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One word more in closing, to avoid the misapprehension so likely to arise from prolonged attention to a discussion of the evils of any occupation; viz., that the community would be better off if no such occupation were tolerated in it. The schools of our State are an incalculable blessing to the State and to every citizen. They are neither "slaughter-houses" nor "prisons." It is because they are so precious that it is worth our while to scrutinize them so closely, and never to cease our efforts to improve them.

THE

WORK OF LOCAL BOARDS OF HEALTH.

BY AZEL AMES, JR., M.D., OF WAKEFIELD.

57

THE WORK OF LOCAL BOARDS OF HEALTH.

Although for many years there has existed, upon the statute-book of this Commonwealth, provision for the creation in cities and towns of independent boards of health, and more or less information and authority for their action, the absence of prominent special causes for interest therein has made, with small exception, all inoperative, and the serious exigencies of the last few years have found the would-be movers in these vital measures uninformed as to their powers and their work, while, to the advanced intelligence of the special observer in this field, the provisions of law seemed often inadequate or wrong.

In the limits of the following review of the peculiar work and observation which fall to the lot of local boards and officers of health, no more can be attempted than to outline, as clearly as may be, the routine duty of those whose efforts will not alone promote the immediate well-being of their various localities, but may prove invaluable in making up the data for future knowledge.

The writer well recollects the eager search of his associates and himself for any items of special instruction, on assuming the work of a local board of health, and the reply of the Secretary of the State Board to an appeal for a code of "health regulations"-"I know of none, and you will be obliged to create them,”—a reply that resulted in the framing of the code published in the report of the State Board for last year, and which has been adopted, in full or in part, in very many towns in various parts of the country.

It is hoped herein simply to give to those who have, without special preparation, been called to the discharge of the responsible duties of health officers, whatever benefits the writer may have derived from a somewhat eventful experience in a like capacity, and from an earnest study of the

subjects involved. The manifold, more intricate and peculiar concerns of the public health of cities, coming as they do under the provisions of special ordinances, it is not intended here to consider, except in so far as they may be analogous to those of towns, and are under the operation of general law.

[Chap. 1.]

ORGANIZATION.-While the statute of Massachusetts provides for the election by a town of an independent "board of health," to consist of not less than three, nor more than nine persons, it also specifics that instead there may be chosen. "a health-officer," and in the event of failure to choose either, the duties of such offices shall devolve upon the board of selectmen. The grave error of this law lies in its failure to make obligatory upon every town the choice of a board of health, the reasons being many and obvious why a board is preferable to a single officer, and equally so why the board of selectmen is inadequate to the performance of the special work.

The composition and organization of a board of health are by no means the least important of its considerations, and it is evident that there should be brought to the peculiar work it undertakes the largest and best possible medical knowledge and judgment.

In no town where there reside one or more physicians of any respectable standing, should there be a failure to secure the services of one, at least, upon the board, and in all cases where possible, a physician should be the secretary and executive officer. The qualities preeminently required for an officer of health are sound judgment, care in investigation, firmness, fearlessness and tact. Given a board composed of citizens possessing these qualities, having as a member an educated and active physician, and preferably a sound lawyer, and the unfavorable hygienic conditions of a town will unfailingly speedily lessen. The following conditions, in brief, should, it is believed, attach to a board of health to secure its greatest efficiency.

It should consist of five persons, chosen for their qualifications.

Gen. Stats., chap. 26, sect. 1.

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