Health is a variable matter, capable of improvement or deterioration. It may be good in one year, and not in another, and not alike in two places at the same time. No plan can therefore be extensively useful, or permanently valuable, which shall be confined to a single year or a single survey. It should extend over a series of years, and through a series of successive observations and examinations. In this way only can the laws of health and life of any place be accurately ascertained, and a sanitary survey produce all the good that might be attained by it. People are prone to neglect their own and the public health, and this fact is a reason why the subject should be frequently brought to their notice.

Our plan consists of a series of measures, which may be rendered permanent if desired, presented in the form of separate recommendations. They are divided into two classes, and are to be regulated and controlled by the agencies which are proposed to be established; one by the legislative authority of the State, and the municipal authorities of towns and cities, and the other by social organization and personal action. Though intimately connected, these measures are in some respects independent of each other. They are not of equal importance, and it is not expected they will all be immediately made use of; a part only may be adopted at one time, and another part at another time, as circumstances may require. They are here presented together, as necessary to give fullness and unity of design to the whole plan. It is not supposed, however, that they are all the useful sanitary measures which a complete and perfect plan would require. The progress of this inquiry, and the circumstances which it develops in different years, the discoveries which will be made by the united intellectual efforts that will be brought to bear upon this subject,will suggest others. Some of these measures are of great magnitude, and would each furnish matter for a volume, if fully explained and illustrated. All we propose to do in this connection is, to name and define each, and to give a brief explanation and illustration of its character and design. These measures, it must be recollected, however, are only a series of plans by which a sanitary survey might be carried forward.

The accompanying information is inserted merely to illustrate these plans.

I. STATE AND MUNICIPAL MEASURES RECOMMENDED. Under this class of recommendations are to be included such measures as require, for their sanction, regulation and control, the legislative authority of the State, or the municipal authority of cities and towns. They may be called the legal measures, the Sanitary Police of the State, (p. 16.)

I. WE RECOMMEND that the laws of the State relating to Public Health be thoroughly revised, and that a new and improved act be passed in their stead.

We suppose that it will be generally conceded that no plan for a sanitary survey of the State, however good or desirable, can be carried into operation, unless established by law. The legislative authority is necessary, to give it efficiency and usefulness. The efforts, both of associations and individuals, have failed in these matters. We have shown that the present health laws of the State are exceedingly imperfect, even for the general object for which they were designed ;-that it is difficult, and perhaps impracticable, to ascertain what precise powers they confer, and what duties they require;—and that they are not adapted, in any way, to the purposes of a sanitary survey. This must be apparent to any one who may examine them.

There are two remedies for these defects: one to amend the existing laws; and the other, to combine such amendments as it would be desirable to make with such provisions of the existing laws as it would be desirable to retain, and to present the whole together, in this amended form, as a complete health act, repealing such acts as are inconsistent with its provisions. We prefer the latter remedy. It will be better understood, and more easily carried into practice, by the people. Such legislation has been common, in this State and elsewhere, in relation to this and other matters.

Entertaining these views, we suggest that a general health law should be passed, which should be comprehensive in its design and simple in its provisions,-be adapted to the present circum

stances of the State, and be so framed that it might be clearly understood and carried into practical operation; and which, while it would answer all the purposes of a general health act, as heretofore understood, would, at the same time, accomplish all the purposes of a sanitary survey.

We have accordingly drawn up, and present in the appendix, a draft of such an act as, in our judgment, it would be expedient to pass, to secure the advantages designed to be attained. It creates a permanent agency, for the regulation and control of all matters relating to the sanitary condition of the State and its inhabitants. It retains such provisions of the existing laws as are deemed worthy of being retained, and incorporates such others as are deemed necessary to form a complete legal sanitary system. It confers no summary powers not now possessed by Boards of Health, but it limits more closely, and defines more clearly, the duties of those by whom these powers are to be exercised. The objects of all the sections of the Revised Statutes now in force are provided for. The first four sections are contained in a more extended form, and provided for by other agencies, in the first 15 sections of the new act; 18 sections, 5, 6, 7, 15, 17, 18, 35 to 42 inclusive, 45, 47, and 48,— in section 16th; 8 sections,-24 to 34 inclusive,-in the 17th; 2 sections,-43 and 44,-in the 18th; 4 sections,-24, 49, 13, and 12,-are inserted with but little modification; 5 sections of the act of 1849, which take the place of 10 and 11 of the Revised Statutes, are inserted, so modified as to apply to towns as well as cities. With these provisions, various other new and important ones are incorporated; and the whole is so arranged as to form a simple but systematic, efficient, and practical plan, adapted to the present condition and wants of the State. The whole act, long as it seems to be, is not so long as the act relating to public health in the Revised Statutes. That contains 49 sections, and this 39 only.'

