THOMAS M. LOGAN, M. D., Secretary State Board of Health.....Sacramento.

On the Salubrity of Public Institutions, Schools, Hospitals, Prisons, Factories, etc.— Dr. A. B. STOUT, Dr. J. F. MONTGOMERY, Dr. F. WALTON TODD.

On Statistics Relating to Life and Health, Modes of Employment and of Living, and the Comparative Healthiness of Different Localities.-Dr. F. WALTON TODD, Dr. JAMES MURPHY, Dr. H. GIBBONS, and Dr. LUKE ROBINSON.

On Intoxicating Liquors, Inebriate Asylums, Pathological Influence of Alcohol, etc.Dr. H. GIBBONS, Dr. JAMES MURPHY, and Dr. J. F. MONTGOMERY.

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Of these different committees, the Secretary is made, by resolution of the Board, a member, as well as ex officio the Executive of the Board.

* Dr. Murphy was commissioned by Governor Pacheco, on the fifteenth of March, eighteen hundred and seventy-five, to supply the place of Dr. Lane, absent in Europe.

GENERAL REPORT TO THE
THE GOVERNOR.

OFFICE OF STATE BOARD OF HEALTH, 1875.}

To His Excellency,
ROMUALDO PACHECO,

SACRAMENTO (Cal.), July 1st, 1875.

Governor of California:

GOVERNOR: In compliance with the requirements of the law establishing a State Board of Health, I have the honor to submit the accompanying report. While performing this official act, permit me to tender my congratulations on the steady advance of the State in public health, which is public wealth. This is attested by the constantly diminishing low death-rate, as seen in the chapter of mortality statistics, and which has already given to California the title of the "Sanitarium of the

World."

Without pretending that anything more than a good commencement has been made in our organized efforts to search out the most important causes of discase and death, in order that they may be avoided, there is yet reason to believe that the direction of the public mind to sanitary measures, through the mere fact of the creation of a State Board of Health, and the dissemination, by these biennial reports, of hygienic knowledge, has already prevented, and will continue to prevent, in some degree, the unnecessary waste of life.

It is only now that we are beginning to realize how vast a proportion of both our illnesses and deaths are due to purely and easily preventable causes, and the knowledge has hardly yet fairly started us into action. And this remark applies not to California alone, but to every part of the civilized world.

Look at London, with her reconstructed sewerage. What originated and put into operation this colossal achievement of sanitary engineering, but the awakened consciousness that thousands, nay, more than a hundred thousand of deaths, could be annually traced to zymotic diseases, generated and propagated by filth, noxious gases, tainted water, and the like-all of which factors of disease might be extinguished or neutralized by the prompt and energetic administration of well known sanitary laws.

Apart from the sickness and mortality arising from the material causes, just mentioned, there is a vast amount of preventable disease attributable to social causes, which legislative measures, or sanitary precautions, do not reach. So far as these causes are concerned, the

hopes of progress and improvement in California, as already stated, must rest, for the present, on education, wide-spread and general. The fundamental principles of domestic as well as public hygiene must become matters of intelligent conviction amongst all classes, and especially amongst the wealthier classes, that they may help those of the poorer, who are unable to help themselves. If, for instance, un wholesome overcrowding were prevented by an adequate supply of comforta ble dwellings for the poor, and if all those dwellings were well drained and ventilated, and furnished with an ample supply of good water, not only might many preventable diseases become controlled, but a number of other evils, now acting and reacting on each other, would be eliminated or greatly mitigated. Each valuable influence, put into operation, is a potent ally of every other, and this is the most encouraging feature of what we are now considering; amendment and reform, in one point, brings amendment and progress in all others. We cannot improve the surroundings of the depraved without, pro tanto, raising the moral feelings, and lessening that craving for stupefying strong drink, created and stimulated by breathing foetid air. We cannot, without the universal establishment of wholesome and decent homes for the poor, minimize the premature deaths caused by the want of such, or vivify the possible sapped health and strength of thousands yet unborn.

It generally happens, whenever such sanitary questions as these are raised, that "education" is pronounced in a dogmatic and unreasonable way, in connection with schools, as the remedy. Now, education is the business of home; instruction is the work of the schools. It is at home that the feelings, affections, habits, and aspirations which govern the conduct of the future life, are matured; and the happiness or misery, the success or failure of the man, depends upon the training of the child. What can be expected of the neglected, street-running child, when ripened into the full fledged vagabond? Long ago Guizot said: "Home is the domestic country of the man," and he pointed to the cultivation of the family ties as essential to the growth of true patriotism. The President of the British Social Science Association declared, in eighteen hundred and sixty-six, his belief, that in order to improve the moral condition of the people, we must improve their domiciliary condition; and in doing so, we should destroy their appetite for spirituous liquors." Intoxication was almost forced upon the people by the depressing influence of the localities in which they lived. Having gone for hours together through filthy localities, he could assert from experience that the atmospheric influences, the sights, and the smells he exposed himself to, produced such a weakness and faintness that he would have given anything for a glass of spirits to sustain his sinking nature. If that were the case with himself, who was generally well fed and in good health, what must be the case with those who live in such places perpetually?

There are, it is feared, multitudes in all our large towns so heavily burdened with the load of a vitiated heritage, and so hemmed in by the barriers of foul air, filth, and want, that teaching and preaching can only be felt as bitter mockeries, unless these barriers are first removed. Therein lie the duties of sanitary authorities, and only in compulsory measures is there any reasonable hope that amelioration and enlightenment may penetrate to these depths.

