HEARING 
BEFORE THE 
COMMITTEE ON INTERSTATE AND FOREIGN COMMERCE 
OF THE 
HOUSE OF REPRESENTATIVES. 
Saturday, February 19, 1898. 
The committee met at 10.30 o'clock a. m., Hon. William P. Hepburn 
in the chair. 
STATEMENT OF DR. WALTER WYMAN, SURGEON-GENERAL OF 
THE UNITED STATES MARINE-HOSPITAL SERVICE. 
Dr. Wyman. Mr. Chairman, and gentlemen of the committee, with 
regard to House bill 8280, which was presented to the committee 
yesterday by Dr. Wingate as representing the views of the American 
Medical Association, I have to give the following brief history of 
this bill: For years the American Medical Association, in its desire to 
enlarge the usefulness, and particularly the dignity of the profession, 
has declared that there should be a department of public health, with 
a secretary in the Cabinet. It has aimed at nothing less, and has 
consistently demanded the secretary in the Cabinet. 
At its meeting in May, 1896, at Atlanta, the committee made a full 
report, canvassed all the means to their end, and finally recommended 
that the Marine-Hospital Service be enlarged and brought up to the 
required standard. 
A committee of one from each State was appointed to prepare a bill 
in accordance with the adopted report. Then the chairman of the 
committee, Dr. Jerome Cochran, died, and Dr. Wingate, of Milwaukee, 
was appointed in his place. The work of the committee was practi- 
cally left to three members, and they prepared a bill which was pre- 
sented at the meeting of the association in June, 1897, in Philadelphia. 
Copies of the bill were with difficulty obtained, and I myself could 
obtain one only a day and a half before it was presented to the asso- 
ciation. On the last day of the meeting, with only a fraction of the 
association present, the report was made; but it was received only, and 
the committee continued. This matter has been set forth in a com- 
QUAK 1 
1 2 
ADDITIONAL QUARANTINE POWERS. 
munication printed in the Boston Medical and Surgical Journal of 
November 25, 1897, from which I quote as follows: 
THE BILL FOR A DEPARTMENT OF PUBLIC HEALTH. 
Washington, November 15, 1897. 
Mr. Editor : Will you kindly permit me to correct a statement made in the editorial 
columns of your esteemed journal of the issue of November 11,1897, under the caption, 
"A department of public health." I refer to a statement in the second paragraph, 
which reads as follows: "The American Medical Association, at the Philadelphia 
meeting of this year, adopted a draft for a bill to establish a department of public 
health." I am informed by the recording secretary of the association, and also by 
others who were present, that the American Medical Association did not adopt a 
draft for a bill to establish a department of public health. 
The facts regarding the proposed bill, referred to in your editorial, are as follows: 
At the last meeting of the American Medical Association, the committee of the asso- 
ciation on department of public health, through its chairman, Dr. U. O. B. Wingate, 
of Wisconsin, read a report of the committee, in which was included the draft of a 
bill providing for a department of public health. The report of the committee was 
received by the association and the committee continued. As the proposed bill was 
presented during the last hours of the meeting of the association, when few were 
present, it was not discussed, adopted, or rejected by the association. An opinion 
on the merits or demerits of the proposed bill was not expressed by the association. 
In fact, the American Medical Association the year previous at the Atlanta meeting, 
in adopting a report of its committee on department of public health, which report 
recommended that the committee be authorized to draft a bill which should be in 
accord with the recommendations of their report, expressed views which are entirely 
opposite to those embraced in the report of the committee at the last meeting, recom- 
mending the proposed bill for a department of public health. It is proper to state 
that by reason of the death of Dr. Jerome Cochran, the chairman of the committee 
in 1896, a new chairman was appointed. 
You are undoubtedly misled in the statement in your editorial, by the editorial 
statement in the journal of the association, as was the case with some members pres- 
ent at the last meeting of the American Public Health Association. The statement 
that the proposed bill was adopted by the American Medical Association was 
announced at that meeting, which undoubtedly influenced members in voting for it. 
However, there were only 19 votes for the bill and 7 against it at the meeting of the 
Public Health Association, whose average membership is about 800. 
Very truly, yours, 
H. W. Austin, M. D. 
[We find that the statements in regard to the American Medical Association 
contained in the above communication are substantially correct, and publish them 
with pleasure. Practically, it seems to be a question whether the proposed depart- 
ment of public health should swallow or be swallowed by the Marine-Hospital 
Service.-Ed.] 
Notwithstanding the facts as above stated the bill was printed in 
the Journal of the American Medical Association, and it was editorially- 
announced that it had been adopted by the great American Medical 
Association, and every subscriber was urged to see his Representative 
and Senator and urge its passage. Then follows the meeting of the 
American Public Health Association in Philadelphia in November last, 
and the same bill is presented to that association, with the statement 
that it had been adopted by the American Medical Association, and on 
that statement it was adopted by the Public Health Association by a 
vote of 19 for to 7 against the resolution, a total of 26 votes out of a 
membership of over 1,000. 
That this bill does not meet with the general approval of the medical 
profession is seen in the fact that opposing views have been printed 
editorially in the New York Medical Record, the New York Medical 
News, the New York Medical Journal, the Sanitarian, of Brooklyn, the 
Philadelphia Medical Journal, the Georgia Journal of Medicine and 
Surgery, and the Bulletin of the North Carolina Board of Public 
Health. (Inclosures Nos. 1-7.) Also by resolutions adopted by the ADDITIONAL QUARANTINE POWERS. 
3 
Tristate Medical Society, representing the States of Alabama, Tennes- 
see, and Georgia. (Inclosure No. 8.) And by a communication from 
the president of the Connecticut Medical Society and member of the 
Connecticut State Board of Health. (Inclosure No. 9.) 
I also have here a copy of an editorial in the New York Herald of 
February 12, 1898, commending the House bill introduced by Mr. Hep- 
burn. (Inclosure No. 10.) 
And I would further invite your attention to the report of the Senate 
committee, Public Health and Quarantine, Report No. 521, January 3, 
1898, accompanying Senate bill 2680, approving said bill, which is prac- 
tically the same as House bill 4363, introduced by Mr. Hepburn, and 
also two resolutions passed by the senate and house of representatives 
of the State of Georgia. (Inclosure Ro. 11.) 
This Wingate bill practically disorganizes the Marine-Hospital Serv- 
ice, deprives it of its quarantine functions, makes no advance in national 
quarantine, and permits the injection of politics into what should be 
a purely scientific organization. It appears even to authorize the repre- 
sentatives of State boards of health to have a voice in the management 
of the Marine-Hospital Service, as it transfers it to the commission. 
At the present time the Wingate bill represents the views of the 
gentlemen who drew it up. An effort was made to have it indorsed at 
the recent Quarantine Convention at Mobile, but the effort failed. The 
American Medical Association has not yet passed upon it, and since 
its approval by the American Public Health Association by an absurdly 
small vote, it has been altered in many of its essential features, and 
therefore has no organized sentiment behind it. On the contrary, the 
opinions of various medical journals throughout the country, a partial 
list of which I have given, indicate an entirely opposite opinion. In 
the city represented by Health Officer Doty, of New York, the four 
leading medical journals published there, known throughout the United 
States and the world, express entirely opposite views. 
With regard to an advisory council, which has been advocated, I 
have to state that an advisory council, in the matter of making quaran- 
tine regulations is very inadvisable, by reason of the fact that the very 
term advisory is misleading. The council as provided in the Wingate 
bill (H. R. 8280; Senate bill 3433) is not an advisory council, but is a 
body which will have the making of the quarantine regulations. 
The theory advanced by the gentlemen yesterday that there would 
be no difficulty in carrying into effect the United States quarantine 
regulations, provided the State health officers made them, was not 
demonstrated last summer, when the State boards were unable to 
enforce their own regulations or exercise the proper control over the 
local boards. Each local board seems to be a law unto itself, and 
State health officers were not permitted to visit certain towns or local- 
ities. In other words, their advice and their rules were disregarded. 
If an advisory council were to make the rules and regulations, then 
the interior States, which outnumber the coast States, would have a 
dominant influence in the making of rules for maritime quarantine, 
outvoting the maritime States, and they might make these rules very 
oppressive. The sanitary and commercial interests of Northern and 
Southern coast and interior States are not identical, and would not the 
rules and regulations for maritime and interstate quarantine adopted 
by the various State health officers be compromise measures or either 
insufficient or discriminating1? 
Again, with regard to the interior States, whose representatives 
would have a majority in an advisory council, said representatives 
have no practical experience in maritime quarantine. 4 
ADDITIONAL QUARANTINE POWERS. 
Even if the maritime quarantine regulations were to be prepared by 
the representatives from State boards of health representing coast 
States, it does not follow that these officers would be men specially 
fitted by experience for this work. Of the twenty-two maritime States 
in only six of them does the State board of health pretend to make 
maritime quarantine regulations; in the others it is left to the local 
quarantine officers, and these officers would be far more competent to 
pass upon maritime regulations than the representatives of the State 
boards of health. Moreover, if these State officers were to make the 
maritime quarantine regulations, the situation would be that a body of 
State officers appointed in the several States, frequently by political 
preference, would be making regulations to be executed by regular 
medical officers of this Government, appointed after a most thorough 
examination, as required by United States statutes, and commissioned 
by the President and confirmed by the Senate. 
Quarantine regulations properly belong to the Treasury Department, 
which has the oversight of all other matters relating to commerce. 
To illustrate: Chicago and St. Louis, or Illinois aud Missouri, are 
not detrimentally affected commercially if a long period of detention at 
quarantine is required of vessels from yellow-fever ports at the quar- 
antines of New Orleans, Mobile, or Galveston. On the contrary, the 
latter places and States in which they are located are affected. In 
point of fact, would not some of the Northern States be benefited com- 
mercially by an unnecessarily long detention of vessels arriving at 
these Southern ports? 
Then, too, the governors of the various States (who are frequently 
changed) hold different views as to how far national authority should 
be exercised in matters pertaining to quarantine, and would see that the 
members of the State boards of health representing their States in the 
advisory council should be those who hold views the same as their own. 
In fact, the provision in the bill which gives the State health officers the 
power to make quarantine regulations relegates all quarantine author- 
ity now existing under the United States statutes back to the States. 
Under this provision the medical officers of the Marine-Hospital Serv- 
ice, who have had long experience in quarantine matters, would have 
nothing whatever to do with the formulation of quarantine regulations. 
Practically the Treasury quarantine regulations are not made by the 
Secretary of the Treasury or the Supervising Surgeon-General alone. 
The Surgeon-General has associated with him a staff of officers, many 
of whom are men whose experience in quarantine matters, both North 
and South, is unsurpassed, and men whose scientific attainments in the 
investigation of the cause of infectious diseases are on a par with the 
most advanced students of the day. 
I submit that making quarantine regulations by men of scientific 
attainments, familiar with actual working details at quarantine stations, 
familiar with all matters pertaining to immigrants, and, too, with the 
complicated machinery of governmental methods and associated serv- 
ices in Washington, that this method is superior to that suggested in 
the proposed bill, with an advisory council, unacquainted with one 
another, and unfamiliar with governmental methods and existing 
branches of the Executive Departments. 
In framing regulations, the Marine-Hospital Bureau, besides its own 
scientific and practical officers, has the assistance of the law officer of 
the Treasury Department, detailed from the Department of Justice, 
and the benefit of the counsel and advice of the heads of the several 
divisions in the Treasury Department conversant with all the executive ADDITIONAL QUARANTINE POWERS. 
5 
and legal details which might require consideration, and finally, of the 
Assistant Secretary and the Secretary of the Treasury himself. It is 
difficult to conceive of any question connected with quarantine regula- 
tions which can not be decided properly and promptly by the Marine- 
Hospital Service and the Treasury Department, to which it belongs. 
In discussing House bill 4363, it is necessary to compare its provi- 
sions with those of the act of February 15, 1893, which it amends. 
The first amendment to the act of 1893 provides that in section 1 the 
following words shall be stricken out, viz, "and with such rules and 
regulations of State and municipal health authorities as may be made 
in pursuance of or consistent with this act." The effect of this amend- 
ment is to obviate the necessity of the National Government enforcing 
unnecessary quarantine rules and regulations made by State and local 
authorities. 
The second amendment to the act of 1893 consists in striking out 
entirely section 3 and substituting a new section 3 in its place. Both 
the old section 3 and the new section 3 relate to two different forms of 
quarantine-one maritime and the other interstate. It will be necessary 
to consider them separately. . 
The Hepburn bill requires the Secretary of the Treasury to make 
such rules and regulations as are necessary to prevent the introduction 
into the United States of any infectious or contagious disease from 
any foreign port or place. The present law (1893) provides that the' 
Secretary of the Treasury shall make regulations for ports in the 
United States where there are no quarantine regulations provided by 
the State or local authorities; and for ports where the quarantine regu- 
lations are deemed insufficient, the Secretary is authorized to make 
additional rules and regulations. 
