50 Sanitary Science in the United States : [January, 
popular sympathy and popular knowledge are running 
almost abreast of the science itself. The proper execution 
of sanitary laws demands the free and intelligent co-opera- 
tion of the individuals ; a system of enadtments, however 
skilfully framed and however supported by a strong central 
authority, alone will not suffice. Not only would it appear 
alien to the genius of our institutions, but also a mode ill- 
suited to attain its objedt, if a Health Department were 
added to the other departments of State at Washington. 
No one would deem it possible for such a department to 
legislate pure air, pure water, and pure food into use 
throughout the nation. On the contrary, it would appear 
far wiser to leave such legislation to each State, and in the 
State as far as possible to each community, recognising that 
the popular agitation and knowledge requisite to obtain 
health laws is the best guarantee that they shall not after- 
wards remain dead letters. What I have to say concerning 
the present and future of sanitary science is mostly the 
record of what such communities have already done, and of 
what ideas are already growing up in their midst, and which 
ere long will bear fruition in new laws and movements. 
I. Vital Statistics. 
We shall begin at the foundation-stones of exadt sanitary 
science — vital statistics. To appreciate the advance in this 
direction we have only to compare the condition of our great 
city, New York, at the beginning of this century with its 
present. At that time it had no registration even of deaths. 
The first “ Bill of Mortality,” as it was called, extended 
from November i, 1801, to January i, 1803 — fourteen 
months. So little accuracy in the nomenclature of diseases 
was thought of or expected, that in this report the people 
are said to have died of “flux,” “hives,” “putrid fever,” 
“ rash,” “ lingering illness ” (which certainly was not a rash 
performance), “ stoppage,” “ breaking out,” “ fits,” &c. 
The first reliable report was that made in the year 1866, 
after the organisation of the Metropolitan Board of Health. 
In the second annual report in 1867, the beneficent results 
of the institution of the Health Boar.d, and of the sanitary 
reforms executed under its superintendence, were shown by 
the fadl that 'there were 3152 less lives lost during the first 
year of its administration as compared with the preceding 
year. The report, moreover, showed that this gain had 
been mainly in the chances of life at the adult ages, and in 
the districts where the greatest amount of sanitary work 
