ABSTRACT OF REPORT 
UPON 
General Health Laws and Local Ordinances, 
With Reference to and Local Sanitary Organization. 
By ELISHA HARRIS, M.D., of New York. 
(Chairman of Committee on State and Local Sanitary Organization.) 
The framing and administration of sanitary laws and regulations 
in the various states and municipalities of North America, should 
conform to the somewhat various and changing conditions of the 
areas and methods of the civil government. Cities and large villages 
throughout this continent maintain as strict independence as they 
possibly can in affairs of their local government. This, and other 
circumstances may tend to delay the enactment of general laws or 
a general sanitary Act in numerous States. But such general laws 
can readily be obtained in each State in which the friends of sanitary 
improvement cordially agree upon the'points that should be attained, 
and upon the most economical and effectual methods of administra- 
tion, by which the desired results may be accomplished. 
A central source of information and of advisory, as well as ulti- 
mate authority should be created and put into operation in con- 
nection with local authorities. Hence it is, that we witness now the 
working of the Boards of Health under general sanitary laws, 
as well as good local sanitary organization, in some of the newest 
of our States, as in Minnesota and California. New machinery of 
government may be more readily adjusted than old parts, re-cast, 
can be adjusted or harmoniously worked. Thus, in some respects, 
the friends of sanitary improvement in the newer States may be the 
first to succeed in their efforts. 
As the progress of sanitary improvement plainly requires that 2 
there shall be an effective system of State organization and a new 
and well regulated method of local sanitary administration, the 
following points appear to be vitally important to the success of 
such plans of progress. 
THE AREAS OF ADMINISTRATION. 
That the General Sanitary Act shall specifically require that every 
township or every county shall organize a local Board of Health, to 
give effect, as far as necessary, to the requirements and duties 
under the General Act. There is much reason to believe that the 
county area and the established and permissible methods of county 
administration, in most of the American States, will constitute the 
most natural and acceptable unit—geographically and civilly—for 
the local sanitary administration of communities; and that towns 
and villages will, in most of the States, quite naturally and effectively 
organize and administer their own respective health duties in connec- 
tion with—often as parts of—the county system. One thing is certain, 
namely, that there should be thorough organization upon that civil 
and geographical basis which will afford greatest facility of efficient 
sanitary duties, and in the settlement of questions that may involve 
general expenditure, and some form of general authority for pro- 
tecting the public health. This is witnessed in the duty of ap- 
plying measures for protection against small-pox, and some other 
diseases, and for securing necessary drainage of malarial districts, 
the preservation of sources and of the purity of water supply, 
etc. 
THE PRIMARY AREAS.-LOCAL SANITARY DISTRICTS. 
The geographical extent and civil competency of the primary 
areas of sanitary administration will be found to have an important 
bearing upon the final sucesss and economy of sanitary improve- 
ments. The experience of the Board of Health and Vital Statistics 
of Richmond County, N. Y., can be quoted as an illustration of 
the utility and popular success of county organization, and of uniting 
every town and village of a county in supporting the organization 
and duties of the Board. 3 
That the areas of sanitary administration—as regards the several 
branches and purposes of the public health service— should corres- 
pond with the best arrangements of the civil government of town, 
village, county, and State, would seem to require no argument; 
but we may properly urge that in respect of all duties which relate 
to the prevention of general causes of disease, the spread of contag- 
ious and pestilent maladies, the provision for and the supervision of 
vaccination, the application of quarantine or any restrictive sanitary 
regulations, the sanitary management of general drainage, and the 
supervision of returns and registration of Vital Statistics, the areas 
of administration should be determined by those limits and considera- 
tions which will secure the most perfect results and the largest de- 
gree of popular and intelligent support from the people. 
STATE ORGANIZATION ESSENTIAL TO LOCAL EFFICIENCY. 
Practically considered, the chief benefits from sanitary govern- 
ment will be insured most completely and permanently only when 
and where the masses of the people become interested, and will aid in 
giving such success. This, however, does not imply tjiat each hamlet 
and town, much less that every little neighborhood, should be left to 
itself, to become a nest of pestilence, or to produce Cretans and con- 
sumptive paupers, by neglecting sanitary obligations that concern 
the county and the State. It was of the debased and ignorant 
sufferers from neglected drainage and cleanliness, and from domestic 
insalubrity, that Mr. Ruskin wrote when he exclaimed, “ . . . They 
resist every effort «to lead them into purity of habit and habitation, 
and to give them wholesomeness of air, as new interference with their 
liberty, . . . insisting on their right to helpless death.” Such 
pestilence-breeding neighborhoods or premises must be brought 
under saving sanitary regulations. County and State sanitary 
authorities need to be required, under General Health Laws, to co- 
operate in giving any necessary enforcement to such regulations m 
any community, place, ground, or building that seriously endangers 
the public safety or the health and welfare of defenceless persons. 
