National Board or Health. 
REMARKS * 
BEFORE THE 
Committee on Public Health 
OF THE 
HOUSE OF REPRESENTATIVES 
IN SUPPORT OF 
House Bill 2785, 48th Congress, 1st Session, for the 
protection of the public health, and in refuta- 
tion of charges made against the Board by 
the Supervising Surgeon-General of 
the Marine Hospital Service. 
WASHINGTON, D. C. 
GIBSON BROTHERS, PRINTERS. 
1884. National Board of Health. 
remarks! 
BEFORE THE . 
Committee on Public Health 
OF THE 
HOUSE OF REPRESENTATIVES 
IN SUPPORT OF 
House Bill 2785, 48th Congress, 1st Session, for the 
protection of the public health, and in refuta- 
tion of charges made against the Board by 
the Supervising Surgeon-General of 
the Marine Hospital Service. 
WASHINGTON, D. C. 
GIBSON BROTHERS, PRINTERS. 
1884. NATIONAL BOARD OF HEALTH. 
President, - James L. Cabell, L.L. D., &c., University of Ya. 
Vice-President, - - Stephen Smith, M. D., &c., N. Y. City. 
Secretary, - - - - George E. Waring, Jr., Washington, D. C. 
Preston H. Bailhache, Surg., M. H. S., Washington, D. C. 
Hosmer A. Johnson, M. D., Chicago, 111. 
Samuel M. Bemiss, M. D., New Orleans, La. 
Robert W. Mitchell, M. D., Memphis, Tenn. 
Tullio S. Yerdi, M. D., Washington, D. C. 
Charles Smart, Major and Surgeon, U. S. A., Washington, D. C. 
Thomas Simons, Esq., Assistant Attorney-General, Washington, D. C. 
John M. Browne, Medical Director, U. S. Navy, Washington, D. C. 
Chief Clerk and Disbursing Agent, 
W. P. Dunwoody, Washington, D. C. CONTENTS. 
PAGE. 
Remarks of Dr. Charles Smart, U. S. A., 1-15 
Letter of Dr. Stephen Smith, - 17-27 
Remarks of Col. George E. Waring, Jb., 29-38 
“ “ Thomas Simons, Esq., Asst. Att’y-Gen’l, with Appended 
Papers, 39-70 
Appendices: 
Appendix A—Letter transmitting endorsements of the Board, - 57 
“ B—Statement of Dr. Smart concerning efforts made to 
HATE MEETINGS OF THE COMMITTEE ON PUBLIC HEALTH, 
47th Congress, 58 
“ C—Rules governing the Board in granting aid, - - - 59 
“ D—Aid to Board of Health of Pensacola; Telegrams, Ac., 61-70 
R—Proofs submitted by Col. George E. Waring, Jr., - 71-76 At the meeting of the Public Health Committee of 
the House of Representatives, Mr. Beach, N. Y., chair- 
man, held Thursday, February 21, 1884, Dr. Smart, of 
the National Board of Health, submitted as follows: 
Mr. Chairman and Gentlemen of the Committee : 
I have been delegated by the National Board of Health to 
explain what the facts really were in the instances cited by Dr. 
Hamilton, of the Marine Hospital Service, as sustaining the 
charges preferred by him against the Board. 
For a long time past charges have been circulated privately 
by Dr. Hamilton, and made use of to the detriment of the 
Board, when its members were not present to reply. Artfully 
worded paragraphs in the daily press have referred to these 
charges in such a way as to suggest to those who were ig- 
norant of the Board’s affairs that it had been condemned after 
a full and fair hearing. I do not say from whom these anony- 
mous paragraphs emanated, but I do say that they did immense 
injury to the public health interests of this country, if only in 
suspending the investigations of the Board into the origin of 
preventable diseases. At last, however, these charges have 
been formally and officially preferred. At last the Board 
knows what are the so-called facts which have been so long cir- 
culated for its condemnation. And what are these? A mass 
of verbiage, without body or basis, malignant enough when in 
concealment, but dissipated, when exposed, by a single breath 
of honesty and straightforwardness. 
In taking up these charges I desire to invite attention to Dr. 
Hamilton’s reply to an inquiry by a member of this Board that 
he had presented his case against the Board fully, and that 
there remained nothing to be hereafter charged against it. 2 
The specifications hardly admit of a classified arrangement, 
so I shall take them up one by one as they come to memory. 
1st. It was stated by Dr. Hamilton that the Board paid 
$5,000 for the hospital barge Selden, which he represented as 
a worthless old hulk or rotten canal-boat. Dr. Bailhache, 
chief of staff to General Hamilton, and his representative on 
the Board of Health, corrected him as to his figures, and the 
sum was subsequently stated at $3,000. The sum actually paid 
for this barge was $2,500, as may be seen by an examination 
of the retained copy of the vouchers on which the money was 
paid by the Treasury. 
Dr. Cabell went to Norfolk, Virginia, to superintend the 
establishment of the station. He consulted with the Quaran- 
tine Commissioners of the Elizabeth River District, and in con- 
junction with them selected the barge Neuse, afterwards 
christened the Selden, as being the best and cheapest. The 
barge has been on duty under the authority of the National 
Board of Health for three years at the station selected by the 
national and local authorities, and her quality or fitness for the 
work has never been called in question until now, when it 
suits Dr. Hamilton to do so. 
I shall read a passage from a letter now in the hands 
of the chairman of this committee, from Dr. Herbert M. 
Nash, one of the gentlemen connected with the purchase: 
“ The barge (Selden) originally built for a propeller, had 
just been thoroughly overhauled by her owner. I recollect 
that there were but two pieces of planking in her deemed de- 
fective, and these were subsequently replaced. All judges of 
such matters here deemed the amount paid for her very reason- 
able. After the house built upon her deck to accommodate 
the sick was finished, she was not only comfortable, but in 
every way suited to the purpose for which she was intended. 
The barge was under my charge as quarantine physician for 
one or two seasons, and if she had been kept where it was in- 
tended to moor her during the prevalence of infectious sick- 
ness, in comparatively smooth water either in Hampton Road, 
between Craney Island and Newport News, or in Little Bay, 3 
just inside of Willoughby’s Point, she would have lasted in- 
definitely, especially if she had been coppered. When carried 
over to the exposed position she occupied at Fisherman’s Island, 
of course her upper works were a disadvantage during high 
winds and seas ; but she was finally wrecked by having a hole 
stove in her bottom by her own anchor through the culpable 
negligence or mismanagement of those in charge of her.” 
The wreck referred to by Dr. Nash occurred after the trans- 
fer of the vessel to the Marine Hospital Service. 
B. P. Loyall, secretary of the Board of Quarantine Commis- 
sioners, testifies : 
“ I hereby certify that I examined the barge Selden before 
and after her completion for quarantine use in smooth water, 
and found her admirably well suited for the purpose in every 
particular. It was regarded by the Board of Quarantine Com- 
missioners as the most prompt and inexpensive way in which 
the question of a receptacle for quarantine patients could be 
met.” 
W. H. Murdaugh, of Norfolk, Va., says of the Selden : 
“ She was purchased by the National Board of Health 
for $2,500, which 1 considered a low price for her. At the 
time of the purchase I was the president of the Board of 
Quarantine Commissioners of this district, and, having been a 
naval officer the greater part of my life, the purchase and fit- 
ting out of the vessel was done by me at the request of the 
National Board of Health. * * * If ever there was a 
faithful job of work done for the Government this purchase 
and fitting out of the Selden was one. She was a sound, ser- 
viceable vessel, and had she been fitted for my own use I could 
not have made her cost me one cent less than she cost the Gov- 
ernment.” 
2d. The Mississippi Sanitary Flotilla was also stated by I)r. 
Hamilton as having been found worthless when he had it taken 
down to New Orleans. These launches, barges, &c., were 
used by the National Board of Health for three years below 
Memphis, and did good service in preserving commercial in- 4 
tercourse between New Orleans and the river cities, as well as 
in effecting their primary purpose of being always on guard to 
prevent the invasion of the interior by yellow fever from New 
Orleans. Its value in these respects was fully appreciated by 
the people of the Mississippi Valley, as may be seen by a ref- 
erence to the testimony of the various railroad and steamboat 
transportation agents, and that of the Memphis Cotton Ex- 
change. (See Annual Report of this Board 1880, page 630, 
et seq.) 
Just before this property passed from the hands of the Na- 
tional Board of Health, the Board of Health of Shelby County 
Taxing District, which includes Memphis, applied for permis- 
sion to use a portion of it in continuing the inspection system. 
A more definite proof that this flotilla was not worthless could 
not well be given, as the Memphis Board knew by an experi- 
ence of three years the character of the floating property and 
the uses it subserved. 
It seems, however, that there is a tendency on the part of 
Dr. Hamilton to condemn everything which belongs to the 
National Board of Health. He even went so far as to con- 
demn the site of the Ship Island Refuge Station, either be- 
cause it was selected and established by the Board, or because 
he was too ignorant of the essentials of such a station to recog- 
nize the superior advantages of Ship Island. At his instance 
the Secretary of the Treasury directed Captain Thos. AV. Lay, 
of the Revenue Marine, to survey the coast and report upon 
this matter. The following is that officer’s report: 
“ After a full consideration of all the requirements of a 
quarantine station, * * * we have decided to recommend 
Ship Island, in Mississippi sound, as the best located and only 
island that possesses these advantages. * * * I will also 
state that there is no other island in the vicinity of the passes, 
within my knowledge, that can be used as a quarantine station.” 
Since this report was rendered we have heard no more from 
Dr. Hamilton concerning the ineligibility of the Ship Island 
site. 5 
3d. Dr. Hamilton criticised the Board for its action in pur- 
chasing the patrol hospital boat, the Benner. This boat was 
purchased in 1879 with the intention of using her as a patrol 
boat, and especially for visiting places on the river reported 
as infected, but which are remote from railroad communication. 
Without a boat of this kind it would have been difficult to ob- 
tain access to such places within a reasonable space of time, 
since none of the steamboats plying on the river would land at 
them for fear of being quarantined thereafter at other ports. 
4th. The Board was also called to account for the sinking of 
two launches, one while being towed down the Ohio river, and 
the other at Memphis. I fail to see the connection between 
these accidents and the constitution or operations of the Na- 
tional Board of Health. Dr. Hamilton, by some remarks in- 
tended to be humorously sarcastic, tried to throw the respon- 
sibility of the loss in the one case on the naval member of the 
Board. Such insinuations do not require attention from me, 
and Dr. Turner is well able to protect himself. In the other 
case the launch was run into by a passing steamer. 
5th. As one instance of the culpable extravagance of the 
Board, it was stated that a member of the Board. Dr. Verdi, was 
paid $300 for an essay on the diseases of the lower animals. 
At a time when much public interest was felt in cattle disease 
the Board, under the requirement of its constituting act, which 
calls for investigations into all matters pertaining to the pub- 
lic health, desired to inform itself concerning this special sub- 
ject ; and, as Dr. Verdi had experience in this line of inquiry, 
he was placed formally on duty to investigate and report on 
the subject at a subsequent meeting of the Board. Dr. Verdi 
was not paid for his so-called essay. The law of March 3, 
1879, prescribes that when a civilian member of the Board is 
on duty on the work of the Board, he shall be paid at the rate 
of ten dollars a day. The Board had nothing to do with set- 
tling the amount to be paid to this gentleman; his pay was 
prescribed by law. He was occupied thirty days in the inves- 6 
tigations needful to the preparation of the report, and the law, 
not the National Board of Health, paid him a per diem of ten 
dollars. 
6th. Another instance was given, wherein the Board is held 
up for censure in that it employed Col. Waring to write con- 
cerning sewer-traps. Col. Waring, with the permission of the 
Committee, will himself reply to this. 
But this charge of high payments for “essay writing” lias 
already been shown to have its basis in misrepresentation. It 
was preferred at the suggestion of Dr. Hamilton by Mr. Ellis, 
of Louisiana, last February, in Congress, and was met by 
Messrs. Manning, of Mississippi, and King, of Louisiana, as 
may be seen by the Congressional Kecord of Wednesday, 
Feb’y 21, 1883, pp. 73-80. 
7th. The names of some men prominent in sanitary matters in 
their respective States were mentioned by Dr. Hamilton as em- 
ployes of the Board, and it was charged or suggested that 
this accounted for their interest in its welfare. The names 
and reputations of these gentlemen ought to have protected 
them from such a slur. Was Elisha Harris, of New York, 
over whose recent death the sanitarians and medical men of 
the country are now grieving, a man to be bought for the re- 
mainder of his life by a few weeks’ employment as a special 
inspector ? The whole tenor of his life is opposed to any such 
slanderous supposition. He is dead. I reply for him. John 
H. Bauch, of Illinois; Wirt Johnson, of Mississippi, and Pro- 
fessor Kedzie, of Michigan, are alive, and would answer Dr. 
Hamilton in stronger terms than I employ were they face to 
face with him. 
It has been a principle consistently carried out by the Board 
to obtain for any work on hand the men best qualified to 
execute it. Thus it came that prominent men were employed 
by the Board, and not unknown and untried nobodies. 
8th. Dr. Hamilton stated that the Board of Health had not  7 
the support of the medical men of the country, but only that 
of a small clique of interested sanitarians. When this Board 
first appeared before your committee, Mr. Chairman, to show 
cause why H. R. bill 2785, now before you, should meet with 
favorable consideration, there was submitted to you a list of 
associations, medical and sanitary, medical societies, and State 
and local boards of health, which had come to the support of 
the National Board when Congress, through agencies which 
are not so obscure now as they were then, failed to appropriate 
for the continuance of the work of the Board. 
Among these associated bodies—27 in number—are to be 
found the leading medical societies of the country, as the New 
York of Medicine, the New York County Medical 
Society, and the College of Physicians of Philadelphia. 
9th. l)r. Hamilton seemed desirous of showing that there 
was dissension in the councils of the National Board of 
Health, that some of its members believed with him that the 
executive of a national quarantine should be in the hands of 
the Marine Hospital Service. He conveyed a just tribute to 
the honorable record, ability, and reputation of Dr. Stephen 
Smith, the Yice President of our Board, and read a sentence 
or two from a letter from that gentleman which seemed to sup- 
port him in his views for the aggrandizement of his bureau, 
i his can hardly be considered a charge against the Board or 
its membership, but as it requires a word of explanation I refer 
to it. 
That letter was written by Dr. Stephen Smith at a time when 
he recognized that the health interests of this country, as rep- 
resented by the Board of Health, were in danger of being 
ground into the dust by the opposition and strong influence of 
the Marine Hospital Service. He desired to ascertain if any- 
thing in the way of a compromise could be effected which 
would save the Board of Health to the country. If, for in- 
stance, by an acquiescence in the transfer of the quarantine 
work the opposition to the other work of the Board might be 
removed, and it be permitted to live shorn, indeed, of much 8 
of its powers for good, but with much vet remaining; but on 
further consideration he closed his correspondence with Dr. 
Hamilton. Dr. Stephen Smith is, and always has been, 
thoroughly in earnest and eii rajpport with the other mem- 
bers of the Board in this matter. He is not here, but has 
transmitted a communication, which will be found on p. 17, 
et seq. 
10. I find that I personally have been charged, while Sec- 
retary of the Board, with packing the Public Health Association 
at its Indianapolis meeting to secure favorable action towards 
the Board of Health. The facts in this case are as follows: 
I was appointed unexpectedly a member and Secretary of the 
Board at a time when its prospects appeared dark. E investi- 
gated its history—its records—and found them unsullied by any 
doubtful transaction. I investigated the cause of the opposi- 
tion to it, and learned, chiefly by conversations with the mem- 
ber from the Marine Hospital Service, that it arose from the 
desire of that bureau to obtain control in quarantine matters. 
