THE PUBLIC HEALTH ASSOCIATION OF NEW-YOKK. 
j§anitarj) legislation iit (Englanii antt fUto-Jark: 
BEING 
A PAPER READ BEFORE THE ASSOCIATION, DECEMBER 8, 1872, 
BY 
Dt B. BATON", Ksq. 
PRINTED BY THE ASSOCIATION. 
Heto-|)ork: 
JOHN W. AMERMAN, PRINTER, 
No. 47 Cedar Street. 
1 8 7 2. THE PUBLIC HEALTH ASSOCIATION OP NEW-YORK. 
legislation in (Snglani) anil fUto-farft: 
BEING 
A PAPER READ BEFORE THE ASSOCIATION, DECEMBER 8, 1872, 
BY 
D. B. EATON, Esq. 
PRINTED BY THE ASSOCIATION. 
'Ittfo-lfork: 
JOHN W. AMERHAN, PRINTER, 
No. 47 Cedar Street. 
18 7 2. New-York, Dec. 9, 1872. 
Dorman B. Eaton, Esq., 
Dear Sir : At a meeting of “ The Public Health Associa- 
tion of New-York,” held Dec. 7, 1872, on motion of Dr. James 
R. Wood, seconded by Judge E. D. Culver, it was unanimously 
Pesolved, That the thanks of this Association be tendered to 
D. B. Eaton, Esq., for his elaborate and instructive paper on 
Sanitary Legislation in England and New-York, and that a copy 
be requested for publication. 
Stephen Smith, M. D., 
Dees’t of the Association. 
2 East 29th St., 
New-York, Dec. 12, 1872. 
Dear Sir : 
Responding to the request contained in your note of yester- 
day, I hand you, herewith, for publication, a copy of the paper 
to which you refer. And I am, with great respect, 
Your ob’t serv’t, 
D. B. Eaton. 
Stephen Smith, M. D., 
President, <£c., &c. SANITARY LEGISLATION IN ENGLAND AND NEW-YORK. 
Mr. President : 
A complete presentation of so broad a subject as that of sanitary 
legislation in England and in New-York would require a space far 
beyond the convenience of this meeting. And yet, I think it will 
be profitable to attempt to gather instruction from a somewhat 
general view of the subject. For if I rightly understand the 
ultimate objects of this association, they are, while elevating the 
medical profession and promoting the study of sanitary science, 
to awaken the public mind to the utility of sanitary legislation, 
and to shed light along its true course. In this view, I shall 
exclude from this paper what is merely, historically interesting or 
only concerns medical men, and shall consider the subject in 
reference to the important question of the best method of making 
legislative authority effectual for the protection of the health and 
lives of the people. 
With exceptions in one or two departments, we shall find little 
that will be profitable for the purposes of this paper in the sanitary 
legislation of England prior to this century; not much prior 
indeed to the second quarter of this century. The causes of this 
barrenness are plain. The first conditions of success in sanitary 
legislation did not exist. The physicians were too ignorant of the 
causes of those frequent contagions that swept to untimely graves 
friglftful portions of every dense population ; too inexperienced as 
to the secret sources of poison and death which came up from the 
sewers and cesspools of every village and city. The majority of 
the people were too ignorant and prejudiced to follow good medi- 
cal advice, even if it could have been obtained. And above all, 
neither the government nor the higher intelligence of the people 6 
had formed any adequate conception of the inestimable value of 
medical learning and sanitary experience, acting in co-operation 
with political power, for the promotion of the public health. High- 
born dunces affected to look down alike upon the doctor, the 
parson and the attorney. 
But beyond all this, the government Avas controlled by a high 
and haughty class, that gave little consideration to common 
human comfort, and took as little care of the public health as it 
did of the people’s education. The jails and the prisons were 
fountains of contagion and shared with the gallows the harvest 
of death. 
But sanitary science is practical Christianity, in close alliance 
with high learning, going about to heal the sick, to bind up the 
wounds of the afflicted and to close the springs of disease; and 
how can it do its work in an age when the just spirit of human 
brotherhood—when a high sense of the duty which the rich and 
the cultured owe to the poor, the afflicted and the humble—were 
Wanting? How can a State, so long as it punishes more than a 
hundred crimes by death, and denies its poor laborers burial in its 
public churchyards, in default of professing the State religion, 
rise to the high and Christian spirit of sanitary legislation ? 
That business pursuits which caused smells offensive to the rich 
and high born, were suppressed; that dangerous lepers and 
dreaded sick men and women, were hustled away; that those 
from abroad, whom it was thought might bring infection, were 
summarily driven back—we need not doubt. But for any com- 
prehensive measures of sanitary precaution against the sources of 
public sickness, for any measures of legislation benevolently con- 
cerned in the interest of the health and comfort of the poor and 
humble, we shall look for almost in vain, until well into this century. 
Yet there are some interesting exceptions. One of the earliest, 
if not the very earliest, of the sanitary laws of England, enacted 
in 1388, imposed a penalty of £20 on any person who cast animal 
filth or refuse into rivers and ditches. How far this had reference 
to fish and fishing, and how far to public health, I cannot tell. 
An act of 1489 prohibited the slaughtering of cattle within cities 
and boroughs. In 1552, as appears from the court rolls of Strat- 
ford-on-Avon, the father of Shakspeare was fined for depositing 
filth in the public street in violation of the By-Laws of the 
manor; and he was again fined in 1588 for not keeping his gut- 7 
ter clean. And as early as Henry VI. and Henry VII., there 
were acts creating “ Commissions of Sewers.” (See Report of 
Royal Sanitary Commission, 1871.) 
The duty of legislation for the health of the millions, as well as 
a sense of the vast pecuniary profit of such legislation, are late 
productions of public intelligence and official fidelity. The earlier 
sanitary legislation has main regard, not to the welfare of the sick 
or of the whole people, but to the safety and comfort of the rich 
and the powerful. The true work of sanitary reform commenced 
only when medical learning began to be duly appreciated, and the 
spirit of beneficence subordinated the pride of birth. 
And it is astonishing how false and shallow was the conception 
of the cajffccity of sanitary legislation to secure even such unwor- 
thy results as the mere safety of the great. While resorting to the 
most cruel and arbitrary measures for thrusting out of sight those 
whose persons were imminent sources of death, this selfish policy 
really left the high and the low alike involved in the perils of in- 
fection and contagion. The filthy houses of the degraded, the 
streets, cesspool and drains, remained the prolific sources of scourg- 
ing disease and death, which spared not those haughty classes 
who seemed to think their own houses safe when they had driven 
the sick poor back to their filthy cellars, garrets and shanties. 
There was tenfold frequency of legislative debate, twenty times 
the number of judicial trials, vastly greater space in statutes and 
legal commentaries, devoted to the subject of the regulating and 
balancing of the artificial relations and ranks in social life, with 
which the law should not meddle, that there was to guai’ding the 
people from the sources of disease, contagion and death, which is 
one of the most profitable and solemn of all the subjects of human 
legislation. 
In 1758, Sir William Blackstoue, in a series of lectures de- 
livered at the University of Oxford, made a masterly exposition 
of the laws of England, which fills four lai’ge volumes. The whole 
of the first volume, of nearly 500 pages, is devoted to setting forth 
what he calls the rights of j>ersons; that is, to stating what he 
regards as the most important personal rights of Englishmen, the 
estimate in which the English law holds those rights, and the 
moral claim they have on the protection of Parliament. Now, 
what portion of these 500 pages do you suppose he devoted to the 
right of the people to have the public health protected ? 8 
One line and two words, and no more! as follows : 
“ 4. The preservation of a man’s health from such practices as 
may prejudice and annoy it.” Not a word of comment! The 
conception of sanitary legislation which existed in the mind of the 
great author, is further shown by his devoting nearly three pages, 
in the same chapter as the above extract, to the right of a man to 
insist on having his limbs protected by law, and especially by this 
definition of his limbs. 
“ 2. A man’s limbs (by which, for the present, we only under- 
“ stand those members which may be useful'to him in fight, &c.) 
“ are the gift of the wise creator, &e. They cannot be wantonly 
“ destroyed or disabled.” 
lie did not feel it proper, his age did not demancq that he 
should spare the space to say as much of the public health. 
To the king and his title, this volume devotes a whole chapter; 
to the royal family, a whole chapter; to royal councils, a whole 
chapter; to the royal prerogative, a whole chapter ; to the clergy, 
a whole chapter ; to the military and maritime state, a whole chap- 
ter. Thus the great question of the public health—of the ability 
of the people to work, to enjoy life, to support themselves and 
the State,—compared with such artificial and expensive adjuncts of 
the government, were, in Blackstone’s day, estimated as two lines 
to many chapters. 
Passing to his third volume, in which he treats of private 
wrongs, we find nearly two-thirds of a page devoted to sanitary 
legislation, or, in his language, to “ injuries affecting a man’s 
health.” He declares, “ that injuries affecting a man’s health are, 
when by any unwholesome practice of another, a man sustains any 
apparent damage in his vigor or constitution. As by selling bad 
provisions or wine, by the exercise of a noisome trade, which in- 
fects the air of the neighborhood ; or by the neglect or un- 
skillful management of his physician, surgeon or apothecary.” He 
points out, that for such an injury, a person suffering damage, 
may bring suit and recover such damage as he can prove. It 
may be interesting to our doctors to know, that in saying a 
suit could be brought against a physician, Blackstone’s text was 
probably not quite accurate; for in that day the profession of a 
physician, like that of a barrister, was honorary, so that they could 
neither sue for a fee, nor be sued for malpractice. But attorneys, 9 
solicitors, apothecaries, surgeons, druggists, and the “ medical 
man,” were not too honorable to sue or be sued. 
It would seem, therefore, that up to nearly the end of the 18th 
century, there was no legislation in England, under which the 
State, at its own expense, undertook to protect the public health; 
nor were there any state agencies, (except so far as hospitals and 
medical colleges are such,) through which the people could seek 
sanitary relief. Such relief must be sought by litigation for 
damage done; sanitary precautions were too theoretical for that 
day. The rich could crush the poor in the courts. The poor man 
could sue, if he dared, the rich owner of a pestiferous nuisance 
that contaminated the air of a dense neighborhood of humble 
life. 
In his fourth volume, in treating of people’s wrongs, Black- 
stone concludes his references to the subject of public and private 
health, by bestowing more than half a page of comment upon the 
subject of the public prosecution of the authors of nuisances inju- 
rious to the public health. He says, “ the fourth species of offences, 
“ more especially affecting the commonwealth, are such as are 
against the public health of the nation; a concern of the highest 
“ importance, and for the preservation of which there are, in many 
“ countries, special magistrates or curators appointed.'1'' 
In these special magistrates and curators we may find old prece- 
dents for those sanitary inspectors and physicians clothed with 
sanitary authority, which are among the most important agencies 
of the recent sanitary legislation of England and the United 
States. 
