3 ^RO^ INTERE3T OF THE STATE IN THE HEALTH AND LONGEVITY OP THE PEOPLE. If Mi MEMORIAL \ BOSTON SANITARY ASSOCIATION LEGISLATURE OF MASSACHUSETTS, ASKING FOR THE ESTABLISHMENT OF A BOARD OF HEALTH VITAL STATISTICS. 'JJ^'ht* 3 5 ) BOSTON: STATE PRINTING OFFICE, 4 SPRING LANE ^ 1861. >?*'. 4f/3# b .m U i O-o \\v VVA Prefatory Note.—The Boston Sanitarv Association appointed the genr tlemen whose names are appended to the following pages, to memorialize the Legislature, in the name of the Association, in reference to the establiip ment cf .a General Board of Ilealtli and of Vital Statistics in the Common- wealth. The Memorial was written by Dr. Jarvis, and read, in the formljjf an address, before a public meeting of the Association in the State House, on the evening of February 14, 1861. Subsequently it was presented to General Court, as originally designed, and by the Legislature referred t( Joint Special Committee, and ordered to be printed. This will sufficient* explain the phraseology in soni_> places. • HOUSE....NO. 112. dommomncaltl) of ittas0atl)usctt0. MEMORIAL. To the Honorable the Senate and House of Representatives of Massachusetts, in General Court assembled. The Memorial of the Boston Sanitary Association respectfully represents, that the interests of human health and life, and the vital statistics and condition of the people of this Common- wealth, in their opinion, require more of the paternal care, watchfulness and protection of the legislature than they now receive, and these objects may be best attained by the estab- lishment of a State Board of Health, clothed with suitable power and authority for this purpose. The wise and sagacious fathers of the Commonwealth, when they formed the constitution in 1780, seem to have had the personal condition of the people, their health, power and com- fort verv prominently in view, and mentioned these several times in their preamble, and in the declaration of rights. They emphatically declared, that " the end of the institution, maintenance and administration of government is to secure the existence of the body politic, to protect it, and to furnish the individuals who compose it with the power of enjoying, in safety and tranquillity, their natural rights, and the blessings of life," and " the people have a right to take measures for their safety, prosperity and happiness." Among the inalienable rights, they say, " may be reckoned the right of enjoying and defending their liberties, that of 2 MEMORIAL. [Feb. acquiring, possessing and enjoying property; in fine, that of seeking and obtaining their safety and happiness." It is assumed to be the duty, as well as the interest, of the legislature to give an active and effective force to all the provisions of the constitution, including, among others, the needful provision for securing the safety and happiness of the people, and enabling them to enjoy all the blessings of life. Our fathers were wiser, in respect to the objects of govern- ment, than the rulers of the world were or had been for many generations before them. They considered man—his personal condition and power—as the essential element of the State, and to be regarded and cared for before all external things and circumstances, and thought his safety, and the blessings he could and should enjoy, ought to be among the first objects of legislative care. Although this had not been a leading purpose with the rulers of nations for many ages, yet they had the high example and authority of the first and greatest Lawgiver the earth has known. Moses did not leave the matter of human health to the chance of man's own thoughtfulness to protect himself, nor to his generosity, or even his sense of justice, to do that which would secure his neighbor's health, or refrain from doing that which might be injurious to others; but he minutely specified many of the rules of self-management, and severely enjoined their observance. His sanitary codes, in their spirit and in many of their requirements, are admirably fitted to the wants of man, everywhere and in all times, and to secure for the people those personal blessings that our own constitution so earnestly offers. Since the days of Moses, this great interest of the people has been less regarded. Most governments have considered it but secondary ; some have ignored it altogether, and left the matter of protection of human health and life, excepting when endan- gered or injured by violence, to each one's own wisdom or ignorance—to the thoughtfulness or carelessness of the people. Capital and wealth, production and income, usually have been and are deemed to be the first and paramount object of State and national power and care, and all due facilities are generally given to their acquisition and protection. Trade, commerce, agriculture, manufactures and other means and 1861.] HOUSE—No. 112. 3 methods of creating money, in every shape, have been and are watched, encouraged and aided by whatever legislation they seem to need, while the health and power, the comfort and the availability of the man himself, by whom and for whom, all thfs is done, is made a matter of secondary consideration, in a national point of view. The apparent object of most national associations, and of government, is to establish and present the largest possible power in the body politic—the largest in estate, in income, in the numbers and efficiency of the people. When they can show a great amount of wealth, an abundant prosperity, both annually increasing, and a large population, they seem to be satisfied that the purpose of their existence is accomplished, and they need do no more. All this is well and should not be neglected; nothing, in this connection, is done that should be left undone; but the greater interest, human life and health, man's vital force, lies beyond and beneath all this, and is the foundation on which all these rest, the origin from which they spring, and the motive power by which they are brought into being and maintained. Human skill, physical power and labor create all the wealth of the world ; they develop all the new conditions of property, and put every thing in such new forms and positions, as give them any value ; and without them, all the natural and raw material is worthless and unavailable for the purposes of humanity. The human mind plans and determines every thing in respect to material and labor ; it appropriates all the forces, it superin- tends all the processes, and carries the chaotic elements, through the necessary changes and combinations, to those conditions and forms that make them useful and valuable. The human intellect and heart alone appreciate and enjoy all that is or can be accomplished, all the results of skill and labor, the property that is produced, the income that is gen- erated, and the comforts and the conveniences that are created and placed within the reach of the world. It is plain, then, that man and his personal condition, the vital machine, the bone and muscle that create, and the mind and spirit that control, direct and enjoy all earthly possessions, stand before all material interests, and should have the first care from those who take cognizance of whatever belongs to, 4 MEMORIAL. [Feb. and constitutes the state. It is equally plain, that the power and the dignity of the state should not be measured by its capi- tal, but by the effective force of those who create it; nor by the amount of its income, but by the energy and wisdom of those who produce and enjoy it; nor even by the extent of its terri- tory, but by the skill and strength, the mental and physical ability of those who cultivate it and use its fruits ; nor yet can they be determined by the number of the people, but by force and effectiveness, the personal and individual strength and availability of each and all its members. The body politic is strong or weak in proportion to the strength or weakness of its elements. A nation, in which all its people are possessed of good health and strength, is superior to another, with the same total popu- lation, but among whom a part, more or less, are sick or debili- tated. As the commonwealth is neither more nor less than the sum of all the estates of the people, each contributing his own amount, so much and no more, the son of wealth his millions, and the son of poverty his mite—so the strength of the nation is the sum or aggregate of all the personal powers, physical, mental and moral of each of its members. As every estate that is encumbered with debt adds so much less to the common capi- tal, so every one encumbered with sickness adds so much less to the common power. Every loss of property, every waste of money, is so much loss to the public estate; and every fever, dysentery, or other disease, every mental disorder, or waste or perversion of personal force, is so much loss to the force of the body politic. As then, in ascertaining the amount of the national wealth, it is not enough to count the number of the estates, so in deter- mining the value and the power of a population, it is not sufficient to count the people, but they must be analyzed, meas- ured, weighed, to show what they amount to, before it is known what each contributes to the power of the state, and what the whole is worth. As the community has a property in every one's estate, how- ever large or however small, and is enriched with his gains and impoverished with his losses, so the body politic has a right in every one's vital forces, and is strengthened with their increase and weakened with their impairment. 