54 PUBLIC HEALTH 



certain beneficent institutions could be organized and maintained 

 by the national government. As a matter of policy, the attitude of 

 Congress is also in accord with the spirit of the Constitution. It has 

 not been deemed desirable that the United States Government should 

 be too paternal, but should leave most of the details in public health 

 matters to the state and municipal governments. Occasionally 

 there is a tendency toward a weak leaning on the national govern- 

 ment, which should not be encouraged, but in the opinion of the 

 Chairman it is the wisest policy at present that the national govern- 

 ment should only give aid when it is necessary to do so in the interest 

 of several states or communities combined. The leaving of ordin- 

 ary public health matters to the management of the state health 

 boards would strengthen them in their organization and in their 

 appeals to the state legislatures for appropriations. Any national 

 system must necessarily include, for its efficacy, the health organiza- 

 tions of the several states and their development in power. 



Time may develop a closer relation between the national and 

 state, or local, governments with regard to local sanitation, since 

 the latter is closely connected with epidemic diseases which become 

 the care of the national authorities. 



Through the Hygienic Laboratory, with its advisory board, the 

 scientific work of the Public Health and Marine Hospital Service is 

 brought into contact with the scientific laboratories of the country. 

 Through the conferences with the state health officials the practical 

 administrative work of the Bureau and its various sanitary pro- 

 blems are now considered in conjunction with the official represent- 

 atives of the state governments; and a good scientific and execu- 

 tive framework of the national health structure exists in the corps 

 of specially trained medical officers, under military discipline, and 

 trained in government methods. 



The national health organization, as thus outlined to-day, is much 

 stronger than was the old national board of health, but it should be 

 stated that while the organization seems to have sufficient scope, 

 much remains to be done to perfect the details. 



