h S^K 
 
 THE WORK 
 
 STATE BOARD OF HEALTH: 
 
 THE ANNUAL ADDRESS FOR 1878, 
 
 R. O. EEDZIE, M. D. ; 
 
 PRESIDENT OF THE BOARD. 
 
 [ Reprinted from the Sixth annua,. Report of the Miohigan State Board of 
 Health for the Year 1878.] 
 
 [Reprint JN"o. 36.] 
 
 ■V ' • i 
 
 KSjsijf 
 
 BY AUTHORITY. 
 
 
 LANSING, MICH.: 
 
 W. S. George & Co., State Printers and Binders. 
 
 18 78 . 
 
 
 • ■ • 
 
 
UNIVERSITY OF ILLINOIS 
 LIBRARY 
 
 Class Book Volume 
 
 Ja 09-20M 
 
THE WORK OF THE STATE BOARD OF HEALTH: 
 
 THE ANNUAL ADDRESS FOR 1878, 
 
 By R. C. KEDZIE, M. D., 
 
 PRESIDENT OF THE BOARD. 
 
 [Reprinted from the Sixth Annual Report of the Michigan State Board of Health, 
 
 for the year 1878. ] 
 
Digitized by the Internet Archive 
 in 2017 with funding from 
 
 University of Illinois Urbana-Champaign Alternates 
 
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 https://archive.org/details/theworkofstateboOOkedz 
 
THE WORK OF THE STATE BOARD OF 
 
 HEALTH. 
 
 The rules of the State Board of Health make it the duty of the president to 
 deliver an address to the Board at the annual meeting in April each year. In 
 the discharge of this duty it seems to me that it might be desirable to take a 
 retrospect of the work performed by the Board, in order to consider what sub- 
 jects in the immediate future demand the attention of the Board. 
 
 The State Board of Health has been in existence for five years. At the time 
 of its organization a great variety of subjects commanded your immediate 
 attention. As Adam and Eve, when they removed into a very new country, 
 found 
 
 The world was all before them where to choose 
 Their place of rest; 
 
 So the Board found the largest liberty of choice of what to do, because 
 everything was yet to be done. The nature and scope of the work of the 
 Board had indeed been blocked out in the organic law ; but the specialties of 
 that work, and even the methods and instrumentalities for carrying them out 
 had to be devised and set in motion. 
 
 The first effort of the Board was to reduce to system the work of the mem- 
 bers of the Board, by appointing a number of standing committees on the 
 general topics which would come before them for consideration. In this way 
 each member was assignee^ to some field of inquiry and investigation most con- 
 genial to his habits and tastes ; at the same time the field of state medicine 
 was, to a certain exteut, mapped out into distinct departments. This general 
 plan of dividing up the work of the Board among a number of standing com- 
 mittees has been so successful in its working that every State Board of Health 
 subsequently organized in this country has followed our example in this 
 respect. 
 
 The second step of the Board was to organize the sanitary forces throughout 
 the State by securing well organized and effective Boards of Health, wherever 
 such Boards were not in existence, in all the cities, villages, and townships in 
 our State, with an active health officer in each Board; and then to bring the 
 State Board of Health into communication and active cooperation with all 
 these local Boards of Health. Two prominent objects were to be secured by 
 this means : (1.) To have an effective channel for imparting information to 
 the people in a form which would most successfully reach the masses, by being 
 placed in the hands of those who could appreciate and would use the informa- 
 tion; (2.) To have organized bodies through which the statistics in regard to 
 public health could be gathered from all parts of the State. 
 
4 
 
 STATE BOARD OF HEALTH-REPORT OF SECRETARY, 1878. 
 
 The third step of the Board was to enlist in the peculiar work of the Board 
 all the physicians of the State and all other persons interested in sanitary 
 matters. A corps of special correspondents was also secured in many promi- 
 nent points in the State to gather more complete information on any subject 
 relating to the public health. 
 
 The Board has sought to work through all these bodies and organizations 
 for the advancement of the public health. Circulars giving information of 
 great value, especially in regard to the prevention of disease, have been issued 
 from time to time and sent to all local Boards of Health in the State, to local 
 correspondents, and all others who seek to promote the public health ; circu- 
 lars asking for information on a variety of topics have been sent to the same 
 Boards and persons. 
 