Blackstone goes on to declare that there are only two of these 
offences which can be publicly prosecuted, viz. : 1. A person en- 
dangering the public health by appearing in a public place when 
infected with the plague, or while dwelling in an infected house. 
2. The selling of unwholesome provisions. He says, that by the 
blessing of Providence, it had been impossible for more than a cen- 
tury to commit the first offence in England ; for the sole reason that 
a statute of James I. had enacted that the mayor or other head 
officer might command the watchman to compel any such person 
to keep his house ; and it would be the duty of the watchman on 
such melancholy occasions to obey such necessary commands ; 
and that if the sick man shall nevertheless go abroad, having no 10 
plague sore on him, he shall be whipped as a vagabond; but 
if he have any infectious sore on him he will be guilty of felony, 
and hence, of course, be punished with death. 
The spectacle of a great nation, at the end of the 18tli century, 
without any precaution or safeguard against the spread of infec- 
tion, contagion and death, save the order of the mayor to the 
watchmen to run around and tell all the afflicted to stay in their 
dens of pestilence, is certainly most striking. One would think 
that mother Partington’s attempt to sweep the Atlantic waves 
clean of her cabin floor would be easy, compared with the duty of 
the watchman in case of the visitation of a great city by the 
plague, the cholera or the yellow fever. 
The second offence, (that of selling uinvholesome provisions,) 
could be committed by violating certain statutes of Henry III. 
and Charles II.; among the more important of which was an act 
prohibiting the selling of unwholesome flesh or flesh that is bought 
of a Jew ; an act which, if now in force in this city, would allow 
us but precious little meat. It was, however, a punishable offence 
under the common law of England, that is independent of any 
known statute, to expose on the streets a person infected with 
a contagious disorder, or knowingly to give a person injurious 
food to. eat. And public nuisances might be publicly prose- 
cuted. 
So limited in those days were the offences against the public 
health which could be redressed by any public proceedings. That 
great author having thus summarily disposed of the public health, 
next considers offences against public police and economy; and 
his language most strikingly marks the contrast between the 
spirit of his generation and of our own. 
He says, “ By the public police and economy, I mean the due 
“ regulation and domestic order of the kingdom, whereby the 
“ individuals of the State, like members of a well governed family, 
“ are bound to conform their general behaviour to the rules of pro- 
“ priety, good neighborhood and good manners, and to be decent, 
“ industrious and inoffensive in their respective stations. This 
“ kind of offences must therefore be miscellaneous.” And he 
thereupon devotes to it twenty times the space accorded to the 
public health. 
Among those miscellaneous offences were these: it was felony, 
punishable by fourteen years’ transportation, to solemnize mar- 11 
riage in any other place besides a church or chapel, wherein bans 
have usually been published ; felony to solemnize marriage with- 
out such publication of bans; felony for persons to wander about 
the realm pretending to be soldiers or mariners; felony to be out- 
landish persons, calling themselves Egyptians or Gipsies, and tell- 
ing women’s fortunes. So, too, those persons were subject to 
prosecution who made and sold fire-works and squibs; who gave 
themselves to idleness ; who were eaves-droppers, and listened 
under walls and windows to hearken after discourse; who (being 
women, it would seem,) became common scolds and vexed the 
neighborhood; and these latter might be sentenced to the tre- 
bucket, castigatory or ducking-stool, and finally be plunged into 
the water; though it does not appear that the latter and only 
proper part of this punishment had any reference to sanitary re- 
sults. 
But we soon find these overstrained efforts of the law subsid- 
ing, and the national mind of England giving its attention to more 
reasonable and salutary measures for promoting the health of the 
people. In the reign of George II. the first general law was en- 
acted for the quarantine of vessels and persons coming from in- 
fected places. On this law, in part as a basis, the British Parlia- 
ment has reared a quarantine system, nearly uniform throughout 
the three kingdoms, and which has proved fairly adequate for the 
protection of the public health. That system cannot, perhaps, be 
said to be more effective than the quarantine laws which apply to 
the port of New-York ; but the English quarantine laws, regarded 
as a whole, have great advantages over the general legislation of 
the same kind prevailing in this country. Parliament having the 
same full jurisdiction over the three kingdoms, is able to enforce 
uniformity and co-operative quarantine regulations in every port; 
while with us, the practical division of jurisdiction between the 
federal and State legislatures and the discordant methods prevail- 
ing in the several States, have caused our quarantine system to be 
generally feeble and defective. One of the great works to which 
sanitary reformers should devote their labors, is to the creation of 
a system of harmonious and efficient quarantine regulations for 
the whole Union, in which State and federal power should each 
have its due agency and discharge its appropriate duty. 
It would be instructive, if I could allow myself the space, to 
trace the various agencies and forces which have co-operated for 12 
the development of the complicated and vigorous system of inter- 
nal sanitary laws now existing in England ; but I can do no more 
than refer to the two most prominent and effective of these in- 
fluences. 
And first, the appeal coming in behalf of the great cities, the 
factories and the mines. This came to the King and to Parliament 
in a double aspect: one in tones of fear and petition from those 
who dreaded the miasma and contagion bred in the dens of igno- 
rance, filth and vice; the other in admonitions of duty and 
schemes of sanitary reform from learned doctors and others who 
sympathized with the afflictions of their fellow beings, and had 
faith in the capacity of intelligent government to avert the con- 
sequences of those offences against the sanitary laws of the uni- 
verse, which bring needless sickness to families and numerous 
inmates to hospitals and asylums. 
Great cities, by creating a density of population and an accu- 
mulation of vice, have always been the prolific sources of conta- 
gion and pestilence; and their better citizens have also been 
the first to suggest and apply legislative measures of relief. 
Long before Parliament had enacted any general sanitary law, 
save those relating to quarantine, some of the larger cities of 
England had secured from the crown authority, generally very 
meagre, to make sanitary regulations. Special sanitary legisla- 
tion for cities began early in the reign of George II. And the 
Municipal Corporations Act of 1835 extended such legislation. In 
this way some protection was secured against filthy slaughter- 
houses, bad drainage, infected cellars and persons afflicted with 
contagious diseases. There was, however, no harmony of action or 
even of theory, but one city had one method, the next another and 
a third none at all. Medical and sanitary science had not reached 
its present high plane; superstition and ignorance interposed far 
greater obstacles than at present; and the benevolent and Chris- 
tian spirit, now so potent in sanitary reform, was far less vigor- 
ous and enlightened in the direction of sanitary legislation. The 
most complete English city charters of even half a century ago 
contained authority for the protection of the public health, which 
would now be deemed dangerously and disgracefully inadequate. 
For example, the latest royal charter for the City of New-York, 
that known as the Montgomerie Charter, granted in the fourth 
year of the reign of George II., though containing the most com- 13 
plete and fatiguing enumeration of powers, relating to nearly every 
possible matter, from cider, stragglers and beadles, up to the 
holding of courts and the making of city freemen for five pounds 
a head, contains but the merest crumbs or hints of sanitary au- 
thoi'ity, and does not so much as mention the public health or 
the preservation of human life. Some vague language about the 
“bailiff and conservator of the water of the North and East 
“ Rivers;” about the Mayor appointing packers, cullers, common 
cryers and scavengers; about sending “ rogues, vagabonds and 
suspicious persons” to the bridewells; and about collecting thirty 
shillings for a “ license to sell ale, strong waters and rum;” are 
all that is to be found in the fifty-five solid pages of this great 
charter of our municipal liberties, touching the most important 
subject with which the government of a city has to deal. We 
may be sure that the authors of this charter would never have 
admitted such a novel word as “ sanitary” into their municipal 
vocabulary, without, at least, carefully consulting a Lexicon. 
The prior charters were equally barren of sanitary provi- 
sions. 
The English mind, at this time, had only fairly began to re- 
gard the protection of the public health as a practical matter. 
Speaking of the I7tli century, Macaulay says, (Vol. 1, pp. 310 and 
311,) “Medicine has become an experimental and progressive 
science, * * &c. ; and the attention of speculative men had 
been, for the first time, directed to the important subject of sani- 
tary police.” 
But sanitary authority gradually became both more extensive 
and more frequent in English municipal charters. More and more 
medical science instructed Parliament, and humane men and wo- 
men out of Parliament inquired into the possibilities and profits 
of sanitary laws, for the promotion of the public health. 
As early as 1840 and 1841, general statutes were enacted, 
(which have since been made more efficient,) for general vaccina- 
tion at the public expense throughout the kingdom ; and similar 
statutes soon followed for the establishment of public baths and 
wash-houses, and for the supervision of common lodging-houses. 
The absence of corresponding provisions in this State, even to this 
day, is a striking commentary on the general belief, that a republic 
must needs excel a monarchy in its provisions for the afflicted and 
the destitute, and is a dishonor to our civilization. 14 
Commissions were also created by law for the making of exten- 
sive sewers in the cities and for the drainage of stagnant waters 
in the rural districts. The unhealthy condition of mines, work- 
shops, prisons and degraded city districts, was pressed upon the 
attention of Parliament by physicians and philanthropists. Great 
nuisances were more frequently prosecuted in the courts ; and 
learned doctors and humanitarians, by their writings, attracted 
public attention to the fearful loss of health, of valuable time and 
of life, by causes against which wise sanitary laws could provide 
safeguards. 
As the result, a net-work of local sanitary legislation was soon 
woven over all England; which, prior to 1845, had become so 
complicated, incongruous, inconvenient and yet inadequate, that 
the creation of a general system and co-operative administration 
was felt to be indispensable. The condition was much like the 
present condition in this State. Parliament first appointed sani- 
tary commissions to bring before it the facts in regard to the 
public health in the great cities, more especially in London, and to 
lay the basis of a sanitary code and to devise a method of sanitary 
administration. In 1838-9 the Poor Law Commissioners had made 
three reports to Parliament on the diseases of London ; in 1839 
the Register General of births and deaths had exhibited a general 
survey of the increasing sickness and deaths in the great towns 
and cities; and in 1840, a report was made from a select commit- 
tee in relation to sewers, interments, lodging-houses and public 
baths. In 1843, a still more comprehensive report was made by 
a commission, headed by the Duke of Buccleugh, as to the general 
causes of disease in the kingdom. The labors of these commissions 
were immense and invaluable. In 1845, the ministry of Sir Robert 
Peel was able to introduce the first of those great measures of 
sanitary relief which have since been known as the “ Model Acts.’’ 
