216 ANNUAL, REPORT OF THE Off. Doc. 



The highest diguitary of the land is as amenable to its rule as the 

 beggar in the street. Local health authorities often fail to recog- 

 nize the full extent of their powers and are too timid in their 

 exercise. The law which creates them carefully defines their duties 

 and the limitations of their jjowers, and within these lines, no' one 

 can interfere with them. 



The first duty of a board of health is to discover the causes of 

 disease within the territory under its jurisdiction. This it accom- 

 plishes in two ways: First, and most important, by insisting on 

 prompt and accurate returns of births, deaths and communicable 

 diseases, from all persons in any way connected with such occur- 

 rences, such as physicians, midwives, undertakers and heads of 

 families. In this manner alone can it determine what diseases are 

 prevalent and in what parts of their territory they are most preva- 

 lent, and thus arrive at a conclusion as to their causes. Important 

 as is their duty for the abatement of nuisances, this does not com- 

 pare in beneficent and far-reaching results with that for the en- 

 forcement of the registration of vital statistics. And yet this is 

 usually the last which boards of health in small towns are inclined 

 to take up, and that for which municipal legislators are willing to 

 appropriate the least money. The intelligence of a community, 

 or even of a Commonwealth, may be gauged with accuracy by the 

 attention which it devotes to this matter. It is the basis of all 

 intelligent sanitary adminstration. Secondly, by inspections. These 

 must be made by officers trained to the work, frequently and sys- 

 tematically, especial attention being, of course, devoted to those 

 quarters, villages or districts which the returns indicate as being 

 the foci of disease or centres of infection. Blanks should be pro- 

 vided on which every possible condition liable to affect the health 

 of a street, alley, yard, dwelling, place of business or manufacture 

 should have its appropriate place. At certain seasons, and during 

 epidemics, house-to-house inspections should be made. Systematic 

 inspection of schools is essential. 



Having determined the causes of diseases and their haunts, how 

 shall health authorities procec^d to their elimination and destruc- 

 tion. 



First, by adopting and rigidly rnrorcing regulations for protect- 

 ing the purity of food products, especially of meat and milk. These 

 latter articles should be kept under supervision from the pasture 

 and the stable to the slaughter house, the market and the delivery 

 wagon. 



Second, by using every means in their power to obtain copious 

 supplies of pure water for their communities. The frequent exam- 

 ination of water sup])lies, both public and private, and the publica- 

 tion of the results is an imporiant means to this end. AA'arice 