 These efforts both to impart information and to gather statistics bearing on 
 the public health have met with gratifying success. Not only sanitarians but 
 the people at large are grasping that very important and revolutionary idea, the 
 possibility of the prevention of sickness and death , that many diseases may be 
 prevented altogether, or that, when they do appear, they may as certainly be 
 stamped out as a forest fire may be extinguished, or they may be walled in like 
 an inundation. A people that fully grasps the idea that half of their sickness 
 and half of their deaths may be prevented or avoided as truly and as really as 
 they may prevent the destruction of their crops by cattle, by proper fencing, 
 has taken a long stride in state medicine. The idea is germinal and will 
 spring up in “ trees of life whose leaves are for the healing of the nations;” 
 for when men clearly see that they may honestly repudiate half the claims of 
 sickness and death, they will soon learn to use the means for their own protec- 
 tion. That old cynic was right when he exclaimed “ Skin for skin ; yea, all 
 a man hath will he give for his life.” But the people need to clearly appre- 
 hend, and to fully comprehend one additional fact, that each person is in the 
 broadest and fullest sense healthy and safe only as every person about him is 
 also healthy and safe. The starved and neglected prisoner in jail or in work- 
 house, the despised or forgotten pauper in filthy hovel or wayside ditch, may 
 vindicate their claim to our common humanity by making us heirs of all they 
 possess, bequeathing to us the very diseases which destroyed them. Rowland 
 Jenkes in the ill-kept and over-crowded Oxford jail, reeking with malignant 
 typhus, when arraigned at the Oxford Assize, vindicated before that haughty 
 court his claim to a common humanity by infecting judge and jury, lawyers, 
 witnesses, and spectators with the dreadful fever contracted in their neglected 
 and suffocating jail ; for the whole court speedily died by this same fever, 
 which spread through that city and the surrounding country till five hundred 
 persons perished within six weeks with the fever imparted by this single pris- 
 oner. No wonder they called it “the black death,” and that this court should 
 go down in history as “ the black assize of Oxford.” 
 
 The lesson that society is an organic whole, and that “if one member suf- 
 fers all the members suffer with it,” the people are slow to learn. It was a 
 murderer (and to conceal his murder) that first asked, “ Am I my brother’s 
 keeper?” The spirit of that inquiry is in direct opposition to the cardinal prin- 
 ciple of state medicine, that each man is safely kept only as he safely 
 keeps his brother. This is a simple lesson, but hard to learn, and still 
 harder to remember. When it is well mastered and universally applied, the 
 problems of state medicine will be greatly simplified. 
 
 The Board has also begun to gather reports of the prevailing diseases, for 
 purposes of comparison and study. The reports required by law for the collec- 
 
THE WOEK OF THE BOAED— PKESIDENT’S ADDEESS. 
 
 5 
 
 tion of vital statistics relate only to births, marriages, and deaths; and in 
 regard to the latter, no return is required except ‘‘the disease or apparent 
 cause of death,” no account being taken of the remote causes of death, or of 
 diseases which did not terminate fatally. It was a grand idea to pluck from 
 the laurels of death a balm of healing, by thus comparing and studying the 
 immediate causes of death. But if benefit is secured by investigation in so 
 narrow a field, how much more would we be benefited by a study of the entire 
 records of sickness of the people, the causes, concomitants, tendencies both 
 immediate and remote, — the whole subject being studied both in regard to the 
 causes of sickness and in relation to the prevention of the same. State medi- 
 cine will never have reached its proper development till the social statistician, 
 by means of returns which shall embrace all the diseases and known causes of 
 such diseases, as well as the deaths and known causes of the same, shall be 
 able clearly to point out how these remote causes have influenced and modified 
 the immediate causes of death. This is a vast field, and it requires a broad 
 grasp of mind to equate all the terms of so complex a problem. 
 
 The Board has also begun to gather data which shall exhibit the physical 
 conditions, in this State, relating to health and disease, — the water-supply, the 
 forest-growth, drainage, natural and artificial, temperature, rainfall, etc. A 
 small but well distributed corps of meteorological observers give hope of valua- 
 ble results in the near future. These physical conditions, which more or less 
 directly influence the public health, are so wide-spread in their action, affecting 
 the entire, population of a district or even a State, as to demand careful consid- 
 eration and investigation at your hands. 
 
 I have thus briefly passed in review some of the means by which the Board 
 in its collective capacity has attempted to promote the public health and to 
 discharge the obligations laid upon it when the law decreed that “The State 
 Board of Health shall have the general supervision of the interests of the 
 health and life of the citizens of this State.” No more solemn charge was 
 ever laid upon a body of men by our legislators, and the Board has not been 
 unmindful of what the State demands at its hands. 
 
 Of the labors of the individual members of the Board I need say little, for 
 these speak for themselves. By laborious and pains-taking investigations into the 
 causes of sickness, the conditions involving insecurity to life and health, and by 
 pointing out the way in which health may be more certain and life more secure, 
 you have toiled on, often without appreciation or thanks from the very persons 
 most benefited; and the Reports of your Secretary, from year to year, bear 
 witness to the faithfulness and thoroughness of your work. I do not recall 
 these things in any spirit of flattery: “So likewise ye, when ye shall have 
 done all these things which are commanded you, say. We are unprofitable 
 servants: we have done that which was our duty to do.” A man is in poor 
 business when he is bragging of having done his duty, and none of us will 
 claim to have done more than our duty on this Board. But I have cast a hasty 
 glance over some of the fields in which the Board has wrought, for the purpose 
 of bringing more clearly before you this inquiry, What subjects in the immedi- 
 ate future demand the consideration of this Board ? 
 