They constitute an era in sanitary legislation, and are an honor to 
England. There were eleven of these acts, all passed between the 
beginning of 1845 and the end of 1847. It was an essential part 
of their object to bring the main provisions of the varied and con- 
fused enactments relating to cities, mines, swamps, manufactories, 
nuisances, the sick and the degraded in localities, under a few 
general statutes, and a more general, official supervision. The 
sphere of sanitary administration was also extended, and certain 
general clauses were provided in these acts, which were to be taken as a part of all subsequent sanitary legislation for munici- 
palities, by mere words of reference. 
But even all this failed to answer the rising demand for better 
protection of the public health; and in 1848, the first compre- 
hensive public health law was passed, with a clause limiting its 
existence to five years. 
A high officer of state was made leading commissioner, and two 
associates were also appointed by the crown to superintend the 
execution of this act, and were called “ The General Board of 
Health the provisions of the act were re-enforced at the same 
session, by another especially intended to guard against the 
cholera then approaching. 
A reference to some of the provisions of this great act of 1848 
will show how much more comprehensive it was, than any thing 
yet enacted for any part of this State, save the City of Rew-York. 
Before making such reference, however, I ought to state that there 
had been, since 1836, a general statute in England, providing for 
an efficient system of registry of births, deaths and marriages 
throughout the kingdom; so that the Register General was able 
to regularly publish the ratio of births, deaths and marriages in 
every part of the country. Even to this day, our registration is 
little more than a sham outside of this city. 
But to our references ; 
15 
(1.) When the deaths were too high in any place, it is provided 
that the central board shall order a sanitary inspection, and report 
to be made by one of its competent officers ; and the proper order 
for cleaning, draining or disinfecting are to follow, until the death 
rate goes down, and the expense was to be assessed upon such 
sickly places; the act having provided for local boards of health 
in cities and villages. 
(2.) The central board is required to cause local boards to take 
proper precaution against sickness caused by bad sewers, offal, 
sewerage, filthy streets and other nuisances, which may be 
neglected. 
(3.) The act prohibits buildings without proper drains, water 
closets and ventilation, and requires all slaughter-houses to be 
properly built and to be registered. 
(4.) Imposes penalties on those creating nuisances detrimental 
to public health. 16 
(5.) Authorizes inspectors of nuisances to enter and inspect all 
premises. 
(6.) Prohibits the letting of cellars for dwellings in future 
houses, or even in those existing, save on certain stringent con- 
ditions. 
(7.) Authorizes local Boards of Health to order water supplied 
to houses and to public baths and urinals, to water closets, pumps 
and cisterns. 
(8.) Gives the members of the local boards of health power to 
act as justices under the law, and provides for recovering penal- 
ties, damages, costs and expenses before them summarily. 
(9.) And to supply the means of doing such sanitary work, the 
boards were not only authorized to levy taxes, but they were 
authorized to mortgage a portion of the local taxes for years to 
come. 
Such are a few of the more striking provisions of the act of 
1848 ; and is it any wonder that, with such a spirit among the 
people, and laws like those well enforced for twenty-five years, 
the death rate of England has fallen below that of this State, or 
that the streets of English cities and villages are decidedly cleaner 
than those of the villages and cities of this State. And how pro- 
digious is the cost of our needless sickness. It is some consola- 
lation, however, to know that the labors of the Health Board of 
New-York have already reduced our local death rate materially. 
This general law was followed by several of more limited scope \ 
such as the important act for the prevention of diseases, (ll and 
12 Victoria, ch. 123,) under which a medical member was added 
to the General Board of Health ; further acts in regard to lodging- 
houses and vaccination ; a second act for the prevention of dis- 
ease, passed in 1855 ; an act to consolidate the nuisance, removal 
and disease prevention acts, passed in 1855, which is far more 
vigorous and comprehensive than any sanitary legislation known 
in this State, (save our Metropolitan Health Act, and goes beyond 
that in some particulars;) the nuisance, removal and disease act 
of 1860 ; and there Avas a further amendment made in 1863. 
In 1858, the great act of 1848 (which had been continued by 
intermediate acts) was modified by a new law, called the local 
government act of 1858. This last act enlarged the power of the 
local health boards, provided for more extensive sanitary precau- 17 
tions, and gave large sanitary powers to a member of the cabinet; 
and thus sanitary administration became a part of the duty of the 
ministry. . 
The great acts of 1848 and 1858 were materially amended by 
the sanitary act of 1866. That act extends the health laws to 
Ireland ; and it approaches very near to making health legisla- 
tion a distinct department of English administration. The prior 
sanitary laws are extended and invigorated ; and local adminis- 
tration and central supervision and control are so united as to 
give uniformity and strength to every part of the vast sanitary 
system. Nothing in the form of general sanitary legislation in 
this country equals the breadth, the spirit of business and the wTise 
precautions, which characterize this system. 
The act of 1866, which is by far the shorter of the three great 
acts, has detailed provision relative to sewers, drainage, water 
supply, wells, nuisances of many kinds, medical practitioners, dis- 
infection, infectious diseases, transporting the sick, receptacles for 
the dead, hospitals, ships, lodging houses, sewerage, infected 
buildings, guardians of the poor, baths and wash-houses, burials, 
removal of nuisances, dispensaries, medical inspectors and many 
other matters ; most of which are of general application. 
And in 1866, also, was enacted an important sanitary law, 
amended in 1869, known as the “ Contagious diseases act,” which, 
though open to some grave objections and the object of consider- 
able popular protest, yet strongly illustrates the rising morality 
of English public sentiment and its courage in dealing with the 
great social evil. We have no corresponding legislation in this 
State, and these statutes are worthy our serious attention. 
To these also must be added the consolidated vaccination act 
of 1867 ; the laborers’ dwelling act of 1868 ; the venereal diseases 
act of 1866; the act of 1860 to prevent the adulteration of food 
and drinks; the pharmacy acts, and the act relating to the sales 
of poisons of 1868 and 1869 ; the alkali works regulation act of 
1863 and 1868 ; the acts relative to smoke and steam of 1858 and 
1866, besides others of less importance too numerous to mention. 
And I especially regret not being able to allow myself the space 
needed to do justice.to the sanitary legislation of England for the 
protection of children and miners ; to that under which such 
admirable and complete returns of deaths and births are secured 
from every city, village, town and hamlet of the kingdom; or to 18 
that which keeps coroners in awe, and prevents their powers being 
used, as is too often the case here, to cover the deadly work and 
to screen from punishment the guilt of charlatans, abortionists 
and partisan bullies. 
It may not be uninteresting to add, that the number of books, 
pamphlets, speeches and voluntary organizations devoted to the 
subject of sanitary legislation and reform is very great—tenfold 
as great as with us. And yet the public demand for more sani- 
tary precaution is not satisfied; and at the session of Parliament 
of 1371, a report in several volumes, prepared by an able com- 
mission, was presented, and further legislation of an important 
character was nearly matured, at the last session, and will doubt- 
less be soon enacted. 
Some of the recommendations of this report, which the new law 
will probably embody, are well worthy our attention, viz.: 
(1.) That there should be one local health authority in every 
place ; so that none should be without it. 
(2.) That the members of all local health authorities should 
retire in rotation, and not at once. 
(3.) That the administration of laws relating to public health 
should be presided over by one minister, as the central authority. 
(That is, that there should be a minister of the public health.) 
(4.) That all expenditures of local boards of health should be 
examined and allowed, or rejected, by auditors appointed by the 
central board. 
(5.) That the central authority should have full powers of 
inspection and supervision, and defined control over all local 
authority. 
(6.) That every local health board shall have one qualified 
medical member, approved by the central authority. 
And at a time when a disease of horses paralyzes our iudustry, 
it is worthy of notice that the sanitary laws of England cover 
veterinary practice, and it is proposed by this able commission to 
place this subject under the care of the department of public 
health. , 
It is plain, therefore, that the health of both man and beast 
receives a far more enlightened and careful attention from legis- 
lative authority in England, than in this country, unless we shall 19 
find better sanitary legislation here than most of us have been 
aware of. 
IT. The other important source and subject of sanitary legisla- 
tion and reform in England, to which I ought to refer, is the 
medical profession ; including therein, not only physicians, sur- 
geons and dentists, but apothecaries and druggists. No well- 
informed person can question the vast advantage to a people of a 
high-toned, able and well-instructed medical profession, or the 
right of the legislature to enact laws that will promote, as well 
as enable the poor to share, such blessings. It is a curious fact 
that Russia, the least civilized of the great European nations, is 
in one respect the most advanced in supplying medical aid to its 
poor. In Grimms’ Life of the Great Empress Catharine, it is de- 
clared that she founded a school for educating women as nurses 
and in the elementary knowledge of physic; and that since that 
time the school has been so extended that one or more of its female 
graduates is furnished by the Government to every village in the 
empire. 
And it is hardly a less curious fact, that the first proposition for 
a statute of which we have an account for regulating the practice 
of medicine in England, made in 1422, was a “ bill to restrain 
“ women and all persons who had not taken the M. B. degree at 
“ Oxford or Cambridge from practicing physic,” but it did not be- 
come a law.* And we are told, (by the same author,) that “ the 
first English statute for regulating the medical profession, was 
enacted in 1511.” 
A Since that date, many Statutes having that object have been 
enacted, and members of that profession have exerted a great in- 
fluence for its elevation, and for the promotion of the public health 
of England. Physicians, like the members of the other profes- 
sions, have risen with the civilization they have promoted. 
A law of Henry VIII. gives us a curious illustration of surgical 
operations regulated by statute; for the law, after saying that 
any one shedding blood in the king’s presence, shall have his hand 
stricken off; then goes on about surgery, as follows: 
“ There shall be present at the execution, among others, the 
“ chief surgeon for the time being, to sear the stump; the sergeant 
* Glyn’s Manual of Laws affecting Medical Men, 1871, page 15. 20 
“ of the pantry, to give bread to the person whose hand has been 
“ stricken off; the sergeant of the cellar, to give the same a 
“ draught of red wine after the searing ; the sergeant of the ewry, 
“ and the yeoman of the chandry, with cloths and seared cloths, 
“ respectively, for the surgeon ; the sergeant of the poultry, with 
“ a cock ready for the surgeon to wrap about the bleeding stump ; 
“ the yeomen of the scullery, to prepare a fire and make ready 
“ searing irons ; the chief of ferror, to bring with him searing 
“ irons and deliver them, when hot, to the surgeon; and the groom 
“ of the salcery, with vinegar and cold water, to give attendance 
“ upon the surgeon.” I cannot say that I should be willing to go 
to Albany to advocate sanitary legislation of this sort. 
