National Boaed of Health. 
CLOSING ARGUMENT 
SUBMITTED TO THE 
COMMITTEE ON PUBLIC HEALTH 
OF THE HOUSE OF REPRESENTATIVES, 
48th Congress, ist Session, 
In support of House Bill 2785 for the protection of the 
public health, and in refutation of the charges made 
against the Board by the Supervising Surgeon- 
General of the Marine Hospital Service. 
WASHINGTON, D. C. 
GIBSON BE OTHERS, PRINTERS. 
1884. National Board of Health. 
CLOSING ARGUMENT 
SUBMITTED TO THE 
COMMITTEE ON PUBLIC HEALTH 
OF THE HOUSE OF REPRESENTATIVES, 
48th Congress, ist Session, 
In support of House Bill 2785 for the protection of the 
public health, and in refutation of the charges made 
against the Board by the Supervising Surgeon- 
General of the Marine Hospital Service. 
WASHINGTON, D. C. 
GIBSON BE OTHERS, PRINTERS. 
1884. Closing argument submitted to the Committee on 
Public Health of the House of Representatives in sup- 
port of House Bill 2785 on behalf of the National 
Board of Health. 
Mr. Chairman and Gentlemen of the Committee : 
At your session of March 13th it was agreed that, instead of 
making the final arguments orally, they should be presented 
in writing, and I therefore submit the following statement on 
behalf of the Board. 
The Board seeks substantially the re-enactment of the act of 
June 2, 1879, and asks you to recommend it as for the public 
good. 
The importance of the subject cannot well be exaggerated. 
The prevalence within our borders of an epidemic of some con- 
tagious disease like yellow-fever is attended with such disastrous 
consequences to the Community, both as to persons and prop- 
erty, as to make the prevention and repression of such evils 
one of the most important public duties which can engage the 
attention of the statesman and lawgiver. It has been repeat- 
edly shown to Congress that the mere pecuniary loss to the 
nation by the destruction and obstruction of commerce caused 
by some of these visitations is very great; that by the epidemic 
of 1878 has been estimated at $200,000,000. 
In one way or another the whole people are interested in 
the subject before yon, and it is safe to say they will not only 
approve but expect some proper measures of protection under 
the national authority. 
It has already been shown you that the National Board was 
created and invested by Congress with the powers now sought to 
be renewed, in response to the strong and growing public senti- 
ment which the frequent occurrence of such epidemics have ex- 
cited. You have seen, also, that the legislation then finally 
adopted was preceded by an exhaustive consideration and dis- 4 
cussion of the principles involved and of the various modes in 
which the problem of extending national aid might be solved. 
I do not understand that the Committee propose to recon- 
sider all this under the present issue, which is simply whether 
the provisions of the act of June 2, 1879. shall be reviyed and 
made permanent, or whether these important interests shall be 
subjected to the uncertainties of annual legislation in the 
appropriation bills. 
A bill has been introduced lately at the request of the 
Surgeon-General to abolish this Board and to vest its past and 
present powers in a departmental Board, including his service, 
and he has made some remarks before you upon that subject. 
Whenever the Committee shall desire to hear from the Board 
as to the merits of that proposition, it will endeavor to 
properly respond. For the present, it is enough to call your 
attention to the fact that the policy of administering national 
aid in quarantine by one or more of the Executive Depart- 
ments, or by a Board composed of members appointed from 
private life, and representing different sections of the country, 
was thoroughly considered by Congress. (Letter of Dr. Smith, 
pp. 19 to 22; Report 1883, pp. 26 to 33.) 
Although the decision was substantially in favQr of the 
latter method, the wise and conciliatory policy was adopted of 
combining the official element by adding representatives from 
four of the Executive Departments to the Board, and by sec- 
tion seven of the act of June 2, 1879, Congress took a further 
step in the same direction by authorizing the President, at the 
request of the Board, to detail officers of the several depart- 
ments for temporary duty under its direction. 
Congress evidently intended the executive authority, acting 
through its representatives in the Board and otherwise, to be 
exercised in hearty co-operation to promote the ends to be 
attained by the Board according to the spirit of the laws en- 
acted in that behalf. The case before you shows that in the 
opinion of the Board this obligation has been loyally fulfilled 
with one exception. 5 
As it stands, the bill appears to have no higher sanction than 
the wishes of the Surgeon-General; and while the power of 
Congress to enact it is undoubted, the right of a subordinate 
of one Department to place three Departments in apparent 
antagonism to the Board is so far questionable at least, I sub- 
mit, as to call for some evidence that the bill represents the 
sentiment of the heads of those Departments before it is se- 
riously considered. 