The duty and adequate authority to organize the Local Boards of 
Health, and to administer the various and proper functions of such 4 
Board, being conferred upon the “ supervisors,” “chosen free- 
holders,” or other chief civil authority in the county (or in the town, 
or in the incorporated village, as the case may be), the central 
Board of Health of the State should be adapted and required to 
give completeness and efficiency to Health Laws. 
THE REGISTRATION OF VITAL STATISTICS. 
The maintenance of a proper system of Registration of Vital 
Statistics in the State requires that the primary returns of such Sta- 
tistics in every county, and, if practicable, in every town, should be 
supervised by the local sanitary authority. It is our duty to urge 
this function upon local sanitary authorities, and upon the States that 
have not yet organized a system of Vital Registration. It is confessed 
to be the special want, now, of the English Registration system. It 
is obviously the want of the State systems, thus far, in our country. 
The original vouchers, and the methods of the records for public 
registration of Vital Statistics need to be under the skilled supervis- 
ion of the local sanitary authority, near to the sources of such vouch- 
ers and records. 
The final and central revision of the State Registration of Vital 
Statistics should be supervised by the State Board of Health, and, 
through the agency of that Board, the most directly useful purposes 
and publicly important information of the Registers should be sought 
and published. Whether the State system of Registration is treated 
as a bureau of the Department of the Secretary of State or other- 
wise, still it needs the supervision of expert officers of public 
hygiene. The local registration especially requiressuch supervision, 
and no methods of vital registration will be satisfactorily correct, as 
respects the records of diseases and mortality, unless such local as 
well as central supervision is provided. 
Uniformity in practice, and comparable results, can be secured in 
the methods and system of registration of Vital Statistics, and of the 
records of disease and of epidemic phenomena throughout all the 
States of North America whenever each State has a central Board 
of Health with reasonable supervisory authority over the Vital Reg- 
istration. Such uniformity is greatly to be desired, and it appears 5 
to be the duty of all such sanitary authorities, in the United States, 
as already direct the public registration of Vital Statistics, to agree 
upon this duty of giving the highest practicable degree of uniformity 
to the methods and periodical abstracts of their registration. 
DEFINITION OF PROCEEDINGS AGAINST NUISANCES. 
The abatement, control, and prevention of Nuisances being uni- 
formly recognized as a duty of sanitary authorities, it is desirable 
that in each state and city, and in all sanitary Acts and Codes there 
should be a reasonably uniform and strictly correct specification and 
definition of the term “nuisance” and its special applications in 
Health government. Evasion of the duty of obedience to sanitary 
laws, and the injurious perpetuation of nuisances detrimental to 
health and life, will become less and less frequent whenever there 
are positive definitions and specific declarations of nuisances against 
health, which, in every community, shall be abated and prevented. 
The power and duty of the Board of Health to declare the existence 
and order the abatement of whatever it finds to be a nuisance, should 
be undisputed, but the people generally must be allowed ample op- 
portunity to understand the reasons and nature of the proceedings 
against nuisances. The provisions of a Sanitary Code ought not 
to be arbitrary. The importance of inciting the interest, inquiry and 
support of the people, in proceedings against nuisances, should be 
understood by the legislative authorities or persons who frame the 
sanitary laws and ordinances. The provision that should be made 
in every Sanitary Code to give patient and sufficient “ hearing” to 
persons prosecuted or enjoined under the health laws, should be so 
framed and so used as to become a means of publishing the most 
important kinds of sanitary information and evidence. 
POPULAR INSTRUCTION IN PHYSIOLOGY AND HYGIENE. 
Instruction in Human Physiology and Hygiene in the course 
of public school education and in all colleges and seminaries, would 
conduce to the prevalence of public regard for sanitary duties. 
Teachers of the public schools should be required, under the State 
laws relating to public health as well as those relating to public in- 6 
struction, to sustain an examination in Physiology and Hygiene. 
The local Boards of Health should have authority to inspect all 
school rooms, and to advise with the Boards of Education concern- 
ing matters affecting life and health. 
The State and local Boards of Health should be required by law 
to make a faithful sanitary inspection and inquiry in every Hospital, 
Medical Dispensary, Asylum, Reformatory, and Penal institution 
every year, and as much oftener as circumstances may warrant; and 
such inspections and duties should be carefully supervised in some 
degree by the State Board of Health aided by counsel or informa- 
tion given by the State Board of Public Charities. A chapter in 
each yearly Report of the Health Boards,—State and local,—should 
comprise a careful statement of results, etc., in this class of duties. 
