TWENTY-FIVE YEARS OF PREVENTIVE MEDICINE. 305 



t^aid, twenty-seven years after, "This magnificent report fell flat 

 from the printer's hands, but when in 1869 the State Board was 

 established it was on the lines Mr. Shattuck had drawn." He 

 did not live to see it carried into efl'ect, but while he lived he 

 never ceased to strive to bring the people of his State to correct 

 views ; and now that a great majority of the States have modeled 

 their boards on that of Massachusetts, we can see that he did not 

 labor in vain. 



Meantime not all the rest of the country was asleep, for very 

 earnest efforts were making in New York city looking toward 

 the establishment of a central health authority. There was 

 need enough of it, as these facts show: twenty thousand peo- 

 ple were living in cellars; there were spots from which typhus 

 was never absent; there were no less than three hundred and 

 seventeen slaughterhouses with their inevitable fat-rendering 

 and bone-boiling concomitants below Eightieth Street ; and there 

 is a credible witness now living who saw a small child killed in 

 Madison Street, by one of the hogs which formerly ran loose in 

 the city. It took fifteen years of eifort, on the part of a set of 

 men whose disinterested devotion to the best interests of human- 

 ity is beyond praise, before, in 1860, they secured a Board of 

 Health for the city. Repeated decimating invasions of yellow 

 fever had visited New Orleans, and in 1855 the Legislature of 

 Louisiana passed a law for the establishment of quarantine, that 

 involved the spending of much money ; its authority was vested 

 in a State Board of Health, and its powers were much enlarged 

 in 1867. It was, no doubt, a valuable instrument with which to 

 repel the invasion of exotic epidemics, but bore little resemblance 

 to the thirty-seven State Boards of Health that have since come 

 into being. The one was a frantic effort to repel an external 

 enemy ; the others direct their main efforts to the correction of 

 internal sanitary sins of omission and commission. These, with 

 their vigilant watchers in every hamlet, and their multipled 

 publications of reports, pamphlets, directions, and leaflets the 

 true leaves that are for the healing of the nations constitute a 

 bureau of information that has saved thousands and thousands 

 of lives. While Lemuel Shattuck's splendid programme of action 

 was calmly slumbering in the State Library the war came, and 

 all minor issues were swallowed up in the one " Shall we have a 

 country left ? " But even this had its compensations. Dr. H. I. 

 Bowditch truly says, " Both North and South discovered the all- 

 important advantages of cleanliness, sobriety, and strict methods 

 of action, as opposed to the distress consequent on filth, intem- 

 perance, and chaotic rule." Dr. Bowditch himself, by the most 

 persistent efforts, induced our military authorities to provide 

 comfortable ambulances for the wounded, and from them has 



701. XLVi. 23 



