In New Jersey the State Sanitary Association has conclusively shown the utter worthlessness of the State vital statistics. They memorialized the legislature, and caused the passage of a law which gives to New Jersey one of the best systems of registration yet devised. It owes its excellence to the following features, which should be universally copied:
1. Burial Permits are issued only after registry has been made by a properly qualified person; and
2. The returns are made to an expert, who collates them and deduces practical lessons from them.
II. Registration of Disease.—A large class of diseases may be prevented from becoming epidemic if their existence is known in time. For this purpose the boards of health should be invested with power and provided with means to investigate, reform, and, if necessary, to punish delinquency. Yet in the face of so practical a requirement little more is annually appropriated for the Board of Health of New Jersey than for the pay of two policemen.
III. State Sanitary Legislation.—The agitation for sanitary reform caused by the yellow fever should not be allowed to die out with the pressure of the calamity that aroused it. It should continue until every State that has been the seat of yellow fever, year after year, has as efficient a health code as Massachusetts and Michigan. The necessity of educating the people before it is possible to secure the requisite legislation will cause a considerable period of time to elapse before all the States have laws in accordance with modern knowledge. Probably no community takes the trouble to protect itself until it has actually suffered. To the distress of London the world owes the report of the Royal Commissions on water supply and the pollution of rivers, still the best repertory of the best knowledge on the subject. The manufactories of England have made it necessary for the government to take cognizance of aerial impurities. Similarly in this country the pollution of the Passaic has caused inquiries to be set on foot in the same direction.*
*See Report to Board of Public Works of Jersey City, by Professors Wurtz and Leeds; also, Analyt. Beiträge aus dem Laboratorium des Stevens Institute of Technology, by Professor Leeds, in Zeitschr. fur Anal. Chem. 1878.
An attempt was made to deprive the inhabitants of New York of their public parks, and to occupy them with buildings devoted to military and other purposes; but the people had already been sufficiently educated up to an appreciation of their sanitary value not to permit it. Dr. Seguin eloquently advocated the improvement of the parks, to make them not only pleasure grounds, but places of æsthetical and practical out-door education of the public school children.
IV. Ventilation.—It would be a great step in the interests of sanitary science if builders, vestrymen, and school or hospital trustees could be persuaded that their offices did not make them temporary authorities on ventilation, and that they had best intrust this matter to specialists who have fought their way into successful practice.
It appears that both the system of ventilation by aspiration and that by propulsion have had great successes and great failures. Many authorities have declared in favor of mechanical ventilation, yet in most institutions where fans had been introduced they are now standing still. In Roosevelt Hospital, New York, they ran their fan backwards for months and then stopped it.
V. Physical Education.—Instruction in hygiene and physical exercise as a part of the college curriculum was first successfully accomplished at Amherst College, and has now had a trial of nearly twenty years. The importance attached to it is shown by the fact that only distinguished members of the medical profession are appointed as professors, and that they have the same rank as the rest of the faculty. Their first duty is to know the physical condition of every student and to see that the laws of health are not violated. In case of sickness, the students are given certificates to excuse them from attendance and are put in the way of obtaining suitable treatment. The records kept are of great interest. All the classes are required to attend the gymnastic exercises four times a week. For a full account see Professor Hitchcock's report on Hygiene at Amherst College to the American Public Health Association. The excellent results of this feature—it can no longer be regarded as an experiment—recommend its introduction in all our colleges and public schools.