In fact, the member from that bureau made no secret of 
this desire. I learned, also, that an effort would be made by 
certain parties to secure the passage of resolutions jumped on 
the Association, which would necessitate the resignation of the 
Board of Health. It appeared to me my duty to the Board— 
a legally-constituted body—to spoil this scheme, and I did so 
by notifying the members of the Association that the affairs 
of the Board would come up for discussion. A copy of the 
communication which I issued has been submitted by Dr. 
Hamilton. 
11. I And myself again held up for censure, in that, during 
the Brownsville epidemic, I employed myself, as Secretary of 
the Board of Health, in writing to those at Brownsville whom 
I deemed inimical to the Marine Hospital Service, to find out 
flaws in its administration, and the mayor of Brownsville was 
indicated as one of my correspondents. At the outbreak of 
the epidemic I communicated with the mayor of the city by 
telegraph, requesting accurate information concerning the con- 9 
dition and needs of the people. I received full replies. 
W1 len the Executive Committee of the National Board of 
Health met I submitted these telegrams, hut it was considered 
that the epidemic fund at the command of the Marine Hos- 
pital Service was better able to sustain this tax upon it than 
the meagre fund with which the National Board had to sup- 
port the Ship Island and other refuge stations. I therefore 
transmitted the telegrams to Dr. Hamilton, who personally 
thanked me, saying they came in time to enable him to fit out 
his relief ship judiciously. These were the only communica- 
tions I sent to or received from Brownsville during the epi- 
demic. I had no other communication with any one in or 
near the city until February 20,1883, when I received a letter, 
dated February 12, from Dr. Happersett, of the army, stationed 
at Brownsville, informing me that Mayor Carson of that city 
had sent a letter to the President of the National Board of 
Health, and asking me to lend my influence to publish it. I 
shall read a few sentences from this letter: 
“ I have just read a paper by Hon. Tlios. Carson, mayor of 
Brownsville, containing answers to questions relating to the 
work of the Marine Hospital Department here in the late 
yellow fever epidemic and propounded by the mayor of 
Pensacola. As the paper presents an entirely correct view 
of the whole conduct of the matter, he is now sending it to 
the President of the National Health Board, and I hope you 
will lend your influence to publish it, especially as, it seems to 
me, the Marine Hospital Service bases its chief claim to pub- 
lic recognition on its valuable labor here. Outside of the 
personal labor of the medical gentlemen who came here under 
its auspices, I cannot see a single advantage either to the 
community or the country. * * * Personally I entirely 
agree with the views of Hon. Tlios. Carson.” 
Shortly after I received this letter a telegram arrived stating 
that the packet had been sent to me instead of the President 
of the Board. On its arrival I communicated its contents to 
a gentleman who has been all along a staunch friend of the 
Board of Health, and his advice continued me in the opinion 10 
that Mayor Carson’s letter should go before the publie over 
his own signature and without any endorsement by the Board. 
Therefore I did not bring the letter before the Executive Com- 
mittee of the Board, but endeavored, as a private individual, 
to have as wide a publicity given to it as possible. Doctors and 
sanitary men were anxious to know all about the resort at 
Brownsville to the expensive measures of an armed cordon, 
and I individually concurred with Dr. Happersett that, in view 
of the credit claimed by the Marine Hospital Service, the other 
side should be heard. 
Dr. Hamilton endeavors to undervalue Mr. Carson’s testi- 
mony by saying that he is a man of no prominence and does 
not own a foot of ground in Texas. Cities do not usually 
make mayors of such men. He says Mayor Carson’s views 
are not entertained by the people of Brownsville. This seems 
strange, in view of the fact that Brownsville has two news- 
papers, and only two, and both of these entertained the views 
of the mayor. Are we to suppose that neither of their news- 
papers represented the feeling of the people of Brownsville as 
regards this matter ? 
The Bio Grande Valley of March 18, 1883, gives Mayor 
Carson’s letter in full, and reiterates the charges in an editorial, 
which closes thus : 
“ The National Board of Health is the only proper vehicle 
through which the Government can act in the prevention and 
suppression of epidemics. From the date of its organization 
up to one year ago the National Board did what the M. H. S. 
never could do, prevented the spread of yellow fever, although 
there were isolated cases every year. By employing the best 
physicians on the frontier a watch was kept on the fountain- 
head in Mexico, and it is a singular fact that while there were 
a few cases of black vomit every year, there was no spread of 
the fever, and it was kept under the most perfect control. But 
the useful had to give way to the ornamental machine of the 
voracious Treasury Department, and the matter became one 
of votes and politics instead of humanity. The National 
Board did with one man what, with this peculiar frontier pop- 
ulation, the Marine Hospital Service cannot do with 100 men. 11 
We have had both methods here, and we know by experience. 
Deliver us hereafter from the methods of the machine in hours 
that try men’s hearts.” 
The Cosmopolitan of March 20, 1883, characterizes Mayor 
Carson’s letter as— 
“ A straightforward statement of facts. The utter ineffi- 
ciency of the Marine Hospital Service in this section was set 
forth. * * * The value of the cordon was accurately 
stated. * * * It was of value inasmuch as it left $17,000 
among our people. * * * In the way the Marine Hospital 
Service was run here during the epidemic we firmly believe 
that it did far more harm than good, and we believe it unfitted 
to cope witli any epidemic of any kind successfully.” 
Dr. Hamilton, unsustained by the public press of Browns- 
ville, and in expectation of adverse criticism, has gathered sup- 
porting signatures from this section wherein, according to his 
own account, he expended in a short time over $49,000. 1 
made no inquiry by letter or otherwise into the shortcomings 
of the Marine Hospital Service, neither during the epidemic 
nor after it; yet testimony of the character I have now sub- 
mitted came to me unsought. The members of the National 
Board of Health knew nothing of Mayor Carson or his views 
until his letter was sent by me for publication to the Sanitary 
Engineer of New York. 
12th. It was charged that the Board of Health of Pensa- 
cola, Florida, was a protege of the National Board, and that as 
the one permitted yellow fever to enter the city the other must 
be held responsible. The Pensacola Board was no more a 
protege of the National Board of Health than any other of the 
hundreds of local boards in the country, which the National 
Board of Health was required by act of Congress to aid when 
their own resources proved inadequate. The National Board 
aided Pensacola to the extent of its ability. The local author- 
ities, as allowed by Dr. Hamilton, prevented the spread of the 
disease. Supplies were furnished by the voluntary eontribu- 12 
tions of the people all over the country ; but money for the pay- 
ment of skilled nurses and for the purchase of disin- 
fectants was not on hand. The National Board promptly 
furnished the disinfectants from the stock remaining on 
hand after the Memphis epidemic, and agreed to 
furnish the city with nurses for the sick. The sum of 
$9,100 was paid for this purpose on vouchers giving the 
name of each person employed, the period of service, and rate 
of compensation, all of which was sworn to by the Secretary 
of the Pensacola Board. Dr. Bailhache, the representative of 
the Marine Hospital Service on the National Board, is person- 
ally cognizant of these facts, and voted for the payment of 
these bills when rendered. One other bill was received from 
Pensacola. The Board sent Dr. Martin, of the navy, to that 
city to investigate the origin of the epidemic. While thus em- 
ployed he was taken sick, and was attended by Dr. Hargis, who 
rendered to the Navy Department a bill for $150 for profes- 
sional services. The First Comptroller having given his opin- 
ion that the bill could not be paid from funds appropriated 
for the Navy, it was referred by the Department to the Na- 
tional Board, and was paid by the Board, the member from 
the Marine Hospital Service voting affirmatively on the ques- 
tion of payment. 
13th. Dr. Hamilton charged that the appropriation for the 
local board of health was a corruption fund, and that it was 
understood that these boards were to support the hands that 
fed them. To sustain this charge his only specification is that 
at Pensacola, after the epidemic had entirely ceased, a requisi- 
tion was made on the National Board of Health for $2,000, 
which requisition was honored and the money distributed among 
the friends of the Board. It surprises me that Dr. Bailhache, 
the member of the Board from the Marine Hospital Service, 
who showed Ins interest in the progress of the investigation 
Thursday last by correcting his superior when he made a mis- 
taken statement with regard to the purchase money of the barge 13 
Selden, should have remained seated while Dr. Hamilton com- 
mitted this egregious mistake. Dr. Bailhache was a member 
of the Executive Committee of the Board at that time, and was 
well aware that no such requisition was received, much less con- 
sidered, and considered favorably, by the National Board of 
Health. The bills here submitted cover all the money expended 
at Pensacola, and Dr. Bailhache, now present, knows it 
Lastly, with reference to the International Sanitary Confer- 
ence of Washington, of 1881, I have the honor to present a 
note written by Dr. Jas. L. Cabell, the President of this 
Board and a IT. S. delegate at the said conference: 
“ In addition to other attempts to depreciate the official acts 
of the National Board of Health, and to arrogate to himself 
superior foresight and wisdom, Dr. Hamilton has made one 
statement which passes the bounds of sanity in the assump- 
tion that he alone had recognized a constitutional difficulty 
that had escaped the scrutiny not only of the Board of Health, 
but also of the National Academy of Sciences, both Houses of 
Congress, the Secretary of State, and the President of the 
United States, and it furnishes a fair sample of the conceit 
which unfits him for the delicate and responsible duties he de- 
sires to assume. 
“ The American Public Health Association, composed of 
representatives from every section of the United States, had 
passed a resolution, at its annual meeting in November, 1878, 
to the effect ‘ that it is the duty of the general Government to 
invite foreign nations to co-operate with it in the establish- 
ment of uniform and effective quarantine regulations.’ By the 
provisions of the constituting act, approved March 3, 1879, 
the National Academy of Sciences was required to co-operate 
with the Board of Health in the preparation of a special re- 
port to Congress on the subject of quarantine. These two 
bodies recognized the great and inestimable value of interna- 
tional co-operation in such measures of preventive sanitation 
as might be most advantageously applied at foreign ports 
of departure to vessels about to sail for any port of the 
United States, but they equally recognized the fact, that in 
conformity with the traditional and well-established policy of 
the general Government, it could not enter into treaty stipu- 
lations which might be construed as giving free pratique to 14 
foreign vessels desiring to enter a port of the United States 
without the consent of the local authorities, or which 
would in any degree interfere with the police powers of 
the States. They accordngly abstained from maiding any 
recommendation in the precise direction indicated in the 
resolution of the Public Health Association, but sought to ob- 
tain some of the ends contemplated by the eminent sanitarians 
of that body by recommending the call of an International 
Conference, which should be in voted to consider the means of 
establishing an international system of notification as to the 
sanitary condition of ports and of the vessels sailing therefrom. 
The recommendation was accordingly made in the first annual 
report of the Board of Health, and in a separate report made 
to Congress by the National Academy of Sciences. In com- 
pliance with this recommendation by the two bodies, a joint res- 
olution of the Senate and House of Representatives, approved 
May 14, 1880, authorized the President of the United States 
to call an International Sanitary Conference to meet at Wash- 
ington, to which the several powers having jurisdiction of ports 
likely to be infected with yellow fever or cholera were to be in- 
vited to send delegates for the purpose of securing an inter- 
national system of notification as to the actual sanitary condi- 
tion of ports and places under the jurisdiction of such powers 
and of vessels sailing therefrom. 
“ It is needless to say that the many distinguished jurists in 
the legislative and executive departments of the Government 
who took an active interest in this matter, and with whom the 
officers of the National Board of Health had frequent and re- 
peated consultations, knew fully the import of the joint reso- 
lution, and had exhaustively considered it in all its bearings, 
and especially with reference to the limited powers of the gen- 
eral Government long before Dr. Hamilton had occasion to 
imagine that he had made a grand discovery. The recommen- 
dations of the conference were such as if carried out would 
not have interfered in the smallest degree with the rights of 
the several States. Especially is this true of the proposition 
submitted by the delegate of France, and voted for by the 
delegates of the United States, as found in Appendix B, pp. 
153-’4 of ‘ Proceedings of the International Sanitary Confer- 
ence, &c., &c., 1881.’ 
u I add that the United States were represented in this con- 
ference by the Hon. John Hay, the Assistant Secretary of 
State, two members of the legal profession—J. Hubley Ash- 15 
ton, Esq., and James Lowndes, Esq., of Washington city—and 
by the President and Secretary of the National Board of 
Health. 
“ Tiiat the recommendations of the conference were not at 
once made the basis of a convention to be submitted for rati- 
fication by the several powers represented in the conference 
was due to the fact that most of the delegates of foreign gov- 
ernments stated that they had no authority to make such a 
convention, and were only empowered to hold the resolutions 
of the conference ‘ad referendum? I add that this has gen- 
erally been the case with similar international conferences, 
and that, nevertheless, the most beneficial results, indicating 
marked advances in international hygiene, have followed each 
of these conferences. In the case of the conference at Wash- 
ington such results have been noticed not only in removing to 
a very considerable extent the difficulties which previously 
impeded our efforts to obtain trustworthy information as to the 
sanitary condition of foreign ports and vessels bound to the 
United States, but also in an improved sanitary condition of 
these great instruments of commerce which had so often been 
permitted to become the carriers of the most deadly eontagia.” Letter of Dr. Stephen Smith. 
Hon. Lewis Beach, 
(JJi’n Coin, on Public Health, House of Rep.: 
Dear Sir : I learn that at a recent meeting of your com- 
mittee rny friend, Dr. J. B. Hamilton, Supervising Surg.-Gen. of 
the Marine Hospital Service, read a letter from me to him in 
relation to the question of the performance of quarantine 
duties by that service. The purport of that letter is liable to 
misconstruction if the circumstances under which it was writ- 
ten are not understood. I beg, therefore, the privilege of ex- 
plaining to the committee the events bearing on the subject of 
that letter, as they came to my personal knowledge. I feel 
greater liberty in asking this favor, as the whole subject of 
the relations of the National Board of Health, and of the 
Marine Hospital Service, to the discharge of public health 
duties, seems to be under consideration by the committee. To 
do so intelligently, however, I must refer to the history of the 
creation by Congress of a National Board of Health. With 
that history, from the first suggestions of a National Board of 
Health to the present, 1 am personally familiar. 
For a quarter of a century I have been interested in the 
efforts of sanitarians to introduce into this country the health 
laws and organizations of England, which have so marvellously 
improved the health of her communities. But it required 
twelve years of incessant work to secure the enactment of the 
law that gave New York city its present excellent and popular 
board of health. Seven years of duty as member of that board 
convinced me that its efficiency and success depended upon the 
fact that it was a board having a membership representing 
various sanitary interests. It required fifteen years of agita- 
tion to secure the law which gave the State of New York a 
hoard of health, which is now one of the most popular branches 18 
of the State Government. These facts, which can be indefi- 
nitely multiplied, show the persistent efforts required of the 
pioneers of this reform to create adequate health organiza- 
tions. 
But as result of this agitation for reform in the administra- 
tion of public health affairs, nearly every city in the country 
has now an active and efficient board of health, and thirty 
States have equally efficient boards of health. It is to be 
noted as an important fact, bearing upon the kind of health 
organizations which is most competent to perform sanitary 
duties and most reliable in assuming the grave responsibilities 
incident to the functions of health authorities, whether muni- 
cipal or State, that boards of health having a varied member- 
ship have always been preferred to health organizations having 
but a single head. 