The usefulness, dignity or permanent influence and success of 
the Local sanitary authority will be promoted if the State authority 
and aid can be extended to the Local officers, when proper, in mat- 
ters of local inspection and inquiry upon subjects of general as well 
as local interest. The purpose and duty of harmonious co-opera- 
tion between the State and Local Boards should be obvious to the 
people. By such influences may the people be kept interested in 
the sanitary duties that pertain to their own localities and affairs. 
The centralization of authority relating to the administration of 
sanitary laws may become desirable at some future time, but it 
would be impolitic and contrary to the well known preferences of 
the people and the usages of civil government in the primary areas 
of political or civil organization, to control the administration of 
Health Laws so as to fail to incite and even require the inhabitants 
to maintain and obey local authority. 
STATE BOARDS OF HEALTH. 
The experience and example of the central Board of Health in 
each of the six States that has organized such a State Board may 
now serve as useful guides to the successful organization of a State 
Board of Health, in each State that will seek to establish a General 
Sanitary System. Each State may require to have various and es- 
sential modifications of any framework of a General Sanitary Act that 7 
might be perfectly adapted to another commonwealth. The 
State Law on this subject in Minnesota would not be completely 
adapted to the necessities or certain existing statutes and necessary 
usages in New York, or in Massachusetts, nor would the Massa- 
chusetts Law answer lor Minnesota, Michigan, Virginia and Cali- 
fornia. It will be seen, upon examination of the annexed outline 
of the special Acts under which each of the five State Boards has 
respectively, been established, that the friends of sanitary improve- 
ments in each State, will manifestly need carefully to forecast the 
amount of general and intelligent co-operation which the people 
will put forth in the duties of sanitary administration. The law 
itself may and always should be an educator, but the laws and 
ordinances that are successful as educators must be so framed and 
administered as to elicit popular and exact inquiries and increase the 
general knowledge and appreciation of the objects for which such 
laws exist. 
The vital importance of Local Sanitary Authority is already exem- 
plified in every State of the Union : and the fact must be conceded, 
that the faithfulness, efficiency, and permanency of good influence 
of the Local Boards of Health in the rural districts, as well as in 
most larger towns, cannot be thoroughly secured without the cen- 
tral influence and certain kinds of authority of the State Board. 
Thus far each one of the State Boards, has succeeded in awaken- 
ing in the communities of the State an increased regard for the 
right and duty of every district, town, and neighborhood, to invoke 
the continued aids of law and instruction, to protect the interests of 
life and health. 
A concise Digest and Comparison of the leading features of the spec- 
ial Acts by which the State Boards of Health have been established in 
six States of the Union. 
STATE OF MASSACHUSETTS. 
[By Act passed in June 1869.] 
‘ ‘ Seven persons shall constitute the Board of Health, and Vital 
Statistics," appointed by the Governor, “ with advice and consent 8 
of the council,” and hold office for seven years, one appointment 
or re-appointment being made every year. 
“ Sanitary investigations and inquiries in respect to the people, the 
causes of disease, and especially of epidemics,” constitute the 
chief duty of the Board. It also advises the government in regard 
to the location of public buildings. The Secretary is the execu- 
tive and only salaried member of the Board. 
BOARD OF HEALTH OF LOUISIANA. 
There are nine members of the Board, a majority of whom are 
appointed by the Governor, and minority of the Municipal Council 
of New Orleans. This Board has full authority over all matters re- 
lating to “Quarantine for the protection of the State." It also has 
charge of the Sanitary Police and Health government of New 
Orleans. 
The powers of this Board are inadequate to the peculiar exigen- 
cies that are associated with the nature of yellow fever epedemics. 
But the chief defect in the State Sanitary powers of La., is that 
they do not require the establishment of local Health Boards in all 
the Parishes of the State. 
The Louisiana State Board of Health has not been commis- 
sioned or empowered to enter upon hygienic inquiries or the gen- 
eral duties which characterize the Massachusetts Board of Health. 
STATE BOARD OF HEALTH OF CALIFORNIA. 
This Board was organized in 1870. It consists of seven 
physicians, who hold office for four years. Their appointment is 
vested in the Governor alone. 
The functions of this Board are defined in the same concise, and 
general phraseology, as are those of the Massachusetts Board of 
Health, and by the Act its members were instructed to devise and 
report “some scheme whereby medical and vital statistics of 
sanitary value may be obtained." 
STATE BOARD OF HEALTH OF MINNESOTA. 
This Board was organized in the Spring of 1873. consists of 9 
seven physicians, who hold office four years, under appointment 
from the Governor. 