 I do not propose to bring before you all the subjects which might properly 
 engage your attention, but to call up some matters which 1 believe may well 
 command consideration at your hands at this time, or in the immediate future. 
 
 I. — STANDARD WORKS ON HYGIENE FOR PUBLIC SCHOOLS. 
 
 The law says, “They shall from time to time recommend standard works 
 
6 STATE BOARD OF HEALTH— RE PORT OF SECRETARY, 1878. 
 
 on the subject of hygiene for the use of the schools of the State.” So far 
 from doing this “ from time to time,” vve have not done it once. It seems to 
 me that the imperative declaration of the law should be obeyed — unless obe- 
 dience is impossible. The Secretary has been accumulating works on hygiene 
 in our library, and it may be found that some of these are standard works fit 
 to be used in the public schools. It may be found on examination that none 
 of these works are of such a kind as to be well adapted for use in the schools. 
 If this is the difficulty in the way of obeying the law, let us frankly say so 
 and vindicate our law-abiding character. By pointing out the want of such a 
 work on hygiene for use in common schools, we may possibly stir up some one 
 to prepare such a work, and thus aid the cause we all have at heart. I recom- 
 mend that this portion of the organic law be referred to a committee to report 
 to this Board at an early date, either by recommending standard works on Hy- 
 giene, or by pointing out the inability of the Board to comply with the law. 
 
 II. — UTILIZING ACQUIRED MATERIAL. 
 
 Whenever information on subjects related to the public health has accumu- 
 lated in such quantity that valuable results may be drawn from the study of 
 the same, such results should early be given to the people. I emphasize the 
 early publication, because of the temptation to hold back such results on the 
 plea that the observations are still incomplete ; but from the nature of the 
 case such observations will forever remain incomplete. This is especially true 
 in reference to observations on the physical conditions that influence the public 
 health. It is said, for example, that the mean temperature of a place cannot 
 be determined short of 25 years’ observations, and even then it is not absolute 
 but approximate. Shall we therefore make no attempt year by year to find 
 the mean temperature of a place? The questions of health and life are not 
 bounded and fixed by lines of mathematical precision ; they fluctuate with the 
 lines of approximate truths. I do not suppose that in attempting to garner 
 some grain from these fields of physical inquiry we shall at once reap a rich 
 harvest, nor that, as in tropical groves the shaken tree drops alike the golden 
 orange and the fragrant flower into the outstretched hand, we shall gather the 
 fruits and flowers of knowledge without toil or weary effort ; but rather shall 
 we gain the golden grains of truth as the miner, who washes away a mountain 
 of concealing dirt to gather the little heap of precious glittering dust. 
 
 While fully aware how liable we are to run into error by deductions from too 
 limited observations, I yet urge that some effort should be made to utilize these 
 records, even though the results could only be regarded as tentative. He that 
 soonest uses information will soonest acquire additional information. Nothing 
 is more discouraging to an observer than to see no results issuing from the 
 observations of many years. I have taken and forwarded to the Smithsonian 
 Institution meteorological observations for the last 15 years without seeing that 
 any use was made of them. I have reduced these observations to tabular form 
 and published them for 15 years, with the settled conviction that not a score of 
 men in our State have ever looked at these records or made the least use 
 of them. From my own experience, therefore, I am convinced that an 
 observer needs either great enthusiasm in his calling, or else some appreciative 
 use of his work, to continue his pains-taking observations year after year. 
 
 We have a small corps of observers of the meteorology of our State, embrac- 
 ing the daily temperature, moisture, barometric pressure, atmospheric ozone, 
 the rain-fall, cloudiness, etc. These report monthly. We have another body 
 of observers who send in weekly reports of the prevailing diseases of their 
 
THE WORK OF THE BOARD— PRESIDENT’S ADDRESS. 
 
 7 
 
 several localities. What relation do these reports of the medical and meteoro- 
 logical observers bear to each other? Is there any causal element in the 
 meteorological conditions which produces effects in the sanitary conditions? 
 We shall undoubtedly find that the curves of temperature have a marked con- 
 trol over certain diseases, that a sharp rise of temperature increases diseases of 
 the digestive system, while a rapid fall of the temperature increases diseases of 
 the respiratory system. Statistics from many lands would lead us to expect 
 this in our land. But let us not be content with this meagre result, let us push 
 on to see if other causal relations may not be discovered. What influence has 
 the presence or absence of atmospheric moisture on diseases of the respiratory, 
 circulatory, or nervous systems? Is there any relation between the presence or 
 absence of atmospheric ozone and the prevalence or absence of any disease? 
 Does the amount of cloudiness have any influence on diseases of the nervous 
 system? Do the barometric fluctuations have any effect on the circulatory and 
 nervous systems? 
 
