in charge the sanitary interests of the whole country - and in March 1879, the following act was passed by congress creating a National board of health :

AN ACT TO PREVENT THE INTRODUCTION OF INFECTIOUS OR CONTAGIOUS DISEASES INTO THE UNITED STATES, AND TO ESTABLISH A NATIONAL BOARD OF HEALTH

Be it enacted by the senate and house of representatives of the United States of America in congress assembled:

§ I That there shall be established a National board of health to consist of seven members, to be appointed by the president, by and with the advice and consent of the senate, not more than one of whom shall be appointed from any one state, whose compensation, during the time when actually engaged in the performance of their duties under this act, shall be $IO per diem each and reasonable expenses, and of one medical officer of the army, one medical officer of the navy, one medical officer of the marine hospital service, and one officer from the department of justice, to be detailed by the secretaries of the several departments and the attorney-general, respectively, and the officers so detailed shall receive no compensation. Said board shall meet in Washington within 30 days after the passage of this act, and in Washington or elsewhere from time to time upon notice from the president of the board, who is to be chosen by the members thereof, or upon his own adjournments, and shall frame all rules and regulations authorized or required by this act, and shall make or cause to be made such special examinations and investigations at any place or places within the United States, or at foreign ports, as they may deem best, to aid in the execution of this act and the promotion of its objects.

§ 2 The duties of the National board of health shall be to obtain information upon all matters affecting the public health, to advise the several departments of the government, the executives of the several states, and the commissioners of the District of Columbia on all questions submitted by them, or whenever in the opinion of the board such advice may tend to the preservation and improvement of the public health.

§3 That the board of health, with the assistance of the Academy of science, which is hereby requested and directed to cooperate with them for that purpose, shall report to Congress at its next session a full statement of its transactions, together with a plan for a national public health organization, which plan shall be prepared after consultation with the principal sanitary organizations and sanitarians of the several states of the United States, special attention being given to the subject of quarantine, both maritime and inland, and especially as to regulations which should be established between state or local systems of quarantine and a national quarantine system.

§4 The sum of $50,000, or so much thereof as may be necessary, is hereby appropriated to pay the salaries and expenses of said board and carry out the purposes of this act. Approved March 3, 1879.

The national board, immediately after its membership was completed, set about the duties required by the statute under which it was organized. Inspectors were appointed to visit the different quarantine stations and report without delay as to their condition and necessities. The action of the board met the cordial approval of the health officials of nearly every state in the Union, and its position was strengthened by further legislation in June 1879, but its usefulness as a public authority was destroyed at the end of the period during which the act was operative (four years) by the failure of congress to make the necessary appropriations for the continuance of

its work.

The board had accomplished much useful sanitary work in the inspection of quarantine stations, in dealing with epidemics, specially the outbreak of yellow fever at Memphis and New Orleans in 1879, and had undertaken and entered upon very many scientific investigations which gave promise of results, which, if continued, would have reflected much credit not only on the board, but on the country which maintained it. These investigations as summarized in the report of the board for 1884, under 32 separate heads, comprised subjects in nearly every department of sanitary work.

An examination of the reports of the board, together with the weekly bulletins which it published for several years, is sufficient proof of the good work accomplished during the operation of the act under which the board was constituted. The failure of congress to continue this useful work, and the final dissolution of the board, as a consequence, can only be regarded as a serious mistake, which should be remedied by its reestablishment upon such lines as will meet the general approval of all state and municipal authorities, with whose hearty cooperation, its own work and their own would be strengthened and made more efficient for the protection of the people.

VOLUNTARY HEALTH ORGANIZATIONS

On April 18, 1872, several gentlemen, mostly physicians, met in New York city for the purpose of considering the question of establishing a voluntary national organization for the promotion of sanitary science and the public health. This preliminary meeting was held at the New York hotel, and after deliberation, a committee was chosen to report a plan of organization at a subsequent meeting.

This meeting was held, and a permanent organization of the American public health association was effected on September 12, 1872, at Long Branch, New Jersey.

The following gentlemen were elected as its officers :
President, Dr Stephen Smith, New York.

Ist Vice-President, Dr Edwin M. Snow, Providence, R. I.
2d Vice-President, Dr C. B. White, New Orleans, La.
Treasurer, Dr John H. Rauch, Chicago, Ill.