It is now upwards of twelve years since some of the more 
advanced leaders in sanitary reform became impressed with the 
belief that the system of health organizations of this country 
could never be complete until the following scheme was per- 
fected, viz : 
1. Local Boards of Health, to protect the individual and 
families from domestic causes of sickness and death. 
2. State Boards of Health, to prevent the spread of do- 
mestic contagious diseases by co-ordinating the work of local 
boards, and co-operating with them, and the removal of the 
causes of disease which extend widely over the State. 
3. A National Board of Health, fully empowered, 1st, to 
investigate the causes and methods of prevention of domestic 
pestilences, widespread among the States and Territories, and 
aid local authorities in their suppression; 2d, to prevent the 
introduction of foreign pestilences into the country and their 
spread from one State into another, by co-ordinating the ope- 
rations of State boards, and co-operating with them ; 3d, to 
examine and determine public health questions of international 
importance. 
In the opinion of several gentlemen, the time had then 19 
come when it was proper to make the effort to secure from 
Congress the legislation necessary to the organization of a 
National Board of Health. -Accordingly a meeting was held 
in Washington, to which representatives from the Army, 
Navy, and the Marine Hospital Service were invited. The con- 
ference continued two or three days. The discussion of the 
subject developed the fact that there was much jealousy be- 
tween the Departments at Washington as to which would be 
most prominent in the new organization. The contest lay 
chiefly between the representatives of the Army and Marine 
Hospital Service, both of which finally took strong ground 
against any plan which did not make their respective service 
the central figure of the proposed Board. The conference 
closed without accomplishing anything farther than request- 
ing Dorman B. Eaton, Esq., of New York, author of the New 
York City Health Law, to prepare a bill creating a National 
Board of Health. Mr. Eaton prepared a bill, which was very 
nearly in the terms of the bill creating the present National 
Board of Health. As this bill placed the Departments on the 
same footing in the Board, the Army and Marine Hospital 
Service both rejected it, and it was never presented to Con- 
gress. From that time until 1879 both the Medical Depart- 
ment of the Army and the Marine Hospital Service endeav- 
ored to secure from Congress such legislation as would make 
their respective services most prominent in sanitary work. 
The Medical Department of the Army was authorized by Con- 
gress to investigate the quarantines of the United States 
and the outbreak of cholera in the Southwest, and the Ma- 
rine Hospital Service was empowered to establish quarantines 
where none existed, &c. 
The great epidemic of yellow fever of 1878 brought the 
whole subject of a National Board of Health prominently for- 
ward, both before the public and before Congress. The 
American Public Health Association, which represented all 
the sanitarians and boards of health in the country, became 
the special medium of the public health interests in securing 20 
legislation. A great variety of bills were introduced into 
Congress, organizing a health bureau, and the whole subject 
was most thoroughly discussed in Congress and throughout 
the country. This was especially true of the question, early 
raised and persistently urged, as to the propriety of conferring 
upon the Marine Hospital Service the necessary sanitary 
powers and duties. This scheme was rejected by the Public 
Health Association, by all sanitarians with one or two excep- 
tions, and, finally, by Congress. The bill which passed 
created a board of health composed of seven members ap- 
pointed by the President and Senate, and four members, ex of- 
ficio., one from each of the Departments, viz., Med. Dept, of 
the Army, Navy, Marine Hospt. Service, and the Dept, of Jus- 
tice. 
This constitution of the Board was originally provided by 
Mr. Eaton in the bill referred to, who, from personal examina- 
tion of the health organizations of Europe, and as author of 
the health law of New York city, brought to the task of pre- 
paring a bill organizing a National Board of Health unusual 
skill and experience. Theoretically no better method could 
be devised of creating a board which at once was representa- 
tive in its character, and combined the several departments on 
an equal and equitable footing. Practically, the wisdom of 
the originator of the plan of creating the Board has been fully 
demonstrated. The members appointed by the President 
were all eminent in the sections of the United States which 
they represented for practical personal knowledge of the admin- 
istration of health laws and familiarity with epidemic and pes- 
tilential diseases, and the members ex ofiicio brought to the 
counsels of the Board the varied knowledge and experience of 
the Army, .Navy, Marine Hospital Service, and Dept, of Jus- 
tice. The law was so drawn as to enable the Surg.-Gen. of 
the Army, the Surg.-Gen. of the Navy, and the Surg.-Gen. of 
the Marine Hospt. Service to be detailed as members of the 
Board. Dr. Woodworth, then Surg.-Gen. of the Marine Hospt. 
Service, expressed to me his intention of personally represent- 21 
ing his Service, and doing all in his power to make the Na- 
tional Board of Health a “grand success.” 
It is proper for me to say in this connection that among 
the bills before Congress during the session was one which as- 
sociated a board of health with the Marine Hospital Service, 
with ample powers to perform sanitary duties. I had reason 
to believe for a time that this was the only health measure 
that would pass Congress, and as it answered in many respects 
the purposes which we had in view, I favored it, in common 
with Dr. John M. Woodworth, Supervising Surgeon-General 
of the Marine Hospital Service, who was an old and valued 
friend and coworker in the field of sanitary reform. But the 
bill was rejected, together with others of a similar nature, and 
all the health duties and powers hitherto conferred upon the 
Marine Hospital Service were transferred to the new Board of 
Health. On the day following the passage of the constituting 
act, viz., March 5, 1879, Dr. Woodworth was seized with a 
fatal illness and died a few days after. Dr. Woodworth had 
labored incessantly during the session of Congress to secure to 
the Marine Hospital Service the proposed Health Department, 
but failing, his health broke down completely. With his 
death all opposition ceased, and the National Board of Health 
assumed the position and the functions of the central health 
organization of the United States. 
It was a matter of general congratulation among the sani- 
tarians of this country and of Europe that the great national 
sanitary questions which our Government must now consider 
were to be committed to the judgment of a board of health 
with a diversified membership rather than to a bureau with a 
single head. England had but recently abolished its Health 
Department with a single head, and transferred all the powers 
and duties to a board, though its previous health officer was 
the most eminent sanitarian living. And experience has am- 
ply proved the wisdom of Congress in finally rejecting a single- 
headed bureau, and adopting the plan, now universally recog- 
nized in Europe and in thirty States of the Union, of commit- 22 
ting all health powers and duties to a well-organized board of 
health. For it must he borne in mind that the duties of a 
board of health are rather deliberative than executive. 
The members appointed represented not only the varied 
sanitary interests of different sections of the country, but they 
were experts in a knowledge of the epidemics peculiar to their 
respective sections, and of the best measures of prevention. 
In the conflict which the Board had to enter upon soon after 
its organization with the great epidemic of yellow fever of 
1879, the immense value of the efficient counsels and personal 
services of the members, familiar with the peculiarities of the 
scourge, and of the people afflicted, was daily apparent. Nor 
did the Board prove to be an unwieldy body in the execution 
of its duties. On the contrary, by the organization of an ex- 
ecutive committee, composed chiefly of resident members, who 
could be summoned in council in ten or fifteen minutes, not 
only was there a rapid despatch of business, but every item 
had the careful consideration of at least four expert men, one 
of whom was the Solicitor-General. Twice in each year the 
whole Board met and reviewed the past work of the ex- 
ecutive committee, projected the future operations of the 
Board, and deliberated with the greatest care and pa- 
tience upon those new and untried subjects which in- 
volved vital questions of public policy. And from large 
experience in similar bodies, I take the liberty of adding 
that, while there was often the greatest diversity of opinions 
expressed on individual subjects, there was always the most 
perfect acquiescence in the conclusions reached. This diversity 
in the discussion of sanitary questions shows the importance of 
a board in determining the policy to pursue in the administra- 
tion of health laws, while the unanimity of the board in carry- 
ing out the decisions of the majority proves that the organiza- 
tion is admirably adapted for its purposes. The records of the 
Board will prove to any one familiar with State medicine and 
the problems which it presents, that during the four years of 
its active existence the Rational Board of Health has repeat- 23 
edly been required to determine public health questions of 
national importance which could never safely be left to the 
arbitrary decision of any single person. If it is true, as 
alleged, that a board of eleven members, seven of whom are 
appointed by the President for their special fitness for their 
duties, and four are elected from the Departments of the 
Government for like qualifications, is liable to, and actually 
does, commit grave errors of judgment, and mistakes in exe- 
cution, what dangers must beset such public service when all 
its delicate and responsible duties are entrusted to the unaided 
judgment of a single person. And as a result of the delib- 
erations of that Board the policy of the General Government, 
in preventing the introduction of foreign pestilences into 
this country, and their spread from one State into another, 
has become the most enlightened and the most successful of 
any nation in the civilized world. I refer to— 
1. The method of securing a good sanitary condition of 
ships. 
2. The projected plan of international notification of the 
sanitary condition of foreigh ports. 
3. The system of refuge stations for infected vessels bound 
to ports of the United States. 
4. The scheme of sanitary inspections of steamboats and 
railroad cars, to secure such cleanliness and freedom from in- 
fection as will interrupt travel and traffic to the least possible 
extent during the prevalence of an epidemic. 
5. The system of securing the vaccination of emigrants at 
foreign ports and on shipboard. 
6. The system of railroad inspections of emigrants to pre- 
vent the spread of small-pox. 
After two to three years of successful work, during which 
the Board had apparently gained the confidence of sanitarians 
and sanitary authorities, at home and abroad, I learned from my 
friend Dr. Hamilton, the successor of Dr. Woodworth as the 
head of the Marine Hospital Service, that he regarded all the 
duties relating to quarantine, conferred upon the National 24 
Board of Health by the law of June 2, 1879, as properly be- 
longing to his Service. It was in response to expressions 
which seemed to me antagonistic and foreshadowing a deter- 
mination to seek the necessary legislation to secure his object 
that I deprecated any hostile movement against the Board 
as liable to end in a loss of all that had been gained. As a 
measure which would place both departments in harmonious 
relations, without loss to the efficiency of either, I revived the 
project in the bill already alluded to, and which was favored 
by Dr. Woodworth, of combining the two services. Such was 
the purport of the letter read to the committee. 
It must be distinctly understood that the basis of the plan 
of uniting the two services which was suggested, was that 
sketched in detail in the Stanley Matthews bill of 1879, which 
organized a National Board of Health in connection with the 
Marine Hospital Service. 
In submitting this compromise measure I did not intend 
to indicate that I was dissatisfied with the National Board, or 
that the consolidation of the two services would be an improve- 
ment. On the contrary, as I have already intimated, I believed 
the plan of organization of the present Board the best that had 
been, and perhaps could be, devised. It is a representative 
body, and hence far more in harmony with our forms of gov- 
ernment than a bureau with a single head ; it combines in its 
membership every variety of knowledge necessary to judicious 
decision, and in its action has the force and precision of a single 
hand. Noj1 do I believe that its duties and powers should be 
curtailed or transferred to any other branch of the public ser- 
vice. The Board has fully demonstrated its ability to solve the 
problem of preventing the introduction of foreign pestilences 
into this country, and their spread from one State into an- 
other ; to aid judiciously local and State boards of health in 
their efforts to suppress epidemics, and to organize and conduct 
exhaustive investigations into the causes of diseases of national 
concern. But more than this, all the health powers and duties 
of the General Government should be conferred upon and ex- 25 
ercised by one branch of the public service, which should be 
fully equipped for the purpose. Divided responsibility must 
end in inefficiency and failure. It is doubtless true that the 
War Department could organize and manage a very good navy, 
and the Navy Department could organize and manage a very 
good army, and thus one department could be abolished. And 
equally, the Marine Hospital Service could manage very well 
a health department, and the National Board of Health could 
easily administer the affairs of the Marine Hospital Service. 
But no one doubts that such consolidation of entirely differ- 
ent branches of the public service would tend to confusion, in- 
efficiency, and, finally, complete failure. If one branch of ser- 
vice is to assume the duties of another, it must also organize all 
the details of the service so assumed. Nothing is, therefore, 
gained in economy, while much must necessarily be lost in effi- 
ciency. 
The compromise was suggested solely to prevent what I 
forsaw would be a contention among friends, liable to degen- 
erate into detraction, ridicule, and unseemly personalities, and 
which could only result in great injury to the public health 
service. The history of sanitary legislation proves that State 
medicine is a plant of slow and uncertain growth. Boards of 
health are too often organized on the approach or during the 
prevalence of great epidemics, and when popular alarm is at 
its height. They cope successfully with the scourge, the 
public is gratified, and due credit is given to the health au- 
thority. But when the danger is past and the same board 
that suppressed the epidemic labors quietly and unseen to cre- 
ate such conditions as will prevent the possibility of a return 
of the epidemic, the inquiry begins to circulate in official cir- 
cles “ To what purpose is this waste ?” “ What need is there of 
this useless and expensive appendage to the Government ?” 
Then comes the period of detraction and ridicule through 
which every health board must pass before it can be sure of 
permanency. Its best preventive measures, and its most 
useful and successful investigations into the hitherto 26 
unknown causes' of the sickness and deatli of the peo- 
ple, are held up to ridicule in legislative halls 
“ amid roars of laughter and applause.” Few boards of 
health pass through this period of detraction and ridicule with- 
out being crippled in their resources and largely deprived of 
their power for usefulness. Jenner’s appeal to Parliament for 
assistance, after his discovery of the great preventive of small- 
pox in -the udder of the cow, was received with unbounded 
ridicule and jeers. Pasteur’s discovery of the infinitesimal 
germ that destroyed the flocks and herds of France, after an 
immense amount of labor in experiments, was at first received 
with ridicule in official circles. Koch’s announcement of the 
discovery of the germ that causes consumption is to-day the 
subject of intense ridicule, in spite of the probability that this 
disease, which annually destroys more human beings than any, 
and, in some latitudes, more than all other diseases combined, 
may be either prevented or cured. 
My earnest wish and purpose in the attempt at conciliation 
was to save the National Board of Health from the perils to 
which it would be exposed in the infancy of its work if another 
department assailed it with the weapons always available against 
boards of health in seasons free from epidemics. For this 
reason, also, I was anxious that Dr. Hamilton should carry 
out the purpose of his predecessor, Dr. Woodworth, and him- 
self be detailed to represent his Bureau in the Board. I was 
persuaded that if he personally shared the labors and respon- 
sibilities of the other members in the work of the Board, no 
antagonism would ever arise between these two branches of 
the public service. If,, indeed, the Board has proved defec- 
tive or delinquent in any particular feature of its organization 
or operations which could have been prevented, or remedied, 
by his counsel, judgment, experience, or aid, his failure to act 
as a member, and thus by his good offices supply, what the 
law contemplated, the full and cordial support of the Marine 
Hospital Service, is certainly much to be regretted. But the 
Board should be exonerated from the charge of culpability for 
such defects and delinquencies. 27 
In conclusion, I beg to say that this letter has been written 
in the spirit of a long-existing friendship for the medical offi- 
cers of the Marine Hospital Service, for whom I entertain 
the highest personal and professional regard. But it is my 
profound conviction that the interests of the people and of 
sanitary science will be best served by conferring all public 
health duties and powers, now and hereafter to be exercised by 
the General Government, upon the National Board of Health. 
Respectfully submitted. 
. * STEPHEN SMITH. 
New York, Feb. 26th, 1884. Col. Waking, Secretary of the National Board of 
Health, submitted the following: 
Mr. Chairman : In order that there may be no misunder- 
standing as to the precise ground taken by the National Board 
of Health in its argument in favor of the control of quaran- 
tine matters being placed in its hands, I ask permission to set 
forth very succinctly the different points made. 
Let me, at the outset, call attention to the fact that the repre- 
sentatives of the Board came here with no other purpose than 
to explain to the committee why and how it is qualified prop- 
erly to perform such duties as pertain to, the control of epi- 
demics. 