The necessity of the amendment is apparent from the fact that at 
some ports 'where local quarantines are maintained the health authori- 
ties have formulated no regulations, but the health officer or quaran- 
tine physician is authorized to exercise his judgment in matters 
pertaining to quarantine. It is therefore necessary, in order to obtain 
uniformity in quarantine rules at the various ports of the United 
States, that the General Government be authorized to prepare quaran- 
tine regulations which shall be observed at all ports of entry without 
reference to local quarantine regulations. 
Section 3 of the present law (1893) further requires that all these 
rules and regulations shall be executed by the State or municipal 
authorities when they will undertake to execute or enforce them, but if 
they fail or refuse the President shall execute and enforce 'them and 
adopt such measures as in his judgment shall be necessary. Under 
the terms of the Hepburn bill practically the same provisions exist; 
but it is further provided on p'age 3, first twelve lines, that at any port 
or place in the United States where the Secretary of the Treasury 
shall deem it necessary that incoming vessels should be inspected by a 
national quarantine officer, such officer shall be designated. The neces- 
sity for this provision lies in the fact that under the present law too 
much time and opportunity for dispute as to whether the regulations 
have failed of enforcement is permitted before the President can be 
called upon to act. This portion of the bill also provides necessary law 
for the establishment of national quarantine on the Canadian and Mexi- 
can borders. The Government should be in position to have actual 
knowledge of whether the national quarantine rules and regulations 
are being enforced at all times by State and municipal health officers. 6 
ADDITIONAL QUARANTINE POWERS. 
Further provisions for maritime quarantine in the bill of Mr. Hep- 
burn, and which are not included in the present law, are as follows: 
First. On page 3, lines 13 to 23, inclusive. This paragraph is intended 
to authorize such sanitary measures as may be necessary with regard 
to vessels from foreign ports coming within the waters of the United 
States without a bill of health and not entering, or attempting to enter, 
any port of the United States. It is intended particularly to prevent 
the introduction of contagious diseases, particularly from Cuban and 
other West Indian ports, by vessels engaged in smuggling. These 
vessels are generally from Haban a, and lie in the worst portion of that 
infected port, and their crews are frequently new recruits from Spain, 
not acclimated to yellow fever, and are liable to have this disease and 
to communicate it either to other vessels or to the shores of the United 
States where smuggling may be carried on. 
Second. Page 3, lines 24 and 25, and page 4, lines I to 5, inclusive; 
this provision is to give definite and distinct character to the quaran- 
tine stations of the United States which have been established in the 
last ten or twelve years under previous laws, and to definitely fix their 
status. 
Third. The remainder of page 4, with the exception of the last two 
lines, provides the penalties necessary for the proper enforcement of 
the law. 
Fourth. Lines 24 and 25 of page 4, and 1 to 4, inclusive, of page 5, 
authorize the medical officers of the United States to administer oaths 
in matters pertaining to the administration of the quarantine laws and 
regulations. 
With regard to the interstate features of the Hepburn bill, beginning 
at line 5, on page 5, the portion thereof included in lines 5 to 20 is prac- 
tically the same as in the present law, with the exception that the Gen- 
eral Government is not obliged to enforce the local quarantine rules 
and regulations, many of which are absurd, the enforcement of which 
would render nugatory the regulations of the Government. 
The remainder of page 5 and page 6 relates particularly to occasions 
when the country is so unfortunate as to have had admitted yellow fever, 
cholera, plague, or typhus fever. 
To enable the General Government to do effective quarantine work 
at such times, it is necessary that the rules and regulations of the Gov- 
ernment be made supreme. It is possible under the existing law for the 
local quarantines of the various small cities in the interior to prevent the 
carrying out of necessary measures adopted by the General Govern- 
ment, and also to completely paralyze commercial intercourse between 
the States. This was clearly demonstrated in the recent epidemic of 
yellow fever in the South, where the local quarantine authorities pre- 
vented the United States inspectors, and even State health officers, 
from entering the towns where fever was prevailing, and also prevented 
the shipment of supplies and the movement of necessary camp equipage. 
Effective work in times of epidemics can not be brought about except 
there is uniformity of regulation, and authority to carry the same into 
effect. 
Section 6, page 7, of the Hepburn bill is the same as section 6 of the 
present law, with the single exception that the pratique of the national 
quarantine officer is made effective regarding vessels inspected as well 
as vessels which have been disinfected. 
Section 8, pages 7 and 8, of the Hepburn bill is the same as in the 
present law, except that it provides for the purchase as well as rental 
of State or local quarantines and means of paying tor the same. ADDITIONAL QUARANTINE POWERS. 
7 
In conclusion I have to state that the present bill corrects defects in 
the present law which have been demonstrated since the law of 1893 
was passed, and I am of the opinion that the law should be amended 
as indicated by the bill H. R. 4363. 
[Inclosure No. 1.-Medical Record, New York, February 12,1898.] 
NATIONAL QUARANTINE AND THE MARINE-HOSPITAL SERVICE. 
The discussion concerning the advisability of a national health law has culminated 
in a concensus of opinion on the part of the general public, of the health authorities, 
and of the medical profession, that the time has come for an ultimate settlement of 
the questions at issue. To this end several bills are now before Congress, advocat- 
ing governmental control of quarantine and the consistent adjustment of State 
rights in preventing the spread of disease from one Commonwealth to another. The 
experiences of widespread epidemics, notably that of yellow fever last summer, and 
the inability of the different health boards adequately to meet the then existing 
emergencies, have proven the urgent necessity for more stringently protective regu- 
lations than at present exist. The fundamental difficulty has been the apparent 
impossibility of reconciling merely local differences with the general good. Each 
State, having a sanitary code of its own and being naturally jealous of its legal 
rights, has fought against a proper understanding of mutual interests and the con- 
sistency of adopting proper means to desirable ends. It is perfectly obvious that, 
in order to harmonize such more or less radical disputes of authority, there should 
be created some centralized power in the General Government, which should control 
every part of the widest territory or the longest stretch of coast and compel each 
State to do its part in the realization of a perfected system of common protection. 
To accomplish such a purpose, very many efforts have been made during years 
past by sanitary and medical organizations, but thus far there has been no reason- 
able agreement on the fundamental principles and on the practicable and consistent 
management of necessary details for effective and comprehensive work. The medical 
profession, with a laudable effort to gain proper recognition in such a movement, 
has been overambitious in claiming too much for itself at the start. While it would 
be eminently desirable that a distinct department of public health should be created, 
having a Cabinet officer at its head, it is quite evident, considering the state of 
public opinion at present, that there is no appreciation of the necessity of such a 
radical and far-reaching measure as yet; and it is also quite clear that the profes- 
sion must grow up to the situation rather than force it. This disposition on the 
part of the framers of many of the bills is the real stumbling-block to all effective 
legislation on the subject. It has been so in the past, and it is so in the present. It 
is the old story-when we ask for too much we are likely to get nothing. Every- 
one who has studied the attempts at legislation in the direction of national quaran- 
tine must have been impressed with their complexity, impracticability, and cumber- 
someness. 
There is just now not so much a necessity for educating the public in sanitary mat- 
ters as for perfecting suitable police regulations for threatening epidemics. Thus it 
would naturally appear to be reasonable to elaborate, strengthen, and amplify what 
we may already have in that line, rather than to aim at some new, untried, and 
obviously unwarrantable measures. From such a point of view the bill of Senator 
Caffery, " granting additional quarantine powers and imposing additional duties 
upon the Marine-Hospital Service," deserves the support of everyone who may hope 
for a logical settlement of the great question at issue. This bill has for its purpose 
such a development of the Marine Hospital plant as will make it possible for the 
General Government efficiently to control all maritime and inland quarantine, and 
is framed on the practical basis of aiding and advising the local authorities, and not 
interfering with them unless in cases of emergency, or when large districts of country 
are affected, and when a general, impartial, and uniform system of protection is 
demanded. The Secretary of the Treasury naturally remains as the legitimate head 
of the department. Much as it would compliment the medical profession to have a 
physician in such position as a member of the Cabinet, the proposed measure is the 
next best solution of a question concerning which there are many pros and cons. 
The Secretary has already supreme control of maritime customs, and can, on sufficient 
grounds, refuse the entry of any vessel bound for our ports. When to such power 
that of enforcing quarantine is added, it is easy to conclude that both functions can 
work together harmoniously and consistently. Then, again, there can be no ques- 
tion, in this instance, regarding the constitutionality of so-called invasion of State 
rights, as Congress has the right to regulate commerce and can interfere with any- 
thing that pertains to it. 8 
ADDITIONAL QUARANTINE POWERS. 
One very forcible argument in favor of the bill is the fact that the Marine-Hospital 
Service, having done so much in arresting and preventing epidemics, is fully com- 
petent to exercise increased powers in the line of work with which it is already per- 
fectly familiar. With such great interests at stake as the health of the entire nation 
there will be no possible temptation to make distinctions in favor of one or other 
district, but all can come under a uniform regulation, "as far as climatic conditions 
will justify." 
The main opposition to national quarantine comes quite naturally from local 
authorities which are jealous of the privileges of revenue and of political patronage. 
This is evidenced by offers on the part of several States to purchase the present 
quarantine plants of the Government and manage them as independent establish- 
ments. The pecuniary measures which comprise the levying of arbitrary and exces- 
sive fees on commerce, and which are the main ones considered by the different 
State quarantines, are to the last degree oppressive, burdensome, invidious, and 
unnecessary. By a new order of things there will be no call for special fees, and 
all the ports of entry will be on an equal basis as regards quarantine regulation. 
The advantages of the latter system are already proven in those localities where only 
national inspection prevails, by the fact that increased trade is naturally attracted 
to such favored ports to the exclusion of neighboring ones not so favored. Thus it 
will be seen that millions of dollars can be saved to commerce which are now 
demanded on the purely technical ground of State rights to collect special fees. 
It is useless, however, to multiply arguments in favor of national quarantine. 
The real question that concerns us now has reference to the best and readiest means 
to the desirable and imperative end. The best answers to objections urged against 
all bills heretofore presented are very effectively, consistently, and practically given 
in the admirable, far-reaching, comprehensive, and just provisions of the Cafifery 
bill. The Marine-Hospital Service eminently deserves every opportunity for 
increased usefulness and good work. Even with its limited resources it has made 
an admirable and unimpeachable record. The profession and the public should be 
ready with their indorsement at the time when such is so much needed- to make all 
the really necessary quarantine reforms within the reach of ready realization. 
[Inclosure No. 2.-Editorial reprinted from the New York Medical News, February 5, 1898.] 
THE SCOPE OF THE MARINE-HOSPITAL SERVICE. 
It is often stated by those who are opposed to the Marine-Hospital Service, and it 
is uttered with all the solemnity of a final pronunciamento, that the service was 
originally established to care for sick and disabled seamen, and is therefore iucapable 
of performing other or alked functions. When this had been uttered, the final blow 
was thought to have been dealt to the service by those who are interested in oppos- 
ing its development. 
That it was originally established for the purpose named is true; but to assign 
that as a reason why it is incapable of performing other functions is both unimpor- 
tant and superficial. The care of sick and disabled seamen brings the officers of the 
service into intimate relations with the hygiene and sanitation of ships, and the 
history of the service abounds with records of investigations made into these sub- 
jects, which are so closely allied to quarantine. 
Long before the Marine-Hospital Service was intrusted with the duties of enforc- 
ing national quarantine laws its officers had made both official and unofficial inves- 
tigations into the cleanliness of ships, the hygiene of the forecastle, sanitation of 
crews, examination of the food supply of deep-sea vessels, all of which may be found 
in the annual reports which have been issued for the past quarter of a century. So 
far from disqualifying officers for the work of a public-health service, particularly 
in its relation to maritime quarantine, the intimate and almost indispensable con- 
nection with the functions of a public-health service peculiarly fits the officers for 
the performance of such duty, and the active participation by them in such work 
during the period named makes them what unbiased persons regard them to be-the 
only corps of medical men in this country specially skilled in the class of work in 
question. The very foundation of a system of safeguards for the national health is 
a protection of the interior of the country from the introduction of contagious dis- 
ease from without. The service which, since its foundation, has dealt with "men 
that go down to the sea in ships," and with the condition of ships themselves, is the 
one best fitted by long and practical experience to deal with the question of mari- 
time quarantine. 
This is not all. Along the line of natural development the Marine-Hospital 
Service has progressed, by direct authority of Congress, in other fields of investigation 
and execution in respect to public-health functions, and besides its original work of 
caring for sick and disabled seamen (of which over 50,000 are treated annually), ADDITIONAL QUARANTINE POWERS. 
