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THE PUBLIC HEALTH., Issue 10455, 27 October 1897
THE PUBLIC HEALTH.
No more momentous question can occupy the public mind or engage the consideration of the colonial and local authorities than the .maintenance of a high standard of good health in the. community. To this object civilised people have always been found willing to foregO freedom of ... individual action so as to ensure, so ~ far wholesome hygienic ;; conditions, "which^ r especially Wbete ;tlie population is at all congested," ai o alike absolutely essential to the prevention of many classes'of disease and tho spread-of-epidemics, which, - notwithstanding .the most capful precautions, are, from the very nature of things, liable to be introduced. The Dunedin Sanitary Institute have already done good service by inducing residents in the City and suburbs . to set their houses in order as - regards hygienic matters. At. a meeting con* yened for' Thursday evening the members propose to discuss the provisions in the Local Government Bill which apply to drainage and sanitation,. The legislation in regard to public health at present in force is admittedly defective, and the Institute; - we have li ttle doubt, will be, able to'make valuable sugghstions,',iri regard especially to cities and large towns. As bearing upon the.matter, our atten* tiou has been directed to an admirable address by Dr Hermann M. Biggs, of the New York- City Health Department, Professor of Therapeutics, etc., which was delivered at Montreal (Canada) in September, and ispublished infull in the ‘British Medical Journal, 1 the subject being ‘ Preventive Medicine in the ‘ City of New York.’ Dr Biggs shows what can be done and what is likely to be done by an- intelligent, sanitary authority acting independently, unfettered by traditions, untrammelled by precedent, and guided “ from “ month to month by what is believed -to “be the best good of the inhabitants, in, “ view of the most recent knowledge, and ■ “the latest developments in scientific “medicine.” lit should be noted that in the United States there is no National. Board of Health, and there are no national regulations of general application. In each of the several States the sanitaiy administration is solely under the control of the State authorities. The Health Department of the City of New \ork is an entirely independent organisation,, not being subject even to the jurisdiction of the Slate Board of Health, and is composed of four- members—namely, the President, who is .the chief executive officer; the Commissioner of Health, who must be a physician, and two ».x officio members ; the Health Officer of the Fort of New York; and the President of Board of Police Commissioners of the City. Three main points, Dr Hermann Biggs states, are dealt with by the departmentdiphtheria, tuberculosis, and the medical inspection of schools; and it may be mentioned here that his name has- long,been associated with the establishment of municipal bacteriological, laboratories,., which are now in full work. Every case of contagious disease reported to the department is .regularly investigated, by the medical inspector assigned to the district in which it occurs. When necessary, removal to the hospital is enforced, but a comparatively small proportion of the total cases are actually treated in the hospitals for contagious diseases. There is a class of medical officers called diagnosticians, two of whom are always on duty day and night, their functions being to give expert assistance in the clinical .diagnosis of contagious diseases. Again, there is a special corps of medical inspectors, to whom is assigned the administration of diphtheria anti-toxin, and on request one of them will visit a person suffering from diphtheria in any part of the city, and administer anti-toxin under the supervision of the attending physician. The New York authorities evidently do not confine themselves to the attempt to limit diphtheria by isolation, but make serious. efforts to deal with the .disease where it occurs, and render the attending physician every-• service and assistance possible. Not only is anti-toxin furnished free of charge to all public institutions, but it is kept for sale at a hundred depots, where it may be obtained by physicians without fee for patients who are too poor to pay for it. The proceedings taken. Dr Hermann Biggs states, in regard to tuberculosis are of more recent • date, and although it may with some truth be said that in dealing with so. slowly progressive a disease as consumption it is too soon to speak with any poaitiveness as to results, the facts collected in regard to the prevalence and . localisation of the disease are of the greatest _ interest and importance. In 1893 notification was required of all cases of pulmonary tuberculosis in public institutions, and private physicians were requested to send in reports of cases occurring in their practices. The premises occupied by persons dying of the disease have been inspected, to the number of about 6,000 each year ; and the renovation of apartments occupied by consumptives has been insisted upon. The methods adopted for preventing the distribution of tuberculous milk are stringent and effective. “It is not a case “of allowing a dealer to go on until ho “does something wrong.” The authorities commence by absolutely prohibiting the sale of milk within the city without a permit from the Health Department. Each waggon, also, must have its perffiit, and all these permits may be revoked at any time. All milch cows which supply the city are subjected to the tuberculin , test, and such as are found to be diseased are killed. Dr Hermann Biggs proceeds to say that medical inspection of school children is one of the most recent developments of hygiene in New, York. Early in the present year 150 medical men ;were ap* pointed to examine daily—at the opening of.public, parochial, and industrial schools —all the children who arc set apart by the class room teachers as not appearing to bo entirely well, and “ during the three “months that this.system has been in “ operation they have examined 63,812 “children, of whom 4,183 were, after “ examination, excluded from the school “ and further dealt with a very significant fact. ~ , It is worthy of consideration, in contrast to our overgrown system of local government, that the-Board of Health for the Gity of New York, with its population of 2,000,000, consists but of four members, and that when next , year its jurisdiction is extended over that greater New York, which .will then contain ■ 3,250,000 inhabitants, the autocratic powers wielded by the department will, even then, Jbe in the hands of 'only five individuals. One more point is that all the administrative and executive work is • concentrated at the main offices,
THE PUBLIC HEALTH., Issue 10455, 27 October 1897
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