Resolved, That, as members of the State Medical Association, we hereby record our high appreciation of his worth as an associate and friend, and our admiration of his unsullied reputation.

Resolved, That a copy of these resolutions be preserved in the archives of the Association; and also that a copy, signed by the President and Secretary, be sent to the family of the deceased.

J. F. HEUSTIS,_ M. D.
J. C. HARRIS, M. D.
E. D. MCDANIEL, M. D.

Committee.

The Committee on National Medical College, Dr. J. S. Weatherly, of Montgomery, chairman. No report. Committee discharged.

New business being in order, Dr. Jerome Cochran read a paper on Public Hygiene and submitted a plan for the organization of a State Board of Health, as follows:

DR. COCHRAN'S PAPER ON PUBLIC HYGIENE.

State Medicine is a thing of quite recent growth. As a distinct branch of medical science it has arisen within the last few years in England, where already it has become a great power for good. "It is, as I understand it," says Dr. Bowditch, the distinguished President of the Massachusetts State Board of Health, "a special function of State authority, which, until these later days of scientific investigation, has been left almost wholly unperformed, or has been exercised only imperfectly and spasmodically under the stimulus of some great danger, such as the coming of plague, cholera, small pox, or some other malignant disease. By this function the authorities of a State are bound to take care of the public health, and to investigate the causes of epidemic and other diseases, in order to elicit such knowledge as will enable every citizen to live as long a life as nature under the most favorable conditions will allow him, and as healthy a life as possible. As the chief aim of every physician in private practice is to cure every disease which is submitted to his care, so the far higher aim of State Medicine is, by its thorough and scientific investigations of the hidden causes of diseases that are constantly at work, to preveut the origination of such diseases-by the destruction of the conditions out of which endemics and epidemics arise to make endemic and epidemic visitations impossible." Dr. Farr, in a recent and able address, as President of the Section of State Medicine in the British Medical Association, pursues the following lines of thought upon this subject: "Public hygiene is a want as much as air, and public roads, and abundant water, and as such must be cared for and paid for by the community. A sanitary code is needed, with proper sanitary officers; for otherwise a code would be a dead letter. Hence a Ministry of Public Health will eventually be needed for the British Empire. Such a ministry would divide itself into four departments-administration, medicines, engineering, statistics-each of

which should be organized so as to work in harmony with a council of health and executive heads. Each town should have its board of health and its health physician in communication with and in aid of the Central Board of Health. The primary object of public medicine is to prevent disease, but it also surrounds the sick with conditions most favorable to recovery, and diminishes the death-roll of the people. But supposing every condition favorable for the perfect operation of the powers of State Medicine, we should still see grave defects in many persons; shortcomings in others; in many, organic degeneracies; in many, criminal depravities. All these it should be our object to remove. Hence the final problem of public medicine is this: How, out of existing seed, to raise races of men to the highest degree of human perfection."

These quotations from distinguished men are full of suggestion. The health of the citizen should be very dear to the State, an object of constant solicitude and wise care. It means, practically, ability to labor, and makes all the difference, so far as this world's toiling millions are concerned, between prosperous homes and happy families, and the peaceful enjoyment of useful lives under their own vines and fig trees; and the dragging out of miserable years in poor-houses and hospitals, and dishonorable dependence on public charity. Indeed, it will be conceded without elaborate argument that government can engage in no more useful, in no more honorable, in no more profitable work than the prevention of diseases, the improvement of human health, and the prolongation of human life. "These are my jewels," said the Roman mother, pointing to her sons; and the jewels of the State are the brave men and virtuous women who live within her borders.

What constitutes a State?

Not high-raised battlements, or labored mound,
Thick wall, or moated gate;

Not cities proud, with spires and turrets crowned;
Not bays, and broad-armed ports,

Where laughing at the storm rich navies ride;

Not starred and spangled courts,

Where low-born baseness wafts perfume to pride.

No. Men, high-minded men,

With power as far above dull brutes indeed,
In forest break or den,

As beasts excel cold rocks and brambles rude.

Men who their duties know,

But know their rights; and knowing, dare maintain;
Prevent the long-aimed blow,

And crush the tyrant while they rend the chain.

These constitute a State;

And sovereign law, that State's collected will,

O'er thrones and globes elate,

Sits empress, crowning good, repressing ill.

It is therefore to this end, to the production of men and women

of the highest grade of physical, mental, and moral accomplishments, that our political economy and governmental policy should direct the large resources of the State; it being quite demonstrably certain that it is from such investments that the largest returns will be realized, and realized, too, in such form as that gold and silver cannot be weighed as the price thereof.

Without adequate organization, and without the fostering care of the State, Medicine has already accomplished a great deal for the amelioration of the public health. The great boon of vaccination, by which small-pox, that most dreaded of the scourges of the middle ages, has been robbed of its terrors, is so well known and so well appreciated by intelligent people that I need only to mention it.

