Reports Relating to the Sanitary Condition of the City of London — Themes and Context

gs of our existing sanitary condition, perhaps I may venture to speak of the almost obvious remedy. ‘Almost obvious’ I say; for surely no one will doubt that this great subject should be dealt with by comprehensive and scientific legislation; and I hardly see how otherwise, than that it should be submitted in its entirety to some single department of the executive, as a sole charge; that there should be some tangible head, responsible--not only for the _enforcement_ of existing laws, such as they are or may become, but likewise for their _progress_ from time to time to the level of contemporary science, for their _completion_ where fragmentary, for their _harmonisation_ where discordant.

If--as is rumoured, the approaching re-constitution of the General Board of Health is (after the pattern of the Poor-law Board) to give it a Parliamentary President, that member of the Government ought to be open to challenge in respect of every matter relating to health. What, for this purpose, might be the best subordinate arrangements of such a Board, it would take a volume to discuss. But at least as regards its constituted head, sitting in Parliament, his department should be, in the widest sense, to _care for the physical necessities of human life_. Whether skilled coadjutors be appointed for him or not; engineers--lawyers--chemists--pathologists; whether he be, as it were, the foreman of this special jury, or, according to the more usual precedent of our public affairs, collect advice on his own responsibility, and speak without quotation of other authority than himself, his voice, unless the thing is to be a sham, must represent all these knowledges.

The people, through its representatives, must be able to arraign him wherever human life is insufficiently cared for.

He must be able to justify or to exterminate adulterations of food; to shew that alum ought to be in our loaves, or to banish it for ever; to shew that copper is wholesome for dessert, or to give us our olives and greengages without it; to shew that red-lead is an estimable condiment, or to divert it from our pepper-pots and curries.

Similarly with drugs and poisons--the alternatives of life and death--a minister of Public Health would, I presume, be responsible for whatever evils arise in their unlicensed and unregulated sale. He would hardly dare to acquiesce in our present defencelessness against fraud and ignorance; in doses being sold--critical doses, for the strength of which we, who prescribe them, cannot answer within a margin of _cent. per cent._; or in pennyworths of poison being handed across the counter as nonchalantly as cakes of soap.[7] Surely, before he had been six months in office, he would have procured some enactment to remedy this long neglect of the legislature, by providing that the druggist’s trade be exercised only after some test of fitness, and in subjection to certain regulations.

[7] Without referring to what may be considered rare--the sale of poison for the purposes of intended homicide, I may remind the reader of the very dreadful facts collected by the Commissioners on Trades and Manufactures, as to the immense sales of opium in our principal manufacturing towns, for the purpose of quieting--and with the effect of killing, children, while their poor mothers are absent from home in their several occupations.

Within his province, likewise, it would fall to be cognisant of all that relates to the constitution of the Medical Profession. The difficulties which have baffled successive Home-Secretaries might soon find their solution in the less divided attention which he could bring to their study. Amid conflicting opinions and an apparent scramble for power, he would soon distinguish where might be the strife of jealousy and covetousness, where a truthful zeal for the honour and efficiency of medicine. I think he could not be long in curing our more scandalous anomalies. Probably--unless human bowels require other doctoring in London than in Manchester, he would manage that a doctor there should be a doctor also here; that no licence for the partial practice of medicine should be recognised--no licence admitting a man to do in Edinburgh what it would be a misdemeanour for him to do in Greenwich. And obviously, in order to this--since a professional diploma is the only criterion by which the public can measure the competence of those who seek their patronage, he would see that, as far as may be, the various licensing bodies exact from their candidates equal and sufficient qualifications; that the diploma entitling a man to call himself Surgeon or Physician, Accoucheur or Apothecary, mean the same thing--imply the same education, whether it be got in Scotland, Ireland, or England; and that any falsification of such diploma, or any unauthorised assumption of the title which implies its possession, be promptly punishable at law.[8]