 These are some of the questions I hope to see brought before us by the com- 
 bined study of our meteorological reports and of the weekly reports of prevail- 
 ing diseases. I am not sanguine that the results will be apparent at first 
 inspection, or that we shall reach any results without prolonged and careful 
 study, even if we shall ever be able to satisfy ourselves on all these questions. 
 But I am convinced that if the relations of these climatic conditions to the 
 public health are ever determined, it will be by the combined study of meteoro- 
 logical conditions and the prevailing diseases, rather than by comparison of 
 meteorological conditions with the mortuary records. A wider scope must be 
 given to the study of vital statistics before results of the highest value are 
 reached. I am glad to know that our hard-working Secretary has a part of 
 this work already in hand. 
 
 I wish to see the meteorological reports combined with the vital statistics of 
 all localities in our State as soon as practicable, for the reason that if these 
 records accumulate year after year without any effort to use them, they soon 
 become a mountain of rubbish, an incubus rather than an inspiration. 
 
 III. — VITAL STATISTICS. 
 
 In defining the duties of the Board, the law says: “They shall especially 
 study the vital statistics of this State, and endeavor to make intelligent use of 
 the collected records of deaths and of sickness among the people.” State 
 medicine has its foundation in the vital statistics of a people : the tripod 
 from which the oracles of sanitary science are uttered, rests on the three-fold 
 record of births, marriages, and deaths. It becomes, therefore, a matter of 
 necessity, as well as a requirement of the law, that we should study these 
 records, if we would promote the health and safety of the people. 
 
 The first and indispensable quality of statistics is accuracy. If the records 
 upon which the vital statistics are founded are notoriously imperfect and inac- 
 curate, the deductions drawn from such records will be proportionally unrelia- 
 ble, if not actually misleading. The causes of this inaccuracy inhere in the 
 present mode of collecting the returns of births, marriages, and deaths. 
 These have been brought to the attention of the Legislature, but without se- 
 curing such changes in the law as seem necessary to secure full and reliable 
 returns. By a few changes in the law, these returns could be made much 
 more accurate, the work of compiling and editing the returns would be simpli- 
 fied, the vital statistics would be more valuable in themselves, and could be 
 much earlier given to the public, — results very desirable to secure. 
 
8 
 
 STATE BOARD OF HEALTH— REPORT OF SECRETARY, 1878. 
 
 I recommend that the Committee on Legislation in the Interests of Public 
 Health, and the Secretary, who is by law the Superintendent of Vital Statis- 
 tics, be appointed a committee to prepare a bill which shall embody the changes 
 required in the present law, and to bring this subject before the next Legislature. 
 
 IV. — GENERAL CIRCULAR ON DISINFECTION. 
 
 One of the principal duties involved in “the general supervision of the in- 
 terests of the health and life of the citizens,” is to guard against the dangers 
 of self -propagating diseases, or to prevent the spread of such diseases when 
 they occur. One of the most important agencies in this latter work is the 
 destruction of the communicable property of such diseases inhering in the 
 dwellings, clothing, etc., of persons attacked by the disease. This requires 
 the use of disinfectants. But the methods and uses of disinfection are so 
 similar, whatever may be the self -propagating disease, that it seems to me that 
 a general circular, giving full directions and precise instruction in regard to 
 the methods of disinfection to be employed in every self-propagating disease, 
 should be prepared and issued by this Board. It seems to me that the whole 
 subject of disinfection could thus be treated more satisfactorily than by repeat- 
 ing these directions over and over again with every circular issued in regard to 
 contagious diseases. 
 
 V. — PRESERVATION AND PREPARATION OF FOOD. 
 
 “What shall we eat, and what shall we drink,” are questions daily recurring 
 in every household in the State. These questions do not come up mainly with 
 reference to the gratification of the sense of taste : the health, the mental 
 activity, and the effective force of the people depend very largely upon the 
 food they eat. I am well aware that some persons regard it as gross and 
 sensual to intimate that intellectual and moral activity bear any relation to 
 so material things as beef and bread ; but we may safely dismiss all sublimated 
 nonsense about “the soul living above the body.” The law of the conserva- 
 tion of energy shows that force can be evoked only by the conversion of some 
 other form of force. The soul can live above the body only by living out of 
 the body, and over that condition of existence the State Board of Health does 
 not have “the general supervision.” 
 
