Chapter IV: New York, the Unclean (3)

“The stay of pestilence, to be effectual, must be prompt, and equally prompt must be the interposition of barriers against the introduction of disease, which may be kept back, but, once introduced, can with difficulty be checked or extirpated. For these reasons, there should be a power existing in other hands that may be ready to be used at the moment the exigency may arise.” * * * “The remedy, apparent to every one, must consist in the adoption of laws transferring the power of sanitary regulations to some other authority of a different order of instruction in sanitary science.” * * * “The first groundwork of reform, in the opinion of the undersigned, is to bestow upon some other body, differently constituted, all power over the sanitary affairs of the city; and, until this is done, all other proposals of reform will be deprived of their essentially beneficial features. To escape present complications is the first great point to be gained; and this point secured, simplicity, promptness, and efficiency may be substituted for inefficiency, complication, and delay.”

Accepting this as the first step in reform, the practical question arises: How shall that body be constituted to which is to be confided the sanitary interests of New York?

[Sidenote: An Efficient Health Board]

If the experience of other large cities is of any value, or, indeed, if we rely simply on common sense, the following are indispensable prerogatives in any well-organized health board:

1. It should be independent of all political influence and above all partisan control.

2. It should combine executive ability with a profound knowledge of disease and the proper measures of prevention. To this end the board should be composed in part of men especially accustomed to the dispatch of business, and in part of medical men of great skill and experience.

3. It should have a corps of skilled medical officers as inspectors, which should be the eyes, the ears, in a word, the senses of the board, in every part of the city, searching out disease, investigating the causes which give rise to it, the conditions under which it exists, the means of its propogation, and the most effectual mode of its suppression.

4. It should have a close alliance with the police, which must be its arm of power in the prompt and efficient execution of its orders.