But other instances are not so familiar. Look, for example, at the connection between typhoid fever and the decomposition of organic substances. It is true that there is another cause, a specific typhoid poison, which is necessary for its development, but the fact still remains that without filth, without putridity, the disease is not born. The evidence connecting this disease and all its kindred with uncleanliness, putridity, decomposing matter, and particularly with the excretions of the bodies of men and animals, conveyed into the human system by air and by water, is given in great detail in the English government reports of the past fifteen years, and can hardly fail to convince any one who will examine them without prejudice. The plagues and pestilences of the middle ages, which sometimes swept away one-third of the inhabitants of Europe, are examples of the virulence of such diseases when people were huddled together in great towns, without drains or sewers, or other provision for the removal of the foul matters which proceed from human beings and the various processes of society. As civilization advanced, from various causes greater attention has been paid to cleanliness and ventilation, and with precisely equal step these pestilences have been shorn of their power. The great fire of London, which seemed a destructive visitation of Providence, proved a blessing in disguise; because in place of the low, dark, damp, dirty hovels which were swept away, houses were erected from which the fresh air and the light of the sun were not excluded, and, as a consequence, the great city has not since been ravaged by the desolating pestilences with which it had been before so familiar. And so it is everywhere. As improved works of sewerage and water supply go into operation in certain districts the death rate falls, and disease becomes less and less terrible.

As another example, let us take that most dreadful of all the physical maladies from which humanity suffers, namely: consump tion. It is more destructive than cholera or yellow fever. The ravages of these diseases are restricted to certain latitudes or to certain seasons, and although occasionally they levy heavy tributes of lives, their appetites are soon satiated, and they allow us long periods of immunity. But consumption is at work in all civilized

countries day and night, and summer and winter, without pause or weariness. It has been regarded by some as a special mode of death intended by Providence to reduce a redundant population, as feeble trees in a forest are crowded out of existence by their more vigorous neighbors. Yet the investigation of its natural history through the aid of vital statistics and the comparison of great numbers of cases promises to lead to the discovery of its causes-that is to say, of the conditions under which it originates-and we may fairly hope that when these conditions are fully recognized they may be avoided. Two of these conditions have already been revealed and are influencing practice and saving lives. One of them is thus stated by Mr. Simon, medical officer of the English Privy Council, and has been abundantly proved by him: "In proportion as the people of a district are attracted to any collective indoor occupation, in such proportion, other things being equal, the district death-rate by lung diseases will be increased." This cause, "collective indoor occupations," may be regarded as almost synonymous with the habitual inhalation of air rendered foul by respiration. Dr. Bowditch, from a comparison of statistics by physicians from all parts of Massachusetts, showed several years ago that among the prominent causes of consumption is exposure to soil moisture. In England this same law has since been even more strikingly shown. In 1855 and 1856 inquiries were made, under government authority, into the effect of drainage works and other sanitary regulations designed to promote the public health. pursuance of this inquiry twenty-four towns were selected in which improved drainage had been established. It appeared that while the death-rate had greatly diminished, it was most strikingly evident in the smaller number of deaths from consumption, the diminution of mortality from this cause amounting in some cases to as much as twenty per centum.

In

I will mention under this head but one other example, but that one is of great and special importance to the dwellers in tropical and sub-tropical countries. I mean all that large class of diseases, including fevers, neuralgias, dysenteries, etc., which are classed together under the comprehensive term "malarial"-diseases which constitute at least one-half of those which physicians are called to treat in the State of Alabama. Of these maladies our knowledge is singularly perfect. We know their entire natural history. We know that they are caused by the introduction into the human system of a specific poison, and we know exactly under what conditions this specific poison springs into malignant life. Wherever water is exposed to the influence of the sun under such circumstances as prevent its easy and rapid evaporation, there the malarial poison armed with the power of pestilence is born into the world. Now it is evident that, with this knowledge to direct us, it would be quite possible to put an end to malarial disease in any special locality by destroying the conditions necessary for the generation

of the malarial poison. Make this mischievous conjugation of the water and the sun impossible by thorough drainage and the whole pestiferous brood of malarial maladies will be utterly abolished and destroyed; surely a consummation most devoutly to be wished.

I think I have made it sufficiently evident that the State may derive incalculable benefit from the skilled investigations of properly trained medical men into the conditions and causes of diseases, and the consequent determination of the means necessary for their prevention. Already the importance of State Medicine is beginning to attract the attention of State governments, and two States of the Union have recently established, by act of the Legislatures thereof, State Boards of Health. These two States are Massachusetts and California, the one where the sun rises and the other where it sets. Massachusetts led off in the good work in an act dated June 21st, 1869; and her example was imitated by California only a few months ago in an act of substantially the same import. The Massachusetts Board is composed of seven members, serving terms of seven years, so arranged that one member goes out of office every year. The appointments are made by the Governor, with the consent of the Council. The duties of the Board are prescribed in the second section of the act, as follows:

"SEC. 2. The Board shall take cognizance of the interests of health and life among the citizens of this commonwealth. They shall make sanitary investigations and inquiries in respect to the people, the causes of disease, and especially of epidemics, and the sources of mortality and the effects of localities, employment, conditions and circumstances on the public health; and they shall gather such information in respect to those matters as they may deem proper, for diffusion among the people. They shall advise the government in regard to the location of any public institutions. They shall, in the month of January, make report to the Legislature of their doings, investigations and discoveries during the year ending December thirty-first, with such suggestions as to legislative action as they may deem necessary."

All honor, say I, to Massachusetts and California, for the noble example they have set in this matter.

At the last meeting of the American Medical Association, which was held in San Francisco, in May last, this subject of State medicine and public hygiene was brought before that august assemblage of the medical wisdom of the nation. Their views were expressed in the following preamble and resolutions, which were unanimously adopted:

WHEREAS, The science of hygiene and its corollary preventive, a State medicine, are subjects eminently congenial with the purposes of this Association, inasmuch as they have for their objects the pre