Returning, then, to the matter in issue, how stands the 
case ? 
The fact that the bill of the Surgeon-General creates a 
Board shows that even he admits its efficiency in principle, but 
lie thought the National Board was unwieldy. The only rea- 
son given for this was an incident of small-pox on the Upper 
Missouri. (Appendix, p. 50.) 
On his own statement he proves nothing, for it took him 
until the next day to answer the telegram of the collector, and 
it would have taken no more time to procure the attendance of 
the non-resident members of the Executive Committee of the 
Board. It appears also that in that remote, unsettled region, 
‘there was no local board of health, and the disease was among 
the sailors on a steamboat—facts which indicate that it was 
more properly a matter for his attention than that of the 
Board. It ought to be said, however, that the Executive 
Committee of the Board has always been so selected as to con- 
tain a quorum of resident members, and those non-resident are 
not farther distant than New York city. 
The trifling nature of the charge at best is a sufficient index 
of the merit of the objection. 
It will be well to note in this connection the claim of cer- 
tain special advantages of the Treasury Department for the 
management of quarantine on which great stress was laid ; 
(Appendix, 51, 52,) consisting in the service of Customs-officers 
thirty-seven revenue cutters and sundry tugs, the Coast Survey 
and Commercial Bureaus, and the Marine Hospital Service. 
As these designated persons or things have other proper du- 6 
ties to perforin, the incidental service that might be rendered 
in aid of quarantine would not be likely to amount to as much 
as is imagined; but the chief defect of the claim is in the im- 
plication that the benefit of these appliances can be obtained 
only by confiding the control of quarantine to the Surgeon- 
General. The requirement of section seven of the act of June 
2, 1879, has been mentioned, and under that, if renewed, or 
even aside from it, it cannot be presumed that the President 
and Secretary, holding their high trust for the public good, 
would withhold from the Board any aid which it might law- 
fully ask. 
It follows that the Hospital Service in this matter must 
stand on its own merits as claimant of the service rendered for 
four years by the Board. 
The character of the Board, the nature and extent of its 
service, and the estimate of it by competent judges, have been 
brought to your attention. No one but the Surgeon-General 
has attacked it before you, and his opposition was invited be- 
cause the Board felt that it would be manifested as heretofore, 
and wished it to be made where the Board could know the na- 
ture and extent of his charges, and be prepared to meet them. 
Tou are advised also of the peculiar advantages he possesses 
in having had the same member of' his service in the Board 
from its organization to the present time, so that nothing in its 
history and records lias not been within his knowledge. No 
organization could be put to a severer ordeal than that of the 
assault of a hostile force so equipped as to means of offence, 
and so inspired as to motive. Your attention is invited to the 
result. 
The main point is : Did the Board faithfully execute the act 
sought to be renewed ? 
In two of the four years there were epidemics of yellow 
fever. In all, the Board was actively engaged in its work. It 
disbursed in aid in all ways more than half a million dollars in 
that time. The details it is impossible to give, but they are 7 
fully set forth in its reports and its records are all open to your 
inspection. 
The sum of the fiscal errors charged is within $2,500, in this, 
that $2,500 was paid for a barge in 1880, which, when it came 
into the hands of the Surgeon-General in 1883, he says was 
worthless. It was charged also that Dr. Verdi was paid $300 
for work alleged to have occupied his time for 30 days, the 
worth of which, in his opinion, the Surgeon-General does not 
state, but this employment had no connection with quarantine. 
You have the Board’s defence on these items, and are satis- 
fied, I trust, that there is no good ground for the objections 
raised; but even if the Board had paid too much for the barge 
and the “ essay,” what would be indicated by errors so trifling 
as compared with the amounts disbursed judiciously, so far as 
appears ? 
As to other errors of judgment, the only allegation is that some 
of the boats turned over to the Surgeon-General in July, 1883, 
(and which had been in use three years,) were then in bad re- 
pair, so that it was concluded to be cheaper to sell them than 
to repair them. The Board questioned this ; but taking it in 
its worst aspect, what does it amount to ? 
There was an attack also mainly directed against the present 
Secretary of the Board concerning work done by him before 
he became a member, being paid only his expenses, which has 
been answered, and this is in substance everything that affects 
the work of the Board—only two of the four charges relating 
to quarantine. 
