November 4, 19 15] 



NATURE 



273 



can apparently be raised, and the suggestion of atomic 

 allotropy appears worthy of development as a possible 

 interpretation of others among the phenomena of pure 

 iron, which considerations of space have excluded 

 from the present summary. 



During the discussion several interesting slides show- 

 iig variations of the micro-structure of iron were 

 exhibited by Prof. H. C. H. Carpenter. 



PREVENTIVE MEDICINE IN 

 PENNSYLVANIA.'^ 



PREVENTIVE medicine is a science so likely to 

 appeal to the genius of the American people 

 that it is of considerable interest to read the reports 

 issued in July, August, and September of 1914, by 

 the Pennsylvania State Department of Health on 

 various aspects of its activities. 



As elsewhere, so in the State of Pennsylvania, the 

 force which caused the development of preventive 

 medicine was the compulsion exerted by outbreaks of 

 disease. An epidemic of typhoid fever in 1885 was the 

 means of obtaining the enactment of a previously 

 twice defeated Bill to establish a State Board of 

 Health, which, however, at first was much circum- 

 scribed in its powers and duties. A severe outbreak 

 of smallpox in the years 1901-04 impelled the Legis- 

 lature to establish a State Department of Public 

 Health. 



At its head is a Conmiissioner of Health, with very 

 great powers of initiative, on whom falls the duty of 

 appointing whatever assistants he may find neces- 

 sary to carry on the work. The State Department 

 of Health has direct executive control over all public 

 health problems of every sort in the more rural por- 

 tions of the State, comprising four-fifths of the land 

 area and one-quarter of the total population. Over 

 the remainder of the population, aggregated in the 

 more densely populated townships, which are required 

 to maintain their own local boards of health, the State 

 Department of Health has advisory and supervisory 

 control, but no executive responsibility except in rela- 

 tion to sanitary engineering, tuberculosis, and the 

 collection of vital statistics. 



The State administrative machinery, therefore, in 

 some resi>ects resembles, but in others is in marked 

 contrast to, that of an English county health depart- 

 ment. Both have general supervisory and advisory 

 duties with regard to the smaller areas within their 

 compass. The English county department has, how- 

 ever, nothing approaching to the wide general execu- 

 tive functions of the Pennsylvania State Department, 

 although in some respects — for example, in the control 

 of tuberculosis^ — their activities are akin. The com- 

 plete responsibility of the Pennsylvania State Depart- 

 ment for the health of the public in the rural portions 

 of its area has no analogy in county administration 

 in this country. The English system is based far 

 inore than is the Pennsylvanian on local as opposed to 

 central administration. 



The organisation of the State Health Department 

 would appear to be on very effective lines. Out of the 

 central department have crystallised a number of sub- 

 departments, or divisions, dealing respectively with 

 vital statistics, school medical inspection, sanitary 

 engineering, tuberculosis dispensaries and nursing, 

 sanatoria, housing, laboratories, and the distribution 

 of biological products. The chief of each division 

 reports directly to the health commissioner. There 

 are two special divisions, one of which conducts all 

 the auditing and accounting and part of the purchas- 

 ing for other divisions, while the other attends to the 

 whole of the storage and shipment of materials. The 



1 Pennvy'vania Health Bulletin, July, August, September, 1914. 



NO. 2401, VOL. 96] 



divisional executive officers are thus left free to devote 

 their energies to the more essential public health work. 



Comparison of the work of some of these divisions 

 with that of health departments in this country is 

 instructive. For example, the registration of births 

 and deaths is far more closely bound up with public 

 health in Pennsylvania than is the case in England 

 and Wales, in which it is not in any way directly 

 controlled by the Health Department; whereas in 

 Pennsylvania, on the contrary, the Division for Vital 

 Statistics, a branch of the State Health Department, 

 under the direct supervision of a health officer, is 

 responsible for precisely the same work as is done by 

 our local and central registrars in respect of births 

 and deaths and marriages. 



In the same way the school medical service, instead 

 of being, as is unfortunately the case in this country, 

 a separate service affiliated only for reasons of con- 

 venience to the public health service, is recognised 

 in Pennsylvania as essentially a branch of public 

 health, and as such is administered by the State 

 Health Department through a division of medical 

 inspection. Sanitary engineering, again, carried out 

 as it is by a special division of the State Health De- 

 partment, is much more clearly recognised as a func- 

 tion of public health than is the case in this country. 



Perhaps the most striking feature of the Pennsyl- 

 vanian scheme is its systematic educational campaign. 

 All reports sent in from every division of the Health 

 Department to the Health Commissioner are dealt 

 with from their public health aspect, and are then 

 handed over to an educational section of the central 

 department, where they are rewritten and issued in 

 popular form as lectures, circulars, leaflets, newspaper 

 talks, or periodical bulletins. This eagerness to_ popu- 

 larise technical knowledge is an important side of 

 public health work, which could with advantage be 

 better developed in this country. In general adminis- 

 tration, probably English methods give as good results, 

 though possibly in more circuitous ways. Pennsyl- 

 vania has had the advantage of beginning at a time 

 when it could develop its public health system at one 

 stroke and as a whole, and so could largely avoid 

 the errors and vagaries of a system which has grown 

 by accretion. H. P. N. 



CHEMISTRY AT THE BRITISH 

 ASSOCIATION. 



ALTHOUGH so many topical subjects were, on 

 account of the war, excluded from the discussions 

 of the section, the attendance at the meetings was on 

 the whole satisfactory, exceeding the anticipations of 

 the earlier part of the year. It is, however, clear that 

 anything like general interest can only be evoked in 

 the Chemical Section by discussions on rather broad 

 subjects, papers giving the results of researches on 

 some particular branch being only too frequently de- 

 livered to nearly empty benches. This not infrequently 

 arises from the paper being so specialised that the 

 author is practically the only person in the room capable 

 of appreciating its significance and value. One cannot 

 help feeling that the atmosphere of the Chemical 

 Society or other specialised body would be more sym- 

 pathetic. Under the exceptional circumstances of this 

 year foreign guests were few in number, but the sec- 

 tion had the pleasure of welcoming and listening to 

 two of our Belgian allies — Prof. Henry and Prof. Ran- 

 wez, from Louvain, the former giving an account of 

 researches on the preparation and properties of vinyl- 

 acetic nitrile, which he has carried out in Prof. 

 Perkin's laboratory at Oxford during his residence in 

 this country, while the latter contributed a paper to 

 the discussion on smoke. 