9 
keeping officers in touch with active professional work, it has performed its func- 
tions as the Federal agency in the management of quarantine; undertaken investi- 
gation of smallpox by direction of Congress, the results of which study are ready 
for publication; has collected and published data respecting health aud mortality 
statistics throughout the United States and the world, the last by the reports of the 
consular service. It has also been engaged for the past year or more in experiments 
in car sanitation with respect to communicable diseases; has conducted investiga- 
tions concerning the pollution of water supplies; performed pioneer work in this 
country in respect to diphtheritic antitoxin and formaldehyd disinfection; and two 
of the officers are now in Havana, Cuba, by detail of the President, conducting an 
investigation into the causation of yellow fever. These varied duties which it has 
performed and is now performing certainly indicate the variety of its work in con- 
nection with public-health service. Its hygienic laboratory is one of the best 
equipped in the country, and here every year, in turn, several officers receive instruc- 
tion bearing upon the advances in hygiene, bacteriology, and allied sciences. These 
facts should certainly satisfy any reasonable professional man that the scope of the 
service is sufficiently varied, and that it is entitled to the sympathy and support of 
the medical profession throughout the country in its development and progress. 
Any movement which has for its cardinal text the relegation of the Marine-Hos- 
pital Service, which has done so much pioneer work in the interests of public health, 
to a secondary or even more obscure position in the ambitious plans of its enemies 
will not meet with a responsive chord in the minds of the majority. 
The service is developing in the exact direction which the promoters of the pro- 
posed department of public health expect to attain by one act of legislation. 
The Senate, upon the recommendation of its Committee on Public Health aud Quar- 
antine, has already indefinitely postponed two bills for the establishment of a 
department of public health and favorably reported the Cattery bill, which imposes 
additional powers and duties upon the Marine-Hospital Service. In view of the 
state of the national finances and the improbability of Congress assenting to the 
large and indefinite expenditure necessary for the establishment of a department of 
public health, it seems to us that the profession should turn its attention to develop- 
ing and supporting the Marine-Hospital Service as the public health service de jure 
as well as de facto, aud that those who are uow, as we think, mistakenly, if honestly, 
expending their efforts in the attempt to create a department of public health 
should join with their fellows in strengthening the hands of their professional 
brothers in the Marine-Hospital Service, who have been so long and faithfully serv- 
ing the public. 
[Inclosure No. 3.-Reprinted from the New York Medical Journal for December 25, 1897.] 
THE NATIONAL GOVERNMENT AND THE PUBLIC HEALTH. 
The group of articles on the subject of the public health which appeared in the 
December number of the North American Review is deserving of careful study by 
every citizen. The authors of the articles are Dr. John H. Girdner, of New York; 
Dr. Alvah H. Doty, the health officer of the port of New York, and Dr. Charles M. 
Drake, surgeon of the Southern Railway Company. These three gentlemen are 
eminently entitled to discuss the matter from their various points of view. Dr. 
Girdner was prominent several years ago in the advocacy of the New York Academy 
of Medicine's bill for the establishment of a bureau of public health. Dr. Doty is 
well known as a quarantine officer of unexcelled efficiency, and Dr. Drake is enti- 
tled to be heard as chief medical adviser of a large transportation company which 
has been seriously affected in its business during the late epidemic of yellow fever 
in the South, and will be equally affected whenever such conditions recur. 
If at this late day there is any intelligent citizen of the United States who doubts 
the desirability of national cooperation, if not control, in the administration of 
health laws, or the desirability of having those laws uniform, we recommend to 
him particularly to read Dr. Girdner's article. The only real matter of disagree- 
ment is as to whether it is better to set up a national board of health, or create a 
bureau of public health with a cabinet officer at its head, or give increased powers 
to the Marine-Hospital Service by some such legislation as would be accomplished 
by the enactment of Senator Caffery's bill, the text of which we print elsewhere in 
this issue. * 
The proposed establishment of a department of public health, involving the instal- 
lation of a deliberative assembly of forty-five members, is an untried scheme, and one 
that does not entirely commend itself. It seems to us to be a radical innovation in 
the development of our governmental system. The growth of the several executive 
* That is, in the New York Medical Journal for December 25, 1897. 10 
ADDITIONAL QUARANTINE POWERS. 
departments of our Government has been by a process of slow increment. It is not 
necessary to recall the process of evolution in the latest addition to the Cabinet 
departments, the Department of Agriculture. This began in a small way, and in 
the course of time a commissioner was set over it. This continued for many years, 
and then, after the success of the experiment was assured and opportunity had been 
given to ascertain the needs of the proposed independent department, its head was 
raised to the dignity of a Cabinet officer. Until 1798 the affairs of the Naval Depart- 
ment were under the control of the Secretary of War. The Interior Department was 
established as late as in 1849. 
We do not believe that a department of public health should be created suddenly, if 
at all. It must and should grow by a process of development, according to the needs 
of the nation in respect to such matters, so that its growth shall be healthy and the 
aspirations of the medical profession shall not be hindered by backward steps, which 
must necessarily be taken if the attempt to graft an undigested departmental 
machinery on our system of Government should succeed. 
This matter also deserves consideration from an economical standpoint. The 
question of expense will largely influence the legislators in their consideration of a 
scheme which involves the creation of a large and thoroughly equipped department, 
with the executive board of forty-five men whose traveling and other expenses of 
an indefinite character are to be paid out of the appropriations for the department. 
Congress has always made use of existing bureaus and officials as the nucleus for 
developing departments, and it seems to us that in the absence of any reasonable 
opinions to the contrary, it will undoubtedly do so in the present case, should any 
action at all be taken in the matter. Indeed, notwithstanding the unjust criticisms 
of the Marine-Hospital Service, the bill advocated by certain individuals recognizes 
the need of using the Marine-Hospital Service as a nucleus for the proposed depart- 
ment. It would be folly to ignore it with its existing establishment of trained 
officers, its hospitals, its quarantine plant, and the experience gained by its surgeons, 
25 per cent of whom have been tried in every yellow-fever epidemic during the past 
twenty years. 
The recent agitation in favor of the proposed health commission consisting of one 
member from each State board of health and territorial health organization has 
doubtless been occasioned by the outbreak of yellow fever in the Southwest. From 
the maritime quarantine standpoint yellow fever is the only disease which need 
engage our serious attention. The probability of cholera or smallpox ever attaining 
epidemic proportions throughout our country is very small, and therefore it is 
chiefly to the subject of yellow fever that the supporters of the proposed measure 
point. As yellow fever is an exotic, and practically every epidemic is the result of 
importation from Central or South America or the West Indies, the matter of mari- 
time quarantine against it is one of the greatest practical importance. The persons 
whose opinions on this subject are worth anything practically are those who have 
been engaged in this work in the past on the seaboard south of Chesapeake Bay. 
It is no reflection on the gentlemen who are proposed as representatives of this 
department from the interior States to say that their practical experience in these 
matters is no better than that of 69,000,000 other people. It has never been their 
business and never will be their business while they remain in the inland States 
mentioned. Their qualifications for preparing rules and regulations governing these 
matters are neither better nor worse than those of 30 other persons selected from 30 
different States not on the seaboard. We mean no unkind criticism when we say 
that their connection with the proposed commission in respect to these matters would 
be far from useful. 
The American Public Health Association bill seems to us a retrograde measure. 
It would involve a departure from all existing methods of departmental work. It 
would create, to stand between the executive of the department and the management 
of an epidemic, a deliberative body of forty-five men whose opinions would have to 
be had before action could be taken. It seems a waste of time to discuss the details 
of a measure which has such a feature for its foundation. 
Dr. Doty states that, after New York, New Orleans, and Boston, the three largest 
ports of the United States, which are under State control, the Marine-Hospital Serv- 
ice has charge of a few smaller quarantine stations, and at first sight this statement 
seems calculated to demolish the idea that the Marine-Hospital Service has anything 
whatever to do with the health interests of the country. It is undoubtedly a fact 
that a large number of vessels enter the port of New York; the same is true of Boston. 
Unquestionably these two cities have the largest ocean commerce of any cities of the 
United States, but after that has been said it may be added that the vessels arriving 
at these two ports have nothing in them seriously involving the health interests of 
the country, as a rule. The few small quarantines which are operated by the Marine- 
Hospital Service are mostly situated in the Southern cities, situations of danger, 
from a quarantine standpoint, and it is pretty safe to say, notwithstanding the 
amount of work which the health officers of the ports of Boston and New York have ADDITIONAL QUARANTINE POWERS. 
11 
to do, that the work done by the Marine-Hospital Service at these Southern quaran- 
tines is ten times as important and valuable. Among the few ports whose quarantines 
are controlled by the Marine-Hospital Service, moreover, the ports of Philadelphia 
and San Francisco should be mentioned. 
The views of those who really deal with the only epidemic scourge to which this 
country is subject are entitled to practical consideration. Dr. Drake, an officer of 
the Southern Railway Company, whose business interests were largely affected by 
the recent epidemic, who is, we may suppose, entirely free from prejudice in the 
matter, expresses satisfaction with the work of the service during the late epidemic, 
and urges that increased powers be given to it to enable it to cope more successfully 
in the future with similar epidemics. It is unfair to criticise the work of a person or 
a number of persons who are operating at a disadvantage by reason of insufficient 
tools or inefficient laws. The national control of epidemics through the Marine- 
Hospital Service has been largely hampered in the past by the objections of State- 
rights theorists. This has been largely overcome by practical experience. The 
Marine-Hospital Service has had to wait until the inefficiency of certain local meas- 
ures was established, and only then would it step in and exert its powers. Thus the 
early and favorable time w'as lost when work should have been done to restrain the 
onward progress of a threatened epidemic. It is the fault of the law and not of the 
service that certain concessions have not been made to the satisfaction of persons 
who are interested, or profess to be interested for one reason or another, in the develop- 
ment of an improved health service. Senator Callery's bill, which would confer 
great powers upon the Secretary of the Treasury, seems to us a far more promising 
measure than any scheme for a national board of health. 
[Inclosure No. 4.-The Sanitarian, December, 1897, editorial.] 
As reported by Dr. Cochran to the A. M. Association, 1896: 
"1. We may desire and advocate a plan to deprive the Marine-Hospital Service of 
its public-health functions, and for the establishment of an entirely new depart- 
ment; or, 
"2. We may accept the Marine-Hospital Service just as it stands as a department 
sufficient for our present use; or, 
"3. We may endeavor to improve the Marine-Hospital Service and make it a more 
satisfactory national health department than it now is. 
"It would seem that this last method promises to be the most fruitful of beneficent 
results; and the question then arises as to the modifications that may be wisely made 
in the existing law." 
Suggestions follow for utilizing the Marine-Hospital Service as the groundwork 
for a national health service, with such amendments and additions to the laws gov- 
erning it as would comprehend the cooperation of the State and local boards of 
health. 
To this end there are no more experienced or better accomplished physicians in 
the United States, in both the theoretical and practical work necessary for an effective 
national sanitary service, than are to be found in the Medical Corps of the Marine- 
Hospital Service. Their scientific investigations in laboratory work will compare 
favorably with any that have ever been made elsewhere. These investigations 
relate to the cause, nature, history, and prevention of epidemic diseases, and their 
practical utility in preventive medicine generally is of universal recognition. 
Moreover, admirably formulated regulations have been promulgated for the preven- 
tion of the spread of yellow fever and other infectious diseases from one locality to 
another. The collection of information regarding the prevalence of infectious and 
epidemic diseases generally, foreign as well as domestic, has been systematized, and 
is in practical operation; and State and local authorities are regularly supplied with 
such collective service by a weekly bulletin. 
Indeed, the foundation of a national board of health is already laid. The proposi- 
tion to extend its scope by such emendations and additions to the laws now governing 
it as would secure the cooperation of the sanitary authorities of the States severally 
and jointly, as suggested by the late Dr. Jerome Cochran after a critical examina- 
tion, is eminently commendable. And in this reference to the judgment of Dr. 
Cochran it should be borne in mind that it was the deduction of a practical sanita- 
rian-of one who had devoted many years of his professional life to preventive med- 
icine and after he had served as chairman of a committee specially appointed to con- 
sider the question of a "Department of public health." Considering all the circum- 
stances and the relations of the leaders of the proposition to supersede the Surgeon- 
General of the Marine-Hospital Service to the present chief of that service, we can 
but regard the proposition as being alike discreditable to both the American Medical 
and the American Public Health associations. 12 
ADDITIONAL QUARANTINE POWERS. 
The proposition reflects political preferment to practical knowledge of preventive 
medicine; it deserves not only the reprobation of every practical sanitarian, bnt 
of every person who is alive to the importance of an effective health service. 
[Inclosure No. 5.-Philadelphia Medical Journal, January 8,1898.] 
THE PUBLIC HEALTH BILLS BEFORE CONGRESS. 
The underlying motive of the various efforts to modify the existing national sani- 
tary laws and administration of this country is well expressed by Professor Jacobi, 
of New York, in a resolution recently adopted by the Academy of Medicine of that 
city, with a view to renewing its activity in this direction, as a desire lor "a cen- 
tralization under the National Government of the means to protect efficiently the 
health of the American people against the importation and dissemination of con- 
tagious diseases." 
