Some Remarks upon National 
and International Sanitary 
Jurisprudence. 
BY 
THOMAS J. TURNER, A.M., M.D., Ph.D., 
MEDICAL DIRECTOR UNITED STATES NAVY. 
l88'l. 
READ BEFORE THE 
AMERICAN PUBLIC HEALTH ASSOCIATION, 
November, 1881, 
AT ITS ANNUAL SESSION IN THE CITY OF SAVANNAH, GA. 
BOSTON: 
FRANKLIN PRESS: RAND, AVERY, AND COMPANY. 
1882. Some Remarks upon National 
and International Sanitary 
Jurisprudence. 
BY 
THOMAS J. TURNER, A.M., M.D., Ph.D., 
MEDICAL DIRECTOR UNITED STATES NAVY. 
1881. 
READ BEFORE THE 
AMERICAN PUBLIC HEALTH ASSOCIATION, 
November, 1881, 
AT ITS ANNUAL SESSION IN THE CITY OF SAVANNAH, GA. 
BOSTON: 
FRANKLIN PRESS: RAND, AVERY, AND COMPANY. 
1882. SOME REMARKS UPON NATIONAL AND INTERNATIONAL 
SANITARY JURISPRUDENCE. 
By T. J. TURNER, M.D., U.S.N. 
“ The application of a rule to various subjects can no otherwise be made but in a manner agreeable 
to the nature of the subject; whence there results a natural law of nations as a particular science, con- 
sisting in a just and rational application of the law of nature to the affairs and conduct of nations and 
sovereign princes.” — Vattel. 
I desire to expressly state at the outset that the views hereinafter presented 
must be considered entirely from the stand-point of preventive medicine. 
The Act of March 3, 1879, introduced by the Hon. J. H. McGowan of 
Michigan, established in the United States, for the first time in its political 
history, a National Board of Health. This Act detailed the method of its 
organization, and, in a general way, assigned certain functions to the Board. 
(Appendix I.) 
The Act of June 2, 1879, introduced by the Hon. Isham G. Harris of Ten- 
nessee, added other duties to those already assigned; and it is proposed to 
consider certain of these duties in their relations to both National and Inter- 
national Sanitary Jurisprudence. (Appendix II.) 
This latter Act, that of June 2, 1879, is known as the “Quarantine Act,” and 
has its foundation in art. I., sect. 8, of the Constitution of the United States, 
which reads as follows : — 
“ The Congress shall have power ... to regulate commerce with foreign 
nations, and among the several States, and with the Indian tribes.” 
The learned Justice Story, in his commentaries on the Constitution, espe- 
cially upon this section of art. I., states, “ In the first place, then, what is 
the constitutional meaning of the words, Ho regulate commerce’?” for the 
Constitution being (as has been aptly said) one of enumeration and not of 
definition, it becomes necessary, in order to ascertain the extent of the power, 
to ascertain the meaning of the words. The power is to regulate ; that is,'to 
prescribe the rule by which commerce is to be governed. The subject to be 
regulated is commerce. Is that limited to traffic, to buying and selling, or the 
interchange of commodities? Or does it comprehend navigation and inter- 
course ? . . . Commerce undoubtedly is traffic; but it is something more, — it 
is intercourse. It describes the commercial intercourse between nations and 
parts of nations in all its bratiches, and is regulated by prescribing rules for 
carrying on that intercourse.” He further states that there are acknowledged 
powers of the States over certain subjects having a connection with commerce, 
and remarks, “ These powers are entirely distinct in their nature from that to 4 
SOME REMARKS UPON SANITARY JURISPRUDENCE. 
regulate commerce ; and, though the same means may be resorted to for the 
purpose of carrying these powers into effect, this by no means furnishes any 
ground to assert that they are identical. Among these are inspection laws, 
health laws, laws regulating turnpikes, roads, and ferries; all of which, when 
exercised by a State, are legitimate, arising from the general powers belonging 
to it, unless so far as they conflict with the power delegated to Congress. 
They are not so much regulations of commerce as police, and may truly be 
said to belong, if at all, to commerce, to that which is pui'ely internal.” 
Justice Story also, in commenting upon the extent, objects, and purposes to 
which the constitutional powers of the General Government may be applied 
among States, says that it “ extends to quarantine laws; ” but upon such sub- 
jects his editor (Cooley) says, “ The power is not exclusive.” 
The Hon. J. R. Tucker, member of Congress of Virginia, in his letter of 
Nov. 19, 1878, to Dr. J. L. Cabell, recites, “that 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.” He also further states, “Congress, 
by limiting commercial privileges by its own rules, which will prevent the 
ingress or spread of disease, and respecting the health regulations of each 
State, will do all for commerce it should do consistently with the welfare of the 
people. ... I confess I can see no constitutional 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.” 
It is not seen how the first part of the quotation can apply without conflict 
of authority; for instances are too well known of the establishment of health 
laws for quarantine purposes by the ports of one State against ports of another 
State, ostensibly for the purpose set forth, but in reality aimed at securing for 
themselves each other’s commercial interests. It is not likely that Congress 
would sustain or make provisions in aid of such laws, especially when para- 
graph 6, sect. 9, art. I. of the Constitution, — “No preference shall be given by 
any regulation of commerce or revenue to the ports of one State over those of 
another,” — is considered in such relations. 
It may not be out of place here to refer to the opinion of Chief Justice 
Marshall in the case of Gibbons v. Ogden, delivered in 1824, and which is so 
frequently quoted as bearing upon the matters under consideration, and either 
directly or indirectly bearing upon the duties and responsibilities of the 
National Board of Health, founded, as it is at present, upon that part of the 
Constitution of the United States “to regulate commerce : ” — 
“ The genius and character of the whole government seem to be, that its 
action is to be applied to all the external concerns of the nation, and to those 
external concerns which affect the States generally, but not to those which are 
completely within a particular State, which do not affect the other States, and 
with which it is necessary to interfere, for the purpose of executing some of 
the general powers of the government. The completely internal commerce 
of a State, then, may be considered as reserved to the State itself. But, in 
regulating commerce with foreign nations, the power of Congress does not SOME REMARKS UPON SANITARY JURISPRUDENCE. 
5 
stop at the jurisdictional lines of the several States. It would be a very useless 
power if it could not pass these lines. The commerce of the United States 
with foreign nations is that of the whole United States. Every district has a 
right to participate in it. The deep streams which penetrate our country in 
every direction pass through the interior of almost every State in the Union, and 
furnish the means of exercising this right. If Congress has the power to regu- 
late it, that power must be exercised wherever the subject exists. If it exists 
within the States, if a foreign voyage may commence or terminate at a port 
within a State, then the power of Congress may be exercised within a State. 
This principle is, if possible, still more clear, when applied to commerce ‘ among 
the several States.’ They either join each other, in which case they are sepa- 
rated by a mathematical line ; or they are remote from each other, in which case 
other States lie between them. . . . The power of Congress, then, whatever it 
may be, must be exercised within the territorial jurisdiction of the several States. 
. . . We are now arrived at the inquiry, What is this power? It is the power 
to regulate — that is, to prescribe — the rule by which commerce is governed. 
This power, like all others vested in Congress, is complete in itself, may be 
exercised to its utmost extent, and acknowledges no limitation, other than are 
prescribed by the Constitution. ... If, as has always been understood, the 
sovereignty of Congress, though limited to specified objects, is plenary as to 
those objects, the power over commerce with foreign nations and among the 
several States is vested in Congress as absolutely as it would be in a single 
government having in its constitution the same restrictions on the exercise of 
the power as are found in the Constitution of the United States.” 
Again, in the same case, the chief justice remarks, in alluding to inspection 
laws, etc., — 
“ They form a portion of that immense mass of legislation which embraces 
every thing within the territory of a State not surrendered to a General Govern- 
ment ; all which can be most advantageously exercised by the States them- 
selves. Inspection laws, quarantine laws, health laws of every description, as 
well as laws for regulating the internal commerce of a State, and those which 
respect turnpikes, roads, ferries, etc., are component parts of this mass. No 
direct general power over these objects is granted to Congress, and conse- 
quently they remain subject to State legislation. If the legislative power of 
the Union can reach them, it must be for national purposes, it must be where 
the power is expressly given for a special purpose, or is clearly incidental to 
some power which is expressly given. It is obvious that the government of 
the Union, in the exercise of its express powers (that, for example, of regulating 
commerce with foreign nations and among the States), may use the means that 
also may be employed by a State in the exercise of its acknowledged powers 
(that, for example, of regulating commerce within the State).... The i\cts of 
Congress passed in 1796 and 1799 (Appendix III.), empowering and directing 
the officers of the General Government to conform to and assist in the execu- 
tion 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 6 
SOME REMARKS UPON SANITARY JURISPRUDENCE. 
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 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 contrary, they are treated as quarantine health laws, are so 
denominated in the Acts of Congress, and are considered as flowing from the 
acknowledged power of a State to provide for the health of its citizens. But 
it was apparent that some of its 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 several States bear to each other, has directed its officers to aid in the exe- 
cution of these laws, and has, in some measure, adapted its own 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.” 
Justice Grier gives the following opinion as a definition of the police 
power of the States : “ It. may safely be affirmed that every law for the 
restraint and punishment, of crime, for the preservation of the public health, 
peace, and morals, must come within this category. . . . The exigencies of 
the social compact require that such laws be executed before and above all 
others. ... It is for this reason that quarantine laws, which protect the 
public health, compel mere commercial regulations to submit to their control. 
They restrain the liberty of the passengers, they operate on the ship, which is 
an instrument of commerce, and its officers and crew, the agents of naviga- 
tion. They seize the infected cargo, and cast it overboard. The soldiers and 
sailors, though in the services of the government, are arrested and imprisoned 
and punished for offences against society. Paupers and convicts are refused 
admission into the country. All these things are done, not from any power 
which the States assume to regulate commerce, or to interefere with the 
regulations of Congress, but because police laws for the preservation of 
health, prevention of crime, and the protection of the public welfare, must 
of necessity have full and free operation, according to the exigency which 
requires their interference.” 
It appears evident from these rulings applied to quarantine and health laws, 
that each State has a reserved right to legislate upon such matters within 
its territorial jurisdiction, and no farther, — this I have chosen to term intra- 
state quarantine. It is also evident that interstate quarantine, between and 
among the States, belonging to no State in particular, is within the competent 
jurisdiction of the General Cxovernment, and also that Congress has the power 
of assuming the control and conduct of the entire subject in all its relations, 
for national purposes, whenever in its judgment such conduct and control is 
necessary. SOME REMARKS UPON SANITARY JURISPRUDENCE. 
7 
It is a well-established fact that certain articles of commerce, of traffic, are 
the carriers of disease-poisons, if not entering themselves as prime factors in 
their causation under certain conditions; and it is known also that even the 
means used for carriage or transportation, — ships, cars, etc., — independent 
of their contained freights and the act of carriage, are more or less suspected, 
according to the evidence existing at the time, to be the source of such disease- 
movements. Now, the Act of June 2, 1879, aims to attain exemption from 
portable disease-poisons being so carried, by securing the best sanitary condi- 
tion of vessel, cargo, passengers, and crew. How are these disease-poisons, 
and diseases introduced ? By the intercourse of persons and the carriage of 
things. The diseases specially noted by the National Board of Health, for the 
purpose of the Act, as being introduced, are yellow fever, small-pox, cholera, 
and plague. 
Whatever may be stated as the characteristics of the yellow-fever poison, it 
is known as a practical fact, needing no demonstration here, that it is carried 
by ships, perhaps, as some assert, originating in them under certain condi- 
tions ; and it is also known to attach itself to many articles that can be and 
are carried from place to place, notably, to cite a very frequent instance, ia 
woollen goods, such as clothing, blankets, etc. So far as to things as the 
carriers of pestilential disease-poison. Now, as to persons. There is no 
hazard of contradiction from any student of the history of medicine, still less 
from any student of preventive medicine, when his attention is directed to 
the fact, that the crowding together of fever-patients gives rise to what was 
known to the early medical writers of this century as an “ idio-miasm,” an 
animal poison, reproducing its like in persons previously unaffected coming 
within the range of its influence. To discuss this matter in 'all its relations 
would lead me into the subject of hopitalism, — in fact into the consideration 
of the causation of all the ochletic diseases. It certainly does not become 
me here to apply the like reasoning to variola, typhus, or the plague, or, with 
immaterial modifications, to cholera. The names being changed, the applica- 
tion is the same. Upon these correctly received ideas, and the known fact of 
the portability of the unknown factors in the production of disease-move- 
ment, is, as I have hinted, the present legislation based. In accepting Justice 
Story’s definitions, I trust to be permitted to state, from a sanitary stand-point, 
that this legislation is a regulation of commerce, and also an act of national 
sanitary police, and to that extent removed from State interference. 