But the advancement of the medical profession in scientific 
Attainments, in moral tone, in social and political influence, is full 
of instruction, and is closely connected with the promotion of the 
public health, toward which, to a large extent, it has ever stood 
in the threefold relation of an inspiration cause, a faithful guide 
and a powerful friend. 
After the Church of Rome refused to allow the monks and the 
clergy to practice physic, surgery fell so low that the barbers and 
the smiths, who had aided the priests in surgery, became almost 
its sole practitioners; and even the more prominent of the surgeons 
were known as “ tbe gentlemen of the barbers company.” Those 
pursuing this combined calling, constituted one of the great guilds 
of London; and in the reign of Edward IV., obtained a charter 
of incorporation. As early, however, as the 32 of Ilenry VIII., a 
statute enacts, that those surgeons using “barbary or shaving 
within the City of London, &c., are prohibited from occupying 
any surgery, letting of blood, or any other thing belonging to 
surgery, drawing of teeth only, exeept” * * And further, that 
“ whosoever useth the mystery or craft of surgery, shall, in no 
“ wise, occupy or exercise the feat or craft of barbary or shaving.” 
The generation which gave so low a place to those who practiced 
the great science of surgery, did not treat the attorney or the par- 
son with any higher consideration. 
Thus the surgeons achieved a statutory severance from the bar- 
bers, and at the same time as they rose, left their old companions, 
the poor dentists, to consort with the shaving fraternity. 
As I shall not have space to again refer to the dentists, I wish 
to say that the great English medical act of the present reign has 21 
provided for their regular examination by the Royal College of 
Surgeons of England ; thus restoring the dentist to that common 
level in the eye of the law which they and the surgeons had for- 
merly occupied. 
The early associations of the apothecaries were with the gro- 
cers, whose common and ample stores included wine, oil, honey, 
lard and spices, together with drugs, herbs, ointment, potions and 
the miscellaneous prescriptions of the physicians. The combined 
grocers and apothecaries were long one of the great guilds of 
London. 
But a sanitary law also came to the relief of the apothecaries, 
and they left the grocers. A charter of James the First made the 
separation, and an apprenticeship of seven years became necessary 
to pursue the separate and rising mystery of the apothecary. 
It does not appear that the physicians ever formed such mer- 
cantile or mechanical connections. But it does appear that they 
were neither above nor below the female sex in those early asso- 
ciations. According to Tacitus, the early doctoring dames of the 
continent competed with the doctoring priests. In the age of 
chivalry, high-born damsels gained some proficiency in the healing 
art; and in the Fairy Queen we have an interesting description 
of the way they cured gallant knights. And in 1422 a vain 
attempt, (I presume by the other sex,) was made to procure the 
enactment of a sanitary law that should impose a fine of £40 and 
imprisonment upon female physicians. Nor is such attempted 
injustice so very remarkable, when we consider that centuries 
after this, the Book of Common Prayer contained a religious ser- 
vice for “Healing the Sick;” and that sittings of the Privy 
Council fixed, (and the clergy solemnly notified the people of,) the 
the days when the king, surrounded by divines in full canonicals, 
and attended by the Royal physicians, would heal ulcers, swellings 
and evils by the mere stroke of his royal hand ! In 1682, Charles 
performed this right 8,500 times ; in 1684 the throng was so great 
to be healed by him that even the presence of several court phy- 
sicians did not prevent six or seven of the sick being trampled to 
death. It was not until the time of George the First that Oxford 
ceased printing this “ Office of Healing” with the Liturgy; nor 
until after King William III. gave an applicant for royal healing 
this good sanitary advice—“ God give you better health and 
more sense”—did such nonsense cease. 22 
Still the standard of medical education was early fixed high in 
England by legal enactment. The first attempt in this direction 
originated with the University of Oxford, which in the 9th year 
of Henry Y. insisted that a degree of Bachelor of Medicine should 
be required as a condition of practice by “ either man or woman,” 
under a penalty of £40; and though failing in this, a sanitary 
statute was procured to be enacted in the 3d year of Henry VIII., 
which required any candidate for medical practice to be examined 
by two learned doctors. And a few years later in the same reign, 
the powers of examination were transferred from such persons to 
the “ College of Physicians,” then lately organized under a char- 
ter of this king. And it indicates the growing consideration in 
which surgeons and physicians were held, that the same king, 
by the advice of his Royal Council, appointed several of each 
profession to attend upon his person. But it would seem from 
Lord Coke’s Institutes, that these new court attendants were 
not very liberally trusted; for he says of them, “ that no physic 
“ ought to be given the king without a good warrant; that this 
“ warrant ought to be made by the advice of his Council; that 
“ they ought to administer no other than what is set down in 
“ writing; that the) should prepare it themselves and trust no 
“ apothecary.” And he adds, “ that the science of physic con- 
“ taineth the knowledge of chirurgery.” It seems to me he 
should also have added, that if the king died by reason of such 
ridiculous delays, the physicians should neither be hung, drawn 
nor quartered. This early statute creating a medical college and 
giving it the power of regulating admissions to medical practice, 
is full of a wisdom we have not yet wholly learned. It is but an 
example of several English institutions of similar character, which 
have had much to do with developing the enlightened sanitary 
spirit and legislation, and with securing the high standard of 
medical education, now existing in England. And with a brief 
notice of a few of these institutions, I shall conclude the portion of 
this paper devoted to sanitary legislation in that country. 
(1.) The Royal College of Physicians of London.—This great 
corporation was founded in 1518, to check and punish rash prac- 
titioners and promote worthy medical practice. It was given 
power to correct physicians, to supervise their medicines and to 
collect penalties of those persons who should practice medicine in 23 
London without the consent of its Faculty. In 1540, its agents, 
together with those of the apothecary’s society, were authorized 
to enter the houses of London apothecaries, and to examine the 
“ drugs and stuff,” and destroy what was defective. The college 
could even commit to prison offending doctors. In the same year 
surgery was enacted to be a part of physic, and surgeons were 
admitted to the privileges of the colleges. As early as 1522, it 
was enacted that no persons, save graduates of Oxford and 
Cambridge, should practice physic in England until they had 
been examined in London by the Examining Board of this Col- 
lege. And so the law substantially remained, up to the medical 
act of 1860, by which the old system was modified without the 
less carefully guarding against low professional morals and attain- 
ments. The college is hereafter to be called “ The Royal College 
of Physicians of England.” It may be readily imagined that 
under such a system England has been, far less than this country, 
afflicted with base quacks and fatal nostrums. There can be no 
doubt that each of the great professions, when organized and given 
proper control over its own membership, will exert its influence to 
raise the standard both of professional attainments and private 
character. And we need to practice on this truth. There has 
long been a similar college in Edinburgh and another in Dublin. 
(2.) The Royal College of Surgeons of England.—This institu- 
tion grew out of the “ Company of Barbers” in London, by passing 
through a hybrid condition from early in the 11th century, in 
which it was called “ The Masters or Governors of the Mystery 
and Commonalty of the Barbers and Surgeons of London,” to 
1800, when it acquired its present respectable name. Its rights 
and authority ai’e similar to those of the Physicians’ College, just 
referred to, and its standard for admission to practice is very high ; 
so high, I fear, as to exclude many who hack, saw and otherwise 
torment our broken limbs in this land of liberty. Ireland and 
Scotland have similar institutions. 
(3.) The Society of Apothecaries, London.—This Society origi- 
nated in a charter of James I., incorporating “ the Wardens and 
Fellowship of the Grocers of the City of Londonbut, about ten 
years later, the moi’e medicinal portion got an amended charter, 
under which they took the more dignified name of apothecaries 24 
So great were the powers given the corporation for supervising 
all medicines, that its agents were “ directed to enter from time 
to time the shops of all sellers of medicines, within seven miles of 
London.” And in 1815 this duty of examination was extended to 
all England and Wales. Medicines were to he tested, and had 
ones were to be summarily destroyed. The society Avas required 
to examine all persons wishing to prepare or sell medicines, and 
none were allowed to do so without the certificate of the society. 
Such certificates could be given to no person under twenty-one 
years of age, to no person who had not served as an apprentice in 
the business of an apothecary for five years, and to no person who 
could not sustain the prescribed and rather severe examination. 
The Society was also authorized to impose and collect heavy fines 
for violating the law or its own regulations. This society is still 
in full vigor, and is held in high public estimation. 
I ought to state that it was a part of the duty of each of these 
medical organizations to preserve registers of those authorized to 
practice in their respective departments, and to expose and prose- 
cute quacks and impostors. 
And, when we consider what a great power for good such bodies 
steadily exert, when we add to all this the stringent English laws 
relative to the sale of poisons, and the preparation of pernicious 
medicines, we need not to be told how much less frequently in that 
country than in this, ignorant physicians and surgeons send their 
victims to untimely graves, nor how much oftener here than there 
the deadly prescriptions of the careless, ignorant or stupid apothe- 
cary does the work of death. How much better the English peo- 
ple are protected against incompetent druggists, (an apothecary 
there is substantially our druggist, the English druggist not com- 
pounding medicines, or putting up prescriptions as with us,) will 
appear by contrasting our comparative defencelessness, with the 
stringent provisions enforced in England. Before a man can be- 
come an apothecary, in England, a license must be secured ; and 
these are some of the preliminaries of such license : 
(1.) The full age of 21 years. 
(2.) A preliminary examination in arts. 
(3.) A pupilage of not less than five years with an apothecary. 
(4.) Attendance upon extended courses of lectures, in each of 
three of those years, of which the winter course is six months. 
(5.) Examinations in classes during these lectures. 25 
(6.) Service as clinical clerk for at least six weeks in a hospital. 
(7.) Two professional examinations; one during the second win- 
ter of lectures, and the other when the five years ai*e completed. 