 America is the land of abundance ; no other nation in all history has been 
 more bountifully supplied with food-materials. Probably no other nationality 
 has such rich provisions and such poor food as Americans. In my opinion, 
 the question of food and its preparation for human use has more vital relation 
 to the health and welfare of our people than all other physical causes com- 
 bined. Leaving out of consideration the necessity of food to sustain life, badly 
 cooked and ill -digested food is the cause of more ill-health, waste of time, loss 
 of effective labor, whether muscular or mental, than all the combined diseases 
 of adult life. The question of food relates to every-day life, while sickness 
 pertains to exceptional periods in the life of our people. Errors in diet become 
 the direct or remote cause of a great many diseases of the nervous and the cir- 
 culatory, as well as of the digestive system ; and they intensify the activity of 
 many diseases which they do not cause. If our people could be taught to pre- 
 serve and to prepare their food so as to secure the best dietetic results, prevent- 
 ive medicine would have won a grand victory. It could no longer be said that 
 our appropriate monument would be a frying-pan , and our epitaph, Saleratus! 
 
 What the people need is not a cook-book, calcimined with French names till 
 a plain man after ordering a dish is in doubt whether he shall receive a boiled 
 
THE WORK OF THE BOARD— PRESIDENT’S ADDRESS. 
 
 9 
 
 egg or a pickled frog. I think our food would digest just as well, if it was 
 eaten in English. What is wanted is a tract which shall state the principles 
 and methods of preserving food-materials so as to suffer the least change or loss 
 of nutritive and digestive qualities ; and the principles and processes by which 
 such materials are converted into wholesome, palatable, and digestible food. 
 
 It is much easier to point out a want than to supply the want, and perhaps 
 we may wait some time before such a tract will be prepared for the use of our 
 people ; but if we can push our preventive measures back even of the formative 
 stages of disease, we shall do much toward securing a condition of general if 
 not of universal health for our people. 
 
 VI. — SANITARY SURVEY OF THE STATE. 
 
 I call your attention to the necessity of a sanitary survey of the State at an 
 early date, with some hesitation, because it is too great a work for the Board 
 to undertake unassisted, and especially without an appropriation of money by 
 the Legislature to defray the necessary expenses of such a survey. Yet this is 
 a work in which the Board is deeply interested, and it is a work which must 
 be done before the highest interests of the State, in a sanitary point of view, 
 are subserved. Take the one subject of the relation of water to the public 
 health : in a State where the public surveys designate about one-ninth the 
 land surface as swamp, with innumerable small lakes and a very large number 
 of small streams and rivers of moderate size penetrating the interior in all 
 directions, none of them so large that they may not readily be obstructed by 
 dams, bearing in mind that while swiftly running streams and deep lakes with 
 banks free from marsh are agents of health, but that stagnant swamps and 
 sluggish streams, whether the retarded current is natural or caused by artificial 
 obstructions, are agents of disease, and that such sluggish streams may be 
 needlessly formed in the midst of cities and villages, when by a little fore- 
 thought they might have been kept at a safe distance from centres of dense 
 population, — we begin to see how much benefit a sanitary survey may confer 
 upon the whole people of our State. But to secure the greatest public benefit 
 with the least private loss, it is necessary that this sanitary survey should be 
 made before capital is invested extensively in works which from their nature or 
 position must prove detrimental to the public health. For instance, it has 
 been quite common in this State to build milldams in such positions that the 
 health of a large part of the community soon requires the removal of the 
 dam ; then arises costly litigation, which if unsuccessful, leaves the nuisance 
 unabated, and if successful causes the waste of property by destroying the 
 mill. How much better to have it determined with reference to the public 
 health where a mill may or may not be built. 
 
 The drainage of swamps, which has been undertaken solely for the reclama- 
 tion of soil otherwise incapable of cultivation, has yet benefited the public 
 health to such an extent as to have paid in money value on this score alone all 
 that the drainage ever cost. If so much benefit to the public health has been 
 secured by drainage undertaken solely for agricultural reasons, may not still 
 greater benefit to the public health be secured by drainage undertaken for san- 
 itary reasons? 
 
 The subject of the pollution of streams by sewage is a question of great im- 
 portance in reference to the public health ; but it is one that must be considered 
 .and settled before sewer systems become practically beyond control on account 
 of the large outlay of money necessary to effect a change. The inertia of cities 
 2 
 
30 STATE BOAEI) OF HEALTH— RE POET OF SECRETARY, 1878. 
 
 and corporations on such subjects, when any radical change involves the throw- 
 ing away of the large sums already invested and the expenditure of still larger 
 sums in new systems, and all for so intangible and impersonal a matter as the 
 public health, will prove an impassable barrier to desirable changes in the 
 future. Detroit adopted a sewer system by which the sewage of the whole city 
 was poured into the Detroit River. When anything was said about the contam- 
 ination of the river-water, and that this water would become unfit for use by 
 those living on the banks of the river below the city, the reply was ready that 
 it was not possible to pollute such a mass of water by any amount of sewage. 
 But the country above Detroit is becoming thickly settled ; large villages dot 
 the river bank, and manufactories of various kinds are springing up along the 
 river ; and the sewage from all these is poured into the river from which Detroit 
 draws its water-supply. Just now there is no little excitement in the City of 
 the Straits concerning contaminated water, and the fear is expressed that when 
 the population along the river above Detroit becomes greatly increased the 
 water of Detroit River will be unfit for domestic and potable use. 
 