Secretary, Dr Elisha Harris, New York.

The next meetings were held at Cincinnati, Ohio, May 1, 1873, and at New York city, November 11, 1873, and from that time onward meetings have been held annually in the fall of each year in different parts of the country, in order that members from all sections might be accommodated. The meetings have usually been opened on Tuesday morning and have continued four or five days, with evening sessions, at which papers have been read and discussed relating to all subjects connected with the work of public health.

After the association had continued its work for 12 years, invitations were sent to the sanitary authorities of the British North American provinces to join it, which they did, and have formed a valuable addition to its membership. Later on, a similar invitation was sent to the states of Mexico, with the result of enlarging the scope and membership of the association still farther. The membership consists of sanitary officials of state and municipal boards of health, of delegates from the army, navy and marine hospital service, of chemists, engineers and bacteriologists, and of citizens in general who are interested in sanitary science.

It has proved to be a great public educator in matters pertaining to the health of the people, not only in the localities where its meetings have been held, but also through the medium of its published transactions, prize essays and other papers. It is not too much to say that its action has had a salutary influence in molding the work of public health at Washington.

Within the association, committees on all the prominent topics connected with public sanitation have been organized, and have proved extremely efficient in carrying out its special lines of work. Not the least of these is the committee on laboratories, which was organized at a recent meeting of the association.

Another organization which is an outgrowth of this association is the National conference of state and provincial boards of health, which, after several preliminary meetings, was first convened at St Louis, in October 1884, the object and end of which is to secure cooperation and uniformity of methods of work among state or general boards of health. This organization at first held its meetings at the same place with the American public health association, but in later years has met at other times and places. The 13th annual report of its proceedings was published at Indianapolis, in August 1898.

The American medical association is a much older organization, having been formed more than half a century ago. Recently, a section of this association was organized for the purpose of discussing questions relating to state medicine and public hygiene. This section meets annually at the same time and place with the association, and has proved to be a very important and useful department of its special lines of work. Many of the members of the American public health association are also members of this section.

Another organization with objects closely allied to those already named is the American climatological association, which was organized at Washington May 3, 1884. Its first officers were Dr A. L. Loomis of New York city, President, Dr F. I. Knight of Boston, Ist Vice-President, Dr W. H. Geddings of Aiken, S. C., 2d Vice-President. The association has published an annual volume of its proceedings in each year since its organization. In addition to the foregoing, state sanitary organizations and conventions have been organized in the older states and have held meetings regularly, usually once in each quarter, for the discussion of topics relating to sanitary science. It has usually been the policy of these organizations to change the place of meeting frequently, in order to give an opportunity to the sanitary authorities and different districts to take part in the meetings, as a matter of mutual benefit to all.

The oldest of these, the New Jersey sanitary association, had its 24th annual meeting at Lakewood, New Jersey, December 9, 1898. Similar organizations exist in Vermont, New Hampshire, Massachusetts, Pennsylvania, Michigan, Ohio, Maryland, and other states.

THE MANAGEMENT AND CONTROL OF INFECTIOUS DISEASES This department of sanitary work constitutes the most important of all the duties, both of general and local boards of health. So far as state or general boards are concerned, the functions pertaining to this branch of work consist mainly in giving advice, in investigating the causes of outbreaks of disease, and in the circulation of general information among the people in regard to the methods of preventing the spread of disease. General boards are sometimes given coordinate powers with local boards, to be used in cases of emergency.

The local board, on the other hand, in consequence of being (by reason of its mode of organization) in closer touch with each individual member of the community, is usually clothed with extraordinary power, for the purpose of dealing with infectious diseases whenever and wherever they are observed among the people.

The operations of local boards of health in this direction are enforced by the aid of laws, ordinances and rules, and the different methods employed are first, notification, second, isolation and third, disinfection. To this may be added, for the purpose of securing immunity from certain diseases, the provision of vaccination as a protection against the dangers of small-pox, and of certain antitoxins for securing immunity against other diseases, notably against diphtheria.

By far the greater use, however, of these latter products, has been of a therapeutic nature, in treating disease when actually existing in the individual. But custom has in this