ADDRESS 
to the 
MEMBERS OF THE 
IMERIG1H ISSOCItTIOR OF P1BLIG HEALTH 
ti-V THE 
CHAIRMAN OF THK LOOAI, COMMITTFB. 
IE. LICE AGA, 
President of the Superior Hoard of Health, 
Professor of Operations in the National School of Mcilicine. 
Director of the Hospital of Matcrnitj 
anil Infancy. Ac., Ac . Ae. 
- wMajTjnn V I ' 
PRINTING OFFICE OF F. F. HOECK, 
l»t. San Francisco Street No. 12. 
18&2 ADDRESS 
to the 
ME MBEBS OF THE 
IMERIGAH mSOmiTIOII OF FIIBLIC HEALTH 
——BY THE 
CHAIRMAN OK THE LOCAL COMMITTEE. 
IE. LICEAGA, 
I'reaitlent of tin1 Superior Hoard of Health, 
}*rofe<->or of Operation* in the National School of Medicine, 
director of the Hospital of Maternity 
ati«l Infancy, Ac,, Ac , Ac. 
PRINTTItTG OFFICE OF F. F. HOECK 
lit 8»n FraacUco Street No 12 
1092 
MEXICO Mk. Chairm \k of the Association, Mr. Mayor, 
Ladies and Gentlemen: 
Tu 
L HE Executive Committee of the American Association 
ol Public Health having honored me with the appointment of 
President ol the Local Committee ol Arrangements, enchar- 
ged by the Statutes with the preparations for its annual meeting 
in this Capital, my first and most agreeable duty is to give pu- 
blic expression to my gratitude for so unmerited a distinction. 
Using the powers which the appointment carried with it, 
I organized a Local Committee ol Arrangements consisting of 
the members ol the Board ol Health, and Drs. Rambn Icaza and 
Manuel Gutierrez, both of whom were already members of the 
Association, and of other prominent gentlemen, such, for in- 
stance, as the Minister of Communications whose official stand- 
ing and personal worth I judged, and judged, as the event has 
proven, rightly, would aid powerfully in furthering the ends 
of the Committee. 
Each member was empowered to appoint as many assist- 
ants as he saw lit for the discharge of the duties allotted to him. 
One ol my lirst cares was to inform the President of the 
Republic and the Minister ol the Interior of the decision of the Association to hold its meeting this year in the City of Mex- 
ico and of the distinguished honor that had been conferred on 
me. It is most gratifying to me to state that the Chief Magis- 
trate of the Republic entered enthusiastically into the plan, 
promising me his best assistance in the despatch of our pre- 
paratory labors. He was pleased, moreover, to apply to the 
Legislature for an appropriation to defray the expenses most 
urgently demanded, and to send a letter to Governors of States 
urging them to appoint delegates from among the members of 
the Local Boards of Health to attend the meetings of the As 
sociation. It is, therefore, another of my duties on this occa- 
sion to pay a public tribute of acknowledgement to the illus- 
trious Chief of the Mexican Executive for his powerful aid to 
the Committee which T have the honor to represent. 
It is also a duty to return my cordial thanks to the Minis- 
ter of the Interior, who, both in his official and private capaci- 
ties, has aided with his advice and personal resources in or- 
ganizing some of the pleasure trips which we shall offer to 
our esteemed visitors. 
My thanks are likewise due to the City Council, to the 
Drainage Commission and to the representatives of the con- 
tractors who have so kindly given thcmembers of the Associa- 
tion an opportunity of inspecting this important Hygienic work, 
to the Jockey Club, to the Railway Companies for considera- 
ble reductions in fares, and to all the gentlemen who consented 
to act on the committees. 
On inquiry of the Secretary of the Association as to whe- 
ther the local Committee was entitled to send out invitations on 
its own account an affirmative decision was obtained, and, in 
consequence, invitations were addressed, through the Consuls 
of Mexico, to the Republics of Central and South America, to 
the Island of Cuba and the other West Indies, to the Gover- 
nors of the States of the Mexican Union and to all the physi- 
cians and sanitary engineers in the Republic. 
The Argentine Republic alone has forwarded, through 
our diplomatic representative there, a complete set of published treatises on hygiene. Venezuela and Guatemala promised to 
send contributions, which, however, have not been received. 
The Governors of the States replied that their delegates would 
contribute essays, some of which have not as yet come to hand. 