It was only after the question of the opposition of the Ma- 
rine Hospital Service had been distinctly presented to us by the 
chairman of the committee, as one that it was desired to have 
discussed, that any member of the Board spoke on that feature 
of the case. 
The issue being thus raised, it became necessary for us to 
meet it by showing the relative qualifications of the two 
agencies properly to perform the limited duties of the National 
Government in connection with the quarantine powers belong- 
ing to and so jealously guarded by the several States. 
The National Board of Health was organized for the pro- 
tection of the health interests of the nation. It consists 
of seven civilian members, representing different sections 
of the country, all but one of them physicians, two of 
them well-known yellow fever experts, all selected for their 
special fitness for this duty, appointed by the President and 
confirmed by the Senate; also three Government medical offi- 
cers and an officer of the Department of Justice. It has no 
other duties than such as relate directly to the preservation of 
the public health. The prevention of the importation of dis- 
ease from abroad and into one State from another is a most 30 
important factor .of the public health problem, and quarantine, 
so far as it comes at all within the jurisdiction of the General 
Government, should be under the control of this body. 
The Marine Hospital Service consists of one medical officer 
appointed by the President and confirmed by the Senate, and 
other employes engaged by the Secretary of the Treasury, 
and employed for a single specific duty—the cure of 
sick sailors. Their services are paid for, not by the Gov- 
ernment, not for any general purpose, but by sailors only, 
and only for the cure of their own sick, the Government merely 
making up deficiencies in supplies, hospitals, etc. Reference 
has been made to the all-pervading facilities of the Marine 
Hospital Service for meeting the invasion of disease. It has 
properly no facilities whatever except curative ones. It can 
properly use, to protect the country against the invasion of 
contagious and infectious diseases, neither its hospitals nor 
its physicians, who are hired by sailors through the Government 
as their guardian. For quarantine work it must use other 
agents and other appliances,—as it has used, during the past 
year, the agents, appliances, and methods established by the 
National Board of Health. 
In other words, the National Board of Health is a body or- 
ganized especially for sanitary work, and fully qualified for 
the performance of whatever quarantine duties it is proper for 
the General Government to undertake. The Marine Hospital 
Service is a special body, organized and maintained for certain 
specific work, with which quarantine work is not only not in 
harmony, but is directly antagonistic. 
Only as bearing on the question as to the fitness of the Ma- 
rine Hospital Service for the administration of quarantine 
duties, I desire to specify my reasons for having said that in 
his quarantine work the Supervising Surgeon-General of that 
service has been injudicious and unskillful. 
It was injudicious for an officer representing a department 
of the Government to contract, as Hr. Hamilton undertook to 
do, with the health board of the city of Pensacola, that if it 31 
would perform its sanitary and quarantine the work under di- 
rection and control of the Assistant Surgeon of the Marine 
Hospital Service, the United States Treasury would pay the 
cost of that Board’s work in removing garbage, cleaning streets, 
and opening drains and gutters. He was estopped from carry- 
ing out this scheme by his superior officer. 
It was injudicious to recommend, as Dr. Hamilton did, the 
abandonment of the Ship Island Refuge Station and the 
establishment of a substitute therefor on Grand Hosier 
Island. This recommendation was referred by the Treasury 
Department to a competent marine officer, who reported that 
Grand Gosier Island was absolutely unfit for the use, and 
that Ship Island was the only suitable place for a refuge sta- 
tion in that neighborhood, and was, as he demonstrated, admi- 
rably adapted for the purpose. (See report of Captain T. W. 
Lay to the Secretary of the Treasury, December 19, 1883,.) 
I believe that Dr. Hamilton’s management was unskillful 
at Brownsville, because he did not apply his efforts to the most 
complete depopulation possible of the infected locality, espe- 
cially when he had before him the success of that method in 
the treatment of the epidemic at Memphis in 1879 ; and that 
he was especially unskillful in his work at Ship Island and 
at Pensacola in 1883. 
I owe the committee an apology and an explanation for my 
action in introducing a personal element into its deliberations 
after the Marine Hospital Service had been brought into the dis- 
cussion. I did this because I believed that Dr. Hamilton would 
abstain from appearing before you unless lashed into doing so by 
distinct charges so publicly made that they could not be disre- 
garded. In him I knew was centered the only effective oppo- 
sition to the National Board of Health, and it seemed to 
me altogether proper that his opposition should be exerted 
openly before this committee rather than, as has been his prac- 
tice hitherto, at the button-hole. To this end only did I here 
accuse him of misrepresentation, and only to secure this end 
did I make the communication that I did to the Associated 32 
Press of the country. Having succeeded in drawing from him 
a full statement of his case, I now proceed, in my own justi- 
fication, to establish, as I think very completely, my charge 
that in his attempt to influence public and official opinion he 
has been guilty of misrepresentation. 
Incidentally I would say that this is not to be considered as 
a side issue. It has a direct bearing on the fitness of the Su- 
pervising Surgeon-General of the Marine Hospital Service for 
the management of the delicate relations between the General 
Government and the sovereign States, which government inter- 
ference with quarantine excites, which are always so sensitive 
to the effect of the least indiscretion, and which can be suc- 
cessfully handled only with the utmost fairness and frankness. 
Distinct statements were made to me by the Secretary of the 
Treasury, which were not founded in fact, and which he could 
not have invented. They were that the National Board of 
Health had spent over $700,000 in one year, which it had not 
done, it having spent much less than that in three years, in- 
cluding its extensive and important work at Memphis in 1879; 
and that it had turned over to local authorities more than 
$60,000 in money, when it it should have disbursed its funds 
only on vouchers, approved by its own officers—the only way 
in which it has ever disbursed one dollar of public money. 
I assume, of course, that Dr. Hamilton was directly or in- 
directly the source of the Secretary’s misinformation. If he 
was not, I withdraw this specification. 
We have the authority of a member of the 17th Congress 
for saying that Dr. Hamilton was the source of information on 
which he based specific statements as to the character, amount, 
and effect of certain expenditures of the National Board of 
Health. I have placed in the hands of the chairman of the 
committee evidence that these statements were incorrect. I 
have given him a copy of each “ essay,” with a statement of 
the amount of compensation and expenses, showing important 
variations from the items given on the floor of the House of 
Representatives, and specific corrections of other errors. These 33 
erroneous statements were intended to be, and they were, inju- 
rious to the National Board of Health. • One of them was that 
the Board had spent $65,000 at Ship Island, and had to show for 
it only two ordinary buildings and the inspection of nine vessels 
in two years. In fact, there were six buildings adequate to the 
work of an active refuge station, a wharf nine hundred feet 
long, a steam launch, a sailing vessel, and other property, while 
nine times nine vessels were inspected in the two years referred 
to, besides a number in the year before. 
The statements made by the same member, as he said on 
Dr. Hamilton’s authority, concerning the Board’s expenditures 
for scientific investigations, were misleading and unfair. They 
grossly misrepresented the real facts of the case. 
Having allowed these misstatements to be made in his own 
interest and on his own authority, Dr. Hamilton became doubly 
responsible for them. 
It was a misrepresentation, in fact, for Dr. Hamilton in his 
preliminary report (1882) to quote an opinion approving the use 
of cordons at Pensacola, where the cordon was placed around the 
navy yard to keep yellow fever out of that locality, in apparent 
support of his action at Brownsville, where the cordon was 
used to keep the yellow fever and the material on which it 
was to feed within the cordon. 
It was misrepresentation, in fact, to publish through the Asso- 
ciated Press the announcement that the Secretary of the Treas- 
ury had decided that the act organizing the National Board 
of Health had expired by limitation. If Dr. Hamilton is not, 
directly or indirectly, responsible for such publication, I with- 
draw this specification. 
I think that a sensitive desire not to be placed in a false po- 
sition should have induced Dr. Hamilton to ask the agent of 
the Associated Press to hold his hand in such of his dispatches 
of 1883 as circulated throughout the country the general be- 
lief that by the action of the 47th Congress the National 
Board of Health had “ ceased to exist.” 
The foregoing is substantially what I said at the first meet- 34 
ing of the Committee; Dr. Hamilton’s remarks before you 
enable me to extend my specifications. 
He said he thought that the cheeks of the members of the 
National Board of Health ought to tingle with shame as they 
listened to him. I do not expect him to experience the emo- 
tion of shame at the recital of his own conduct, but it has been 
hameful nevertheless. 
Let me explain what I mean by misrepresentation. I call it 
misrepresentation of the worst sort for one occupying the chief 
position of an important public bureau, and at the same time 
performing the duties of an instructor of youth, to make use 
of the prestige thus given him, both to set forth facts in a 
perverted light and to disregard facts in his statements. 
It is a fact, as Dr. Hamilton said, that I was commissioned 
by the National Board of Health, and it was at my own sug- 
gestion, to make an investigation concerning drain-traps, also 
that I then had a patent trap of my own. The impression he 
attempted to produce was that I, the Secretary of the National 
Board of Health, had made an improper use of my employ- 
ment by the Board to advance my own interests. I was not 
then even a member of the Board. 
When my report was received, the Board, considering the 
important character of the subject, submitted it to two other 
engineers to have my experiments repeated under other condi- 
tions. The report of this second set of trials shows much 
variation from my results, and modifies my deductions. In 
this matter the Board was surely cautious and considerate. 
The full report of my investigations had long been before 
the public, and has been widely and frequently discussed by 
sanitarians. A careful accuser would have learned something 
of the case before using it as an evidence of impropriety. The 
simple fact is this, and my report shows it clearly: Neither my 
own trap, nor any like it, was in anywise investigated or re- 
ported on, or affected by, the experiments or the report. I 
made that investigation in a purely scientific spirit, for the 
benefit of the public and of my own reputation only, and en- 35 
tirely without compensation. To pervert these facts, which he 
knew or could have learned very easily, as Dr. Hamilton has 
done, was a shameful proceeding. 
Dr. Hamilton has charged the National Board of Health 
with using public money in its hands to corrupt leading sani- 
tarians and local health officers. This charge is false, and 
knowingly false. As he very well knows, the law required 
the Board to confer with the National Academy of Sciences. 
The Academy committee advised the making of investigations 
into certain scientitic matters affecting sanitary questions, and 
the Board accepted the advice. It naturally and neces- 
sarily had recourse for this work to the best and best known 
sanitarians of the country, whom it engaged for valuable 
services, paying them, not for their friendship or favor, but 
for services rendered, the payments being approved and or- 
dered by the Executive Committee, of which Dr. Hamilton’s 
representative, Dr. Bailhache, was a member concurring. I 
leave the committee to form its own conclusions as to the mo- 
tive which maj7 have actuated Dr. Hamilton in preferring a 
charge of disgraceful conduct on a collateral department of 
the Government, and in implicating in that charge men of 
such standing as Dr. Elisha Harris, Dr. Kedzie, Dr. Bauch, 
and Dr. Wirt Johnson. It seems to me that recklessness in 
misrepresentation could go no farther. 
He has charged the Board with paying Dr. Verdi $300 for 
writing an essay of a few pages. This is false. The Board 
put Dr. Verdi on duty to make researches in an important mat- 
ter affecting the public health. He reported the result of his 
researches in the paper to which reference has been made. 
For the time thus occupied Dr. Verdi was paid, according to 
the law organizing the National Board of Health, his regular 
per diem and nothing more. He would have been entitled to 
the same had his report been a simple “ yes ” or “ no " to a 
question propounded for investigation, and Dr. Hamilton knows 
this perfectly well. 
He has told you that he was called in consultation by the 36 
Board, and that this showed that that body considered lnm a 
sanitary authority. It showed nothing of the kind. He had 
been administering the quarantine law of 1878 for a year or 
more, and he was called in consultation because it was supposed 
that his experience in the matter would have qualified him to 
give valuable aid in connection with the Board's work. When 
he was asked to make suggestions as to the proper course for 
the Board to pursue, did he do so in a generous spirit and with 
due consideration for the interest of the public ? Far from 
it. He was doubtless already scheming to regain the conspicu- 
ous position that the law of June 2d, 1879, had taken from 
him. He had been told in a letter of the Secretary that the 
Board desired to obtain the results of his experience in the 
execution of the former law, “ to receive such suggestions as 
to the course to be taken ” as he might give, and to examine 
his blanks, forms, &c. 
At the meeting of the Board which he attended in response 
to this invitation, the minutes show that he expressed himself 
as ready to give any information lie could relative to what had 
been done, but as far as his making any suggestions as to 
future operations was concerned “ he could not do it for many 
reasons.” One of these reasons, doubtless, was that he hoped 
that the Board would, largely by reason of the obstructions 
that he might be able to place in its path, and if he withheld 
such suggestions as his experience had enabled him to give, 
fail to do satisfactory work. 
It is misrepresentation to base a reputation for a good sani- 
tary standing on this—concealing the real facts and covering 
them with the courteous letter that any public body would nat- 
urally address to any public officer of good repute, as Dr. 
Hamilton then was. 
As to the regulations which he says he disapproved, and 
which his disapproval caused the President to return for amend- 
ment, he had seen them before they were first sent to the 
President, and his representative had aided in preparing them. 
Why did he not have them made right at the outset? Why 37 
did lie not ? Because this would have given him no occasion 
to pretend, as lie now pretends, that his sagacity was a chief 
factor in their proper construction. As a matter of fact, nearly 
all of his suggestions were rejected, and, with a single excep- 
tion, those which were accepted were trivial, generally a mere 
improvement of the wording, and the suppression of some re- 
quirements not suited to the mercantile marine, though en- 
forced in the navy. 
Dr. Hamilton read you a letter from Pensacola, charging 
the Board with sending $2,000 to that city for distribution 
among physicians. He read this letter impressively, and he 
meant the committee to believe it. 
lie himself knew it to be false. 
When he wanted to give weight to an anonymous news item, 
clipped from a medical paper, which he adduced in his prelim- 
inary report on Brownsville to defend his much criticised 
Cordon Sanitaire, he signed it “ Clias. Smart, Secretary Na- 
tional Board of Health.” 
Dr. Smart had not signed it, nor had it been published in 
connection with his name, nor as his statement, nor as the 
Board’s. 
Every accusation that I have made against the Supervising 
Surgeon-General of the U. S. Marine Hospital Service is 
susceptible of absolute proof, and the proof is mainly before 
the committee. I submit, in all seriousness, that one whose 
methods are so uncontrolled, even by judiciousness or by skill, 
is disqualified for the management of the public health inter- 
ests of the nation. 
Dr. Hamilton’s misrepresentations before you concerning 
Brownville, the Mississippi fleet, and the barge Selden, I leave 
to Dr. Smart’s demonstration. In no single important point 
at issue has he tried to give you the impression that would 
have been given by a more scrupulous and fair-minded man, 
whatever might be his personal bias. 
He has from the outset done his utmost to bring discredit 
upon the National Board of Health and to secure to himself, 38 
through the influence of the Treasury Department, the dis- 
bursement of moneys appropriated for quarantine work. There 
is no evidence with which I am acquainted that he has ever at- 
tempted to perform the obvious duty of a public officer, which 
was to use his influence, if he used it at all, in such a manner 
as to increase the efficiency of a regularly constituted branch 
of the public service. He used it always to serve his own am- 
hitious ends. 
Happily he has far overshot the mark. Remarks submitted to the Committee on Public 
Health of the House of Representatives in support of 
House Rill 2785, by Thomas Simons, member of the 
National Board of Health : 
Mr. Chairman and Gentlemen of the Committee; 
I wish, as a member of the National Board, to state my 
views of the case before you. 
