i86 



NATURE 



[Julys, 1877 



always exist between such a central board and the various 

 local boards, in the kingdom to add to the name of Health 

 Department that of Local Government Board. But for 

 the sanitary object the leading name must be Health, and 

 Local Government must come in merely as indicative of 

 the connections that exist between the State and the local 

 centres — as the machinery. 



In this question of progress there is involved an immense 

 deal in a name. It is essential to the scientific sanitary 

 teacher tliat every reasoning mind in the kingdom sliould 

 become familiar with the two significant words, pubhc 

 health, or national health. It is equally necessary to let 

 the people know fully that the Government has the health 

 of the country under its general and wise supervision. 

 But it is utterly impossible to make either of these facts 

 understood by the masses so long as any sanitary autho- 

 rity, central or local, has a title which fails to convey the 

 meaning of its functions. To speak to the masses who 

 are listening to a lecture or discourse on health about a 

 local government board is only to confuse tliem. They 

 ask you afterwards what it all means, and they go away 

 imbued with the impression that it means anything 

 except what relates to the health of the people. 



1 am speaking very practically in suggesting that in 

 the course of political sanitary progress it is an absolute 

 necessity for success to give its proper and only name to 

 the department of state which presides over the national 

 health. I do not state too much in declaring that every 

 public measure vk-ould carry more weight if it went forth 

 as being under the supervision of the health department. 

 It may appear a refinement of illustration, and yet 

 it is a sound argument that vaccination would have 

 met and would meet with far less opposition if it 

 were enforced under the general supervision of a State 

 department of health. As it is the people connect the 

 carrying out of vaccination with something other than 

 health, and even as distinct from the idea of conservation 

 of health. It is looked upon as a legal tyranny, having no 

 scientific setting forth of its intention, and as springing 

 from no scientific authority. If you attempt to reason 

 with its active opponents on the subject, and refer to the 

 authority that exists, they dispute the competency of the 

 authority in name and form ; and, foolish as the objection 

 may be, it is potent for obstruction. 



In making this suggestion there is no necessity to offer 

 a word agamst the continued action of local self-govern- 

 ment. The work of the local centres in all parts of the 

 kingdom instead of being in any degree curtailed and 

 restrained, should be encouraged and maintained. In 

 the sanitary local work the word health should, however, 

 again come forward as the one prominent designating 

 term to which all others should be subject. 



Our Sanitary Institute could not turn its attention to 

 any more suitable labour than that of inculcating the 

 necessity for the institution of one state department exclu- 

 sively devoted to the healtli of the people. In the success 

 attending such an efioit a double result would be achieved. 

 The country would have secured for it the best and most 

 direct guidance on iis most vital interest, and scope 

 would be given to the industry of men of science in a new 

 direction. Men, whose lives have been devoted to the 

 study of life and health, would be prepared by their devo- 

 tion for the accepted service of their country in public 

 form, and the Houses of Parliament would become, at 

 last, congenial spheres for their labours. The Houses 

 would be strengthened by such adhesions ; the men would 

 be more useful and honoured. 



Another work in the political line which will be 

 demanded in the future for the benefit of the sanitary 

 cause is the preparation of such a digest of all our prac- 

 tical sanitary laws that every person of intelligence can 

 read and understand what may be legally enforced for 

 the maintenance of health. What may be done in this 

 direction ought to be so simple and so plain as to be 



brought into a school-book. Not a line should be left 

 for the subtlety of the legal brain to twist into contor- 

 tioned illegibihty. The laws by which the health of a 

 man, and thereby of a nation, can be preserved to the 

 utmost, are so simple in nature that nothing but the utmost 

 simplicity can truly express them, and the whole labour of 

 the future, if it is to be of any service whatever, must be 

 directed to the discovery and establishment of such sim- 

 plicity of exposition and direction. Up to the present 

 time much that has been done has been provoked by that 

 most untrustworthy of all human provocadves to action, — 

 fear. Some great epidemic has occurred that has caused 

 universal dismay ; some great catastrophe has occurred, 

 like that of the Crimean campaign, which has excited 

 universal criticism on the failure of sanitary provisions 

 by the authorities of the nation. Some such slip has been 

 permitted in sanitary rule as that which recently let scurvy 

 undermine the workers during a great enterprise of dis- 

 covery. Straight ivay on the heels of such events there 

 have been commiisions of inquiry, and as a direct or in- 

 direct result there has often come forth some particular 

 enactment. Or — and this is by no means rare — some indi- 

 vidual of the House of Commons, impressed with the 

 danger of a great national evil, has pressed for a national 

 remedy, and, by steady persistence session after session, 

 and by showing that he never knows when he is beaten, 

 has forced the Government to take up his measure and to 

 carry it through. 



From these modes of legislating for health we have 

 obtained many minor acts which fill and refill the national 

 statute books. And still this process promises to go on, 

 a process of labour in a circle with much lo;s of time and 

 expenditure of force without ultimate progression. 



It would be vain to find fault with the past for its 

 doing.s. As vain to find fault with the State for meeting 

 State disorders by empirical remedies as it would be to 

 find fault with the physicians of a former day for the same 

 mode of procedure. If the people demand a recipe they 

 must have it, be it from the State or the family physician. 

 The question that now comes forward is vdiether the 

 time has not arrived for ceasing to treat the health of the 

 nation by specific or supposed specific remedies for par- 

 ticular errors, and whether we may not find in the future 

 a few veiy simple and natural guiding principles on which 

 all acts of ParHamen'. relating to the health of the people 

 may be based ? 



Before this effort can be attempted the existing acts 

 that .touch on health, — public health acts, metropolitan 

 health acts, contagious diseases acts, vaccination acts, 

 factory acts, acts relating to the importation of caitle, 

 adulteration acts, and others relating to prisons, work- 

 houses, and the like, and which, if they even lie latent are 

 not repealed, — these, one and all require to be considered 

 together, with the view of determining whether an Enulish 

 or even a British act of setilement for the vital regenera- 

 tion of the realm is not practicable on a simple natural 

 basis of natural requirement. 



I am fully aware that this suggestion carries with it the 

 idea of a gigantic labour ; but it will have to be done, and 

 once fairly tackled I dare say the apparent difficulties will 

 readily dissolve away. It is a mere question between 

 doubting and attempting : and we all know and feel that — 



" Oar doubts are traitors, 

 And make us lose the good we oft might win 

 By fearing to attempt." 



Supposing the existence of an efficient central depart- 

 ment of health acting under the direction of a minister ot 

 health, a grand new duty, as it seems to me, would be to 

 determine what is the evil or what are the evils that 

 have to be removed in order that the cleanest bills of 

 health may be regularly presented to the nation. With- 

 out such preliminary knowledge all sanitary work is 

 unsound to the last degree. It were as wise for me to 