1861.] HOUSE—No. 112. 5 Whatever interest the state or nation may have in its capital, or the manifold capitals of its people, it has the same and a greater interest in its physical, mental and moral force, or the manifold personal and vital forces of its members that produce all its wealth and constitute all its power. Governments generally recognize the public interest in pri- vate prosperity, and lend no small part of their legislative authority to encourage and promote, and all the needed force to protect it. And in the most civilized countries, where the ruling powers are the most enlightened, they lend their wisdom and their legislation for this purpose, and consequently agricul- ture, commerce, manufactures, all the arts of peace, the means and pursuits of profit, flourish the most extensively, capital is created, and income is gained the most abundantly. A higher advancement in civilization, the universal increase of knowl- edge, and a more comprehensive and generous view of govern- mental responsibility now demand that the same provident care of the legislature should be extended into the field of human life, to encourage and watch over and protect the vital machine, by which alone all other interests, public and private, are created, sustained, or made of any value. It will be well, then, to analyze the body politic as it actually is, to take an account of the vital and productive force that it now possesses and wields, and learn whether it enjoys all that the natural and organic law offer it the means of possessing and using. And if it be discovered that there are depreciations of life and power, then the legislature will want to know what and how great these are, whether they grow out of the essential conditions of our being on earth, and whether they or any part of them may be modified, diminished, or prevented, by any action of the government, or by any intelligence and cooperation which may be enlisted and authorized for this purpose. The vital machine is not created at once. Men are not mature at the moment of their birth. They must go through a long, uncertain and dangerous process of growth, which requires, at least, fifteen years, for its completion. During this forming, or growing period of life, the child and youth are not only non- productive, contributing nothing to the general capital, but they are a burden and an expense for their support until they arrive at sufficient maturity and strength for their own self- sustenance. 6 MEMORIAL. [Feb. Looking then on men and women as members of the body politic, which are to increase its force, contribute to its wealth and add to its income, or looking upon them as vital machines which shall do the work of life for themselves, their families and the state, then every child that is born is a machine begun ; and, as a matter of profit and value, each one is worth to the com- monwealth at least the amount that it has cost or should cost to build him up—that is, for his support, education, develop- ment and fitness for responsible and self-sustaining life at fifteen, or later, perhaps at twenty. Dr. Farr, the reliable administrator of the Registration law of England and Wales, estimates the national value of a common laborer, twenty-five years old, at (£246 Is. or,) $1,231.75. At a low estimate, it costs, not less than fifty dollars ($50) a year, on an average, for the support and education of children, from birth to maturity. Every child and youth then is worth to the state ($50), fifty dollars multiplied by as many years as he has lived; and consequently the death of every one under fifteen years old, is a loss of that amount to the commonwealth. In this way the public or national loss, by early mortality, may be easily estimated. In 1859, the last reported year, 8,953 children and youth under the age of fifteen, died in Massachusetts. These had lived an average of two years, five months and twenty-one days each, or a sum of 22,171 years in all. At fifty dollars a year, they bad cost their families or the com- munity, $1,108,550 for their maintenance, which must be charged to the general income or capital of the State, and so much was lost by their premature death. Here is the direct interest of the State to save the lives of these children and youth, to finish these vital machines which had been begun and thus far built, to put them into working order, into active and effective operation, and to receive back in return, the cost of their creation and growth, and also derive a profit from their future labors. The number of children, in any community, is often referred to as evidence of general prosperity, and as the sure promise of future power, in a coming generation of men and women who will sustain the responsibilities of society, and contribute to the force and the capital of the nation. 1861.] HOUSE—No. 112. 7 In as far as these children are to grow up and become mature and working people, they are indications of future strength and prosperity. But in as far as they are to die before they reach their fulness of stature and development, they are an evidence of weakness, and not of strength : they are a burden and a tax on public force and wealth, and an element of debility in the body politic. In the eight years, from 1852 to 1859 inclusive, 265,278 children were born in Massachusetts, and 63,065, or 23.7 per cent, died under five years of age, and 73,287, or 27.6 per cent. died before they had passed their fifteenth year. Mr. Elliott's careful calculation of the mortality of this State shows, that about 27.42 per cent, died under five, and about 31.27 per cent, died under fifteen, in the year 1855. These losses are to be deducted from any estimate of a. nation's future power, founded on the number of children. At fifteen, the youth is usually able to earn sufficient for his own support, and so continues until he reaches his three score and ten, and in most of this period, in all the years except a few of the first and last, he can generally earn more than he consumes, and add something to his own, and of course to the common estate and income of the country. In these fifty-five self-sustaining years, between fifteen and seventy, men and women do all the work of the world, they accomplish all the business, create all the wealth, and bear all the responsibilities of society. Then the creative and sustaining force, the power and effective strength of any nation is in the proportion of the numbers of its people, who are between fifteen and seventy, and in good health. Beside sustaining themselves, the people who are living in this, the productive period, must bear the burden of sustaining the'two dependent classes—the young, in the forming stage, under fifteen, and the old who are past seventy, and are resting from their labors. Of course, this burden is heavy or light, in the proportion that the first and third, or dependent classes bear to the second, or sustaining class. The larger the number of children born, that fail to reach the productive age, the smaller is the number of those whose labors must support A northern climate is generally more favorable to the life of 8 MEMORIAL. [Feb. children than a southern one. In the warmer, more must be born to secure a definite number of the productive class, than in the colder region, and consequently the burden of the de- pendent class is greater, while the power of the sustaining class is less. The populations of New Hampshire and North Carolina were progressive in a nearly similar degree, in the decade, from 1840 to 1850. According to the seventh census, for every 100 children under fifteen, there were, between fifteen and seventy, that, is in the productive period, 200 in the colder, and 129 in the warmer State. That is, while 100 in the productive class had to sustain 50 in the dependent class, in the northern and more healthy State, they had to sustain 77 in the southern and less healthy region. It is then further manifest, that the ratio of the power of a State to the numbers of its people in the productive class is to be modified by the extent of the burden of the dependent class that rests upon it. Having entered upon the self-sustaining age at fifteen, a person is supposed to work, or he has the chance of working for himself and for the community, until he shall have passed his seventieth year, or lie seems to have an offer of 55 working years, and in the best state of things, and the most favorable circumstances, the State may reasonably expect so much labor, cooperation and force from its members. This, how- ever, is the theory, but not the fact. In the year 1859, in Massachusetts, 7,772 persons died, after they had entered upon their productive age, and before they had passed it. These had enjoyed an average life of 35.62 years. They had labored 20.62 years, and had done so much for their own support, and contributed so much of their vital force to the body politic. But inasmuch as their productive life was not 55 years, but only 20.62 years, the State lost by their early death, all the difference between these periods, that is nearly 30 years of cooperation and labor from all of these 7,772 persons. According to life insurance tables, the value of life in this State, at fifteen, is not 55, but 39.5 years. That is, all the people in this State, who enter upon their working and productive period at fifteen, enjoy, on an average, 39.5 working and productive years, and contribute their active and efficient force to the general support and profit, for that period. Comparing 1861.] HOUSE—No. 112. 