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From L. W. BUSH, M.D., member of the Section for Delaware.

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WILMINGTON, DEL., April 27, 1875.



I conceive the subject on which you propose to report of great consequence to our country, and to the cause of medical science.



Our State has not yet established a State Board of Health ; nor have any efforts been made to establish such a Board.



Very respectfully,


From C. B. NOTTINGHAM, M.D., member of the Section for Georgia.

Macon, March 2, 1875.

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1st. I most heartily approve of the policy of organizing a National Health Council, and believe it should be a separate and independent establishment free from all embarrassing political conditions and not subordinate or secondary to any other Bureau or Department of the Government. It should be composed of a Chief, a medical man, to be nominated by the President of the country and confirmed by the Senate, whose residence and office should be at the national capital, of a representative member of the Medical Corps of the Army, from the Medical Corps of the Navy, and from each of the State Boards of Health, all of whom should assemble in council at the City of Washington at least once a year, and continue in session until the business bringing them together shall have been disposed of. The paramount object of the organization and of the annual meetings should be the promotion of sanitary science by the examination, generalization, and elaboration of all the facts pertaining to vital statistics, hygienic laws, and the public health that are presented in reports or records of the State Boards of Health or in information obtained from other sources, and the dissemination of these facts by suitable publications to be distri. buted over the country and to the scientific world.

2d. As such a Council would, I apprehend, be dependent, in a great measure, for the material from which its usefulness would result, on the State Boards of Health, which would be its most constant, uniform, and reliable tributaries and feeders, its organiza. tion should be deferred until active and efficient Boards shall have been established in most of the States. Eight of the States, I



believe, already have created these Boards, and as a deep feeling of interest in what we term preventive medicine has been very generally awakened in the profession and to a considerable extent among the people and legislators throughout the country, the hope I think may be reasonably indulged that a sufficient number will in a few years wheel into line to warrant the National Association in memorializing Congress on the subject of creating a Central Council for the nation; as an independent Department, calculated to subserve the interests of science, to improve and better the con. dition of the population, and to reflect lasting honor on the nation. Any effort in that direction, if made at this time, should be made simply with the view of stimulating the formation of State Boards, and any act of Congress establishing a Council should at least provide against any meeting until a majority of the States shall bave organized such Boards as will annually send up valuable and instructive records. A Bureau subordinate to or connected with any other department of the government would be inadequate to the wants of the age, the requirements of the people, and unworthy the ambition of the great American Medical Profession. Such an organization probably would accomplish but little, if anything, more than is being already effected by the enlightened efforts of the Surgeon-General and the Department of the Interior, under the restrictions and with the limited means at their command.

3d. Georgia has established a “State Board of Health.” The fight was a hard one, but the friends of progress, enlightenment, and science ultimately triumphed at the recent session of the Leg. islature and secured the passage of a good bill creating a Board.

4th and 5th. Our Board is composed of eight physicians, one from each congressional district, to be appointed by the Governor, and of three laymen—State officials—the Surveyor General, the Comptroller General, and the State Geologist.



Fraternally yours,


From A. G. FIELD, M. D., member of the Section for Iowa.

Des Moines, April 12, 1875.

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1st. What should be the character and object of a national health council ?"

Its chief officer should be appointed by the President of the United States, to serve for a term of not less than four years.

There should be at least one member from each State, chosen by the respective State Boards of Health, to serve for terms of not less than two years each. While as a rule it is believed that members of the medical profession would be most efficient, there should not be an arbitrary exclusion from membership, of scientists, pbilanthropists, or statesmen, of whatever avocation. Its meetings should occur as often as once a year, and at such time and place as shall afford the best opportunities for observations and practi. cal results.

Its object should be to advise and assist each State Board in perfecting means and plans for the most efficient work, in the peculiar line devolving upon each, in behalf of the greatest public good. It should also develop, collect, generalize, and diffuse knowledge relating to medicine, and its collateral sciences. But its province should be more especially the elucidation of questions not within easy reach of individual effort, such as those relating to medical topography, statistics of mortality, and hereditary transmissions; as well as the ultimate constitution of miasms, contagions, and infections, the laws which regulate their development and operation, and kindred topics. To these ends it should be amply authorized and provided.