Whatever side issues may exist, and whatever personal ambitions may be secretly 
at work, the general sentiment of physicians, of sanitarians, and of the great com- 
mercial interests is that it is the duty of the National Government to protect us 
against the invasion of infection from abroad as well as from armed invasion. And 
even beyond this, in these days of rapid transit and immense movements of popula- 
tion. when the seeds of a pestilence may be carried across the domains of several 
States in a few hours, and when at the same time, the interruption of travel and 
traffic is so disastrous, it is felt that the interests involved are too vast to allow great 
lines of intercommunication within our own borders to be at the mercy of the igno- 
rant authorities of every little country town. The events of the past few months 
have greatly deepened these convictions, especially in our Southern States, which 
have suffered so seriously from the inefficiency of certain local health authorities 
and the insane and murderous activity of others. To such a pitch has public feel- 
ing been aroused in the city of New Orleans that even the efficient State board of 
health of Louisiana, which maintained a quarantine inspection service and also con- 
ducted the sanitary administration of the city of New Orleans during the recent 
outbreak of yellow fever, and stood up so nobly to its work, has been compelled to 
bow before the popular storm of indignation and to resign as a body. This feeling 
has taken shape in the bill recently introduced in the United States Senate by Sena- 
tor Caffery, of Louisiana, which is directly aimed at both of these evils. The bill is 
simply an amendment to the law of February 15, 1893, which "granted additional 
quarantine powers and imposed additional duties on the Marine-Hospital Service," 
and is intended to still further extend those powers and increase those duties. It 
makes the regulations formulated by the Treasurer of the United States the para- 
mount law of the land as regards both seaboard quarantine and the sanitary super- 
vision of interstate travel and traffic, while allowing the local authorities to execute 
or enforce the same, " if they will undertake to do so." It authorizes the placing 
of a national quarantine officer "at any port or place where the Secretary of the 
Treasury may deem it necessary" for the purpose of inspecting vessels from foreign 
ports. Its principal object, however, is evidently " to prevent unnecessary restric- 
tions upon interstate commerce." Hence, in all its provisions for the control of the 
movement of vessels, trains, or vehicles it is careful to convey the power, not only 
"to prohibit," but also to "permit" such movements, thus doing away with the 
vexations and harmful restrictions of local cordons and shotgun quarantines. 
There is one feature of this bill, however, which is open to serious criticism. We 
refer to the amendment to section 6. This clause might be construed so as to per- 
mit vessels which have been inspected and passed at a United States quarantine 
station to disregard and defy the regulations of a State or municipal quarantine 
station, established for the more complete protection of a port situated farther up 
a stream. In this way the State quarantine board of Pennsylvania, for example, 
would be entirely superseded. The attention of the representatives of Pennsylvania 
at Washington should be called to the matter, and they should insist on a modifica- 
tion of this provision. 
The distinguishing feature of the bill which flies the flag of the American Medical 
Association, but which was never adopted by that body, is that it proposes to estab- 
lish a "department of public health." To the ear of the sanitarian this has a very 
seductive sound. He has long felt that the protection of the public health was one 
of the great national issues, as well as entitled to recognition as a coordinate branch 
of government as either of those the chief function of which is the destruction of 
human life. The bill, however, does not fulfill the promise of its title. It establishes, 
not a true department, with representation in the cabinet, but merely a commission. 
As a rule, it may be affirmed that a system or institution which has been developed 
by the process of growth is more serviceable and has in it more elements of perma- ADDITIONAL QUARANTINE POWERS. 
13 
nence than one which has been artificially constructed on theoretic principles, and 
this because its provisions have been devised to meet actual emergencies. It is not 
strange, then, that the committee to which was assigned the duty of drawing up a 
bill for the establishment of such a department found that it could not do better 
than to adopt the provisions already formulated and put in force by the Marine- 
Hospital Service, and to propose that the new department should take into its 
capacious maw that entire service, Surgeon-General, '•building, offices, officers, 
laboratories and appurtenances, and property of whatever name and nature." 
It seems, therefore, to be little more than a change of names which is proposed, with 
the creation of a few additional salaried officers. We have the thing already. The 
Marine-Hospital Service is in reality the national department of health. The dog 
in the fable lost his bone in trying to seize its magnified reflection in the rippling 
stream. Let us be careful how we risk the perpetuity of our present tried and prac- 
tical, although not thoroughly ideal, system in the troubled waters of a Congressional 
struggle. The wiser alternative, as we view the matter, is that suggested by that 
eminent and well-trained sanitarian, the now lamented Jerome Cochran, health 
officer of Alabama, and then chairman of the very committee which now proposes the 
bill we have been considering, viz, "To endeavor to improve the Marine-Hospital 
Service and to make it a more satisfactory national health department than it now is." 
[Inclosure No. 6.-The Georgia Journal of Medicine and Surgery, August, 1897.] 
THE DEPARTMENT OF PUBLIC HEALTH BILL. 
In this issue we quote in full the " bill to establish a department of public health, 
and to define its duties," as reported at the last meeting of the American Medical 
Association at Philadelphia. The bill was not adopted by the association, but was 
received and the committee continued. 
So important a matter as this should be fully discussed and thoroughly understood, 
and the present condition of affairs at "Washington, as regards the Marine-Hospital 
Service, known and appreciated before the indorsement and aid of the profession is 
given to it. 
With its intended merits and vast field of usefulness this bill, in our opinion, has 
its loss of advantage inseparable from political intrigue and power and our demo- 
cratic form of government. 
The power would be vested in the President of appointing to his Cabinet a sec- 
retary or commissioner of health, and would, therefore, be the judge of his qualifica- 
tions. We have no doubt that the President would select a proper commissioner, 
but would he appoint the modest man of thorough scientific and practical attain- 
ments? Would he not be more liable to choose the superficial man of skillful news- 
paper notoriety, with a penchant for politics and a quota of adherents who might 
expect their spoils? This same might also apply to the assistant commissioner. 
Maritime quarantine, as all will acknowledge who know anything about it, can 
not be learned from books, and it requires several attainments besides those of a 
bacteriologist or a sanitarian to be a capable quarantine officer. Theory is very 
well in its place, but when plague, cholera, or yellow-fever infected ships are seek- 
ing to gain entrance to our ports considerable experience in dealing with seafaring 
men, as well as disease, is called for. The Marine Hospital officer would undoubtedly 
have to do this work, and it is not conducive to good health, good feeling, or proper 
esprit de corps, where inferiors are on a higher mental plane than their superior 
officer. 
We dislike very much to see the element of politics pure and simple enter such 
important work, for when it begins at the head of a Department, no telling where 
it may end; and there might be danger of our commissioner being not only a figure- 
head, but also a monument to political intrigue. We are aware of the fact that a 
certain amount of political finesse is always displayed in the selections and appoint- 
ment of the surgeons-general of the Army, Navy, and Marine-Hospital Service, but 
men of education in medicine and other sciences, and with years of special work 
and training, and passing many difficult examinations, their qualifications for office 
can not be denied. 
How much more just and fair, and how much better for the country, therefore, it 
seems to us, to draft a bill imposing additional duties and enlarging the field of use- 
fulness of that very important department of public health (which it now is), the 
Marine-Hospital Service, and including in the marine-hospital bill all the good fea- 
tures (for they are practically and virtually carried out in toto by the marine serv- 
ice at this moment) of the new bill under discussion, without its objections. 
The question of stream pollution, interstate and land quarantine, in some of its 
phases, are about the only points not thoroughly under the supervision and being 
acted upon now by the marine service contained in this bill. 
Let us see what the marine service is doing, not summing up the very important 
quarantine and prevention work they have done, which can be learned upon inquiry 
at "Washington. 14 
ADDITIONAL QUARANTINE POWERS. 
Their officers must, to first gain admission to the service, pass a rigid and impar- 
tial physical, academic, and medical examination, practical and theoretical, in which 
absolutely politics plays no part. Should the.examination prove satisfactory, they 
are appointed by the President, with the approval of the Senate. The officers are 
getting practical work and experience at the several national quarantine stations, 
and are placed in charge of such stations. They receive a course of training at the 
hygienic laboratory in all the most important biological' discoveries, especially m 
contagious and infectious diseases. 
The Harris bill of 1893, under which the Department controls, manages, and super- 
vises quarantine stations, contains all the important matter in the public-health 
bill, and much of it seems an extract from the Harris bill and amended rules and 
regulations promulgated by the Secretary of the Treasury, copies of which may be 
had upon request. 
Therefore they have the advantage of special training, theoretical and practical, 
from the hygienic laboratory to the ship's bilge and forecastle, and are thoroughly 
competent to deal with threatened invasion of contagion through the shipping. 
Honest and skilled medical inspectors are kept in the countries which are the most 
dangerous sources of infection, whose duty it is to see that all measures tending to 
prevent the introduction of quarantinable diseases are carried out, and to render 
full reports of the same. This, together with foreign statistics, consular reports, 
domestic vital statistics, and all health questions that are presented weekly, are pub- 
lished, and sent to all who ask. 
An epidemic or emergency fund is at the disposal of the Marine-Hospital Service in 
case of necessity in occurrence of epidemics in any of the States or Territories. The 
service has means at its disposal, and is thoroughly capable of fulfilling the most 
minute requirements of the new bill. 
By enlarging the service, numerous new vacancies would be made, offering oppor- 
tunities for entrance to young, thorough, and scientific men. 
We can not see what good it is going to do to appoint from civil life a commissioner 
and assistant commissioner and placing them in charge of a department that has 
been slowly evolved by years of work and thought into one of the most important 
of the bureaus of the Government, when the men in it, who, by dint of study and hard 
work, and after passing several difficult examinations, rise to the highest plane of 
promotion. 
The commissioner and assistant commissioner will cost the Government $9,500 per 
annum, and outside of politics, from the cold science standpoint and in view of what 
the Marine-Hospital Service is doing, will they be worth it? 
[Inclosure No. 7.-Bulletin of the North Carolina board of health. December, 1897.] 
In pursuance of the second plan, a bill has been proposed establishing a "depart- 
ment of public health." We haven't the space to print this long bill in full, but the 
following extracts will be sufficient for our purpose. 
There are several objections to this bill, but the most important-and, to our mind, 
fatal one-is the injection of politics into our quarantine system, for the President 
has to appoint, not only the commissioner, but all the medical officers-the latter 
after an examination, it is true, but the rules governing the examinations are to be 
made by the commissioner. Admitting that the President would always appoint a 
good man, he would almost surely be inexperienced in that particular work, and by 
the time he thoroughly learned it he would have to give place to another inexperi- 
enced man, in all probability. 
Then, too, there are many able men, "learned in sanitary science," who, however 
accomplished in other respects, are lacking in that rare, but in this case most impor- 
tant, gift of executive ability. Few men are born with this peculiar talent to any 
marked degree, and most successful administrators become such by close application 
and long experience. Is it likely that a political appointee from civil life, changed 
every four or eight years, would make a first-class executive? We think not. 
The Marine-Hospital Service as at present constituted is as far from the baneful 
influence of "practical politics" as are the Army and Navy. Its members are 
appointed solely for fitness, and their business in life is fighting disease-largely 
through quarantine work. They are seasoned veterans in that peculiar warfare. 
Their commanding officer, the Surgeon-General, is always one of their most experi- 
enced men, and while it might happen that he was not the man in the service best 
fitted for that position, it would always be true that he had been thoroughly trained 
in the business. And if it were our personal business, involving great consequences 
to us, as the proper management of our quarantine service does to the people of our 
country, we would not hesitate a moment in deciding in favor of the trained experts, 
and we do not believe the candid reader would, either. ADDITIONAL QUARANTINE POWERS. 
15 
Another objection, we think, is the large and unwieldy advisory council, strange 
as it may sound coming from one of the beneficiaries of that feature with its delight- 
ful semiannual visit to our beautiful capital city, with all expenses paid by tlncle 
Sam. While we might be able to tell the commissioner of public health, recently 
appointed from civil life, something he did not know about disinfection and quar- 
antine, it would be much better to have some one in charge who could tell us some- 
thing we did not know, perhaps. And, besides, there would be so many conflicting 
views, probably, and so many modifications of the rules for particular localities 
desired, that confusion rather than enlightenment might be the result. While we 
do not deny that, in many instances, there is wisdom in a multitude of counselors, 
we have come to the deliberate conclusion, after considerable experience, that in 
sanitary matters an enlightened despotism-an organization with the power and the 
will to override merely individual or local preferences in the interests of the whole 
people-would be best. We are afraid that our confreres will think this rank heresy, 
but that is what we believe, nevertheless. 
[Inclosure No. 8.] 
Resolutions adopted by the Tristate Medical Association of Alabama, Georgia, and Ten- 
nessee at Nashville, October, 1897. 
Resolved, That the recent outbreak of yellow fever in the South, and the numer- 
ous conflicting State and municipal quarantine regulations, emphasize the great 
need of national quarantine laws which are uniform and protecting; and 
Resolved, That the Tristate Medical Association, in convention assembled, hereby 
urges upon Congress the necessity of national quarantine laws which shall give 
exclusive charge of quarantine to the United States Marine-Hospital Service in 
connection with the development of cholera, yellow fever, smallpox, and the plague. 
[Inclosure No. 9.] 
Thomaston, Conn., February 15, 1898. 
