of the food, clothing, exercises and amusements of school children. It is probable that these matters should be made the subject of regulation in the public interest, but should the board of health be the instrument chosen to regulate them?
Obviously some limit should be placed upon the exercise of the power possessed by boards of health when questions not strictly germane to the sanitary welfare of the public are concerned. If no such limit is placed, it is difficult to understand where the activities of boards of health are to cease. Almost every act and occupation and nearly every feature of city life may be construed as having some bearing upon public health and welfare. Before a board of health sets out upon a campaign of more esthetic than sanitary value it should be certain that all its simple and essential duties are being efficiently discharged. There is often much inconsistency in public health work.
So extensive and so numerous are the conditions of modern civilization which certainly affect health, that boards of health generally do not pretend to cover them all. For example, the construction and maintenance of public water supplies and sewerage systems, although undertaken by the public at the public expense, are not conducted by health authorities but by private corporations or special municipal departments. Likewise the collection and disposal of garbage, and even the cleaning of privies, is often done by other than public health authorities.
There is something incongruous about a board of health conducting a crusade against smoke and noise and at the same time allowing the streets to be filthy with dirt and dust and offensive with accumulations of fermenting garbage. Again a great deal of the attention of health boards is occupied with alleged private nuisances which affect comfort but not health. The history of every city is a record of more and more strict regulations to minimize the unpleasant as well as the unsanitary conditions of household life.
The work of boards of health has been, on the whole, very decidedly for the advancement of the general welfare. The great reduction in the general death rate and the more wholesome and agreeable conditions of living of to-day as compared with those of a generation ago, bear ample testimony to this success. If it be objected that other factors have been at work to improve the sanitary conditions of cities, it must be answered that much of the inspiration for this other work has come from health authorities. It should never be forgotten that it is sanitation which has made the growth of cities possible.
Having thus briefly referred to the scope and bearing of public health work we may pass to a consideration of the relation of city, state and nation in protecting the public health.
The authority exercised by public health boards is derivable from