In my former remarks I referred to charges which seemed 
to bear, though in an indefinite way, against the integrity of 
the Board. The language cited relating to a “ corruption 
fund ” (p. 46) is explained in the reply (p. 7) in such a way, 
as I understand it, as to relieve it of that imputation, as is the 
reference also to the endorsement of prominent sanitarians 
from any imputation of a corrupt understanding, (p. 6;) but 
the Surgeon-General reiterates his conviction of the truth of 
the statements of the Tarble letter, (p. 10.) My remarks on 8 
that subject were from recollection only. I find the letter 
makes no direct charge against the National Board, but in- 
dulges in some statements as to the division of the money, the 
probable truth of which you can judge of from the fact that 
the National Board has brought before you the vouchers for 
every dollar of that expenditure, showing that it was disbursed 
apparently to nurses, as indicated by their receipt on the pay- 
rolls, in accordance with the terms of the appropriation. (Ap- 
pendix D, remarks, p. 60.) 
These charges, as now explained, were made apparently to 
break the force of the natural inference in favor of the Board 
from the endorsements laid before you of its worth and ser- 
vice by various sanitary and medical organizations, and they 
are reduced substantially to the allegation that these com- 
mendations are entitled to little or no weight, because it has 
been the policy of the Board to secure the support of local 
boards and of individuals by pecuniary aid and employment. 
If the Board has been governed by such motives, is it not 
remarkable that in the present crisis it has presented you 
with testimonials from only four out of fifteen aided boards, 
while testimonials from eleven unaided boards and twelve 
other medical and sanitary associations are included. Stronger 
proof of the integrity of the Board’s intent in that respect can 
hardly be given than is afforded by this circumstance. 
The weakness of the attack is evident when he has to assail 
the policy of Congress in making such appropriations, (Reply, 
p. 7,) not reflecting that the best judgment of statesmen at all 
times in our history has been that national aid can be constitu- 
tionally extended only in that way. His likening the relation 
between the national and local boards to that of employer and 
employe is essentially unjust. Congress gives money for the 
use of the latter, and their claim is one of right and not of 
favor, though the National Board may rightfully exercise its 
judgment as to the extent of the need and its means of relief. 
The Pensacola correspondence before you (Appendix D, p. 60) 9 
and circular No. 7 (Appendix C, p. 58) set the matter in its 
true light. 
There is nothing left of these charges, then, but the fact that 
four aided local boards have u endorsed ” the National Board, 
and that three or four eminent sanitarians who have at some 
time been employed by the Board in its work may have given 
their influence in its favor in local organizations to which they 
belonged. That there would be no impropriety in this is man- 
ifest not only on its face, but from the fact that the Surgeon- 
General has produced a like endorsement of his service by the 
Pensacola board, whose President was employed to maintain 
the cordon there. (Reply, p. 7 ; Appendix, pp. 46, 47, 48.) 
Assuming even that the Board had sought for these endorse- 
ments, what more proper step could it take than to ask those 
best qualified to judge of its work to state their opinion of it 
for the information of Congress as bearing on the proposed 
legislation ? Is it fair to presume without proof or reason that 
these twenty-seven organizations in all parts of the country 
have combined to sustain a Board by representations which 
they did not know or believe to be true ? 
Enough has been said to demonstrate the baselessness of the 
Surgeon-General’s criticism of the Board. In the reply, some 
new matter in the line of that already considered has been 
added. Not being acquainted with the facts for the reasons 
heretofore given, I have requested Dr. Smart to set forth the 
details of the various matters presented in the reply, and his 
statement is annexed. 
Some points in reply to the criticism of the Board remain 
to be noted. 
Attention is called to vouchers of the Board for expendi- 
tures at New Orleans. (Reply, p. 15.) 
That was for service found necessary during the epidemic 
of 1879. If the Surgeon-General had expended money at Pen- 
sacola under like circumstances, it is likely his judgment would 
not have been questioned by his superiors; but as I understand, 
he made an agreement that the Government would pay for 10 
certain work out of the epidemic appropriation under circum- 
stances which his superiors did not regard as justifying it, and 
his judgment was not approved. 
It is said also to he “ singular that Mr. Ellis’s speech was 
singled out for attack among all those that were made against 
the Board.” 