Sect. 4794 of the Revised Statutes reads, “That there shall be purchased or 
erected, under the orders of the President, suitable warehouses, with wharves 
and enclosures, where merchandise may be unladened and deposited from any 
vessel which shall be subject to a quarantine, or other restraint pursuant to 
the health laws of any State, at such convenient places therein as the safety 
of the public revenue and the observance of such health laws may require.” 
It will be observed that merchandise under these circumstances is under 
United States laws, and that such merchandise may be carried anywhere in 
the Union from such warehouse; and it is the opinion of the writer that it is 8 
SOME REMARKS UPON SANITARY JURISPRUDENCE. 
not even an extension of the power of the General Government to control the 
whole matter under such circumstances. 
Granting as an unquestioned fact that the State laws and regulations are 
those of police and wholly internal, the difficulty has been and still will be to 
keep such transportable disease-poisons within the limits of the State lines and 
under State regulations. The Hon. Erastus Brooks, at the last session of this 
Association, stated that which must be received as a sanitary axiom : “ Epi- 
demics are public enemies.” The disease-poisons producing epidemics are 
spread by commercial intercourse, traffic, and other means. Being a public 
enemy, the whole matter, so it occurs to me, should be relegated to the 
national authorities, so as to provide for that other enumerated duty of the 
General Government, “ to provide for the common defence.” 
But an epidemic cannot be handled like a bale of goods, or other packages 
of merchandise. As common enemies they have often broken the centre, and 
outflanked strict military sanitary cordons, and won deadly victories, because 
we do not as yet have the arms of precision wherewith to combat them. 
Nevertheless I believe that some day, with improved armaments, sanitarians 
will be able to conquer a lasting peace. 
There is no question, that, if, say, yellow fever could be confined to one 
State, the unanimous and cordial assent of every other State in the Union 
would be given to that State to keep it there and enforce its internal police laws 
to the utmost. The moment, however, that the epidemic arrives by commer- 
cial avenues at the borders of another State, and commerce between the States 
commences at that moment, the supreme law of the land should and does 
stand ready to interpose whatever of efficiency can be wielded to protect the 
public health. In the third section of the Act of June 2, 1879, occurs these 
words : “ To prevent the introduction of contagious or infectious diseases into 
the United States from foreign countries, and into one State from another.” 
To put in force such measures as the various States may have ordered by 
appropriate legislation to the end of preventing the introduction of said 
diseases, there must be, — 
First, A knowledge that such diseases are in existence in another State. 
Second, That this knowledge should be communicated between like respon- 
sible authorities. The methods of communicating such information to such 
authorities in the different States is a matter of minor detail. 
To obtain the first, it is deemed essential that local health boards should be 
constituted in the various municipalities. The knowledge received by such 
boards should be collected, received, formulated, and published by a State 
board as the central bureau for the common information of all, as well as a 
means of facilitating the administration of the health laws of the State. In 
the United States, by a parity of reasoning, the National Board of Health 
should remain permanently established, in order that the information collected 
By the State boards may be utilized for the common weal, and because, in 
entering upon the broader field of international sanitary jurisprudence, a 
recognized central health bureau under the General Government is a primary SOME REMARKS UPON SANITARY JURISPRUDENCE. 
9 
essential, without which we are cut off from the means of obtaining from 
other governments official and trustworthy information as to all matters con- 
cerning the public health of their territories. It is thus seen that there is 
proposed a wider sphere of action for the National Board of Health, and also 
a desire to bring the Board into closer relations with State and analogous for- 
eign boards, in order that the interest and object we all, I trust, sincerely have 
at heart, — public health, — may be advanced. 
My adherence is given to a central superintending board with more powers 
than are now delegated to the National Board of Health. How far super- 
vision and administration for both should, in the opinion of the writer, be 
united in one body, is a question which demands long and thoughtful con- 
sideration. He is also of the opinion that the States should co-operate with the 
National Board of Health, by means of such instruments as State boards of 
health or like State organizations, in all the duties and responsibilities which 
appertain to such boards, and that the National Board of Health should co- 
operate with the duties of State boards, and be able, by statutory provision, to 
secure promptly trustworthy and accurate detailed information upon all mat- 
ters concerning the public health in a State. A great many of these matters, 
it has been suggested, have been proposed by Bentham for the consideration 
of his health minister.1 
That scheme, as many of you are aware, especially those who have been 
interested in sanitary jurisprudence, grouped preventive and curative medicine 
in all their details, and proposed codes for their administration : it also proposed 
to extend these duties to the care of all subjects which are now grouped under 
the comprehensive term of social statics. The very extent of the duties would 
have demanded Argus eyes with Briarean hands for their accomplishment. 
But, to secure all this, appropriate legislation is necessary; and such legisla- 
tion needs the careful and profound consideration of jurists. As sanitarians 
we exhibit the object to be secured: the legal profession must in turn show us 
the ways and means. 
I may remark here that it seems more than useless to depend on voluntary 
information from either States or nations as to the conditions of the public 
health in their respective territories. What are now but voluntary contribu- 
tions to such information in the United States should be made mandatory in 
character. My experience and observation suggest no other means. I also 
beg to state, that not for a single moment is undervalued the cordial and zeal- 
ous manner in which the contributions of hundreds of observers have been 
made; but I am compelled to remark, that to secure even matter enough to 
have a fractional idea of disease and death movement in the United States has 
been a labor of combating, frequently, assumptions presented as facts, and of 
pretences rather than knowledge. The means of securing prompt and trust- 
worthy information of the existence of contagious or infectious diseases, and 
its rapid publication between nations, however, is a subject of treaty. No 
State or municipality can officially deal with a foreign state in such matters; 
1 See Richardson’s (B. W.) Ministry of Health passim. SOME REMARKS UPON SANITARY JURISPRUDENCE. 
for foreign states recognize in all their relations only the sovereignty of the 
United States. Art. I., sect, io, of the Constitution states, “No State shall 
enter into any treaty, alliance, or confederation.” Art. II., sect. 2, delegates 
the treaty-making power to the executive, “ by and with the advice and con- 
sent of the Senate.” States therefore are powerless under the Constitution to 
furnish the necessary official information to foreign governments ; and, even in 
the matter of interstate comity upon these subjects, a central, national, organ- 
ized body, as has been stated, to which all alike could apply for authentic 
information, is an essential in the interests of public health. An instance may 
bring this point out clearly. During the present year the government of Spain 
declared quarantine against the port of Philadelphia on account of cholera. 
The government of Sweden and Norway instructed its pilots to have a watch- 
ful care over vessels coming from Philadelphia with sick on board, on account 
of cholera. This information was communicated to the National Board of 
Health by the Department of State, and the health authorities of Philadelphia 
were promptly notified. In the official reply to this notification the health 
authorities of Philadelphia, under the seal of their office, declared that not a 
case of cholera had occurred in that city for a year. This information was 
communicated to the State Department for its use and guidance. 
A useless quarantine had been established against the commerce of the 
second largest city in the Union, that had not the shadow of fact for its base, 
only rumor alone. I am perfectly safe in stating, that at the time of the pro- 
mulgation of the quarantine against Philadelphia on account of cholera, for 
six months previous, and until the present writing, not a case of cholera had 
been reported as existing anywhere in the United States. 
Had the question of the existence of cholera been addressed by the respec- 
tive governments interested to the National Board of Health, and had the 
Board the legal right to obtain the necessary official information, a useless and 
perhaps burdensome restriction upon the commerce of that city might have 
been entirely prevented. As it was, the information given was an act of cour- 
tesy, not a matter of right; and the subject is presented to the consideration 
and judgment of any interested as to what mischief might have occurred, had 
such rumor gone to the full extent of affecting the whole commercial interests 
of the United States. The like action may take place in the future towards any 
port in the United States ; and the outcry will be more or less loud, according 
to the size of the port, and the extent to which its commercial interests are 
interfered with or affected. I offer all I have stated as part of my plea for 
the permanency of the National Board of Health, not proposing any plan ,for 
or change in its organization, but to call attention to what will become a more 
or less prominent function of the Board in its relations with the States and 
with foreign health authorities. I have also to offer my convictions regarding 
:the functions of the National Board of Health. In its full action it would 
simplify the modes of administration of health and quarantine laws; it would 
secure their efficiency by prompt action; it would remove some of the cause 
of commercial jealousy between ports; it would secure a better sanitary condi- SOME REMARKS UPON SANITARY JURISPRUDENCE. 
11 
tion of ships, cargoes, passengers, and crews than now obtains; it would afford 
to the numerous local health boards accurate and trustworthy information, in 
so far as that is attainable by official routine, as to the sanitary conditions of 
places, etc.; in cases of dissension between health boards, it would be made 
the umpire, as it would be removed from local or partisan bias; it would secure 
a uniformity in the collection of vital statistics, and so determine, in so far as 
it is possible, those laws governing the living man in his social relations, the 
which laws are now unknown and conjectural. It would encourage and foster 
those important elements in general sanitation, sanitary surveys, both geologi- 
cal and topographical, of localities; the water-supplies of cities and towns, as 
well as their drainage; the hygiene of industrial pursuits; the preparation and 
care of food-supplies; the construction, ventilation, lighting, and warming 
of public buildings; the removal of excreta, garbage, etc.; the utilization or 
other disposal of sewage, etc. It would relieve in many instances the burden- 
some and annoying restrictions imposed by local quarantines upon commerce 
by giving facts, rather than suspicions, upon which a health officer should base 
a sound, practical judgment. It would teach to those who would learn, that 
quarantine does not mean detention for forty days, but does mean the vigor- 
ous application and action of sanitary laws. It would aid the practising phy- 
sician by giving him due and timely notice of the locality, existence, rise, 
prevalence, and decline of pestilential diseases, and discover, perhaps, the laws 
of the modes of their transmission. It would stimulate places likely to be 
attacked by such diseases to inaugurate such measures of prevention conso- 
nant with the scientific knowledge of the time as would render such places 
less liable to become affected, if not preventing entirely such attack, and so, in 
a greater or less degree, avert danger, disarm panic, reduce the chances of 
sickness and death, and in the like many instances fulfil its great object, — 
guarding the public health. 
It is believed that the National Board of Health is but an evidence of the 
slow but inexorable operation of the law of evolution as it applies to sanitary 
science; and, whilst fully agreeing with Spencer as to the possibilities of a 
coming sanitary millennium far in the future, it is not considered wise or pru- 
dent to neglect the proper means to that end by either supineness of thought or 
act. The facts are all patent enough, the conditions and relations of the facts, 
perhaps, also; and it is the sublimity of foolishness to fold one’s hands with- 
out an endeavor to put out the fire that is consuming the house rapidly, be- 
cause one possesses the knowledge that a much slower process of oxidation 
will destroy the building in time. The writer has endeavored to present this 
view of the subject simply as one who is interested in sanitary science, and not 
from any politico-economical views he may entertain, provided he has any, 
and desires to reiterate his honest conviction that centralization of the means 
to accomplish all that is desirable, and considering also in such centralization 
the eminent utilitarian results, in matters affecting the public health, can best 
be accomplished by the National Board of Health as now organized, with, 
however, enlarged jurisdiction. Such a “ consummation is devoutly to be 12 
SOME REMARKS UPON SANITARY JURISPRUDENCE. 
wished for; ” and he believes, that, in the future advance of sanitary science in 
this country, such will be the outcome. The opinion of the Hon. D. B. Eaton 
is of practical value in this connection. Mr. Eaton considers, that, if the 
nation can make the minute inquiry required by the census, can collect and 
publish the weather-signs, obtain information concerning the extent and value 
of the crops, exercise jurisdiction over every package of merchandise, and 
over every vessel in navigable waters, tax for educational purposes, and seize 
private property for public benefit, “ how can it be denied that it is the 
right and duty of the General Government to bring the diverse elements of 
sanitary jurisdiction, «as far as practicable, under one efficient Board, which 
shall act in harmony with the health boards of the several States? ” 
It is the opinion of the writer that the whole matter of quarantine is within 
the competent jurisdiction of Congress; and this opinion is based upon 
judicial decisions. 