9 this with the ideal, with that which is enjoyed and gained by the most favored, here is a loss of 15.5 years on each, or 28 per cent, of the productive force of our people, and they are enabled to render to the State only 72 per cent, of the service that nature seems to offer them the chance, or the hope of giving. SICKNESS. There is another and very important drawback from the effective power of the people, in the amount of sickness that falls upon the productive age. The vital machines run une- qually and irregularly. They are often impaired and their motions impeded, and even suspended, before they are quite broken down or worn out. The average amount of sickness, or time lost by it, in each period of life, is very carefully ascertained and accurately determined here, by the health insurance companies, and in Europe, by the friendly societies, and other associations that take a similar cognizance of the cases of sickness or inability to labor, and by various inquirers in this field of humanity. From these, from Mr. Edwards' reliable calculations, and other sources, the average annual amount of sickness, or num- ber of days lost by disease, impairment and debility, is deter- mined for each period of life. Applying these calculations to the 743,523 people who were living in Massachusetts in 1855, between the ages of 15 and 70, we have the following table, showing the sum of the sickness of all in each period, and of the whole of the productive class, during that year. Amount of Sickness in Massachusetts in 1855. Average Days' Aggregate Days Sickness each. of Sickness. 4.96 580,554 7 2,227,407 8.5 701,445 9.5 1,059,250 10 379,740 13.5 484,042 21 500,472 39.5 730,395 8.82 6,663,305 AGE. Population. 15 to 20,..... 1*17,047 20 to 35,..... 320,421 35 to 40,..... 80,303 40 to 50,..... 111,500 50 to 55,..... 37,974 55 to 60,..... 35,855 60 to 65, . 23,832 65 to 70,..... 18,591 15 to 70,..... 743,523 2 10 MEMORIAL. [Feb. Thus we see that the population living in this State, between the ages of 15 and 70, in the year 1855, were assessed with 6,663,305 days of sickness, during which they were unable to attend to their business. This is an annual average of 8.82 days for each one in the productive period. This is not all that is lost by sickness. The calculation is made upon the tables of the friendly societies, and health insurance companies, which make no allowance for, and therefore do not include the shorter periods of illness of less than a week, nor the lesser ailments, when men are unable to perform their usual labors, although not laid up. FINANCIAL ASPECTS OF HEALTH. In all these ways the interests of the State suffer; the loss of children in the forming period, before they reach their self-sustaining years ; the loss of 28 per cent, of the productive period by death, and the burden of sickness imposed upon the diminished period—all these losses make a great discount in the force, the industrial power and the productive energy of the people. Yet notwithstanding all these curtailments of force, the results of the labors of those who are able to work are immense. The last report of the Industry of Massachusetts shows that the products of the labor of the people of this State, in the year 1855, were worth $295,826,691. Considering that this did not include all the products of industry, that the houses, stores, shops, factories, churches, school-houses, barns and all other buildings, bridges, rail- roads, highways that were built, enlarged or improved, were not included, and that the labor of men engaged in the trans- port of passengers, merchandise, agricultural products and other freights, the labor of professional men, merchants, agents, engineers, were omitted, it will be believed that this is a very low statement of the results of the industrial exertion, the work of hand and brain of the 743,523 people of this Com- monwealth, of the self-sustaining age between 15 and 70 years old, or of so many of them as were in good health, in pos- session of their mental and physical powers, and willing to work. Dividing this among the producers shows that°the average value of the earnings of each individual was $396 in that year. 1861.] HOUSE—No. 112. 11 Allowing that this amount of products is not all new crea- tion, that some part of it is raw material; yet, whatever deduc- tion is made on this account, it must be conceded, that all of this property was created, or put into such form, combina- tion or position as to be available and useful, by the inter- vention of our people, and without their agency and action, their labor of body and mind, their skill and force, all these products would have been either uncreated, or in such a state as to be worthless. It is solely by the power of men and women, in the enjoyment of health and strength, that so much value was added to the income, means and resources of the Com- monwealth. In the creation of so much value, all did not contribute alike, but each one did contribute such portion as his,health, power and skill, and his inclination and opportunities allowed him. It has been already shown, that there were about nine days sickness to be charged in each year, upon all in the productive age. This is nearly two and a-half per cent., (2.41 per cent.) So much was taken from their power of labor, for the indus- trial exertions were suspended to that extent, and the produc- tions diminished in the same degree. Consequently, the earn- ings of the people of this State were lessened $7,129,422 by this cause. This corresponds to what may be supposed to be the loss of time by sickness in the productive class, which, by calculation, was shown to be 6,663,305 days, in the year 1855. Then, if there had been no sickness, and every laborer had been able to work without interruption from disease, the earnings would have been 2.41 per cent, greater, and the whole would have been $302,956,113 instead of $295,820,681. The year 1855 was not an extraordinary one. The labors of that year were no greater, nor more successful than others. The earnings were similar to those in years preceding and suc- ceeding. It may then be safely assumed, that in the average of years, the products of industry will be about the same, in pro- portion to the number of laborers, and average power of pro- duction will be worth about $400 a year, that is, the living people, between fifteen and seventy, are each worth so much annually to the community. Supposing the whole of the productive class could be kept in working order, through the whole of the period allowed 12 MEMORIAL. [Feb. to the most favored, and they could labor through fifty-five, instead of 39.5 years, then the total earnings of each would be $27,000 ; and his life would be worth so much to the State, for he would contribute that sum to the general wealth or income. But as the working years of the people of Massachusetts are only 39.5, they contribute not 827,000, which is the ideal of production, but $15,642. This is a loss of 811,358 on each. Moreover, as those who died in 1859, had survived their fifteenth year, only 20.62 years, on an average, they had there- fore earned only $8,175, the loss on each of these was $18,325- The average number of working years of the people of this State is thirty-nine and a-half, being a loss of 28 per cent, of the productive period. But if this loss of life should be prevented, and none should die between fifteen and seventy, then the num- ber of living laborers would be increased to that extent, and the products of industry multiplied in the same ratio. These are the differences between the results of the labor and earnings of a people, who enjoy the present average amount of vital force, and the results of the labor and earnings of a people whose health should be as well sustained, and life protracted as long as the most favored. POLITICAL ASPECTS OF HEALTH. The political importance of this matter is none the less certain, though not so easily measured. Whatever differences there may be in the value of life, they are the most manifest in the differ- ence of numbers in the classes who are in the more advanced years. The results of lower vitality and increased pressure of mortality, of course, accumulate, and are most seen in the later years. Thus, for every thousand children who are just enter- ing on life, and under one year old, there were in the class of mature men and women between forty and seventy, 11.687 in New Hampshire, and only 5.117 in North Carolina, and in the riper class, between fifty and seventy, there were 6.395 in New Hampshire, but only 2.642 in North Carolina. The greatest effect of increased mortality, then, is in the diminished numbers and proportion of persons in more advanced years, whose prolonged lives have given them a fulness of expe- rience and a maturity of wisdom; and a necessary corollary of this is a greater proportion of children and youth in whom 1861.] HOUSE—No. 112. 