department. To their desire to conceal nothing, and to their unfailing courtesy in furnishing all possible information, is due whatever merit these pages may possess. For it is not from books, but only by accompanying the different inspectors on their daily rounds of duty and coming in personal touch with their chiefs, that a layman, not officially connected with the department, can hope to derive anything of real value.

As at present organized, the Health Department of New York city seems to be a model of efficiency and smooth running. Doubtless this is due more than anything else to the ability of the present commissioner and his assistants, and certainly one must be very careful not to lay undue stress on the forms rather than the methods of administration. Nevertheless, a knowledge of just how the department is organized is necessary to a clear understanding of its working; and it should also prove interesting and helpful in judging of the comparative merits of the various forms of organization in some of our other large cities.

In 1866 the general sanitary condition of New York had grown so appallingly bad that doing the year no less than 33 persons died out of every 1,000. Public opinion became thoroughly aroused. A Brooklyn Board of Health had been established as early as 1824, and with apparently good results, and New York's citizens resolved to lag behind no longer. In consequence, the Board of Health of the old city of New York was established, and since that time has remained practically unchanged until the Greater city was created by the Consolidation Act of 1897.

As organized under the present charter, the Board of Health is the head of the Department of Health, and is composed of the commissioner of health, the commissioner of police, and the health officer of the port. The commissioner of health is the executive head of the department and president of the board, and, like the police commissioner, is appointed by the mayor, at an annual salary of $7,500, and removable at his pleasure. The board appoints most of the other officers and agents, nine-tenths 'See table opposite. 2 Charter of 1901, chap. xix.

NOTE.-Horizonital lines indicate officer's title; vertical lines indicate his office and functions.

of whom are in the classified service, and may therefore be appointed only after a rigid civil-service examination, and removed for cause. The health officer of the port is appointed by the governor of the state, and, on account of the close connection of his work with the sanitary welfare of the city, he was given a place on the Board of Health. It is his duty to keep the department informed, by written reports and otherwise, of the number of vessels in quarantine and the number of persons sick in the marine hospitals. Furthermore, he must not allow any person, vessel, or article which has been quarantined to return to the city without a permit from the sanitary superintendent of the department. For the same reasons the police commissioner is also a member of the Board of Health. For it is especially provided in the charter that the police shall co-operate, wherever necessary, with the Department of Health, both in the serving and enforcement of orders, and in the general sanitary inspection work. This is done largely through the medium of a special squad of so-called "Sanitary Police," who are detailed from police headquarters at the request of the Board of Health, and chosen by it because of their special fitness. The squad is commanded by a sergeant and roundsman, and, though remaining under the discipline of the Police Department, and reporting its work to police headquarters, is under the sole direction of the sanitary superintendent of the Department of Health. The nature of the work carried on by these officers will be touched upon later, but their high character and efficiency under the present administration is undoubted and well worthy of imitation by other cities, and perhaps also by some of the men on New York's regular police force.3

It is necessary to remember that the two chief functions of the Department of Health are preventive and curative. That is, its efforts to promote the public health take the form both of the prevention of disease and its cure. And of these two, the first

I

1 Cf. sec. 166 of Sanitary Code. 2 Charter of 1901, secs. 1202, 1202a.

3 The squad must not number over fifty men, selected from those who have seen at least five years' service on the regular force. They are paid from a special fund appropriated by the Department of Health.

is probably the more important, and the one upon which both medical and philanthropic authorities rightly lay the greatest emphasis. Everywhere today we find men of practical experience and sound judgment seeking to solve the problems of crime and poverty and disease by positive measures of precaution, by attacking the evils at their very source. No branch of the municipal service illustrates this better than the Health Department, for, as Mayor Low remarked recently, "it is both easier and better to create conditions that make for health than it is to cure people after they have been taken sick."

The authority of the department extends over the entire city and the waters immediately adjacent, as well as over the waters of the bay within quarantine limits. As already mentioned, the powers of the board are enormous, and it is its duty to take all necessary measures for the preservation of human life, and the care, prevention, and protection of the public health. For this purpose it draws up from time to time, as occasion requires, a series of regulations which are embodied in the Sanitary Code. Thus, besides enforcing all existing laws relating to the health of the city, any measure adopted by the board and published in the "City Record" for two weeks becomes a part of this code, and as such is enforcible by civil or criminal proceedings, or both. Indeed, the city charter expressly. provides that the board may embrace within the Sanitary Code "all matters and subjects to which, and so far as, the power and authority of said Department of Health extends, not limiting the application to the subject of health only."3 A still clearer conception of the powers of the department can be derived from a consideration of the work intrusted to the various inspectors. But it may be repeated here that, while the New York laws relating to tenement houses are now generally enforced by the new Tenement House Department, the Board of Health still has full authority to 'See his "Talk," quoted in Charities, September 20, 1902, p. 270.

Charter of 1901, chap. xix, secs. 1168, 1169.

3 Sec. 1172.

By an amendment of the city charter of 1901 (chap. xix a) all the duties of the Board of Health with reference to tenement houses were conferred not transferred - upon the new Tenement House Department. This change, of course, afforded an immense relief to the old Department, for it allowed it to concentrate its efforts upon

vacate all buildings that are themselves unfit or which make adjacent buildings unfit for human habitation;' to prescribe and enforce rules relating to the sanitation of lodging houses, shops, or dwellings; to deal with all sources of infection or disease; to remove dead bodies from the streets or from houses; and to abate any public nuisance.

The sanitary superintendent.-Aside from the Bureau of Records, which collects and tabulates all the vital statistics of the city, the most important work of the department is that carried on under the Sanitary Bureau. This includes all the sanitary and medical inspection of various kinds, as well as the hospital service, and the work of the chemical and bacteriological laboratories.

At the head of the Sanitary Bureau is the sanitary superintendent. He is appointed by the board, at an annual salary of $5,000, and at the time of his appointment must have been at least ten years a practicing physician and for three years a resident of the city. Under him are five assistant superintendents, who serve at an annual salary of $3,500, and direct the work of the Bureau in each of the several boroughs of the Greater city. It is the duty of the sanitary superintendent and his assistants to make weekly, quarterly, and annual reports to the board so that the president may keep in close touch with other important sanitary work. At the same time the framers of the amendment wisely permitted the Board of Health to retain all its original powers to be exercised by it at any time in case of emergency.

Sec. 1299 of the present charter gives the department full power to vacate any building or part of a building which is "infected with contagious disease, or by reason of want of repair has become dangerous to life, or is unfit for human habitation because of defects in drainage, plumbing, ventilation, or the construction of the same, or because of the existence of a nuisance on the premises which is likely to cause sickness among the occupants." Sec. 1300 also gives it the power to condemn and remove all such buildings where necessary, and prescribes the proceedings for condemnation. This sweeping principle was derived from British law -"Houses of the Working Classes Act," 1890, 53, 54 Vict., chap. 70- but has never been sustained by the American courts. Hence in this country a building may be vacated in the interests of the public health, but not actually condemned and removed. Cf. Dassiro vs. the Health Department, Appellate Division Reports, Vol. XXI, p. 348, October, 1897.

* Both the sanitary superintendent and the assistant sanitary superintendent hold office during the pleasure of the board.