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13
The milk supply of Baltimore is in the main good and clean. The bulk comes
from farms within a radius of 50 to 60 miles round the city though some travels
long distances. About 98 per cent. is pasteurized and except hulk supplies to
bakeries, hotels, etc., all is sold in bottle. A very large number of samples are
taken daily and examined bacteriologically in the laboratory of the health department.
While in Baltimore I gave one morning to an inspection of the hospital. This
contains nearly 700 beds and is very largely a teaching institution. It is richly
endowed and has, in most departments, all the most up-to-date of appliances and
arrangements. Many of the doctors and surgeons at Johns Hopkins are, of course,
men of world wide reputation.
At Baltimore the whole personnel of the interchange had met, but on leaving
we once more re-formed into our own groups. The group of which I had charge
left for Boston to investigate conditions in the State of Massachusetts, and in two
cities in that State—one small, viz., New Bedford, and the other large, Boston
itself.
THE STATE OF MASSACHUSETTS.
Our arrival in Boston was not well timed. Dr. Kelly, the Commissioner of
Health for the State, was at the moment exceedingly busy, partly in preparation for
his annual leave, which was to begin two days later, and could only spare us a few
hours on the morning of our arrival from Baltimore. Moreover, on account of
the fact that various of the State Departments were in the throes of an economy
campaign, the staff, or certain members of it at any rate, appeared to be upset
and the wheels of the organization appeared to be running less smoothly than
might otherwise have been the case. In conncction with the economy campaign
one of the efforts that appealed to me, on account of its originality and because I
suffered personally on account of it, I noted in the lavatory provided for male members
of the staff. This involved the discontinuance of towels of all kinds for hand-drying
purposes with the substitution therefor of rolls of ordinary toilet paper.
The programme of our visit to Boston to study the organization, work and
methods of the Health Department of the State of Massachusetts was timed to
begin at 10 o'clock on the morning of our arrival in the city and before we had
had an opportunity of finding accommodation and removing the stains of a very
uncomfortable night journey. In spite of all these difficulties Dr. Kelly, the
Commissioner, endeavoured to give us information with regard to the activities of
his department. From him we learned that the State Board of Health of Massachusetts
is one of the oldest in the United States; that the body charged with
the responsibility of looking after health matters is the Health Council, consisting
of six members all appointed by the Governor. The Commissioner is also appointed
bv the Governor. The chief functions of the State Board in Massachusetts are
advisory and investigatory. Unlike other Boards, e.g., in Virginia, it has no
power to make orders or regulations, the various towns in the State, of which
there are 3(5"), being completely independent even though their total population may
number no more than 50. For one reason or another the authorities of many of
the towns are unwilling to undertake health works, and it is one of the chief duties
of the members of the staff of the department to induce them to give attention to
various matters and to assist them by advice and encouragement. Assistance
particularly in connection with outbreaks of disease, is also rendered, the State
being divided into seven districts with a medical member of the staff in charge of
each.
In addition to these officers there is one charged with the duty of encouraging
authorities to give attention to maternity and child welfare; another—Dr. Pfeiffer,