To state the case concisely, the National Board of Health was not in accord with the spirit of American government, and the people rejected it. Now, what do the American people want? I will not attempt to answer this question, but will suggest that they want a general sanitary administration which is capable of steady development, and yet may be subject to such modifications as the changing conditions of our country may necessitate, a sanitary policy which can be made to expand until it will answer the public needs not only for the present but even for decades to come.
Its direct aim should be the ultimate intelligence and education of the average citizen in matters relating to his personal health, and the health of his commonwealth. No better plan for sanitary government appears at the present time than one modeled upon the structure of the general government itself. Broadly stated, this sanitary policy expects of each State a sanitary autonomy whose influence should be appreciated by every individual in every hamlet, however small, in its domain. It contemplates a State pride in the development of sanitation, a self-reliance and an unwillingness to surrender functions or call for aid from the general government excepting after the clearest convictions of propriety or necessity. This policy expects from the general government that since it controls commerce, both maritime and interstate, it will prevent commerce from conveying disease; that it will respect the sanitary institutions of the States; that it will have such organizations and establishments as properly belong to its sphere of action to supplement where States fail, and to enable it to wield its peculiar power when urgency demands.
As an apt illustration of this conception of authority in health control, let us consider the present activities of our Federal Public Health Service. These are as follows:
1. The prevention of the introduction of infectious and contagious diseases.
2. The sanitary regulation of foreign commerce.
3. The observance of international sanitary treaties.
4. The prevention of the spread of infectious and contagious diseases from one State to another through co-operation with State and municipal health authorities.
5. The collection and dissemination of sanitary information.
6. The conduct of scientific research in matters pertaining to the public health.
7. The enforcement of sanitation in Federal territory and in connection with Federal administrative affairs.