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And to begin with:

1. What is the Existing Machinery of Public Health in what are called—with a grim sarcasm—our Rural Sanitary Districts? Is health or sickness, life or death, the greatest miracle in the present condition of things? To some of us the greatest miracle, repeated every day, is that we can live at all in the surroundings which our ignorance and neglect create.

There is the

Board of Guardians[1]: "Sanitary Authority," who give the tag-end of their time to a subject which might monopolise the whole of it, and yet not be exhausted.

Medical Officer of Health: generally a busy man with a private practice covering a very large area, who earns a pittance for doing a most important public duty; a man appointed to his office and maintained in it by those whom he ought to criticise fearlessly and openly, when they are careless about the health of those dependent on them. His salary, which ought to be proportionate to his capital of knowledge ever accumulating, and his income of experience rolling up as years go on, which should give him an opportunity for sufficient leisure to work at public health as a scientific study, apart from his medical practice—his salary, which should be enough for this, is often hardly sufficient for his necessary travelling expenses as a public official—sometimes only a few pounds per annum.

  1. By the Local Government Act, 1894, all the powers and duties of the Board of Guardians, as Sanitary Authority, are transferred to the newly-constituted District Council of the Rural District, which takes the place of the Rural Sanitary District.