I was detailed to that position by the Attorney-General under 
the constituting act, on December 13, 1882, and had no pre- 
vious knowledge of the operations of the Board. Nearly 
everything that lias been discussed before you took place before 
that date. In speaking of such matters I have to rely on 
records and statements before you, and on information from 
the records of the Board and from my associates, data which 
seem to me to be entitled to credit until otherwise shown. 
Since becoming a member I have tried to acquaint myself with 
the main facts, at least, in the history of the Board, and have 
seen nothing therein to reflect upon its integrity, nor, so far as 
my judgment extends, upon its administrative capacity. In 
advocating its cause I am not conscious of any feeling or mo- 
tive in what I shall say other than that the truth should be 
known and right be done. 
The primary and, I think, only question before you is, 
whether H. R. bill 2785, or some equivalent measure, shall be 
favorably reported. That bill contains the chief provisions of 
the act of June 2, 1879, chapter II, which expired by limita- 
tion June 2, 1883, and which, in brief, gave the Board certain 
authority respecting interstate and maritime quarantine. The 
bill is advocated by the Board on the ground that it is for the 
public good that such authority be renewed, and this because— 
First. The grant of such authority was and is a wise and 
expedient measure. 
Second. It was faithfully and efficiently executed. 40 
Proof of these propositions will make at least a, print a facie 
case. 
On the first point I assume that you do not require probf 
that Congress acted understandingly in 1879, but the letter of 
Dr. Stephen Smith and the Board’s report of 1883, (pages 26 
to 33,) before you, fully set forth the history of that legisla- 
tion. I assume, further, that as Congress has not failed since 
1879 to make some provision for aiding local authorities to 
prevent and suppress epidemics of contagious or infectious 
disease, 1 need not defend the policy of such legislation; and 
that leaves only the question whether an organization like this 
Board is better fitted to carry out the purpose of such laws 
than any other agency. 
I would recall to your memory what was said by Dr. T. S. 
Verdi on that subject, and refer also to the letter of Dr. Ste- 
phen Smith, before mentioned. 
It would seem on principle that in matters of such import- 
ance and delicacy as those in question, the judgment of a num- 
ber of experts in council ought to be more surely trustworthy 
than that of a single person, however well informed. The al- 
most universal practice of entrusting such authority to “ boards 
of health” is the best evidence that this presumption accords 
with human experience in matters affecting the public health 
as in other relations. It is the verdict of common sense. 
The real matter you wish to ascertain, I venture to say, is 
that which is indicated by the second point, namely, whether 
this Board has in all respects discharged its duty under the act 
of June 2, 1879. 
1. The presumption is in their favor. If you examine the 
list of members composing the Board during the pendency of 
that act, you will find some names of great reputation in medi- 
cal and sanitary science and in connection with the special sub- 
ject of the act. Incapacity, neglect of duty, or malfeasance 
cannot be predicated of them. Their colleagues are not less 
entitled to the presumption of innocence of wrong and of at- 
tention to their duty. 41 
2. They do not rely on this alone, but produce the evidence 
of what they have done as recorded in their official reports of 
their action under that statute from beginning to end. There 
are five of these, (not very lengthy without the appendices,) 
which they beg you to read or examine, as it would be impos- 
sible in the limits of an address like this to adequately state 
their contents. 
A few of the leading facts shown are that before July, 
1879, yellow fever, which had raged in Memphis in 1878, 
broke out there again, and the new powers of the Board were 
taxed to the utmost degree in combating the disease at that 
and other points in the Mississippi Valley. 
No one has undertaken to say before you that its duty in 
that crisis was not faithfully and efficiently done. 
The Board took measures forthwith to assist in excluding 
the introduction of that disease from foreign parts by estab- 
lishing refuge stations at exposed points on the coast, and in 
such other measures as are detailed in its reports. 
In 1880 and 1881 there was no epidemic of yellow fever in 
this country. It is a reasonable presumption that the action 
of the Board aided in securing that immunity. 
In 1882 Congress appropriated only $50,000 to be expended 
by the Board under said act, (act Aug. 7, ch. 433,) an amount 
insufficient to enable it to conduct all the service required that 
year. Yellow fever prevailed as an epidemic in Pensacola and 
Brownsville. The Board maintained its system of inspection 
and refuge stations, and specially assisted the local authorities 
at Pensacola. I do not understand that any one has asserted 
before you that the National Board was responsible for the 
outbreak of disease at that point, or did not render prompt 
and effective aid within its means there. 
In 1883 Congress appropriated $10,000 only for pay and 
expenses of its members, and failed to continue the act of 
June 2, 1879. 
It would seem, on this showing, that the Board executed 
this act faithfully while it existed, and though no one has 42 
charged here that these manifestly successful results were ob- 
tained at an extravagant cost, I refer you to the report of Nov. 
28, 1883, (pages 97 to 99,) containing a tabulated statement 
of the expenditure of each fiscal year, the aggregate to June 
30, 1883, being $639,446.19, which, considering the time cov- 
ered and the results obtained, will be found a very moderate 
amount. 
3. The Board has also laid before you testimonials of con- 
fidence and commendation from a large number (twenty-seven) 
of the leading medical and sanitary authorities and associations 
of the country, as set forth in the letter of its secretary an- 
nexed, (Appendix A,) which they believe are entitled to your 
consideration, as indicating the opinion of those especially 
qualified to judge of their work and its results. 
This was the case which the Board made before you at your 
session of January 31st, and on which it rested, but the Com- 
mittee, being apparently advised that opposing influences had 
been exerted against the Board in respect to this subject-mat- 
ter, very naturally and properly inquired as to their source 
and as to the reasons for the action or inaction of Congress 
heretofore in the matter. 
The members of the Board present were gratified that the 
opportunity was presented of expressing their views on that 
subject. The President said that the apparent indisposition 
of the preceding Congress to sustain the Board by renewing 
the act in question, and in other respects, was due, in the 
opinion of the Board, to doubt and distrust excited in the 
minds of members of the House more especially, by state- 
ments prejudicial to it, made by the Marine Hospital Service, 
through its chief officer; that these statements were put in 
circulation privately, and were unknown to the Board until 
brought forth by some member in the crisis, perhaps, of a 
debate, when the Board could have no opportunity to present 
its defence; that the only noticeable opposition to the Board 
since its creation had come from the said Service and from the 
Louisiana State board of health, and that the hostility of the 43 
Hospital Service was apparently based on the repeal of the act 
of April 29, 1878, chapter 66, and the transfer of the powers 
therein given to that Service to the Board hy the act of June 
2, 1879, since which there had been, as he believed, a persist- 
ent effort on the part of the representatives of that Service to 
undermine the Board, with a view to supplant it in the admin- 
istration of those powers. He hoped the Committee would 
take measures to obtain the attendance of the Surgeon-Gen- 
eral, so that the Board could answer such objections or charges 
as he might present, and that they would investigate the other 
matters referred to so far as they should regard them as ma- 
terial. 
The Committee agreed that if the Surgeon-General had 
aught to say against the Board it was desirable for them to 
know what it was, and proper for the Board to have the op- 
portunity of answering it, and it was decided that he should 
he requested to attend at the next meeting for that purpose. 
By inadvertence the notice was not given by the Committee, 
hut information of its action was given to his office hy the 
Secretary of the Board. 
On February 7th the Committee met, and six members of 
the Board attended, hut no representative of the Marine Hos- 
pital Service was present. The President presented a written 
statement of the reasons for approving the hill in substance as 
informally given at the previous meeting. 
The chairman said the Committee desired to know further 
why the Board was and the Marine Hospital Service was not 
best qualified to conduct the service contemplated by the bill. 
This point was accordingly taken up hy members of the Board, 
one of whom, in comparing the merits of the two agencies, 
said that the Treasury Bureau ought not to he preferred, be- 
cause the Surgeon-General, at its head, had in his opinion been 
injudicious and unskilful in the connection he had had with such 
operations, instances of which he cited. He said, further, that 
the Surgeon-General had sought, through the agency of the 
press and before Congress and otherwise, by misrepresentation 44 
to injure the Board in order to benefit his Bureau, and for that 
reason also his administration of such affairs was not to he de- 
sired. The President also filed a written statement touching 
the inquiry of the Committee, which it was not intended to 
present unless the course of the discussion should seem to jus- 
tify it. 
I have stated the manner in which, as I recollect it, the per- 
sonal features in the above statement on behalf of the Board 
were introduced, in order to consider their actual and possible 
bearing on the issue before you, and the position of the Board 
in that matter I understand to be this: 
Theoretically the merits of the Surgeon-General as an ad- 
ministrator of quarantine are not involved, because Congress 
has not since June 2, 1879, given him any authority of that 
kind, but practically they may be so considered, since the 
Board claim he has always been a contestant for such au- 
thority, and the President has for two years delegated to the 
Secretary of the Treasury his power under the so-called epi- 
demic fund provisions in the appropriation acts of 1882 and 
1883, while the Secretary has put his subordinates in charge. 
At all events, the Committee, in calling on the Board to show 
why they should be preferred to the Marine Service, seem 
to regard that Service as entitled to consideration in the prem- 
ises, and the Board were desirous to satisfy the Committee on 
that as on all points. 
If, then, for any reason it was pertinent to institute a com- 
parison between the Board and the head of the said Service, it 
must be apparent that to allege that that officer has been inju- 
dicious and unskilful in his administration of the delegated 
authority was as directly in point as for that officer to make 
similar charges against the Board. 
It seems to me the inquiry of the Committee was pertinent, 
because it was apparent that the controversy would sooner or 
later come to that point. If the Committee should disregard 
it and report the bill on the merits of the Board alone, the 
question would no doubt be raised in the House; and it would 45 
be better if the Committee could say that they had investigated 
the matter in every aspect. 
The Board was and is especially anxious to have it so ex- 
amined, because they feel that they have suffered great injus- 
tice heretofore for want of such full and deliberate considera- 
tion. It is unreasonable to suppose that such a controversy 
can be properly decided in the hurried debate on some clause 
of an appropriation bill in the last days of a session, and yet 
that, the Board says, was the only opportunity that was given 
at the last session for consideration of their case, though the 
question before you was then pending, and the}' had earnestly 
endeavored to get it examined by the then Public Health Com- 
mittee of the House, as the annexed statement of the late 
Secretary will show. (Appendix B.) 
The question will arise in this connection whether the Board 
is justified in going so far as to make a charge affecting the 
moral character of the head of the Hospital Service, it being 
in substance that of wilfully misrepresenting the acts of the 
Board to members of Congress, and otherwise to injure it and 
benefit himself and his Service. 
It is greatly to be regretted that there should be any such 
feature in the discussion, and if it does not bear on the matter 
to be decided it ought not to be entertained. Whether it does 
or not depends, I submit, on two things : 
First. If it is material to consider the fitness of the Surgeon- 
General to discharge such duties as are in question, I do not 
see how the element of moral character can be excluded, for 
if he has done that which is charged he is not trustworthy. 
Second. If it be material in anywise to regard the action of 
the last Congress as affecting the present issue, then the Board 
have clearly the right to show, if they can, that the misrepre- 
sentation mentioned caused or influenced the result, or may 
have done so. 
I am somewhat embarrassed in this matter by having to put 
my remarks in writing for future submission, on account of 
flic absence of a quorum at the last meeting of the Committee, 46 
because I had intended, in orally addressing you at that time, to 
omit or refer to these personal considerations as you should 
direct in connection with such a limitation of the subject of 
inquiry. 1 shall endeavor to say what I think ought to be said 
under the circumstances in support of the views of the Board 
on that phase of this case as briefly and fairly as I can. 
In the first place, however, the charges made by the Sur- 
geon-General of the Marine Hospital Service against the 
Board, when he appeared before you on February 7tli and 
14th, should be noticed, as they, at all events, are material to 
the issue. 
The list may be fairly regarded as exhaustive, for the fol- 
lowing reasons: The maker has had an officer of his staff sit- 
ting as a member of the Board from its organization to the 
present time, and openly aiding him before the Committee, so 
that nothing has been done by the Board that he presumably 
does not or cannot know. If the Committee find that he has 
long desired and sought to get possession of the Board’s power 
in respect of quarantine, it proves that he has had the strong- 
est of motives, self interest, to inform himself of all the acts 
of the Board and to make use of his information against them. 
The Board believe that he has had that object and motive and 
the means of knowing their acts fully, and they thought that 
if he would come before the Committee and make his state- 
ment it would know all that could be said against them. He 
has come and told, as we understand, all he had to tell, and I 
proceed to consider the charges made. 
Those affecting the integrity of the Board in the discharge 
of its duty are the most serious, and should be first noticed. 
The Surgeon-General said: 
“ The appropriation in aid of local boards of health is, in 
its nature, a corruption fund, nothing more. It means, when- 
ever a board of health applies for money, that board of health 
gets the money. They are bound to endorse the hand that 
feeds them. They cannot help it. That is one of the condi- 
tions. If that is the policy of this Government, a disbursing 47 
clerk is all that is necessary to carry out the obje -ts of such 
an appropriation. If I must draw a check, if a check must be 
drawn by anybody in favor of a local board of health for so 
much money, Mr. Kelly could just as well draw the check as 
to have, from time to time, eleven dignitaries to authorize him 
to draw it.” 
The appropriation spoken of has been made by Congress 
every year since 1879 in terms for aid of local boards of 
health, among other things, and for two years past it has been 
in charge of and disbursed by the Surgeon-General himself. 
For the two preceding years Congress put it in charge of the 
Board, and as there was no epidemic in those years, it was not 
touched. (Report 1883, page 100.) The Board has given aid 
to State and local boards applying therefor in proper cases out 
of the appropriation made by Congress for the general pur- 
poses of executing its powers, and out of an appropriation of 
$50,000 for that purpose, made in 1882, and the amounts so 
expended in each year, are shown in its reports. (Report 
1883, pages 97-98.) You will see there that about $90,000 
was expended in aid of State and local boards during the 
yellow fever epidemic of 1879, and that the expenditures given 
for that purpose have been : In 1880, about $15,500 ; in 1881, 
about $5,000, and in 1882, when there was an epidemic at 
Pensacola, for maintaining refuge stations and aid at that 
place, about $50,000. (Report 1883, p. 97.) 
Of course the general operations of the Board in maintain- 
ing the refuge stations and inspection service were indirectly 
in aid of the various health boards of the region protected, but 
that is not the form of aid which I understand to be im- 
peached. 
I do not know what is meant by the language quoted unless 
it is a charge that the Board has used the appropriation above 
named, or any appropriation applicable to aid of local boards 
as a corruption fund; that it has granted every request of a 
local board for money without regard to the actual require- 
ments of the case, exacting as a condition that the recipients 
shall endorse the hand that feeds them. 48 
This is a grave charge, and it ought to be well proven to 
enable the Committee to find that eleven persons of presuma- 
bly good repute, one of them an officer in the Surgeon-Gen- 
eral’s own service, sitting beside him at the time he spoke, have 
been guilty of it. No proof of it whatever has been ten- 
dered—no single instance has been specified when that was 
done, directly or indirectly—so that the Board can only defend 
itself by denying it in the most, emphatic manner, and pointing 
you to the above-mentioned facts, which indicate, if they do 
not demonstrate, its baselessness. 
It is implied also in the charge that the practice of the Board 
was to draw its check for so much money in favor of the local 
board, leaving the disbursement to the discretion of the local 
board. The Board say no such thing was ever done. The purposes 
for which aid was desired were in all cases required to be stated, 
and were considered and approved before any amount was al- 
lowed therefor. The Board’s circular No. 7 annexed (appen- 
dix C) shows how carefully such expenditures were guarded. 