And no person can act, even as an assistant to an apothecary in 
compounding medicines, unless, after serving an apprenticeship 
of five years to an apothecary, and an examination by or under 
the examiners of the apothecaries’ societ y. And competency is 
not merely demanded by the letter of the law, but it is enforced 
by the decisions of the courts. A chemist’s apprentice has been 
convicted of manslaughter, in causing the death of an infant, by 
sending a different medicine from that requested; and an apothe- 
cary was also convicted of manslaughter, for unskillfully using an 
instrument which resulted in death. Such are the guarantees 
between the people and the dispensing and compounding druggists 
or apothecaries. Such the safeguards against the sale of adulter- 
ated and pernicious medicines. And to all these must be added 
the constant inspection of the apothecaries’ shops, processes and 
prepared medicines; and the far more prompt and vigorous prose- 
cutions than are known to our laws, in cases of abuses found to 
exist. Nor is this all; for in 1841, a society was formed for pro- 
moting the study of chemistry and pharmacy, with a view to the 
better securing of the public health. In 1843 it obtained a royal 
charter, and this provided that it should consist of chemists and 
druggists ; and the charter was reinforced by a law of 1852, and 
another of 1868. The society is authorized to make and enforce 
by-laws for the elevation of the standard of pharmaceutical and 
chemical attainments. These laws required a public registry to 
be kept under the care of the society of chemists and druggists, 
and forbid any person to keep any shop for selling, dispensing or 
compounding poisons, or to assume the name of chemists, drug- 
gists or pharmacists, in any part of Great Britain, unless registered 
under this act. And the society has the right of examination for 
such registry. 
I have no time to notice the conditions under which certain 
universities in the United Kingdom are authorized to confer medi- 
cal degrees; and it is, perhaps, enough to say, that they are such 
as not to let down the standard of professional knowledge, or to 
give encouragement to any sort of professional incompetency. 
But that same wise sauitary policy, which so long ago demanded 
a true record of the cause of every death in England to be sent to 26 
tlie central office, and to be classified and published to the people, 
which has thus carefully elevated and guarded the great healing 
professions, has exhibited a yet more extended care for the 
knowledge of the human body. As early as 1832, legal provision 
was made for a regular supply of human subjects for anatomical 
dissection ; and of so high sanction is anatomical science deemed 
worthy, that the Secretary of State for the Home Department 
now issues the licenses to practice anatomy; and the same au- 
thority appoints inspectors of the places where it is carried on ; 
and every snch inspector makes a quarterly report to that cabinet 
minister. Such is the progress made in that branch of sanitary 
science—such its elevation, since the time of Elizabeth, who 
allowed four bodies for dissection, and that of Charles the II., 
who increased the allowance to six. 
And in order to place safe and useful knowledge as to medi- 
cines, as fully as possible before the people of England, several 
laws enacted from the 21st to the 25 th year of the reign of Queen 
Victoria have provided for the publication, by a “ Medical 
Council,” of a book containing a list of medicines and compounds, 
and the manner of preparing them, together with their true 
Aveights and measures, &c., &c., and such other matters, as 
the Council shall think fit; to be called the “ British Pharma- 
copneand the “ General Council of Medical Education and 
Registration” is given the exclusive right of publishing that book ; 
the price to be fixed from time to time by the Treasury Depart- 
ment of the British Government ! The “ Pharmacopise” thus 
prepared has taken the place of the several similar books formerly 
published by the various medical organizations to which I have 
referred; and thus the people of England, Ireland and Scotland 
are furnished, at the cheapest rates, Avith a manual of medical 
prescriptions having every guaranty of safety, utility and sound 
knowledge, Avhieh the highest professional attainments and the 
most stringent legislation of Parliament can confer. And heavy 
penalties are enforcable by the Pharmaceutical Society against 
any person who shall compound a medicine mentioned in this 
book otherAvise than according to its directions. 
This “ General Council of Medical Education and Registration 
of the United Kingdom” is a very important body, and wields 
a general authority over the whole medical education and prac- 
tice of the British Empire. Having originated in the “ Medical 27 
Act” of 1858, its powers and duties were enlarged by Parliament 
in 1862. It has branches in Scotland and Ireland; and upon its 
Board of twenty-four members, there are those elected by each 
of the medical colleges and societies before referred to, by the 
corresponding societies in Ireland and Scotland, and by each of 
the universities of the three kingdoms having medical faculties; 
and there are also four members who are appointed by the 
Queen. 
The body, thus constituted, enforces and supervises the com- 
plete registration of every person connected with the healing art, 
from the druggist who sells, the apothecary who compounds, and 
the clerk who puts up a medicine, up to the most distinguished 
practitioner and the ablest professor of medicine; takes care that 
no one assumes any medical title, publishes sanitary qualifica- 
tions, lays claim to any medical education to which he is not 
entitled; compels every medical society, college and university, 
(not excepting proud and venerable Oxford and Cambridge,) to 
make report of the medical instruction they give, and to keep that 
instruction up to the high standard which the public interests 
demand; publishes to the people the names, with proper sug- 
gestions of the qualifications, of every person entitled to practice 
as a druggist, apothecary, surgeon or physician on the British 
Islands; and exposes and causes to be prosecuted the quacks, the 
charletans, the ignoramuses and the knaves, who attempt gains 
from the folly and ignorance of the afflicted. 
Such is another instance of the care which the laws and the 
benevolence of England take of the health and lives of her 
people; and the example demands the study of our legislators 
and of our doctors. 
It Avould carry me far beyond permissible limits to sketch even 
the outlines of that detailed sanitary legislation which aims to 
secure competent surgeons and physicians in the army, navy and 
mercantile marine; proper medical inspectors of merchant sea- 
men ; skilled surgeons and physicians for prisons, asylums and all 
the great factories most dangerous to health; and safe medical ad- 
visers for the poor in all the parishes and unions of the kingdom. 
There can be little doubt, I think, that English legislation has 
very nearly reached the creation of a “ minister of public health,” 
who will not only be a member, but the most important member 
of the national cabinet. His peaceful and brighter glory will take 28 
the place, in some measure, we may hope, of that costly and 
bloody glory which has gathered around the brows of the great 
war ministers, of that senseless pomp and display which have 
attended the glittering Lord Chamberlains of the court. 
This outline, in which I have set forth the comprehensive and 
vigorous methods of the later sanitary legislation of England, 
would convey a false impression, if I did not add that they are 
greatly encumbered by a vast accumulation of incongruous and 
half antiquated statutes. In nearly every department of English 
law and administration, the need of codification is apparent; and 
our more systematic and extensive labors in that direction are 
worthy the attention of the English jurist. 
And on the other hand, though hardly within the scope of this 
paper, I cannot omit calling attention to the numerous and in- 
valuable discussions of the great questions of sanitary science by 
which the medical men of England have laid the world under 
obligation. The public opinion which demanded such wise and 
varied legislation was formed by the writings of able men, rich 
in medical skill and benevolent spirit. They have given a breadth 
and precision to sanitary knowledge, and a certainty anil vigor 
to preventive measures, which are among the greatest blessings 
of human effort. The sanitary literature as well as’legislation of 
England deserve a more careful study on this side of the Atlantic. 
NEW-YORK. 
It will not require so much space to present a sketch of all that 
is useful in the sanitary legislation of this State. Our country is 
so new, our absorption in business and politics has been so great, 
our neglect of the public health has been so general, our estimate 
of human life, which so steadily floods our shores from the Old 
World, has been so natural and complete, that our sanitary legis- 
lation is, with a single exception, very narrow in its range and 
very imperfect in its methods, as compared with that of England. 
We have already seen that this city secured almost no sanitary 
powers under its English charters ; nor prior to the Revolution 
does there appear to have been any sanitary legislation worthy 
of mention for any part of this State. The first act of that kind 
appears to be that of 1784, entitled “An act to prevent the 
bringing in and spreading of infectious distempers.” It is really 29 
a quarantine law, and provides for the medical inspection of ves- 
sels. An act of 1794 amends the former, and provides the not 
very Christian remedy of sending infected persons out of the 
State. An act of 1796, provided for a health officer and seven 
commissioners of health, and combines quarantine with what are, 
with us, more commonly called health powers; that is, internal 
precautions against the development and spread of disease, under 
the same commission. This act naturally suggests a simplification 
of our present sanitary legislation for this city, by uniting the 
powers of the Quarantine Commissioners, the Health Officer, and 
of the Board of Health of this city, into the same board. This 
act of 1796, confers, for the first time, upon the Mayor, Aldermen 
and Commonalty of the City of New-York, the power of making 
by-laws and ordinances requiring cleansing, and the removal of 
offensive substances and nuisances out of regal’d to the security of 
the public health. The act of 1796 was amended in the same 
spirit in 1797 and 1798, in such manner as to confer larger powers 
for the regulation and for removal from the city of manufactories 
and occupations that threatened the public health. Acts of not 
much sanitary importance were enacted in 1800,1801 and 1804. 
All this legislation is limited in its application to the cities of 
New-York, Hudson and Albany, which were then the only cities 
in the State. 
The next sanitary law of importance is an elaborate act of 45 
sections, enacted in April, 1820, containing these interesting pro- 
visions : it combines quai’antine and ordinary internal sanitary 
powers, and confers them on the same body ; and that body is a 
board of health, made up of commissioners of health, appointed 
by the State, and members of the board appointed by the Mayor, 
Aldermen and Commonalty of the City of New-York. The num- 
ber of members to be appointed by the city is unlimited; the 
powers of the board and the method of its action are very loosely 
defined. And if the mercenary combinations and party spirit of 
that day were as strong as at this time, it is very plain that such 
indefinite and arbitrary powers as the board possessed, if exer- 
cised at all, must have been a great public peril. This union in 
the same board of members appointed by the State with those 
appointed by the city deserves consideration at this time, and 
might perhaps be repeated with advantage. 
This act related only to the cities of New-York, Hudson and 30 
Albany, and the navigable waters connecting them; and it first 
provided for health wardens in this city to inspect dwelling houses 
and other buildings. This act was amended and extended in 
1823, and the whole health legislation was revised in 1827 ; the 
City of New-York, by that time, securing nearly all sanitary 
authority within its own limits. 
The approach of the Asiatic cholera in 1832, caused the passage 
of a law in that year, entitled “ An act for the preservation of the 
public health,” which is the first I find which extends to the State 
at large, or which provides for the organization of health boards 
in the cities and villages generally; though this act recites that 
some such boards then existed. It also covers the sphere of 
quarantine legislation, especially along the great lakes, the St, 
Lawrence and the Hudson. “ It declares that all persons arriving 
from Canada or from any other place out of this State, shall be 
subject to quarantine.” The common council of cities and the 
trustees of villages are to appoint boards of health ; the super- 
visors, overseers of the poor and justices of the peace of each 
town are declared to be a board of health for such town. 
The boards in each town, village and city are to meet forthwith ; 
they are “ to appoint each a health officer; they are to make 
“ regulations, in their discretion, concerning the place and mode 
“ of quarantine.” 
Nothing can better illustrate the crudeness and arbitrary 
methods of our sanitary legislation than such laws, subjecting 
every foreigner and every resident of our other States to summary 
and ill-defined local authority. Like other laws, I shall refer to, 
it illustrates the need of co-operative sanitary legislation by the 
State and National Governments upon some carefully matured 
plan. 
