of filth, and causes of sickness, which may be on board of any vessel at any wharf within the harbor of Boston, or in any article which may have been landed from any vessel on any wharf or other place, and, under direction of the mayor and aldermen, to cause the same to be removed and destroyed;"— "to vaccinate all persons who may apply to his office for the purpose, and to give certificates of vaccination, without charge;" -"to attend upon all cases of disease in the jail," and "within the city, whenever he shall be called upon by the Health Commissioners, or overseers of the poor."

5. A Port Physician, to be the physician of the city establishments at Deer Island, and to superintend the quarantine of all vessels and passengers which arrive in the harbor of Boston.

6. Five Consulting Physicians, "in case of an alarm of any contagious, infectious, or other dangerous disease, occurring in the city or neighborhood, to give the mayor, or either branch of the city council, all such professional advice and information as they may request, with a view to the prevention of the said disease, and at all convenient times to aid and assist with their counsel and advice in all matters that relate to the preservation of the health of the inhabitants."

7. A City Registrar, to record births, marriages, and deaths, and to superintend the interment of the dead.

8. A City Marshal, to act as health officer; "from time to time to pass through the streets, alleys, and courts of the city, to observe nuisances, to receive complaints from the inhabitants," &c.

Each of these departments is independent of the others. The superintendent of streets collects the street dirt and house dirt, deposits it in an outer limit of the city, and sells it as wanted. He also collects the house offal, and delivers it at a given place within the city, to contractors, who remove it without the city, and who paid $8,000 for it in 1849. The night soil is removed under the direction of the city marshal ; the householders paying $3.00 per load for its removal in summer, and $1.50 in winter.

The annual net expenses of all the health departments have been as follows, for the years ending May 1:

Total,

$70,525 96 $87,144 51 $95,786 67 $129,241 33

The extra expense of $28,245 87 for the Cholera Hospital, and other precautionary measures on account of the cholera, in 1849, are included in the amount under 1850.

In Salem, Roxbury, Charlestown, and most of the cities, the superintendence of all matters relating to the public health is placed under the city marshals, as health officers, subject to the control of the mayors and aldermen. No Boards of Health or health committees are appointed, and no separate accounts are kept of the expenses incurred.

The towns of Marblehead and Plymouth have Boards of Health under their special acts, though often inactive. Springfield, Danvers, and some other towns, have had health committees for several years. Danvers has published some valuable reports of their committees. But, as far as our knowledge extends, few towns have chosen Boards of Health, or health committees, nor have the selectmen often acted in that capacity. With the exception of a few cities and towns, nothing whatever has been done on the subject. Much good has resulted in Boston and some other places, from their health regulations, but not so much as might and ought to have been effected. The whole plan, where any plan exists, for the sanitary police of the State, is essentially defective. The sanitary laws are inefficient and inoperative. They allow something, but require little or nothing to be done, and consequently little or nothing is done. Health, if attended to at all, is considered merely a secondary, incidental matter, and not, as it should be, a leading, essential matter. In some towns, when Boards of Health or health committees have been chosen, it has been done in open town meeting, by nominations at large, like fence-viewers, or other unimportant town officers. Such a practice is not likely to

secure competent men. And in places where more consideration is given, persons holding office for one year only are often appointed, who, though worthy in other respects, cannot, from their education and position, be supposed to be qualified to act intelligently on these great matters.

Even in Boston, where so much has been done, and well done, far more might be accomplished, at the same expense, by the plan which we propose, than by the existing regulations. This it would be easy to show, if space were allowed for discussion and illustration.

A permanent Board of Health, having the general superintendence of all sanitary matters, constituted as it might and should be, would supersede the consulting physicians, relieve the over-burdened aldermen of some of their onerous labors, and manage every department with more uniformity, wisdom, economy, and efficiency. The city registrar and mayor would be ex officio members of the Board. Through the former they would have access to the records of every death which takes place, and thus be made acquainted, at all times, with the prevailing diseases, and the public health; and through the latter a constant intercourse might be kept up between the Board and the city government. The annual reports, which such a Board would be required to make, might be made of far more interest and usefulness than any now distributed. They would be annual sanitary surveys of the city, affording suggestions of the highest importance to the welfare and improvement of the citizens.