Two hundred and fifty physicians o{ the capital city and the 
Interior and a few sanitary engineers signified their intention 
of being present at this meeting. Mr. Mayor, 
Honorable Representatives of the City of Mexico: 
I have the honor of introducing to you the members of the 
American Association of Public Health, our distinguished col- 
leagues of tin- United States and cf the Dominion of Canada, 
as well as our own fellow citizens. All of them have left their 
business and their homes, bearing hither their store of wisdom 
and experience wherewith to lurther the great work which 
the Association has in view, and conferring on this city the 
distinction of being chosen as the scene of their annual labors. 
In the name of the Superior Board of Health, which invit- 
ed you to hold your meeting here and feels honored in your 
acceptance of that invitation, I extend a welcome to the As- 
sociation of Public Health and express the hope, in which all 
my colleagues unite with me, that the biiefstay of its mem- 
bers in our midst may be in every way agreeable. 
Gentlemen, it is to me a source of the purest satisfaction 
to see you come from distant lands, animated by the noble re- 
solve to shed on all sides the light of science and to help the 
nations ol the earth to a better understanding of the blessings 
of hygiene. You come like apostles of the Gospel ol Science to preach on the time-honored Hippocratic text “Mens Sana 
in Corpore Sana," to show that to make men healthy is to put 
them on the right road to beinggood (1), to remind mankind that 
Nature furnishes us with light and air in lavish abundance (2), 
that pure water and good food preserve health and lengthen 
life (3), that the clothes which cover us must not incommode 
us, and that the dwellings in which we seek protection from 
the extremes of heat and cold must be so disposed, and the 
ground on which they are erected so drained, as not to be- 
come a source of harm to their inmates (4). 
The inevitable refuse of men and animals is a source of 
many diseases when it is allowed to accumulate and putrify 
near us. and you show us how to dispose of it without injury 
either to ourselves or our neighbors (5). 
The factories which cater to our wants, which are the life 
and soul of commerce, and constitute so important a factor of 
national wealth, discharge into rivers and drains, or scatter far 
and wide in the atmosphere, substances injurious to health or 
offensive to our senses. The health of factory operatives may 
be impaired by emanations from the material to be worked 
up, by the nature of the substance to be handled, by an insuf- 
ficient supply of air, by excessive hours of toil. The nature of 
the labor may be such as to imperil life itself, as in under- 
ground mining or the handling of explosives. 
It would seem hopeless to attempt to combat the num- 
berless evils that beset the life of the operative—a class which 
constitutes the bulk of the population of every large city,— 
and yet Hygiene is always on the watch, marking every peril, 
and telling us through yrou how to obviate them and how to 
prevent capital from over-riding the claims of humanity. 
But what is to be said of the diseases that from time to 
(1) Dr Formento—Dr. Septien. 
(2) Dr. Geo Homan. 
(3) Dr. Kedzie. 
(4) Dr. Kedzie—Dr. Corlett. 
(5) Dr. Chapin—Dr. Hoyt. time afflict and decimate the human race? Is not history pre- 
sent to attest the small progress that has been made in com 
batting the worst of those diseases, when they appear in the 
epidemic form? Have we not before our eyes the sad picture 
of cholera killing half of those on whom it lays hold? True. 
Hut, on the other hand, we see Bacteriology patiently at work, 
discovering the germ which produces those diseases, the con- 
ditions under which it lives, thrives and propagates, as well 
as those which are antagonistic to it and of which we must 
avail ourselves in combatting it. No, gentlemen, we are not 
entirely impotent in the presence of disease, for some we can 
master, others mitigate, and yet others abridge. But, above 
all, it is given to us to ward them off, to prevent their devel- 
opment and propagation. For this the Natural History of Di 
sease has been slowly built up by the labors of physicians in 
every ageand every clime,—a goodly foundation which Science 
has bequeathed to us and on which the structure of modern 
progress has been reared. Observation is ever patiently at 
work, noting symptoms, watching the progress of diseases, 
marking their termination, the proportion in which they prove 
fatal, the climates and places most favorable to their develop- 
ment, the influence of seasons, of age, sex, condition and em- 
ployment. 
Look at the history of the great epidemics that haveswept 
the earth, with death and mourning in their wake, that daunt 
the weak and paralyze the energies of the timid, and you will 
see, in the midst of the panic-striken throng, the man of science, 
calm and self-possessed, studying the characters of the scourge, 
inquiring whence it came, how it spread, what strength it 
draws from air and soil, how Nations and Governments must 
act to protect themselves from future visitations. 
