes 
being limited by Congress, and the Commission to be constituted as fol- 
lows : 
The Surgeon-general of the Army (representing the War Department). 
The Chief Signal Officer of the Army (representing the War Depart- 
ment). 
The Surgeon-general of the Navy (representing the Navy Department). 
The Surgeon-general of the Marine Hospital Service (representing the 
Treasury Department). 
The Commissioner of Education (representing the Interior Department). 
The Superintendent of the Census (representing the Interior Depart- 
ment), and a permanent secretary and executive officer, who shall be a 
citizen of the United States, shall be chosen by the above-mentioned mem- 
bers of the Commission (but may be nominated by this Association), and 
who shall be selected for his executive ability, and especially for his expert 
ability in vital statistics and sanitary Science, and whose duty it shall be to 
constantly attend to the duties of the office, and have immediate charge of 
the work of the Commission at the Capitol. RESOLUTIONS RELATING TO SANITARY LEGISLATION 
17 
Whereas, Meteorological data of the right kind, and sufficient for the 
determination of the conditions under which yellow fever or any other 
epidemic occurs, have not been, are not now, and probably will not be col- 
lected, except it be done by the National Government; therefore, 
Resolved: That the permanent National Sanitary Commission should be 
especially required to utilize the meteorological data now collected, and to 
inaugurate a system of meteorological observations and reports by which it 
can learn the condition of the atmosphere at every season of the year in 
different parts of the United States, as regards relative amount of ozone, 
kind and amount of electricity, and such other facts of this nature as may 
promise aid in the study of the causes of epidemic and other diseases. 
Resolved: That a committee, of which the President of the Association 
shall be chairman, be appointed to represent this Association on the sub- 
jects upon which Congress is to be memorialized; the duties of the com- 
mittee to be, to consult with the officers whom it is proposed shall constitute 
the- National Public Health Commission, and to frame a bill in accordance 
with the resolutions adopted by this Association, for presentation to the 
proper congressional committee, and to present to such committee facts and 
considerations showing the national importance of legislative action inaugu- 
rating more effective measures for the prevention of sickness and deaths 
from removable or avoidable causes, and explaining more definitely than 
can be done in brief resolutions what is hoped to be accomplished through 
the establishment of a permanent National Health Commission. 
Resolved: That the interests of public health and safety in these United 
States will be promoted by the establishment of State and National Exam- 
ining Boards, not connected with medical schools or colleges, but under 
governmental direction, whose duty it shall be to examine applicants for 
degrees in sanitary science and public hygiene, and to confer such degrees 
only upon such as on examination are found learned in such specialties ; 
that this will promote accuracy in these studies, will stimulate many to 
become proficient, will create a demand for increased efforts for the teaching 
of sanitary science and such “ knowledge of most worth ” by schools and 
colleges, and, finally, that it will make it possible for State and city officers 
to select health officers and members of boards of health from a class 
of persons whose proficiency in sanitary science has been ascertained by 
those competent to judge. 
Resolved: That in order to insure that such Examining Boards shall be 
formed of competent persons, such State Examining Boards shall be formed 
and controlled by the State Boards of Health, and the National Examining 
Board by the permanent National Public Health Commission; which may 
be economically done by the assignment of Army, Navy, and other medical 
officers of the government to act with sanitary experts from civil life (as 
suggested by Dr. Busey, member of this Association). 
Resolved: That, in transmitting to Congress the memorials and resolu- 
tions of this Association, the officers or committee of this Association shall 
include a respectful memorial to the United States Senate and House of 
Representatives, praying for the establishment of a standing committee on 18 
REPORT ON PROPOSITIONS RELATING TO YELLOW FEVER. 
public health in each legislative branch of the government, and respect 
fully suggesting, as a reason therefor, that the needs of the people for pro- 
tection to “life, liberty, and the pursuit of happiness” from preventable 
causes of sickness and death are real and more constant than their need 
for protection from armed foes, against which the government protects by the 
Army and Navy, to which departments Congress gives much attention, in 
its general sessions as well as in its standing committees. 
RESOLUTION WITH REGARD TO THE CENSUS. 
Dr. Steiner offered the following resolution, which was adopted 
Resolved: That a committee of three be appointed to urge upon the 
special committees of Congress now engaged upon the organization of the 
next census the great importance, to public health of the subject of these 
resolutions. 
Pursuant to the above resolution the following committee was ap- 
pointed : 
Hon. L. H. Steiner, M. D, 
Ezra M. Hunt, M. D. 
Elisha Harris, M. D. 
REPORT OF A COMMITTEE ON PROPOSITIONS RELATING 
TO YELLOW FEVER. 
A committee consisting of Dr, J. S. Billings, United States Army, Dr. 
E. M. Snow of Rhode 'lsland, Dr. John Morris of Maryland, and Dr. 
R. W. Mitchell of Tennessee, was appointed to prepare propositions or 
questions relating to yellow fever, to serve as a basis for discussion in the 
body of the Association. 