 A similar trouble may yet vex the people of Lansing. The Grand River 
 flows from Jackson through Lansing: this stream receives a certain amount of 
 sewage from Jackson and this polluting material is reinforced as the stream 
 flows past the State Prison, where the night-buckets of all the prisoners are 
 emptied into a sewer which at once discharges the excreta of nearly 1,000 men 
 into Grand River. I can see no necessity of this pollution of the river, for all 
 this excremental matter might be sold to farmers for manure and removed 
 without any expense to the Prison authorities. 
 
 Other proofs that a systematic pollution of our rivers has already been begun 
 in our State might be brought forward, but they are not necessary ; for any 
 one can easily see that these evils will come in with an increase of our popula- 
 tion, unless they are excluded by timely precaution on the part of the public 
 authorities. The evil can be successfully resisted or averted only by early and 
 combined opposition. Resist the beginnings of evil is the demand of sani- 
 tary science on this subject. But some system of sewerage must be introduced 
 and some means of disposing of sewage must be devised, on account of the de- 
 mands of increasing population. These considerations tell strongly in favor of 
 an early sanitary survey of the State. 
 
 The Rivers’ Pollution Commission of England and the Committee of the 
 State Board of Health of Massachusetts to “investigate the question of the 
 use of running streams as common sewers in its relation to public health,” 
 show that such efforts to preserve the streams as rivers of life, are no novelty 
 in this age. We are laying the foundations of a mighty empire, and its 
 corner-stone should be public health. 
 
 A sanitary survey will cost money. I know the people hesitate about voting 
 monev for such intangible objects as they consider sanitary matters to be ; but 
 nothing is so ecomical as health , and nothing so wasteful as sichiess : a true 
 economv will freely expend money to secure health. 
 
 VII. — SANITARY CONVENTIONS. 
 
 With a good deal of doubt and hesitation, I bring one more subject before 
 you ; namely, the holding of sanitary conventions, or meetings in different 
 parts of the State, to consider and discuss sanitary matters. At these meet- 
 ing papers shall be read by members of the Board, and others who are desirous 
 of promoting the public health, — the papers to present in popular form the 
 
THE WORK OF THE BOARD— PRESIDENT’S ADDRESS. 
 
 11 
 
 more salient points of sanitary science ; the discussions following each paper 
 to be open, under proper restrictions as to time and question, to every person 
 who either has information to impart, or who desires to gain information on 
 the subject under discussion. 
 
 I hesitate in presenting the subject of sanitary conventions, for three reasons : 
 
 1. They are an untried experiment. I know we have the American Public 
 Health Association in which men who have made a special study of sanitary 
 science read papers and discuss subjects relating to the public health. While 
 recognizing the great value of these papers' and the excellence of the work done 
 by the American Public Health Association, I only insist that these Sanitary 
 Conventions occupy a different ground, in that the sanitary laity are repre- 
 sented, both in the papers and discussions, and the work is not confined to' 
 those who have made such matters their principal study. It may be said 
 
 •that the effort to popularize sanitary matters and to bring them down to the 
 comprehension of the masses, — to make these topics such every-day and com- 
 mon-place affairs as that they shall enter into the daily thought and conversa- 
 tion of the common people to such an extent that their daily lives shall be 
 modified and improved thereby — will be to degrade science and profane her 
 mysteries. True science is never debased by contact with those it was sent to- 
 bless and save ; and for one, I should be glad to see the day when these ques- 
 tions that lay hold on life shall be as freely discussed by the laity as they are- 
 now by thfe experts in sanitary science, 
 
 2. They will throw a large amount of work upon the members of the Board, 
 and will make no inconsiderable demand upon their time. But unless all the 
 members of the Board will give to these Sanitary Conventions all the labor 
 and all the time their successful prosecution will demand, it will be useless to- 
 inaugurate the system. Knowing how much of labor and of time is now given 
 to the public by members of the Board, I hesitate to ask of them still greater 
 sacrifices of the same kind. For all such labors, the sense of benefits confer- 
 red upon the whole people must be its “own exceeding great reward;” for the 
 State has no other that it will offer you. 
 
 3. These meetings may prove a failure from want of public interest in these 
 subjects, or because we fail to properly present the facts and principles of san- 
 itary science. 
 
 These are some of the considerations which would lead us to hesitate about 
 attempting the untried experiment of holding such meetings. 
 