Allowing even a large estimate for the alleviation of preventable diseases, subjected to our present sanatory administration, still it is to be apprehended that the waste of life would, nevertheless, remain as

needless as it is appalling. What is wanted under these circumstances is power-coercive power, delegated under legislative restrictions, and exercised solely for the improvement of the public health.

SANATORY LAWS MUST BE ENFORCED.

In this country sanatory laws, to a certain extent, are permissive. In most of our cities and towns we find but little effort made to remedy the state of neglect, still existing in ill-ventilated buildings, and undrained and ill-drained localities. The local authorities, to whom are referred the execution of measures recommended by our Boards of Health, are not always imbued with the true spirit of humanity. Money considerations are with them often of greater importance than the question of life and death, and they too often overlook the hard fact, that while they remain inactive, disease and death do not.

Take San Francisco for example. With the full knowledge, derived from the experience of all the large cities in the world, of that most dangerous, if most natural of all tendencies in a productive and advancing country-the concentration of population into great towns, without any adequate effort to provide for it, or forestall its consequences-we are scarcely dreaming of the necessity of expanding our social garments, as our social body is outgrowing them. The same municipal government, or rather the same municipal makeshifts, which sufficed for San Francisco fifteen or twenty years ago, we seem to think will answer for the vast commercial mart of to-day. The same drainage system, the same sort of water supply, the same haphazard mode of multiplying buildings, which answered for a town of fifty thousand inhabitants, are being applied to the same town grown to two hundred and fifty thousand. To allow to perish by sanatory neglect is just the same as to take so many persons out of their homes, and forcibly put them to death; and yet, if this were done, the whole world would revolt at the barbarous act. Still, in how many instances do our local authorities calmly look on, while poor and innocent victims are condemned to breathe a poisoned atmosphere, or drink poisoned water, which is a great crime in the eyes of humanity. In view of the fact that this terrible continuing tax on human life, and all this needless suffering, fall with immense over-proportion upon the most helpless classes of societyupon the poor, the ignorant, the immature; upon classes which, because of their dependent position, cannot utter their indignant protest against the miseries thus permitted to be brought upon them-they have, from these circumstances, the strongest of all claims on a Legislature which can justly measure and can abate their grievances.

A LEGISLATIVE COMMITTEE ON PUBLIC HEALTH.

Our Legislature always has various committees, consisting of men selected for their special intelligence, to watch over the several classes of public interest and see that they suffer no damage; and more than this, to see that they derive the most benefit from the wisdom, care, and power of the Government. There are Committees on Education, Agriculture, Manufactures, Insurance, Finance, Fisheries, Railroads, Mercantile Affairs, Hospitals, Asylums, and other matters of public interest. The Legislature of New York adds to these a Committee on Public Health. I would, therefore, respectfully suggest to your Excellency to recommend the raising of a joint committee of the Senate and Assem

bly, to act in concert with the State Board of Health, in so modifying the laws relating to public hygiene that they may have their basis and potency in the well recognized principle: "Salus populi suprema est lex." In as far as human life is more important than all financial interests, and even in the financial view the creative power of human force is more valuable than all created capital, the interests of the people should take precedence of all other provisions. Every law, grant, or privilege from the Legislature should have this invariable condition, that human health should in no manner or degree be impaired or vitiated thereby. When the Legislature grants the right to dig a canal or ditch, or to build a dam for reservoirs to flow the land or irrigate, the grantee is properly held responsible for all the damage that may be caused thereby to other lands, crops, or mills. This is right and proper; but besides this, the grantee should be held responsible that no damage shall be caused to human life by the changes in the condition of the waters. This cannot be compensated by money.

In all cases where life and health are in question, the arm of the Government should be used with sufficient force to protect them. When a person tampers with human life by adulterating food, or knowingly offers to sell unwholesome articles of diet; when he adulterates milk with water, or other foreign matter, and thus deprives children and adults of their due nourishment, or impairs their stomachs with indigestible mixtures; when men thus selfishly jeopardize the health and sacrifice the lives of others for their own gain, the law should recognize this as a crime, and hold the offense amenable to the same punishment as robbery or manslaughter. Nor should it relax its stringency until the people are assured of safety whenever they purchase milk or other articles of diet.

I am aware how fully the laws represent the feelings and opinions of the people, and that, if the law is inefficient or unacted upon, it arises from a want of knowledge on the part of the people themselves. Not only does this ignorance tell upon the Legislature, but even if it were possible for the Legislature to provide all the conditions of a healthy existence, this object could not be obtained unless the people were sufficiently instructed to avail themselves of the rights thus conferred upon them. It would be in vain for the Legislature to enact a plan upon which houses shall be built to insure ventilation, unless the inhabitants of those houses understand the worth of fresh air. In vain would it be to bring an abundant supply of fresh water to our doors, if in our ignorance and indolence we refuse to use it. There must be intelligence both in the legislator and those for whom he legislates, if we are to take advantage of our present knowledge of the laws of life to secure us from disease and death. Such being the general ignorance, to postpone State action until the people become educated would be to neglect the State's noblest function, and to consign its inhabitants meanwhile to very great dangers.

LEGISLATION AGAINST QUACKERY.

There is one terrible evil, however, with which the profession of medicine has long had to cope, and against which I would now specially urge legislative action, inasmuch as the people appear ripe for the movement. I allude to the unrestricted quackery which now sits like a vampire upon the body politic, and which is never satisfied until the last drop of the blood of its victim is exhausted. To no body of scientific observers