13 the passions are stronger, the imagination more active, and the feelings less controlled by reason. Although young men, from twenty to thirty-five, can strike as many and as hard blows, and direct them as certainly to their intended purpose,—although they can work as vigorously, skil- fully, and effectively as their fathers, yet the common maxim of " old men for counsel and young men for action" holds true. The administration of the work of life, of public affairs, and private business, the arrangement of plans and the application of coordinate forces to the accomplishment of purposes, are most usually and successfully effected by persons, who are from thirty-five to seventy years old, and more commonly by those who have seen at least forty years. It is, therefore, of the highest importance for private prosperity and public safety, that there should be in every community a good proportion of people of the maturer age, whose experience has ripened their judgment, and whose comprehensive wisdom and far-seeing sagacity are adequate to the management of all the affairs of persons and of state, and give the body politic the best guaranty for its safe conduct through all the common con- tingencies that daily happen, and the extraordinary emergencies that may occur. The vigor and success of private business and the administra- tion of common affairs depends on the proportion of those between twenty-five and seventy, including both those who bring promptness and energy to the work, and those whose sagacity and prudence prevent the misapplication of force and guide the movements of life to safe results. The safety of public administration, of town and of state, is in the proportion of men who are over forty—who have passed the years of impetuosity and impatience—whose zeal is tem- pered with caution, and whose reason is paramount over their feelings and passions. In some communities where youth predominates, law has less force, order is less maintained, and governmental organization has less authority. The British reports present remarkable and painful examples of this in Limerick, and in several of the man- ufacturing towns, where life is so short, and such a small part of the people survive early manhood, that there are not enough of the mature and the staid, of the calm and the disciplined, 14 MEMORIAL. [Feb. to control or repress the excitability, the occasional passionate disorder, and the riotous indiscretions and frivolities of the youthful majority. Therefore strikes, mobs, resistance to law, and disturbance of the ordinary purposes and plans of business, take place there more than elsewhere. MORAL ASPECTS. The still higher and more impressive view of humanity, in considering the depression and loss of vital power, by sickness and early death, ought to take precedence of the pecuniary and political relations, but it has been less urged here, because it is so obvious to every one, and so severely felt by all. In all the human family there are few that have not been painfully called upon to feel or understand the waste of physical comfort, the loss of moral power and mental energy, the personal suffering and family distress, the agonized sympathies and affections, when friends and relations are sick, and the anguish of heart when they are taken away. Nor can we overlook the poverty of some and embarrassment of many, when their means of support are diminished or destroyed, when the industrial power or admin- istrative ability of the family's head is suspended in sickness or lost in death. Our civilization hitherto has not felt a due responsibility for these destructive influences, which, in manifold ways of sorrow and pain, weigh heavily on every class of society: but, in another step of advancement, it will look after and grapple with them and apply its resources of intelligence and power to modify and diminish them. That work is yet to be done. These evils are still present with us; they endanger the people's safety ; they mar their happiness; they very seriously curtail the bless- ings of life, which the constitution specifies as among the objects of the institution and maintenance of government. Thus, in every point of view, it is manifest that the health and longevity of the people are the great interests of the body politic. There is no interest of the State that does not depend upon these—whether it be capital—the accumulated wealth of the nation—this is dormant, unproductive and of no value, and all advantage and income from it ceases, unless there be healthy brains to manage it;—or be it commerce, there must 1861.] HOUSE—No. 112. 15 be discreet minds and bold hearts to conduct it;—or agriculture, or manufactures, these are nothing without vigorous and strong hands to do the work. Human health and strength are the foundations on which rest all general and individual prosperity, all state and national dignity and power, all safe administration of public and private affairs, and these rise or fall in proportion to the quantity of vital force, bodily and mental, enjoyed by the people. The late Health Report, published by the British government, says, " the physical strength of a nation is no mean part of its prosperity." " But the subject may justly claim to be considered, by the government and the legislature, on higher grounds than these. The sacredness of human life against unjust aggressions, is the principle above all others, by which society subsists. To have realized this principle, in law and government, is the first indication of a social state ; and in any country pretending to be civilized, the failure of protection for human life has ever been felt as a public scandal." " Modern civilization would scarcely deserve its name, if, with the light of its much greater knowledge, it had refrained from applying the same principle to all cases, which fairly come within its terms; and our statutes contain abundant evidence, that, according to the spirit of English law, life cannot be wasted by neglect any more than it can rightfully be taken by violence." * In Massachusetts, especially, where universal education gives every one so much personal power, where capital is so great and yet so intimately connected with, and dependent upon, the men- tal and physical force of the people, where human intelligence, skill and energy control, move and utilize property valued at $897,795,326, f and with this vast estate, creates or develops $300,000,000 more in each year, the duty of watchfulness over this great sanitary interest, by the government, to keep the vital machine in the best condition, and the motive power in the highest state of effectiveness, becomes imperative and irre- sistible. * Dr. John Simon, Health Report, 1858, p. xviii. t Valuation 1860. 