 On the other hand there are certain possible if not probable advantages which 
 might be secured by such means. 
 
 1. We may in this way interest the people in sanitary work. I fear the work 
 of the Board never really reaches the mass of the people. Six thousand Reports 
 indeed are printed and distributed every year, but among a population of 
 1,500,000 this would be one copy for every 250 persons. But even of those 
 who receive a copy of the Report, I fear that but few read it and master its 
 contents. Somehow the people have learned to look upon “Pub. Doc’s” as- 
 literary lumber , well adapted to fill an aching void on the library shelves, good 
 to keep, and good for naught else. From the Patent Office Reports of the 
 general government down through the documents “ By Authority ” of State 
 governments, the public seem to regard them as official offscourings. But the 
 State Board of Health that only reaches and influences the few, and comes short 
 of benefiting the mass, fails of its duty: it is “the interests of the health and 
 life ” of the people that we are set to guard. I do not think this end could be’ 
 
12 
 
 STATE BOARD OF HEALTH-REPORT OF SECRETARY, 1878. 
 
 secured by merely issuing an increased number of copies of our Report. Cer- 
 tainly we could not ask the government to print a copy of the Report for every 
 individual or even every family. There are other ways by which to reach the 
 public ear, and one is by the public press. The State Board of Health needs 
 recruits to win victories in sanitary science in every hamlet in our State ; but 
 no recruits from other quarters can equal in wide-spread influence the ubiqui- 
 tous secular press. Just so far as we bring sanitary matters into popular form 
 suited for publication in newspapers, I have found the press of this State eager 
 to place them before their readers. By the public press we may reach every 
 hamlet, aye, every household in our State. 
 
 2. We may in this way not only interest the people in our work, but induce 
 them to practically apply the sanitary principles already brought out in our 
 Reports and circulars. There is in every people a social inertia, a disposition 
 to let things alone, a conservatism which regards everything as “good enough, 
 well enough, time enough/’ which is the enemy of all progress. But if we can 
 show the people that the dangers from the neglect of sanitary precautions — 
 from the use of low-grade kerosene, of unventilated rooms, foul cellars, con- 
 taminated wells, ill-kept privies, from contagious diseases, etc. — are not 
 distant and fanciful dangers, but that they threaten them now and in their 
 very homes, that they walk by their side or dog their footsteps wherever they 
 go, we shall break up this apathy and cause people to act, 
 
 Act in the living present , 
 
 Heart within and God o’erhead! 
 
 3. Another benefit from holding sanitary conventions will be that we shall 
 secure the active cooperation of physicians and others interested in sanitary 
 matters. We may hope to secure papers of great value from this class, which 
 will add to the value of our Report. By securing the assistance of sanitarians 
 in the convention, we shall also secure their aid out of the convention in all 
 sanitary matters in their vicinity. The sanitary convention will thus react 
 upon the public, setting many persons at work in different localities in the 
 promotion of sanitary reforms. 
 
 By mingling with sanitarians in different places we shall best learn what 
 work immediately requires to be done to promote the public health. 
 
 4. Another benefit which may be secured by these sanitary conventions is to 
 exhibit and illustrate sanitary appliances, and to make the people practically 
 .acquainted with those that are now in use. Many sanitary appliances of much 
 value confer but little benefit upon the public, because they are unknown and 
 hence unused. No suitable means are now offered by which people may become 
 familiar with the nature, kinds, and uses of devices designed to secure condi- 
 tions of both health and comfort. Nor have the inventor and the manufac- 
 turer of sanitary appliances any direct means of bringing them to the notice 
 of the people. At our agricultural fairs the inventor and the manufacturer of 
 labor-saving machinery of every kind find a ready means to bring their imple- 
 ments to the notice of the public : the farmers also find there an opportunity 
 to see the machinery, see it work, and how it works ; to compare one machine 
 with a competing machine, learn the price, where it can be bought, etc. In 
 the same manner, let us bring the manufacturer of sanitary apparatus and the 
 health-lover and health -preserver together, to the mutual benefit and enlight- 
 enment of both. Let us make the sanitary convention a sanitary fair, where 
 may be exhibited every kind of appliance which directly or indirectly promotes 
 
THE WORK OF THE BOARD— PRESIDENT’S ADDESS. 
 
 13 
 
 the health and well-being of the people. I would not restrict the exhibition to 
 sewer pipes, ventilating cowls, and nose-skinning disinfectants. A good cook- 
 stove is eminently a sanitary appliance ; an improved sauce-pan or soup-kettle, 
 a better can for preserving fresh fruit, a better lamp for saving our eye-sight, 
 are each and all sanitary instruments. In short, any thing which will give us 
 better food, purer air and water, cleanfer clothes, sweeter and more restful 
 sleep, is a sanitary appliance. The danger is that we shall make the field of 
 our exhibit of sanitary appliances too narrow, instead of too broad. 
 