The next important sanitary enactments were made in 1850. 
A general act of that year for the preservation of the public 
health, provides, that the Common Council of every city, and the 
trustees of every village shall, once in each year, appoint a board 
of health, to consist of not less than three, nor more than seven 
persons; and a competent physician to be the health officer. In 
towns, the supervisors and the justices of the peace, or the major 
part of them, are to be the board of health; and they are to ap- 
point a physician to be the health officer of the town. Such 
boards are to have power to regulate quarantine, and the deten- 31 
tion of all persons arriving in such city, village or town ; to pre- 
scribe powers and duties of health officers ; to regulate intercourse 
of infected places; to suppress and remove nuisances; to issue 
warrants for the arrest of those violating the rules, and to make 
such regulations as they shall deem proper for the preservation of 
the public health ; and finally, to employ such force as they deem 
necessary. This act applies to the whole State, excepting New- 
York City and Brooklyn. 
This law is obnoxious to many objections. It secures nothing 
of that continuity of service needed to devise wise sanitary pre- 
cautions ; it subordinates medical skill to official expediency and 
numerical majorities; it gives undefined and dangerous power, 
without securing an offending party any chance for a hearing or 
an appeal; it creates a too great number of boards, and provides 
for no general responsibility, method, co-operation, rules of action 
or supervision. 
Other laws enacted the same year, constitute the Common 
Councils in the Cities of New-York and Brooklyn, respectively, 
boards of health; and gave to certain persons, to be by those 
bodies appointed, the exercise of the executive powers of such 
boards. By such legislation, the State handed over to these mu- 
nicipalities its high duty of taking care that the health of every 
one who frequented them, should not be needlessly imperilled ; it 
mingled sanitary powers with the great mass of political authority, 
partisan tactics and mercenary intrigue, by which great city 
affairs are controlled. Men elected by party caucuses were 
treated as competent to administer the science of health, and to 
solve the problems of sanitary precaution. Health wardens and 
other officers were allowed to be selected and salaried without 
limit by the city aldermen and councilmen. It is no wonder 
that the exercise of sanitary authority soon became a greater 
peril than miasma and contagion ; that political doctors became 
the agents of partisan and mercenary city officials; that mayors of 
New-York, by no scrupulous or timid, did not dare, for a 
whole term, to even call a meeting of theNew-York Board of Health; 
that of the 48 health wardens and assistants, more than one-half 
were keepers of corner groggeries, and the other half were partisan 
repeaters and bullies ; that nearly the whole sanitary force of the 
city was, for utility, worse than a sham, and was, in reality, a 
scandal and a peril to a civilized community. Until I860, there Avas little other sanitary legislation of import- 
ance, save that relating to quarantine at the port of New-York. 
Were it not that the health officer is notoriously and disgrace- 
fully a partisan appointment, conditioned upon an implied promise 
to levy and hand over large sums for working the party machinery 
of the State; were it not that there is no need of a quarantine 
board and health officer of the port, distinct from the general 
health authority having jurisdiction of the cities and villages along 
the harbor, the general quarantine system at this port would not 
be very objectionable. The known impossibility of their remov- 
ing such partisan abuses in connection with that system, was the 
reason why the metropolitan health law of 18G6 did not interfere 
with it, and only made the health officer of the port a member of 
the metropolitan board. 
The great length which this paper has reached will not allow 
much explanation of the peculiar provisions of this most import- 
ant act, nor much notice of the inestimable advantages this city 
has derived from it. This generation will not forget the self-sac- 
rificing labors of those worthy members of the medical profession 
which arrested public attention and gave intelligence and author- 
ity to that public opinion that made such legislation possible. 
And we may congratulate ourselves that even the insurrection of 
municipal venality and barbarism, which despoiled and destroyed 
so much in our midst, shrunk from the attack of the main struc- 
ture of the metropolitan health law of 1866 ; although it grasped 
the patronage of appointing members of the board, cut down its 
jurisdiction to the limits of this island, and, worse than all, by a 
crafty indirection, repealed that salutary provision under which 
any abuse of its officers could be summarily brought to light 
through a public examination before the courts of justice. 
I will only refer to a few leading and original provisions of the 
law of 1866, which especially deserve the attention of those who 
attempt sanitary legislation for cities or villages: 
1. Recognising the inevitable necessity of a board of health, 
possessing powers partly judicial, partly executive and partly leg- 
islative ; and of its exercising them in the united light of legal 
principles,.medical and sanitary science and practical wisdom; 
that act created a board, of which three members were to be phy- 
sicians, (one the health officer of the port,) another a layman, and 33 
the four others, the Metropolitan Police Commissioners, (one of 
that board having been the chief justice of one of the city courts.) 
2. Having regard to the great importance of securing experi- 
ence and steadiness of action by the board, that law required the 
members to be so classified that their terms should be for four 
years, and that only one of the members should go out in any 
year. 
3. Intending to avoid the feebleness and corruption of so many 
health boards, caused by their direct dependence on frequent 
popular suffrage, sure in a great measure to be controlled by the 
authors of those nuisances and other perils to health, which the 
board ought to attack, this law provided that its members should 
be appointed by the Governor and confirmed by the Senate. 
4. Desiring that its doings should be just as well as vigorous, 
this laAv provided that in all cases where the property or business 
of a citizen should be interfered with by the proposed action of 
the board, the citizen should have reasonable notice and a fair 
opportunity to be heard before that body; and of course he could 
have a rebearing before the courts on a certiorari to bring up its 
record. 
5. And with a view to energy and harmony, as well as intelli- 
gence and certainty in all its executive action, that action was to 
be taken through one superintendent, who was to be a highly 
qualified physician ; and the work of inspection was to be carried 
on by a number of inspectors, who were to be worthy medical 
men, who were to report in writing at stated times. 
6. Upon a body thus organized, the whole sanitary authority 
of the district was devolved, and that body was required to act 
in public, to preserve full records and to make complete annual 
reports. 
The "board was given much more adequate power as to the 
City of New-York than had before been conferred, for the enforced 
registration of births, marriages and deaths; but until there is 
general and far more efficient legislation, that great subject must 
in this State remain in a condition disgraceful to our civilization. 
It is safe to say that so much power, so carefully guarded and 
so justly conditioned, was never devolved upon any health board 
in tliis country, if any where; and that this power, on the whole, 
and despite partisan coercion, has been used in a manner equally 34 
gratifying to the promoters of the law and to the true friends of 
the public welfare. It may be true that our late municipal 
degradation has lowered the standard of sanitary administration 
as well as narrowed its sphere; but it is a great fact, of which the 
people should take notice, as a test of political methods, that in 
the midst of such prevailing corruption and infidelity in our 
municipal affairs, no serious charge except want of vigor has been 
brought against this board, and no connivance at spoliation has 
been proved against its members. 
Of its work, I can only say, that New-York has had no other 
officers who have more faithfully withstood powerful seductions ; 
none other wTho have attacked and removed more serious perils to 
the public welfare. The abatement of many manufactories which 
were a public nuisance ; the removal of slaughtering from, and the 
prevention of cattle driving in, the built up portions of the city; 
the public protection in the case of contagious diseases to man 
and beast; the great improvements it has caused in tenement 
houses; the cleansing of so many thousands of places of filth and 
disease; the enforcement of greater care in the preparation of 
gas; the making and enforcement of tens of thousands of orders 
and inspections; the great courage given to the better classes 
and the steady coercion upon those who disregard the public 
health, which the action of this board has caused; have been an 
inestimable public blessing. 
And yet, among all the benefits it has secured for the future, I 
hold that by no means the least, which is conferred by the de- 
cisions of the highest court of the State to the effect that, under 
our American constitutions, it is possible to abate the wrorst classes 
of nuisances without a resort to the delay and the expense of a 
jury trial. These decisions are the first solid legal basis, on this 
side of the Atlantic, of truly effective sanitary administration. 
It is painful to turn from such laws and administration to the 
miserable sanitary methods and the feeble sanitary results which 
have been the natural consequence of the partisan and dishonest 
control of our public affairs in this State during the last two or 
three years of our political degradation. 
I have time for but a few illustrations: 
The Brooklyn charter of 1854 provides for a mayor, annually 
elected; and for a board of aldermen, consisting of two from 
each ward, of which one-half are annually elected for a term of 35 
two years. The aldermen and mayor are the Common Coun- 
cil. 
Sanitary powers of a varied and ill-defined character are con- 
ferred by the act of 1854 upon the Common Council. It creates 
a board of health, which is to be composed of as many of the 
aldermen as the mayor and all the aldermen shall at any time se- 
lect ; and upon this annually shifting and utterly undefined body 
of politically elected aldermen are conferred a considerable va- 
riety of sanitary powers; all of which may be arbitrarily exer- 
cised without notice or opportunity to be heard on the part of 
those complained of. Of course, the aldermen are the mere reflec- 
tion of the party majority of the moment in their respective wards, 
and every wholesome and vigorous exercise of their sanitary 
authority would offend some voter. Such a relation, even if 
ordinary aldermen had adequate scientific or medical knowledge 
to administer the sanitary authority required for the protection of 
a great city, would disarm all their independence and efficiency for 
sanitary usefulness. Yet a law of 1870, enacted in the same spirit 
and at the same session as the Ring charter of New-York, took 
Brooklyn wholly out of the Metropolitan District, and carried 
back the sanitary administration of that great city to the con- 
fused, shifting, partisan, divided, aldermanic health board of 
1854; and in addition conferred upon it the great powers given 
by the metropolitan health act of 1866. It may have been but 
just to confer upon a Brooklyn board of health certain powers of 
local administration ; but to confer them upon a partisan body, 
without continuity of existence, strength of tenure or medical 
skill; to provide for no records or reports ; to allow secret and 
arbitrary action and to give those about to be condemned no 
opportunity for hearing ; to subject the water front of the harbor 
of New-York again to numerous jurisdictions; are examples of 
legislative barbarism and injustice unsurpassed even during the 
last three years of recklessness and partisanship. 
Sanitary legislation* in the charters of Long Island City and 
New-Utrecht, a part of the Metropolitan Sanitary District, is 
hardly better than that provided for Brooklyn. The provisions as 
to New-Utrecht, (under which almost the sole power of the board 
of health is to cause a hunt annually up and down its little por- 
tion of the bay for carcasses and stinking substances,) would be 
simply ridiculous, did it not assume a serious aspect as illustrating 36 
our disgraceful need of general and comprehensive sanitary legis- 
lation, which shall have as little regard for mere town and village 
lines as does the otfal that poisons our water, the stenches that 
contaminate the air, the contagion and pestilence that, borne on 
the winds, wraps cities, villages and towns in one common winding 
sheet of disease, dismay and death. 