16 MEMORIAL. [Feb. GOVERNMENTAL INFLUENCE. Here it may be asked, by those whose cooperation is wanted, what" can the legislature do ? Sickness and health, life and death, are not at man's disposal, nor do they come within the control of human authority. This is not the first time this doubt has been raised. The same objection has been made aforetime, when evils were present and the remedies seemed as far beyond the reach of the government as human health and life now appear to be; and yet those remedies were sought and obtained. They came slowly, indeed, but surely, because the men in power went to work wisely and generously, and perse- vered until they found a reward from their endeavors. VEGETABLE AND ANIMAL LIFE EXPANDED. Life, in other fields, has been expanded, invigorated and en- riched, and its results made more valuable by the fostering care of the government, and the same may be done in the human field now open to us. The life of man is as clearly within the reach of legislative wisdom and influence as the life of the lower animals and vegetables. In this lower field of life the legislature has accomplished a great work, or has aided and encouraged others to do it. AGRICULTURAL BOARD. The whole principle and practice of agriculture consists in the development of life and the production of its results in vegetables and lower animals. And all the improvements in agriculture consist in the expansion or the increase of life and its results. The study of the agricultural philosopher, and the experiments cf the practical cultivator, are to discover and to adapt the means of doing this ; their endeavor and search are to find the food, the conditions and circumstances, by which the living principle, in beast and in plant, shall have the freest play, and the best opportunity and power to produce in them, according to their several natures, flesh, fibre, muscle, fat, milk, wood, pulp, leaf, seed, juice, and other and desirable elements of life. As none of these blessings of life come without observation— but as they do come the most richly and generously, with the 1861.] HOUSE—No. 112. 17 most careful and faithful observation—and our people and rulers believe in the doctrine, so in all the counties and dis- tricts of the State, agricultural societies have been formed and incorporated by the general court, and sustained, in great measure, by the general treasury. The best agricultural talent and experience have been gathered and associated, for the im- provement of every thing connected with the cultivation of the earth and with domestic animals. These men and others have been induced to study, to watch and to experiment with life and its elements, its capacity and its progress, in beasts and fowls, in grass, grains, fruits and roots. While these have been working practically, philosophers, chemists and naturalists have wrought scientifically for the same purpose. The legislature has gathered the elite of the agricultural wisdom of the whole State and formed a Board of Agriculture, with a Secretary of large learning, high accomplishment, and untiring zeal in his work. These men, by study at home, by practical observation on their own farms, by conference with the skilful and successful cultivators, whenever opportunity offers, and by consultations at their meetings in the State House, have done much to break up the unprofitable habit of routine culture and energize the spirit of improvement. They have set men to thinking and observing more, and to using their brains, as well as their hands in the management of farms. Thus they have elicited a great increase of agricultural knowl- edge, and created a new and more effective interest in the cultivation of the earth. All the practical and theoretical wisdom, connected with this subject, that could be developed at home or obtained from abroad, has here been gathered and concentrated. The faithful and intelligent secretary, under the direction of the board, has digested and arranged all these • facts and principles, or such parts of them as would be profit- able, and published them, at the cost of the Commonwealth, for . gratuitous distribution among the people, in order that every farmer and gardener may know and derive advantage from the improvements and the success of all the world beside. Here, too, in the State House is an exchange established—an exchange of agricultural science and facts. Here in the room of the board, the documents of this and other Stales, books, 3 18 MEMORIAL. [Feb. pamphlets* reports, magazines and other publications relating to farming, gardening and their collateral subjects, are gath- ered, for any or for all to read or to consult. Here the cultivator of the earth, the cattle-raiser, the shep- herd and the floriculturist, may obtain the information they desire in respect to their several pursuits. Here they are sure to meet men of high intelligence and comprehensive interest in these matters, who are ready to solve all agricultural doubts, so far as the present state of the science will allow them to be solved; here all may, and many do, come to drink of this fountain of knowledge so wisely prepared and so generously offered by the government, and here they can and do strengthen themselves for a more successful work. Moreover, the legislature, ever alive to the public interests, finding these means of disseminating knowledge of agriculture so profitable, has authorized the secretary to employ agents, at the cost of two thousand dollars a year, " to visit the various towns in this Commonwealth, for the purpose of inquiring into the methods and wants of practical husbandry, ascertaining the adaptation of products to the circumstances of soil, climate and markets, and encouraging the establishment of farmers' clubs, agricultural libraries and reading-rooms, and of disseminating useful information by means of lectures and otherwise." For all these purposes the State paid in 1860, the sum of $25,426, and in 1859, $24,704, and in the previous years, sums similar though less, for these appropriations have been gradually increasing. Can any one say that this money has not been wisely expended by the government ? Under the influence and by the aid of these means, agri- culture has greatly improved, crops have increased, cattle and all domestic animals have become more profitable, the labors of the farmer have been better and more successfully appropriated, and his income enlarged: the value of farms and every thing connected with them, buildings, stock, tools, &c, has been augmented, the markets are better supplied, the families of both the farmer who produces and of the consumer who buys have better sustenance and food, the State is made richer and the people are made more comfortable and happy. 1861.] HOUSE—No. 112. 19 It cannot be doubted, then, that the State has made a good investment of its funds, and found a rich reward, not only in the increase of its capital and income, but in the higher tone of agricultural life, and the supply of more abundant, nutritious and agreeable food for the people. LIFE EXPANSIBLE. While the State, through the farmers, have caused this expansion of fruits of the earth, and of nil sorts of domestic animals, it has also demonstrated another principle of still wider application, that life is not a fixed quantity in any living being, nor a thing nor a quality that may not be increased and improved. This is manifested in every animal and veg- etable that the cultivator produces, better and larger than he did before. It is clearly established, that although the law of life is determined from the beginning, and cannot be altered; yet the degree of the expansion of the living principle, the extent of the development of vital force, and all the results of its action depend very materially on the circumstances amidst which the living being is placed, and the influences that bear upon it. By placing the lower animals and vegetables in more favor- able circumstances, and giving them conditions better adapted to their growth, and more suitable nutriment, protection and position, they have been very materially changed and improved; the wild crab of the forest has become a multitude of delicious, digestible and nutritious apples. The pear, the plum, the potato, and other fruits and vegetables, have been improved in the same way. Sheep, cows, swine, fowls, have also been made to enjoy a higher health—a larger life. HUMAN LIFE EXPANSIBLE. Life is no more a fixed and unalterable quantity or quality in man, than it is in domestic animals, and in fruits and grains. It varies in him as well as in them, according to the nature of the influences that control it. This has been demon- strated by many happy experiments in Great Britain and in France. It is there found, that where external circumstances 20 MEMORIAL. [Feb. are unfavorable, and personal habits are bad, there health is low, disease is abundant and fatal, and life is short. But where these circumstances and habits were changed for the better, sickness has diminished, death was less frequent, and life protracted. In nineteen towns in England, which contain a population of 468,000, the average rate of mortality for several years was 28 in 1,000 of the living; but after the streets were cleaned and drained, the narrow lanes widened, and the houses supplied freely with^mre water, the rate of death fell to 21 in 1,000 of the living. In some places the increase of life was still greater in consequence of the sanitary improvements. The reduction of the death rate in Liverpool, was from 39 to 27 in 1,000. In Macclesfield it was from 33 to 26 in 1,000 in the whole town, and in the districts which were improved, the mortality was reduced 60 per cent, in some, and 42, 40 and 34 per cent, in others, and the average age of the persons dying was increased from 24 to 29 years, being an addition of five years, on an average, to each one's life. In some districts of London, where the mortality was 30 to 40 in 1,000 before the improve- ments, it was only 13 to 15 in 1,000 afterward. In others it was reduced from 28 to 16, and in some from 26 to 17 per 1,000. In some of the agricultural districts, by improving the laborers' cottages, removing the waste heaps of decaying animal and vegetable matter, that had usually been allowed to accumulate near the dwellings, and by draining the wet and marshy grounds, the death-rate was reduced 50 per cent.