The Board has not charged that the material of the other 
speeches referred to was furnished by the Surgeon-General, 
because there was no direct proof of the fact. I selected the 
case in which the record put the intervention of the Surgeon- 
General beyond question, and there was no attack on the 
member making the remarks quoted. His name, even, was not 
mentioned by me. I merely argued that he was misled by his 
informant, who had the means of accurate knowledge, and 
was therefore responsible for not imparting it. The Board 
believes, however, from all the facts and circumstances in the 
case, that the opposition of the other members mentioned was 
inspired by the Surgeon-General, and that they also were mis- 
led in the matter. Without charging any intentional wrong 
on any one, the Committee can readily see how much injustice 
might be done to the Board by ex-parte statements, as for in- 
stance the letter of the Surgeon-General to a member of the 
Committee of the last Congress, to which the Board had no 
opportunity to reply, (Appendix to Ileply, p. 46,) and the 
value, therefore, of such an investigation as this in eliciting 
the truth. 
I have not intended in my remarks to give more weight to 
the personal features of this controversy as affecting the Sur- 
geon-General than the necessities of the case in the opinion of 
the Board seemed to demand, and I regret that there should 
have been any such necessity. The charges made against him 
are reasonably definite, and such, I think, as go to the merits 
of the case. Of their importance to the issue and sufficiency 
you are the judges. On the other hand, the Board has good 
ground to call your attention to the vague, indefinite nature 
and terms of the statements against it, and to the fact that 11 
they rest so largely in innuendo in print, and were conveyed 
so largely by tone and manner in the oral address. The Board 
has endeavored to meet the possible implications as well as 
the legitimate inferences from the form of that address, and if 
it shall seem to you that in some cases needless labor has been 
expended the apology is that it desires to leave no doubt in 
your minds of its fidelity to the trust it has held for the public 
since it was created. 
Respectfully submitted. 
THOMAS SIMONS, 
Member of the Board from the Department of Justice. Tiios. Simons, Esq’r., 
Hss’£ Attorney-General: 
Sir : The following criticism on the papers laid before 
the Committee on Public Health of the House of Rep- 
resentatives by Dr. Hamilton, on March 13, 1884, is 
respectfully submitted : 
The charge against Dr. Hamilton of having circulated mis- 
statements to the detriment of the National Board of Health, 
when its members were not present, is characterized by him in 
the most positive manner as untrue. “ This is false,” he says, 
(Answer of the Supervising Surg’n-Gren’l, page 3,) “ and no 
proof has been submitted to the Committee to sustain it.” 
This charge was based upon Dr. Hamilton’s connection with 
misrepresentations as to the cost of the work at Ship Island 
Refuge Station, and as to the character of the investigations 
conducted by the Board under the authority of its constituting 
act. The member of Congress who, under the influence of 
those misrepresentations, charged the Board with having frit- 
tered away the public money, appropriated for them, uselessly 
and foolishly, not to say extravagantly, stated that he had ob- 
tained his information from Dr. Plamilton. Indeed, Dr. Ham- 
ilton (Answer, p. 18) acknowledges that he furnished the infor- 
mation. He endeavors to shield himself in this matter under 
the assumption that the words essay and investigation are 
synonymous—a position which no school-boy would assume ; or 
that the investigations in the cases tabulated by him as essays 
were in reality no other than what he called them—a position 
which no intelligent man who has looked at the reports of the 
Board containing the accounts of these investigations would 
assume. Since neither of these assumptions may be entertained, 
it must be inferred that the information was furnished to be 
used, as it wras used, to the detriment of the Board, when its 
members were not present to reply. 14 
As to the work at Ship Island, Dr. Hamilton must be held 
capable of knowing that inspected and infected have not the 
same meaning; and if, through any mistake of his, Mr. Ellis 
or others were led to believe the Board or any of its members 
unworthy or incapable, his part, as an honorable man, consisted 
in immediately acknowledging that mistake and in apologizing 
publicly to the Board therefor. 
Dr. Hamilton says (p. 21) that “ it is somewhat singular 
that Mr. Ellis’s speech is singled out for attack among all those 
that were made against the Board,” and inquires why the 
Board did not attack Mr. Cox and others. It seems proper to 
point out that Mr. Ellis’s speech was not attacked. The sub- 
ject of attack, to use Dr. Hamilton’s phraseology, was the pub- 
lic official who furnished Mr. Ellis with mistaken statements, 
(allowing the word inspected to have been a mistake for in- 
fected, although in matters touching the integrity of an hon- 
orable body mistakes of this character should not be permitted 
to occur,) and with facts perverted with the intent to deceive. 