This is what hygienists have always done: witness the 
measures laid down in the Mosaic Law at the dawn of ages. 
History still preserves record of the stringent and effica- 
cious laws which in the Middle Ages almost stamped out le- 
prosy,—barbarous measures, it is true, but proving beyond all 10 
manner of doubt that, though to cure diseases is hard, man 
has it in his power to avoid them. 
It appals us even now to lead of the measures taken 
against the Plague. Yet the Plague has been blotted out from 
the face ot the earth. How terrible the means employed to ac- 
complish that end! Isolation carried to the extent of sequestra- 
tion, the loss of civil rights, enforced celibacy, the severance 
of family ties—in a word, the sacrifice of the individual to the 
good of the community! 
Our milder customs, our ampler resources, enable us to 
carry onward the work of our forefathers in a different form 
and justify us in hoping that our descendants will acknow- 
ledge their indebtedness to us for their deliverance from cho- 
lera, from yellow fever, from diphtheria and from typhus. 
The immortaljenner taught us how to ward off the small- 
pox, a disease which, with the lapse of time and the growth 
of enlightenment, will die out from among mankind. 
Pasteur, the glory of our times, has taught us, too, how 
to render innocuous the bites of mad animals. 
Pasteur, pointing to the atmosphere as the habitat of pa- 
thogenic germs, and Lister, that benefactor of humanity, ward- 
ing off those germs which poison and render fatal the wound 
where they find a lodgment, have taught our modern savans 
to look to science for the means of forecasting and baffling di- 
sease. 
Bacteriology is the hope of hygiene both now and for the 
future (1). It will discover germs as yet unknown, will continue 
to study the Natural History of those that are known, and when 
it has found out their mode of generation, their habitat, their 
nourishment, the conditions under which they thrive, and, 
above all, those under which they die off, then it will be in a 
position to place more effective weapons in the hands of Hy'- 
giene. 
When the day comes on which we shall know the condi- 
tions which render the life of each class of microbe difficult or 
(i) Kellogg. impossible, jind tlie natural or chemical agents capable of des- 
troying them, then all that Hygiene will have to do will be to 
produce those conditions or to apply those agents. 
But, I shall be told, all this is a mere dream, an unattain- 
able ideal. I answer, No. The teiritory we have won is an 
earnest of still wider conquests. Already much has been made 
clear as to the cholera bacillus. It is known to penetrate into 
the human organism through the alimentary canal, to live and 
propagate in the juices of the stomach and intestines, when 
they are in an unhealthy condition, but not when they are 
sound. It has been proved that the germ is contained in the 
discharges of patients, that those discharges contaminate wa- 
ter and soil, that water, in particular is a favorable medium 
for its cultivation and propagation, and that a damp soil is al- 
so propitious to its development. Hygiene avails itself of all 
these facts, as it has done of late to check the ravages of the 
epidemic in Europe. Clinical science teaches us that the germ 
of tuberculosis cannot thrive, except precariously, at conside- 
rable altitudes (1), that abundant air and light are the best 
preservatives against the Koch bacillus, and that darkness, 
insufficient air, bad food, and an undermined constitution, are 
the agents which give it potency. We have learnt from science 
that the microbe finds its way into the human body through 
the organs of respiration or the organs of digestion in milk and 
in food, through wounds or abrasures (2), which either main- 
tain it locally or transmit it to the lymphatic glands. Equip- 
ped with this knowledge, Hygiene busies itself in curing the 
sick, in isolating patients, in erecting sanatoria, in taking 
measures to stop the spread of the disease. No; the feasibility 
ol arresting disease is no longer an irrealizable ideal. 
The comma bacillus, the Koc h bacillus or bacillus of 
consumption, the bacillus of typhus, and the diphtherial poison, 
(i ) Le Plateau Central du Mexique ( La Mesa Central de Mexico) con- 
sidert* conune station sanitaire pour les phthisiques. Metuoire lue par le I)oc- 
teur E. Liceaga au Congres International de Berlin, Aout, 1890. Berlin. 
(2) I)r. Corlett. 12 
part with their virulence at temperatures exceeding 75° C. 
and, without doubt, are totally pasteurized when subjected 
to temperatures of 100° C. 
The destructive action of acids on the germs of these di- 
seases is a fact completely established by bacteriology and 
clinics. 