* Sickness has been reduced by the same means, and in some districts enormously. Some places which had been the especial abodes of fevers, diarrhoea, and other diseases of low vitality, become free from them, and as healthy as other districts, by removing the causes—filth, foul air, stagnant water, &c. A remarkable instance is stated by Mr. Chadwick, in his report on the health of the laboring classes, of the effect of ventilation. A long building in Glasgow was inhabited by 500 persons, one family in each room. The rooms were crowded and the air foul; fever was rarely absent, and there were some- times seven cases a day, and in November and December * Chadwick's Address at Glasgow, September, 1860. 1861.] HOUSE—No. 112. 21 1831, there were fifty-seven cases in the building. The build- ing was contiguous to a large factory in which was a very tall chimney. The owners of the dwellings also owned the factory. They " fixed a simple tin tube two inches in diameter into the ceiling of each room, and these tubes led into one general tube, the extremity of which was inserted into the chimney of the factory furnace. By the perpetual draught thus produced upon the atmosphere," each room was continu- ally ventilated, and consequently " during the ensuing eight years fever was scarcely known in that place."* There are many circumstances and conditions which nature does not establish, but which men and society create, wherein life has a very different value. It is longer and more vigorous, more effective and happy in the prosperous than in the unpros- perous classes. From Mr. Chadwick's report, it is seen that the deaths of children under five were, in ^the best condi- tions, 20 per cent., and in the worst, 50 per cent. Under 20, they were, in the best conditions, 28 per cent., and in the worst, 66 per cent, of all that were born. In the best state 46 per cent, survived their 60th year, and in the worst only 8 per cent. The average age among the poor was 20.4 years, and among the comfortable classes 42.6 years. A similar difference in early and late mortality and in the length of life, has been found from a limited observation of these different classes of society in this country. There is a difference in the value of life in city and country —condensation of population is attended with an increased mortality, especially of children—and a lessened longevity of the whole. These and many other circumstances and conditions, that are so intimately and constantly connected with differences of health and life, are no more the fixed law of nature than the methods of agriculture, practiced in the last century, were the necessary and fixed law of life in plant and beast. These depressing and exhausting conditions of man may be changed as well as the management of crops and cattle, and with as favorable result on his health and life. * Sanitary Condition of JLaboringClasses, p. 107. 22 MEMORIAL. [Feb. The improvements in the lower field of vitality were not made by accident, they came by design and by study. They were not begun until the world believed them to be possible and the best intelligence and observation pointed the way. Nor could they have made their rapid and great progress without the encouragement of the State. Now life in the higher sphere, in man's own person, asks the same aid from the higher intelli- gence, and the same encouragement from the government. BOARD OF HEALTH. By the establishment of a Board of Health and Vital Statistics, composed of men fitted to look after the vital interests and con- dition of man, as the Boards of Education and Agriculture are, to look after and promote the interests entrusted to them, a similar work may be accomplished, and a similar progress be made, and a nobler and happier result be obtained in the expansion of human life. In this purpose, no new principle of legislation is proposed. Here and elsewhere, health in various ways is or has been the subject of governmental care. We have laws in respect to smallpox, quarantine, nuisances, and some other sources of disease or circumstances injurious to life. We have legislated for the health of cattle, and even of roots. The legislature had a special session last year to provide for the disease then prevailing among cows and oxen. Commis- sioners were appointed to superintend this malady, and take measures for the security of the unaffected flocks, and generous appropriations were made to pay the cost. A few years ago the general court offered a large reward for the discovery of a remedy for the potato disease, and the means of securing this vegetable thereafter from similar attacks. In all this sanitary legislation, the government recognized the principle, that its influence and its power may be used for the protection of life from the causes that waste it, and now the time has come to place that influence and power in an organ- ized form, to establish a Board for this purpose and clothe it with authority to watch over the sanitary interests of the whole people. In this matter it is not expected that there shall be any di- rect interference with the people, by the government or any of 1861.] HOUSE—No. 112. 23 its officers. They are not expected to go forth and heal dis- eases, nor is it asked that fever shall be prohibited by law, or that death shall be arrested by the arm of power. The State did not forbid weeds to grow in the fields, or the farmer to raise poor crops; nor did it prohibit ignorance or require more geo- graphical and mathematical knowledge among the children and youth. Yet the State did create and spread good influences, from which these should come, and those influences have accom- plished their great purpose, and are still moving onward in their work of improvement. It is not expected that the legislature will write a treatise on health. It did not write a treatise on education nor on agricul- ture ; but it has caused manifold useful and effective treatises on both of these sciences to be written by the learned secreta- ries of these Boards, which have very greatly aided in the teaching of youth and in the cultivation of the earth. Not only have these government officers written for these pur- poses, but the Boards, considering that there is no valuable knowledge that should be lost, and no good light should be hidden under a bushel, but that all should be brought forth and made available for all, invite every one who has any thing good to say to come forth and publish his ideas. They ask every school committee and every teacher to send their thoughts on teaching, books and discipline, &c, and every farmer to send statements of his observations and experience, his plans and success in cultivation and in cattle raising, &c. All these re- turns are carefully analyzed, and the profitable parts selected and published by the secretaries, for the use of those engaged in these pursuits throughout the Commonwealth. An objection may be made to any State action in behalf of health, that in regard to human life more than in regard to any other matter, there is no perfection here below, and that the world needs more resignation to the inevitable lot of disease and early mortality than hope for improvement by any means within mortal reach, and it is in vain to try to amend our sanitary condition. The world has always had those who supposed there could be no improvement, because they saw no better ideal than their practice. Where these rule, no advancement is made. If the legislature of Massachusetts had listened to these, our schools 24 MEMORIAL. [Feb and farms would have been now as they were in the last cen- tury. But the wiser legislators thought, that although there may be no absolute perfection in either of these matters, still there ever may be a progress toward it. The best thing that is produced or done in either of these fields, is the ideal of per- fection for the time, and it is offered to all others for their imi- tation. The State finds an opportunity to present it to the people. Whosoever has a lesson is invited to come forth and teach it, and be paid for so doing. If any one produces a larger expansion or manifestation of life in plant or in beast, if he raises better grains or a better cow, or makes better butter, or cultivates his land in a better manner, he is asked to come to the agricultural fair, show his work and tell how he did it. That is the lesson in the expansion of life which he can teach, and he receives his reward from the public treasury. The State believes it