Wm. Ripley Nichols, for chemical investigations and report,
Paid for special investigations,-to Edward Jarvis,

$536 68

301 39

165 30

116 02

104 37

100 57

97 92

80 45

95 05.

75.00

19 97

PREVENTIVE MEDICINE

AND

THE PHYSICIAN OF THE FUTURE.

BY HENRY I. BOWDITCH, M. D.,

CHAIRMAN OF THE BOard.

PREVENTIVE MEDICINE AND THE PHYSICIAN OF THE FUTURE.

Gentlemen of the State Board of Health.

In my earliest communication with you I endeavored to express in a few words some general views of the great and benign objects presented before us, and the correlative public duties that devolved upon us, by our appointment as members of the State Board of Health. I wished then to give my highest ideal of those objects and duties, and I then expressed my belief that we should not fail of doing some service to the people of Massachusetts if, with simplicity of purpose and single-hearted devotion to that purpose, we should pursue, slowly, perhaps, but steadily, the path opening before us.

It is not my intention now to review what we have already done. I may, however, be allowed to say that the annual liberality of the legislature in regard to our reports, and the fact that the example of Massachusetts has been followed by several States of this Union, who have established similar boards, is certainly gratifying. It would seem that our example has stimulated others to a like course of action in regard to Preventive or State Medicine, as it has been sometimes called, because the improvement of the public health and the prevention of disease among the people is the object of both. This object has now occupied us for five years, and we can, perhaps, see more clearly its tendency and noble scope. We can also, perhaps, prophesy more decidedly than before the beneficial results that will accrue to mankind when the world enters heartily into its objects, and when similar boards have been formed, and have worked for many years in every civilized community.

Preventive or State Medicine is of recent origin. It has been the natural outgrowth of modern thought and resources, stimulated by centuries of suffering and by the sacrifice of

multitudes of human beings. Modern thought, later and more scientific methods of investigation, and more rapid means of communication of thought and of action have given this idea to the nations. It is true that Hygiene, or the science which would promote human health, has been discussed from earliest times, but commonly as applied to the individual man. The scientific study of the laws of disease as they affect large masses of men, and the voluntary efforts of great states to study those laws by means of boards of health, or of experts set apart for this special purpose, are strictly of modern origin. Hippocrates, wise as he was, could not, with the imperfect means of communication in his day, have inaugurated it. Moreover, in the earlier states, man as an individual never stood, in the estimation of his fellows, nor of the government, so high as he does at the present day under European or American civilization. Formerly his welfare was subordinated to that of the state. Now, the theory is exactly the reverse, and the state claims to have the tenderest interest in the welfare of each and every one, the humblest or richest of its citizens. Formerly, all persons believed, as many now believe, that prayer should be offered to the offended gods in order to stop plagues, famine and death. But now, most persons feel that, although prayer may avail much to enable an individual or a state to bear calmly some terrible calamity or to die bravely, if need be, in a great cause, it can never drive away fever, cholera, nor small-pox. It can never cure consumption, though it may help both sufferer and friends to bear it more patiently. To submit quietly · to any remediable evil, as if to the will of Providence, is not now considered an act of piety, but an unmanly and really irreligious act. It is the part of error and stupidity which does not believe in the duty of studying into the physical causes of disease, and in at least endeavoring to crush out these originators of pestilence and of death.

Modern Preventive Medicine has been hinted at by Nature from the earliest time. Occasionally she has shown us how she can summarily strangle disease, and drive it forever from its usual haunts. The great fire in London, in 1666, burned up the greater part of that metropolis. With its great sorrows, trials and losses, it brought one of London's greatest