It has been decided, — 
That the power of Congress to regiilate commerce with foreign nations, or 
between the several States, is exclusive.1 
That to regulate implies full power over the thing to be regulated.2 
That it may regulate ships and vessels so far as they are engaged in the carry- 
ing-trade.3 
That it includes every subject of commerce to which legal discretion may 
apply; and to regulate the whole subject as much by what it leaves out, with- 
out any positive regulation, as by what it expressly provides for.4 
That it is for Congress to determine when its full power shall be brought 
into action, and as to the regulations and sanctions which shall be provided.5 
That the power may be exercised wherever the subject exists; and this may 
be within the territorial jurisdiction of the several States, and, when exercised, 
is exclusive of the same power in the several States.6 
That the power to regulate comprehends the control for that purpose, to the 
extent necessary, of all the navigable waters of the United States accessible 
from a State other than those in which they lie; to the control of all navigable 
waters extending to the seacoast, and does not stop at the State boundary.7 
That in the concurrent powers of the National and State Governments, whilst 
the States are not absolutely prohibited from legislation as to regulating com- 
merce, they may do so while the power of Congress lies dormant. Amongst 
1 Gibbons v. Ogden, 9 Wheat. 1. Brown v. Maryland, 12 Wheat. 412. Martins. Wad- 
dell, 16 Peters, 367. Allen v. Newberry, 21 How. 246. Passenger cases, 7 How. 282. 
2 State Freight Tax, 15 Wall. 279. 
3 The Martha Washington, 3 Wall. 249. 
4 Dred Scott v. Sandford, 19 How. 622. The Chusan, 2 Story, 466. Gibbons v. Ogden, 
9 Wheat. 1. Holmes v. Jennison, 14 Peters, 450. 
5 New York v. Miln, 11 Peters, 102. U. S. v. Combs, 12 Peters, 72. 
6 Gibbons v. Ogden, 9 Wheat. 1. U. S. v. New Bedford Bridge, 1 Wood and M. 486. 
U. S. v. Duluth, 1 Dill. 172. Cooley v. Port Wardens, 12 How. 299. 
7 Gilman v. Philada, 3 Wall 713. Gibbons v. Ogden, 9 Wheat. X. The Daniel Ball, 
10 Wall. 564. The Genessee Chief, 12 How. 443. The James Morrison, Newb. 248. SOME REMARKS UPON SANITARY JURISPRUDENCE. 
the concurrent powers of Congress and the States, quarantine is enumerated: 
and it has been decided, that, where Congress does not act, the States may 
legislate on local and appropriate matters, though they may be connected with 
commerce ; but, in case of the action of Congress, the State laws must yield.1 
Such are the facts upon which the writer bases his opinion that both quaran- 
tine, and all regulations flowing from it concerning the public health, so far as 
the States are concerned, are within the competent jurisdiction of the Con- 
gress. 
Pertinent to this whole matter, it is desired that observant and thoughtful 
attention be given to the remarks of my colleague, the President of the 
National Board of Health, Professor James L. Cabell, as presented to the 
American Medical Association in a paper read at its meeting in Richmond, 
May, 1881, entitled, “The National Board of Health and the International 
Sanitary Conference.” 
The American Public Health Association, at its meeting in Richmond, 
adopted the following resolution : — 
“ That it is the duty of the General Government to invite foreign nations 
to co-operate with it in the establishment of uniform and effective quarantine 
regulations.” 
The result of this resolution was the passage of a joint resolution of Con- 
gress, approved May 14, 1880 (Appendix IV.), authorizing the President of 
the United States to call an International Sanitary Conference to meet at 
Washington, D.C., to which the several powers having jurisdiction of ports 
likely to be infected with yellow fever or cholera should be invited to send 
delegates, properly authorized, for the purpose of securing an international 
system of notification as to the actual sanitary condition of ports and places 
under the jurisdiction of such powers, and of vessels sailing therefrom. It 
will be observed that the resolution of the Association was directed to the 
establishment of uniform and effective quarantine regulations; and that the 
joint resolution of Congress, whilst actually specifying ports likely to be in- 
fected with yellow fever and cholera, extended the research far beyond the 
quarantines of such places to the extent of determining the actual sa7iitary 
condition of ports and places, and vessels sailing therefrom, and also a system 
of international notification of these conditions. This conference met in 
Washington, D.C., in the Hall of the Department of State, Jan. 5, 1881 ; ad- 
journed sine die, March 1, 1881 ; and the various protocols of its proceedings 
were presented to the Senate, Oct. 12, 1881, and are now in the course of 
publication. 
At this conference twenty-seven governments were represented, for the most 
part by their already accredited diplomatic officers to the United States. Ger- 
many, Austria, Hungary, Belgium, Spain, Great Britain, Mexico, the Nether- 
lands, Portugal, and the United States of Colombia were in part represented 
1 License cases, 5 How. 583. The George S. Wright, Deady, 596. Hobard v. Dorgan, 
10 Peters, 121. The John Fraser, 21 How. 184. The America, How. 177. Brown v. 
Maryland, 12 How. 419. Lincoln v. the Volusia, 4 Pa. L. I. 65. The Panama, Deady, 32. 14 
SOME REMARKS UPON SANITARY JURISPRUDENCE. 
by special delegates, many of them being medical men of high official posi- 
tion in their own countries. 
The delegates from the United States presented to the conference an in- 
formal paper based upon both the letter and spirit of the joint resolution of 
Congress. This paper had reference to such international concessions as were 
considered necessary to enable the consular agents of the several powers to 
obtain and transmit to their respective governments trustworthy information as 
to the sanitary condition of ports of departure, and also of the vessels about 
to clear from such ports for their respective countries, each government reserv- 
ing to itself the application of its own quarantines. This paper was referred 
by the conference to a committee composed of all the special delegates pres- 
ent, with several of the diplomatic delegates who had previously given atten- 
tion to such matters. The committee adopted the preamble and several of 
the propositions noted in the paper presented by the delegates of the United 
States, but prefaced the matter by two fundamental articles. These articles 
were, — 
I. That it be recommended to the conference that it be admitted as an 
international principle of sanitation that it is highly desirable to adopt an 
international system of notification concerning sanitary matters and the ap- 
pearance and disappearance of contagious and infectious diseases. 
II. That it is the opinion of this committee that it must be’highly advan- 
tageous to permit certain sanitary inspections to be made by foreign agents in 
ports of various nations, subject to such rules as are necessary for the safe- 
guard of each country’s sovereignty and of each country’s commercial inter- 
ests. 
The special propositions following indicated the methods by which these 
principles could be rendered effective; but the committee were disinclined to 
accede to the proposition of the United States delegates that the consuls 
should have the right to make the sanitary inspections, considering the duty as 
technical in character, belonging especially to medicine, and therefore to be 
made by medical men attached to the consulates. 
Whilst fully admitting the fact that the duty, being technical in character, 
should be delegated to an officer skilled in sanitary science, the delegates of 
the United States objected to the methods on the score of its expense, and the 
institution of a corps of officials, grave ones in a country that coins the phrase 
“the almighty dollar,” and where office-seeking is an avocation as well as a 
recognized cause of mental unsoundness. Consuls were selected because 
they are the accredited representatives of the government at the port of de- 
parture, that their official status would secure trustworthy information, that due 
credence pertains to their official acts, and because the issue of the certifi- 
cates of such inspection, and the other sanitary information, — that is, a bill of 
health, — is legally one of a ship’s papers.1 The idea that a consul should be 
limited to his personal views upon the matters presented for his consideration 
1 See Marshall on Insurance. Jacobsen’s Sea Laws. That a bill of health is essentially 
a necessary paper, see Appendix V. SOME REMARKS UPON SANITARY JURISPRUDENCE. 
15 
in the sanitary history of the vessel, cargo, passengers, and crew, or as to the 
sanitary condition of the port of departure, is not to be entertained for a 
moment: it is far more likely, that, even to form an opinion worthy the name, 
he will be compelled to resort to the technical knowledge and experience of a 
physician. 
After the committee had submitted its report to the conference, two difficul- 
ties were presented which very much impeded the road to a ready and prompt 
acceptance to that report. The first was the decided opposition manifested 
by the diplomatic members of the conference to the fundamental proposition 
that it is desirable to permit sanitary inspections to be made by foreign agents 
in the ports of the various nations of all vessels taking their departure from 
such port to the port of entry represented by a foreign agent. This proposition 
— a concession on the part of the delegates of the United States — is deemed 
essential to the attainment of the ends submitted by the United States in call- 
ing together this conference. The second difficulty was the proposed estab- 
lishment of cumbrous systems of international sanitary bureaus. It is proposed 
here to consider the first-mentioned objection, having expressed my views as 
to the second in the first part of this paper. How well or ill the duty assigned 
to the delegates of the United States has been performed, it does not become 
me to speak; but from my own stand-point is submitted some of the results 
attained in which we are all more or less particularly interested, and because it 
has been didactically stated, before the International Medical Congress, that 
the conclusions of the conference are not satisfactory, and will give no practi- 
cal result. It must be stated here, that, before the closing of this conference, all 
the decisions upon the questions presented, as well as the final act, were ex- 
pressly stated to be held “ ad referendum ; ” in other words, that the matters 
so presented must be referred to the home governments. The meeting was 
simply a conference, not a convention, with plenary powers ; and the expres- 
sions of opinion, therefore, have more or less of personal character, and are 
not to be taken as the expressed views of the powers represented. A conven- 
tion with plenary powers, so that a treaty could be made, is, in the opinion of 
the writer, now a necessity; for he feels assured that a further consideration 
of the subjects presented by the United States delegates would be followed by 
concessions of importance to sanitary science, and more particularly to the 
interests of public health. 
The opposition of the diplomatic members of the conference, as has been 
stated by my colleague in the conference, Professor James L. Cabell, to the 
principle of permitting sanitary inspections by agents of foreign powers, was 
persistent and unyielding. In the final act of the conference, this principle is 
admitted under certain restrictions. It will be observed that the right of 
visitation and search is in a measure involved in the word “inspection.” The 
terms “visitation,” “ search,” “ approach,” “ examination,” appear, in the legal 
text-books consulted, to be used as synonymous. In the Act of June 2, 1879, 
the word “inspection ” can be understood in no other sense. 
Now, according to jurists, the right of search and visitation is a belligerent 16 
SOME REMARKS UPON SANITARY JURISPRUDENCE. 
right, exercised only on the high seas, by public armed vessels of the belliger- 
ents, upon vessels flying neutral flags; it ceases with the termination of hostil- 
ities between the belligerents ; is allowed by the general consent of nations ; is 
limited by the time of war; is essential to the right of determining and captur- 
ing an enemy’s property, contraband of war, and vessels committing a breach 
of blockade; is for determining the nationality and regularity of the ship’s 
papers, etc. A ship’s papers are defined to be in law, “The documents 
expected to be found on a neutral ship, and are,1 the register, the passport, 
or sea-letter, the muster-roll, the charter-party, the bills of lading, the invoice, 
the log-book, and the bill of health." 2 
How jealously this right is guarded, and to what extent it pertains, may be 
understood from the following opinions of jurists who have given attention to 
the matter: and it will be observed, that, from these opinions, the fact that a 
qualified right of search, or inspection, may be deduced; and, upon such de- 
duction, a sanitary right of search, as I have termed it, can be based. 
Judge Story, in commenting upon the right of search and visitation, says, 
“ Mere visit does not give the necessary information. The moment you ask 
to examine the papers, or ask a single question, it is a search.” 
Masse (Droit Commercial Liv. 2, Tit. 1, chap. 2, sect. 2) says, “that, what- 
ever may be the object of the visit in time of peace, it is always an act of police, 
which cannot be exercised by one nation towards another, because it implies, 
on the part of the visitor, a sovereignty, incompatible with the reciprocal 
independence of nations. Furthermore, two nations cannot advantageously 
grant one another, by special conventions, the reciprocal right of visit in peace. 