has its money's worth, and offers to purchase more of the same kind in another year. In order to make these lessons of improvement the most profitable to the whole community, the State gathers them from their several localities, puts them into the government reports and sends them through the Commonwealth, so that the wisdom and success of the most intelligent and skilful may be available to all who are engaged in the same work. Like the Boards already referred to, the Board of Health, after surveying the ground before them, would find its own way of usefulness, and lay its own plans of operation. It would seek its cooperators among the people, and find its own means of accomplishing the purposes of its creation. In the returns of mortality, they would find the first indications of the sani- tary condition of the various parts of the State, and the dangers that may be present. They will learn, where and in what circumstances life has its largest expansion and the smallest burden, where childhood, in the largest proportions, survives the perils of its years, and prepares the greatest number of men and women for responsible and self-sustaining life, and where their working period is the longest protracted and endowed with the greatest amount of productive force, and men and women are consequently the richest blessings to their families, and the most effective and valuable members of the body politic. 1861.] HOUSE—No. 112. 25 By the same means the Board of Health would discover the places and circumstances where life is the lowest and weakest, where of those who are born, the fewest pass through the dangers of infancy and youth and become mature workers in society, and where the productive term is the shortest and least efficient, and contributes the least to the power and capital of the Commonwealth. The way being opened, first through the mortality returns, the inquiry will be pursued, in every possible way, so that the sanitary conditions of all parts of the State shall be revealed, and all the salubrious and morbific influences made known. All the variations of life will be discovered and recorded by the Board, and they will understand how much is enjoyed in the most favorable places and circumstances, and how much is lost in the worst. With this knowledge, growing in extent and importance from year to year, the Board and its agents will be the sanitary teachers to show how great an amount of vitality is possessed by some and how small an amount of the same blessing is accorded to others. The best, the strongest and the longest life is the ideal, the type of what man may have, and the worst is the measure of what he sometimes obtains. These are the lessons which the Board will teach, and which the people should learn with advantage to themselves. Like the other Boards herein mentioned, so successful and useful in their administration, this, in pursuit of its purpose, will endeavor to create an interest in its work among the people and raise up friends in all parts of the Commonwealth to cooperate with them in their investigations, in gathering sanitary knowledge and in spreading it again abroad. They will endeavor to persuade the world to regard their vital force as their most precious gift by which all others are to be weighed, and to which every thing else must be subordinated, their most reliable capital which is not to be expended for any meaner advantage nor put to hazard for any ordinary purpose. So that, as the best citizens, the best members of the body politic when they consider any plan of business or pleasure, now count the cost in money, to see if they can afford the expense, they will then count the cost in life, and see whether and how much this too must suffer in the undertaking. 4 26 MEMORIAL. [Feb. CITIES. Connected with this matter, new considerations will from time to time, present themselves to the government, and on suitable occasions may have an important bearing on legislation. There are tendencies among the people, the motive power of which is gain or position, and over which the legislature may have some influence. There is a constant tendency of popula- tion to gather in compact masses and live in cities. The cities and large towns of this and the other States have increased rapidly, while the country districts have increased much more slowly and some are stationary. In the twenty years from 1840 to 1860. Twenty-eight cities and large towns in Massachu- setts, gained,.......145 per cent. The rest of the State gained, . . . . 32 " Fifty-nine largest cities in the United States gained, 198 " The rest of the United States gained, . . . 75 " The growth of these towns seems to be evidence of public prosperity, for wheresoever business is more active, a larger capi- tal accumulates, income is greater, and many of the luxuries and comforts of society are more abundant, and some would add, that a higher civilization is gained. Admitting all this, the question yet remains, whether life and happiness, health and productive power are the gainers or losers. It is yet to be seen, whether the average amount of life's earnings and contri- butions to the public capital are greater or less, by all that are born and live in the cities than by all that are born and spend their lives in the rural districts. Cities are said, by some, to be the destroyers of families and of generations. A French writer says, that of the 1,000,000 people who now live in Paris, not 1,000 are descendants of those who lived in that city 200 years before. That is, the 200,000 people who were in Paris at the time of Louis XIII., instead of multiplying as elsewhere, to become ten times as many in the course of two centuries, have dwindled down to a two- hundredth of their numbers, and the same writer adds, that Paris is obliged to depend upon the country from generation to generation for its population, in the same manner as it depends 1861.] HOUSE—No. 112. 27 upon it from day to day for its food. A similar fact is found by the examination of the records of the population of London and some other cities. It may be the same here.* Manufactures, agriculture, commerce, the professions, &c, in their manifold varieties of occupation, employ the people. These are usually selected in consideration of their offers of pecuniary advantage. But they may involve the value of life. The larger annual earnings and profits in some employ- ments, may be counterbalanced by their shortened period of productive power, and the total accumulations in different occupations, may be more nearly equal than at first appears. Many other movements, habits and conditions of the people, always depending upon and often affecting the vital force, are, in greater or less degree, influenced by the legislature, which grants facilities or gives encouragement and may some- times interpose obstacles to their beginning and progress. The government then needs to have in view, the interests of life and health as well as of those of property and business, and be prepared to shape its action in such manner, that neither of these shall suffer, but that the great purposes of man's individual and associate existence may be best attained. For this end the Board of Health will be the sanitary eye of the Commonwealth to discover all its wants and its dangers in this respect, and to see how its vitality may be affected for good or for evil by any legislative action for its own or for other interests. If then, with the light that may thus be obtained, from year to year, any governmental " measures can be taken, to remove the causes of the depreciation of health, productive energy and happiness of the people ; if the amount of public and private prosperity and enjoyment can be increased in any degree ; if any advancement can be made in this matter, from the actual to that which is shown to be possible; and if legislation guide the way to this improvement or take away any obstacles to this progress, then the wisdom and power of * Some important facts are given in Massachusetts Senate Document No. 186, 1859, showing the destructive influence of cities on human life. These are taken from the^British Government Reports on Health. They prove that most diseases are more prevalent and fatal; that death is more frequent and life shorter in city than in country. 