Vol. 65, No. 1. Whole No. 1730.

VICE-PRESIDENT OF THE AMERICAN ACADEMY OF MEDICINE; HON. VICEPRESIDENT OF THE BRITISH CONGRESS ON TUBERCULOSIS; VICE-PRESI DENT OF THE PENNSYLVANIA SOCIETY FOR THE PREVENTION OF TUBERCULOSIS; HON. DIRECTOR OF THE NEW HAVEN ANTITUBERCULOSIS ASSOCIATION; CORRESPONDING MEMBER OF THE INTERNATIONAL CENTRAL BUREAU POR THE PREVENTION OP CONSUMPTION: MEMBER OF THE NEW YORK TUBERCULOSIS COMMITTEE OF THE CHARITY ORGANIZATION SOCIETY; VISITING PHYSICIAN TO THE RIVERSIDE SANATORIUM POR CONSUMPTIVES OF THE CITY OF NEW YORK; CONSULTING PHYSICIAN TO SANATORIUM GABRIELS, GABRIELS, N. Y.; ETC.. ETC.

Mr. President, Fellow Members of the Society of Medical Jurisprudence, and Invited Guest:

In order to plead my cause successfully before a distinguished audience of the jurists and physicians of this great metropolis, I must, to speak in legal parlance, state my case. To do this intelligently and conscientiously I will divide my discourse into three parts, and speak first, of official, second, of private, and third, of professional phthisiophopia. Phthisiophobia means, in plain language, an exaggerated fear of the presence of a consumptive. Official phthisiophobia started in the United States about two years ago when the Surgeon-General of the Marine Hospital Service issued a declaration that pulmonary tuberculosis must be classed as a dangerous contagious disease, and that in future immigrants, or aliens visiting our shores, afflicted with pulmonary tuberculosis, must be debarred from all ports of the United States. In June of last year an order was issued confirming the above decision, and adding that tuberculous individuals should be debarred regardless of boards of special inquiry, which heretofore had used their discretion in the matter.

It goes without saying that none of us desire pauper immigration, and we do not want any such class to enter our country, whether they are tuberculous or not. The question here is simply: is it right, just, and scientific to declare pulmonary tuberculosis a dangerous, contagious disease, and exclude on that account worthy immigrants who offer a guarantee that they will not become a burden to the community, or to exclude aliens and visitors afflicted with pulmonary tuberculosis? Have those who have been instrumental in bringing about the Government decision to declare pulmonary tuberculosis a dangerous contagious disease, or who favor this decision, ever thought of the fearful meaning of a designation which virtually classes every American consumptive with patients who may be suffering from smallpox, leprosy, yellow fever, etc.? Have they ever thought how really few families there are who have not at least one, more or less near relative or friend who is a consumptive? Tuberculosis is the *Read before the Society of Medical Jurisprudence, on December 14, 1903.

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most frequent of all diseases, and it is most prevalent in the pulmonary form. It is a disease of the young and old, of the poor and rich, the East and the West, the North and the South.

I cannot do better here than to give you the concurrence of opinion of the medical profession of this city on this subject by reading to you the resolutions which I had the honor to present to the New York Academy of Medicine at the time, and which were seconded by Prof. Edward G. Janeway of this city and adopted by the Academy at its regular meeting on February 6, 1902:

Whereas, The Treasury Department of the United States, upon recommendation of the Surgeon-General of the Marine Hospital Service, has recently decided to classify pulmonary tuberculosis with dangerous contagious diseases, Be it

Resolved, That the New York Academy of Medicine deeply deplores this decision, which is not based on either clinical experience or on scientific experiments. Be it further

Resolved, That the Academy considers the exclusion of non-pauper tuberculous immigrants and consumptive aliens visiting our shores unwise, inhumane, and contrary to the dictates of justice. Be it further

Resolved, That, while the Academy is convinced of the communicability of tuberculosis and urges all possible precautions against the spread of the disease occasioned by sputum and tuberculous food, the Academy is opposed to all measures by which needless hardship is imposed upon the consumptive individual, his family and his physician.

The secretary of the Academy was instructed to forward a copy of the resolutions to the Treasury Department, the Surgeon-General of the Marine Hospital Service, and to the secretary of the New York State Medical Society.

Of the men who stood on my side at the time I presented these resolutions and helped me to carry them, I wish here to remember gratefully Prof. Edw. G. Janeway, Prof. Hermann M. Biggs, Prof. T. Mitchell Prudden, Prof. Geo. M. Peabody, Dr. A. H. Doty, the Health Officer of the Port of New York; Dr. Aug. J. Lartigau of the Pathological Department of Columbia University, Dr. Geo. B. Fowler, Ex-President of the New York County Medical Society; Dr. Geo. F. Shrady, Editor of the MEDICAL RECORD; Dr. Andrew H. Smith, the present president of the New York Academy of Medicine, and Dr. Frank P. Foster, editor of the New York Medical Journal.

Let me also give you a few opinions of men outside of our own city on this vital question. Dr. Geo. M. Gould, the editor of American Medicine, in a leading editorial on this subject, said: "We think professional and lay opinion will not justify the exclusion of tuberculous immigrants on the simple ground that the disease is 'contagious' or 'communicable.' It is only so in such a low degree that the severe measure of exclusion for this reason alone seems unjustifiable." Dr. Geo. H. Simmons, editor of the Journal of the American Medical Association, the representative organ of the American medical profession, says in regard to the resolutions: "The resolutions presented to the Academy of Medicine. are to the point and express the opinion, I believe, of about 90 per cent. of the best men in the profession who have given thought to the subject." Dr.