The appreciation of the utility of conventions of this nature is undoubtedly a 
political question. But it is certain, that, as such conventions imply an aban- 
donment of the sovereignty, which is, in its very essence, inalienable, and inca- 
pable of being parted with, the two nations which have mutually given up their 
rights can only have made a temporary abandonment of them, which no lapse 
of time can render definitive.” 
Part of Masse’s opinion is true. In this instance the visitation certainly is 
an act of sanitary police; but the statement, that on the part of the visitor it 
implies a sovereignty over the visited, or that the visited have surrendered 
1 See Marshall on Insurance, Book i., chap. 9, sect. 6, Burrill’s Law Dictionary, etc. 
2 “ Bills of health,” “ passports of health,” “ letters of health,” etc., are said to have 
been first used in 1527, during a fatal plague in Italy. In 1596 a Turkish company in 
Aleppo established a like practice. In 1636 a bill of health was made obligatory in Eng- 
land, but they did not come into general use until 1665. The earliest quarantine was 
against the Black Death, and was instituted by the Viscount Bernabo of Reggio, Jan. 17, 
1374. Goods were confiscated, and the admission to the city of persons from infected places 
was forbidden under pain of death. The first lazaretto was established about 1403. The 
first council of health, or board of health, the “ Sopra la Sanita,” was founded in Venice in 
1485, and was composed of three nobles. In 1585 they were empowered to impose im- 
provement, and to sentence to death any infraction of their rules and regulations; and from 
their decisions there was no appeal. The captain of every ship was obliged to show at 
their lazarettos a bill of health. This bill of health was written and issued by the consuls 
of the different commercial nations. SOME REMARKS UPON SANITARY JURISPRUDENCE. 
17 
sovereignty upon such visit, cannot be defended upon logical grounds, nor 
also that it is incompatible with the reciprocal independence of nations. Nor 
does the writer see that nations cannot advantageously grant one another, by 
special conventions, agreements, or treaty, the reciprocal right of sanitary visita- 
tion and search inuring to the common weal of both; nor is it seen, from a 
sanitary point of view, that such conventions imply an abandonment of any 
sovereignty whatever. The position that two or more nations cannot grant by 
treaty the right of visitation in time of peace, is, to use the words of an emi- 
nent jurist, “ simply absurd.” 
Lords Aberdeen and Palmerston assert that the right of visitation and 
search cannot exist in time of peace, independent of treaty; and this asser- 
tion, says Lawrence, is established as well by institutional writers as by the 
practice of nations. 
I have now to offer my views upon what has been already termed “ the 
right of sanitary visitation and search.” 
This right is a peaceful right, to be exercised within the territorial jurisdic- 
tion of the contracting parties; to be exercised by civil officers at the port 
of entry to which the vessel is bound, irrespective of the nationality of the 
vessel; is to exist, if called into existence, at the will of the consenting parties ; 
is an essential to the public-health interests of the agreeing parties; is for the 
purpose of determining exclusively the sanitary condition of the vessel, cargo, 
passengers, and crew, that they are not severally and collectively contraband 
of public health; is in the interests of peace, humanity, civilization, and com- 
merce ; and is to be regulated by treaty. 
The terms “ contraband of public health ” have been used. The word has 
its derivation from “ contra,” “bannum,”— under the ban, against public 
proclamation, prohibited. It is suggested for consideration the propriety 
of declaring by legal proclamation certain articles as are known to be more 
or less the carriers of disease-poisons shipped from infected ports as contra- 
band of public health, under certain circumstances affecting the health of the 
port. To what extent this should be carried, both as to time and place, the 
writer is not now prepared to say. The government of Portugal has taken a 
step in that direction by prohibiting the introduction of certain articles from 
infected ports. In New Orleans in 1881 a committee of the medical and 
sanitary associations divided commercial articles for such purposes into three 
classes. The report of the committee on quarantine regulations made to the 
Fourth National Sanitary Convention, i860, also divided all merchandise for 
quarantine purposes into three classes. The law of Denmark in regard to 
the introduction of infectious diseases makes provision for a proclamation 
forbidding the importation of certain articles arriving at the ports of the king- 
dom from infected or suspected places. 
Austria-Hungary, Turkey, Russia, England, Germany, Italy, and the regency 
of Tunis classify merchandise for quarantine purposes; and in Spain certain 
articles of merchandise are “ suspected ” in vessels arriving with “ foul ” bills 
of health. The further consideration of this question becomes a matter of 
detail. 18 
SOME REMARKS UPON SANITARY JURISPRUDENCE. 
The writer is of course cognizant of all the differences between the right 
of search and its exercise as defined by writers upon international law and the 
proposed sanitary right of search. The differences, he submits, are well 
defined; but there is no controverting the fact that it is a search, and he 
admits it in its entirety. What restrictions should be made to secure its 
practical efficiency, and prevent any abuse of the proposed right, is a question 
which he is not competent to discuss, as it passes from the domain of inter- 
national jurisprudence to the complexities of local legislation. It certainly 
appears to him that it is within the scope of the enlightened jurists of the day 
to determine the mode of overcoming the difficulties, and to reduce to har- 
monious action the various rulings. That which may in the outset be consid- 
ered in such matters as a courtesy between nations, becomes, in the lapse of 
time, custom; and custom makes law. 
It is not desired, nor is it deemed advisable, that an inquisitorial search 
should be made : the search and visit are to be made in the interests of the 
public health of all concerned, by mutual consent, and the sovereignty of the 
vessel jealously respected under all the circumstances. I know the delicate 
nature of the ground upon which I tread, and in these matters would incul- 
cate no sentimental affability, but a manly recognition of doing unto others 
as we would have them do unto us. It is, however, an acknowledged axiom 
of universal law, that every party, while exercising his own rights, must take 
care not to violate the rights of others. “ Sic utere tuo, ut non alienum 
laedas.” 
Furthermore, Woolsey states that “'it is admitted by all, that within the 
waters which may be called the territory of nations, as within a marine league, 
or in creeks and bays, the vessels of a friendly state may be boarded and 
searched on suspicion of being engaged in unlawful commerce, or of violating 
the laws concerning revenue,” and also observes “ that this kind of right of 
search is an accident of sovereignty in a state of peace, but is confined, in its 
exercise, to a small range of the sea.” 
Of like character, it must be conceded, is the right of visitation and exam- 
ination made by quarantine and health officers. Now, it is only proposed to 
subject this same right of sanitary search, as executed by the quarantine offi- 
cers at the ports of entry, to the consuls of the agreeing powers at the ports of 
departure, and under such restrictions that no offence occurs to the sovereignty 
of said port of departure. There are no inherent difficulties in the matter, 
none certainly which a civilized jurisprudence cannot readily set aside. Mutual 
respect and forbearance should characterize this sanitary search for peaceful 
and humane objects; and such forbearance and respect is placed upon the 
opposite scale to the offensive belligerent right founded upon distrust, and the 
anger engendered by a state of war. It appears to me, in the language of Mr. 
Woodbury, “that it is within the province of a sovereign nation to do-what 
is just and honorable as to the world at large, or as to the general interests 
of humanity.” 
“If,” said Lord Stowell, in his decision in the case of the French vessel, SOME REMARKS UPON SANITARY JURISPRUDENCE. 
19 
the “Louis,” in 1817, “this right of war is imported into peace by convention, 
it will be for the prudence of states to regulate in that convention the exercise 
of the rights with all the softenings of which it is capable.” 
. In considering the whole matter, it seems that the progress of the law of the 
right of search, from perhaps its earliest enunciation in the “ Consolato del 
Mare,” or the antecedent “ Rhodian laws,” and the “ Roles d’Olerdn,” to its 
present legal limitation, as well as the proposed extension of its use as a san- 
itary measure involving the protection of the health interests of nations, 
emerges from the slow but steady advances in civilization. 
Most of the argument, the writer admits, is in behalf of the sanitary inspec- 
tion of vessels, cargoes, passengers, and crews; and he trusts to be excused for 
any earnestness in presenting it, as he believes it to be the primary object of 
sanitary interest, in order to prevent the introduction from foreign ports of 
contagious and infectious diseases. The knowledge of the condition of a 
port from which a vessel sails, is, however, of secondary importance, but is not 
at all to be undervalued. 
Diseases may be introduced, (1) By foul vessels with stagnant and putrid 
bilge-water, and the drippings and drainings from putrescible cargoes ; (2) By 
cargoes of rags, woollens, and the like animal and vegetable articles (porous in 
character) from ports where contagious and infectious diseases existed whilst 
the vessel was being laden ; (3) By filthy bedding, baggage, and clothing of 
emigrants in overcrowded vessels; (4) By the poisoned air in the hold; (5) 
By diseased passengers being crowded together; (6) By diseased passengers. 
Always a vessel, — a ship the carrier of disease. Quarantine establishments 
costly in construction, costly in maintenance, vexatious and harassing to mer- 
cantile interests, have their foundations in foul ships as the carriers of disease- 
poisons. 
I am disposed, both from my own observation and experience, to accept the 
position of M. Fauvel (1871) that the nature of all quarantines is determined 
by the sanitary condition of the ship. This places the sanitary condition of 
the ship as of primary and quarantine of secondary importance in the means 
of prevention of disease and the protection of public health. Considered as 
a financial question, these establishments would be reduced to their minimum 
of expense and mercantile annoyance by attention to the exact conditions 
detailed upon the bill of health. It seems easy to have the jurist frame a law 
which will prevent this state of things, and not interfere with commerce. The 
whole point to be presented to him is, to secure a clean ship, clean cargo, clean 
passengers, clean crew, and sailing from a clean port. It is so simple, so plain, 
that it appears to me it could all be accomplished by the simplest code of 
Naval Hygiene, — save the clean port, which, of course, is in the domain of 
municipal sanitation. Were proper officers appointed at every port, with 
power to examine into the condition of all vessels sailing thence in respect to 
construction, dryness, and ventilation, the health and number of the crew, the 
condition and accommodation of passengers, the sufficiency of the food and 
water, and the general cleanliness of the vessel itself, and of the persons, cloth- 20 
SOME REMARKS UPON SANITARY JURISPRUDENCE. 
ing, and bedding of her entire company, and to allow no vessel to sail that 
in all these matters falls below the proper hygienic standard; and were the 
officers of all vessels enjoined under severe penalties to see to their cleanli- 
ness, dryness, and ventilation during the entire voyage, as well as to the car- 
rying into effect of these measures necessary to insure the health of all on 
board, — much would be done to prevent the occurrence of disease, before or 
after the arrival of a vessel, either among its own company, or, through it, 
among the people of the port, to which its cargo, crew, and passengers are 
landed. 
Associated with the bill of health should be the “ log-book,” another of the 
ship’s papers. 
The log of American vessels, if kept according to the Revised Statutes, sect. 
4290 (see Appendix VII.), will give in a measure the condition of the passen- 
gers and crew during the voyage so far as recording the occurrence and cause 
of a death or the outbreak of disease. It is suggested, that at all times the 
precautions taken to secure cleanliness, ventilation, dryness, and other sanitary 
measures as tend to the preservation and promotion of health of the passen- 
gers and crew, should be noted in the log. 
The 17th section of the Passenger Act of 1855 (Appendix VIII.) provides 
for a report to the Secretary of the Treasury by the collector of the port of as 
much as could be expected regarding the sanitary condition of the vessel, 
passengers, and crew during the voyage. 
Sect. 9 of the proposed Passenger Act of 1881 (Appendix IX.), presented 
by the Hon. P. V. Deuster, M.C., of Wisconsin, to Congress, proposes a much 
more detailed sanitary history of the vessel, passengers, and crew, to be de- 
livered to the officer of customs who first comes on board, and enforces the 
provisions of the section by penalty. 
With these papers the boarding officer at any port would be enabled to 
determine if a vessel requires the visit of the health officer of the port, if she 
should proceed to the quarantine station, or continue the course directly for 
her wharf, -dock, or anchorage. 
It was asserted at the International Medical Congress in London, Aug. 3, 
1881, that the conclusions of the International Sanitary Conference of Wash- 
ington were not satisfactory, and will give no practical result. In the enumer- 
ation of the proper basis for an international agreement, it was stated that it 
was necessary: — 
1. To secure prompt, and reliable information of the existence of certain 
diseases. 
