time to time deem necessary for the preservation or improvement of public health, and it shall be the duty of all police officers, sheriffs, constables, and all other offi- Duties of offcers and employes of the State, to enforce such rules and regulations, so far as they shall be intended to effect [affect] their respective duties.

cers of state.

Rooms to be provided for

SECTION 11. The Secretary of State shall provide a room suitable for the meetings of the Board, at Madison, board and secand office room for its secretary.

SECTION 12. This act shall take effect upon its pas

retary.

General Report of the Board.

STATE OF WISCONSIN,

OFFICE OF STATE BOARD OF HEALTH,

January 10, 1877.

To the Honorable, the Legislature of the State of Wisconsin:

In accordance with the provisions of the law under which the State Board of Health has been organized, its first annual report is herewith presented.

The progressive spirit of the present era manifests itself in no direction more beneficently than in its efforts for the prevention of disease and of premature death. Indeed one of the most marked characteristics of this age, is the advanced estimate which it places on the value of human life and the care which is taken for its preservation. Under improved sanatory conditions and surroundings, the plagues and pestilences which once swept the earth have mostly ceased to exist, and statistics of longevity establish the fact that the average duration of man's life has been materially lengthened.

Doubtless, a part of this bettered condition of mankind is due to the increased comforts that have accompanied the advance of civilization, but in a much larger measure it is due to the better observ. ance of sanitary laws by individuals and by communities-to individual and to public hygiene. It has been chiefly left to this age to extend a knowledge of these laws to the people, to urge, and in some cases to enforce, an obedience to them, and so wonderful haye been the resulting benefits, that we may be truly said to have entered upon a new era in medicine "-"its highest and most beneficent development." Men have learned, and are learning, the grand fact which is the underlying principle in all sanitary labor, that "disease and death are in a great degree preventable." It is upon this foundation that the rapidly multiplying Boards of Health and Public Health Associations are builded. It is the effort of the

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physician to cure, if possible, individual cases of disease. It is the labor of the sanitarian to prevent the very inception of disease. In this, his is the higher work, and it is also one which gives greater promise. Dealing largely with communities and with the influences affecting bodies of men in these efforts, their importance rises beyond that which seeks alone to cure the disease of the individual, and preventive medicine assumes a rank beyond the curative.

In all these labors for the physical good of man, it is not to be forgotten that other good is at the same time accomplished for "the same causes which promote physical disease and favor preventable mortality, foster also immorality, degredation and social misery. Uninhabitable habitations, over-crowded rooms, foul air, neglect of personal and public cleanliness, insufficient sanitary appliances, intemperance, uncontrolled habits of impurity; these are not only the factors of disease but they are also the factors of moral degredation." To eradicate these causes of disease and death is therefore to elevate man both morally and intellectually and to assist in his restoration to the likeness of his Maker.

It is not needful here to recapitulate what has been accomplished by State Health Boards since they were first organized in this country in the State of Massachusetts. It would be easy to show that they have proven here, as in England and elsewhere, of real and practical benefit-conservators of their best physical interests and a real blessing to the people of the several States where they are in operation. This has been so manifest indeed, that though less than eight years have elapsed since the inauguration of this movement in this country ten States have already adopted and put into practical operation the idea of STATE MEDICINE, which number will doubtless be considerably increased during the present winter. We believe that it would be easy to demonstrate the wisdom of these organizations not alone on the score of humanity but also on the score of the truest economy, for while there is "nothing so costly as sickness," neither is there anything which so much contributes either to the happiness, or to the wealth of a State as the health of its citizens. That "public health is public wealth has become a part of the inner consciousness of the people." It is not a hasty or unconsidered statement that we make when we assert that the pecuniary loss to a State from preventable sickness, annually exceeds its entire cost of govern

ment; yet to build an argument in favor of an organization of this character, upon the cost of preventable sickness in money, is to build it upon the lowest and most unworthy ground. If by its investigations into the causes of disease, and its timely words of advice or of warning, it shall be able to save the life of a single citizen, then might a State consider itself repaid for the cost of its Health Board, and humanity might well demand this at its hands. Victories over disease are grand victories, and in the language of Dr. Baker, to those who shall call forth and so marshal facts and generalize the scattered forces of knowledge as to lead to victory over any one of the causes of disease which now annually destroy our citizens by hundreds or by thousands, humanity may well accord a higher praise than to the most successful of warlike generals."

To enlighten the people concerning such causes; to instruct them that they may escape sickness and death from preventable diseases; to teach them "a better knowledge and observance of hygienic laws," is the legitimate work of a State Board of Health, and is included in the comprehensive term "State Medicine,” which, with Dr. Bowditch, we understand to be "a special function of State authority by which it is bound to take care of the public health, to investigate the causes of epidemic and of other diseases, in order that each citizen may not only have as long a life as Nature would give him, but likewise as healthy a life as possible." Certainly "these objects rank among the most important matters discussed by the humanest hearts," and none "can be nobler or more deserving the attention of learned men, of philanthropists, or of statesmen."

"The primary object of public medicine," says Dr. Farr, "is to prevent disease; but it also surrounds the sick with conditions. most favorable to recovery, and diminishes the death-roll of the people." And the same eminent authority, recognizing the difficulties that environ this labor, says: "Supposing every condition favorable for the most 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." And he gives, as the closing thought of an able address: "How, out of the existing seed, to raise races of men to divine perfection is the final problem of public medicine."

Accepting these exalted views of State Medicine, and of the duties of a State Board of Health, the undersigned have entered upon the

duties imposed upon them by the commission of his Excellency the Governor, with a feeling of individual responsibility in view of the greatness of the work before them; with an earnest desire so to meet the varied duties and difficulties which will confront them as that their work will commend itself to the intelligent judgement of the people; and with the hope that they may so inaugurate this new and important depart nent of public service, as to demonstrate its capacity for a usefulness which shall not be limited to the present time, but which will increase with the passage of years, and prove to be a blessing to the people of the State, lasting through all time. In presenting this first annual report, the Board beg leave to say that they regard the work thus far done as largely of a preparatory nature. The time which has elapsed since its organization is much too limited for it to hope for the exhibition of any great results, yet they believe that some good preliminary work has been done, and that there has been awakened in the minds of many of the people a thoughtful interest in sanitary matters, which cannot fail to be productive of future good. It has been the object of the Board to enlist the interest and co-operation of thinking men, both within and without the medical profession. It has been its belief that thus they could best create and develop a public sentiment in favor of hygienic principles and practices. It is painfully evident that this must of necessity be a comparatively slow work-that a large majority of our fellow citizens are both ignorant and careless as regards many of the fundamental principles of hygiene, and that they live in daily and direct disobedience of many of the simplest laws of their physical being.

For the purpose of systematizing the labors of the Board, and of bringing before the people such useful knowledge as is contemplated by the law, each member of the Board has been charged with the special study of some branch of sanitary science, with the view of presenting the result of such investigations to the people. We present here with the fruit of such labor in a series of papers, which are designed to convey such knowledge in a popular, rather than in a scientific manner, which papers we commend to your attention.

For a more formal and detailed report of the operations of the Board, we refer to the accompanying report of the Secretary.