The American Minister to the Secretary of State.

No. 236.]

Sir: In continuation of my No. 228, of April 26, 1911,1 reporting the termination of the International Plague Conference at Mukden, I have the honor to inclose herewith copy of a communiqué issued on the 4th instant by the Wai-wu Pu, giving a summary of the results of the conference. It may interest the Department to know that this memorandum was drafted by Dr. Strong, the American delegate, at the request of Mr. Alfred Sze, the Imperial Chinese commissioner to the conference. There is also inclosed copy of a note, dated the 5th instant, addressed to me by Prince Ch’ing, wherein he expresses appreciation of the Chinese Government for American participation in the conference and asks that this message of thanks be conveyed to you. Several prominent Chinese officials in conversation with me recently commented on the splendid representation of the American Government and the Red Cross Society at the conference and expressed the highest appreciation of the services rendered by Dr. Strong. I can safely state that Dr. Strong is generally regarded by Chinese and foreigners alike as having done the most valuable work at the conference. He leaves to-day for Manila, where he will edit the proceedings of the conference, which will be published several months hence by the Government press at Manila.

Upon arriving at Manila Dr. Strong will prepare and forward direct to you for transmission to the Red Cross Society a detailed report on the conference proceedings. Along with this report Dr. Strong will transmit for your information some pertinent observations on the political aspects of the conference.

I have, etc.,

W. J. Calhoun.

The Prince of Ch’ing to the American Minister.

Your Excellency: On the occasion of the convening of the Plague Conference your excellency’s Government selected and sent to Mukden a medical expert, who assisted in the investigations into the nature of the plague and regarding preventive measures in such a way as to throw great light on the matter.

My board is extremely grateful. Now that the conference is ended, I send this note to your excellency to express our thanks, which I beg your excellency to convey to the American Government.

Seal of the Wai-wu Pu.
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the results of the international plague conference of mukden.

[Official statement by the Wai-wu Pu.]

The following communiqué has been issued by the Wai-wu Pu:

The opening ceremony of the International Plague Conference took place in Mukden on April 3, and the closing ceremonies were performed on April 28. The original intention of the Government in the organization of the conference and in extending an invitation to scientists from the different countries represented to participate in the work of the conference was to obtain further information regarding epidemics of pneumonic plague which would be of value both to this Empire and to the world at large. The work of the conference was divided into two sections, (1) epidemiology and (2) bacteriology. In all, 23 sessions were held. The original program, which was most comprehensive in outline and which covered practically every point in connection with the investigation of the pneumonic plague, was fully carried out.

During the last week of the sessions the time was devoted to the framing of the provisional conclusions and of recommendations. These conclusions and recommendations will be published with the final report of which they are a part.

Among the more important conclusions and resolutions of the conference the following are mentioned: The disease spread by direct infection from man to man, and whatever may have been its primary origin there is no evidence that a concurrent epizootic in rodents played any part in its general dissemination. From Russian medical sources it has been reported that an epizootic disease exists among Tarabagans and that it is not unlikely that this disease is plague; but that it is plague has never yet been proved bacteriologically, and this question needs further study.

The chief factor in the decline of the epidemic has probably been the preventive measures which were enforced either in accordance with scientific methods or by the efforts of the people to protect themselves. The decline has not been due to any loss of virulence of the bacillus.

Infection was introduced into towns and villages by persons actually suffering from plague or by those in the incubation stage of the disease. There has been no positive epidemiological evidence to show that the disease has been spread by clothing, merchandise, or other inanimate objects.

The epidemic has been almost without exception one of primary pneumonic plague. The incubation period varies as a rule from two to five days. A rise in temperature and an increased pulse rate are usually the earliest symptoms observable, but a diagnosis can not be made until the organisms are recognized and the sputum has become characteristically bloodstained. An accurate diagnosis can be made only by a bacteriological examination of the sputum with the view of excluding pneumonic infection due to other microorganisms. Since the evidence points to the conclusion that in the epidemic all the cases became septicæmic, an examination of the blood microscopically or culturally may be a valuable aid in diagnosis. The physical signs of lung involvement are too indefinite and appear too late in the course of the disease to be of diagnostic value, and even in cases in which the condition of the person is grave they may be very slight.

The fatality of the disease during the past epidemic has been extremely high, scarcely any cases of recovery having been reported. The general experience has been that no method of treatment has been of any avail in saving life, but the serum treatment seems in a few instances to have prolonged the duration of the illness.

The strain of bacillus isolated during the past epidemic has differed in no essential respect from, strains of the Bacillus pestis previously isolated from other sources. So far as can be ascertained the only infective agent in the epidemic has been the sputum from the plague patient. In the majority of the cases the disease has been contracted by the inhalation of plague bacilli in droplets of sputum (so small as to be visible only by the microscope), causing infection of the lower portion of the trachea and bronchi. In the case of inhalation the risk to the person exposed bears a direct relation to his proximity to the patient and the duration of exposure.

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In view of the special danger of infection by inhalation that has been manifest during the past epidemic, masks and goggles should be worn by all those who come in contact with cases of the disease or suspected cases. The best form of mask is a simple three-tailed gauze and cotton wool pad, which should be destroyed or disinfected after each exposure to infection.

The statistics which have been collected during the past epidemic did not allow of any definite conclusion about the value of active prophylactic inoculation against plague pneumonia, although it was argued that some degree of protection is conferred against bubonic plague by the use of vaccines. It was recommended that further experiments be made on animals in reference to securing immunity against pneumonic-plague infection.

A number of resolutions relating to the question of sanitation and disinfection were also presented. * * *

The evidence before the conference was to the effect that it is unnecessary and undesirable in respect to pneumonic plague to restrict the transit of goods (other than personal luggage) and of mails. Should there be evidence at any subsequent time of an epizootic in rats it would become necessary to take measures to destroy the animals.

The services of the Imperial Commissioner Sao-Ke Alfred Sze have been greatly appreciated. He has outlined the principles to be followed at the conference in his opening address to that body and in other ways directed its care. The Government also appreciates the fact that the period of the epidemic was short, and acknowledges the assistance of both foreign and Chinese doctors who volunteered their services for the purposes of combating the epidemic.

  1. Not printed.