2. To communicate to all concerned this information. 
3. The agents of the port of destination of a vessel to be permitted to 
make an inspection. 
4. As a means of communication in emergency, these agents to use the 
telegraph. 
5. That, in the event of the issue of a bill of health, it should be in the 
form proposed by the International Sanitary Conference of Washington. SOME REMARKS UPON SANITARY JURISPRUDENCE. 
21 
I have to state that the statement can hardly be based upon a knowledge 
of facts at all, and 1 beg leave to present some of the achieved results of the 
conference. 
The conference, in its Final Act, determined, — 
“ Bills of health shall be in the form hereto annexed.” (Appendix VI.) 
This form being that presented by the delegates of the United States, and 
taken from the National Board of Health form, as modified by the Board at 
one of its sessions. 
Bills of health shall be delivered at the port of departure by the responsi- 
ble sanitary agent of the central government. The consul of the country of 
destination shall have the right to be present at the examination of ships made 
by. the representative of the territorial government, under such rules as ?nay 
be laid down by international agreement or treaty, and the authority to 
authenticate the bill of health, and to add thereon such remarks as he may 
deem necessary. 
An inspection of the bill of health, as recommended by the International 
Sanitary Conference of Washington, will reveal to any thoughtful sanitarian 
the fact that all the points enumerated as the proper basis for an international 
agreement are accomplished facts, so far as the conference is concerned, and 
that once again in its history, demanded by the progress of scientific sanita- 
tion, does the bill of health resume its primary and legitimate rank as a 
sanitary document. 
To make out the bill of health, as required by the conference, information 
as to the existence of contagious and infectious disease must, ex necessitate 
rei, be secured. 
The bill of health is also the means by which said information is communi- 
cated. 
That, to issue such a bill of health, a sanitary right of search is admitted to 
the consul of the port of destination; the sanitary agents of the territory being 
present to furnish the information, and to guard against any infraction of the 
sovereignty of the vessel or port. 
It may be a question to be decided in the future, but the writer is of the 
opinion that the permission to use the telegraph in emergencies affecting the 
public health cannot be considered as “privileged communications” are 
considered. The common weal does not permit of such construction in this 
matter as a point of privilege. 
The writer is disposed to estimate the bill of health, as proposed by the 
conference, at a much higher value than it appears at first sight to have. 
The bill may not meet all the requirements of the sanitarian, but it is an enor- 
mous advance in sanitary science. Each vessel should be compelled by law 
to carry one as part of her papers; and, whilst not refusing entrance to our 
ports of any vessels without such bill properly authenticated, a fine should be 
imposed upon such as fail to produce this evidence as to the sanitary condi- 
tion of the vessel and of the port of departure. The right to impose such a 
penalty is an inherent right of the General Government; and in providing for 22 
SOME REMARKS UPON SANITARY JURISPRUDENCE. 
the common welfare of the people, both as regards health and commerce, a 
properly authenticated bill of health, as it involves an inspection of the vessel, 
its cargo, passengers, and crew, as well as its previous sanitary history, and 
access to all sources of information as to the sanitary condition of the port of 
departure, will furnish to quarantine and health officers data upon which they 
can, other things being equal, base an intelligent opinion upon the necessity 
for at least admitting a vessel to free pratique, or such detention in quarantine 
as the local law may determine. A proper bill of health is the sanitary patent 
of the vessel that she is not dangerous to the lives of the community, and is 
the ship’s safeguard in all ports against harsh restrictive quarantines; and I 
am disposed to think, that, in a reflex manner, it may have its influence in 
showing the way to improved sanitary work in otherwise foul ports. It may 
be that a vessel should be cleared without a bill of health. The refusal to 
take out the bill of health from the consulate should not be a bar to her clear- 
ance from the port of departure; but its absence from the ship’s papers upon 
her arrival within any revenue district should subject the vessel to a fine of 
$500, as well as the subjection to examination and inspection at' the port 
of entry as a suspected vessel, and liable, therefore, to be placed in quarantine. 
Such action brings the protection of the public health, so far as vessels are 
concerned, under national supervision, but does not interfere with any right 
of the States to enforce their respective quarantine laws where they do not 
affect the General Government. Perhaps at this time this is all that can be 
obtained. 
It will be observed in this connection also, that there is required “ a respon- 
sible sanitary agent of the central government.” Out of this arises the 
necessity of a National Board of Health, as the responsible sanitary agent of 
the central government. It needs no calling the attention of the Association, 
that in the United States, in many States, and in many more municipalities, 
there are no responsible sanitary agents of even the State or municipality; 
and a central bureau should be empowered to collect, formulate, and publish 
all sanitary information concerning such States and municipalities, as well as to 
do the like for those States and municipalities where health officers are recog- 
nized by law. It is demonstrated that the acceptance of the bill of health, 
as proposed by the International Sanitary Conference of Washington, carries 
with it all the requirements necessary for a proper international sanitary 
agreement. 
Viewed simply from a realistic politico-economical stand-point, I believe 
that such an international agreement would be but a step in the onward prog- 
ress of that process of assimilation now evident amongst all civilized nations, 
which has for its ultimate end a general security upon all matters affecting the 
common weal. The time is opportune for this departure : it secures in a 
degree the greatest good for the greatest number. Behind it is the sanctity 
of human life, and “ the inalienable rights to life, liberty, and the pursuit of 
happiness,” to secure which “governments were instituted amongst men.” 
Justinian wrote that “the exigencies and necessities of mankind have induced 
all nations to constitute certain rules of right.” SOME REMARKS UPON SANITARY JURISPRUDENCE. 
23 
Hobbes states “that the law of nations is the law of nature applied to 
states and nations.” 
Vattel remarks, “ If a nation is obliged to preserve itself, it is not less 
obliged to preserve all its members. The nation owes this to itself, since the 
loss, even of one of its members, weakens it, and is injurious to its own preser- 
vation.” 
Numerous other authorities have enunciated more or less distinctly these 
propositions, and it is considered that the time has arrived at which it is neces- 
sary to interpolate in the law of nations some rule applicable to the public- 
health interests of mankind. Such a rule appears to flow from the opinions 
above stated. 
The preamble presented by the committee of the International Sanitary 
Conference of Washington, that 
“ Nations have an inherent power to prevent, without any breach of their 
international obligations, the introduction into their territories of contagious 
or infectious disease,” and which was modified by the conference so as to 
read, that 
“ Nations have within the limits of international law the right to take the 
precautions they consider necessary in order to prevent the introduction into 
their territories of contagious diseases,” would have been the inauguration of 
such a rule in action. This, however, is another accomplished result of the 
International Sanitary Conference; as it distinctly enunciates that which the 
writer feels assured will in time become an axiom in the law of nations. It 
seems that such a law applied to nations is but a logical deduction from the 
rule that “ self-preservation is the first law of nature,” as well as an obligation 
imposed by nature on all. 
The rules and regulations for securing the best sanitary condition of vessels 
(including their cargoes, passengers, and crews) coming to the United States 
from any foreign port where any contagious or infectious disease exists — pre- 
pared by the National Board of Health in accordance with the provisions of 
the Act of June 2, 1879, entitled “An Act to prevent the introduction of 
infectious or contagious diseases into the United States ” — have their basis in 
the inherent right and obligation of nations to protect and preserve themselves 
from pestilence. (Appendix X.) 
As to the matter of the introduction of contagious and infectious diseases 
from adjacent foreign countries, not separated by such geographical bounda- 
ries as the seas along other highways of commerce, — such as Canada and 
Mexico in their relations to the United States, — it is simpler than at first sight 
appears; but the detail for such prevention needs separate consideration apart 
from this paper. It is suggested for the consideration of the legislators, that, 
in all future treaties with foreign powers, provision should be made for the 
protection of the public health of the contracting parties; and the access of 
consular and other like accredited officers of the governments to all sources 
of information relating to it should also be secured by stipulation. 
It will be noticed that the writer has presented the subject of national sani- 24 
SOME REMARKS UPON SANITARY JURISPRUDENCE. 
tary jurisprudence in its relations almost exclusively to quarantine, and that, in 
considering the matter of international sanitary jurisprudence, existing sources 
of information represented by the bill of health as proposed by the United 
States delegates to the International Sanitary Conference of Washington has 
been used as the basis of these remarks. He asks the lenient consideration 
of the Association for the imperfections of this reconnoissance into the domain 
of the jurisprudence of hygiene. No opinion, however, has been stated that 
is not founded on fact; nor has any deduction been advanced which he does 
not believe to be logical from the premises and in accordance with the princi- 
ples of science. In conclusion, he believes, with Ordronaux, “that the basis 
of human society lies in the recognition of the first law of nature, and that 
the protection of life, after all, must ever be the culminating point of human 
legislation.” » 
The following list of books, pamphlets, etc., have been read and consulted 
more or less in the preparation of this paper: — 
Vattel, “ Law of Nations ; ” Ward, “ Inquiry into the Foundation and His- 
tory of the Law of Nations ; ” Desty’s “ Shipping and Admiralty; ” Wheaton, 
“ History of the Law of Nations,” “Elements of International Law;” Mar- 
shall on “Insurance ;” Woolsey, “International Law;” Lawrence, “Visitation 
and Search;” Kent’s “Commentaries;” Abbot on “Shipping;” Story on 
the “ Constitution ; ” Jacobsen’s “ Sea Laws; ” Pardessus, “ Collection de Lois 
Maritimes,” “Cours de droit Commercial;” “The Black Booke of the Ad- 
miralty ; ” “Revised Statutes of the United States; ” Wharton, “Decisions of 
the Supreme Court; ” “ Howard License Cases; ” Burrill’s “ Law Dictionary;” 
Baker, “ The Laws relating to Quarantine ; ” “ Report of the Seventh Annual 
Conference of the Association for the Reform and Codification of the Law of 
Nations ; ” “The Southern Law Journal and Reporter; ” “The General Sani- 
tary Maritime Regulations of the Kingdom of Portugal; ” Proust’s “ Hygiene 
International; ” Rumsey’s “ Essays on State Medicine ; ” Beckmann’s “ His- 
tory of Inventions; ” the reports of the Quarantine and Sanitary Conventions 
(1857-60); the works of Jeremy Bentham; McCulloch’s Commercial Dic- 
tionary ; McElrath’s Commercial Dictionary; various papers upon State medi- 
cine, etc., published in the American Public Health Association reports and 
transactions of American Medical Association, as well as monographs by Drs. 
H. I. Bowditch, J. S. Billings, U.S.A., J. L. Cabell, S. E. Chaill6, A. L. Carroll, 
Edwin Chadwick, B. Dowler, E. Harris, E. McClellan, U.S.A., John Simon, 
D.C.L., the Hon. T. G. Jones, and others. 
I desire also to acknowledge the courtesy of the Hon. Samuel F. Phillips, 
Solicitor-General of the United States, for placing at my disposition for refer- 
ence the library of the Department of Justice, as well as to the Hon. A. R. 
Spofford, librarian of Congress, and Mr. T. F. Dwight, librarian of the Depart- 
ment of State, for similar favors. SOME REMARKS UPON SANITARY JURISPRUDENCE. 
25 
APPENDIX I. 
An Act to prevent the Introduction of Infectious or Contagious Dis- 
eases into the United States, and to establish a National Board of 
Health. 
Be it enacted by the Senate and House of Representatives of the United 
States of America in Congress assembled, That there shall be established a 
National Board of Health, to consist of seven members, to be appointed by 
the President, by and with the advice and consent of the Senate, not more 
than one of whom shall be appointed from any one State, whose compensa- 
tion, during the time when actually engaged in the performance of their duties 
under this Act, shall be ten dollars per diem each and reasonable expenses, 
and of one medical officer of the Army, one medical officer of the Navy, one 
medical officer of the Marine Hospital Service, and one officer from the 
Department of Justice, to be detailed by the Secretaries of the several Depart- 
ments, and the Attorney-General, respectively; and the officers so detailed 
shall receive no compensation. Said Board shall meet in Washington within 
thirty days after the passage of this Act, and in Washington or elsewhere from 
time to time upon notice from the president of the Board, who is to be chosen 
by the members thereof, or upon its own adjournments, and shall frame all 
rules and regulations authorized or required by this Act, and shall make or 
cause to be made such special examinations and investigations at any place or 
places within the United States, or at foreign ports, as they may deem best, to 
aid in the execution of this Act and the promotion of its objects. 