This committee divided its report into two parts. The first contained 
the following questions intended for discussion, not merely on the floor of 
the Association, but throughout the country, and with regard to which it 
was neither expected nor considered desirable that the Association should 
then as a body express an opinion. 
i. In case of the occurrence of an epidemic of yellow fever in a com- 
munity unprotected by previous attacks, how are the well to be disposed of, 
and what organization and measures are desirable to afford relief? 
These questions were as follows : 
2. When should yellow fever be declared epidemic in a community? 
3, Can yellow fever be transmitted by personal contagion independent 
of clothing and fomites of every description ? 
4. Can yellow fever spread in a place which is and has been previously 
in a perfect sanitary condition ? 
5. Can any known disinfectants be relied on to arrest the progress of 
yellow fever in a city or village ? 
6. What are the best methods of disinfecting ? REPORT ON PROPOSITIONS RELATING TO YELLOW REFER. 
19 
7. What influence has the daily thermometric, barometric, or hygrometric 
range, or both, in promoting or retarding the spread of yellow fever in a 
community ? 
8. Are any measures of personal prophylaxis of service ? 
9. Is it possible and desirable to establish such a maritime quarantine 
for the Southern Atlantic and Gulf coasts of the United States as is neces- 
sary to secure immunity from the importation of yellow fever ? 
10. Is it possible to secure such a quarantine without placing it under 
the control of the general government? 
n. In case of the arrival of a vessel believed to be infected with yellow 
fever, what course should be pursued with the passengers, the baggage and 
freight, and the ship ? 
In addition to these questions the committee submitted certain proposi- 
tions to be voted on by the Association at the close of the discussion, 
simply to serve as a test of the prevailing opinion of those present. These 
propositions were as follows : 
1. Yellow fever is a specific disease, not indigenous to or originating 
spontaneously in the United States, and its appearance in this country is 
always due to a specific cause. 
2. Quarantine established with such rigor and precision as to produce 
absolute non-intercourse will prevent the importation of the specific cause 
of yellow fever. 
3. It is the duty of the general government to aid in the establishment 
of a practical and proper quarantine by all means in its power. 
4. It is the duty of the General Government to appoint a commission of 
experts to make a thorough investigation into the causes of yellow fever, 
and the best methods of preventing its introduction into this country, and 
to make such an appropriation as will permit of the securing the services 
of the best men and of the best means for carrying out such investigation. 
5. That it is the duty of the General Government to invite foreign nations 
to cooperate with it in the establishment of uniform and effective interna- 
tional quarantine regulations. 
6. That whatever may be the practical value of quarantine, there is no 
doubt of the importance and value of internal sanitary measures in the 
prevention or modification of epidemic yellow fever, and that this Associa- 
tion strongly urges upon State and municipal authorities the great amount 
of responsibility which rests upon them on this account at times when no 
disease is prevalent or threatening. 
All these propositions except the first were adopted by the Association, as 
submitted. The first one was modified so as to apply exclusively to the 
yellow fever epidemic of 1878, and was then adopted. 20 
RECOMMENDATIONS BY THE PRESIDENT. 
RECOMMENDATIONS BY THE PRESIDENT OF THE 
ASSOCIATION. 
The following suggestions were submitted in Dr. Harris’s discourse open- 
ing the Annual Meeting in Richmond : 
I deem it a duty to suggest, among other modifications of the plan for 
which this body exists, if found practicable, the following: 
First, That each State Board of Health shall be entitled to one seat in 
the Executive Committee of the Association, that member being elected by 
his associates and holding office for one year. 
Second, That members of the State Boards of Health may be ex officio 
members of the association. 
Third, That the members of the Executive Committee annually elected 
by the Association shall equal the total number of members ex officio ; this 
committee to be henceforth designated, The Council of the American Pub- 
lic Health Association. 
Fourth, That for the purpose of shaping expert investigations, and the 
scientific reporting of the same, and and for encouraging continual re- 
searches, there should be appropriate committees or sections to give full 
effect to the plan designed in the original construction of standing com- 
mittees. 
Fifth, The maintenance in each State and Territory of a system of 
periodical reports—weekly, monthly, yearly —of all epidemic and other 
prevalent diseases, supervised by State Boards of Health, and where there 
are no such boards by the resident members of the Association, designated 
for the purpose ; all studies and reports to be by a method designed to yield 
comparable results. 
Sixth, The study of meteorological and atmospheric conditions with 
reference to epidemiology and health. 
Seventh, The maintenance of a committee for study and consultation in 
regard to biological and anthropological investigations, including the con- 
tributions from the census and other national and State systems of regis- 
tration. 
Eighth, The, introduction of a clause in the Constitution of this Associ- 
ation to provide for editorial and supervisory duty in the publication and 
diffusion of sanitary information. 
Ninth, A formal recognition of both national and international obliga- 
tions in the work of this Association by means of correspondence with State, 
national, and international sanitary authorities, and especially to contribute 
to researches in regard to pestilential diseases and their contagia. 
These suggestions were referred to a select committee, who, after confer- 
ring with the members of fifteen of the State Boards of Health, and with 
members from all States represented in this meeting, recommended that the 
following changes in the Constitution be submitted and made at the next 
Annual Meeting. PROPOSED AMENDMENTS TO THE CONSTITUTION. 