Dear Sir: I take the liberty of calling your attention to the Caffery bill, as 
reported to the United States Senate, January 19 last, by Senator Vest, and of seek- 
ing to enlist your interest in its behalf. I will not weary you with arguments that 
might be made in favor of its various provisions, but as a member of the State board 
of health of Connecticut, and as president of the Connecticut Medical Society, I 
take a deep interest in the subject of national quarantine, and I firmly believe that 
the Secretary of the Treasury is the proper officer of the Government to make such 
rules and regulations as shall be necessary to prevent the introduction into the 
United States, or the spread from one State into another, of infectious and conta- 
gious diseases, and that the Surgeon-General of the Marine-Hospital Service is the 
proper executive authority who, under the direction of the Secretary of the Treas- 
ury, should be charged with the responsible duty of stamping out and preventing 
the invasion of contagious disease. 
It seems to me that a national board of health, composed of eminent sanitarians, 
though it might be ornamental, would not be practical. We had such a board once, 
and it came to naught; was blotted out as inefficient. There is a movement now on 
foot, as you are doubtless aware, to create another similar board. Such a national 
board, composed of representatives of the various State boards of health scattered 
throughout the country, would, I believe, be a cumbrous piece of machinery, which 
would be likely to prove inefficient, tardy, and powerless in the presence of an 
epidemic such as that which paralyzed the commerce and terrorized the people of 
the South last fall. I would, therefore, most respectfully and earnestly call your 
attention to this matter, hoping that you will see the necessity of granting such 
additional powers and of imposing such additional duties upon the Marine-Hospital 
Service as, under the direction and authority of the Secretary of the Treasury, may 
enable it to cope with any future epidemic, however formidable, that may threaten 
to devastate our country. 
Respectfully submitted. 
Ralph S. Goodwin, M. D., 
Member of the State Board of Health and 
President of the Connecticut Medical Society. 
Hon. Joseph R. Hawley, 
United States Senator, Washington, D. C. 16 
ADDITIONAL QUARANTINE POWERS. 
[Inclosure No. 10.-New York Herald, February 12, 1898.] 
NATIONAL QUARANTINE AND THE MARINE-HOSPITAL SERVICE. 
With the experiences of the late epidemic of yellow fever in fresh recollection the 
necessity for a national system of quarantine can hardly be questioned. At the time 
when the pestilence was spreading, as the result of conflicting regulations of inde- 
pendent State boards of health, when railroad travel from one Commonwealth to 
another was interdicted by local authorities, when shotgun quarantines were insti- 
tuted in stricken districts, and when almost every threatened town had an improvised 
quarantine of its own, the Herald took occasion to advocate a centralized control of 
all such disturbing, inconsistent, and antagonizing interests. In maintaining such a 
view it voiced the sentiments of advanced thinkers on the subject and was in accord 
with the opinions of leading authorities on protective sanitary measures. 
Now that the discussions here and elsewhere have borne legitimate fruit in the 
various national health bills now before Congress, it becomes us to inquire which 
one of the latter is most likely to pass on its merits. 
The main question hinges either upon the advisability of abolishing the Marine- 
Hospital Service, now having partial charge of our maritime quarantine, and substi- 
tuting another system, or of enlarging the powers of that service and thus utilizing a 
plant already existing. While the friends of the various measures are consistently 
working in the direction of a comprehensive form of national quarantine, it'is quite 
evident that the odds are in favor of developing a system we have already at hand 
rather than institute new ones, however comprehensive and efficient they may prom- 
ise to be. 
The advocates of a radical change of the present law favor the creation in one 
form or other of departments of health, having either a Cabinet officer, at the head 
or an executive board. Each system has varied, expansive, and comprehensive func- 
tions, with wide representation throughout the different States. The avowed pur- 
pose of all is to reconcile the different State interests in a consistent whole for 
mutual protection, although with the manifest danger of being confused by a multi- 
tude of advisers whose real interests are necessarily conflicting. This disposition 
is particularly apparent in one of the bills, which separates the maritime from the 
inland quarantine and provides independent officers for each. 
It is easy to understand that, however good the intentions may be in other direc- 
tions, the actual working of such laws would be unsatisfactory, complicated, cum- 
brous, and impracticable. What would be gained in division of responsibility and 
apportionment of local interest would be lost in centralization of authority and 
simplicity and effectiveness of action. 
The Caffery bill offers seemingly the best solution of these difficulties. 'The Sec- 
retary of the Treasury, who has the control of the commerce of our ports, is retained 
as the proper head of the quarantine department, maritime and inland, and the 
Surgeon-General of the Marine Hospital remains as executive officer. All the States 
and ports of entry are to be subjected to uniform regulations, which are to be carried 
out by local authorities, the General Government interfering only when large terri- 
tories become involved and where it is impossible for the States to act independently. 
The stations already established are to be enlarged and multiplied, thus utilizing 
the work of a large medical staff already trained for duty. We could hardly do 
better than this in view of adapting available means to desirable ends. Thus far 
the Marine-Hospital Department has done very satisfactory work under most trying 
circumstances, and there is no tangible reason why it should be wiped out of exist- 
ence on any plea that radical and wholly untried methods are necessary. The public 
has every confidence in the ability of the Marine-Hospital Service and every hope in 
the amplification of its resources. 
[Inclosure No. 11.] 
Whereas the present epidemic of yellow fever in the South has demonstrated that 
the local authorities are insufficient to prevent the introduction and spread of epi- 
demic diseases, principally because of want of uniform regulations governing health 
affairs; and 
Whereas the health regulations now in force, viz, State, municipal, and county, 
each dependent on the other, and one frequently conflicting with another, have 
proven disastrous to travel, State and interstate commerce, and business generally; 
and 
Whereas it is desirable in the interest of the public health and State and inter- 
state commerce to provide for a more uniform system of quarantine; and 
Whereas the regulations of the United States Marine-Hospital Service are framed 
with due regard to local and climatic conditions: Therefore be it additional quarantine powers. 
17 
Resolved by the legislature of the State of Georgia, That hereafter, in case of an out- 
break of yellow fever, cholera, smallpox, or plagues, all quarantine matters ip the 
State of Georgia shall be turned over to the United States Maiine-Hospital Service 
during the continuance of such epidemic, under appropriate legislation to be here- 
after enacted by Congress enlarging the powers of the United States Marine-Hospital 
Service granted under the act of Congress approved February 15,1893. 
Resolved f urther, That, pending such additional legislation by Congress, all certifi- 
cates of freedom from danger of conveying infection from persons, localities, bag- 
gage, freight, and vehicles for the transportation of passengers and freight duly 
signed by medical officers of the Marine-Hospital Service shall be accepted by the 
State and local authorities in the State of Georgia. 
Resolved f urther, That we respectfully memorialize Congress to enact the necessary 
legislation to effectuate this resolution. 
Resolved further, That we request our Senators and Representatives to use all proper 
means to have such legislation adopted. 
Resolved, That the Surgeon-General of the United States Marine-Hospital Service 
be furnished with a copy of this resolution. 
Mr. Corliss. Have you made any estimate of the additional expense 
incurred in the Marine-Hospital Service by the adoption of what is 
known as the Hepburn bill ? 
Dr. Wyman. There is no additional expense. 
Mr. Corliss. Why? 
Dr. Wyman. There is no additional expenditure called for by it; it 
is simply amending the present law. 
Mr. Corliss. Would it not necessarily increase the force of the 
Marine-Hospital Service? 
Dr. Wyman. No, sir. 
Mr. Bennett. Could you conduct the quarantine stations of the 
United States with the same corps of assistants that you have now? 
Dr. Wyman. This bill does not call for conducting all the quarantine 
stations. It leaves the quarantine stations practically as they are, as 
far as the stations are concerned, only we make the regulations. 
Mr. Bennett. It jiermits a State to surrender its quarantine stations 
to the Government whenever they choose, does it not? 
Dr. Wyman. Yes, sir. 
Mr. Bennett. It is permissive and not directory? 
Dr. Wyman. Yes, sir; that is all. 
Mr. Bennett. Suppose they surrender their quarantine stations to 
the Government; what would be the effect on the Marine-Hospital 
Service? 
Dr. Wyman. Well, we would have to employ additional assistants 
for running them. Is that what you mean, or the expense? 
Mr. Bennett. That is what I mean. 
Dr. Wyman. Yes. 
Mr. Bennett. And you have made no estimate of what that expense 
would be? 
Dr. Wyman. I did some time ago, in a very rough way. The addi- 
tional cost of running the whole quarantine service of the United 
States ? 
Mr. Bennett. The additional cost, if it was surrendered; yes. 
Dr. Wyman. If the United States Government was to have posses- 
sion of every quarantine station in the United States 
Mr. Bennett. That is what this would practically amount to if the 
bill were made directory instead of permissive. 
Dr. Wyman. I think in the neighborhood of $350,000 a year. I am 
told by Dr. Kinyoun, who made an estimate for me, $300,000 a year. 
Mr. McAleer. That much more than now? 
Dr. Wyman. That much more than now. 
QUAE 2 18 
ADDITIONAL QUARANTINE POWERS. 
Mr. Mann. These present quarantine officers are paid by fees that 
are collected1? 
Dr. Wyman. Yes. 
Mr. Mann, Suppose the National Government should take control? 
Dr. Wyman. The National Government charges no fees. We have 
11 national quarantine stations now and the expense of running them 
is about $150,000 a year, and there are no fees charged at any national 
quarantine station. 
Mr. Mann. If it is proper for the local quarantine service to charge 
fees, would it not be proper for the National Government to charge 
fees ? 
Dr. Wyman. Yes; if Congress should so elect. 
Mr. Corliss. What proportion of our vessels enter the ports where 
the quarantine service is now established and working? 
Dr. Wyman. What proportion of our commerce is composed of for- 
eign vessels ? 
Mr. Corliss. That would require quarantine service? 
Dr. Wyman. You mean vessels from foreign ports? 
Mr. Corliss. Would it be limited to them? 
Dr. Wyman. We quarantine our own vessels when they come from 
foreign ports as well as vessels flying foreign flags. 
Mr. Corliss. Do you not quarantine vessels coming from New 
Orleans, for instance, to New York, when yellow fever is prevailing in 
New Orleans? 
Dr. Wyman. Yes ; we would if the port from which the vessel came 
was infected, but it is only rarely that it is necessary to quarantine 
against domestic ports. 
Mr. Corliss. Upon whom is the burden now imposed by the local 
quarantine officers in the collection of fees? 
Dr. Wyman. On the steamship and vessels owners, on the vessel 
owners and captains. 
Mr. Corliss. And that is imposed upon incoming vessels, is it not? 
Dr. Wyman. Yes. 
Mr. Corliss. Laden with produce and things for consumption by 
our people? 
Dr. Wyman. Yes. 
Mr. Corliss. Therefore it conies out of the consumers, out of our own 
people. 
Dr. Wyman. Well 
Mr. Bennett. That is a question. 
Mr. Joy. Would it impair the service to defray the expenses of that 
service by fees from incoming vessels or from the immigrants or the 
steamship owners? Would it impair in any instance the efficiency that 
could be rendered by the Marine-Hospital Service or the quarantine 
service ? 
Dr. Wyman. It would probably not be as efficient, but that is a sepa- 
rate question of itself as to whether the National Government should 
not pay by direct appropriation for the quarantine-for maritime quar- 
antine-because maritime quarantine protects the interior States as well 
as the coast States; the whole country is benefited by it. 
Mr. Bennett. It appeared yesterday from the testimony of Dr. Doty, 
I think, or the testimony of someone, that the New York State quaran- 
tine station collected in the neighborhood of $60,000 a year, as I under- 
stand it. 
Dr. Doty. It varies from year to year; that was it last year; yes. 
Mr. Bennett. With that as a basis, do you think with the rate ADDITIONAL QUARANTINE POWERS. 
19 
charged in New York that the fees by the local quarantine officers of 
the State could be made sufficient to make this service self-sustaining? 
Dr. Wyman. I do,* yes, sir. 
Mr. Bennett. Instead of the Government paying anything in appro- 
priations? 
Dr. Wyman. Yes. 
Mr. Corliss. Do you think it would be wise for the Government to 
establish a department for the preservation of the health generally of 
the people; to impose a fee for such inspection upon commerce? 
Dr. Wyman. That is a question which is a subject for serious con- 
sideration. There are two sides to it. 
Mr. Corliss. Is it not true that in the quarantine stations in which 
the Government of the United States now does the inspecting the com- 
merce pays no burden in consequence of such service? 
Dr. Wyman. Yes; that is true. 
Mr. Corliss. And at the ports in which the local quarantine officers 
make the inspection-for instance, New York-our people are paying 
$50,000 or $60,000 a year to maintain that local quarantine? 
Dr. Wyman. The commerce is paying that; yes. 
Mr. Corliss. That is, coming direct 
Dr. Wyman. Out of commerce. 
Mr. Corliss (continuing). Out of our people. 
Mr. Mann. I don't think you ought to try to put him on record on 
the tariff question. 
