Striking examples of the value of medical sanitary inspection are furnished by this voluntary organization. One inspector found diarrhoeal affections very prevalent in a settlement in an up-town ward, and for a long time was baffled in his efforts to discover the cause. He was finally led to examine the water of a neighboring well, which the people used. This water appeared to be of an excellent quality, but on examination by Prof. Draper, it was found to contain a large amount of organic matter, derived either from a sewer or privy. Prof. Draper pronounced it liquid poison. The mystery was at once solved, and the proper remedy suggested.
In another instance a very contagious disease was found in a tenant-house, and after a long course of inquiry it was at length discovered that a washer-woman, living in the basement, had taken in sailors’ clothing. The sailors were found, the ship visited from which they came, and there the disease was found. None but medical men can prosecute such investigations with success, or suggest the proper remedy. If such a corps of sanitary inspectors were daily patrolling their districts, visiting from house to house, searching out sanitary evils, advising and aiding the people in the adoption of preventive measures, no epidemics of smallpox, typhus, scarlet fever, or cholera would ever gain more than a transient foothold. The sanitary inspector would truly become an officer of health and would be everywhere welcome.
The remedy for our evils must be apparent; and this remedy is suggested in such terse unqualified language by the City Inspector above quoted, that I call the attention of the committee especially to this remark, as a proper guide in your deliberations. The
Remedy In the City Inspector’s report for 1861 we find the following:
“The stay of pestilence, to be effectual, must be prompt, and equally prompt must be the interposition of barriers against the introduction of disease, which may be kept back, but, once introduced, can with difficulty be checked or extirpated. For these reasons, there should be a power existing in other hands that may be ready to be used at the moment the exigency may arise.” * * * “The remedy, apparent to every one, must consist in the adoption of laws transferring the power of sanitary regulations to some other authority of a different order of instruction in sanitary science.” * * * “The first groundwork of reform, in the opinion of the undersigned, is to bestow upon some other body, differently constituted, all power over the sanitary affairs of the city; and, until this is done, all other proposals of reform will be deprived of their essentially beneficial features. To escape present complications is the first great point to be gained; and this point secured, simplicity, promptness, and efficiency may be substituted for inefficiency, complication, and delay.”
Accepting this as the first step in reform, the practical question arises: How shall that body be constituted to which is to be confided the sanitary interests of New York?
If the experience of other large cities is of any value, or, indeed, if we rely simply on common sense, the following are indispensable prerogatives in any well-organized health board:
1. It should be independent of all political influence and above all partisan control.
2. It should combine executive ability with a profound knowledge of disease and the proper measures of prevention. To this end the board should be composed in part An Efficient
Health Board of men especially accustomed to the dispatch of business, and in part of medical men of great skill and experience.
3. It should have a corps of skilled medical officers as inspectors, which should be the eyes, the ears, in a word, the senses of the board, in every part of the city, searching out disease, investigating the causes which give rise to it, the conditions under which it exists, the means of its propogation, and the most effectual mode of its suppression.
4. It should have a close alliance with the police, which must be its arm of power in the prompt and efficient execution of its orders.