1868.] Its Recent Progress and Present Condition. 49 
Happily they do not now stand alone. The exertions of a small 
band of zealous men, continued through many weary years, have 
at length succeeded in placing Preventive Medicine in something 
like its proper position in the estimation of the profession and of 
the general public. It is now seen to be as much the duty of our 
rulers to care for the Public Health, as to make provision for the 
peace and the material prosperity of the community. 
Within the last few years several Acts of Parliament bearing 
upon Public Health, each on the whole an improvement on its 
predecessor, have been passed, and the last of them, the ‘Sanitary 
Act of 1866,’ requires only, to make it almost perfect, that some of 
its enactments, now permissive, should be made compulsory. 
In other countries also the subject is attracting attention. We 
have lately seen an assemblage of diplomatists met, not to divide 
conquered provinces or to obviate threatened war, but to prevent, 
if possible, another invasion of Europe by the pestilence which 
had already three times ravaged many of its cities and towns. 
These are encouraging facts, but to make our condition perfectly 
satisfactory much has yet to be done. We want a Government 
Department of Public Health, presided over by a single responsible 
head. We want travelling inspectors, constantly at work, to anti- 
cipate local outbreaks of preventable disease, and not to be sent 
down only when such outbreaks have occurred. We want medical 
officers of health in every registration district, and we want a higher 
status and more power for the medical officers in the three great 
public services, the Army and Navy and that of the Poor Law. 
Recent events have shown the miserable consequences of the dis- 
regard of the advice of military and naval surgeons, and the country 
would have been spared the shame and the sorrow of the recent 
revelations of the condition of the workhouse infirmaries, metropo- 
litan and provincial, had the medical officers been placed in a more 
independent position, and had the Poor Law Board trusted rather 
to their reports than to those of inspectors too often incapable or 
careless. Thanks to the non-official inspections organized by the 
proprietors of the ‘Lancet,’ and more recently by the British Medical 
Association, a better state of things has already been inaugurated 
in the metropolis, and improvements will, it is to be hoped, follow 
in the provinces. 
Before concluding, we wish to direct the attention of our medical 
readers especially to one mode of preventing disease, to which some 
of them, it is to be feared, are not yet sufficiently awake. Too many 
of the buildings designed for the reception and treatment of 
poor persons suffering from various ailments or accidents, by their 
very construction, generate maladies far more dangerous than those 
they are designed to cure. We believe that there is not a public 
hospital in the kingdom, built before the Crimean War, which is 
VOL, V. E 