The Surgeon-General, it would seem, must have known that 
the business was done in this way, and yet his language was 
apparently intended to convey the impression that it was done 
otherwise, and in a negligent, if not an illegal, manner. 
The animus of this charge seems to be directed against the 
testimonials of confidence in the Board given by State and 
local boards, in common with other medical and sanitary asso- 
ciations before mentioned. The records of the Board show, 
as I am informed, that but four of the twenty-seven bodies repre- 
sented have applied for and received aid, and of the unaided 
residue ten are State and local boards. Eleven boards that 
were aided are not represented among the twenty-seven. These 
facts alone are a sufficient refutation of the charge. 
In this connection the Surgeon-General also charged that 
such testimonials, or some of them, were given in considera- 
tion of the employment by the Board heretofore of certain of 
the signers, and the names of four prominent sanitarians were 
mentioned who had at some time received compensation from 49 
the Board for service rendered to it. Of- course there was 
no proof of any understanding of the kind insinuated, and of 
course it ought not to have been insinuated unless proof was 
at hand. The persons named were employed in matters which 
their skill and experience made them particularly competent to 
investigate and care for, the details of which will be found in 
the reports of the Board. (Ileports for 1879, 1880, 1883.) 
It is not claimed that they were given more than just com- 
pensation for their services, but the fact that made it proper 
for the Board to desire their service is taken as the basis of an 
intimation that both parties were actuated by improper motives. 
There was another statement made touching the integrity 
of the Board. The Surgeon-General read a letter from the 
mayor of Pensacola charging, as I recollect, that the Board, 
after the epidemic had ceased, sent some $2,000 there to be 
divided among certain of its friends. This letter, it may be 
presumed, would not have been read unless the Surgeon-Gen- 
eral intended the Committee to understand that in his opinion 
the charge was true or was likely to be true. 
The best answer to this is to put before you the facts as 
contained in the communications annexed. (Appendix D.) 
The whole record, with accounts and vouchers, is at the service 
of the Committee. You will thus be enabled to see not only 
the falsity of the particular charge, but also the manner in 
which the Board received and responded to the applications of 
local boards for aid, and that the representative of the Marine 
Hospital Service was cognizant of and took part in what was 
done. Under such circumstances, it would seem that the 
Surgeon-General ought, before presenting such a statement, to 
have ascertained the facts from his assistant. 
The remaining charges of the Surgeon-General bear on the 
wisdom and efficiency of the Board. They have been quite 
fully answered by Dr. Smart in his statement, and I shall re- 
fer to them very briefly. 
The Surgeon-General criticised the Board as to the cost of 
the barge Selden, without knowing apparently what she did 50 
cost. It is not certain, therefore, whether he would contend 
that $2,500, for which she was bought, was too high, or how 
much too high it was. It does not appear that he saw her or 
knows her condition and value when bought in 1879. The 
Board furnishes the statements of those who did see her then, 
and who know those facts. (See letters filed.) 
The Surgeon-General also charged that certain of the barges 
and other vessels which the Board had employed in connection 
with its work on the Mississippi river were worthless, and had 
been sold last year by direction of the Secretary of the 
Treasury. 
The experience of the Board in the epidemic of 1879 was 
such as in its opinion to make it advisable to purchase and fit 
up a steamboat as a hospital boat, with launches, barges, and 
fiats for inspection and other service along the course of the 
Mississippi. (Report 1883, pages 54 to 56.) 
They regarded these appliances as invaluable in case of an 
actual epidemic at any point on the river, and as coming, there- 
fore, within the category of necessary preparations for such a 
contingency. They might well have been held accountable if 
they had waited until an epidemic was declared on the chance 
of being then able to procure suitable steamboats and other 
craft for their service. 
These vessels the Board employed for three years usefully 
in their opinion, and in that of the communities benetitted by 
the service; and when Congress last year failed to give the 
Board the means to use or preserve their property, it offered the 
custody and use of that property to the President for the pub- 
lic benefit. The Board does not believe that any of it wus 
worthless when transferred, and think that their rights in it 
should have secured for them at least the courtesy of a notice 
of the intention to sell it. Dr. Smart shows (p. 4) that the 
Shelby County Board of Health was desirous to obtain the 
custody and use of a part of this property, which the Board 
submits is better evidence of its worth than the statements of 
the Surgeon-General. 51 
The difficulty in this, as in other cases, is to discover what 
is charged—whether it is meant to assert that there was no oc- 
casion for such a service, or whether these vessels were not 
adapted to it, or were worthless when originally bought, or for 
what other reason. 
The charge that the Board paid Dr. Yerdi $300 for writing 
an essay of eight pages has been answered by Dr. Smart and 
the secretary, (pages 5-22.) It turns out that the facts are 
not at all such as the Committee would be led to suppose 
from the statement. The writer was put on duty to investi- 
gate and report on a certain subject, and if he was engaged 
thirty days, (the time for which he was paid,) the law fixed his 
compensation. 
' To make anything out of these facts, as against the Board 
the Surgeon-General should show that Dr. Verdi falsely charged 
for thirty days’ service when he had not rendered it, and that 
that was known to the Board, which he certainly has not done. 
The charge that the Board engaged Colonel Waring, (not 
then a member of the Board,) who had a patent on some form 
of drain-trap, to report on that subject, is as ill-defined as the 
rest. As he was not paid for his services the Surgeon-General 
must have intended to charge that Colonel Waring had some 
improper motive or object in the matter, which the Board 
shared, arising from the fact that he had a personal interest in 
the subject. The facts stated by Colonel Waring (pp. 20, 21) 
show that even if the Board had been aware of that interest 
there would have been no impropriety in his or their action; 
but it is needless to discuss that question when it is not proved 
nor even alleged that the Board knew it. 
This completes, I believe, the list of charges made against 
the Board. To summarize them there is substantially but one 
charge affecting the integrity of this Board, namely, that it 
has bought the expressions of confidence and commendation 
from various medical and sanitary associations laid before you 
by a system of illicit grants of money or bribes of employ- 
ment. Though not expressed in these words, that is the sub- 
stance of what was said. 52 
The individuals in and out of the Board affected by the 
charge belong, for the most part, I believe, to the same honor- 
able profession as the person making it; they are entitled to 
the presumption of good character and motive, and the Com- 
mittee will judge how far that has been affected by proof of 
the contrary. 
There are, besides, four charges, seemingly directed against 
the judgment of the Board in making certain expenditures 
and employments. So far as intelligible they appear to be as 
trivial as they are unfounded. 
This review, I submit, justifies the exertions of the Board to 
secure this investigation before you. You can realize, per- 
haps, how much of suspicion and prejudice might be excited 
by ex parte statements, such as you have heard, made against 
the Board, and how great a wrong might be effected thereby. 
Now you have heard (as Congress has never done) the Board 
and its accuser face to face, with time to investigate and de- 
liberate, and the Board confidently looks to you for its vindi- 
cation, hoping that if any point has been overlooked in 
charges that they answer, with one exception, from recollec- 
tion of what was said before you, their attention will be sea- 
sonably called to it. 
I proceed to consider the charge of misrepresentation before 
mentioned, and I shall refer to it only in connection with the 
action of Congress affecting the Board. 
The Board thinks it will not be denied by the Surgeon-Gen- 
eral that he has always been of the opinion that the powers 
and duties in question should belong to his Bureau rather than 
to the National Board, and that he has sought to bring about 
that result. His right as a subordinate official to act in that 
direction may be questioned, but, letting that pass, he should 
of course be responsible for wliat he does. 
The debate in the House on the sundry civil appropriation 
bill on February 20, 1883, (vol. 14, Cong. Rec., 3015,) shows 
that upon an amendment offered in the interest of the Board, 
a member opposed it strenuously, and said among other 53 
tilings : “ Yet I regret to say that from documents in my pos- 
session, taken from their own hooks, it is demonstrated that 
they are not only incapable of dealing with the problem trans- 
mitted to them, hut they have frittered away the public 
moneys appropriated for them in some instances, it seems to 
me, uselessly and foolishly, not to say extravagantly. It is a 
source of regret to me that I am obliged to give to the public 
records facts such as are before me.” A tabular statement 
was introduced, which is headed, “ Essays written by order of 
the National Board of Health under the law authorizing ‘in- 
vestigations,’ some of which were printed,” and comments on 
the items in it were made, the purport of which is apparently 
that the money was illegally paid for writing essays instead of 
for investigations, and that some at least of these were on sub- 
jects outside of the legitimate duty of the Board. 
He further said as to the station at Ship Island : 
“ What have they done at Ship Island ? They have erected 
two very ordinary board buildings, which at the outside, as I 
am informed, could not have cost more than $6,000 or $8,000 
all told. By their own report, they have inspected in the last 
two years nine vessels, and they present to the Government a 
hill of $65,000.” 
A member questioned the speaker as follows, (3021:) 
“ My colleague has gone into what he calls a statement of 
facts relating to the expenditure of money by that Board. I 
would be glad if he would answer me one question, and state 
from whom he derived the information upon which he has 
made his statement here ? 
A. “ From the books of the National Board of Health.” 
Q. “ Did he get that statement officially ?” 
A. “ They came from a member who took them from the 
hooks of the National Board of Health.” 
Q. “ Was he in charge of those books ?” 
A. “ I give them upon the authority of Surgeon-General 
Hamilton.” 
These citations show that alleged • facts were stated in de- 54 
hate before the House purporting to be taken from the books 
of the National Board by one of its members, and produced 
by the speaker on the authority of the Surgeon-General of the 
Marine Hospital Service, and used by him in the debate as 
justifying his strong denunciation of the Board. 
I assume, of course, the truth of the member’s responses, 
and also that this information was furnished to be used, as it 
was used, against the Board. If it was not substantially true, 
or if it was so imparted as to convey a false impression, it may 
be justly regarded as wilful misrepresentation, because the Sur- 
geon-General had abundant means of knowing the truth, and 
was especially bound to state it where a misunderstanding of 
the matter would benetit him. 
In the remarks of members immediately before and after 
the passage last cited will be found stated the facts as they 
were alleged to be on the part of the Board. I am informed 
that, owing to the limitation of time for debate and the unex- 
pected direction of the attack, those members were unable to 
inform themselves on the matter in time to answer fully dur- 
ing the debate, but obtaining the facts very soon after from 
the Board, incorporated them in their remarks as printed in 
the Record, so that the Board did not really get the benetit of 
the defence before the matter was acted on in the House. 
You will find also in the reports of the Board a full account 
of the investigations conducted, in connection with which the 
alleged “essays” were written, as well as the facts relating to 
the Ship Island station, and will be satisfied, 1 think, that the 
criticism was unjust, and the member misled in making it. (See 
Reports 1879, pp. 9-10 ; 1880, pp. 4-6 ; 1881, pp. 7-10 ; 1882, 
pp. 3-8; 1883, pp. 92-94; 1882, p. 17.) 
The heading of the tabular statement indicates particularly 
the intent to misrepresent the nature of the matters included, 
and this table, as I understand the statement of the member, 
is the production of the Surgeon-General, or of the member 
of the National Board referred to, and who must be the repre- 
sentative in the Board of the Marine Hospital Service. It is 
impossible to doubt that this table was made up and supplied 55 
to produce the impression that the Board had, under the pre- 
tence of conducting investigations under the constituting act, 
been paying large sums of money for different and unauthor- 
ized objects. If this was not the fact what will you say of 
the action and motives of those who made and furnished such 
material to be used against the Board—one of them being a 
member of the Board ? No fair-minded person would con- 
sider that the unfavorable action of the House on the amend- 
ment, under such circumstances, should weigh against the 
Board. 
The intent to misrepresent the facts as to the expenditure at 
Ship Island seems also to be plain. It can hardly be doubted 
who was the member’s informant. The facts, as represented, 
were not true, as has been shown in the Record referred to and 
by Col. Waring’s statement, all of which can be ascertained, if 
questioned, from the records of the Board. If the informer 
did not know the facts he had the means to know them, and is 
responsible for perverting them. 
The debates in Congress in the preceding session on the 
same bill give evidence of the same kind of opposition, (vol. 
13, Cong. Rec., 5750, 6892, 6950,) but it is needless to multi- 
ply instances of what must be self-evident, that the Board has 
had certain powers which the Surgeon-General has coveted and 
endeavored to obtain. The methods employed by him the 
Board believe to have been unfair, and so they claimed before 
you the right to know what was alleged against them and a 
full investigation of the whole matter. 
-I have but little to add to what has been said by other 
members touching the want of judgment or skill of the Sur- 
geon-General. I am not qualified, of course, to give an opin- 
ion on a question of medical science, such as is involved in the 
Brownsville discussion, and will merely state the case. 
The Board say that the sanitary cordon employed there was 
not the best method of treating the epidemic, considered scien- 
tifically and on the ground of expense, and that is all the 
charge, as I understand. It cost‘about $49,000, it seems, and 56 
the Board say the cordon feeds the disease by shutting the 
people in the infected place, when it is better and more humane 
to allow the inhabitants, under proper precautions, to leave. 
As to the agreement with the health authorities of Pensacola, 
I understand the fact to be that the plans of the Surgeon-Gen- 
eral were not approved by his superiors. What purports to 
be a statement of the agreement in a newspaper article is tiled 
with you, and the action thereon is doubtless of record in the 
Treasury Department, and accessible if disputed. 
The Surgeon-General’s action with regard to the Ship 
Island station is also criticised. He seems to have been for 
some reason so disposed to a change as to obtain a survey of 
the adjacent coast, which resulted in confirming the selection 
of the Board as the most, if not the only, suitable site. (See 
his annual report 1883, p. 59, and report of Capt. Lay, on file.) 
Your attention was called to these things as bearing on the 
alleged fitness of the Surgeon-General to exercise the respon- 
sible duties in question, and, if correctly stated, they tend to 
show that in the exercise of his judgment in the discharge of 
such duties his plans have not been in these instances such as 
were or should be approved. 
Some charges of a personal nature were made by the Surgeon- 
General before you against Dr. Cabell and Dr. Smart for 
alleged action of those members of the Board in its interest. 
The former answered on the spot, and the latter has answered 
in his statement on file. I do not deem it necessary to further 
consider matters not charged against the Board, unless the 
Committee should desire it. In that case the persons affected 
have the first right to be heard, but I am ready to state my 
views. 
In common with other members of the Board, I desire to 
express my thanks to the Committee for its patient attention 
to what has been said before it and its disposition to give the 
parties a full and fair hearing. 
Respectfully submitted. 
THOMAS SIMONS, 
Member of the National Board. Appendix A. 
National Board of Health, 
Washington, D. C., JarCy 26th, 1884. 
Hon. Lewis Beach, 
Chairman Committee on Public Health ; 
Dear Sir : Herewith I beg to forward for your information 
a number of resolutions, &c., giving expression to the approval 
of the action of the National Board of Health during the past 
few years. 
The following is a list of the documents enclosed, and I beg 
that after their perusal by the committee they maybe returned 
for the files of the Board : 
State Boards of Health : 
Alabama, 
Connecticut, 
Illinois, 
Iowa, 
Michigan, 
New Jersey, 
New York, 
West Virginia, 
Wisconsin. 
Local Boards of Health: 
Charleston, S. C. 
Memphis, Tenn. 
Norfolk, Va. 
Pensacola, Florida. 
Pittsburg, Penn. 
Other Sanitary Organizations, Medical Societies, Ac.. 
American Public Health Association. 
Sanitary Council of the Mississippi Valley, 1882—’3. 
Florida Medical Association. 
College of Physicians, Philadelphia. 
New York County Medical Society. 
New York Academy of Medicine. 
Newport Medical Society. 