And what might be done on a large scale in Boston, might be done on a smaller one in all the towns in the State.

VI. WE RECOMMEND that each local Board of Health appoint a Secretary; and also, if occasion require, a Surveyor and Health Officer.

The 12th section of the proposed act provides for the appointment, and the 13th, 14th and 15th sections prescribe the duties, of the officers of Boards of Health. Every Board should have a secretary, to keep its records, books and papers, and perform such duties as usually pertain to such an office. A surveyor or engineer would also be useful, especially in cities

and populous villages, to examine into all questions which may require the investigation of such an officer, as prescribed by the act, or for the office of engineer of the General Board, page 113. In many of the small country towns this officer might be dispensed with, though in all he would be useful. Each Board should have an Officer of Health, who should, where practicable, be an intelligent physician, well educated, and especially acquainted with sanitary science, having no peculiar theory to build up or support, as regards different modes of practice for the cure of disease, but conscientiously desirous of doing all within his power to prevent disease, and to raise the standard of health within his jurisdiction, by carrying into execution all proper local regulations, and those of the general Board of Health. Some towns may not be able to select such an one, and in such cases, persons of other professions or occupations may be substituted. All officers of local Boards of Health should possess, in as great degree as possible, the qualifications already stated as proper to be possessed by the members and officers of the general Board of Health. (Page 113.) From an examination of the sections of the proposed act to which we have referred, and of the various recommendations and sugges tions of this report, officers of local Boards of Health will be able to learn their duties, without a recapitulation in this place.

The 3d and 4th sections of the health laws in the Revised Statutes, authorize Boards of Health to "appoint a physician to the board," and to "establish the salary or other compensation of such physician, and shall regulate all fees and charges of every person, appointed by them in the execution of the health laws and of their own regulations." This is a power greater than is proposed to be conferred by the new act.

VII. WE RECOMMEND that local Boards of Health endeavor to ascertain, with as much exactness as possible, the circumstances of the cities and towns, and of the inhabitants under their jurisdictions; and that they issue such local sanitary orders and make such regulations as are best adapted to these circumstances.

The sixteenth section of the proposed act, authorises local Boards of Health to issue orders and make rules and regulations for nineteen purposes. This authority, however, is to be exer

cised only in certain contingencies, of which they are to be judges. If, in their opinion, the public health suffers; or if it would be promoted by making such regulations, in regard to either particular, they are bound to make them; if otherwise, they may omit doing it. No regulations inconsistent with the constitution and laws of the State, however, can in any case be made. Any regulation may be modified or annulled, as circumstances may require. Discretion and wisdom, in this as in other matters, will be required in carrying this provision into effect. The powers conferred are not greater than those now possessed under the Revised Statutes, nor in some respects are they so great and summary. The proposed act limits, defines, and restrains existing powers, though it allows them to be extended to some other matters not now specially provided for, which seem to us properly to come under the cognizance of local Boards of Health.

In the appendix, we have given several regulations for local Boards of Health, extracted from many existing codes in our possession; and from them may be formed and arranged, by modification, alteration, abridgement, and extension, a system adapted to different localities.

VIII. WE RECOMMEND that local Boards of Health endeavor to carry into effect all their orders and regulations in a conciliatory manner; and that they resort to compulsory process only when the public good requires it.

In carrying any public measure into effect the favorable opinion and coöperation of the people is desirable. It can thus be accomplished more easily and more thoroughly. Boards of Health should diffuse information concerning their regulations, and the measures they propose for execution; and public opinion should be educated and properly influenced in their favor. It would be unwise, in most cases, to enforce any regulation or measure against the general and deliberate wishes of the inhabitants, after such a regulation has been fully and fairly laid before them and comprehended. It sometimes happens, however, that opinions are given from interested motives, or from local or party prejudices, which are not the deliberate, unbiassed sentiments of the people generally. Such opinions