 5. Finally, in carrying out any sanitary reform, we need and must have the 
 aid of the women of our State. When I make this statement, do not hastily 
 suppose that I add my voice to the crowd who are shrieking for “woman’s 
 rights.” I do not believe that our political and social evils are to be expiated 
 by immediately putting forward woman as the sacrificial victim, following the 
 example of Minos who exposed the Athenian virgins to be devoured by the 
 Minotaur. Do not suppose that I advocate any such change in the constitu- 
 tion of this Board as will place representatives of the female sex among our 
 number. I do not suppose that the efficiency of our Board or the success of 
 our work would be promoted by such a change. But there are other fields 
 where not one or two, but all the women of our State may aid this work. 
 Whether we regard the objects of sanitary science as the removal of the cause 
 and limiting the spread of diseases, or as the improvement of the physical con- 
 dition of the people, in either work we need woman’s helping hand. Woman 
 makes the home, for her life is there ; and the appliances and conditions of 
 comfortable living come from her plastic hand. Except in his sleeping hours, 
 man spends but a small fraction of his time in the house : he merely contrib- 
 utes, in their crude form, the materials for the family support, while it is the 
 deft hand of woman that transmutes these dead materials into the family 
 living. 
 
 In the introduction of most sanitary reforms among the people, we must rely 
 upon the active, hearty, and intelligent cooperation of woman. To secure this, 
 we need to awaken her interest in such reforms and cause her to comprehend 
 the nature, scope, and needs of such reform. All these can best be accom- 
 plished by the presentation of sanitary principles in popular form, which can 
 effectually be accomplished in these sanitary conventions. Whatever woman 
 may have to contribute to the stock of sanitary science can be appropriately 
 brought forward in these meetings, in which I should hope that women as well 
 as men would be encouraged to take an active part. 
 
 The work of a sanitary convention must be confined to sanitary work. All 
 questions of party politics, of denominational theology, and of curative medi- 
 cine must rigidly be excluded both from the papers and the discussions. The 
 field of preventive medicine and of the improvement of the physical condition 
 of the people is broad enough to consume the entire time and attention of a 
 sanitary convention. 
 
 Such are some of the features of a sanitary convention as the thing has 
 formed itself in my mind, and such are some of the considerations for and 
 against your undertaking such a work. Perhaps it is wild, visionary, and im- 
 practicable ; I do not ask you to adopt it at sight ; I hope you will not reject it 
 without consideration. The most I now ask of you is to appoint a committee, 
 of which I shall not be a member, to carefully consider the whole subject, and 
 report at some future meeting. 
 
 In all our plans for future effort we are not to forget that our work is advis- 
 
14 
 
 STATE BOARD OF HEALTH-REPORT OF SECRETARY, 1878. 
 
 ory, not mandatory. We command nobody but ourselves. In the legislative 
 discussions which preceded the organization of the Board it was objected that 
 the proposed Board would have no power to enforce its precepts, and hence 
 would be a harmless thunderbolt. But among a free people the surest if not 
 the quickest way to remove any great evil is to clearly point out the evil itself, its 
 extent, and its effects ; many interests, injured or at least threatened by the evil, 
 without concert silently place themselves in opposition ; a thousand eyes at 
 once are turned to the examination of this evil and its tendencies ; the social 
 forces and instincts rise up in serried ranks like the armed warriors which 
 leaped forth from bush and stone at the whistle of Roderick Dh'u ; that wonder- 
 ful and complex phenomenon which we name “a change in public opinion,” en- 
 sues, and the evil finds it must take itself out of the way, for it has no home amid 
 a hostile people. In this way the wrongs which threaten society in mass, right 
 themselves when brought to the bar of enlightened public opinion. Such rec- 
 tifications are the more permanent and abiding because they take place by the 
 action of natural laws, and not by the exercise of arbitrary authority. The 
 silent forces are the most powerful ; the noisy and loud-mouthed forces dissi- 
 pate half their energy in the very noise itself. The boom of the cannon is 
 brag but the silently whirling cannon-shot means business. Many persons 
 seem to feel a sort of contempt for the sunshine — “good and useful, but so 
 weak and powerless” — the strongest name by which they call it is “ the gentle 
 sunshine yet before the flashing lightning and rolling thunder the same 
 persons turn pale with awe “ because they are agents of such terrible power;” 
 whereas the sunlight exceeds in energy, a thousand fold, the lightning, and, 
 but for the hiding of the power of the sunlight, the lightning itself would die 
 still-born. 
 
 The office of this Board is not to convulse the community with lightning- 
 shock, but to let in the sunlight, which, “silent as the footfalls of time, yet 
 resistless as destiny,” shall mould and fashion the very conditions of life in our 
 State. 
 
 Agricultural College, April 3, 1878.