Mr. Corliss. I want to ask one more question in that line. Is it 
true that the commerce entering the port of New York is limited to the 
State of New York? 
Dr. Wyman. I did not quite understand your question. I do not 
suppose that everything that comes in 
Mr. Corliss. Does it not affect every part of the United States? 
Dr. Wyman. Yes, sir. The quarantine measures at the port of New 
York affect the rest of the United States. 
Mr. Corliss. And the resident of Michigan or any other State hav- 
ing commerce going upon a foreign vessel landing at New York from 
some foreign land must pay the burden of that inspection by the local 
officers, must he not? 
Dr. Wyman. The vessel which brings him does, and 1 suppose the 
vessel may make it up on the passenger 
Mr. Corliss. Or the commerce? 
Dr. Wyman. Yes, sir. 
Mr. Bennett. What would be the practical difference whether it was 
paid by the steamship company or whether the United States Govern- 
ment paid it, so far as the burden on the consumer is concerned? 
Mr. Corliss. Otherwise it would fall on the people 
Mr. Mann. What is the custom in other countries in regard to quar- 
antine charges? 
Dr. Wyman. I really do not know. 
Mr. Mann. Is it not a universal rule everywhere that they make a 
local charge specifically against a vessel that is quarantined or 
examined? 
Dr. Wyman. I do not know what the custom is in other countries. 
Mr. Bennett. I notice that these bills which have been presented to 
us, especially this one introduced by Mr. Hepburn, were introduced by 
request, and I would like to have an exiiression cf opinion by you as to 
why a change in the quarantine regulations of the United States is 
desired at this time-the water quarantine. 20 
ADDITIONAL QUARANTINE POWERS. 
Dr. Wyman. Well, the experience in administering the law of 1893 
has demonstrated the necessities of these changes. 
Mr. Bennett. As a matter of fact 
Dr. Wyman. Yes; as a matter of fact. 
Mr. Bennett. As a matter of fact, during the cholera troubles at the 
port of New York, managed by Dr. Jenkins, was it not managed to 
the perfect satisfaction of the General Government; was it not the 
understanding that if the New York quarantine officers needed any 
help that the General Government would give it to them; and is it not 
true that they did not need it and the General Government did not 
have to give them any assistance, and were they not successful in deal- 
ing with the cholera in New York Harbor? 
Dr. Wyman. The success that the New York quarantine officials had 
in 1893 in dealing with the cholera was largely due to the continual 
presence of an officer of the United States MarineHospital Service, 
who aided Dr. Jenkins by his advice and counsel and watched very 
closely in the interest of the rest of the country the disinfection of the 
baggage of the immigrants, and, in fact, all the quarantine procedures. 
Mr. Bennett. That is disputed on the part of the officers of the State 
of New York who were members of the quarantine corps at that time. 
I desired to bring that point out. 
Dr. Wyman. I will further state, as illustrating the necessity of this, 
in regard to the port at San Francisco. The quarantine procedures 
there under the local health officer were faulty, and it took a much 
longer time than it should have taken to bring about, under the law of 
1893, the assumption in accordance with the order of the President of 
the quarantine authority by the General Government. 
Mr. Barham. In that connection I want to call attention to a protest 
of the board of health in the city of San Francisco, since you have 
mentioned it. Among other things, they say: 
You petitioners protest against the adoption of such a law- 
That is the law you are talking about- 
as tending not only to centralize in a particular branch of the Treasury Department 
the entire quarantine functions of the various States, but serving to express and con- 
vey direct insult to the State government. We further charge that this proposed 
amendment in its very inception has for its main object the protection of the Super- 
vising Surgeon-General from criticism and possible legal prosecution on account of 
the numerous violations of section 3. 
Dr. Wyman. He refers there to the clause which I have requested to 
have stricken out of the bill in aid of State and local 
Mr. Corliss. Calling upon the Government to aid State and local 
quarantine authorities. 
Mr. Barham. What do they mean by this: 
We have no hesitation in charging the Marine-Hospital Service with violation of 
the laws of the State of California. 
Do you know anything about what they mean by that? 
Dr. Wyman. I do not know exactly what they mean, except that the 
Marine-Hospital Service was enforcing the act of Congress. 
Mr. Barham. As it is now? 
Dr. Wyman. Yes. 
Mr. Barham. Do you recollect what the difficulty out there was? 
Dr. Wyman. The difficulty was: We have a quarantine plant there. 
The National Government established a very expensive and complete 
quarantine plant, but for some time the boarding vessel was not ready. 
In the meantime the boarding was kept up by the local officer, and ADDITIONAL QUARANTINE POWERS. 
21 
when the vessel was ready the local officer objected to the national 
officer doing any of the boarding. But in the meantime certain trans- 
actions occurred which showed that the quarantine officer was not 
really performing his duty properly. 
Mr. Barham. In disinfecting the mails and everything 
Dr. Wyman. There was great danger of the admission of contagious 
disease, and finally the President took action under the law of 1893, 
and detailed Passed Assistant Surgeon Bosenaw as quarantine officer 
for the port of San Francisco. The General Government already had 
the plant established by act of Congress. 
Mr. Barham. They charge in this that Dr. Bosenaw, at Angel 
Island, refused to fumigate the mail from the steamer Peru, as requested 
by the State quarantine officer, by order of the municipal board of 
health-that is the San Francisco Board of Health-and that they com- 
municated these facts to the Treasury Department and had no reply. 
Dr. Wyman. They have been replied to. That is true, that Dr. 
Bosenaw refused to receive orders from the local quarantine officers 
after the President had detailed him as quarantine officer of the port. 
Mr. Mann. He refused to follow out that provision of the law regard- 
ing aid in the carrying out of the local regulations; is that it? 
Dr. Wyman. That had been abrogated by the action of the President. 
Mr. Mann. Nobody out there can abrogate it. 
Dr. Wyman. The President had done it. He had appointed him as 
the quarantine officer for the port of San Francisco. 
Mr. Mann. But the President could not abrogate that provision of 
the law, could he? 
Dr. Wyman. Well, it was simply impossible that there should be two 
quarantine authorities under the United States law. 
Mr. Mann. Do I understand, then, that in California the national 
authorities took charge of the quarantine? 
Dr. Wyman. Yes. 
Mr. Mann. And that the local authorities had nothing more to do 
with it? 
Dr. Wyman. That is the situation. 
Mr. Mann. What more legislation do you need, then? 
Dr. Wyman. The point is, it took so long to do it they fell short. 
Mr. McAleer. Please explain this matter as to the alleged violation 
of the law. 
Dr. Wyman. The quarantine regulations of the Secretary of the 
Treasury were not carried out. 
Mr. McAleer. By whom? 
Dr. Wyman. By the local quarantine officer. 
Mr. Bennett. That is a direct charge against the local quarantine 
officer at the port of San Francisco? 
Dr. Wyman. Yes. 
Mr. McAleer, That he refused to carry out the quarantine regula- 
tions? 
Dr. Wyman. He did not carry them out. He failed to carry them 
out, and so, after a due course of time, the President, after full reports 
were made to him, detailed, under the law of 18 3, an officer of the 
Marine-Hospital Service to take charge of the port at San Francisco as 
quarantine officer at that port. 
Mr. McAleer. Did he carry out the act of Congress? 
Dr. Wyman. Yes; he carried out the act of Congress. 
Mr. McAleer. He exceeded the act of Congress in relation to carry- 
ing out those instructions? 22 
ADDITIONAL QUARANTINE POWERS. 
Dr. Wyman. No, sir; the law says the President shall detail or 
appoint an officer for the purpose of executing the quarantine regula- 
tions. 
Mr. Joy. Did he execute those quarantine regulations, do you know? 
Dr. Wyman. Yes; he did. 
Mr. McAleer. Then you do not know of any violation of law upon 
the part of the quarantine officer as designated by the President? 
' Dr. Wyman. No, sir. 
Mr. Barham. Reading further from this: 
We charge the Supervising Surgeon-General of the Marine-Hospital Service with 
having failed to cooperate and aid the State board of health of California and of the 
port of San Francisco in the execution and enforcement of the rules and regulations 
of such board, or in the execution and enforcement of the rulesand regulations made 
by the Secretary of the Treasury. 
Dr. Wyman. The Surgeon-General denies the charge. That is all. 
Mr. Bennett. As a matter of fact, if the Marine-Hospital Service, 
by direction of the President or superior authority-whether it be the 
Secretary of the Treasury or otherwise-should take charge of the 
quarantine station, you would pay no attention to any State laws; you 
would use your own judgment, would you not? 
Dr. Wyman. We would follow the regulations of the Secretary of 
the Treasury. 
Mr. Bennett. And the local regulations would be disregarded; 
would be wiped out ? 
Dr. Wyman. We would not enforce the local regulations where they 
were in conflict with the Treasury regulations. 
Mr. Bennett. Do you know of any other cities besides the city of 
San Francisco where there was a failure of the quarantine officer to 
properly conduct his quarantine office? 
Dr. Wyman. Yes. 
Mr. Bennett. What city was it? 
Dr. Wyman. Brunswick, Ga. 
Mr. Bennett. Are those the only two cases that you know of in 
which a failure of the quarantine officer to properly conduct his office 
has occurred? 
Dr. Wyman. There have been a great many instances where the 
regulations have not been adequately carried out and where proper 
provisions for quarantine measures have not been made by the State 
or local authorities. I 
Mr. Bennett. That is the question as to the proper and efficient 
manner of conducting a quarantine station-the difference between a 
national law and the local law. Is it not the question as to the proper 
way of conducting a station? 
Dr. Wyman. Yes, sir. 
Mr. Bennett. That is a matter of opinion, though. 
Dr. Wyman. In those instances the attention of the local and State 
authorities has been called to the deficiencies and they have been 
remedied. 
Mr. Davey. What complaint was it at Brunswick, Ga.? 
Dr. Wyman. The medical officer at Brunswick, Ga., was not carrying 
out quarantine regulations properly at all. 
Mr. Bennett. Did you take charge of the station? 
Dr. Wyman. Yes, sir. 
Mr. Stewart, of New Jersey. Is it not a fact that outside of New 
Orleans and New York there is no sufficient State quarantine service 
in this country ? ADDITIONAL quarantine powers. 
23 
Dr. Wyman. I would not like to make that broad statement, because 
there are some quarantine services that are well run. 
Mr. Davey. I would like to have a more definite answer to my ques- 
tion as to Brunswick, Ga.? 
Dr. Wyman. The health officer there was permitting people who had 
been exposed to yellow fever at the quarantine station to go into the 
city; he permitted the ballast laborers who discharged the ballast from 
infected ships to go up into the city; they had free access to the city, 
and the quarantine in that way was Very lax, and it was through the 
faulty quarantine that yellow fever got into Brunswick. 
Mr. Davey. That was several years ago? 
Dr. Wyman. Yes; in 1893. 
Mr. McAleer. They also violated the local laws in that case as well 
as the laws of the United States, did they not? 
Dr. Wyman. Yes; they did. 
Mr. Wanger. In what ports have you quarantine stations? 
Dr. Wyman. Beginning on the Atlantic coast at the north, following 
the coast around, we have a quarantine station at the mouth of the Dela- 
ware Bay, and another one to supplement it 45 miles up the river, at Reedy 
Island, in the Delaware River. We have a quarantine station at the 
mouth of Chesapeake Bay. We perform all the quarantine services for 
the State of North Carolina. We have a disinfecting station in Cape 
Fear River, below Wilmington. We have a quarantine station off the 
coast of Georgia, called the South Atlantic quarantine station, located 
on Blackbeard Island. We have a quarantine station at Brunswick, 
Ga. We have one at the Dry Tortugas, Fla. Also at Ship Island, 
in the Gulf of Mexico, off the coast of Mississippi. We also have a 
quarantine station at San Diego, Cal. We have one at San Francisco, 
and we have one at Port Townsend, Wash. 
Mr. Barham. What salary did Dr. Rosenau get? 
Dr. Wyman. His pay is $2,000 a year. 
Mr. Barham. Do you think it would be proper to send to a port to 
override or direct or control the local board, say, at New York or San 
Francisco, a one-thousand dollar doctor, as was spoken of by somebody 
here yesterday ? Do you think you could get a man for that money with 
sufficient ability to go there and override the judgment of these men? 
Dr. Wyman. Not in the matter of quarantine; no, sir. 
Mr. Barham. Where does that thousand-dollar business come in-in 
this bill? 
Dr. Wyman. No, sir; not in this bill. It was put on in the Senate 
bill. 
Mr. McAleer. I suppose they would not object to getting $10,000 a 
year, though. 
Mr. Barham. No; but you can not get a doctor for $1,000 a year, 
you know. 
Mr. Mann. They send in a $1,500 captain sometimes to override the 
governor of a State. 
Mr. Bennett. What are the possibilities of a doctor entering the 
Marine-Hospital Service as regards promotion? What does he enter 
the service as? 
Dr. Wyman. As assistant surgeon, at $1,600 a year. 
