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must be put in requisition, before reform can be complete. The Board should therefore contain

1. Two physicians, at least, of scientific attainments, and of extensive practical experience in their profession, thoroughly understanding sanitary science, and deeply feeling the importance of wise sanitary measures.

2. One counsellor at law, who, besides the general knowledge of law and medical jurisprudence which he could bring to the purposes of the Board, might especially be able to investigate any legal question that might arise.

3. One chemist, or natural philosopher. Many questions relating to the influence of the elements on the production or prevention of disease, may require the special investigation of an experienced chemical philosopher, and this important branch of science should be ably represented at the Board.

4. One civil engineer, possessing competent knowledge to determine the best methods of planning and constructing public works, and the best architectural sanitary arrangements of public buildings, workshops, and private dwelling-houses, would be an exceedingly valuable member.

5. Two other persons, of acknowledged intelligence, good judgment, and of practical experience in the common business affairs of life, and capable of investigating and fully understanding the principles of sanitary science, might compose the remainder.

All should make themselves thorough masters of the objects of their appointment; have sagacity and foresight to perceive the bearing and effect of every measure proposed; be eminently practical men, wise in deliberation, and judicious in decision. The objects of the Board will be of the greatest importance and interest; and it should, and undoubtedly will, command, not for its pecuniary emoluments, but for its high respectability, honor, and usefulness, the greatest talent in the Commonwealth, and the services of those who, in an eminent degree, possess the public confidence.1

1 Dr. Duchatelet, an eminent member of the Council of Health of Paris, in describing the qualifications of officers of Public Health, says: It is generally thought in the world that the medical knowledge acquired in the schools is all that is necessary to become a useful member of the Council of Health. The greater part of medical men themselves share this

IV. WE RECOMMEND that the Board be authorized to appoint some suitable and competent person to be the Secretary of the Board, who should be required to devote his whole time and energies to the discharge of the duties of his office, and be paid a proper salary for his services.

The duties of the Secretary are defined in the eighth section of the proposed act. Besides keeping the records and accounts. of the Board, he is to superintend the taking, and prepare the abstracts of each State census; to perform the duties relating to the registration of births, marriages, and deaths, now performed by the Secretary of State; to make special sanitary surveys of places, when directed; to report annually an abstract of the information obtained; to perform such other duties as may be legally imposed upon him; and to diffuse "throughout the Commonwealth information relating to the sanitary condition opinion; and, on the strength of some precepts which they have collected from books on health and professions, they think themselves sufficiently instructed to decide on the instant the gravest questions, which can only be resolved by special studies. A man may have exhausted medical literature; he may be an excellent practitioner at the sick-bed, a learned physician, a clever and eloquent professor; but all these acquirements, taken in themselves, are nearly useless in a Council like that of Paris. To be really useful in the Council, it is necessary to have an extended knowledge of natural philosophy; to know with exactness the action which trades may have on the health of those who exercise them, and the much more important action of manufactories of every species on men congregated in towns, on animals, and on plants. This knowledge, so important, of the action of manufactories and trades, is not to be acquired by ordinary study, or in the science of the cabinet. It is not to be obtained without positive notions on the arts, and on the greater part of the processes peculiar to each trade. It requires habit, and the frequenting of the places of work. In this particular, more even than with medicine, books are not a substitute for practice. From what has been said, the necessity will be evident to introduce into the Council those physicians who have made health, and particularly the public health, a special study; and to join with them chemists, and, above all, manufacturing chemists, and other professions."-Chadwick's Sanitary Report, p. 423.

The Edinburgh Review for Jan., 1850, (p. 221,) in an article on Sanitary Reform, holds the following language in relation to the Board of Health in England:-"We believe that some not unnatural jealousy has been felt by the medical profession, as to the constitution of the Board; but we cannot regret the circumstance that its chief operative leader is not a physician. It is very necessary that such a department should have the best scientific counsel and assistance that the country can afford, and the debt which it owes to the recent services of Dr. Southwood Smith, Dr. Sutherland, and other physicians, cannot well be overrated; but, on the other hand, it seems indispensable that an administrative body, coming in contact with constitutional rights and responsibilities, should have another kind of leadership. To balance the heroism and disinterestedness, for which we most willingly give them credit, the medical body have some defects, especially in their jealousies and prejudices. It is difficult to get them to countenance any thing inconsistent with what they have long seen and practised; and they would certainly not be so ready as laymen to give way to the collective wisdom of their own brethren. We firmly believe, in short, that the first physicians in the country will more frankly communicate to such a board as the present, their individual convictions, than to any convocation of their professional brethren; and that the board will more candidly weigh and more cheerfully adopt their views. The value of unprofessional superintendence,-the same class of persons who are to execute arrangements never being entirely the same as those who devise them,-has been evinced in the management of the Admiralty. It has been appositely remarked, that Nelson never would have obtained high command from a board of old admirals. Nor is it uninstructive to remember that, though they have liberally responded to it, the idea of sanitary reform, on the scale which we are now considering, did not originate within the medical profession. And, in truth, the constant direction of the faculties to the cure of actual disease, does not seem likely to leave much observation to devote to the study of its external causes."

of the State and its inhabitants, to the end that the laws of health and life may be better understood, the cause of disease ascertained and removed, the length of human life extended, the vital force and productive power increased, and the greatest amount of physical improvement and of happiness attained and enjoyed."

