

HEALTH, NATIONAL BOARD OF. 



467 



terior communication. In compliance with 

 law the National Board publishes weekly bul- 

 letins, thus distributing gratuitously to those 

 who are most interested in such matters a 

 record of all important work done by the 

 Board, or information gathered. Still further 

 di>-> tninated by the daily press, it thus fur- 

 nishes to the working minds of the country the 

 data most important for them to obtain, and 

 which would be extremely costly in time and 

 money if only to be accumulated by private 

 endeavor. In one of its circulars it proffers 

 aid, in means and information, to leading pro- 

 fessional or scientific men who are willing to 

 devote their labors to the objects in view. 

 Being in complete communication with local 

 boards and associations, it is in a position to 

 mass and sift facts and to compare results, so 

 as to reduce to a system all tentative efforts. 



Beyond a doubt the most important function 

 of the Board is the fashioning of a permanent 

 organization. The deliberative wisdom of 

 Congress will rarely be employed on a more 

 important work than the framing of the act 

 which will place the permanent National Board 

 of Health on a solid basis, far above sectional 

 or party considerations. It should become a 

 great national educator, collecting facts and 

 distributing knowledge, unadulterated by indi- 

 vidual theories or prejudices. It must apply 

 science to the stamping out of disease, and 

 erect barriers against its importation, at the 

 same time that it must render impossible all 

 selfish or senseless quarantines suggested by 

 other interests than the public health. The 

 act must clearly determine the means and reg- 

 ulate the mode. Local rights and customs 

 should be respected so far as they are not in- 

 imical to the interests of the general public. 

 Suitable officers must be selected to carry out 

 the provisions of the act with the greatest pos- 

 sible advantage to health and the least possible 

 disturbance to trade. These delicate functions 

 may be so exercised as to insure the barring 

 out of all preventable diseases. 



Other diseases have been ignored by the 

 public mind, and in point of fact the Na- 

 tional Board is judged by its yellow-fever 

 work. It is difficult to say just how much 

 effect upon the spread of this infection has 

 been due to the labors of the National Board. 

 The original bill contained a clause authoriz- 

 ing the Board to pay half the expenses ot 

 local boards, organized on the plan proposed 

 by the National Board. This clause was al- 

 tered. Doubtless it would have increased the 

 efficiency of local boards, which have at least 

 experience and interest to lead them to use 

 such funds properly. By subordinating the 

 local boards to the National Board uniformity 

 of action is obtained. If the National Board 

 is accused of halting and vacillating, it may be 

 answered that its powers are ill-defined, its 

 labors are in a new field, there are no pre- 

 cedents to guide, and there are many subtle 

 questions of State and inter-State and national 



rights involved. With the desire on all Bides 

 to waive other considerations than the public 

 good, these causes account for hesitation and 

 other sins of omission and commission. The 

 personnel of the Board has also been the sub- 

 ject of much criticism. Physicians with lucra- 

 tive practices and scientists with life- pursuits, 

 if found, are not easily induced to surrender 

 them and devote their entire energies to such 

 purposes. It is conceded that some at least 

 of the leading men of the country are members 

 of the Board. The only proper inquiry is not 

 who are they, but what are they doing ? Here 

 the people and the press have a proper topic 

 for discussion. Early in the summer the Board 

 issued a well-considered circular. If its terms 

 seem too cautions, let it be remembered that 

 the whole question is still an open one. Not 

 only do physicians of all ranks differ in re- 

 gard to diagnosis and treatment, but men of 

 equal pretensions to science dispute rancorous- 

 ly whether yellow fever is contagious or infec- 

 tious, preventable or non-preventable, exotic 

 or indigenous. Hence the non-committal tone 

 of the following official utterance of July 12th : 



Whatever opinions may be held as to the causes of 

 yellow fever and the recent appearance of that disease 

 in Tennessee and Mississippi, it is best to act as if it 

 were a disease due to a specific particular cause, which 

 is capable of growth ana reproduction, transportable, 

 and may be destroyed by exposure to a temperature 

 above 240 F., or by chemical disinfectants of sufficient 

 strength if brought into immediate contact with it 

 It is also prudent to assume that the growth and re- 

 production of this cause are connected with the pres- 

 ence of filth, in the sanitary sense of that word, in- 

 cluding decaying organic matters and defective ven- 

 tilation as well as high temperature. 



The cases of yellow fever recently observed should 

 be considered as due to causes surviving from last 

 year's epidemic, and not to recent importation from 

 other countries. . . . The object of the present circular 

 is to advise that all cities and towns be made clean, 

 in a sanitary point of view. . . . The results of a care- 

 ful sanitary inspection of almost any city or town 

 will show the existence of collections of decaying and 

 offensive matters previously unknown. . . . Such in- 

 spections, to bo of value, must be thorough, and made 

 by persons competent to recognize foul soils, water, 

 and air, as well as the grosser and more palpable forms 

 of nuisance. They should also be made oy persona 

 who will report fully and frankly the result* of their 

 observations, without reference to the wishes of per- 

 sona or corporations. . . . The remedy in usually self- 

 evident. 



The weekly reports contain, besides other 

 valuable information, the mortality from spe- 

 cific diseases of the chief cities of the world. 

 The Board hr s also issued six bulletins, which 

 contain rules and regulations " for securing 

 the best sanitary condition of vessels, cargoes, 

 passengers, and crews coming from infected 

 foreign ports " ; " for quarantined ports, with 

 special reference to yellow fever " ; " concern- 

 ing the sanitary condition of vessels, cargoes, 

 passengers, and crews going from an infected 

 port of the United States to another port in 

 the United States"; "for securing the best 

 sanitary condition of railroads, station-houses, 

 road-beds, and of cars, freights, passengers, and 

 employees coming from a point where yellow 