Sect. 2. The duties of the National Board of Health shall be, to obtain 
information upon all matters affecting the public health, to advise the several 
departments of the government, the executives of the several States, and the 
commissioners of the District of Columbia, on all questions submitted by 
them, or whenever, in the opinion of the Board, such advice may tend to the 
preservation and improvement of the public health. 
Sect. 3. That the Board of Health, with the assistance of the Academy of 
Science, which is hereby requested and directed to co-operate with them for 
that purpose, shall report to Congress at its next session a full statement of its 
transactions, together with a plan for a national public-health organization, 
which plan shall be prepared after consultation with the principal sanitary 
organizations, and the sanitarians of the several States of the United States, 
special attention being given to the subject of quarantine, both maritime and 
inland, and especially as to regulations which should be established between 
State or local systems of quarantine, and a national quarantine system. 
Sect. 4. The sum of fifty thousand dollars, or so much thereof as may be 26 
SOME REMARKS UPON SANITARY JURISPRUDENCE. 
necessary, is hereby appropriated to pay the salaries and expenses of said 
Board, and carry out the purposes of this Act. [Approved March j, i8yg. 
APPENDIX II. 
An Act to prevent the Introduction of Contagious or Infectious Dis- 
eases into the United States. 
Be it enacted by the Senate and House of Representatives of the United 
States of America in Congress assembled, That it shall be unlawful for any 
merchant ship or vessel from any foreign port where any contagious or infec- 
tious disease exists, to enter any port of the United States except in accord- 
ance with the provisions of this Act, and all rules and regulations of State 
boards of health, and all rules and regulations made in pursuance of this Act; 
and any such vessel which shall enter, or attempt to enter, a port of the 
United States in violation thereof, shall forfeit to the United States a sum, to 
be awarded in the discretion, of the court, not exceeding one thousand dollars, 
which shall be a lien upon said vessel, to be recovered by proceedings in the 
proper district court of the United States. And in all such proceedings the 
United States district attorney for such dis rict shall appear on behalf of 
the United States, and all such proceedings shall be conducted in accordance 
with the rules and laws governing cases of seizure of vessels for violation of 
the revenue laws of the United States. 
Sect. 2. All such vessels shall be required to obtain from the consul, vice- 
consul, or other consular officer of the United States at the port of departure, 
or from the medical officer, where such officer has been detailed by the Presi- 
dent for that purpose, a certificate in duplicate setting forth the sanitary 
history of said vessel, and that it has in all respects complied with the rules 
and regulations in such cases prescribed for securing the best sanitary condi- 
tion of the said vessel, its cargo,' passengers, and crew; and said consular or 
medical officer is required, before granting such certificate, to be satisfied the 
matters and things therein stated are true; and for his services in that behalf 
he shall be entitled to demand and receive such fees as shall by lawful regula- 
tion be allowed, to be accounted for as is required in other cases. 
That, upon the request of the National Board of Health, the President is 
authorized to detail a medical officer to serve in the office of the consul at 
any foreign port, for the purpose of making the inspection, and giving the 
certificates hereinbefore mentioned : provided, that the number of officers so 
detailed shall not exceed at any one time six; provided further, that any 
vessel, sailing from any such port without such certificate of said medical 
officer, entering any port of the United States, shall forfeit to the United 
States the sum of five hundred dollars, which shall be a lien on the same, to 
be recovered by proceedings in the proper district court of the United States. 
And in all such proceedings the United States district attorney for such 
district shall appear on behalf of the United States, and all such proceedings SOME REMARKS UPON SANITARY JURISPRUDENCE. 
27 
shall be conducted in accordance with the rules and laws governing cases of 
seizure of vessels for violation of the revenue laws of the United States. 
Sect. 3. That the National Board of Health shall co-operate with, and, so 
far as it lawfully may, aid, State and municipal boards of health in the execu- 
tion and enforcement of the rules and regulations of such boards to prevent 
the introduction of contagious or infectious diseases into the United States 
from foreign countries, and into one State from another; and at such ports 
and places within the United States as have no quarantine regulations under 
State authority, where such regulations are, in the opinion of the National 
Board of Health, necessary to prevent the introduction of contagious or infec- 
tious diseases into the United States from foreign countries, or into one State 
from another, and at such ports and places within the United States where 
quarantine regulations exist under the authority of the State, which, in the 
opinion of the National Board of Health, are not sufficient to prevent the 
introduction of such diseases into the United States, or into one State from 
another, the National Board of Health shall report the facts to the President 
of the United States, who shall, if, in his judgment, it is necessary and proper, 
order said Board of Health to make such additional rules and regulations as 
are necessary to prevent the introduction of such diseases into the United 
States from foreign countries, or into one State from another, which, when so 
made and approved by the President, shall be promulgated by the National 
Board of Health, and enforced by the sanitary authorities of the States, where 
the State authorities will undertake to execute and enforce them; but, if the 
State authorities shall fail or refuse to enforce said rules and regulations, the 
President may detail an officer or appoint a proper person for that purpose. 
The Board of Health shall make such rules and regulations as are author- 
ized by the laws of the United States and necessary to be observed by vessels 
at the port of departure and on the voyage, where such vessels sail from any 
foreign port or place at which contagious or infectious disease exists, to any 
port or place in the United States, to secure the best sanitary condition of such 
vessel, her cargo, passengers, and crew; and, when said rules and regulations 
have been approved by the President, they shall be published, and commu- 
nicated to and enforced by the consular officers of the United States : pro- 
vided, that none of the penalties herein imposed shall attach to any vessel, or 
any owner or officer thereof, till the Act and the rules and regulations made in 
pursuance thereof shall have been officially promulgated for at least ten days 
in the port from which said vessel sailed. 
Sect. 4. It shall be the duty of the National Board of Health to obtain 
information of the sanitary condition of foreign ports and places from which 
contagious and infectious diseases are or may be imported into the United 
States; and to this end the consular officers of the United States, at such ports 
and places as shall be designated by the National Board of Health, shall make 
to said Board of Health weekly reports of the sanitary condition of the ports 
and places at which they are respectively stationed, according to such forms 
as said Board of Health may prescribe; and the Board of Health shall also 28 
SOME REMARKS UPON SANITARY JURISPRUDENCE. 
obtain, through all sources accessible, including State and municipal sanitary 
authorities throughout the United States, weekly reports of the sanitary condi- 
tion of ports and places within the United States; and shall prepare, publish, 
and transmit to the medical officers of the Marine Hospital Service, to col- 
lectors of customs, and to State and municipal health officers and authorities, 
weekly abstracts of the consular sanitary reports, and other pertinent informa- 
tion received by said Board; and shall also, as far as it may be able, by means 
of the voluntary co-operation of State and municipal authorities, of public 
associations and private persons, procure information relating to the climatic 
and other conditions affecting the public health; and shall make to the Secre- 
tary of the Treasury an annual report of its operations, for transmission to 
Congress, with such recommendations as it may deem important to the public 
interests; and said report, if ordered to be printed by Congress, shall be done 
under the direction of the Board. 
Sect. 5. That the National Board of Health shall from time to time issue 
to the consular officers of the United States and to the medical officers serving 
at any foreign port, and otherwise make publicly known, the rules and regula- 
tions made by it and approved by the President, to be used and complied 
with by vessels in foreign ports for securing the best sanitary condition of such 
vessels, their cargoes, passengers, and crews, before their departure for any 
port in the United States, and in the course of the voyage; and all such other 
rules and regulations as shall be observed in the inspection of the same on the 
arrival thereof at any quarantine station at the port of destination, and for the 
disinfection and isolation of the same, and the treatment of cargo and persons 
on board, so as to prevent the introduction of cholera, yellow fever, or other 
contagious or infectious diseases; and it shall not be lawful for any vessel to 
enter said port to discharge its cargo or land its passengers except upon a cer- 
tificate of the health officer at such quarantine station, certifying that said rules 
and regulations have in all respects been observed and complied with, as well 
on his part as on the part of the said vessel and its master, in respect to the 
same and to its cargo, passengers, and crew; and the master of every such 
vessel shall produce and deliver to the collector of customs at said port of 
entry, together with the other papers of the vessel, the said certificates required 
to be obtained at the port of departure, and the certificate herein required to 
be obtained from the health officer at the port of entry. 
Sect. 6. That to pay the necessary expenses of placing vessels in proper 
sanitary condition, to be incurred under the provisions of this Act, the Secre- 
tary of the Treasury be, and he hereby is, authorized and required to make the 
necessary rules and regulations fixing the amount Of fees to be paid by vessels 
for such service, and the manner of collecting the same. 
Sect. 7. That the President is authorized, when requested by the National 
Board of Health, and when the same can be done without prejudice to the 
public service, to detail officers from the several departments of the govern- 
ment, for temporary duty, to act under the direction of said Board, to carry 
out the provisions of this Act; and such officers shall receive no additional SOME REMARKS UPON SANITARY JURISPRUDENCE. 
29 
compensation except for actual and necessary expenses incurred in the per- 
formance of such duties. 
Sect. 8. That, to meet the expenses to be incurred in carrying out the pro- 
visions of this Act, the sum of five hundred thousand dollars, or so much there- 
of as may be necessary, is hereby appropriated, to be disbursed under the 
direction of the Secretary of the Treasury on estimates to be made by the 
National Board of Health, and to be approved by him. Said National Board 
of Health shall, as often as quarterly, make a full statement of its operations 
and expenditures under this Act to the Secretary of the Treasury, who shall 
report the same to Congress. 
Sect. 9. That so much of the Act entitled “ An Act to prevent the intro- 
duction of contagious or infectious diseases into the United States,” approved 
April twenty-ninth, eighteen hundred and seventy-eight, as requires consular 
officers or other representatives of the United States at foreign ports to report 
the sanitary condition of and the departure of vessels from such ports to the 
Supervising Surgeon-General of the Marine Hospital Service, and so much of 
said Act as requires the Surgeon-General of the Marine Hospital Service to 
frame rules and regulations, and to execute said Act, and to give notice to 
Federal and State officers of the approach of infected vessels, and furnish said 
officers with weekly abstracts of consular sanitary reports, and all other i\cts 
and parts of Acts inconsistent with the provisions of this Act, be, and the same 
are hereby, repealed. 
Sect. 10. This Act shall not continue in force for a longer period than 
four years from the date of its approval. [.Approved June 2,1879. 
APPENDIX III. 
Title LVIII.—The Public Health. 
Sect. 4792. The quarantines and other restraints established by the health 
laws of any State respecting any vessels arriving in or bound to any port or 
district thereof, shall be duly observed by the officers of the customs revenue 
of the United States, by the masters and crews of the several revenue cutters, 
and by the military officers commanding in any fort or station upon the sea- 
coast ; and all such officers of the United States shall faithfully aid in the 
execution of such quarantines and health laws, according to their respective 
powers and within their respective precincts, and as they shall be directed 
from time to time by the Secretary of the Treasury. But nothing in this title 
shall enable any State to collect a duty of tonnage or impost without the con- 
sent of Congress. 
Sect. 4793. Whenever, by the health laws of any State, or by the regula- 
tions made pursuant thereto, any vessel arriving within a collection-district of 
such State is prohibited from coming to the port of entry or delivery by law 
established for such district, and such health laws require or permit the cargo 
of the vessel to be unladen at some other place within or near to such district, SOME REMARKS UPON SANITARY JURISPRUDENCE. 
the collector, after due report to him of the whole of such cargo, may grant 
his warrant or permit for the unlading and discharge thereof, under the care 
of the surveyor, or of one or more inspectors, at some other place where such 
health laws permit, and upon the conditions and restrictions which shall be 
directed by the Secretary of the Treasury, or which such collector may, for 
the time, deem expedient for the security of the public revenue. 
Sect. 4794. There shall be purchased or erected, under the orders of the 
President, suitable warehouses, with wharves and enclosures, where merchan- 
dise may be unladen and deposited from any vessel which shall be subject to 
a quarantine or other restraint, pursuant to the health laws of any State, at 
such convenient places therein as the safety of the public revenue and the ob- 
servance of such health laws may require. 
