PRESENT PROBLEMS 71 



inclined to pursuits of this character chose rather the courses which 

 would fit them for engineering, civil or mechanical, and he therefore 

 advised that studies of this character might more profitably be 

 offered through the medium of night schools and the like. 



This was evidence to me that young men of the class which can 

 afford a university education aimed at higher pecuniary rewards 

 than are now afforded to workers in hygiene; it was also evidence 

 that wider efforts should be made to demonstrate the great public 

 need of educated sanitary officers, and the great opportunity the 

 practice of hygiene affords for valuable public service. I believe 

 that, in time, we shall have in this country a class of educated 

 public sanitarians; but that time will not come until scientific work 

 of this character is adequately paid for, and it will come sooner if 

 the sanitary bodies in various states and cities, now working along 

 independent and often conflicting lines, are coordinated and made 

 a part of the greater activities of a national board of health, de- 

 riving its powers as do other main branches of the Federal Govern- 

 ment. 



To define the present problems of a modern board of health is to 

 classify and describe its multifarious activities. Broadly speaking, 

 of course, its main objects are to prevent the spread of contagious 

 disease, and to enforce sanitary ordinances; but to these have been 

 added, some may say "arrogated," so many other powers and 

 duties that the sanitary officer of a generation ago would have great 

 difficulty in understanding the scope of the work to-day. 



Public opinion, in the last analysis, is responsible for the exten- 

 sion of these powers. The expansion of sanitary police functions, 

 especially in the suppression of nuisances, has resulted from the 

 growth of public opinion as to what constitute nuisances; forty 

 years ago what we now define as "offensive trades" and relegate 

 to certain prescribed sections of New York City flourished on many 

 of the best streets. The force of public opinion has gradually branded 

 one nuisance after another as "detrimental to health," and driven 

 them to places where they are no longer an offence to the nostrils, 

 the eyes, or the ears. Power to affect these removals, and to keep 

 sources of nuisance under observation, has been given to boards of 

 health in continually increasing measure, because the public has 

 found that in the great majority of instances powers previously 

 delegated had not been abused. It is this support of public opinion 

 which has in recent years so increased the authority and multiplied 

 the duties of sanitary officers. 



Thus supported and uplifted by the public which they serve, the 

 greatest of all the present problems confronting boards of health in 

 this country, I have no hesitation in saying, is the responsibility of 

 preserving the sanitary service from the evils of partisan politics. 



