Πολιτικὸν, ἔφη, λέγεις Ασκληπιόν. Δῆλον, ἦν δ ̓ ἐγώ . *Αρ ̓ οὐκ ἀγαθοὺς δεῖ ἐν τῇ πόλει κεκτῆσθαι ιατρούς ; εἶεν δ' ἄν που μάλιστα τοιοῦτοι, ὅσοι πλείστους μὲν ὑγιεινοὺς, πλείστους δὲ νοσώδεις μετεχειρίσαντο.-PLATO. De Repub. lib. iii. INTRODUCTORY ESSAY. CHAPTER FIRST. PRELIMINARY. HAD it been my intention, in the following pages, to treat methodically of all the various matters pertaining to the care of the Public Health, for which either the enactment of special laws, or the delegation of discretionary power to constitutional authorities, has been found necessary in this and other countries, I should, both as regards matter and arrangement, have drawn more or less from some of the most approved treatises, chiefly German and French, which have been published within the last eighty years* on the continent; for, to say the truth, this subject has never been systematically+ written upon in England. Or, had I wished to describe in detail the most successful methods of effecting a few sanitary objects, special in kind and limited in application, I should have examined the measures now in progress in certain cities and towns, at home and abroad; I should have compared these, not merely with some of the public works and municipal regulations of ancient times, but also with those other more appropriate and practicable * Johann Peter Frank's classical work on Medicinische Polizei, commenced publication in 1779. + The nearest approach to a system of Medical Police-and the first attempt, I believe of the kind-in this country, was the large work on Medical Jurisprudence, by Dr. Paris and Mr. Fonblanque, in 1823. But by far the larger portion of that treatise is occupied with that department of Medical Police, to which we now restrict the term-Medical Jurisprudence. 4 UNITY OF STATE MEDICINE. projects, suggested in the many pamphlets and reports on sanitary affairs, which have deluged this country during the last twenty years. My design is, however, of a more elementary character, as regards this introductory Essay; and, in some respects, of a more temporary nature, as regards the subjects considered in the following Essays. In the first place, I wish to draw attention to the UNITY OF STATE MEDICINE; and to point out the connexion, legislative and administrative, which ought to exist between its several departments; and partly, also, to induce those whose leisure, scholarship, and opportunities for research, qualify them specially for such a task, to bring before English readers a correct account of the rise, progress, and present condition of medical and sanitary police in Europe.* Secondly and mainly, I am anxious to show the singular absence of comprehensive design which has characterized all attempts at legislation in this country, whenever circumstances or events have imposed on Government and Parliament the necessity of adopting measures, either for preserving the health and diminishing the sickness of the people, or for regulating the education and duties of the medical profession. "Medical polity," said Niemann,† "is a necessity for every State. Hence, in some nations, laws and regulations for the improvement of the Public Health were in existence before those nations brought the principles of such laws into scientific combination." England is almost the only great European State still in this anomalous position. So little indeed have our countrymen considered the subject as a whole, that in the rare event of its being referred to, the Have any of the Travelling Fellows of our old Universities employed their ample means and opportunities thus usefully? + Taschenbuch der Staats-Arzneiwissenschaft. Leipzig, 1828, § 7. NEW SCHEME OF STATE AGENDA. 5 question is probably asked, "What is the meaning of State Medicine?" To this question, which has often been put to myself, I would now reply; not by endeavouring to define State Medicine with logical accuracy, and in a sentence or two, but by stating in order what appear to me to be its principal constituents, and their mutual relationships. Without following any of the systems of arrangement which are to be found in French works on Hygiène Publique, or in German systems of Medicinal Polizei, or Staats-Arzneikunde; without attempting to make a philosophical classification of the details of State Medicine; and without professing even to specify every requisite particular, I venture to offer a new scheme of STATE AGENDA, for promoting the physical welfare of the people at large. This scheme may show, I hope, the intimate, and not safely separable, connexion of its several divisions. It is almost needless to explain, that many English expressions, relating to places, territorial areas, institutions, o ffice and regulations, are often used in what follows, although the sanitary arrangements which they are intended to designate, may not exist in this country at the present time. This introductory Essay is, in fact, but little more than a catalogue raisonné of Public Hygiene. It may, I fear, prove somewhat dry and insipid to the literary Sybarite, who cannot relish a grave and difficult subject, unless it be served up in dainty style, seasoned with Attic salt, and garnished with illustrative anecdote. But, it is my earnest hope, that all who take a real and hearty interest in this, the most momentous subject of the day, as regards the internal policy of the nation, will not hesitate to follow me through these details, nor have reason to regret the time devoted to their perusal, even though they may sometimes differ from the opinions of the writer. The outline of a Sanitary Code, traced in the succeeding chapters of this Essay, may also serve as a normal project, a |