57 58 
Newport Sanitary Protection Association. 
South Carolina Medical Association. 
Hancock Comity (Miss.) Board of Health. 
New Orleans Medical and Surgical Association. 
Orleans Parish Medical Society. . 
New Orleans Auxiliary Sanitary Association. 
Very respectfully, your obedient servant, 
(Signed) ' GEO. E. WARING, Jk., 
Secretary. 
P. S.—The Sanitary Council of the Mississippi Valley is 
made up of representatives of the health authorities of the fol- 
lowing States : 
Arkansas, Illinois, Indiana, Iowa, Louisiana, Mississippi, 
Michigan, Missouri, Ohio, Tennessee, and Wisconsin. 
Appendix B. 
I certify that on three or four occasions during the second 
session of the 47th Congress, I saw Mr. Van Aernam, chair- 
man of the Public Health Committee of the House of Ilepre- 
sentatives, and urged him, on the part of the National Board 
of Health, to call a meeting of his Committee and request the 
Board to appear before it for the purpose of expressing its 
views on the advisability of re-enacting the law of June 2, 
1879, or of preparing a bill as a substitute for it. 
I certify also that having failed to get Mr. Van Aernam to 
take action in this matter, I called upon several of the mem- 
bers of his Committee, as Gen’l Rosecrans, of California; Mr. 
Cullum, of Illinois, and Mr. Aiken, of South Carolina, and 
represented to them, in like manner, the desirability of having 
the Committee meet for the purpose above mentioned. 
CH. SMART, 
Surg. U. S. A. 
Circular No. 7. 
The following rules govern the action of the National Board 
of Health in co-operating with and aiding State and local boards 
to enforce the rules and regulations of such boards to prevent 
the introduction of contagious and infectious diseases into the 
United States, or into one State from another. 
Appendix C. 59 
1. The regulations to be enforced are those of State and 
local hoards, and must be such as are approved by the National 
Board. The National Board, in its circular published in its 
Bulletin No. 48, May 29, 1880, has recommended certain 
regulations with regard to maritime quarantine for adoption 
by State and local boards ; and in its Bulletin No. 50, June 
12, in 1880, pages 402-403, it has advised the adoption of 
certain regulations during the existence of yellow fever. 
It should be observed that these recommendations embody gen- 
eral principles only, the end in viewr being to protect and promote 
the public health by measures which interfere with travel or 
traffic as little as possible; in other words, to render commerce 
secure ; and (with rare exceptions) not to put an end to or even 
suspend it. In this connection it is proper to add that non- 
intercourse quarantines, especially by local authorities, are not 
approved by this Board. 
2. Applications to the National Board of Health for aid 
should be made by or through the State hoard ; or in case 
there is no State board, then by or through the governor of 
the State, and should be accompanied by a copy of the rules 
and regulations for enforcing which aid is desired. 
3. An application for aid must give details of what is re- 
quired, and the estimated cost of each item, and must be accom- 
panied by an official certificate from the governer of the State 
or the mayor or other chief officer of the municipality, re- 
spectively, to the effect that there are no State or municipal 
funds available to carry out the particular sanitary measures 
to secure which the application is made. 
4. The aid furnished by this Board to local authorities must, 
as a general rule, be applied to other objects than those of 
shelter and furniture. Where, however, it shall be otherwise 
ordered, the local authorities will be expected to account to 
this Board from time to time for the safe-keeping and proper 
use of the furniture, provisions, medicines, &c., so furnished. 
5. Whenever this Board shall order the erection of tem- 
porary buildings, or provide any buildings for the purpose of 
quarantine, the necessary contracts therefor shall be subject to 
the approval of the Board or of its executive committee. 
6. Care should be taken that the officers to be paid from 
funds furnished by the National Board are employed only in 
such number and for such time as there is actual need of their 
services. The National Board of Health reserves the right of 
judging from time to time, by means of reports received from 
its own agents, whether such need exists. 60 
7. Funds are not furnished by the Treasury to State or local 
boards. They are placed in the hands of the disbursing agent 
of the National Board of Health, by whom bills, properly cer- 
tilied and approved, will be paid by check on Washington or 
New York. All bills must be in accordance with the estimates 
as approved by the Secretary of the Treasury, must be made 
out in duplicate ou forms furnished by the National Board, 
and be certified, as to their correctness, by some authorized 
officer of tlie State or local board, and must be approved bv 
some member or inspector of the National Board, duly au- 
thorized. 
All bills for services rendered, or for articles furnished local 
or State boards, must be sworn to by the persons rendering 
the service or furnishing the articles. 
The names of all persons whose services as inspectors, Ac., 
are to be paid for out of its funds must be submitted to and 
approved by the National Board. 
8. State and municipal boards of health which receive aid 
from this Board are requested to furnish weekly reports to this 
office of their operations, including copies of orders issued by 
them and of reports made to them by their quarantine and 
sanitary inspectors with reference to the occurrence of cases 
of yellow fever and to measures adopted for isolating such 
cases ; such reports to be presented in a form suitable for pub- 
lication in the Bulletin. 
It is expected that at the close of the season a full report 
will be made by boards of health to the National Board as 
to their operations in carrying out those rules and regulations 
in which the National Board has rendered aid and co-operation, 
and it is desired that copies of all orders issued from time to 
time to inspectors shall be promptly furnished to this Board. 
It is to be remembered that a full account of its expendi- 
tures must be made by the National Board of Health to Con- 
gress, and such account must set forth these expenditures in 
detail, and exhibit their propriety and necessity. 
Appendix D. 
Action of the National Board of Health in the matter of 
the epidemic of yellow fever in Pensacola in 1882. 61 
TELEGRAMS -EXTRACTS FROM EXECUTIVE MINUTES. 
Telegram.] Pensacola, Aug. 30, ’82. 
Secretary Nat. Board of Health, Washington, D. C. : 
We have had fifteen cases of yellow fever and three deaths. 
The disease is confined to a small portion of the city, and the 
board of health are doing all in their power to stamp it out. 
Our expenses are heavy, all our funds being needed for quar- 
antine purposes. Should we need aid can your Board help us 
J. C. WHITING, Sec’y. 
Reply: 
Telegram.] Washington, I). C., Aug. 30, ’82. 
J. C. Whiting, Pensacola, Fla.: 
Send in accordance with Circular 7, Bulletin 51, vol. 2, esti- 
mates for such services and supplies as you may require. 
SMART. 
Telegram.] Washington, D. C., Aug. 31, ’84. 
Dr. J. L. Cabell, Hot Springs, Va.: 
Bailhache, Turner, Smart think duty of the- Board to assist 
Pensacola; Smith did not answer. I have requested local 
hoard to send in estimates for needful services and supplies. 
They will want to commence operations immediately. * * * 
SMART. 
Telegram.] Pensacola, Fla., Sept. 3, ’82. 
Dr. Smart, Sedy Nat. B'd of H., 
Washington, D. C.: 
Total mortality for the week, seven; live from yellow fever. 
No excitement and people very hopeful. If fever does not 
spread, will only need little aid. Will make up estimates as 
soon as we can. Will send you a daily bulletin. 
J. C. WHITING, See’y B. of II. 
Extract.] Executive Minutes, Sept. 5, ’82. 
The Committee met at 10 A. M. Present: Drs. Cabell, 
Turner, Bailhache, Geirl Phillips, and I)r. Smart, Secretary. 
The President stated that the authorities of Pensacola had in- 62 
timated that they wished to apply for aid, and that they had 
been called on for estimates which have not yet been received. 
Ordered, That the Secretary be directed to call a meeting of 
the members on the arrival of the estimates from Pensacola, 
and be guided in his action by the vote of the majority com- 
municating the result to the absent members. 
But if an agreement cannot be thus obtained, or if the cir- 
cumstances appear to require it, the President shall be notified 
and a formal session called. 
Telegram.] Pensacola, Fla., Sept. 5, ’82. 
Sec’y Nat’l Board of Health, IF, D. C.: 
One new case since my last report. No deaths. Letter by 
mail with estimates in accordance with circular 7. 
WHITING, Sec’y. 
Telegram.] Washington, D. C., Sept. 5, ’82. 
Dr. Jno. 0. Whiting, Pensacola, Fla.: 
Telegram received. Awaiting further advices. 
SMART. 
Telegram.] Pensacola, Fla., Sept. 6, ’82. 
Dr. Smart, Sedy Nadl Board of Health, 
Washington : 
No new cases to-day. One death. Will try and get esti- 
mates off to-morrow—was prevented to-day. 
WHITING, Sedy. 
Telegram.] Pensacola, Fla., Sept. 7, ’82. 
Dr. Smart, Sec’y N. B. of Jl., IF., I). C.: 
Ten new cases to-day. No deaths. Since outbreak of fever 
thirty-four cases and eight deaths. 
Estimates forwarded. 
WHITING, Sec'y. 
Telegram.] Pensacola, Sept. 11, ’82. 
Dr. Smart, Sect’’y Nadi Board of Health, 
Washington, I). C.: 
Please telegraph if our estimates for funds have been re- 
ceived. We are depending on you and are in immediate need 
of your assistance. 
WHITING, Seedy. 63 
Telegram.] Pensacola, Fla., Sept. 11, ’82. 
Dr. Smart, Nafl Board of Health, 
Washington, D. C.: 
Twenty new cases to-day. Three deaths. Disease is spread- 
ing rapidly, and weather propitious for large increase. We 
will need funds in excess of estimate sent you and at once. 
The demand is urgent. Forty paid nurses on duty to-day. 
Sickness confined principally to persons without means. 
Wired you this A. M. As yet no reply. Please answer. 
WHITING, Sedy. 
Telegram.] Washington, D. C., Sept. 11, ’81. 
J. G. Whiting, Sedy B. I/., Pensacola : 
Eeplied this A. M. If estimates do not come to-morrow 
morning will call for telegraphic synopsis. If they come yon 
shall hear immediately, as we have been waiting for them for 
days past. We wish to aid. 
SMAET. 
Telegram.] Washington, D. C., Sept. 12, ’82. 
Dr. J. L. Cabell, care Equitable Life, 
121 Broadway, N. Y.: 
Estimates received; exorbitant in certain points; commit- 
tee about to consider them. Would it be well to ask Bemiss to 
go to Pensacola to advise and supervise ? 
SMART. 
Telegram.] Washington, I). C., Sept. 12, ’82. 
Dr. Jno. C. Whiting, Pensacola.: 
Estimates received. For street cleaning, laborers, and drays 
not approved. Disinfectants approved, but in meantime sul- 
phur, iron, &c., will be sent from Memphis. Inspectors ap- 
proved, and one hundred dollars a day for nurses. It is sug- 
gested that live dollars is too high when compared with inspec- 
tors’ pay. Will write. 
SMART. 
Telegram.] Washington, D. C., Sept. 12, ’82. 
Dr. Fayette Dunlap, Memphis, Tenn.: 
Ship to Dr. John C. Whiting, hoard of health, Pensacola, 
40 barrels sulphur, 25 barrels copperas, and 20 barrels car- 
bolic acid. Notify me when shipped. 
SMAET. 64 
Telegram.] Pensacola, Fla., Sept. 12, ’82. 
Dr. Smart, Nat'l Board Health, 
Washington, D. C.: 
Telegram received. We have thirty-six nurses on duty, and 
will likely have more to-morrow. We will cut expenses down 
to lowest notch, but one hundred dollars per day will not pay 
for nurses. Disease confined principally so far to persons with 
little or no means, and, in addition to nurses, we have to sup- 
ply provisions, medicines, &c. If Board is not disposed or 
able to help us let us know at once, so that we can make an 
appeal to the people. Our necessities are pressing and imme- 
diate. Twenty-two cases to-day and two deaths. Total cases, 
one hundred and fourteen, and nineteen deaths. We cannot 
estimate exact amount we need, but will account to you for 
every cent expended. 
WHITING, Sedy. 
Telegram.] Pensacola, Fla., Sept. 12, ’82. 
Dr. Smart, Sedy Nafl Board of Health, 
Washington, I). C.: 
Telegram received. We sent estimates by mail, stating that 
we had expended up to seventh inst. about fifteen hundred 
dollars for disinfectants, labor, and so forth. That our daily 
expenses were upwards of two hundred dollars. Since then 
fever lias increased rapidly, and we have over fifty paid nurses 
on duty; besides, we have to supply rations to indigent persons. 
Have not solicited outside aid because we are depending on 
National Board. Send us immediately what money you can 
spare, and we will account for it. Nurses are charging five 
dollars per day, and hard to get. Expect some from New 
Orleans to-night. 
WHITING, Sedy. 
Telegram.] Washington, D. C., Sept. 12, ’82. 
Jas. L. Cabell, care Equitable Life, 
120 Broadway, N. Y.: 
Approved for Pensacola one hundred dollars daily for 
nurses and seventeen for inspectors. Disinfectants ordered 
shipped from Memphis. But this is not enough to satisfy 
wants. They require at least $200.00. Shall we accede ? 
SMAET. 65 
Telegram.] Washington, D. C., Sept. 13, ’82. 
Dr. J. C. Whiting, Pensacola : 
We think you can nurse your cases more economically by 
establishing hospitals, when $100.00 for nurses would be more 
than enough. People with little means should go to hospital. 
People who can afford to remain at home should pay their own 
nurses. Shall I send you hospital tents ? 
SMAKT. 
Extract.] Executive Minutes, 
Sept. 13, 1882. 
The Committee met at 2 P. M. Present: Drs. Cabell, Tur- 
ner, Bailhache, and Smart. The minutes of the meetings held 
August 22d and Sept. 5, 1882, were read and approved. 
Aid to Pensacola. 
The Secretary submitted the estimates prepared and for- 
warded by the secretary of the city board of health, in ac- 
cordance with circular 7, and stated that on their arrival a 
call had been made on the members of the executive commit- 
tee to discuss them, and take action upon them, as authorized 
by the committee at its meeting on Sept. 5th, 1882. Drs. 
Bailhache, Turner, and Smart responded, and the following 
reply was despatched : 
“ Estimates received, For street cleaning, laborers and drays 
not approved. Disinfectants approved ; but in meantime sul- 
phur, iron, Ac., will be sent from Memphis. Inspectors ap- 
proved, and one hundred dollars a day for nurses. It is sug- 
gested that live dollars a day to nurses is too high when com- 
pared with inspectors’ pay.” 
The Secretary stated the Pensacola board was dissatisfied 
with this reply, and urged their need of a larger appropriation 
for nursing. That he had thereupon suggested the aggrega- 
tion of the sick in hospitals, the better to utilize the services 
of the nurses employed, but that to this as yet there had been 
no reply. 
The action of the Secretary was approved. 66 
Telegram received during the session of the Committee. 
Pensacola, Fla., Sept. 13, ’82. 
Dr. Smart, National Board of Health, 
Washington, D. C\: 
Telegram received. Plan you propose not practicable or 
feasible. You do not understand our situation. This is no 
time to indulge in red tape at the expense of suffering human- 
ity. We need relief. If you cannot send it say so, and we 
will apply elsewhere. If the Government will not help us the 
people will. Fou suggest hospital tents. They would insure 
ninety-nine per cent, of mortality, the nights being exceed 
ingly chilly. Answer at once. 
J. C. WHITING, M. D., Sec'y. 
The telegram was read by the Secretary, and he was ordered 
to despatch the following: 
“We can give you to the end of this month one hundred 
and fifty dollars daily for inspectors and nurses. We regret 
that our means are limited. If this is insufficient for your needs 
you must appeal. Money disbursed on vouchers and pay-rolls 
as heretofore.” 