Mr. Ellis’s speech was singled out to sustain the charge 
against Dr. Hamilton, because the misstatements, his connec- 
tion with them, and the real facts in the case may all be found 
in the one issue of the Congressional Record, (Feb’y21, 1883,) 
p. 73 et seq. 
Other instances involving misrepresentation on Dr. Hamil- 
ton’s part were not brought forward ; first, because the charge 
made against him was sustained by the proofs of the one 
specification, and secondly, because this instance was consid- 
ered of itself as sufficient to show his animus towards the 
Board of Health and his methods of operating. 
The Board in replying to the statements or charges preferred 
against it by Dr. Hamilton had to trust to memory for the 
terms in which they were conveyed. Dr. Hamilton declined 
to furnish a written summary, although this was officially re- 
quested of him. The Board recognized that the purchase 
price of the barge “ Selden ” and its condition at the time of 
purchase were in some manner brought in question, and testi- 15 
mony from the Quarantine Commissioners, Norfolk, Ya., was 
submitted (see Board’s Statement, pp. 2 and 3) on these points. 
It is now found (Answer, p. 4) that while they were properly 
touched upon in the Board’s reply, a direct reference to the 
statements that the barge “ has been of no service and is now 
a total wreck ” was omitted. 
The letters of the Quarantine Commissioners (on file) afford 
evidence that the barge was admirably suited for the work in- 
tended, and that she was at her station ready for the appear- 
ance of yellow fever from the time of her purchase till she 
was transferred, June 30, 1883. Her wreck was an accident 
which occurred subsequent to her transfer to the Marine Hos- 
pital Service, and of this the Board has no knowledge save 
that conveyed in Dr. Hamilton’s own statement, and a refer- 
ence to it in the filed letter of Dr. Nash, “ that she was finally 
wrecked by having a hole stove in her bottom by her own an- 
chor through the culpable negligence or mismanagement of 
those in charge of her.” 
The letters which Dr. Hamilton submits (Answer, p. 4) mainly 
refer to the unseaworthiness of the barge in rough water. 
When purchased she was not intended for sucli service. Her 
station and duties were defined, and she was found well fitted 
to last at the one and to discharge the others. As well might 
our river steamers be declared worthless because unfit to go 
on the Greeley Belief Expedition. 
On page 5 (Answer) Dr. Hamilton attempts to strengthen 
the case of the Selden by the statement that $1,678.73 was 
paid for repairs immediately after her purchase, evidently im- 
plying that, since such a large percentage on the purchase 
money had to be expended, she must have been very worth- 
less indeed. This is fresh matter and more misrepresentation. 
The money was paid for building a hospital ward on her deck 
and fitting her out otherwise for the accommodation of the 
sick. Beferences to this work may be seen in the letters of 
Dr. Nash and Mr. Murdaugh, the latter having superin- 
tended it.. 16 
To a man wlio supervises hospitals which cost from fifty to 
five hundred thousand dollars, the Selden, as a quanantine 
hospital, must have appeared of small value, although she gave 
satisfaction as a temporary and cheap substitute for the refuge 
station, which, since her wreck, Dr. Hamilton has recom- 
mended to be built at an expense of 150,000. (See his Ann. 
Rep., 1883, p. 52.) 
The Board was led to infer from Dr. Hamilton’s reference 
to the sop on which sanitarians had been fed, and from his 
statement that the appropriation in aid of local boards was, 
in its nature, a corruption fund, that a charge of corruption 
was insinuated. It is found now, however, (p. 6, Answer,) that 
all that was meant by the loose use of such words was to de- 
tract from the value of the testimonials furnished on behalf 
of the Board and its work by boards of health and sanitary 
and medical societies and associations. “ Of course they en- 
dorse,” he says. # “ I do not say—I have not said—that the 
endorsement was corrupt.” Dr. Hamilton has failed to ob- 
serve that Mr. Simons had already touched on this view of the 
charge and showed its want of foundation in facts. (Board’s 
Statement, p 48.) Testimonials of confidence in the Board, 
given by twenty-seven bodies, were filed in the present inves- 
tigation, and of these but four have applied for and received 
aid. Eleven boards that were aided are not represented among 
the twenty-seven. 