I cannot take the time needed to point out the similar defective 
and objectionable sanitary legislation for Yonkers and other parts 
of the late Metropolitan Sanitary District. Every where sanitary 
authority has become one of the agencies and forces of the party 
politics of municipalities ; and no general supervision, no concert 
of action, no common responsibility, is provided for. 
A new charter for the City of Albany, enacted in 1870, is no 
better. The mayor and aldermen, elected by the party majorities, 
are the common council and the board of health. Various sani- 
tary powers, loose in definition, narrow in range, utterly ex parte 
and arbitrary in their contemplated method of exercise, are con- 
ferred ; and all the ready methods I have pointed out, adopted to 
secure public efficiency and private justice, are utterly disregarded. 
No inspectors, no reports, no records, no hearings, no medical 
skill, are within the theory of this charter. Partisan, short term, 
aldermen are supreme. 
The new charter for the City of Buffalo, granted in 1870, is in 
some respects a considerable improvement on those last referred 
to, but in others there is much in it to regret. That part of the 
proper sanitary powers relating to abating nuisances and removing 
slaughter houses, (the former a very undefined and extensive 
power,) is conferred upon the Common Council, consisting of the 
mayor and aldermen. The residue of such power is conferred 
upon a board of health, to be made up of the comptroller, en- 
gineer and the president of the Common Council, with authority 
to appoint a health officer, who is to be a physician ; which is 
certainly better than a mere partisan body, directly dependent on 
the votes of those who endanger the public health. Some other 
features of this Buffalo charter illustrate both the want of some 
legislation by the general government as to sanitary matters and 
the great need of a general State law containing certain provisions 
that should be deemed a part of every local health law. For this 
charter contains important and, it seems to me, unconstitutional 
discriminations in favor of residents and against non-residents. 37 
For example, after referring to certain dangerous diseases, the law 
says the hoard of health may “ catise any resident infected with 
“ such disease to be removed to the pest house,-or to some other 
“place on the certificate, &c.; * * but it may cause any person 
“ not a resident of the city, infected or believed to be infected with 
“ such disease, to be sent to the pest house on the certificate, &c.; 
“ * * * * and may stop, detain and examine for that pur- 
“ pose person coming from any place infected, or believed to 
“ be infected, with such disease, &c., &c.; and the board may for- 
“ bid any vessel by them suspected to have on board any infected 
“ or diseased property or person to enter the city or harbor,” &c., 
and the violation of such order is made a misdemeanor. When 
we reflect that Buffalo is a port of entry for foreign vessels, and 
is on the great line of internal rail-road travel, it seems incredible 
that a law could have been enacted consigning travellers to a city 
pest house on the mere belief of a local board of three persons, 
and for suddenly turning away friendly merchants with passen- 
gers and cargo on mere suspicion. No mandate of a high feudal 
lord of the Rhine could be more arbitrary; no provisions of any 
quarantine law of any other civilized State was ever so destitute 
of all guarantees of caution or justice. Nothing but the long 
continued abnegation by the State of its duty to provide, as far 
as possible, general laws and stringent supervision for all munici- 
pal administration ; nothing but the mean ability and the low 
standard of fidelity which have of late filled our halls of legisla- 
tion would have made such disgraceful provisions possible. So 
long as the work of such men fill five hundHed pages of our annual 
statutes with special charters and other laws for cities and vil- 
lages, we can hope for little better. 
It is some relief, however, to refer to a brief act of 1872, creat- 
ing a board of health for the village of Saratoga Springs, for that 
board is composed of three persons, one of them a justice of the 
peace, another a village trustee, and the third a practicing physi- 
cian of the village. The elements of the board secure varied in- 
telligence ; and had the terms been for three years, and so classi- 
fied that only one should go out each year, it would have been a 
far greater improvement on old precedents. Still there are no 
notices, no hearings, no reports, and no records provided for. 
And I ought to add, that a law of 1872, creating a board of 
health, and vital statistics for Richmond County, still further 38 
illustrates the healthy reaction against the demoralization of 1870, 
and gives hope of the ultimate triumphs of the great principles of 
the metropolitan health act of 1866. The county judge of Rich- 
mond County, with the board of supervisors, are to appoint five 
sanitary commissioners, all of whom are to be physicians; and 
they, with said judge, constitute the board of health, and hold 
office for three years. Had three of these sanitary commissioners 
not been physicians, but business men, and the board beeu so 
classified that the terms of only one should expire each year, Rich- 
mond County would have just reason to congratulate itself. So 
many doctors, if they are not very rare men, will excite the jeal* 
ousy of the people, will give too much scope to nice theory, and 
will be found wanting in general business and political experience. 
A law containing sanitary provisions applicable to this city, en- 
acted in 1871, (Laws 1871, vol. 2, chap. 801,) further illustrates the 
habit of division and disintegration, when concentration and union 
are indispensable. The city comptroller is authorized to borrow 
as much money, not exceeding $100,000, as the “Commissioners 
of Charity and Correction shall need to procure or purchase 
proper accommodations, and to take charge of them, for the care 
and treatment of persons sick with contagious diseases.” Now, 
no person, I venture to assert, but those who have dictated recent 
legislation for this city and those who have made it to order at 
Albany, would have doubted that of all bodies, that most fit to 
have charge of a public hospital for those sick of contagious dis- 
eases, would be that Board of Health which, save this innovation, 
has sole authority and responsibility, and the best of all applian- 
ces and experience, in regard to persons so affected and the pro- 
tection which the public health requires in respect of them. What 
confusion of responsibility, conflict of jurisdiction, needless ex- 
pense and mutual jealousy, will not this unwise enactment pro- 
duce ? 
An act of 1871, for the creation of a board for the examination 
of druggists, is open to the same and still more serious objections. 
For, besides the evils of a subdivision of sanitary power in the 
city, by the creation of a new sanitary board, this act fails to make 
any use of the pride and self-respect of the medical profession as 
the elements for raising the standard of its vOW'n membership. 
We have seen how, and with what sanitary results, for centuries, 
every branch of the medical profession in England has had the 39 
effective guardianship of the gates to its own ranks, and a 
duty of weeding out the tares which have encumbered them. 
The same has also been true, of late, of the legal profession; and 
since this druggist law has been enacted, that profession, in this 
city, has courageously shown the wholesome vigor of its organ- 
ized action. But the authors of this law, treating the question 
as one of partisan or political power, gave all authority of appoint- 
ment to the mayor, instead of conferring it upon the medical pro- 
fession, the board of health, and the medical colleges. It brought 
every druggist, every druggist clerk, and every political doctor 
to the feet of the throne of the mayoralty. Every commissioner, 
every druggist and druggist clerk and doctor must beware how 
he votes and what he says, if he hopes to gain a salary, or retain 
a license. The only apology for passing such an act, was the ex- 
istence of a law of 1839, under which a druggist was entitled to 
vend his fatal nostrums in this city, on producing a diploma 
granted in any quarter of the globe, though he might be utterly 
ignorant of our climate, our diseases, or our remedies, or have 
fled, as a criminal, from the country whose diploma he had 
prostituted. 
Among the most important and benevolent agencies for the 
protection of the public health, are dispensaries and hospitals; 
and, so far as private generosity is concerned in sustaining and 
personal devotion in caring for them, I believe that such institutions 
here may safely challenge comparison with those of England or 
any other country. Nor has our legislature dealt ungenerously 
with such institutions. But the general political and municipal 
degradation to which I have referred, has reduced begging by 
such institution to a fine, or rather, I fear, to a very coarse art ; 
and has disclosed the need of some careful legislation for regu- 
lating the amount of State contributions, and testing the good 
faith and merits of all applicants. For example, on the 26th day 
of April, 1870, (the year which may be regarded as the very 
nadir of municipal pollution,) an act was passed making provision 
for our city government, which meant, in part, the giving of 
many honest, and probably as many corrupt or unmerited dona- 
tions. The dispensaries and hospitals were aware of their chances, 
and appear to have been ready to improve them, under that 
act. 
Homeopathic, Allopathic and Eclectic dispensaries alike, and 40 
many other institutions obtained their thousands from the treasury. 
But on the 6th of May of the same year, (Laws 1870, chapter 
704,) and hence only ten days later, it accorded with the policy 
and profits of our party managers, to open the doors of the trea- 
sury a second time to “ Public and Charitable Institutions” and 
others; and what do we find ? Why, these same dispensaries 
and other institutions on hand,” and holding out their hands 
again, and securing many other thousands. That most of these 
institutions are great public blessings, I fully believe, but no one 
can read the statutes I have cited without perceiving too much 
evidence of a system, a persistence and a co-operation in begging, 
by no means admirable, even if innocent. It is but too plain 
that such mongrel unions, such dangerous confederations between 
religion and charity, politics and medicine, as this City and State 
have encouraged, and have been screened under the sacred name of 
benevolence and the public health, are equally dangerous and dis- 
graceful. 
I have no time to refer to our sanitary legislation relative to 
poisons, abortions and mal-practice; but must close this paper, 
already far too long, with some general reference to the State 
laws relative to medical education. 
In 1801 a general act was passed, “ To regulate the practice of 
physic and surgery in this State;” and the act refers to existing 
regulations on the subject, and requires medical practitioners to 
come forward and make proof before the judges that they are con- 
forming to such regulations. 
Such a requisition at this day would doubtless create a first-class 
medical sensation, and would probably give our judges con- 
siderable work. 
In 1813, the physicians and surgeons of the several counties of 
this State were by statute authorized to meet together and 
organize themselves and choose otficers; and when so organized, 
they became corporations caj>able of suing and being sued. The 
act recites that some such societies had already been established, 
and refers to a State medical society as being then in existence, 
probably organized under an act of 1806. These medical societies 
are authorized to examine students and give diplomas ; and stu- 
dents dissatisfied with such examinations may appeal to the State 
Medical Society. The author of this act had evidently some 
knowledge of the great medical societies of England, to which I 41 
have referred; for the preamble recites, that “well regulated 
“ medical societies have been found to contribute to the diffusion 
“ of true science, and particularly the knowledge of the healing 
“ art.” 