The action of solutions of bichloride of mercury and sul- 
phate of copper on the comma-shaped bacillus is also well 
ascertained, as is also that of phenic acid on the Eberth mi- 
crobe and that of a concentrated solution of the same on the 
Klebs microbe. 
By a careful application of these natural and chemical 
agents the destruction of germs is assured and the spread of 
bacterial diseases avoided. 
If we are to form an accurate estimate of the province 
of antiseptics in the extinction of infectious diseases, we must 
survey their marvelous results in the department of surgery. 
By dint of sagacious and patient observation, Lister arrived 
at his theory of antiseptical surgery. In the paper read by 
him before the British Medical Association, at Dublin, on 
August 9th., 1867, he enunciates his theory as follows: "But 
inasmuch as the experiments of Pasteur have shown that the 
air does not derive its deleterious properties from oxygen or 
any other gaseous elements, but from certain inferior orga- 
nisms which it holds in suspense, it occurs to me that it would 
be possible to prevent the putrefaction of wounds by exclud- 
ing air from them and treating them with substances des- 
tructive to the particles which float about in the atmosphere.» 
Such was the beginning of antiseptical surgery, which, 
in the space of twenty-five years and in the hands of the 
most eminent surgeons of the civilized world, has succeeded 
in completely revolutionizing the whole practice of surgery 
and in diminishing the seriousness of wounds, and the number 
of deaths arising from them, to an extent that would appear 
incredible were it not lor the testimony of statistical returns 
recognised as unimpeachable alike by foes and friends. By excluding from wounds the pathogenic germs which 
<»nce poisoned them, we are able to avoid suppuration, septi- 
c;cmia, pyaemia, hospital gangrene, erysipelas etc. The anti- 
septic method as applied to obstetrics has put an end to the 
disastrous cfl'ects once wrought by disease germs in women 
during the period of labor and which at one time caused such 
ravages in maternity hospitals that the idea of closing those 
establishments was seriously entertained. 
1 he aseptic and antiseptic methods are now complete 
masters ol the field of surgery, but to accomplish this result 
what difficulties had they not to contend with! The opposition 
\\ hich every innovation arouses had to be overcome. Men 
ridiculed the rules laid down by the founder of the method 
requiring the use of the silk protective, the folding of the 
bandage saturated with phenic acid a given number oftirr.es, 
the application of mackintosh, the enveloping of the whole 
with cotton-wool, etc., without remembering the object under- 
lying these minute precautions, viz, the exclusion of disease 
germs from the wound, without reflecting that the first steps 
were being taken in a new science, that the details were not 
identical with the method. 
When the world had assimilated the idea, the skill of 
practised surgeons was applied to the simplification of the 
details, while the investigations of thousands of scientific men 
are ever carrying the method nearer and nearer to perfec- 
tion. 
I he results have more than c< mpensated the labor spent 
in obtaining them. 
I he task now to be accomplished is to .apply the practice 
of antiseptics to other transmissible diseases. If the germs 
which pioduce those diseases are similar to those which 
poison wounds, they can be destroyed before they attack 
men or animals. 
Let us apply the theory ol Lister to disinfection. Cholera 
is a ti ansmissible disease; the discharges of patients contain 
the comma-shaped bacillus: apparel tainted with those di>- 14 
charges harbors it and m;iv transmit it to our persons and 
thence to our food. But the domestic water supply is the 
great vehicle of infection, owing to its constant use for drink- 
ing and in cookery. The soil furnishes a congenial home to 
the germ. But, on the other hand, the only way by which it 
can penetrate into our organism is through the digestive 
organs. Let these be in good condition, let the juices of the 
stomach be in their normal state of acidity, and we are in 
possession of the real antiseptic agent furnished by Nature 
for our protection. But when the stomach or intestines are 
unsound, their secretions form a congenial element for the 
microbe. Then it is that it multiplies and produces the disease. 