As illustrating the methods by which, in his opinion, such 
testimonials are obtained, Dr. Hamilton shows by an extract 
from the executive minutes of the Board, August 1, 1879, that 
the Board communicated with the State board of health of 
Kentucky inquiring whether aid was necessary, and requesting 
to lie furnished with the names of two or three men capable 
of acting as inspectors. He further shows that on Oct. 23, 
1879, a list of thirty-two appointees of the State board of 
health of Tennessee was approved. It is not charged that there 
was anything corrupt in this, but only that it explains how 
these boards come forward with testimonials. Dr. Hamilton 17 
is unfortunate in his illustrations, inasmuch as no testimonials 
from these boards of Kentucky and Tennessee appear in the 
list of twenty seven filed. 
While showing that the Board of Health cooperates, in 
accordance with law, with State and local boards, Dr. Hamil- 
ton takes occasion to say that his methods are different, and 
that he has no financial transactions with local boards or their 
officers. He has expended the epidemic fund at Brownsville, 
Texas, and Pensacola, Florida. At Brownsville there wTas no 
local board of health, and at Pensacola Mr. Guttman, the 
worthy gentleman—energetic, faithful, and thoroughly compe- 
tent—whom he placed in charge of the Pensacola navy-yard 
c ordon was the president of the Pensacola board of health 
And on page 48 of Hamilton’s report to the Secretary of the 
Treasury on the management of the epidemic fund may be 
found resolutions of the board of health of Pensacola ex- 
pressing perfect satisfaction with the conduct of the Marine 
Hospital Service, signed Jno. B. Guttman, president. 
On page 8 Dr. Hamilton gives extracts from the minutes of 
of the Board showing that it had under consideration the pro- 
priety of sending representatives to the Sanitary Council of the 
Mississippi Talley. This appears in connection with a state- 
ment that it has not been the custom of the Marine Hospital 
Service to ask the endorsement of societies or to appoint per- 
sons to represent it at such meetings with the view to 
imply that the Board of Health has done one or other of these 
things. The Board has considered it its duty, under the re- 
quirement of its constituting act to obtain information on all 
matters pertaining to the public health, to be present by rep- 
resentation at such meetings, and, with other members, Dr. 
Bailhache, the member from the Marine Hospital Service, has 
represented the Board at the American Public Health Asso- 
ciation. 
But no evidence is offered that the Board influenced the San- 
itary Council. Indeed, it is not in terms charged with having 
attempted to do so. 18 
As to the editorial from the St. Louis Medical Review of 
February, it cannot but be a source of satisfaction to the mem- 
bers of the Board to learn (page 16, Answer) that some one 
is always to he found at the meetings of the sanitary and med- 
ical societies to secure support to the Board of Health, and 
that it counts many friends in at least two prominent sanitary 
associations. It is gratifying to know that the work of the 
Board in the public interest is so well and favorably known, 
despite much published and unpublished detraction. 
On page 15 Dr. Hamilton endeavors to justify his contract 
with the Pensacola board of health, to pay for their street- 
cleaning and drainage out of the funds of the United States, 
by showing that the National Board of Health in September, 
1879, paid for laborers, drivers, carts, and wagons which were 
used in New Orleans. He does not state the difference in the 
conditions of the two cities at these times. New Orleans was 
infected with yellow fever, and the laborers, drivers, carts, and 
wagons were engaged in the effort to check the progress of 
the pest by disinfection. Pensacola, at the time of the Marine 
Hospital Service contract, wTas as free from the disease as De- 
troit, Michigan, or any other Northern city. 
On page 20 Dr. Hamilton reiterates his inability to under- 
stand how his cordon at Brownsville differed from that estab- 
lished by Dr. Owen of the Navy, at the Pensacola navy-yard. 
Dr. Owen placed a guard around 1,700 men, women, and chil- 
dren, and by doing so preserved them from the infection of 
yellow fever. Dr. Hamilton placed a guard around so many 
yellow fever patients, and more than 1,700 well men, women, 
and children in Brownsville, and kept it there until each of 
those well men, women, and children who were susceptible to 
the disease had suffered from or died from yellow fever. But, 
he says, there was room between his guards and the city for 
the people to scatter, had they so desired. Many may hare 
desired to do so, but were unable to effect it for want of shelter 
and provisions. (See the remarks of Dr. Hillary Ryan, of 
Texas, Proceedings American Public Health Association, vol. 19 
8, p. 273.) At Memphis, in 1879, the National Board of 
Health, by co-operating with State and local boards, scattered 
the people in camps, and so preserved them from the plague; 
but we are told that at Brownsville “ the Treasury Depart- 
ment had no authority to send tBe people into a camp away from 
their home.” 
