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7
FOREWORD
Under this heading in the reports of the last two or three years I have given
a note with regard to some matter of importance or interest from the health
point of view. This year it appears to me that it might not be out of place if
instead of following the usual practice I give instead some of my impressions
of the health work I saw during the visit I had the opportunity of paying to the
United States in the autumn of 1923. These impressions were originally given
in letters sent to the Chairman of the Public Health Committee of the Council,
and the notes that follow are abstracts from these letters.
WASHINGTON : THE UNITED STATES PUBLIC HEALTH SERVICE.
What we have been doing here has been making a study of the activities of
the Federal Public Health Service, a body which is quite different from any
organization at home, and so far as I know, is unique in the world.
Its aims, objects and constitution have been explained to us by various of
its members, and by others we have had the work either described or demonstrated.
Primarily it exists for the purpose of preventing the entrance of disease into
the States as a whole, and in addition for preventing the spread of disease from
one State to another. As regards disease within the various States, the States
themselves are responsible, the majority having a State Board of Health that deals
with this and a variety of other matters that affect the State as a whole.
In the matter of disease, the Federal Public Health Service is given a very
wide field, and is particularly concerned with investigating into causes and modes
of prevention. For the purpose there is a special Research Division with one of
the finest equipped laboratories I have ever seen. At this laboratory splendid work
is done, the staff, like the staff of all the departments I have seen, being highly
qualified, and most enthusiastic.
One most valuable piece of work is that done in connection with such things
as vaccines against smallpox, etc., antitoxin, as used in diphtheria, and so on.
All manufacturers of these materials must be licensed, and this is only done after
a full inspection is made and the department is satisfied as to the purity and value
of the material. At home there is no such arrangement, though it is obviously
one that ensures a great measure of protection for the people.
In addition to this Research Division, within the department and under the
Surgeon-General there are six others, each concerned with one special branch of
work, e.g. Quarantine and Immigration. On our arrival in American waters the
first man to board the vessel was an officer of this latter division. As he was
charged to welcome us in the name of the Public Health Service and to show
us his work we had an opportunity of judging of its value. We had only about
250 immigrants on board. These were all roughly examined for vermin and
gtoss defects, fairly thoroughly I thought, by people of experience. Afterwards
they would be more completely examined. As we visit Ellis Island at the end
of the course I shall be able to form an opinion with regard to the work done
there.
The relations of the Federal Health Department with the . States are rather
peculiar. Apparently they have little or no powers of supervision or criticism,
interfering only if requested to do so. Their services in this direction are widely
taken advantage of, many of the States that have health departments having set
them up after consultation with the Public Health Service.