The following paper on "Quarantine Problems in the Far East," ead by Dr. Wa Lien-teh, the famous investigator of bubonic ' plague, a the Pan-Pacific Food Conservation Conference in Honolulu this month, has been sent us for publication:
The need of a uniform quarantine procedure throughout the Far East, nay the Pacific, grows in importance 'a3 "communications" become more frequent between the several countries concerned. This holds as good for food conservation as for human traffic. For a long time interested health officers, working in the Pacific regions have watched with dismay the multitudinous laws affecting international health. Such laws, Jwhile unduly severe in some advanced countries, are altogether absent in others, 'Hence shipping companies, trade organisations and individual' travellers have at one time or another suffered on the one hand from laxity of health regulations leading to unnecessary. infection and sometimes even death, and on the other from an over-rigid, at times purely theoretical, system resulting in panic and often entire stoppage of human and commercial intercourse over vast areas. The International Sanitary Convention of Paris (1911-12), even with its revised suggestions (1923), deals with only one side of the problem, namely, the protection of Europe from the East. Again, such a disease as plague is treated as human instead of a rodent infection, The establishment of the Health Section of the League of Nations with head-quarters at Geneva, has. been justly acclaimed as a move in the right direction and the visit of a Health Commission to the Far East under Dr. Norman White in welcome that international the early months of 1923 is a
the attention that it deserves. For it obvious that in order to obtain the maximum of benefit for tries the problem of international hygiene must be treated in the same way as communal hygiene, in other words each unit (in this case a country) should render its best so that the whole may succeed.
For the promotion, of this high Indeal no country will ea-operate greater zeal than Chi Handleapped by the thoughts and Practices of a 4,000 year-old civilization, her modern public health officials have often had to fight a hard battle, but the task will be Jeasier if she receives encouragement and ce-operation from neighbouring countries possessing more complete Jorganisation. Of the five dangerous diseases, to wit, bubonic plague, cholera, small-pox and yellow fever, the first is principally found in the northernmost provinces, but only in a form; bubonic plague is confined to the two coastal provinces of Fukien and Kwangtung; cholera is often non-existent; smallpox ix almost universally endemic; while yellow fever has never been known to The eradication of small-pox been making considerable headway during the Last few years by ex tensive propaganda and free vacfcination among the masses. jeontrol of bubonic plague still awaits proper ce-operation between the Chinese and neighbouring governments. The terrors of cholera have largely disappeared since Roger's treatment with hypertonic saline solution, which in our hands has saved 85 per cent. of the most severe cases. There is not much need tu fear yellow fever, since it is a rapidly disappearing disease, thanks to the immortal researches of Walter Reed, Carroll, Agra monte, Gorgas, and Noguchi. Lastly the origin of pneumonic plague, that most feared of all known diseases, i has now been definitely traced to the Siberian marmot, and we express a hope that the temporary. understanding between the Soviet medical organisation and our Ser-wice may soon culminate in a permanent agreement for the mutual protection of the two great republics, and therefore of the world.
To summarise them, if all emigrants from China are' properly vaccinated against small-pox at their point of departure, the only disease which may be considered of international importance is bubonic plague, and the principal port from which this is conveyed is Hongkong. No standard yet exists for the treaty ports of China, by which one locality may exchange quick reports with the other for mutual) protection. In order to clarify' matters, a brief summary of the present quarantine problem in this country may be given.
The Chinese Maritime Customs have, since the introduction of quarantine laws in China, been the sole authority in the appointment of port health officers. The latter are usually busy foreign local medical practitioners, who as a rule do not examine any vessel until epidemic disease threatens or in-wades the locality.
With the exception of Woosung, Tsingtao, Dairen, Newchwang, Harbin and Antung, no quarantine hospitals yet exist, though port health officers are appointed.
Although the Commissioner of Customs of each port, as representa tive of the inspector-General of Customs, is nominally responsible for its safety and as such issues instructions to the Port Health Officer, yet before any quarantine re~ gulations may be enforced against any vessel flying a foreign flag, the permission of the local consular body must be obtained according to 'Treaty. Should any adverse vote be given by any consul, these laws cannot be enforced.' Sometimes jeonsiderable delay is caused by reference to the respective Ministers Plenipotentiary in Peking or to the Diplomatic Body as a whole. In of urgent stress, as in cholera, cedure is suicidal point of view. tine laws of
Text read from the printed page and cleaned; old type leaves the occasional error.