1 The "Act relating to Public Health in the City of New York," passed by the Legisla ture, April 10, 1850, covers 48 octavo pages, and contains 89 sections and 31 sub-sections; the acts relating to the Board of Health in Philadelphia cover 111 pages; that relating to the public health in England fills a duodecimo volume of 330 pages; that of Liverpool, contains 231 sections, and several sub-sections; that of Edinburgh, 260 sections, or 101 closely printed octavo pages.

II. WE RECOMMEND that a GENERAL BOARD OF HEALTH be established, which shall be charged with the general execution of the laws of the State, relating to the enumeration, the vital statistics, and the public health of the inhabitants.

The act establishing the Board of Education was one of the most important acts relating to common schools, ever passed in Massachusetts. That central agency, under the guidance of its late talented secretary, has given to the cause of public education an importance, and to the common schools a standard of elevation and usefulness, not before attained. The cause of Public Health needs a similar central agency, to give to the whole sanitary movement a uniform, wise, efficient, economical and useful direction. If different local authorities, or individuals,—not always possessed of the best means of information,—are left to originate plans for their own guidance, and anything is done, they will be more likely to make unintentional mistakes, and create unnecessary expense, than if wise and able minds were devoted to the subject, and suggested what ought to be done, and the best and most economical mode of doing it. Such an agency would have an exact knowledge of the condition of every city and town in the State, and by these means of information would be able to suggest the measures best adapted to the different circumstances. They would prevent a wasteful expenditure of money in imperfect or inefficient measures. The advantages which would result to the whole State, and to every part of it,—to each and all of the inhabitants,-from the establishment of such a central General Board of Health, composed of the best scientific counsel and the best practical experience which the State can afford, having constant access to the most enlightened intellects, and to a knowledge of the labors of the best practical men in the world, and assisted by at least one mind wholly devoted to the object in view,-are too great to be fully seen at once, and can scarcely be over-stated or over-estimated..

The duties of the Board are pointed out in the fourth section of the act. They are to have the general direction of each to superintend the execution of the sanitary laws of the State; to examine and decide upon sanitary questions, sub

mitted to them by public authorities; to advise the State as to the sanitary arrangements of public buildings and public institutions; to give instructions to local Boards of Health, as to their powers and duties; to suggest local sanitary rules and regulations; to recommend such measures as they may deem expedient, for the prevention of diseases and the promotion of the public health; and to report their proceedings annually to the State.

III. WE RECOMMEND that the Board, as far as practicable, be composed of two physicians, one counsellor at law, one chemist or natural philosopher, one civil engineer, and two persons of other professions or occupations; all properly qualified for the office by their talents, their education, their experience, and their wisdom.

The constitution and powers of the Board are prescribed in the first seven sections of the act proposed for its establishment and organization. It is intended that it shall be composed of seven persons, besides the governor and secretary of the Board of Education for the time being. And that the disadvantages of too frequent changes may be avoided, that successive Boards may know the proceedings of their predecessors, and that the outgoings and incomings of new members may not destroy its system and vitality, it is provided that the members shall be appointed for seven years, and go out of office alternately.

The members should not be selected exclusively from one profession, for two reasons:-1. Numerous questions, requiring a knowledge possessed by different professions, will be presented for discussion and decision; and it is desirable that the Board should be able to bring competent knowledge to the investigation of every subject. And 2. To show to all that the promotion of public health is a matter which does not belong exclusively to the medical profession, but concerns every profession and every person. The idea which too generally prevails, that every thing relating to health belongs exclusively to one profession, operates against sanitary improvement. The services of medical men are indispensable; but the services of other professions, and of every person in their respective spheres,