Telegram.] Pensacola, Fla., Sept. 13, 1882. 
Dr. Smart, Sec'y Nafl B’d of Health, 
Washington, D. C.: 
Telegram received. Your allowance of one hundred and 
fifty per day, though inadequate, is accepted. Will appeal for 
outside aid. We have sixty-four nurses on duty to-day. Please 
send all necessary blanks at once. Nineteen new cases to-day, 
and three deaths. 
WHITING, Secy 
Telegram.] Washington, D. C., Sept. 14, ’82. 
Dr. Jno. C. Whiting, Pensacola, Fla.: 
Telegram accepting offer received. Will send blanks. Forty 
barrels sulphur, twenty-five copperas, twenty carbolic shipped 
to-day from Memphis. 
SMART. 67 
Extract.] Executive Minutes, 
Sept. 27, 1882. 
The committee met at 11A.M. Present: Drs. Cabell, 
Turner, Bailliache, Smart, and Phillips. 
The minutes of the meeting held on September 13, 1882, 
were read and approved. 
Aid to Pensacola. 
The Secretary stated that the offer of the National Board to 
the city of Pensacola, Fla., as conveyed in the terms of the 
order of the Executive Committee, dated Sept. 13, ’82, had 
been accepted, that the necessary blank-rolls had been sent to 
enable payment for services to be made, and that Dr. Fayette 
Dunlap, superintendent at Memphis, had been directed to send 
from that city forty barrels of sulphur, twenty-five of copperas, 
and twenty of carbolic acid to Dr. Jno. C. Whiting, secretary 
of the city board of health, Pensacola. 
Telegram.] Pensacola, Fla., Oct. 11, ’82. 
Surgeon Chas. Smakt, Nat''l Board of Health, 
Washington, D. C.: 
Fifty-six new cases; seven deaths. Can you provide any re- 
lief for us beyond Sept, thirtieth ? 
J. C. WHITING, Secy 
Telegram.] Washington, D. C., Oct. 12, ’82. 
J. C. Whiting, Sec’y B. of II., 
Pensacola, Fla.: 
Shall submit your telegraphic inquiry to Executive Com- 
mittee. Session to-morrow. 
SMAET. 
Extract.] Executive Minutes, October 13, 1882. 
The committee met at 11 A. M. Present: Drs. Cabell, 
Bailliache, Turner, Smart. 
The minutes of the meeting held on Sept. 27th, 1882, were 
read and approved. 
The President read communication from Dr. Jno. C. Whi- 
ting, sec’y hoard of health, Pensacola, Fla., inquiring whether 68 
the National Board of Health can extend the aid heretofore 
granted beyond the thirtieth of September. 
Ordered, That the aid, one hundred and fifty dollars ($150) 
daily for nurses and inspectors, be continued until October 15, 
1882. 
Telegram.] Washington, D. C., Oct. 13, ’82. 
Dr. J. C. Whiting, Sedy B. of H., 
Pensacola, Fla : 
Board extends aid, one hundred and fifty dollars daily, until 
October fifteenth. 
SMART. 
Telegram.] Pensacola, Fla., Nov. 4, ’82. 
Surgeon Chas. Smart, 
Sec1 y National Board of Health, Washington, 1). C.: 
The Rational Board has been very considerate, and our 
board have not been ungrateful or unmindful of their appre- 
ciation of our needs. We are fearful lest our relief fund, 
now quite depleted, will not meet the innumerable obligations 
on account of the alarming destitution among our people. 
Can your honorable body grant additional relief to pay nurses 
for ten days beyond the fourteenth October, not to exceed two 
thousand dollars ? Rolls to conform to your regulations will 
be forwarded. Contributions have about ceased. Dr. Martin, 
who, by the way, we are glad to announce is doing well, is 
fully cognizant of the condition of affairs. 
R. B. S. HARGIS, Pres., 
W. F. FORDHAM, 
D. G. BRENT, 
J. P. JONES, 
J. C. WHITING, Sedy. 
Telegram.] Washington, Nov. 4, 1882. 
Dr. J. L. Cabell, U. of Va.: 
Telegram from Pensacola. B’d fearful relief fund will fail 
to meet obligations. Begs additional relief to pay nurses; not 
to exceed $2,000. Turner and Bailhache gone home, but shall 
see them to-nie;ht. What do you say ? 
SMART. 69 
Telegram.] Washington, Nov. 6, ’82. 
J. C. Whiting, Sedy, etc., Pensacola, Fla.: 
In response to telegram of 4th instant Executive Committee 
N. B. grants further aid to the Pensacola board for nurses, to 
be paid on rolls as heretofore, the sum not to exceed $2,000. 
SMABT. 
Telegram.] Pensacola, Fla., Nov. 6, ’82. 
Chas Smart, 
Sedy N. B'd of Health , Washington, D. C.: 
Telegram received. Again our board of health recognizes 
the reality of your sympathy by the generous response which 
it received from you to its appeal. 
Bolls in preparation ; will be forwarded. 
WHITING, SecY 
Extract.] Executive Minutes, 
Nov. 16, ’82. 
The Committee met at 11 A. M. Present: Drs. Smith, 
Turner, and Smart. The minutes of the last meeting, Oct. 
13, were read and approved. 
Aid to Pensacola. 
The Secretary stated that upon the order of the Executive 
Committee meeting of October 13th, extending the aid of 150 
dollars a day for nurses to the 15th day of October, bills for 
nursing up to that date had been presented and paid. 
That on November a telegram was received from Dr. John 
C. Whiting, secretary of the Pensacola board of health, 
representing the great destitution of the population and the 
inadequacy of the relief fund, and requesting further aid for 
the payment of nurses, not to exceed two thousand dollars. 
That the resident members of this Committee were consulted 
as to the action to be taken on this request, and that in ac- 
cordance with the views of the Committee thus gathered a 
telegram was despatched granting further aid to the Pensacola 
Board for nurses to be paid on rolls as heretofore, the sum not 
to exceed two thousand dollars. 
The action of the Secretary was approved. 70 
Extract.] Executive Minutes, 
Dec. 5, 1882. 
The Committee met at 2 P. M. Present: Drs. Cabell, 
Turner. Bailhache, and Smart. 
The minutes of the last meeting, held Nov. 16, 1882, were 
read and approved. 
Pensacola, Fla. 
The President read for the information of the Committee 
communication from Dr. D. G. Brent, acting Sec’y of the 
board of health of that city, expressing the thanks of the 
Board for the aid extended to it during the recent visitation of 
yellow fever. Appendix E. 
Hon. Lewis Beach, 
Chairman Committee on Public Health, 
House of Representatives : 
Dr. Hamilton having through his counsel put in a “ gene- 
ral denial ” of all of my charges against him, a member of the 
committee having said that charges not proved react with 
double force on him who made them, and Dr. Hamilton hav- 
ing demanded proof, I submit the following statements con- 
cerning specific charges, which I number front 1 to 11 consecu- 
tively : 
1. The charge that the Secretary of the Treasury made cer- 
tain statements to me I support by my own reputation for 
truthfulness, and by the fact that after this interview I wrote 
a specific letter to the Secretary of the Treasury reciting his 
errors ; assuring him that he was in error and expressing the 
hope that he would not allow the reputation of honorable gen- 
tlemen and the public health interests of the country to suffer 
because of influences so unworthy as those which had led to 
his false belief concerning the National Board of Health. The 
Secretary of the Treasury did not see fit to reply to this letter, 
but he will hardly deny that he received it. 
2. I beg to refer the Committee to the Congressional Record 
of Feb’y 21, 1883, speech of Mr. Ellis, pages 73 et seq. On 
page 78 Mr. Ellis is reported to have said that he derived his 
information from the books of the National Board of Health, 
and again “ I give them upon the authority of Surgeon-Gene- 
ral Hammond.” In the Congressional Record for Feb’y 22, 
page 17, Mr. Ellis is reported to have made a correction, say- 
ing : “ I said ‘ Hamilton ’ and I meant Dr. Hamilton, the head 
of the Marine Hospital Service of the United States.” 
The facts concerning this specification are already in the 
hands of the committee, in which it is shown that of the nine- 
71 72 
teen essays tabulated eleven were prepared without compensa- 
tion to the gentlemen who made them, they being paid either 
nothing at all or only their actual disbursements. The outra- 
geous statement concerning Ship Island made by Mr. Ellis is 
included in the list of charges concerning which he said he 
got his information from Dr. Hamilton. 
That the statement of Mr. Ellis concerning the Board’s ex- 
penditures for scientific investigations were misleading and 
unfair is sufficiently shown by the following extract from his 
speech: 
“ 1 Now listen, all ye gods !’ What a spectacle! In the 
heavy slumbrous air of the tropics the Angel of Pestilence is 
hovering with lungs breathing poison, and outstretched wings 
from which death drops, preparing to swoop with the death 
instinct of the vulture and the fierceness of the condor upon 
the Southern coast. Cities grow pale and the land cowers 
with dread and men cry for help from the threatened death. 
Where, then, is the National Board of Health? Gathered 
about a table, that distinguished body is engaged in inspecting 
[injecting ?] a certain kind of water under the skin of a rabbit 
just to see how the rabbit will like it and how the health of 
the rabbit will be affected by it. [Great laughter and ap- 
plause.] Was there ever such a spectacle!” 
3. Proof of this charge is covered by the proof adduced in 
par. 11. 
4. In proof of this charge I submit the following extract 
from a despatch published in the New York Evening Post, 
and dated July 28, 1883: 
“ The Secretary, [of the Treasury,] after thoroughly exam- 
ining the subject, decides that the contagious disease act of 
June 2, 1879, which created the National Board of Health* 
and which repealed provisions of pre-existing statutes giving 
the National Board of Health certain jurisdiction as to sani- 
tary matters, is itself repealed by limitation, the act having 
expired in accordance with its tenth section on June 1, 1883. 
His decision is that, in view of this expiration of limitation, 
the former contagious or infectious disease act of April 29, 
* The italics are mine.—G. E. W., Jr. 73 
1878, chapter 66 Revised Statutes, is revived. This is the 
first ofiicial declaration that the law organizing the National 
Board of Health has ceased to exist,* and that the old Marine 
Hospital act is revived.” 
5. This charge is circumstantial. In proof of it I submit 
to the Committee a copy of my report on the siplionage of 
traps, published in the American Architect of October 14, 
1882; also a copy of the patent in which my own trap is de- 
scribed. 
6. In proof of this charge I refer to Dr. Hamilton’s re- 
marks before this Committee as made; also to his rendering 
of his remarks, as printed by him; and also to the law organ- 
izing the National Board of Health, which he has certainly 
read; to all the facts of the case, reported to him regularly by 
his representative on the National Board ; and to the actual 
relations always existing between the National Board of Health 
and the organizations it has aided, as well as the scientific ex- 
perts it has employed. 
7. For proof of this charge I refer in like manner to Dr. 
Hamilton’s spoken and to his printed words; to Dr. Verdi, 
who made the researches paid for; and to Dr. Bailhache, of 
the Marine Hospital Service, a member of the Executive Com- 
mittee at the time the detail was made and the services were 
paid for. 
8. This charge, so far as it is a charge of misrepresentation, 
is fully explained by the facts of the case as stated, all of these 
facts being the subject of record, and the inference from them 
being such as no one having the least experience with the 
methods of thought of vain, ambitious, and unscrupulous 
minds could fail to draw. 
9. This charge is subject substantially to the same explana- 
tion as is given in the next preceding paragraph. ]% own 
authority for making the Statement that I have made is infor- 
mation received from a gentleman, then a member of the 
* The italics are mine.—G. E. W., Jr. 74 
National Board of Health, who took an active part in the dis- 
cussion, and concerning whose truthfulness and the accuracy of 
whose memory no doubt could be raised. So far as the facts 
are a matter of record, it is plainly shown that the onlv im- 
portant suggestion made by Dr. Hamilton, that was adopted, 
was that a ship having a clean bill of health should be re- 
quired to have that bill vised at any intermediate port at which 
she might stop; that many of his suggestions were rejected, 
and that what were accepted were generally trivial and unim- 
portant amendments of verbiage or modification of minor re- 
quirements. 
10. This is a charge that Dr. Hamilton read a certain letter 
to you impressively, and that he meant you to believe it. 
Proof of his manner and of his obvious meaning is to be 
found in the recollection of every gentleman present at the 
time. I made the direct charge that he knew this letter to be 
false. This charge I sustain by the statement that for a 
long time past Dr. Hamilton’s representative on the Board, 
forgetting the loyalty he owed to his colleagues, has allowed 
himself to be used in Dr. Hamilton’s interest as a close 
scrutinizer of its disbursements ; that through this member he 
has informed himself of the financial management of the 
Board; that he has never scrupled to make the records 
of the Board’s operations the material for the prosecution 
of his virulent and systematic enmity ; and that it has not 
been his custom, having such ready means of access to all its 
records as Dr. Bailhache has afforded him, to leave anything 
to assumption that could be established by investigation. Had 
the Board spent $2,000 for the corrupt purpose that Dr. Ham- 
ilton substantially charged, absolute evidence of that fact, in 
black and white, would have been ready to his hand, and 
would have been used here, in place of the bare impression that 
he hoped to produce by his reading.of Mayor Tarble’s letter. 
So far as circumstances can support my charge, every circum- 
stance connected with the whole transaction is unmistakable. 
It is an easy matter, if such be the fact, for Dr. Hamilton now 75 
to deny the charge, and to say that he believed Mayor Tar- 
hle’s accusation (that the JNational Board of Health had cor- 
ruptly used $2,000 in Pensacola, after the epidemic was over, 
to rewards its medical friends.) to be true. If he will make 
this declaration now and in open Committee I will withdraw 
this charge and apologize to him most humbly for having ac- 
cused him of an act of the basest character. 
11. The specific statements of this charge were made on in- 
formation which I had a right to consider authentic, and which 
was so in fact, although not so in definite form. I endeavored 
to procure a copy of the “ Preliminary Report. ” from Dr. 
Hamilton. He refused to supply it. I have, therefore, had 
recourse to a copy in the library of the Surgeon-General of the 
Army, from which the quotation below is taken. It will be 
seen that the signature appended by Dr. Hamilton to the foot- 
note referred to is not “ Clias. Smart, Secretary National 
Board of Health,” but “ Dr. Smart, Secretary National Board 
of Health,” the name of the journal from which the statement 
is copied being given in connection therewith. This does not, 
of course, modify, in any degree, my charge of misrepresenta- 
tion with reference either to the use attempted to be made of 
the opinion cited, or of the unwarranted use of Dr. Smart’s 
name and official title. 
If it was in fact a less serious offence to sign the foot-note 
as it was signed than as I originally stated that it was signed, 
Dr. Hamilton is certainly entitled to whatever advantage he 
may derive from the difference. 
“ The success of that measure [the cordon sanitaire\ has 
been met by a like success attending similar management here,* 
* “ ‘ The navy yard Xat Pensacola) continues free from fever by virtue of its 
cordon sanitafre, notwithstanding it has so long been within sight of infected 
localities. Dr. Owen must feel grateful, not only that his seventeen hun- 
dred people have been saved from the infection and its dangers, but that 
a demonstration has been given as well of the non-indigenous nature of the 
disease ns of the necessity for a less subtle means of communication than is 
afforded by the air.’—Dr. Smart, Secretary National Board of Health, in Phil- 
adelphia Medical News, Nov. 11, 1882.” 76 
and it is only necessary to point out the difference between the 
rapid and fatal extension of the disease in Mexico, where there 
was no cordon or local quarantine, and in Texas, where the 
disease was held within the original limits of infection,” &<\, 
&c.