Probably no previous meeting of the association has been presented with so rich a programme of scientific essays and so charming a variety of intellectual entertainment. The local faculty, the citizens, and the railroads vied with each other in banquets, receptions, and excursions, which, with the more than full registers of the several sections, embarrassed with its very richness the delegates, and undoubtedly drew many away from the more serious, if not more important, sessions of the association proper. As a result, the address on surgery by Dr. J. B. Murphy, of Chicago, Ill., to be read in the open meeting, although of most tremendous importance as an entirely new view in the treatment of tuberculosis, was given but a half hour of time, and the distinguished author was able only to read the heads of his essay. It is, fortunately, printed in full in the journal of the association. In the sections many of the most promising papers were read only by title, a physical impossibility to crowd them into the time allowed.

At the second general session, June 8, Dr. W. H. Sanders, State health officer of Alabama, offered a series of resolutions in regard to the public health, as follows:

[Resolutions submitted to the American Medical Association at the Denver meeting, June 8, 1898, by W. H. Sanders, M. D., health officer of Alabama.]

Whereas the protection of the public health is one of the duties and functions of all well organized and progressive governments: Therefore, be it

Resolved (1), That it is the sense of this body that a public-health system, correct in principle, complete in detail, and applicable alike to every part of the country should, at the earliest time possible, be created and put into vigorous operation.

Resolved (2), That in order for such a system to be constitutional, coherent, and permanent, it should logically conform to the genius and plan of our concentric systems of government-that is to say, its roots should be deeply planted among the people, the recognized source of governmental power under our Constitution, and its branches should reach up through and be sustained by every political division of our State governments to one central and resourceful power, the nation.

Resolved (3), That to lay the foundations for such a system the States should formulate their policies of public health with sufficient uniformity as to render them susceptible of being united into one symmetrical and harmonious whole, and to lead up to and terminate in one central and cooperative head, namely, the General Government acting through a bureau of public health.

“Resolved (4), That while the officials for actively conducting a public health system should be of local origin and authority, and therefore directly and proximately responsible to the people, the States and the nation should cooperate with the local authorities in furnishing the expert skill and financial aid necessary for suppressing dangerous, contagious, and epidemic diseases when they appear in any given locality, and for preventing their spread from one part of a State to another part of the same State, or from one State to another State.

Resolved (5), That the principles herein announced should apply to the theory and practice of quarantine, which, although an important part and function of a public health system, is not the only one of its numerous and beneficent powers. To divorce the exercise of quarantine power from a public health system and to confer it upon a separate organization which derives its existence and vitality from the General Government, and not from the people of the States, would be to emasculate and ultimately to destroy said system, as well as to overthrow one of the most sacred and valued principles upon which our Government is founded. **Resolved (6), That an earnest appeal is hereby made to the Congress of the United States to recognize the principles herein proclaimed as constitutional and unassailable and as in thorough accord with the generic truths out of which our political fabric has been evolved."

These resolutions having been read by the author, were referred, under the rule, to the business (or executive) committee. Dr. Sanders, however, moved their adoption as an expression of the opinion of the association on the matters treated of, which was, according to the official report of the proceedings, "seconded and carried." It would appear, however, from the same official report, that Dr. Sanders asked, on the third day's session, as to what disposition had been made of his resolutions. Thereupon, on motion, the resolutions were (same official report) referred to the business committee, with power to act.

The business committee, however, on examining them, concluded that it was not competent for that committee to take any action in the matter, and so they were laid on the table by that committee.

It will be observed that the official report of the business committee's report, June 9, 1898, does not speak of these resolutions. It is difficult to know whether they are approved by the association or not.

It is proper to state here that through some misadvertence the original of these resolutions was withdrawn from the secretary's table and no copy of them could be had until after considerable correspondence, which brought me simultaneously within the past six days copies from Dr. Sanders himself and from the chairman of the executive committee.

On the evening of the second or the morning of third day the report of the special committee on department of public health, neatly printed in small pamphlet form, was distributed to the association. At the proper time during the third day's session the chairman of that committee, Dr. U. O. B. Wingate, of Milwaukee, Wis., began its reading, and after some minutes, possibly one-quarter of it having been read, the further reading was dispensed with, and some discussion ensued which terminated in a motion that the report, with the resolutions, be adopted, except that the clause appropriating $1.000 be referred to the board of trustees, with power to act. This motion was promptly seconded, and although this reporter, with some other members of the association, attempted vigorously to get the floor to debate upon or otherwise express their opinions on the subject, the ayes and noes were immediately taken and the report and the resolutions declared adopted.

This somewhat unusual procedure (that is, of not referring the report to the appropriate committee) was doubtless due to the statement made on the floor of the association that this matter had been seven years in preparation by its committee and that it should not be referred, like other similar matters, to the business committee, because that committee has no business with it.

This meeting was next to the largest (Philadelphia, 1897) yet had by the association, and many of the members were much disappointed at the absence of the president, Surg. Gen. George M. Sternberg, U. S. A., detained by pressing official business.

