July 5, 1877] 



NA TURE 



18S 



seed of sanitation ; to think out plans of projects for 

 working methods ; to lend its many minds, as if they 

 made up the mind of one man, for devising from the past 

 the best for the present, and respectfully to declare our 

 conclusions. 



The directions in which we shall hive to move, the lines 

 on which we shall have to move, are, I repeat, chiefly 

 three — the political, the medical, the social. The powers 

 on these lines must be approached in every work of ours, 

 however simple, however complicate it may be. I shall try, 

 as the title of my discourse explains, to indicate certain 

 points in which we are most likely to come in contact 

 with these powers and the changes we may expect to work 

 in and through them. 



The Political Part. 



In this country political action has been varied in 

 relation to sanitary improvements. Sometimes politi- 

 cal necessity has crossed sanitary progress, as, for ex- 

 ample, in the imposition of a tax on sunlight, on foods 

 that are essential to life, and in the granting of licences 

 for the sale of pernicious drinks. At other times, 

 and by fits and starts, political action has been in 

 aid of sanitary work. So far back as the reign of 

 Edward the Third, 1361, a royal proclamation was 

 made through Parliament for preventing the slaughter of 

 cattle in the streets of London because of the pollution of 

 the streets and the drains which arose from that cause. 

 From that time under great emergencies other similar 

 acts came into force. They rarely lasted very long. As 

 the urgent necessity for their existence passed away, they 

 were allowed to fall into abeyance, and no permanent 

 machinery was kept in order for insuring their continued 

 and effective action. 



Let me not, however, in saying this, be understood as 

 conveying any special charge of neglect against English 

 legislation. It is just to state, as an historical fact most 

 creditable to our national history, that our legislators have 

 by a long precedence taken the lead in sanitary affairs 

 over those of o:her nations. In 1802 the great sanitary 

 act for regulating the labour of children in factories set the 

 example tiom which much useful legislation has followed 

 at home and abroid. In 1838 that great original sanitary 

 scheme for the registration of the births and deaths of the 

 kingdom was inaugurated, to become a collection of facts 

 relating to life, and disease, and death, of which there is 

 elsewhere no parallel. And, since the era of the Crimean 

 campaign, so much legislation has been attempted bearing 

 on health, I dare not attempt even to enumerate the titles 

 of the different measures that have been introduced. At 

 this moment there can b; no doubt as to the sincerity 

 of our governments, of whatever party they may be 

 composed, for dealing with every subject relating to 

 the public health in an efficient manner, and in as 

 rapid a progression as the slow and sure mode of par- 

 liament iry procedure will permit. The subject indeed 

 presses at this moment with so much force on the govern- 

 ing mind, that if there be any danger ahead it is the 

 danger of too miraculous a draught of small enactments, to 

 the exclusion of comprehensive measures which all who 

 run may read. 



In saying this it is necessary to guard myself against 

 error of expression. By comparison with all the nations 

 of the world beside, we have obtained legislative measures 

 which are splendidly comprehensive. No other country 

 in the world can present an approach to the Public Health 

 Act of 1875. That Act, as far as it goes, is admirably con- 

 structed. Its constitution of sanitary authorities through- 

 out the kingdom ; the power it vests in those authorities 

 to appoint learned medical officers of health ; the pro- 

 visions it makes for securing to each locality better 



sewerage, freedom from nuisances, improved water supply, 

 regulation of cellar dwellings, governance over offensive 

 trades, and removal of unsound foods ; the provisions for 

 prevention of spread of infection and for the erection of 

 hospitals and mortuaries ; and the provisions for the 

 regulation of streets and highways, lighting of streets, 

 estabhshment of pleasure grounds, and regulation of 

 slaughter houses ; these, as well as the general provisions 

 for the carrying out of the Act, are most commend- 

 able as practical plans by the working of which the 

 nation may be tempered into sanitary mould of thought 

 and character. 



In a word the Act of 1875 is an improvement of the 

 first degree on all that has preceded it, and although 

 much of it, by the necessities of the constitution of our 

 country, — which recognises the domination of free will 

 even in its age of ignorance, — of a permissive nature, 

 the working of the Act must in a few years remove 

 a great amount of disease from the land and prevent 

 the invasion of diseases of an epidemic and spreading 

 type. 



Sanitation however admits of being studied from two 

 distinct points of view, the legislative and the scientific. 

 The legislatoi may say, and perhaps with justice, that the 

 production of such a measure as the Act of which I now 

 speak is as much as can hi done. The man of science 

 may say that this is childish talk, that much more requires 

 to be done, and that after all that which has been done, 

 though it be comparatively great, is practically imperfect 

 and very little. Science in this respect is always in 

 advance of legislation, and that is her true place,— the 

 pioneer's place. I remember the time perfectly when every 

 fragment of the Public Health Act of 1875 was in the 

 hands of men of science solely, and was called a chimera, 

 over which great lawgivers shook their wise heads and 

 passed by. 



At this moment the positions of science and legislation 

 are relatively the same as they have ever been, and it is 

 fair for us men of science now as in the past time to de- 

 clare the way ahead for the law-maker. 1 shall proceed 

 again, therefore, as I have often before, to indicate one 

 or two new starts in sanitary legislation, not from 

 the legislative but from the purely scientific poiat of 

 view, uninfluenced by the many and vehement individual 

 grievances and troubles which beset the path of the 

 minister of state. In so doing I shall indicate also, by 

 inference, what I think our society ought to support in 

 the sanitary policy of the future. 



In the first place, then, we ought to expect in the political 

 progress of sanitation that there will be established in con- 

 nection with the Government one central department in 

 which every subject, directly and even indirectly, con- 

 nected with the health of the people, will be considered. 

 Tnis department, it is to be hoped, will be under the 

 control of a Cabinet Minister, and will supervise the sani- 

 tary work performed at present by the Local Government 

 Board, the Registrar- General's department, the sanitary 

 regulations of jails and reformatories, and all the duties 

 now pertaining to the supervision of factories, in so far as 

 the health of the employed is concerned: in fine, every 

 sanitary work that can be weeded out of every other 

 department of the state. 



To such a central board or department a specific name 

 is necessary. The name should be as distinct as that of 

 the department for war, for the navy, for the exchequer, 

 or for the post-office. The name, it is to be hoped, will be 

 emphatically the Health Department, and the chief of it 

 the Minister of Health. 



It may be urged that substantially we are drifting into 

 some such order as is here suggested. It may be urged 

 that the Local Government Board is step by step assum- 

 ing the duties assigned, as above, for the State Depart- 

 ment of Health. To some extent this is true, and it might 

 be advisable, for the sake of the connection which must 