It thus appears that, in the healthy condition ol the body, 
the gastro intestinal juices are the primary antiseptic agent 
furnished us. Bu we are enabled, too, to destroy the germs 
before they reach our organisms, just as Lister destroyed the 
germs capable of finding a lodgement in wounds. .As soon as 
discharges are produced, we can treat them with the solution 
of sulphate of copper, of phenic acid or bichloride of mercury 
in suitable proportions. If the discharges have tainted the soil, 
we can counteract their ill effects with the disinfectants nam- 
ed already or with limewater or chloride of lime. If matres- 
ses, bed-clothes, underwear, hangings, &c , have been soiled 
let us not negleet to subject them to the action of the steam 
disinfector where the combined heat and pressure will exter- 
minate the bacteria. If our hands have been polluted, let us 
be sure to wash them with a solution of phenic acid, before 
carrying them to our lips. If there is any possibility of our 
water-supply having been contaminated, we must not fail to 
boil it, for ebullition deprives the bacillus of all its virus. The 
same precaution must be taken with milk and all other sus- 
ceptible liquids. 
As the soil, under favoring conditions of heat and moist- 
ture, is known to harbor the germ, we must take care, in times 
of epidemic, to avoid low-growing plants as well as fruits and 
everything else likely to have been in contact with the ground. Such arc the counsels contained in every publication on 
the subject, and, in reality, they are nothing more than prin- 
ciples of aseptics and antiseptics applied to the case of a bac- 
terial disease. 11 the practice of antiseptics is of the highest 
\ alue in protecting wounds from noxious germs, why should 
it not prove of equal efficacy against the organisms producing 
contagious diseases.-' Clinical operations have proved it in 
practice and bacteriology has demonstrated it scientifically in 
the laboratory. Our duty as hygienists is to proclaim the’su- 
preme utility of disinfection, to call into use against each mi- 
crobe the antiseptic that will most surely destroy it, to inspire 
our colleagues with our own unshaken faith, and, above all, 
to preach the creed contained in the following words: Just, 
as m practising laparotomy, in order to enjoy the security 
that septic peritonitis ‘hall not supervene and snatch away 
our patient, it behooves ns not only to know that aseptics and 
antiseptics are useful but to have undergone a long course of 
practice m their use and acquirui an absolute mastery over 
all the details of the operation, so, in the case of disinfection, 
we must become familiar with our weapons and learn lioir to 
wield them with the same precision as in surgery has been 
attain'd by such menus Lister, Billroth, Volkmami, Berg- 
mann, and th ir camp ers, who are indebted to the system of 
disinfection for their most signal triumphs in the performance 
< f difficult surgical operations. 
But there is one difference between surgery and hygiene, 
as considered in relation to disinfection, which must not be 
passed over, for in sanitary science a science of pure appli- 
cation it is of the highest importance to understand tho- 
roughly the practical side of the problem. The difference in 
question is that, while, in surgery, the application of the dis- 
infective method is performed directly by men who have 
spent the better part of their lives in studying the theory and 
practice of operations, sanitary disinfection has to be carried 
out vicariously, by men who, having had no scientific train- 
ing, do not adjust their work to scientific rules. Such, for ins- 16 
tance, arc the men entrusted with the disinfection of dwellings,, 
furniture, hangings, upholstery, &c., of ships or infected por- 
tions of ships. 
But these men are but the necessary instruments, and 
the man of science must guide their hands while engaged in the 
process of disinfection, must furnish them with minute in- 
structions must put them through repeated lessons until entire 
familiarity is attained. 
On the other hand, the disinfection of matresses, bed- 
clothes, underwear, rind the articles technically known as sus- 
ceptible, is performed by means of the steam disinfector, an 
apparatus which does its work with entire perfection. 
The principle that it is easier to prevent disease than cure 
it is older than medicine. The sacred books of India and the 
Book of Genesis are the earliest witnesses to the existence of 
that principle. Hygiene has always formed an integral part 
of medical science and the Hippocratic works are full of it. 
But Sanitary Science, as at present understood, is quite mo- 
dern and its progress has been so rapid that the degree of 
perfection attained in the sanitation of cities constitutes to 
day the great standard whereby the civilization of nations 
may be estimated. The eagerness of scientific men to extend 
their knowledge in this science is evinced by the fact that 8 
International Health Congresses have already been held. To 
night’s assemblage is itself a signal proof of the tendency ol 
modern hygienists to widen their field of observations. 
If there be any one who still persists in believing that it 
is not given to man to diminish the number of diseases, to 
prolong human life and to ameliorate the condition of the race, 
he would surely be disabused of his error if he saw this small 
army ot the most eminent authorities in sanitary science from 
every State of the American Union and the Dominion of Ca- 
nada, who, leaving their homes and their affairs, have travelled 
thousands of miles and assembled in this spot with the pur- 
pose of contributing by their teachings to the improvement 
of the health of Nations. It is absurd to suppose that a mere