Mr. Bennett. And what promotion is there ahead of him, and how 
large is the corps of assistants? 
Dr. Wtyman. We have about seventy medical officers. 
Mr. Bennett. And what are the possibilities of promotion? 
Dr. Wyman. At the end of live years they pass a second examina- 
tion, and if successful they are appointed passed assistant surgeons. 24 
ADDITIONAL QUARANTINE POWERS. 
Mr. Bennett. At what salary ? 
Dr. Wyman. Two thousand dollars a year. 
Mr. Bennett. Is that the limit? 
Dr. Wyman. No, sir; then as vacancies occur in the grade of sur- 
geon they are promoted to that grade. 
Mr. Bennett. How many surgeons are there? 
Dr. Wyman. Fourteen. 
Mr. Bennett. What is the salary of a surgeon? 
Dr. Wyman. The salary of a surgeon is $2,500 a year and fogies. 
Mr. McAleer. And do they have to take another examination? 
Dr. Wyman. Yes; they have another examination before they can be 
promoted to the grade of surgeon. 
Mr. Bennett. A surgeon is the highest rank, is it? 
Dr. Wyman. Yes. 
Mr. Bennett. Where are the surgeons of the Marine-Hospital Serv- 
ice located; where are their districts; are they distributed in districts 
throughout the country? 
Dr. Wyman. Throughout the whole United States. You mean the 
surgeons of that particular grade? 
Mr. Bennett. The surgeons of the Marine-Hospital Service. You 
said there were fourteen of them. 
Dr. Wyman. Well, I would have to think. 
Mr. Bennett. No special districts to which they are assigned? 
Dr. Wyman. No, sir. 
Mr. Bennett. Under the direction of the Supervising Surgeon-Gen- 
eral of the Marine-Hospital Service? 
Dr. Wyman. Yes, sir; they are ordered from station to station as 
the necessities of the service demand. 
Mr. Bennett. And a man may come from Virginia and be sent to 
California-, or vice versa? 
Dr. Wyman. That is true. 
Mr. Corliss. Is it not true that your force devote their entire time 
to the one interest of the country-the quarantine service? 
Dr. Wyman. The Marine-Hospital Service has charge of the sick and 
disabled seamen of the merchant marine of the United States. 
Mr. Corliss. In addition to quarantine? 
Dr. Wyman. Yes, sir. We have 20 marine hospitals, situated on the 
coast and on the lakes and rivers, and besides that over 100-I forget 
the exact number-of relief stations, where the importance of the serv- 
ice is not sufficiently great to warrant the detail of a regular commis- 
sioned medical officer. In those places we have acting assistant 
surgeons, men who are appointed after careful consideration, generally 
they are prominent practitioners of the places where they are appointed, 
and they accept these positions and remain year after year and become 
very valuable officers; but they are not subject to change of station 
except with their consent. 
Mr. Corliss. The removals, then, are only for cause? 
Dr. Wyman. That is all. 
Mr. Corliss. Is it not true that the local health officers and quar- 
antine officers of the States are constantly changing their location? 
Dr. Wyman. Yes, sir; frequently. They have not the tenure of 
office that the regular Government service has. 
Mr. Corliss. What effect does that have upon their efficiency and 
experience? 
Dr. Wyman. Occasionally it has a very bad effect. I do not wish 
to attack the local quarantine officers, but a new man might be additional quarantine powers. 
25 
appointed to a quarantine without any practical experience, and I 
have known of such instances. » 
Mr. Stewart. Is it not so, Doctor, that in a great many States they 
have no local boards whatever? 
Dr. Wyman. Yes; no State boards. 
Mr. Stewart. And in some of our most important points are not 
they largely inefficient? Take Florida, for instance, where yellow fever 
is apt to be started, are not the boards there rather inefficient? 
Dr. Wyman. The local or State? 
Mr. Stewart. The State boards. 
Dr. Wyman. I do not like to state that of the State board of health 
of Florida. On the contrary, J think that the State board of Florida is 
pretty good. 
Mr. Stewart. It was reorganized, was it not? 
Dr. Wyman. Yes; it was reorganized. 
Mr. Bennett. I maintain that the changing of the quarantine offi- 
cers is a benefit rather than a detriment, because the men who are 
brought in are men who come with experience; and in comparison, 
your officers who are appointed and who progress to be assistant sur- 
geons, and then surgeons, as I believe you stated, do not have the 
same opportunity of experience as those new men have who come in. 
Is not that a fact? 
Dr. Wyman. I do not think so, because we send our younger officers 
to the older officers for the experience. 
Mr. Bennett. For instance, when you appoint your $1,600 men, 
what opportunity have they had for experience in your department? 
Dr. Wyman. I have ordered one recently to assist an older officer at 
one of the quarantine stations. 'Hie younger officer stays with the 
officer in charge. The younger officer, you understand, does not com- 
mand the station, but is an assistant, and in the course of the year he 
has acquired a very large experience, and before he is promoted he is 
thoroughly qualified and competent to take entire charge of a quaran- 
tine station. 
Mr. Bennett. Does he have as much experience as the man engaged 
in local practice in a large city-for instance, like New York? 
Dr. Wyman. Yes; far greater. 
Mr. Wanger. Is experience considered in the selection of these 
$1,600 men-the previous experience of the applicants? 
Dr. Wyman. Yes, sir; nearly all the men who obtain admission to 
our corps are men who have had considerable experience in hospital 
practice, not in quarantine, of course, but in hospital practice, and to 
show the care that is exercised in their selection 1 will mention the fact 
that we have recently had a board for the examination of candidates 
for admission to the corps, and that 30 applicants appeared before the 
board, and of that number only five made the required percentage. 
Mr. BaRham. Who appoints that board? 
Dr. Wyman. I appoint the board; or the Secretary of the Treasury, 
rather, appoints the board, on my application. 
Mr. McAleer. Those thirty applicants were all graduated physi- 
cians, were they? 
Dr. Wyman. Yes; all graduated physicians. They are not fresh from 
the colleges, either, except in rare instances. They generally have had 
hospital experience before they come to us. 
Mr. Joy. Your assistants over the grade of assistant surgeons, are 
they allowed under your regulations as now existing to accept private 
practice in addition to their official service as officers of the Marine 
Hospital Corps? 26 
additional quarantine powers. 
Dr. Wyman. There is no law forbidding it. They engage in private 
practice. Quite a number of the officers are professors in the medical 
institutions where they are stationed. 
Mr. Bennett. And they are allowed leave of absence 
Dr. Wyman. No, sir; no leave of absence is necessary. 
Mr. Bennett. They have time at their disposal, then ? 
Dr. Wyman. They have time to deliver two or three lectures a week. 
The Chairman. There has been something said rather sneeringly 
of the $1,000 doctors. There are 92,000 or 93,000 doctors in the United 
States. Is not $1,000, in your judgment, a sum above the income of 
one-half of those physicians? (After a pause.) That is true. I am 
talking about something I have given some attention to. There are 
not one-half of the physicians of the United States-of the 92,000 phy- 
sicians in the United States-that are making $1,000 a year. I have 
seen that stated in medical journals a number of times. 
Mr. Mann. Have you a retired list ? 
Dr. Wyman. No, sir; we have no retired list. 
Mr. Mann. What becomes of your surgeons when they get old? 
Dr. Wyman. Well, we have not any too old for work. We have the 
privilege of putting them on waiting orders. 
Mr. Mann. Does that mean that you can put them practically on a 
retired list; are they paid when on waiting orders? 
Dr. Wyman. A certain percentage of their regular pay. 
Mr. Mann. So, practically 
Dr. Wyman. Yes; you might say practically it is. 
Mr. Mann. They are taken care of in their old age if necessary*? 
Dr. Wyman. We have only one man in the whole corps on waiting 
orders, and that is on account of tuberculosis contracted in the line of 
his duty. 
Mr. McAleer. Is it not true that a number of the young men who 
enter the service have probably been three or four years in practice1? 
Dr. Wyman. Yes, sir; we have examined the records and find that 
is the case-before they came in. 
Mr. Mann. Do you think you get as good doctors by appointment 
through the Civil Service Commission as if we recommended them"? 
Dr. Wyman. I do not think a civil-service examination is necessary 
for the appointment of our acting assistant surgeons, but the acting 
assistant surgeons above $300 a year are within the civil service, but 
they are only acting assistant surgeons. The commissioned corps are 
of course examined by law, under our own rules and regulations, and 
have nothing to do with the civil service. 
Mr. McAleer. You give them an examination*? 
Dr. Wyman. Yes, sir. 
Mr. Simpkins. Is it not true that the special demand for this legis- 
lation comes from the part of the country that is most exposed to the 
dangers of disease, and that it is recognized there and realized that the 
local requirements are not sufficient for their protection ? 
Dr. Wyman. That is undoubtedly true. 
Mr. Bennett. Each State is responsible for its own health, and have 
they not as much interest in proper protection in the way of quarantine 
as the National Government would have? For instance, take the State 
of New York. The appointment of health officer is made by the gov- 
ernor and confirmed by the senate. Would the governor not be as 
careful in selecting a health officer as though the President of the 
United States was in charge of the health of the State? 
Dr. Wyman. The State of New York might be, and some other State 
might not be. ADDITIONAL QUARANTINE POWERS. 
27 
Mr. Stewart. Is it not a fact that the Marine-Hospital Service is 
better fitted for a uniform system of quarantine than the States are, 
with their diverse practices and theories? 
Dr. Wyman. There is no doubt about that. 
Mr. Corliss. What effect would the establishment of the national 
board of health, as proposed, have upon the Marine-Hospital Service? 
Dr. Wyman. The only measures proposed are those that would 
practically obliterate the Marine-Hospital Service. 
Mr. Corliss. Is that advocated by anyone but physicians? 
Dr. Wyman. I have not heard that it has been; no, sir. 
Mr. Mann. What is your position with reference to these bills giving 
the Government control over interstate quarantine? 
Dr. Wyman. I have indicated it here in this communication I have 
read. I think we should have control under the circumstances, as 
stated in this communication. I believe that we should have control of 
interstate quarantine measures, of cholera, yellow fever, and plague, 
when such diseases come into the country. 
Mr. Barham. Have you ever had any difficulty or conflict with the 
manner in which the service has been conducted in New York in the 
past ten or fifteen years? 
Dr. Wyman. Under the present regime at New York we have had 
no trouble at all, but we did have previously. 
Mr. Bennett. Please explain that-what you mean by previously? 
Dr. Wyman. I mean that after the law of 1893 had been passed, weK 
felt that, in accordance with the terms of that law, when a ship with 
cholera on board arrived at the port of New York, it was our duty to 
make certain that the proper quarantine regulations were being carried 
out. Some objection was made by the local quarantine officer at that 
time to the inspection of the methods of quarantine. It then resulted 
in the framing of the regulation authorizing and directing the Surgeon- 
General of the Marine-Hospital Service, under the law, to inspect any 
quarantine station in the country at any time he might see fit, and visit 
any part of the quarantine plant to see that the regulations were being 
complied with. That regulation, before it was issued, was submitted 
to the Attorney-General, and it was approved by him as being in 
accordance with the law; and it was then issued and we had no further 
trouble. 
Mr. Bennett. As a matter of fact, there was no opportunity at the 
port of New York for interference by the Marine-Hospital Service in 
quarantine? 
Dr. Wyman. There has been no necessity. We were not seeking an 
opportunity. 
Mr. Hawley. How many of these surgeons that you have are sub- 
ject to the classified service? I mean the under men. 
Dr. Wyman. There are two classes of men in our service. The reg- 
ular commissioned corps, appointed by the President, and their commis- 
sions are approved by the Senate; then we have a corps of acting 
assistant surgeons. 
Mr. Hawley. Didn't you say that they were 70 in number? 
Dr. Wyman. Over 100 of them; and there may be at times a great 
many more of them. 
Mr. Mann. You said these 70 were the assistant surgeons? 
Dr. Wyman. Yes; of the regular assistant surgeons. There are 
more than 70 acting assistant surgeons, and a feature of the service 
which I think of great value, which enables us to act in times of epi- 
demic, is the fact that while we have, as it were, a regular army in our 28 
additional quarantine powers. 
regular commissioned officers, we are able to increase the corps at any 
time to any desired limit. For example, during the yellow-fever epi- 
demic last fall,«one officer alone, in Memphis, Tenn., in carrying out the 
provisions, employed as many as 44 acting assistant surgeons. They 
were employed three months. He picked out the best men he could 
obtain, and they did efficient service. As soon as the necessity for their 
service had passed their services were discontinued. 
Mr. Hawley. What is the maximum age at-which these surgeons can 
apply-those that are appointed through the Civil Service Commission ? 
A Bystander. They are not appointed through the civil service. 
Dr. Wyman. I think there is no age limit to the acting assistant 
surgeons. 
Mr. Hawley. Not the acting assistant surgeons, but I mean the 
regular assistat surgeons. 
Dr. Wyman. Oh, the regular corps. A candidate must not be more 
than 30 years of age. 
