No. 216] 449 



tricts identical with those of the present dispensary districts, and to 

 unite the offices of Health Inspector and Dispensary Physician, in 

 the same individual. 



The duties of the Dispensary Physician carry him in the very track 

 of the nuisances which should be corrected, and while administering 

 to the relief of his patients, he would, as Health Inspector, cast about 

 for the source of the evil, and apply the remedy. By the perform- 

 ance of his duty in one capacity, his labors in the other would be 

 materially lessened. 



How great a proportion of the rheumatisms, the fevers, the inflam- 

 mationSjthe pulmonary and other disorders, of all kinds are attributable 

 to the damp cellars, the filthy tenements, the foul yards, courts and alleys 

 in which the poor are crowded, can be known only to the dispensary 

 physician, who spends much of his time amid these wretched scenes, 

 where he is now powerless for any preventive action that may occur 

 to him. 



But all are aware, for bitter experience has shown, that it is in 

 those places the cholera, yellow fever, small pox, scarlet fever, measles, 

 typhus fever, and all other contagious and infectious disorders, are par- 

 ticularly abundant and malignant. 



It has been customary upon the breaking out of an epidemic, for 

 the public authorities to use great exertions and spend much money 

 in cleansing and purifying these pestilential spots, in order to arrest 

 the extension of the disease. Their previous neglect, or a false eco- 

 nomy, has repeatedly sown a wide-spread desolation, which such pre- 

 ventive measures as are now suggested, would to much extent have 

 saved. 



In addition to the duties now performed by the health wardens, 

 the health inspectors should be required. 



1st. To see that all persons are vaccinated, and for this purpose, 

 to visit all houses, especially among the destitute, once a year; to be 

 constantly prepared, and to offer their services, to perform the ope- 

 ration gratuitously, and to urge it upon all who may require it. 



2d. To be subject to the requisition of the mayor or any alderman, 

 or assistant, to perform any professional duty they may justly re- 

 quire ; the health inspector, in whose district may be a watch house 



[Am. Inst.] DD 



