Official proceedings of the annual meeting: 1923

I68

LAW AND GOVERNMENT

disease of an infectious nature was due to faulty environment and capable of eradication
by correction of environment. These views led to such ideas as the generation of
diphtheria by sewer gas, and upon this and similar unscientific bases were erected
elaborate but unsound legal and administrative practices.
The names of two men deserve special mention as the apostles of this doctrine of
sanitary salvation by the route of complete control of the environment of manChadwick in England and Shattuck in Massachusetts. The activities of the first
named were instrumental in the establishment of the first real central sanitary authority
in the British Isles, while the other, from the influence of his masterly report on sanitary conditions of Massachusetts submitted to the legislature of that State in I849,
may fairly be called the father of all the state health departments of this country.
Shattuck was fully a generation ahead of his time, for it was not until I869 that some
of his principal proposals were adopted in the statute creating the Massachusetts
Board of Health. In one particular he builded far wiser than his great British contemporary, viz., by insisting on the necessity of sanitary education and persuasion of the
public as the only permanent and sound basis for advances in public health.
It is of peculiar significance to social workers to recall that officially it was the
Poor Law Commissioners of England who were directly responsible for the establishment of the first modern health department. Their greatest argument was that by
expending money on sanitary improvements "nuisances, by which contagion is generated and persons reduced to destitution, could be prevented," and hence the burden
of poor rates upon the well-to-do reduced.
Men soon perceived that it was not by sanitation alone that public-health administration was to achieve its aim. About thirty years after the general acceptance of
the sanitary doctrines just sketched, the discoveries of Pasteur and his followers opened
up the great and previously unsuspected realm of bacterial life, and demonstrated how
profoundly these minute organisms affected human health.
Then followed a period corresponding roughly to the second half of the last century,
which is of intense interest to every student of public health or sociology. It is of the
deepest significance, because during this period practically all the principles of publichealth administration under which we now work were either forecasted or completely
formulated. During this period, also, sanitary science shook itself free from the cumbersome legal principles and administrative procedures which had come down to it
through the centuries and which had been built around the old view that conditions of
disease or of health were practically all attributable to causes external to man and
controllable by modification of environment.
The revolutionary idea of infection by the agency of germs grew slowly at first,
then by leaps and bounds. Coincident with its rapid growth came about a curious
state of mind amounting almost to an obsession on the part of the sanitary-scientific
leaders of the period, a belief that "germ control" was about all that did count in
public health administration.
The doctrine of the right of organized society to interfere with the freedom of
action of the individual for the good of society at large received great impetus during
this period. The old doctrine of quarantine greatly modified by applying its principles
to the individual rather than to the city or village or vessel was expanded as never
before, and men honestly believed that by the multiplication of contagious hospitals,
by earlier and more stringent quarantine, and by the use of methods for avoiding infec