This law further provides, that these societies shall have autho- 
rity for selecting “censors to conduct the examinations; for the 
making of by-laws relative to the admission and expulsion of 
members; for the election of one delegate each to the State Medical 
Society; for a record of membership and of the proceedings ; for 
procuring a library and apparatus, and encouraging useful disco- 
veries.” There can be no doubt that such organizations are well 
adapted to develop salutary professional pride and aspiration, and 
to raise the standard of medical attainments; but their powers 
were wanting in nearly every element of coercion, and were utterly 
defective, as compared with the corresponding English organiza- 
tions, in failing to declare it to bo the duty or the right of these 
medical corporations to punish impostors or otherwise protect the 
people against ignorant and dishonest practitioners. 
There being, then, no law as to laws being limited to one general 
subject, it happened curiously enough that this medical act was 
first amended by an unique clause foisted into a law of 1814, 
entitled “ An act to raise money to build a bridge over Allen’s 
Creek, in the town of Le Roy;” from which I infer that the 
medical society agents of 1814 kept quite as sharp an eye on the 
legislature as did the dispensary agents of 1870. 
A law of 1818 amended the act of 1812, by providing that the 
State Medical Society should also elect censors for examining 
students, and by authorizing each of the colleges of medicine in 
this State to elect a delegate to the State Medical Society. This 
last provision is a feeble foreshadowing of the election by English 
colleges and universities of members of the “ General Council of 
Medical Education and Registration,” already referred to. The 
several subsequent amendments to the law of 1813 do not appear 
to have materially affefted the efficiency or modified the structure 
of the societies formed under it; but a law of 1819 authorized 
them to levy a tax of one dollar a year on every physician and 
surgeon, whether belonging to the societies or not. 
But there are several general provisions of law, which if 
properly executed, would greatly increase the efficiency of those 42 
societies, and would bring them more nearly up to the utility of 
the English organizations. 
(1.) The county society may require every physician or surgeon 
to apply for and procure a certificate of membership; and if any 
such practitioners fail to do so, his license is to be deemed for- 
feited. 
(2.) If any such practitioner shall be charged before any county 
medical society with “ gross ignorance or misconduct in his pro- 
fession, or with immoral conduct or habits,” and two-thirds of 
the members at a meeting sustain such charges, they are to be de- 
livered to the district attorney, and he is to prosecute the same 
before the court; and the court may give judgment declaring the 
guilty party for ever incapable of practicing physic or surgery in 
this State, or may suspend him for a time. 
These are stringent provisions; more severe, indeed, than any 
that apply to any other profession, and have doubtless done much 
to raise the general learning and character of the medical profes- 
sion. 
I have no time to state the legal provisions as to qualifications 
and examinations for medical practice. If they were made into a 
harmonious code, and all the methods and avenues through which 
the right of practice may be reached were subjected to a more 
vigorous central authority, there would be much less to be de- 
sired in this direction. 
As early as 1840 the regents of the University were authorized 
to enforce the honorary degree of “ Doctor of Medicine;” and a 
law of 1872 has authorized that body to appoint one or more 
boards of examiners in medicine, and to give diplomas which shall 
entitle the party examined, “ whether male or female,” to practice 
physic and surgery. It is, therefore, a curious fact, that the last 
statute of New-York relative to medical education, enacted after 
the elapsing of more than four hundred and eighty years since 
the English law deprived women of their ancient right to practice 
physic, should have restored that right to the female sex ! 
I cannot, however, but regard it as a misfortune to thus create 
an independent source of authority for practicing medicine instead 
of conferring the entire power of that nature upon some central 
body, representative of the medical profession, in which all its 
schools, institutions and societies, aud every branch of its mem- 43 
bership should he fairly represented, and for which the profession 
should feel responsible. Proper provisions would, of course, be 
(needed, so that no one school or class of medical men or women 
should be allowed to domineer over the others. 
An act of 1857 authorizes the organization of Homeopathic 
medical societies in the several counties under the law of 1813, 
and a law of 1866 recognises a State Homeopathic Medical So- 
ciety. 
An act of 1856 gave legal sanction to a College of Pharmacy, 
and this act was amended in 1871. The powers of the college 
are adequate to encourage pharmaceutical learning, and its influ- 
ence is doubtless salutary, but it has no adequate authority, or 
rather none whatever, for bringing ignorant and dishonest drug- 
gists or chemists to any punishment, or even for exposing them. 
The law fails to avail itself of the honorable pride of those of a 
common profession, in promoting learning and character among 
its members, and so falls far below the corresponding English 
statutes in practical efficiency for promoting the general welfare. 
The act to regulate the practice of pharmacy and the sale of 
poisons, passed in 1872, (and repealing the partisan druggist act 
of 1871,) is a better specimen of legislation, and shows that public 
opinion is developing in the right direction. Yet, this act is de- 
fective in these essential particulars; in not providing that every 
druggist and chemist, wherever graduated or instructed, should 
have a license from the board; in not making it the duty of the 
board to make inspections of medicines sold; in not requiring it 
to prosecute all offending and unqualified druggists and chemists ; 
and in not placing it in some legal and co-operative relations with 
the New-York Board of Health. 
In 1868 the dentists of the State procured the passage of aAvell 
conceived law for their organization, after the analogy of the medi- 
cal societies. This law, amended in 1870, while it gives the dentists 
as an organized body no adequate power over those charletans who 
do not become menders of it, is yet calculated to do much good ; 
and is a further illustration of the tendency of all the professions? 
if encouraged by law, to use their organized influence for the ele- 
vation of their oAvn membership and the protection of the health 
of the people. 
Here, too, as in England, we notice how physicians and medical 
science came gradually to have higher and more intimate relations with legislation and administration ; and the day is probably not 
remote when a department of the public health may be thought 
to be as essential to the public welfare as a canal department or 
an engineering department. Some recent acts may, perhaps, be 
regarded as direct steps in that direction. 
For example : an act passed in 1864 authorized the Secretary of 
the State Medical Society to arrange a series of questions and in- 
structions to be transmitted to county judges ; and the latter are 
to appoint a physician in each county to examine into and report 
upon the condition and treatment of insane persons in poor houses, 
alms houses, asylums and other institutions throughout the State. 
But as the entire expense is to be only $300, the act may be re- 
garded either as a remarkable illustration of the niggardliness of 
the legislature or of the supposed unselfish spirit of the medical 
profession. 
A law of 1871 authorizes certain courts and also the Governor, 
to institute a summary inquiry, through a commission to be ap- 
pointed, into the sanity of persons charged with or convicted of 
capital offences, and an appropriation of $3,000 was made the 
same year to pay the expenses of such medical commission. 
This review of the sanitary legislation of England and New-York 
may, I think, fairly lead us to believe that we are not far from 
some salutary reforms, of which there is great need ; and it cannot 
fail to convince us that societies like this are leading the public 
mind up to those reforms and have a high sphere before them for 
labors of inestimable public utility. The value of sanitary precau- 
tions against needless sickness and premature death are becoming 
more and more appreciated. 
I venture to suggest the following as some of the organic 
measures of sanitary legislation now greatly needed, not only in 
this State, but wherever there is dense population. 
1. Co-operative sanitary legislation between the Federal and 
State governments.* 
2. A general law on the subject of public health, with some 
special clauses applicable to all villages, and others applicable to 
all cities ; our sanitary legislation, in regard to cities and villages 
generally now being in the most confused, inefficient and demora- 
lizing condition. 
* Since this paper was read, a sanitary bill has been introduced into Congress, and per- 
haps it is the first bill of that nature ever presented to that body. 3. General laws regulating every variety of medical practice, 
and the preparation and sales of medicines; under which those 
engaged in either shall have an organization and authority for 
securing, (coupled with a duty of keeping up,) a high standard of 
capacity and character, for examining all candidates, for exposing 
all malpractice, and for expelling all unworthy members. 
4. A central medical board having a classified membership, with 
proper relations to the State government, clothed with a super- 
visory control in respect of all such organizations, and the studies 
and standard of scholarship in all medical institutions; with the 
duty of looking into the sanitary administration of every city and 
village of the State, so far at least as to facilitate their harmonious 
action and to report their sanitary abuses ; with the authority and 
obligation of examining into the general sanitary condition and 
management of every public prison, school, jail, poor-house and 
public institution of charity or correction in the State ; with the 
right to demand reports in respect to all matters to which the 
supervision of such boards should extend, and the duty of making 
an annual report in respect of all such matters to the Governor. 
Such medical board should also have all the authority in regard 
to medical education now belonging to the Regents of the Uni- 
versity ; medicine not being, any more than law or divinity, a fit 
subject for the control of the Regents ; and such board should also 
be an appellate tribunal in regard to all medical societies. And 
in such medical board, (of which a part of the members should not 
be physicians,) there should be a bureau of registration of births, 
deaths and marriages, with authority to require full returns from 
every part of the State. It should also supervise the enforcement 
of compulsory vaccination throughout the State. It is not less a 
calamity than a disgrace to this great State to be without such a 
board of registration. 
With sanitary administration upon such methods, properly re- 
inforced and criticized by voluntary organizations, much needless 
sickness and municipal corruption would be avoided ; not a little 
pernicious charlatanry and not a few poisonous medicines might 
be suppressed; the catalogue of crimes might be reduced, and 
public morality and sanitary intelligence might be greatly ad- 
vanced. 
It is further indispensable, not only in this supervisory health 46 
board, but in respect of all local boards of health, that there be a 
divorce of sanitary administration from party and village politics. 
Until our people come to regard all sanitary laws and precautions 
as measures based on science, experience and medical skill, and 
not as mere agencies of caucus politics and party majorities, we 
can never have the public health duly protected, or any other 
results than corruption and inefficiency from our sanitary adminis- 
tration. Nothing can be more absurd than annual, party elections 
of village politicians to administer our health laws. They are 
generally utterly without qualifications, when elected; and while 
in office for short terms, they stand in constant fear of losing the 
votes of the bad men they ought to coerce; and by the time they 
have gained a little sanitary knowledge, their terms of office are 
expired. We have many stringent sanitary laws, so stringent 
indeed that any real enforcement of them would raise a general 
protest. They are in no sense enforced at all; but the threat of 
enforcement serves the purposes of mercenary officials and village 
demagogues. When the public mind shall comprehend that in 
every local board of health there must be united, medical skill, 
sanitary knowledge and classified terms of several years duration, 
so that there shall always be some experience and courage for the 
work; that every such local board should be organized on the same 
principles, and be subject to some general supervision, both in re- 
gard to methods and to expenditures; that our methods of arrest- 
ing disease must, no more than the disease itself, be limited by 
mere political boundaries or municipal jurisdictions ; then and not 
until then, can we hope for that kind of sanitary administration, 
which the common safety requires, and every consideration of 
economy and morality alike commends. Until that time, our city 
and village health laws and administration must, in the main, 
continue a scandal to our institutions and a disgrace to our po- 
litical intelligence.