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and especially in London during that time. It was probably in this
way that public health became related so intimately to the environment,
and most of the work done in the first half of the hundred years which
has elapsed since the appointment of the first medical officer of health
was of an environmental nature. The improvement of water supplies,
improvement of drainage, improvement of sanitation, proper disposal of
refuse, general increase in cleanliness of streets, private houses and shops,
were all things which took first place. At the turn of the century,
however, another stimulus occurred, and that was due to the South
African War. At this time it was found that recruits for the Army were,
on the whole, of very poor physique, and had relatively little stamina.
The public disquiet at all this resulted in a crop of welfare legislation,
notably the Midwives Act of 1902, the Notification of Births Act of 1907
and legislation for the beginnings of a school medical service, also in
1907. This group of enactments brought in the personal health services
as opposed to the purely environmental health services, and since then
there had been an increasing development of the personal health services
in what was regarded as the field of general public health. More and
more power was given to local authorities to develop personal health
services, and it will be remembered that, again through stimulus of war,
namely, the first German war, when the fact was apparent that we still
had a considerable number of C3 people in our population, an Act was
passed which, though short in extent, had the potentialities for very
comprehensive development. This was the Maternity and Child
Welfare Act, passed in the darkest days of 1918, which enabled maternity
and child welfare authorities to do almost anything (with the consent
of the Ministry of Health), for the health and well-being of expectant
and nursing mothers and for children under 5 years of age not in
attendance at school. Welfare centres, health visiting, and the various
clinics attached to the centres can be regarded as dating from this Act,
although in fact it must be remembered that in many localities similar
clinics and visiting had been carried out on a small scale for a considerable
number of years before. All this time however there was a gradual integration
of the personal with the environmental health services, and
the medical officer of health, being after all a medical practitioner, was
naturally biased towards the development of the personal health
services to an even greater extent than the environmental health services.
Now the National Health Service Act, passed through the stimulus
of the second German war, has brought the position of the district