TWENTY-FIVE YEARS OF PREVENTIVE MEDICINE. 309 



The board had to blaze out a new path into regions hitherto 

 unoccupied. At its first meeting Dr. Bowditch said : " I know of 

 no higher office in the State than that which we now hold, viz., 

 that of inaugurating the idea of State medicine in Massachusetts, 

 Upon our high or low appreciation of the position, and of the 

 duties resulting from that position, and upon our wise or foolish 

 performance of these duties, depends the success of the object 

 aimed at. Our work is for the far future as well as for the present. 

 ... I wish to impress upon you the essential dignity of the offices 

 we now hold, and that we should assume them with minds loyal 

 to the truth. . . . State medicine ranks among the most important 

 matters now discussed by the highest intellects and the humanest 

 hearts in Great Britain. . . . The chief object of the physician is to 

 cure J the far higher aim of State medicine is, by its thorough and 

 scientific investigation of the hidden causes of diseases that are 

 constantly at work in an ignorant and debased community, to 

 prevent the very origination of such diseases." He quoted Simon's 

 " platform," that the sole object of State medicine is " the im- 

 provement in human health, and the lengthening out of human 

 life of each individual man and woman." He also cited Dr. 

 Farr's : " The primary object of public medicine is to prevent dis- 

 ease, but it also surrounds the sick with conditions most favor- 

 able to recovery, and diminishes the death-roll of the people. 

 But supposing every condition most favorable for the operation 

 of State medicine, we should still see grave defects in many per- 

 sons ; shortcomings in others ; in many, organic degeneracies ; in 

 many, criminal depravities. How, out of the existing seed, to 

 raise races of men to divine perfection is the final problem of 

 public medicine. Public hygiene is a want, as much as air and 

 public roads and waters are public necessities, and as such, must 

 be cared for and paid for by the community." 



The high ideal was nobly lived up to, and in a sort of mani- 

 festo addressed to the Municipal Boards of Health, nominally ex- 

 isting in all the towns of the State, they say : " We believe that 

 all citizens have an inherent right to the enjoyment of pure and 

 uncontaminated air and water and soil ; that this right should be 

 regarded as belonging to the whole community ; and that no one 

 should be allowed to trespass upon it by his carelessness or his 

 avarice, or even by his ignorance. . . . These propositions are rec- 

 ognized in existing statutes, but they are not enforced, and the 

 reason of that is, that the public mind is not sufficiently aware of 

 the dangerous elements around us, does not understand the con- 

 nection between filth and disease, and is not convinced that un- 

 drained land is not wholesome to live upon." The board at once 

 set about collecting the mortality statistics in the principal cities 

 and towns of the State, and addressed themselves to investigating 