28 MEMORIAL. [Feb. the lawgivers will be applied to their noblest arid most effective purpose." REGISTRATION OF BIRTHS, MARRIAGES AND DEATHS. This Board of Health and Yital Statistics would naturally and necessarily have charge of the Registration of Births, Marriages and Deaths, and find, in the administration of that law, the most important means of usefulness. This work is now done in the office of the secretary of State, where it has no natural affinity nor proper position. Although that is a miscellaneous office, the depository of all duties, labors and. responsibilities not otherwise provided for, yet the legislature has, from time to time, removed one after another of these, first, the education, then the agriculture, then banks, insurance, &c, and pro- vided for each an appropriate board of supervision and admin- istration, and yet the office is burdened and needs another relief in the removal of the registration. Even now this is a mere excrescence there, and delegated to other hands, which do the work but which are not clothed with the needful authority to make that work as useful and complete as it may be. In the hands of the Board of Health this would be made to subserve the interests of health and show the sanitary progress from year to year. CENSUS. All other vital statistics, the decennial census especially, which is now an unwelcome and unfitting* burden upon the secretary of State, would find an appropriate position in this board. In England and in some other countries, the same officers have charge of the registration of the dead and of the enumeration of the living, and by this combination, they make .each duty more easy, and the results of both more profitable to the people. It will be so here. HOSPITALS, ETC. Both as a matter of political economy and of science, other vital statistics of the State should come under the supervision of this Board. They or their executive officer should have some v.sitor.al or supervisory power over all the State hospitals and almshouses, so far as they are hospitals, and all the public 1861.] HOUSE—No. 112. 29 establishments and medical charities, wherein any sick, insane, blind, idiotic, deaf and dumb, belonging to the State are kept, or which receive any part of their support from Massachusetts. The facts of insanity, idiocy, disease and injuries, bodily and mental deficiency, in public establishments, are now scattered in fourteen different reports of as many different institutions, which have no connection with each other. It is difficult for the government or the people to comprehend these in one view, and understand the whole extent of this burden of human suffering and privations, which the State provides for, or supports by its funds. Without interfering with the reports of these institutions as they are now made, all their common facts should be centralized in this Board, and through them presented in one form to the legislature. As they now are, they fail to convey their full lessons of instruction. Detached and few in their separate reports, they are comparatively useless both to the physician and the political economist. But together they make a large mass and may be made to subserve a higher purpose in medical and sanitary philosophy as evidence of disease and its prevalence in various forms or as pointing to cause, and leading to means of prevention. LUNATICS. In Massachusetts, there were, in the year 1854, two thousand six hundred and thirty-two insane persons. Unquestionably they are no less, but probably more, at the present time. But allowing that there had been neither increase nor decrease of insanity, within five years, we have 2,632 lunatics at the present time, living in or belonging to this State. There were at the end of the last reported year, thirteen hundred and sixty-one (1 361) patients in the five public lunatic hospitals, and these we're supported in that year, in those institutions, at the cost of $245,257 ; adding the estimated cost of the 1,271 lunatics who are at their homes, in poor-houses, prisons, &c, $100 a year for each, the whole cost of maintaining insanity in the last year was $372,357. This sum was paid by the State, the town's and the friends of the patients, and came out of the o-eneral public and private capital and income of the Common- wealth This is the expenditure of last year; it was about the 30 MEMORIAL. [Feb. same in the year before, and for several or many years previ- ous, and there is no reason to suppose that it will not be the same next year, and in years beyond, unless insanity shall diminish. Eight hundred and seventy-one patients were received into the lunatic hospitals during the last year; seven hundred and fifty-one in the year previous ; seven hundred and sixty-seven in the year before that.* A few of these came from other states to the M'Lean Asylum; a few were trans- ferred from one hospital to another, and were consequently counted twice, and some others were doubtless old hospital residents, that had been out for a season and returned. Making all these allowances, it is safe to assume, that there were seven hundred new patients admitted in the last year, and these must represent the number of new cases of insanity in the last and in each of several of the years previous ; and unless the habits and exposures of our people change, it will be the same this year and next, and in years beyond. Seven hundred of our men and women, in the responsible and self-sustaining age, are taken from the sphere of action and usefulness, and cause so much loss of productive power, to their families and the State, and so much addition to the public and private burden in their support, and the extraordinary care and watchfulness needed for them. This is a matter of terrible interest to the people and the government, to see whether it need to be perpetually renewed. It is worthy of the profoundest consideration of the legislature to inquire, whether this burden upon the sympa- thies and the comforts of home, upon private property and the * Burden of Insanity in Public Institutions of Massachusetts. Patients Admitted * Patients at end of year. Cost of sup- HOSPITAL. 1855. 1850. 185?. 1858. 1859. 18GO. port last year. Worcester, . Taunton, . . Northampton, McLean, . Boston, . . 199 167 123 97 241 185 149 52 271 207 141 43 307 223 14 155 68 200 231 93 131 96 215 245 167 121 126 331 361 315 187 167 $58,137 55,000 41,128 63,370 27,622 5S6 627 662 767 751 874 1,361 $245,257 * Not including those who were known to be transferred from other hospitals in the State. 1861.] HOUSE—No. 112. 31 general treasury, this mill-stone hanging on the neck of the body politic may not be lessened, and a better inheritance of a more general health of mind, as well as of body transmitted to our children. In consideration of these facts and reasons, your memorialists respectfully ask your honorable bodies to establish a Board of Health and of Vital Statistics, which shall look after the vital and sanitary interests of this Commonwealth, superintend the execution of the law for the registration of births, marriages and deaths, and prepare the annual report; have the charge of the decennial census under the direction of the legislature ; have a visitorial power over all the hospitals and the public medical charitable institutions, where the insane, the sick, the defective in body or mind are kept or supported by the State, and assume such other responsibilities, and perform such other duties in connection with life, sickness and mortality of the people, as you, in your wisdom, may determine. Respectfully submitted, For the Sanitary Association, EDWARD JARVIS, JOSIAH QUINCY, Jr., JOSIAH CURTIS, Committee. Boston, February 15,1861. THE BOSTON SANITARY ASSOCIATION. Organized April 7, 1860. CONSTITUTION. Article 1. The objects of this Association shall be the improvement of the sanitary condition of the people, and, so far as connected therewith, the advancement of their economic and moral interests:— Fint, By promoting the investigation of facts and principles relating to per- sonal, domestic, and public Hygiene ; Second, By diffusing information on the laws of health and life, and the best means for their practical application ; Third, By such other influences and agencies as maybe deemed expedient; Article 2. Any person may become a member on payment of one dollar 1o the Treasurer, and shall continue a member se long as the same sum is paid annually. Article 3. The Officers of the Association shall be a President, two Vice- Presidents, a Corresponding and a Recording Secretary, a Treasurer, and six Directors, who shall together constitute a Board of Management, of which five shall be a quorum. These shall be chosen at the Annual Meeting, and shall hold their offices one year, or until their successors are chosen. Article 4. The Annual Meeting shall be on the third Thursday in January. Other meetings shall be held as frequently as the Board of Man- agement shall from time to time judge necessary; and they shall also regulate the order of business and other proceedings at such meetings. Article 5. The presiding officer shall nominate all committees, unless otherwise determined by the Association. OFFICERS. JOHN WARE. M. I)., • • President Hon JOSIAH Ql'INCY, Jr., ' . . Vice-Presidents. Hov F W. LINCOLN, Jr., ) n c " tV ox-i'r i ivf KVn • Cor. Secretary. GEO. H SN LLUNG b*Q, ■ Secretary. JOSIAH CI RriS, M. D, • • Treasurer. OTIS CLAPP, Esq., _,. , n„ tIlvrvG Ci.mik. Dr. Edward Jarvis. (Dorchester.) RXr»im"'ta »r.0«,«.. W. F*.».«, Judge T„o3. Rr„;KLl..a!irtllKXi.vH. Rouliiis. hsq. m