Dr. Hamilton claims (p. 12) that there has never been a 
time when vessels could not be inspected by officers of the 
Marine Hospital Service, and shows by copies of letters and 
papers that the Louisiana board of health asked him to insti- 
tute them, but he does not explain that the local authorities 
on the shores of the Mississippi above New Orleans did not 
have confidence in his Service and would not accept his certifi- 
cates of inspection. After one shipmaster had been fined fifty 
dollars by J udge Hadden, of Memphis, for entering that port 
without a certificate from the National Board of Health, al- 
though possessing one from an officer of the Marine Hospital 
Service, that Service was not called upon to make many in- 
spections. (Proceedings Am. Pub. Health Association, vol. 
8, p. 270.) 
On page 13 Dr. Hamilton characterizes the railroad in- 
spection of immigrants as “ an infringement on the rights 
and duties of State and municipal boards of health, and 
cannot legitimately fall within the province of agents of the 
National Board.” The State and local boards have not con- 
sidered the co-operatipn with and co-ordination of local powers 
by the National Board in this light. On the contrary, those 
interested, from New York city westward, petitioned Congress 
at its last session to have the immigrant inspection service of 
the Board continued. 
The letter of Mayor Tarble, of Pensacola, which was read 
in connection with remarks by Dr. Hamilton characterizing 
the appropriation fund of the National Board of Health as a 
corruption fund, now that the full report is in print, is found 
to have no bearing whatever on this Board. It only assails 
the integrity of Mayor Tarble’s fellow-townsmen. When 20 
trusting to memory and the impressions conveyed by Dr. Ham- 
ilton while filing the mayor’s letter, and in the absence of a 
stenographic report of his words, the Board considered it neces- 
sary to place the whole of the records having reference to the 
aid given to Pensacola before ‘the Committee. The whole of 
the bills, amounting to over $9,000, were also submitted. The 
executive minutes show that the aid granted was in every in- 
stance approved by the member of the Board representing the 
Marine Hospital Service. Col. Waring has well said that had 
the Board spent $2,000 for the corrupt purpose that Dr. 
Hamilton substantially charged, absolute evidence of the fact 
would have been ready to his hand. Dr. Bailhache would 
have furnished it. But instead of evidence of this character 
Dr. Bailhache furnishes only a letter, (p. 22,) in which he de- 
nies matters of fact. He says that he did not approve the 
Pensacola bills, and that as bills were passed on a majority 
vote the record does not show that he voted aye, or that he 
voted at all. When the vote was unanimous it was not the 
custom to repeat on the record the names of those present, but 
all negative votes and failures to vote were recorded ; and as 
the record shows that he did not place himself upon it in op- 
position to the payment of any of the bills, even passively by 
a failure to vote, it as clearly indicates that he voted aye on 
these appropriations and payments. He further states that he 
was not present when the sum of $2,000 was appropriated on 
November 16, ’82. But this money was not appropriated at 
that meeting. On the arrival of the telegram of Nov. 4, 
signed by the members of the Pensacola board asking for ad- 
ditional relief to pay nurses for ten days beyond Oct. 14, not 
to exceed $2,000, it was submitted to the resident members, 
Dr. Bailhache included, and in accordance with their vote the 
Pensacola board was notified that the relief would be granted. 
At the meeting on the 16th this action was formally approved 
and entered on the records. Dr. Bailhache was not present at 
this meeting, but at the meeting on Dec. 5 the following entry 21 
regarding Pensacola was read and approved in Dr. Bailhache’s 
presence and with his concurrence: 
“ That on Nov. 4 a telegram was received from Dr. Jno. C. 
Whiting, sec’y 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 wTere consulted as to the action to 
be taken on this request, and that, in accordance with the 
views of the Committee thus gathered, a telegram was de- 
spatched granting further aid to the Pensacola board for nurses 
to be paid on rolls as heretofore, the sum not to exceed 
$2,000.” 
But Dr. Bailhache had a more intimate knowledge of these 
bills than appears from the record, for on their arrival for set- 
tlement he examined them in the presence of the secretary of 
the Board and in the presence of others in the office of the 
Board, and suggested that the local board was put to much 
trouble in fulfilling the requirements of circular 7, and that 
for his part he would vote to turn the money over in bulk to 
the local board, taking the receipt of its president or secretary 
therefor. 
