be able at any and all times to report the vital condition of the people, the prevalence or absence of diseases which endanger the public health. It would soon become his duty to do more than this, and to warn the people of prospective danger at any point where danger threatened, either through epidemics or endemics, of contagious or infectious diseases, or such meteorological conditions as extreme heat, moisture, dryness, etc., and the warning should include suggestions which would enable those so disposed to best avoid the particular cause of sickness or death. Only in some such way as this can it be made easier for the most intelligent of our race to avoid or survive those scourges which now sweep off all who come within the infected districts, or to whom contagion is brought. The members of the Commission might be appointed by the President and confirmed by the Senate. In the selection of members, the President should receive the aid of the leading National or State Associations of sanitarians or physicians, so far as that a number of persons should be nominated by such bodies from which the President might select if he chose. In answer to the first question of our Chairman, then, I have endeavored to give some of the reasons why I think that the character of the national sanitary organization of this country should be a "Public Health Commission;" that it should be made its duty to collect, collate, and present to Congress all useful information relative to public health; that because of its duties, it should be composed of the leading sanitarians of this country; that it should meet quarterly, or oftener if unusual circumstances should demand it; that it should have an executive officer at Washington all the time; that this officer should act as a Registrar of Vital Statistics and perform other duties, some of which I have endeavored to indicate. In answer to the second question, I would say that, in my opinion, some such national organization should have gone into operation years ago. Some of us have been laboring for this object for several years, and many of the leaders have long complained of the apathy and conservatism which thus far prevented this most important movement in the interest of the people. I am ashamed to say it, but it is true, that some of this indifference and even active opposition, has been found in our own liberal-minded and philanthropical profession, which has usually been foremost in movements for ameliorating the condition of mankind. To answer the second question briefly, this Commission should begin their operations immediately. It cannot be appointed or begin its labors too soon. Very respectfully, HENRY B. BAKER, Member of the Section for Michigan. From A. B. STUART, M.D., member of the section for Minnesota. * * WINONA, Dec. 28, 1875. * * 1st. It should be composed of duly chosen representatives of the several State and City Boards of Health of the United States, and any others whose duties and qualifications for such work may recommend them to the Council as corresponding members. Those who become members by virtue of representing either State or City Boards cease to be active members when not chosen as delegates. The Council should be the outgrowth of these lower organizations. The object of a National Health Council should be, in brief, to bring the knowledge and experience of each Board into the possession of the whole, and to systematize and harmonize the great work of public hygiene. 2d. Its character and object being as above stated, it might go into operation at any time, six States, including Louisiana, having organized State Boards of Health in addition to the several city Boards. Instead of waiting, as has been suggested, for a majority of the States to organize State Boards of Health, before an effort is made to frame a National Health Council, or an Association, let the latter be established immediately, and educate the States in the direction of the former. * * * Yours, most respectfully, A. B. STUART. From D. V. DEAN, M.D., member of the Section for Missouri. ST. LOUIS, April 23, 1875. * * * * Missouri has not made any attempt to establish a State Board of Health, and if perfect silence on the subject is any index, I should say there is no immediate prospect of such a Board being established by the Legislature. If State Boards of Health should not wait for town, county, or city Boards, I do not see why a National Board should be deferred. until after the formation of State Boards. The desire of States to be represented in the National Board, would be an incentive to the organization of the former Boards; and the orders, suggestions, and general information on sanitary matters, emanating and going out from a National Board officered by, and composed of learned and efficient sanitarians, would, I think, lead far toward greater harmony and intelligence of action in State, county, and city Boards. When smaller and larger districts shall find their labors are not to be annulled or rendered practically inefficient by conflicting regulations, or by utter lack of regulations, in the country around them, when their proposed health ordinances or laws shall not be cumbered with unwise restrictions, or be clipped and shorn of all valuable features before they are passed; and when boards of health shall be composed of sanitarians holding their positions by a reasonably permanent tenure; and not of politicians utterly ignorant of the practical advances or even the general principals of sanitation; then will there be some encouragement for smaller or local Health Boards. National Health Boards can, through home and international agencies, gather statistics and disseminate knowledge. Such a Board would extend its influence to, as well as draw from, the very corners of our country; and it might bring to pass that valuable and well-tried sanitary rules and regulations could be broached in local Boards without being ignored or treated and put down as new-fangled nonsense. Then there would be more of systematic, salutary action in health matters, and less of the impractical inventions of raw untrained Health Boards to meet ever recurring emergencies. From J. W. PARSONS, M.D., member of the Section for New Hampshire. * * PORTSMOUTH, Dec. 16, 1874. * My idea is that there should be a National Health Bureau, the objects of which should be the collection and investigation of facts and theories concerning the sanitary condition of the country. It should be in close relation with all health associations whether State or town; should have some voice in matters of quarantine. It should take cognizance of and investigate extensive epidemics, their causes and prevention. It should be a repository for all vital and death statistics, etc. etc. With this Bureau might be associated a council composed of one member from each State which has a State Board of Health, whose duty it should be to report and advise upon all sanitary matters. If a distinct Bureau could not be created for health (and physicians well know that health is the last thing the people legis. late for), then let it be attached to one of the civil departments. Whatever shape it takes, it should be sustained by special appropriations by Congress. It should be officered by competent medical men, and not by political hacks. 2d. It should go into operation as soon as ten States have Boards of Health, Very respectfully, J. W. PARSONS. From E. M. HUNT, M.D., member of the Section for New Jersey. * * METUCHEN, December 31, 1874. * * I doubt the present expediency of a National Health Council. We are not yet sufficiently organized in States to do effective national work. The American Public Health Association is for the present doing the general work, and what we need is more effective State organizations. Our State has not yet established a State Board of Health, but has this year a State Sanitary Commission, striving by their report to advocate and secure such a result. It has on it four physicians, the State geologist, and one other lay member. We tried some six years ago to establish a Board and failed. From EDWIN M. SNOW, M.D., member of the section for Rhode Island. * * PROVIDENCE, November 23, 1874. * * In relation to a "Health Council for the Nation," I can conceive that a Council whose duties should be confined entirely to investigation, and the diffusion of information and advice upon sanitary matters, if composed of the right men, might do much good and render valuable assistance to the cause of public hygiene. In reply to your questions in regard to a State Board of Health in this State, I would reply there is no State Board of Health in R. I. No efforts whatever have been made to establish a State Board of Health here. * * * Truly yours, EDWIN M. SNOW. From D. R. WALLACE, M.D., member of the Section for Texas. * * * AUSTIN. * "A Health Council for the Nation:" let us have it by all means. "When shall it go into operation ?" At just the earliest moment it can do so advisedly-as a plan can be well matured and agreed upon. Let there be no faux pas in the starting off. From W. E. EAST, M.D., Secretary of the Texas Medical Association, though D. R. Wallace, M.D., member of the Section for Texas. It has been a settled conviction in my mind for years, that a National Health Council would be productive of incalculable benefit to the country. The space of a letter is too confined to admit. of one-half being stated. Suffice it to say, it would elevate the science, add dignity to the profession, present a rallying point for all the scattered information of the land, reduce to the test of ex |