Sect. 4795. Whenever the cargo of a vessel is unladen at some other 
place than the port of entry or delivery under the foregoing provisions, all the 
articles of such cargo shall be deposited, at the risk of the parties concerned 
therein, in such public or other warehouses or enclosures as the collector shall 
designate, there to remain under the joint custody of such collector and of 
the owner or master or other person having charge of such vessel, until the 
same are entirely unladen or discharged, and until the articles so deposited 
may be safely removed without contravening such health laws. And, when 
such removal is allowed, the collector having charge of such articles may 
grant permits to the respective owners or consignees, their factors or agents, to 
receive all merchandise which has been entered, and the duties accruing upon 
which have been paid, upon the payment by them of a reasonable rate of 
storage, which shall be fixed by the Secretary of the Treasury for all public 
warehouses and enclosures. 
Sect. 4796. The Secretary of the Treasury is authorized, whenever a con- 
formity to such quarantines and health laws requires it, and in respect to ves- 
sels subject thereto, to prolong the terms limited for the entry of the same, 
and the report or entry of their cargoes, and to vary or dispense with any 
other regulations applicable to such reports or entries. No part of the cargo 
of any vessel shall, however, in any case, be taken out or unladen therefrom, 
otherwise than is allowed by law, or according to the regulations hereinafter 
established. 
Sect. 4797. Whenever, by the prevalence of any contagious or epidemic 
disease in or near the place by law established as the port of entry for any 
collection-district, it becomes dangerous or inconvenient for the officers of the 
revenue employed therein to continue the discharge of their respective offices 
at such port, the Secretary of the Treasury, or, in his absence, the First Comp- 
troller, may direct the removal of the officers of the revenue from such port 
to any other more convenient place, within, or as near as may be to, such 
collection-district. And at such place such officers may exercise the same 
powers, and shall be liable to the same duties, according to existing circum- 
stances, as in the port or district established by law. Public notice of any 
such removal shall be given as soon as may be. (See sect. 1776.) SOME EE MARA'S UPON SANITARY JURISPRUDENCE. 
31 
Sect. 4798. In case of the prevalence of a contagious or epidemic dis- 
ease at the seat of government, the President may permit and direct the 
removal of any or all the public offices to such other place or places as he 
shall deem most safe and convenient for conducting the public business. 
(See sect. 1776.) 
Sect. 4799. Whenever in the opinion of the chief justice, or, in case of 
his death or inability, of the senior associate justice of the Supreme Court, a 
contagious or epidemic sickness shall render it hazardous to hold the next 
stated session of the court at the seat of government, the chief or such asso- 
ciate justice may issue his order to the marshal of the Supreme Court, direct- 
ing him to adjourn the next session of the court to such other place as such 
justice deems convenient. The marshal shall thereupon adjourn the court, 
by making publication thereof in one or more public papers printed at the 
seat of government, from the time he shall receive such order until the time 
by law prescribed for commencing the session. The several circuit and dis- 
trict judges shall, respectively, under the same circumstances, have the same 
power, by the same means, to direct adjournments of the several circuit and 
district courts to some convenient place within their districts respectively. 
(See sect. 1776.) 
Sect. 4800. The judge of any district court, within whose district any 
contagious or epidemic disease shall at any time prevail, so as, in his opinion, 
to endanger the lives of persons confined in the prison of such district, in 
pursuance of any law of the United States, may direct the marshal to cause 
the persons so confined to be removed to the next adjacent prison where such 
disease does not prevail, there to be confined until they may safely be removed 
back to the place of their first confinement. Such removals shall be at the 
expense of the United States. 
Sect. 1776. Whenever any public office is removed by reason of sickness 
which may prevail in the town or city where it is located, a particular account 
of the cost of such removal shall be laid before Congress. (See sects. 4797- 
4799-) 
APPENDIX IV. 
Resolved by the Senate and House of Representatives of the United States 
of America in Congress assembled, That the President of the United States 
is hereby authorized to call an international sanitary conference to meet at 
Washington, District of Columbia, to which the several powers having juris- 
diction of ports likely to be infected with yellow fever or cholera shall be 
invited to send delegates, properly authorized, for the purpose of securing an 
international system of notification as to the actual sanitary condition of ports 
and places under the jurisdiction of such powers, and of vessels sailing 
therefrom. [Approved May 14, 1880. 32 
SOME REMARKS UPON SANITARY JURISPRUDENCE. 
APPENDIX V. 
Levy v. Costerton, i Starkie, 212. 
“ Under a covenant in a charter party that the ship shall be provided with 
‘ every thing needful and necessary for the voyage,’ the owner is bound to 
provide the proper documents as well as necessaries for the ship itself, and is 
therefore bound to provide a bill of health, if it be essential to the perform- 
ance of the voyage, within a reasonable time within the intention of the par- 
ties.” The counsel for the defendant contended, Firstly, that no documents 
were included in the terms of the covenant; and secondly, that, supposing 
that the terms of the covenant included documents, they did not extend to a 
bill of health, which was not a document required by the general law of States. 
Gibbs, Chief Justice, was of opinion that the words in fair construction were 
not to be confined to such things as should be necessary for the ship itself, but 
that they comprehended every thing necessary for the voyage; and, upon the 
second point, his lordship was of opinion that a bill of health was to be con- 
sidered as a necessary document, since it was essential to the performance of 
the voyage, according to the intention of the parties, within a reasonable time. 
The verdict was for the plaintiff. 
APPENDIX VI. 
International Bill of Health. 
I, (the person charged to deliver the bill), at 
the port of , do hereby state that the vessel hereinafter named 
clears from this port under the following circumstances : — 
Name of vessel: 
Tonnage: 
Apartments for passengers, No.: 
Destination : 
Name of medical officer (if any) : 
Total number of passengers : 1st cab- 
in, ; 2d cabin, ; steerage, : 
Nature (vessel-of-vvar, ship, schooner, 
etc.) : 
Guns: 
Where last from: 
Name of captain: 
Total number of crew: 
Cargo : 
Vessel. 
1. Sanitary history of the vessel: 
2. Sanitary condition of vessel (before and after reception of cargo, with note 
of any decayed wood). Note disinfection of vessel: 
3. Sanitary condition of cargo : 
4. Sanitary condition of crew : 
5. Sanitary condition of passengers : 
6. Sanitary condition of clothing, food, water, air-space, and ventilation : SOME REMARKS UPON SANITARY JURISPRUDENCE. 
33 
Port. 
1. Sanitary condition of port and adjacent country: — 
a. Prevailing disease (if any) : 
b. Number of cases of and deaths from yellow fever, Asiatic cholera, 
plague, small-pox, or typhus fever during the week preceding : 
Number of cases of—• 
Yellow fever: 
Asiatic cholera: 
Plague : 
Small-pox: 
Typhus fever: 
Number of deaths from — 
Yellow fever: 
Asiatic cholera: 
Plague: 
Small-pox: 
Typhus fever: 
c. Population according to the last census : 
d. Total deaths from all causes during the preceding month : 
2. Any circumstances affecting the public health existing in the port of de- 
parture to be here stated : 
I certify that the foregoing statements are made by , 
who has personally inspected said vessel; that I am satisfied that the said 
statements are correct; and I do further certify that the said vessel leaves this 
port, bound for , in 
In witness whereof I have hereunto set my hand and the seal of office, 
at the port of , this day of , 
188 , o’clock. 
[seal.] [Signature.] 
APPENDIX VII. 
Log-Book. 
Sect. 4290. . . . Fifth, Every case of illness or injury happening to any 
member of the crew, with the nature thereof, and the medical treatment. 
Sixth, Every case of death happening on board, with the cause thereof. 
Seventh, Every birth happening on board, with the sex of the infant and 
the names of the parents. 
Eighth, Every marriage taking place on board, with the names and ages 
of the parties. 
Sect. 4291. Every entry hereby required to be made in the official log- 
book shall be signed by the master and by the mate, or some other one of the 
crew : and every entry in the official log-book shall be made as soon as possi- 
ble after the occurrence to which it relates; and, if not made on the same day 
as the occurrence to which it relates, shall be made and dated so as to show 
the date of the occurrence, and of the entry respecting it: and in no case 
shall any entry therein, in respect of any occurrence happening previously to 34 
SOME REMARKS UPON SANITARY JURISPRUDENCE. 
the arrival of the vessel at her final port, be made more than twenty-four hours 
after her arrival. (See sect. 4597.) 
Sect. 4292. If, in any case, the official log-book is not kept in the manner 
hereby required, or if any entry hereby directed to be made in any such log- 
book is not made at the time and in the manner hereby directed, the master 
shall, for each such offence, be liable to a penalty of not more than twenty-five 
dollars; and every person who makes, or procures to be made, or assists in 
making, any entry in any official log-book in respect of any occurrence hap- 
pening previously to the arrival of the vessel at her final port of discharge, 
more than twenty-four hours after such arrival, shall, for each offence, be liable 
to a penalty of not more than one hundred and fifty dollars. 
APPENDIX VIII. 
“Passenger Act, 1855.” 
“ Sect, i 7. And be it further enacted, That the collector of the customs 
shall examine each emigrant ship or vessel on its arrival at his port, and ascer- 
tain and report to the Secretary of the Treasury the time of sailing, the length 
of the voyage, the ventilation, the number of passengers, their space on board, 
their food, the native country of the emigrants, the number of deaths, the age 
and sex of those who died on the voyage, together with his opinion of the 
cause of the mortality, if any, on board, and, if none, what precautionary 
measures, arrangements, or habits are supposed to have had any, and what, 
agency in causing the exemption.” 
APPENDIX IX. 
Proposed Passenger Act, 1881. 
“ Sect. 9. And be it further enacted, That it shall not be lawful for the mas- 
ter of any such steamship or other vessel, not in distress, after the arrival of 
the vessel within any collection-district of the United States, to allow any per- 
son or persons, except a pilot, officer of the customs, or health officer, to come 
on board of the vessel, or to leave the vessel, until the vessel has been taken 
in charge by an officer of the customs, nor, after charge so taken, without leave 
of such officer, until all the passengers with their baggage have been duly 
landed from the vessel; and on the arrival of such steamship or other vessel 
within any collection-district of the United States, the master thereof shall 
deliver to the officer of customs who first comes on board the vessel, and 
makes demand therefor, a correct list, signed by the master, of all the passen- 
gers taken on board the vessel at any foreign port or place, specifying sepa- 
rately the names of the cabin-passengers, their age, sex, calling, and the 
country of which they are citizens, and the number of pieces -of baggage 
belonging to each passenger; and also the name, age, sex, calling, and SOME REMARKS UPON SANITARY JURISPRUDENCE. 
35 
native country of each emigrant passenger, or passengers other than cabin- 
passengers, and their intended destination or location, and the number of 
pieces of baggage belonging to each passenger, and also the location of the 
compartment or space occupied by each of such passengers during the voy- 
age ; and, if any of such passengers died on the voyage, the said list shall 
specify the name, age, and cause of death of each deceased passenger; and 
a duplicate of the aforesaid list of passengers, verified by the oath of the 
master, shall, with the manifest of the cargo, be delivered by the master to the 
collector of customs on the entry of the vessel. For a violation of either of 
the provisions of this section, or for permitting or neglecting to prevent a 
violation thereof, the master of the vessel shall be liable to a fine not exceed- 
ing one thousand dollars.” 
APPENDIX X. 
Rules and Regulations for securing the Best Sanitary Condition of 
Vessels, including their Cargoes, Passengers, and Crews, coming to 
the United States from any Foreign Port where any Contagious or 
Infectious Disease exists. 
\Prepared by the National Board of Health in accordance with the provisions of an Act ap- 
proved June 2, i8yg, entitled “ An Act to prevent the introduction of infectious or conta- 
gious diseases into the United States.”] 
EXPLANATIONS. 
1. The object of the following rules and regulations is to prevent the intro- 
duction into the United States of “ contagious or infectious diseases.” 
2. The following diseases are recognized as “contagious or infectious dis- 
eases,” for the purposes of these rules and regulations : viz., Asiatic cholera, 
yellow fever, plague, small-pox, typhus fever, and relapsing fever. 
