1462

,cholera hospital, steam launches, staff, number of ships- entering each port &c.

The Conference now began to discuss the all-important.question of quarantine, which was defined as the detentionof a healthy ship. Mr. Williams stated that at Bridgewater.a man belonging to a vessel from an infected port was seizedwith cholera in a train and travelled many miles in anrunconscious condition. Mr. Harris was the only speaker who’.insisted on the fact that passengers from infected towns’could penetrate into the country without entering the Thames- or any of the ports where inspection was organised. Dr.Mason insisted on the importance of the second line of- defence. A man who had landed from a ship at Hull hadbeen seized an hour after medical inspection, but the secondline of defence was ready and in another hour’s time he wasin the cholera hospital. Dr. Davies proposed and Dr. Mason- seconded, "That in the opinion of this Conference quarantineor the detention of a vessel having no sickness on board and:so certified by the medical officer of health is unjustifiable."

Dr. Collingridge pointed out that quarantine in the Port ofLondon would mean the detention of 2000 to 4000 persons,per week on board ships at the mouth of the river ; and, inas-much as anyone would be able to land at night for half-a-,crown, it would be useless. Quarantine might be excellentun theory-it was absurd in practice; and the Conference:should emphatically declare, once and for all, that quarantine.could not be relied upon and therefore must not be attempted.This advice the Conference followed, for the above resolution’declaring quarantine unjustifiable was carried unanimously.

While disapproving of quarantine, the Conference approved,the practice of taking the name and addresses of passengers.and of the crew, and, to simplify the procedure, voted thatthese addresses should be communicated direct from the

port medical officer to the medical officer of health of the,district where the passenger was about to reside. Dr. Colling-ridge described how, on investigation being made, it was- found that, out of a large number of Jew emigrants coming toLondon, 30 per cent. had given false names and addresses.Several hundred of these Jew emigrants had not been allowedto land, and the ships’ companies were obliged to conveythem back to Germany, because they were dirty and couldnot give their addresses. The Cllote’l’a Circitlar had very,effectively checked the tide of foreign pauper emigration toLondon. A resolution was passed requiring lodging-housekeepers to have a register containing the particulars regardingsailors and others who came from infected or suspected ports.

The question of disinfection was now brought forward, and,the discussion showed that the vaguest ideas prevailed on thismatter. No one attempted to indicate how a ship should be’disinfected. It was acknowledged that the bilge water wastoo considerable in bulk to be disinfected, and thereforeshould be pumped out, but the danger of such a practicefor inland ports was not touched upon. Nor did anyone’venture to describe how the cabins, hold or cargo of a shipwere to be disinfected, and nothing was said as to the mannerbedding, clothing, furniture, carpets &c. removed from a shipshould be treated. There is no general principle governingthese operations and every port authority does just what it- can or what it likes. The Conference, in the face of thisdeplorable and dangerous state of affairs, carried a resolutionto the effect that "more efficient methods of disinfection beapplied," and a committee was elected for the purpose ofinvestigating the entire question.

In respect to hospital accommodation, the necessity of not- confusing the general infectious diseases hospital with thespecial cholera hospital was insisted upon. Several speakersdescribed the difficulty of building cholera hospitals on shorein consequence of the opposition of the population. AtSunderland there had been violent demonstrations against’the cholera hospital. Thousands of people gathering together,headed by brass bands, had mobbed the authorities and stonedthe medical officer. On the other hand, considerable objec-’tion was made to floating hospitals, as these could only beplaced on the smooth water of a river, which might easily be,contaminated by the patients. Then, again, the amountof accommodation provided in cholera hospitals was

not based on any sort of principle and did not corre-

spond with the traffic in the ports or their popula-tion. Nor was there at these hospitals or elsewhere themeans of giving baths and properly disinfecting the crew andpassengers from an infected ship. The Conference voted thatdt is the duty of the sanitary authorities to provide forthwithproper and special hospital accommodation for the treatment:and isolation of cholera cases.

The difficulty of finding the necessary funds to meet all thisexpenditure was discussed. Under the stress of panic moneywas forthcoming, but it was more needed beforehand. Whenthe panic begun it would be already too late. At Southamptonthe cost this year was equal to a twopenny rate and it wasdoubtful whether the ratepayers would again support such anoutlay ; at Weymouth and Portland Roads expenses had tobe incurred without any compensation. The shipping broughtno trade to a port of refuge ; it was all cost and no profit.Some ports were extremely poor and yet had to pay for pro-tecting rich inland manufacturing districts from the dangerof cholera. The Conference resolved that "Special pre-cautions against cholera, being incurred for the benefit ofthe entire country, should be defrayed by the ImperialExchequer. "

Dr. Collingridge now explained that the Conferencehad accomplished the first part of its task, they hadcome to a common agreement as to what was mostneeded. The next step would be to invite the sanitaryauthorities to hold in London a larger conference; and,travelling over the same ground, reaffirm the principlesestablished that day. Then the Local Government Boardcould be approached by a representation from the entirecountry ; and, by that means, the desired reforms might beobtained. This proposal was adopted. The Conferenceflnally carried a vote of thanks to the Lord Mayor of London;to the chairman, Dr. Collingridge ; and to the various portauthorities, Custom House Officials &c., who had assisted thePort Medical Officers in their difficult task of warding off thecholera epidemic. In the evening, a number of the membersof the Conference dined together at Frascati’s Restaurant,and thus terminated a gathering which had lasted, with butbrief intervals, for close upon twelve hours.

THE RUSSIAN CHOLERA CONGRESS.

THE fatality connected with the cholera epidemic whichhas been raging during the present year, and which,according to official records, has carried off some 280,000victims, has induced the Zemstvo (local) medical practi-tioners to hold a Congress at St. Petersburg to discussvarious questions in connection with the epidemic, and todevise or suggest measures it would be expedient to adopt inview of its probable appearance next year. No one not

personally engaged in the work of combating the diseasewill be admitted to the Congress. Physicians and

reporters for the Russian press will, we are told,form no exception to this rule. An official speciallyappointed for the purpose will attend the meetings and willreceive all the papers from the authors immediately aftereach has been read. The Congress will assemble on

Dec. 25th (new style) and will continue its sittings for a

week. The following is an abridged programme of the pro-ceedings :-On the first day (Sunday) the members will receive the

whole of the statistics relating to the epidemic, togetherwith reports on the causes and conditions of the outbreak(illustrated by plans, maps &c.), the measures devised forthe sanitation of places of public resort as well as of per-sonal cleanliness. Monday, the 26th, will be devoted to meet-ings of committees, the demonstration of approved methodsof disinfection, the exposition of measures, against the impor-tation of cholera (quarantine, cordons, closing of schools,prevention of extensive migration of the population, over-

crowding, provision of reception-rooms for the sick, organisa-tion of registration &c.). On Tuesday, in addition to thecommittee meetings, the report on measures for combatingthe epidemic will be discussed, such as the organisation anddetermination of the amount of medical aid and the appoint-ment of stationary and flying columns, isolation, means to beemployed for the proper burial of cholera patients, disinfec-tion &c. The proceedings of the Congress on Wednesday andThursday will consist chiefly of discussions on reports of com-mittees detailed off to consider the various subjects includedin the foregoing programme, which committees will hold ageneral session on the evening of Thursday and be continuedon Friday and Saturday. On Sunday the proceedings of theCongress will close with the usual formality.