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August 2, 1976

The Scientific Background of the International Sanitary Conferences, 1851-1938

JAMA. 1976;236(5):514. doi:10.1001/jama.1976.03270050058042

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The International Sanitary Conferences were the real forerunners of the World Health Organization. They were held irregularly, often at the request of a single country, beginning with French initiatives in 1850. Norman Howard-Jones gives a concise analysis of each of the 14 conferences, stressing the interplay between medical theories of epidemic disease and national interests. The relative merits of quarantine vs urban sanitary measures in the case of cholera dominated discussion at the conferences until the turn of the century. The medical world was divided in its opinion about the etiology of cholera along a spectrum ranging from extreme anticontagionism to extreme contagionism. This welter of opinion, based on a mixture of preconception and fact, allowed the politicians at the conferences a certain freedom to marshal medical theory along lines of national interest. Thus, in the 1885 conference, the British delegate, fearing strict quarantines, effectively banned any discussion of Koch's