"2d. When should it go into operation ?"
As soon as practicable.
" 3d. Has Iowa established a State Board of Health ?"

"6th. Have any ineffectual efforts been made to establish such a Board ?

None. “7th. What are the prospects of such a Board being established by the Legislature ?" It is impossible to state until the subject has been presented.



From E. L. HOWARD, M.D., member of the section for Mary. land.

BALTIMORE, December 26, 1874.

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“1st. What should be the character and object of a National Health Council ?" The question presents itself to my mind in a twofold relation: first, as purely a matter of scientific and professional


interest; secondly, as viewed in its political bearings and relations. If such a Board could be established and maintained free from the contaminating influence of party politics, I have but little doubt of its beneficial results. But that its members would, in all probability, be appointed from political consideration, and as a reward for partisan assistance, rather than from merit and scientific attainments, I entertain strong fears !


It would unquestionably be a great gain if our coast quarantine could be brought under some central national head and reduced to a more uniform system. But while this improvement would be effected in our quarantine, I think I see in it a source of great danger to the efficiency and integrity of the Board itself. I do not see how it would be possible to clothe the Board with administrative or executive powers, without great liability to dangerous abuses! Whatever might be the ultimate character of a National Sanitary Bureau, I am quite clear that, at the outset, it should be strictly prohibited the exercise of any executive functions. Its duties should be entirely those of an advisory nature. Let it gather and disseminate information, and let only the municipal and possibly the State Boards be clothed with power to act as at present. The difficulty might be solved by having the coast quarantine brought under one national head, in the same manner as the medical departments of the army and navy are now managed. The chief of this new department, together with the Surgeon General U.S. A., the Chief of Bureau of Medicine and Surgery U.S. N., and the Chief Signal Officer U. S. A., should be ex-officio members of the “National Health Council." The other members of the “Council" (to be nominated if practicable by the American Medical Association, the Surgeon General U.S.A., and Chief of Medical Bureau U.S. N., or some other competent medical authority) should be appointed to serve for a long term of years, and they should be well remunerated.

The duties of the Council, so constituted, would largely consist in gathering information from the coast quarantine, from ical officers of the army and navy, from all signal stations, and also from State and municipal health boards ;-or, in other words, each quarantine station; each army post; each naval vessel,—off the coast, or in port, each weather signal station; and the various State and municipal health boards, would constitute a reliable source of monthly or quarterly reports exhibiting meteorological and sanitary conditions and changes, from one end of the country to the other, with but slight cost to the government. In possession of these vast sources of information, and restricted to simply advisory functions, such a Council could accomplish a large and most beneficial work in the practical assistance it could render State and local authorities, and in the accumulation and classification of statistical knowledge. Of course many minor points will suggest themselves; the Council, for instance, should have author. ity to employ competent parties to make special investigations wherever such may be deemed advisable.

Such, in brief, are the opinions I have arrived at regarding the most feasible plan for the organization of a National Health Council. If started on this basis, doubtless important improvements and amplifications will suggest themselves for adoption.

I have submitted my views in obedience to your request, but with great diffidence.

“2d. When should it go into operation ?" In answer to this query

I submit that a Council, such as I have described, might at once be put into operation, to be improved upon from time to time as occasion may dictate.



Your obedient servant,

E. LLOYD HOWARD, M.D., Secretary State Board of Health of Maryland.

From HENRY B. BAKER, M.D., Secretary of the State Board of Health, and member of the Section for Michigan.

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It is well known that a "National Health Council," a Health Department,” “Bureau,” or “Proper Central Sanitary Organization” at Washington has been proposed and recommended by various National and State Societies and Associations. A "National Board of Health" has been proposed, and the necessity for a “National Quarantine Board" has also been urged. These numerous though not very dissimilar expressions indicate that in the minds of those who have given this matter the greatest degree of thought, there is a general belief that it is the duty of the National Government to inaugurate and maintain some organized

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