Dr. Hamilton desires (p. 50, B-ept. to Sec’y Treas’y) to 
prove the unwieldy character of the Board in times of emer- 
gency. Surely some illustration of that unwieldiness, if it ex- 
isted, might have been drawn from the incidents of the terri- 
ble epidemic of 1879, and sustained by the verdict of the peo- 
ple of the Mississippi Valley States. It certainly was not 
manifested in the emergency at Brownsville, the needs of 
which city were fully known to the National Board and com- 
municated by it to the Supervising Surgeon-General of the 
Marine Hospital Service, who did not know them until so com- 
municated, but wdio, nevertheless, was fitting out a relief-ship 
for their supply. (See Board’s Statement, page 9.) Nor was 
it manifested at Pensacola, Fla., as a reference to the tele- 
grams and extracts from the records already submitted will 
clearly show. But it was manifested, according to Dr. Ham- 22 
ilton, in the epidemic of small-pox on the Upper Missouri, and 
the Committee is referred to an official document—his own re- 
port for the year 1882—for the proof. The statistics of this 
epidemic I find are not tabulated in the report, but an exami- 
nation of the money expenditures shows that three men were 
cared for during the prevalence of the epidemic, and that these 
three men were sailors of the river steamer “ General Meade,” 
the expenses of their treatment having been paid from their 
own—the Marine Hospital fund. It is in the face of this 
epidemic that Dr. Hamilton elects to demonstrate the un- 
wieldiness of the Board. But he should remember and place 
it to the credit of the Board that when he presented the tele- 
gram of the collector of customs of Ft. Benton to Dr. Turner, 
then secretary of the Board, that gentleman was unaware of 
the extent of the epidemic. The telegram only was before 
him. It said : 
“ Fort Benton, Mont., May 12, 1882. 
“ Steamer General Meade in Missouri river en route to this 
point has small-pox on board. At request of local authorities 
I shall order her to be quarantined below Coal Banks station, 
forty miles below here. There are no Territorial sanitary laws. 
More boats coming with disease reported on board. I ask in- 
structions by telegraph. 
“ W. H. HUNT, Jr., 
“ Collector of Customs.” 
Dr. Turner was well aware that cases of small-pox were oc- 
curring at that time in many parts of our country, (see Na- 
tional Board of Health Bulletins for May, 1882,) and that the 
local authorities were alive to the importance of isolation and 
vaccination in preventing the spread of the disease. He knew, 
also, that while the Board was at that time organizing an inspec- 
tion of immigrants to prevent the importation of small-pox from 
abroad, the local authorities were generally competent to deal 
with the disease within their respective jurisdictions. In the 
few cases where aid was required the Board acted on the ap- 
plications of such local authorities as were presumably referred to in Mr. Plant’s telegram, and not on the personal application 
of the Surgeon-General of the Marine Hospital Service. 
Nevertheless, the Secretary of the Board, in sympathy with 
Dr. Hamilton’s evident excitement, courteously offered to call 
a meeting of its executive committee. But in the Surgeon- 
General’s opinion this emergency was too urgent to be met by 
the men and methods which had dealt with yellow fever in 
Memphis. “ This will not do,” he said ; “ something has got 
to be done at once.” 
Dr. Hamilton will have to get up a better illustration of the 
unwieldiness of the Board. “ This will not do.” It has de- 
monstrated only the urgency of his desire in this direction. 
Dr. Hamilton closes by enumerating the facilities possessed 
by his Service for the management of quarantine. It is hardly 
necessary to suggest that Collectors of Customs, the thirty- 
seven vessels besides harbor tugs of the Revenue Cutter Ser- 
vice and the Coast Survey, have duties to attend to which 
would possibly prevent their detail en m,asse to duty under the 
Supervising Surgeon-General, as aids in quarantine work. 
Strictly speaking, the Marine Hospital Service has its hospitals 
and its medical officers. Dr. Hamilton allows that the former 
cannot be employed as yellow fever hospitals—and as to the 
latter, if they are employed on quarantine or yellow fever 
work, they must cease to be Marine Hospital Service doctors, 
for these are paid from the merchant sailors’ fund for caring 
for the sick of the mercantile marine. If a quarantine bureau 
is to be organized in the Treasury, it must be in addition to 
the Marine Hospital Service. The Hospital Service cannot 
be quarantine doctors paid by the United States Government, 
and attending physicians paid from the sailors fund at one and 
the same time. 
CHARLES SMART, 
Surgeon U. S. Army, 
Member National Board of Health.