Gesundheitspflege, vol. i. pp. 132 and 284" et seq.1 There was great opposition in the beginning, from local points of view. Quite recently, such a Board has been organized, but on a miserable scale (a medical man, a veterinarian, and a statistician). It will, in the beginning, do nothing but collect medical statistics, and study the organization in other countries.

In Saxony, the central Board of Health is pretty well organized. It publishes a yearly report (till now, 5). You will find an abstract of the 1st Report in Deutsche Vierteljahre Schrift, vol. i. p. 628 et seq.: 2d Report in vol. iv. p. 270; 3d Report in vol. ii. p. 96; 4th Report in vol. vi. p. 631, of the same journal.

In Bavaria, this body is organized in intimate relations with commissions, elected by the medical societies of the eight different provinces of the kingdom. You will find the statistics of this organization, vol. iii. 580-3; and the rules for the preceding, in vol. v. 477; vii. 764 et seq.

In Würtemberg, just now, a very similar organization has been formed, or is to be formed immediately.

In the same way, nearly, the Grand duchy of Baden is working. You will find an abstract of its doings in vol. iv. p. 278.

In the province of Schleswig Holstein, an organization of a more local character is existing. You will find an account of its mode of action in vol. vii. p. 396.

The two republics of Hamburg and Bremen have quite recently organized their Boards of Health. Vide vol. iii. 368; vol. vi. 440.

For the last five or seven years, in many towns, Public Health Societies have been formed; engineers, teachers, town councilmen, and, above all, physicians, being members. Some of them are very active; for example, those of Halle, Hanover, and Magdeburg. They publish reports, not exactly annual. Above all others, the Niederslandische Verein für öffentliche Gesundheitspflege is to be mentioned. It comprises, in the Prussian Rhineland and Westphalia, the representatives of

1 A complete set of this trimestrial journal of Public Health, edited by myself, is in the hands of (a) Dr. Edward Jarvis, of Dorchester, Mass.; (b) D. Edwin Snow, City Registrar, Providence, R.I.; (c) Metropolitan Board of Health, New York.

more than fifty-six towns, and has more than one thousand members. It holds several meetings a year, and publishes a trimestrial journal of Public Health, which is particularly remarkable for its articles on the medical statistics of the towns of this region.

Basel, though not in Germany, may be mentioned. It has, I think, the best organized Board of Health on the Continent, which is vested with the greatest powers. You will find its

regulations in my journal, vol. ii. 356, 366.

As to the prevention of infectious diseases among the children in schools, we have, so far as I know, no exact laws upon the subject. There is much discussion about it amongst the physicians of the country. The opinion is, I believe, prevailing, that children affected with diphtheria, scarlatina, and whoopingcough should be prevented from returning to school too early. Some say their brothers and sisters should be prevented from visiting; and some even say that if scarlatina, and especially diphtheria, has affected a pretty large number of children of one class, this class should be suspended for some time. Measles are rather too mild in our country, and are communicated particularly during the prodromes of the disease. So one is not inclined to order any thing in regard to them.

There exists nearly everywhere a certain hygienic inspection of schools; but a very insufficient one. I may say that, in the last year, nearly every government and municipal central school-board has had a medical man as one of the committee. But its duties are not very carefully defined. Nearly everywhere, the Kreis-medicus, i.e. the public officer on matters pertaining to medical jurisprudence and Public Health, has the duty of making a certain inspection of the schools. In Saxony, the school boards have the power of keeping from school diseased children, in whose families diseases are prevailing. the villages, even those children who are living in a house where certain diseases such as cholera, typhus petechialis, scarlatina, and measles - prevail, may, on order of the Kreisphysicus, be kept from school. In Saxony, there is no medical inspector. The powers of the Kreis-physici are regulated by the law, April 26, 1873, &c., §§ IV. 37, and by the regula tions.

In

For Würtemberg, please consult Deutsche Vierteljah., vol. iii. 490.

I am sorry not to be able to give you a more satisfactory In fact, all is in preparation: very little is already

answer.

done or organized.

I add a report I had to make, several years ago, on the organization of local Boards of Health, particularly in Frankfort. It had no real or full effect, because the political position of Frankfort has been entirely changed since.

I have the honor to be, sir, your obedient servant,

DR. GEO. VARRENTRAPP.

NORWAY.

While these pages are passing through the press, I find the following in the London "Lancet," Dec. 17, 1877, p. 251:

"We have received a copy of the first of a new series of weekly returns for the city of Christiania, which bears unmistakable evidence that the capital of Norway is considerably in advance of the capital of England, in the organization of its Public Hygiene. Christiania is a city with an estimated population, not exceeding 79,000 persons. The weekly return, in question, records, however, the number of living and still births, distinguishing the legitimate and illegitimate; and, as regards the deaths, shows the ages of the deceased in eight groups, and the diseases under sixteen headings. Beyond this, the return records the number of new cases of epidemic diseases, reported by the medical practitioners during the week; and a note, appended to these figures, states that it is compulsory upon a medical practitioner to report to the sanitary authorities all cases of infectious diseases, occurring under his notice. With reference to the causes of death, it is stated that they are generally reported by the medical practitioner; but, in cases where no medical practitioner has been in attendance, they are verified by professional certifiers. It appears, therefore, that in two important essentials of effective sanitation, Christiania is far ahead of London, or, indeed, of any large town of the United Kingdom. Not only is scientific evidence forthcoming

of the cause of every death, but every case of infectious disease is compulsorily reported to the sanitary authority. It is far from satisfactory to find that, while such important sanitary progress is being made abroad, sanitation is standing still at home, for want of a minister of health, and of a capable central health authority."

N. B. References made, in Mr. Pickering's Digest, to special diseases are
omitted in this index, because they would have made it too long and confused;
but, as the States are arranged alphabetically, a person can easily refer to the
laws of each State on any special diseases which have not only called for the
interference of Government, but which have been, at least, partially restrained
by legal enactments.