21 
This notice of the proposed change in the Constitution is given in ac- 
cordance with Section XIII. 
PROPOSED AMENDMENTS TO THE CONSTITUTION. 
Article 111. to be amended so as to read as follows : 
There shall be two classes of members, viz.: (i) the members of State 
Boards of Health, ex officio; (2) elected members who shall be selected 
with special reference, etc. 
MEMBERS. 
IV. to be amended so as to read as follows 
IV. The officers shall be a President, a First Vice-President, a Secretary, 
a Treasurer, and a Foreign Corresponding Secretary. 
OFFICERS. 
All the officers shall be elected by ballot, annually, except the secretaries, 
who shall be elected for a term of three years. 
VIII. to be amended so as to read as follows 
THE COUNCIL, 
VIII. There shall be a Council, to be composed as follows, viz.: Of the 
President, the First Vice-President, the Secretary, and the Treasurer, and of 
one member from each State Board of Health as appointed by said boards, 
and of an equal number of members to be elected by the Association, and a 
representative from the medical service of the Army, of the Navy, and of 
the Marine Hospital Service. 
THE EXECUTIVE COMMITTEE. 
IX. There shall be an Executive Committee which shall consist of the 
President, the First Vice-President, the Secretary, the Treasurer, the past 
Presidents, and five other persons whom the Council shall elect from their 
own number, at least two of whom shall be from the elected members of the 
Council. Five members shall constitute a quorum of this Committee. 
IX. to be amended so as to read X. 
THE DUTIES OF THE COUNCIL. 
XI. The Council shall at each Annual Meeting make to the Executive 
Committee any recommendations it may deem proper. It shall also ob- 
tain such reports from State Boards of Health and from States not having 
boards, as shall secure the objects of the Association. 
XI. amended so as to read XII. 
XII. amended so as to read XIII. 
XIII. amended so as to read XIV, 
XIV. amended so as to read XV. 22 
OFFICERS OF THE ASSOCIATION. 
OFFICERS OF THE ASSOCIATION FOR 1878-79. 
President, Prof. James L. Cabell, M. D., University of Virginia, Char- 
lottesville. 
First Vice-President, John S. Billings, M. D,, Surgeon U. S. Army, 
Washington, D. C. 
Seco7id Vice-President, Samuel Choppin, M. D., New Orleans, La. 
Secretary, Edward H. Janes, M. D., New York. 
Treasurer, Henry B. Baker, M. D., Lansing, Mich. 
ELECTED MEMBERS OF EXECUTIVE COMMITTEE. 
C. B. White, M. D,, New Orleans, La. 
T. J. Turner, M. D., U. S. N., Washington, D. C. 
E. M. Hunt, M. D., Metuchen, N. J. 
J. D. Plunkett, M. D., Nashville, Tenn. 
C. F. Folsom, M. D., Boston, Mass. 
C. N. Hewitt, M. D., Red Wing, Minn. 
Dr. R. D. Webb, Livingston, Ala. 
names of the advisory committee. 
Dr. Henry Gibbons, San Francisco, Cal. 
Dr. J. P. Wall, Tampa, Fla. 
Hon. J, G. Thomas, M. D., Savannah, Ga. 
Dr. J. H. Rauch, Chicago, 111. 
Dr, George Sutton, Aurora, Ind. 
Dr. Wirt Johnson, Jackson, Miss. 
Dr. Samuel Choppin, New Orleans, La, 
Hon. L. H. Steiner, M. D., Frederick, Md. 
Dr. H. I. Bowditch, Boston, Mass. 
Dr. J. Howard Taylor, Philadelphia, Penn. 
Dr. Thomas C. Minor, Cincinnati, O. 
Dr. E. M. Snow, Providence, R. I. 
Dr. T. A. Atchison, Nashville, Tenn. 
Dr. L. S. Joynes, Richmond, Va. 
Dr. H. O. Hitchcock, Kalamazoo, Mich. 
Dr, J. T. Hodgen, St. Louis, Mo. 
Dr. James E. Reeves, Wheeling, W. Va. 
Dr. J. M. Toner, Washington, D. C. 
Hon. D. B. Eaton, New York City. 
Dr. Thomas F. Wood, Wilmington, N. C. 
, Dr, Robert Lebby, Charleston, S. C. 
Dr. G. C. Chamberlain, Hartford, Conn. 
Dr. S. P. Conn, Concord, N. H. 
Dr, Henry D. Holton, Brattleborough, Vt. 
Dr. A. R, Kirkpatrick, Waco, Texas. 
Dr. E. L. Griffin, Fond du Lac, Wis. OFFICERS OF THE ASSOCIATION. 
Dr. D. W. Hand, St. Paul, Minn. 
23 
Hon. Samuel Lilly, M. D., Lambertville, N. J. 
Dr, R. E. Jennings, Little Rock, Ark. 
U. S. Army. 
Dr. B. F. Gibbs, U. S. Navy. 
# Marine Hospital Service. 
■* Bureau of Education. 
* Not appointed.