3. An “ infected ” port or place, in the sense of these rules, is a port or 
place at which either Asiatic cholera, yellow fever, plague, small-pox, relapsing 
fever, or typhus fever exists. 
4. To secure the “best sanitary condition” of a vessel, the following points 
shall be observed by the owners, agents, or master of such vessel: — 
A. Exclusion from the vessel, as far as possible, of persons or things known 
or suspected to be infected. 
B. Cleanliness, dryness, and ventilation of the vessel, both preliminary to 
loading and during the voyage. 
C. Disinfection, — that is, the destruction or removal of the causes of dis- 
ease, — which includes measures of cleanliness, ventilation, fumigation, etc. 
D. The crew shall not be allowed liberty on shore after nightfall in sus- 
pected localities. They shall not be allowed to sleep on deck, except under 
awnings. The forecastle shall be well ventilated, and kept dry. Both in port 
and at sea the bilge shall be pumped out each morning and evening, or more 
frequently if necessary. The utmost cleanliness shall be observed at sea as 
well as in port. Each seaman shall have two suits of underclothing. The 36 
SOME REMARKS UPON SANITARY JURISPRUDENCE. 
clothing and bedding shall be aired every clear day. In tropical climates the 
men shall be required to wash their persons and change their underclothing 
every evening after work while in port; and each working-suit shall be washed, 
dried, and aired after a day’s use. These regulations as to clothing, airing of 
bedding, and ventilation, shall, as far as possible, be observed at sea as well as 
in port. 
RULES AND REGULATIONS. 
1. All merchant ships and vessels sailing from a foreign port where conta- 
gious or infectious disease exists, for any port of the United States, must 
obtain from the consul, vice-consul, or other consular officer of the United 
States, at the port of departure, or from the medical officer, — where such 
officer has been detailed by the President for that purpose, — a bill of 
health in duplicate, which shall set forth the sanitary history of said vessel, and 
that it has in all respects complied with these rules and regulations. 
2. No vessel shall have more than one bill of health; but, if she touches at 
other ports on the passage, that fact, and the condition of those ports as to 
the existence of contagious or infectious disease, shall be indorsed upon the 
original bill of health by the consul, vice-consul, consular officer, or medical 
officer of the United States. 
3. The bill of health shall be in the form appended: — 
FORM A. 
No. . Port of 
THE UNITED STATES OF AMERICA — NATIONAL BOARD OF HEALTH. 
Bill of Health. 
I, (the person charged to deliver the bill), at 
the port of , do hereby state that the vessel hereinafter named 
clears from this port under the following circumstances: — 
Name of vessel: 
Tonnage: 
Apartments for passengers, No.: 
Destination : 
Name of medical officer (if any) : 
Total number of passengers : 1st cab- 
in, ; 2d cabin, ; steerage, : 
Nature (vessel-of-war, ship, schooner, 
etc.) : 
Guns: 
Where last from: 
Name of captain: 
Total number of crew: 
Cargo: 
Vessel. 
x. Sanitary history of the vessel: 
2. Sanitary condition of vessel (before and after reception of cargo, with note 
of any decayed wood). Note disinfection of vessel: 
3. Sanitary condition of cargo : 
4. Sanitary condition of crew : 
5. Sanitary condition of passengers : 
6. Sanitary condition of clothing, food, water, air-space, and ventilation : SOME REMARKS UPON SANITARY JURISPRUDENCE. 
37 
Port. 
1. Sanitary condition of port and adjacent country: — 
a. Prevailing disease (if any) : 
b. Number of cases of and deaths from yellow fever, Asiatic cholera, 
plague, small-pox, or typhus fever during the week preceding: 
Number of cases of— 
Yellow fever : 
Asiatic cholera: 
Plague: 
Small-pox: 
Typhus fever: 
Number of deaths from — 
Yellow fever: 
Asiatic cholera: 
Plague: 
Small-pox: 
Typhus fever: 
c. Population according to the last census : 
d. Total deaths from all causes during the preceding month: 
2. Any circumstances affecting the public health existing in the port of de- 
parture to be here stated : 
I certify that I have personally inspected the said vessel, and that the above 
statements are correct. 
[Signature of medical officer.] 
I certify that the foregoing statements are made by , 
who has personally inspected said vessel; that I am satisfied that the said 
statements are correct; and I do further certify that the said vessel leaves this 
port, bound for , in 
In witness whereof I have hereunto set my hand and the seal of office, 
at the port of , this day of , 
188 , o’clock. 
[seal.] [Signature.] 
4. Each consul, vice-consul, consular officer, or medical officer of the 
United States in a foreign port shall keep himself thoroughly acquainted with 
the sanitary condition of the port and its vicinity, especially with regard to the 
existence of contagious or infectious diseases or epidemics, and shall, upon 
the request of the owner, agent, or master, make, or cause to be made, an in- 
spection of every ship or vessel bound for any port in the United States, and 
give the bill of health required by these regulations. Vessels carrying a for- 
eign flag shall be inspected, when practicable, in company with the consul 01 
consular agent of the nation to which the vessel belongs. 
5. The fee for such inspection shall be such as may be fixed by the Secre- 
tary of the Treasury. 
6. The certifying authority at the port of departure shall certify whether 
vessels carrying passengers are provided with the means of carrying out the 
provisions of sects. 4267 and 4293 of the Revised Statutes. 
Sect. 4257. Every such vessel so employed in transporting passengers 38 
SOME REMARKS UPON SANITARY JURISPRUDENCE. 
between the United States and Europe, and having space according to law for 
more than one hundred such passengers, shall have at least two ventilators to 
purify each apartment occupied by such passengers, one of which shall be 
inserted in the after part and the other in the forward part of the apartment; 
and one of them shall have an exhausting-cap to carry off the foul air, and the 
other a receiving-cap to carry down the fresh air. Such ventilators shall have 
a capacity proportioned to the size of the apartments to be purified; namely, if 
the apartment will lawfully authorize the reception of two hundred such pas- 
sengers, the capacity of each such ventilator shall be equal to a tube of twelve 
inches diameter in the clear, and in proportion for larger or smaller apart- 
ments. All such ventilators shall rise at least four feet six inches above the 
upper deck of any such vessel, and be of the most approved form and con- 
struction. If it appears from the report to be made and approved, as provided 
in sect, 4272, that such vessel is equally well ventilated by any other means, 
such other means of ventilation shall be deemed to be a compliance with the 
provisions of this section. 
Sect. 4263. .The master of any vessel employed in transporting passengers 
between the United States and Europe is authorized to maintain good disci- 
pline and such habits of cleanliness among passengers as will tend to the 
preservation and promotion of health; and, to that end, he shall cause such 
regulations as he may adopt for this purpose to be posted up, before sailing, 
on board such vessel, in a place accessible to such passengers, and shall keep 
the same so posted up during the voyage. Such master shall cause the apart- 
ments occupied by such passengers to be kept at all times in a clean, healthy 
state; and the owners of every such vessel so employed are required to con- 
struct the decks, and all parts of the apartments, so that they can be thoroughly 
cleansed; and also to provide a safe, convenient privy or water-closet for the 
exclusive use of every one hundred such passengers. The master shall also, 
when the weather is such that the passengers cannot be mustered on deck 
with their bedding, and at such other times as he may deem necessary, cause 
the deck occupied by such passengers to be cleansed with chloride of lime, or 
some other equally efficient disinfecting agent. And for each neglect or vio- 
lation of any of the provisions of this section, the master and owner of any 
such vessel shall be severally liable to the United States in a penalty of fifty 
dollars, to be recovered in any circuit or district court within the jurisdiction 
of which such vessel may arrive or from which she is about to depart, or at any 
place where the owner or master may be found. 
7. For the purpose of isolating the sick, especially those suffering from con- 
tagious or infectious diseases, every steamship or other passenger vessel shall 
have two compartments or spaces to be used as hospitals, one for men and 
the other for women. These hospitals shall, when practicable, be constructed 
on the main deck, or on the deck next below the uppermost deck of the 
vessel. 
8. Every vessel, before taking on cargo or passengers, shall be clean and 
dry; and the certifying officer may, at his discretion, require that it shall be SOME REMARKS UPON SANITARY JURISPRUDENCE. 
39 
thoroughly disinfected, if last from an infected port, or if the port of departure 
be itself infected. The examination of the vessel as to cleanliness shall be 
made before the cargo is taken on, and shall extend to all accessible parts, 
especial care being taken to note upon the bill of health the presence of 
decayed wood. 
9. Earth and porous stone shall not be used for ballast if avoidable. 
10. Merchandise or articles known to be infected shall not be received or 
taken on board. 
11. In case the port is infected, the certifying authority may require that the 
officers, crew, and passengers shall be examined by a medical officer or physi- 
cian selected for that purpose, and the result reported to him not more than 
twenty-four hours before certifying to the bill of health. 
If small-pox exists at the port, the certifying authority shall require that the 
medical examination above provided shall extend to all passengers, as well as 
to the officers and crew, for the purpose of determining their protection against 
small-pox; and every person found unvaccinated, or not satisfactorily pro- 
tected, shall be properly vaccinated before the vessel leaves the port; and a 
record of such vaccinations, including the name of each individual vaccinated, 
and the date of vaccination, shall be given to the master of the vessel, to be 
by him delivered to the quarantine authority at the port of arrival. 
12. Bills of health can be considered valid only when . delivered within 
twenty-four hours last preceding departure. If the departure is delayed be- 
yond this period, the bill must be vised by the authority delivering it, stating 
whatever changes have taken place in the sanitary condition of the port, 
vessel, officers, crew, or passengers. 
13. When the port of departure, or it! vicinity, is infected, that fact shall be 
noted in the bill of health; and, when the sanitary or other local authority of 
the port declares the existence, of such infection, the bill of health shall give 
the date of the declaration. 
14. A port shall not be considered infected by reason of the existence of 
contagious or infectious disease confined within the limits of the quarantine 
station of such port. 
15. Physicians attached to sea-going vessels shall be specially charged with 
the duty of watching their sanitary condition and the health of their officers, 
crew, and passengers. On arrival of the vessel, they shall report to the health 
officer of the port the sanitary history of the voyage. 
16. In case of the occurrence at sea of Asiatic cholera, yellow fever, 
plague, small-pox, relapsing fever, or typhus fever, the wearing apparel and 
bedding used by those affected with such disease shall be boiled for not less 
than two hours, or burned or sunk. 
17. Captains, owners, or agents of vessels shall, at the port of departure, be 
required to answer, under oath, to the consuls or sanitary officers, all questions 
as to the sanitary condition of the vessel, etc. 
18. Whenever any vessel shall leave an infected foreign port, or, having on 
board goods or passengers coming from any place or district infected with 40 
SOME REMARKS UPON SANITARY JURISPRUDENCE. 
Asiatic cholera, yellow fever, or plague, shall leave any foreign port bound for 
any port in the United States, the consul, consular officer, or other representa- 
tive of the United States at or near such port, may, at his discretion, immedi- 
ately give information thereof by telegraph to the National Board of Health 
at Washington, D.C., reporting the name, date of departure, and port of desti- 
nation of such vessel. The cost of such telegrams will be paid by the National 
Board of Health. 
19. All merchant ships or vessels from any foreign port where any conta- 
gious or infectious disease exists, and bound for any port of the United States, 
must present to the health officer at the quarantine station of such port evi- 
dence that these rules and regulations have been complied with, in order that 
such vessel may enter such port, discharge its cargo, and land its passengers. 
Additional Rules and Regulations necessary to prevent the Introduc- 
tion of Small-Pox into the United States from Foreign Countries. 
1. That all persons coming from or through any foreign port or place in 
which small-pox exists, who, after the fourteenth day of November, 1881, shall 
arrive at any port of entry within the United States, shall be subjected to 
examination as regards their protection from that disease by the proper health 
authorities of the State within which such port lies, or, in case such authorities 
shall fail or refuse to enforce this rule, then by some officer or other proper 
person to be designated by the President of the United States. 
2. That in case any person so arriving shall refuse to submit to such exam- 
ination, or, upon undergoing the same, shall be found not sufficiently protected 
from small-pox, such person, and, in case he or she be not sui juris, then also 
the person having him or her under charge, shall be detained in quarantine 
until he or she shall have been properly vaccinated, or shall have passed the 
period of incubation from date of last exposure.