Respectfully, yours,

SURGEON-GENERAL MARINE-HOSPITAL SERVICE.

JAMES M. GASSAWAY,
Surgeon, U. S. M. H. S.

REPORT OF SURG. CHARLES E. BANKS, DELEGATE TO THE NINTH INTERNATIONAL CONGRESS OF HYGIENE AND DEMOGRAPHY, HELD AT MADRID, APRIL 10-17, 1898.

SIR: I have the honor to submit the following report of services rendered in connection with my detail as delegate, on the part of the Department, to represent the Government at the International Congress of Hygiene and Demography, held at Madrid, Spain, April 10 to 17, 1898.

As a preliminary to the subject-matter of the report, I desire to refer to the date of my orders, March 15, 1898, which, as will be seen by a reference to international

events then pending, brought my contemplated trip to the very brink of war between this Government and Spain. Indeed, after the receipt of the order the existing difficulties between the two nations had reached such a point that I had practically abandoned the expectation of going. An apparent improvement in the strained relations a few days prior to the date of my departure, however, induced you to approve my attempting to fulfill my mission, and I hastily started for New York to take passage by steamer on the 26th of March.

While I was crossing the Atlantic the long-expected report of the board of inquiry into the disaster to the U.S. S. Maine was made, and upon my arrival in London the excitement had intensified and the relations between the two countries had become more strained. Acting upon your verbal instructions after my arrival in London to consult with our diplomatic representatives abroad as to the situation and the desirability of proceeding to Madrid, I did so, and was advised from day to day to await developments. I endeavored to secure by letter and telegraph advices from our legation at Madrid, both before and after arrival in London, but did not receive any reply. I occupied such time as I could, while awaiting events to transpire, in carrying out the directions of your letter of March 16 with respect to an examination of the hospital ambulance systems abroad and the hospital equipments of all hospitals in the course of my journey, a report of which is made in a separate communication.

I proceeded to Paris on the 8th of April, still uncertain as to the probability of reaching my destination, arriving there on the night of the same day, with the expectation of consulting our ambassador in Paris. In consequence of the legal holidays which intervened-Easter Sunday and Easter Monday-and his absence from the city I was unable to see him until the 12th instant, during which time the President's message to Congress had been delivered, asking authority to intervene, and the rupture of relations between the two countries was practically settled. The family of our minister at Madrid had left that city in anticipation of the immediate severance of diplomatic relations, and it was currently reported, though definite information was unobtainable at our embassy in Paris, that our minister was also on the point of leaving or had left. I determined, however, on the 12th instant to proceed and ascertain by personal observation the chances of accomplishing my mission. I reached Madrid on the 13th, at midnight, and found the congress in session the next day. After enrolling myself as a delegate I was presented to the secretary of the congress and made known my official standing. I was not surprised, however, at the unmistakable character of the greeting accorded me, nor could I take exception to its pronounced formality, considering the situation. The prevailing sentiment was of unconcealed hostility to the United States and the tone of the surroundings was, therefore, anything but pleasant. This is not remarked as a complaint, but as the inevitable condition of impending hostilities and the natural sympathy of European delegates with a neighboring people-a sympathy that was openly avowed by delegates from Republics on this hemisphere.

The attendance was stated to be about 1,500 members, representing twenty-six countries, of which 1,350 were from Spain, 110 from France, 50 from Great Britain, and 48 from Germany. Of the latter representation it should be stated that 22 were "official" delegates from the Imperial Government, as showing how other nations recognize such events. In the Lista Provisional de Delegados" 5 were accredited to the United States-1 from the Army, 1 from the Marine-Hospital Service, and 3 others from civil life. It is not known that these latter attended, but I met, in addition to the Army representative, a medical officer of the Navy, whose name did not appear on the official list.

Of noted men in attendance, I might mention Pagliani, of Rome; Brouardel, of Paris; Mahmoud Pasha, of Constantinople: Surgeon-General MacPherson, of London; Professors Behring, Loeffler, and Liebrich, of Germany.

The management of the congress was under the nominal control of the ministro de la gobernacion (interior), and all the social functions and excursions were managed by government officials. As this was the week in which the President of the United States had delivered his message to Congress, and that body was on the eve of passing resolutions which meant war, it can be readily seen that the Spanish Government officials had but little time to enter into the spirit of the literary and social proceedings of the congress of hygiene. The whole atmosphere was that of restraint. It was the sole topic of conversation, and the newspapers were filled with the most inflammatory articles, and the dead walls on the streets placarded with appeals to Spanish patriotism and pride and caricatures of the "Yankee pig."

