Page:Encyclopædia Britannica, Ninth Edition, v. 15.djvu/830

Rh 798 MEDICINE [SYNOPTICAL VIEW. tenances of the milk trade, and particularly of guarding against the well-known liability of milk to take up effluvia existing or arising near it. The order of council having remained inoperative, it is proposed to deal with the matter by a new Act of Parliament, to be administered by the local government board. While cows milk has thus been recognized by the sanitary law as a carrier of certain of the human contagia, the milk of diseased cows, and more especially of tuberculous cows, continues to be sold with impunity, the alleged communication of tubercular disease from the cow to man being difficult to prove to the satisfaction of the legislature. The want of constant supervision of the slaughter-houses is thought by many to be a serious defect in the sanitary law of the country ; and there is no doubt that much flesh of diseased animals (especially the tuberculous) is sold merely as inferior meat. Public Health Law of the United States. Questions of public health in the United States come under the common law and the statute law. In the larger part of the Union they are subject to the common law only ; in a certain number of the States there is statute law; and there has been since 1879 a national board of health and a quarantine law established by Act of Congress. Generally speaking, the public health procedure of the United States suffers from the want of organization. Decisions at common law relate chiefly to nuisances, and to the recovery of damages for loss caused by the same. The first attempt at statute law was an Act of 1866 creating a metro politan sanitary district and board of health for the city of New York ; in 1869 a board of health was created by the State legislature for Massachusetts ; the District of Columbia obtained its board of health in 1870 ; and other States have followed at intervals, so that there are now at least nineteen State boards of health, New York State and Pennsylvania having health boards only for their respec tive capitals and other individual towns. Besides the municipal boards in those States, there are very few others for towns in the Union, and still fewer for counties. The powers and activity of the hoards of health are very various; the Massachusetts board has powers amounting to that of a court, while the function of several of the State boards is hardly more than advisory. The sanitary statutes made by the State legislatures are in some cases very numerous. Wherever questions of quarantine for yellow fever have arisen, as in Louisiana (New Orleans), Georgia, and Alabama, the State board of health has acquired vigour and has enlisted popular support, in the capitals at least; but in most of the States laissezfaire is the ordinary feeling towards the board and its operations. The medical profession in each State is the most powerful force, and the State medical society is not unfrequently in a semi-official connexion with the sanitary board ; on the other hand, it is alleged that the unfortunate sectarian differences in medicine (represented chiefly by homoeopathy) have on several occasions prevented the formation of a State board of health, or have tended to paralyse the action of a board already existing. It is a charge also against boards of health, or at least against those in the great political centres, that their efficiency is apt to be impaired by the introduction of irrelevant political considerations in such matters as the making of appointments. The first step towards a national public health law was gained by the Act (approved 3d March 1879) &quot;to prevent the introduction of infectious or con tagious diseases into the United States, and to establish a national board of health.&quot; The board consists of seven members appointed by the president and of four officials detached from the public departments of State. Its duties are &quot; to obtain information upon all matters affecting the public health, to advise the several depart ments of the government, the executives of the several States, and the commissioners of the District of Columbia, on all questions sub mitted to them, or whenever, in the opinion of the board, such advice may tend to the preservation and improvement of the public health. &quot; Quarantine was to be a special object of the board s attention, especially the establishment, if possible, of a federal quarantine system which would preserve the legitimate commercial interests of the several States and their seaports. A quarantine law passed in 1879 provides that all vessels coming from any foreign port where contagious or infectious diseases exist shall obtain a bill of health from the consular officer of the United States at the, port of sailing. One of the principal functions of the national board of health hitherto lias been to institute scientific inquiries into the nature and causation of diseases of national importance, such as malarial fever. Among the acknowledged desiderata in the national sanitary law of the United States are a uniform carrying out of the practice of vaccina tion there is no vaccination law in certain States, and in others it is imperfectly applied and a uniform system of registration of births and deaths. See Bowditch, Public Hygiene in America, together with a Digest of American Sanitary Law (by Pickering), Boston, 1877; Billings, Introduction to Hygiene and Public Health, edited by Buck (Eng. ed., London), and in the Transactions of the Internal. Medical Congress, London. 1880, vol. iv., sect. Health.&quot; Public Health Law of oilier Countries. In France there is a council of health for each district, composed of medical prac titioners, pharmacists, engineers, and other experts, its function being purely advisory with respect to nuisances, unwholesome dwellings, schools, food, drugs, epidemics, and the like. The executive power rests with the prefect (to be carried out by the j the Seine and the prefect of police. The minister of agriculture and commerce is responsible to the chambers. In Prussia there is a certain amount of bureaucratic care of the public health under the ministry for ecclesiastical, educational, arid medical affairs. The minister is advised by a scientific commission ( Wisscnschaftliche Deputation fur das Medicinalwesen) ; and there is a subordinate board for each province, and a medical officer for each district or town (Kreisphysikus, or Stadtphysikus). Numerous offences against the public health are defined in the code, and penalties fixed (see Eulenberg s work, taken from official sources, Das Medicinal wesen in Preusscn, Berlin, 1874). 2. The lunacy laws have been fully treated of in a special section of the article INSANITY (q.v.). By an Act of 1879 habitual drunkards have been placed in a position somewhat analogous to that of lunatics, and there are now existing certain licensed asylums for their detention. 3. The Acts relating to the status of the medical profes sion are known as the Medical Acts. The principal measure, passed in 1858, created a body of twenty -four, called the general council of medical education and registration ; by a subsequent Act the council received a charter of incor poration, so that it might draw up, and become the publisher and proprietor of, a list and description of officinal drugs, which should be called the British Pharmacopoeia, and should supersede previous pharmacopoeias. The principal duty of the medical council is to keep a register of qualified medical practitioners. The preamble of the Act by which the medical register was created asserts the desirability of those in want of medical aid being able to distinguish qualified from unqualified practitioners; and those whose names are on the register are alone presumably qualified. To be a registered medical practitioner confers a certain positive legal status (right to sue for fees, hold appointments, give certificates, &c.); but there is nothing in the English law to prevent any person whomsoever from practising medicine and taking fees, provided he does not assume misleading titles. Those who are entitled (on pay ment of five pounds) to have their names inserted in the medical register are graduates in medicine or surgery of the universities of the United Kingdom, licentiates, members, or fellows of the Royal Colleges of Physicians or Surgeons in London, Dublin, and Edinburgh, licentiates or fellows of the Faculty of Physicians and Surgeons of Glasgow, and licentiates of the Apothecaries Halls of London and Dublin. The council consists of the repre sentatives of those bodies, of six crown nominees, and the president. The medical council possesses certain judicial and executive powers over the names on its register ; if, after due inquiry, a registered practitioner be judged by the medical council to have been guilty of infamous conduct in any professional respect, the medical council may, if they see fit, direct their registrar to erase the practitioner s name from the register. The medical council keeps also a register (unpublished) of medical students ; whoever has passed a recognized^ examination in arts, and has forwarded a certificate signed by a teacher of medicine that he has bona fide begun the study of medicine, is entitled to have his name entered in the register of students of medicine, with the date of his com mencement. The object of the students register is merely to provide a common and convenient record of the date of commencement of medical study, and, by implication, of the fact that the examination in arts has been passed. The medical council owes its title of a &quot;council of educa-
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 * tendered. In Paris there are two heads of executive, the prefect of