The State Board is required to “place themselves in com- 
munication with local boards of health, the hospitals, asylums, and 
public institutions throughout the State,” and “ take cognizance of 
the interests of health and life among the citizens generally.” To 
these duties are added all the functions which Massachusetts, 
Louisiana and California have respectively assigned their State 
Boards of Health. 
A supplementary Act has enjoined upon every town and city in 
the South, the duty of establishing a local board of health ; and the 
State Board is authorized to enforce this duty, and required to advise, 
and aid the local board. 
The Secretary of State, who has general charge of vital statistics, 
under an old law, is required to seek the counsel, and aid of the 
State Board of Health in the Bureau of Vital Registration. 
STATE BOARD OF HEALTH OF VIRGINIA. 
Organized in the Spring of 1872, and consisting of seven mem- 
bers, all of whom must be physicians, three being residents of the 
city of Richmond, and four from different sections of the State, this 
“ Board of Health and Vital Statistics ” was set at work, with the 
strict injunction that it “ shall not in any way be a charge upon the 
State.” Its functions are precisely like those of the State Board of 
California. 
STATE BOARD OF HEALTH OF MICHIGAN. 
This Board was organized this year. The phraseology of the 
Act to erect the Board, and define its functions is so well adapted to 
aid the deliberations of the Public Health Association, that the 
chief sections are here quoted. It needs to be mentioned here that 
other laws in Michigan provide local boards of health to establish a 
system of Vital Statistics : 
“ Section i. The People of the Stale of Michigan enact, That a 
board is hereby established which shall be known under the name 10 
and style of the “State Board of Health.” It shall consist of seven 
members as follows : Six members who shall be appointed by the 
Governor with the consent of the Senate, and a secretary, as pro- 
vided in section four of this act. The six members first appointed 
shall be so designated by the Governor that the term of office of two 
shall expire every two years, on the last day of January. Hereafter, 
the Governor, with the consent of the Senate, shall biennially ap- 
point two members to hold their offices for six years, ending Janu- 
ary thirty-first. Any vacancy in said board may be filled, until the 
next regular session of the Legislature, by the Governor. 
“Sec. 2. The State Board of Health shall have the general su- 
pervision of the interests of health and life of the citizens of this 
State. They shall especially study the vital statistics of this State, 
and endeavor to make intelligent and profitable use of the collected 
records of deaths and of sickness among the people ; they shall 
make sanitary investigations and inquiries respecting the causes of 
disease, and especially of epidemics; the causes of mortality, and 
the effects of localities, employments, conditions, ingesta, habits 
and circumstances on the health of the people. They shall, when 
required, or when they deem it best, advise officers of the govern- 
ment, or other State boards, in regard to the location, drainage, 
water supply, disposal of excreta, heating, and ventilation of any 
public institution or building. They shall from time to time 
recommend standard works on the subject of hygiene for the use of 
the schools of the State. 
“ Sec. 3. The board shall meet quarterly at Lansing, and at such 
other places and times as they may deem expedient. A majority 
shall be a quorum for the transaction of business. They shall 
choose one of their number to be their president, and may adopt 
rules and by-laws subject to the provisions of this act. They shall 
have authority to send their secretary, or a committee of the board 
to any part of the State, when deemed necessary to investigate the 
cause of ahy special or unusual disease or mortality. 
Sections 4 and 5 provide for the election and services of a Sec- 
retary, and specify his functions under the Board. 
Sections 6 and 7 relate to expenditures. 
“Sec. 8. It shall be the duty of the health physician, and also 
of the clerk of the local board of health in each township, city, and 
village in this State, at least once in each year, to report to the 
State Board of Health their proceedings, and such other facts re- 11 
quired, on blanks and in accordance with instructions received from 
said State board. They shall also make special reports whenever 
required to do so by the State Board of Health. 
“ Sec. 9. In order to afford to this board better advantages for 
obtaining knowledge important to be incorporated with that col- 
lected through special investigations and from other sources, it shall 
be the duty of all officers of the State, the physicians of all mining 
or other incorporated companies, and the president or agent of any 
company chartered, organized, or transacting business under the 
laws of this State, so far as practicable, to furnish to the State 
Board of Health any information bearing upon public health which 
may be requested by said board for the purpose of enabling it better 
to perform its duties of collecting and distributing useful knowledge 
on this subject. 
“Sec. 10. The Secretary of the State Board of Health shall be 
the superintendent of vital statistics. Under the general direction 
of the Secretary of State, he shall collect these statistics, and pre- 
pare and publish the report required by law relating to births, mar- 
riages, and deaths.”