Mr. Hawley. Then he is not a man of any very considerable expe- 
rience, as a rule-a man who applies for this position? 
Dr. Wyman. No; when they come into the grade of assistant surgeon 
they are young men. We want them to be young men. It is the same 
way in the Army and the Navy. When they come in they are young 
men, under 30 years of age. 
Mr. Hawley. You are obliged to use these men, are you not, or 
would be obliged to use them, in caring for a number of quarantine 
stations? 
Dr. Wyman. Not the assistant surgeons; no, sir; not until they have 
been in the service four or five years, and have had experience under 
older surgeons. 
Mr. Barham. Dr. Doty would not be eligible. He could not get into 
the service? 
Dr. Wyman. He could be employed as an acting assistant surgeon. 
Mr. Hawley. Temporarily? 
Dr. Wyman. No; permanently. 
Mr. Hawley. That would be only in the case of an emergency, would 
it not ? 
Dr. Wyman. There is no limit to the time of the appointment of 
acting assistant surgeons. 
Mr. Mann. They are paid only for their service, are they not? 
Dr. Wyman. I will make it plain to you. I can employ an acting 
assistant surgeon temporarily without going to the Civil Service Com- 
mission. I can employ them for three months. And then, at the end 
of three months, I can extend their service for three months more. 
But if we should appoint them permanently, they must pass through a 
civil-service examination. 
Mr. Joy. There is no age limit to them? 
Dr. Wyman. No, sir. 
Mr. Hawley. What is his salary? 
Dr. Wyman. It varies according to the necessities of the case. 
Mr. Joy. You make an arrangement or contract with him? 
Dr. Wyman. Virtually a contract; yes, sir. 
Mr. Hawley. These surgeons, then, are the representatives of the 
M arine-Hospital Service ? 
Dr. Wyman. These acting assistant surgeons, you mean? 
Mr. Hawley. Yes. 
Dr. Wyman. They represent us in a measure; yes, sir. 
Mr. Hawley. When you find that an epidemic or a danger of an ADDITIONAL QUARANTINE POWERS. 
29 
epidemic is on, do you immediately employ an acting assistant surgeon 
in the locality where the disease is threatened? 
Dr. Wyman. I send an experienced medical officer to that place, and 
send him the assistants of the regular corps if he needs them, or per- 
mit him to employ acting assistant surgeons if he thinks it is prefer- 
able to do that. 
Mr. Hawley. Do you mean if you think it is preferable to do that 
instead of trusting to his own experience? 
Dr. Wyman. I mean to aid him in case one man would not be suffi- 
cient to do the work. I will give as an example our recent action at 
Birmingham, Ala. They had had the smallpox there for a number of 
months and had been unable to suppress the disease. The governor 
of the State and the secretary of the State board of health both made 
application to the Treasury Department and myself for assistance in 
stamping out the disease. We sent an officer there, a past assistant 
surgeon, who has had large experience in smallpox, with instructions 
to investigate the situation and make recommendations. I sent one 
regular officer to assist him. That was all he needed. If he had 
wanted more he could have had them, but he put into operation the 
well known means of stamping out smallpox and he could do it by 
employing local acting assistant surgeons, which he has done. 
Mr. Hawley. Smallpox is indigenous to this country; that is, it is 
supposed to be? 
Dr. Wyman. It is here nearly all the time. 
Mr. Hawley. And yellow fever is supposed to be an exotic? 
Dr. Wyman. Yes, sir. 
Mr. Hawley. That being so, and entering this country only through 
the ports, is it your invariable custom for the Marine-Hospital physi- 
cian in charge of the port to take charge of the quarantine regulations 
in any way? 
Dr. Wyman. At that port? 
Mr. Hawley. Yes. 
Dr. Wyman. No, sir; only the quarantine officer especially detailed 
has anything to do with the quarantine at a port. 
Mr. Hawley. Is it a custom of the Marine-Hospital Service to detail 
always a special quarantine officer where there is agitation and excite- 
ment and fear and apprehension of the disease entering that port? 
Dr. Wyman. Yes, sir; we send a man there to observe matters 
closely, to see if things are going on right in accordance with law. 
Mr. Hawley. Suppose you found the local authorities vigilant and 
intelligent in every way, what is the policy of the Goverment? 
Dr. Wyman. The policy is to hold up their hands and help them all 
we can. 
Mr. Hawley. Well, suppose it is determined that they do not need 
anybody to help them; that they are doing everything that can be 
done? 
Dr. Wyman. Then we do nothing. 
Mr. Hawley. Suppose that the reverse were true-that the authori- 
ties are neither vigilant nor intelligent-what is 
Dr. Wyman. Then we would take hold. 
Mr. Hawley. Arbitrarily? 
Dr. Wyman. There is generally a way of getting at it by appealing 
to the common sense of the local authorities, and in nearly every 
instance-in every instance, in fact-they have gladly consented to the 
officers taking charge. That was illustrated in Jersey City, N. J., in 
1893, when there was one case, if not more, of cholera in that city. 30 
additional quarantine powers. 
The local authorities did not know how to proceed, nor did they have 
the proper medical force. I went down there myself and took a num- 
ber of officers, and explained to the local authorities the law as it is 
now. 
We wished to operate in aiding them, but I had to see that the regu- 
lations of the Treasury Department were carried out in the interests of 
the rest of the country. They accepted the aid, and one of my officers 
was right in the office of the health officer there, and we furnished the 
men as guards and men to inspect houses, and all precautions were 
taken, but it was not done under us, but under local authority. 
Mr. Hawley. Through your cooperation ? 
Dr. Wyman. Yes; through our cooperation. 
Mr. Hawley. Do you believe that you can rely in all cases-I believe 
you did not make a single exception in your answer to the former ques- 
tion-upon the intelligence and efficient cooperation of the local authori- 
ties, when the circumstances are as we are discussing? 
Dr. Wyman. No, sir; I do not think we can. 
Mr. Hawley. I understood you to say that you had in every instance 
found that, where the local authorities were ignorant or inefficient, 
where you interposed they invariably consented and cooperated with 
you ? 
Dr. Wyman. I was thinking of interstate quarantine at that time. 
Mr. Hawley. My question was more comprehensive. 
Dr. Wyman. I must correct that a little. 
Mr. Stewart. Is it not true that without the proper quarantine reg- 
ulations yellow fever is just as much of an epidemic in Florida as it is 
in Cuba? 
Dr. Wyman. I think the facts will show that. 
Mr. Stewart. One more question. Do you find any active opposi- 
tion to national quarantine outside of those who are receiving pay or 
holding positions or office under some State quarantine? 
Dr. Wyman. No, sir; I do not. 
Mr Bennett. I have maintained through this argument that there 
was authority with the Treasury Department to enforce the proper 
quarantine laws and regulations, and I find 
Mr. Hawley. Let me interrupt you one moment right there. We 
are getting at that, if you will permit Dr. Wyman to answer the ques- 
tion with respect to the relations that exist between the national 
quarantine officers and the local quarantine officers. 
Mr. Bennett. I wanted to introduce this. That is all. 
Mr. Hawley. I would like to have some enlightenment on the 
proposition. 
Dr. Wyman. That has been necessary partly in the case at San 
Francisco, where the regulations were not properly enforced, and where 
the local quarantine officer did not perform his duty properly. 
Mr. Bennett. You took possession there? 
Dr. Wyman. We took possession of the quarantine; yes, sir. 
Mr. Mann. That was under the present law? 
Dr. Wyman. Yes, sir. 
Mr. Bennett. In volume 27 of the United States Statutes at Large, 
Fifty-second Congress, chapter 114, approved February 15,1893, under 
section 3 of that act, I find this: 
Sec. 3. That the Supervising Surgeon-General of the Marine-Hospital Service 
shall, immediately after this act takes effect, examine the quarantine regulations of 
all State and municipal boards of health, and shall, under the direction of the Sec- 
retary of the Treasury, cooperate with and aid State and municipal boards of health 
in the execution and enforcement of the rules and regulations of such boards and ADDITIONAL quarantine powers. 
31 
in the execution and enforcement of the rules and regulations made by the Secretary 
of the Treasury to prevent the introduction of contagious or infectious diseases 
into the United States from foreign countries and into one State or Territory or the 
District of Columbia from another State or Territory or the District of Columbia; 
and all rules and regulations made by the Secretary of the Treasury shall operate 
uniformly and in no manner discriminate against any port or place. 
I have maintained that there was sufficient authority in that law for 
the Marine-Hospital Service, under the direction of the Secretary of the 
Treasury, to enforce quarantine regulations. Is not that a fact? 
Dr. Wyman. I will read what I read a moment ago. Section 3 
requires that all these rules and regulations shall be executed by the 
State and municipal authorities, when they will undertake to enforce 
them, but if they fail or refuse to enforce them, then they shall be 
enforced; the President shall then, as in his judgment seems best, 
execute and enforce them. Under the terms of the new bill practically 
the same provision exists, but it is further provided that at any port or 
place in the United States where the Secretary of the Treasury shall 
deem it necessary that incoming vessels shall be inspected by a national 
officer, such officer shall be designated. 
The necessity for this provision lies in the fact that under the present 
law too much time and opportunity for dispute as to whether the regu- 
lations have failed of enforcement is permitted before the President can 
be called upon to act, and this provision in the new law is practically 
the same as that joint resolution which passed the Senate and the 
House, which you kindly put through the House in the last Congress, 
but which the President allowed to lie on his desk for a day and a half, 
and it did not become a law because he failed to sign it. 
Mr. Bennett. Thinking it unnecessary. [Laughter. ] The wording 
of this section is: 
Where such regulations are, in the opinion, of the Secretary of the Treasury, 
necessary to prevent the introduction of contagious or infectious diseases into the 
United States from foreign countries or into one State or Territory or the District 
of Columbia from another State or Territory or the District of Columbia, and at 
such ports and places within the United States where quarantine regulations exist 
under the authority of the State or municipality which, in the opinion of the Secre- 
tary of the Treasury, are not sufficient to prevent the introduction of such diseases 
into the United States or into one State or Territory or the District of Columbia 
from another State or Territory or the District of Columbia, the Secretary of the 
Treasury shall, if in his judgment it is necessary and proper, make sucb additional 
rules and regulations as are necessary to prevent the introduction of such diseases 
into the United States ? 
Dr. Wyman. Yes, sir. 
Mr. Bennett. That I believe to be a sufficient authority. 
Dr. Wyman. I do not say so. I do not think so under the present 
law. There is too much time required. 
Mr. Bennett. But you have the quarantine regulations of the differ- 
ent ports at your command. They will be published and printed? 
Dr. Wyman. Yes, sir. 
Mr. Bennett. And this does not say "may be insufficient," but 
where those regulations "are insufficient the Secretary of the Treas- 
ury," etc. 
Dr. Wyman. Yes; but the law relates to the enforcement of the regu- 
lations as well as to the making of them. 
Mr. Bennett. But as a matter of fact are you not in communica- 
tion with the quarantine officers of the different ports to such an extent 
that you know whether they are being enforced properly or not at all 
times? 32 
ADDITIONAL QUARANTINE POWERS. 
Dr. Wyman. No, sir; I do the best I can under the circumstances- 
inspect the local quarantine stations from time to time, but I have not 
an officer at every station all the time. 
Mr. Bennett. But if you wished to send one there you could, and 
he would be properly treated by the quarantine officers? 
Dr. Wyman. I suppose he would, but it would be impracticable to 
keep a regular officer at each station all the time. 
Mr. Stewart. Does not the difficulty lie in this, that the execution 
of the laws is by the State and not by the national authorities? 
Dr. Wyman. Yes, sir. 
Mr. Stewart. And that is the difficulty. That is the remedy that 
the Caffery bill wants to remove? 
Dr. Wyman. The Caffery bill provides that the regulations should 
be made by the Government instead of by the States, and insures 
prompt execution of same. 
One thing I do not think I brought out plainly enough-in regard to 
the age of our officers. There seems to be an impression that our offi- 
cers are young and inexperience men. I wanted to say that the aver- 
age age of our officers is about 45. 
Mr. Bennett. That is the average age? 
Dr. Wyman. Yes. sir. 
Mr. Bennett. What is the minimum age? 
Dr. Wyman There are only a few under their thirtieth year. 
Mr. Mann. I thought they had to be under 30 in order to get in? 
Mr. Hawley. There have been no recent appointments; that is the 
explanation of that. 
Thereupon the committee, at 12 o'clock, took a recess until 2 o'clock. 
AFTER RECESS. 
The recess having expired, the committee reassembled. 
ADDITIONAL STATEMENT OF SURGEON-GENERAL WYMAN. 
I would like to correct a few little verbal errors that I perhaps made 
in my statement this morning. Where I said that the salaries of the 
surgeons were $2,500 a year with fogies, I do not know that it was 
understood what fogies are. That is • 10 per cent additional for every 
five years up to 40 per cent, and no further. 
I think I stated that 45 years was the average age. As to the young- 
est officers in the Marine-Hospital Service, I would state that there may 
be three or four of the youngest assistant surgeons under 30 years old.