He should be amply qualified, in all respects, for the office; know what to do, and how to do it, and what information to obtain, and how to obtain it. He should be thoroughly educated in the science of public health, and the causes and prevention of disease; and be capable of arranging, analyzing, abstracting, combining, and publishing the facts that may be collected, with proper deductions and conclusions from them, in such form as will be most useful to science, and contribute most to the improvement of practical life. To discharge the duties of such an office in such a manner as they might and ought to be discharged, would, in our judgment, be enough to satisfy the desires of any man who wished to be honored and useful.

V. WE RECOMMEND that a LOCAL BOARD OF HEALTH be appointed in every city and town, who shall be charged with the particular execution of the laws of the State, and the municipal ordinances and regulations, relating to public health, within their respective jurisdictions.

The constitution, and the powers and duties of these Boards, are defined and prescribed in the proposed act. They are each to be composed of not less than three nor more than seven persons, besides the mayor and city registrar of cities, (or the city clerk, where there is no city registrar,) and the chairman of the selectmen, and the town clerk, of towns; and are to be appointed for the same number of years as there are members constituting the Board; and to go out of office alternately, like the General Board of Health, and for the reasons already given. Any one, however, being duly qualified, may be reappointed. These Boards should be filled by men of similar character to the General Board, and without reference to any peculiar political or religious opinions they may entertain. One or more physicians, educated in sanitary science, should be members of each

Board. Persons of sound judgment and good education, of other professions or occupations, and qualified and fitted for these peculiar duties, might supply the remainder. All should have the public respect and confidence. It is intended that they shall be appointed by the mayor and aldermen of cities, and the selectmen of towns, because this mode would be more likely to secure a better Board, than a nomination and election in general town meeting.

The duties of these Boards are pointed out in the act, and particularly in the sixteenth section; and also in the several recommendations in this report. They will be required, generally, to carry into execution, within their own town, the sanitary laws of the State, and the orders of the General Board of Health; and, as far as possible, to prevent disease, and raise the standard of public health to the highest point.

We have referred (pp. 48-54) to the sanitary laws and customs of this State; and we deem it proper again to refer to the subject, that we may compare them with the measures proposed in this recommendation. The Revised Statutes (p. 208) provide that

"Every town, respecting which no provision is made, by any special law, for choosing a Board of Health, may, at their annual meeting, or at any other meeting legally warned for the purpose, choose a Board of Health, to consist of not less than three, nor more than nine persons; or they may choose one person to be a health officer; and, in case they shall not choose any Board of Health, or health officer, the selectmen shall be the Board of Health."

Each of the charters incorporating the nine cities in this State, contain a provision similar to the following:

"All the power and authority now by law vested in the Board of Health for the town of or in the selectmen of said town, shall be transferred to and vested in the city council, to be carried into execution by the appointment of Health Commissioners, or in such other manner as the city council shall deem expedient."

And the act of May 2, 1849, provides that

"1. All the powers vested in, and the duties prescribed to,

Boards of Health of towns, by the general laws, shall be vested in, and prescribed to, city councils of cities, in case no special provision to the contrary is made in such laws themselves, or in the special laws applicable to any particular city.

"2. The powers and duties above named may be exercised and carried into effect by city councils, in any manner which they may prescribe, or through the agency of any persons to whom they may delegate the same, notwithstanding a personal exercise of the same, collectively or individually, is prescribed in the instance of towns, as above referred to. And city councils are hereby authorized to constitute either branch, or any committee of their number, whether joint or separate, the Board of Health for all, or for particular purposes, within their own cities."

In addition to these general provisions of law, some special Boards of Health, as we have already shown, have been incorporated. Under their operation, it is left optional with each city and town to make or not to make ordinances and regulations on the subject of public health. The practice of different cities and towns, in exercising their powers, has been various.

In Boston, the mayor and aldermen are constituted Health Commissioners, and they appoint, annually, a Committee on Internal Health, on External Health, on Streets, on Drains and Sewers, on Water, and on Burial Grounds; each consisting of three members, who examine into all complaints and matters affecting the public health in their respective departments. The city council choose, annually, the following officers :—

1. A Superintendent of Streets, to have the general care of sweeping and cleansing the streets, lanes, alleys, public walks, squares, &c., of the city.

2. A Superintendent of Common Drains and Sewers, to superintend the location and construction of these important aids to comfort and health.

3. A Water Board, to superintend the distribution of the inestimable blessing to health, which is now furnished in all desirable quantities by the Boston Water Works.

4. A City Physician, "to examine into all nuisances, sources

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