The secretary of the congress, Senor Dr. D. Amalio Gimeno, had been engaged in a political campaign as candidate for senator of the Cortes from the province of Valencia, and it is not difficult to see how he was unable successfully to carry the innumerable details of the congress and at the same time give consideration to the greater political matter which was then agitating the Spanish Government. During it all, however, there was a courageous attempt to ignore the unpleasantness of the situation, and most of the social functions were carried out with an attention to the entertainment of the guests which could but excite the admiration of those who knew the difficulties under which the officials labored. Many of the excursions were postponed from day to day and at last fell through, owing to the "political situation," which was the accepted explanation of all deficiencies. The social functions consisted of a bull fight on Easter Sunday, a reception by the Queen Regent at the Palacio Real, a performance at the Royal Opera House, another at the Opera House Alphonso XIII, a reception by the civil governor of Madrid at the Ayuntamiento, closing with a bull fight at the Plaza del Toros on the 17th (Sunday). In addition to these there were advertised excursions to Toledo, the Escorial, and Grenada, but, owing to the difficulty of obtaining information and the frequent postponements, but few attended. The American legation was so much occupied with the existing political situation, living from day to day at the official residence in "marching order," that it could not give any time or attention to social courtesies to the official representatives of our Government, and under the circumstances none were expected. For the same reason the wearing of uniforms was omitted by the delegates from the United States.

From the above statements it will be seen that in consequence of the unfortunate time in which the congress was held the fulfillment of my detail was accomplished under unpleasant circumstances.

Sessions of the congress were held in the Palacio de la Biblioteca y Museos Nacionales, a fine building on the Paseo de Recoletos. It is devoted to the exhibition of literary and art collections, but owing to its internal arrangements was quite unsuited to the purposes of a large assembly which intended to devote its time to scientific discussions. Rooms assigned to different sections opened into each other, and were necessarily passageways to other rooms, so that there was the continual noise from morning till night of delegates passing to and from sections, making careful attention to the proceedings almost impossible. The ground floor was used for the display of machinery, paraphernalia, and articles employed in the conservation of the public health. A large part of the display came from the Spanish peninsula, and consisted for the most part of articles intended for military and naval use, water filters, models of municipal sewerage systems, and hospital construction. It was a creditable exhibit. France was represented by surgical appliances, disinfecting stoves, instruments of precision; Germany by chemical products, disinfectants, and disinfecting apparatus, and England by prepared foods and lavatory and sanitary appliances.

The congress was divided into thirteen working sections, and it was the opinion of those who had attended previous meetings that the acknowledged mistakes of administration at Berlin and Budapest were repeated by this dissipation of the working strength of the members by an excess of specialization. The bacteriological section attracted the greatest interest and attendance. Dr. Behring read a paper on "Tuberculosis antitoxin; " Dr. Janowsky, of Warsaw, on a "Uniform standard for therapeutic serums," and Dr. Durham on the "Micrococcus of Malta fever." This section passed a resolve in favor of an international bacteriological commission, which was adopted by the general congress. The section of preventive medicine discussed vaccination and revaccination and serum therapy of cowpox. The section on demography considered the subject of climatology of tuberculosis, the sanitation of cemeteries, and child labor. The section on school hygiene held animated discussions, amusing to one accustomed to the phlegmatic debates of the Anglo-Saxon, relative to education of children. The ardor of the Latin temperament in manner and expression upon abstruse subjects was extravagantly expended upon a proposition of an official of the public instruction board of Spain that children should not have books for study, but be didactically instructed until 10 or 12 years of age.

The closing session was held in the great hall of the Central University, and consisted of the adoption, without discussion, and probably without much understanding upon the part of the delegates, of the resolutions prepared by the several sections. Out of a large attendance of many hundred but a few could hear the announcements, and but a few voted upon the propositions. Complimentary speeches followed from the representatives of the various nations, and adjournment was taken, to meet in Paris, France, for the next congress in 1900.

As the Congress of the United States had practically agreed to the passage of the resolutions granting the President power to intervene on Monday, the 18th, and having no further business to detain me, I left that day, and our minister was given his passports on the 20th.

I proceeded to Paris and remained three days in the fulfillment of your order respecting the inspection of hospitals, equipment of same, and the municipal ambulance system, and thence to London, Leeds, and Liverpool on the same duty, and sailed for New York on the 4th of May.

REPORT OF SURG. CHARLES E. BANKS ON HOSPITAL EQUIPMENT, WARD FURNITURE, AMBULANCES, ETC., IN CERTAIN HOSPITALS OF SPAIN, FRANCE, AND ENGLAND.

WASHINGTON, D. C., September 10, 1898. SIR: In accordance with instructions contained in your letter of March 16, 1898, directing me to visit, "while in Europe, such civil and military hospitals as may conveniently be seen, for the purpose of inspecting hospital equipments and modern improvements in ward furniture and the ambulances in use,” I have the honor to submit, as therein directed, a written report of my investigations for the information of your office.

The duty involved in the above-named order was contemplated in connection with my detail as delegate to represent this Service at the Ninth International Congress of Hygiene and Demography, held at Madrid, Spain, April 10-17, 1898, and the opportunity afforded during my travel to and from Madrid was made available as far as possible in fulfillment of the plan. I did not alter the usual route of travel for the purpose of extending my journey in this respect, but confined myself to the large cities of Madrid, Paris, Southampton, London, Leeds, and Liverpool, with the exception of the towns of Greenwich and Chatham, England. I visited these two last-named points because at them are located the famous seamen's hospital (lately known as the "Dreadnought)" and the branch