president's address SECTION I. 177 



great body of sanitary law administered by local authorities ; and 

 the completeness of this body of law and the thoroughness of its 

 administration is one of the best, if not the best, standard where- 

 with to measure the real civilisation of a people. 



I propose, as an introduction to the work of this section, to 

 address to you some observations on the general scope of the 

 powers entrusted and duties imposed by modern legislation on the 

 municipal authorities who are the guardians of the health of a 

 town community, with illustrations of the means employed by some 

 of these authorities in the exercise of these powers and fulfilment 

 of these duties. In speaking of powers entrusted and duties im- 

 posed 1 hold that in health matters the entrusting with power is 

 the imposing of a duty — that where issues of life and death are 

 involved may and can should be read ought and must. Of course 

 the means employed must always greatly depend upon the circum- 

 stances of the community under the care of the authorities, as a 

 large and wealthy city may employ a staff and do work quite 

 beyond the capabilities of a small and poor one. But it is none 

 the less interesting and useful to know what may and ought to be 

 done, when financially jjossible, and it is better to set up a high 

 standard for attainment than a low and easier one. Furthermore, 

 a small community can often usefully modify the means employed 

 by a large one, and thus arrive at the end to be aimed at — the 

 securing and safeguarding the health of the people. 



The work of the health board for a town may be broadly 

 divided into the prophylactic, the curative, and the constructive — 

 the first and second being under the direction of the medical 

 officer of health, and the third under that of the engineer or town 

 surveyor. There is no definite boundary between these divisions ; 

 and the work to be done often belongs almost as much to one 

 di\dsion as to another, and can be efficiently done only by the 

 hearty co-operation of both branches of the service, for much pre- 

 ventive and curative work requires special constructions, and most 

 sanitary construction is undertaken with the view, at least indi- 

 rectly, of preventing or treating disease. 



The duties of the officer of health embrace the measures to be 

 taken to guard the public health generally, and the special means 

 to be used in regard to infectious and epidemic diseases. He needs 

 a staff of inspectors sufficient for the thorough and continuously 

 recurrent examination of the whole of his district, and a material 

 equipment to enable him to deal promptly and efficaciously with 

 infectious diseases as they arise. The sufficiency of this equip- 

 ment is the principal factor which determines in ordinary circum- 

 stances whether an outbreak of such disease shall or shall not 

 assume the proportions of an epidemic. 



The town surveyor or engineer's staff should be sufficient not 

 only for designing and superintending the construction of the 

 sanitary works undertaken by the municipal authorities, but also for 



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