CHAPTER XXVIII. SANITARY SUPERVISION. § 1. The current ideas respecting legislative interference in sanitary matters do not seem to have taken the form of a definite theory. The Eastern Medical Association of Scotland does indeed hold "that it is the duty of the state to adopt measures for protecting the health as well as the property of its subjects;" and the Times lately asserted that "the Privy Council is chargeable with the health of the Empire; "* but no considerable political party has adopted either of these dogmas by way of a distinct confession of faith. Nevertheless, the opinions that widely prevail on questions of sewage, water-supply, ventilation, and the like, fully commit their advocates to the belief these dogmas embody. That it comes within the proper sphere of government to repress nuisances is evident. He who contaminates the atmosphere breathed by his neighbour, is infringing his neighbour's rights. Men having equal claims to the free use of the elements-having faculties which need this free use of the elements for their due exercise--and having that exercise more or less limited by whatever makes the elements more or less unusable, are obviously trespassed against by any one who unnecessarily vitiates the elements, and renders them detrimental to health, or disagreeable to the senses; and in the discharge of its function as protector, a government is obviously called upon to afford redress to those so trespassed against. Beyond this, however, it cannot lawfully go. As * See Times, Oct. 17, 1848. A VIOLATION OF RIGHTS. 407 already shown in several kindred cases, for a government to take from a citizen more property than is needful for the efficient defence of that citizen's rights, is to infringe his rights-is, consequently, to do the opposite of what it, the government, is commissioned to do for him-or, in other words, is to do wrong. And hence all taxation for sanitary superintendence coming, as it does, within this category, must be condemned. § 2. This theory, of which Boards of Health and the like are embodiments, is no only inconsistent with our definition of state-duty, but is further open to strictures, similar to, and equally fatal with, those made in analogous cases. If by saying "that it is the duty of the state to adopt measures for protecting the health of its subjects," it is meant (as it is meant by the majority of the medical profession) that the state should interpose between quacks and those who patronize them, or between the druggist and the artisan who wants a remedy for his cold—if it is meant that to guard people against empirical treatment, the state should forbid all unlicensed persons from prescribingthen the reply is, that to do so is directly to violate the moral law. Men's rights are infringed by these, as much as by all other trade interferences. The invalid is at liberty to buy medicine and advice from whomsoever he pleases; the unlicensed practitioner is at liberty to sell these to whomsoever will buy. On no pretext whatever can a barrier be set up between them, without the law of equal freedom being broken; and least of all may the government, whose office it is to uphold that law, become a transgressor of it. Moreover this doctrine, that it is the duty of the state to protect the health of its subjects, cannot be established, for the same reason that its kindred doctrines cannot, namely, the impossibility of saying how far the alleged duty shall be carried out. Health depends upon the ful filment of numerous conditions-can be "protected" only by ensuring that fulfilment: if, therefore, it is the duty of the state to protect the health of its subjects, it is its duty to see that all the conditions of health are fulfilled by them. Shall this duty be consistently discharged? If so, the legislature must enact a national dietary; prescribe so many meals a day for each individual; fix the quantities and qualities of food, both for men and women; state the proportion of fluids, when to be taken, and of what kind; specify the amount of exercise, and define its character; describe the clothing to be employed; determine the hours of sleep, allowing for the difference of age and sex: and so on with all other particulars, necessary to complete a perfect synopsis, for the daily guidance of the nation: and to enforce these regulations it must employ a sufficiency of duly-qualified officials, empowered to direct every one's domestic arrangements. If, on the other hand, a universal supervision of private conduct is not meant, then there comes the question-Where, between this and no supervision at all, lies the boundary up to which supervision is a duty? To which question no answer can be given. 3. There is a manifest analogy between committing to government-guardianship the physical health of the people, and committing to it their moral health. The two proceedings are equally reasonable, may be defended by similar arguments, and must stand or fall together. If the welfare of men's souls can be fitly dealt with by acts of parliament, why then the welfare of their bodies can be fitly dealt with likewise. He who thinks the state commissioned to administer spiritual remedies, may consist ently think that it should administer material ones. The disinfecting society from vise may naturally be quoted as a precedent for disinfecting it from pestilence. Purifying the haunts of men from noxious vapours may be held quite as legitimate as purifying their moral atmosphere. The fear that false doctrines may be instilled by unauthorized preachers, has its analogue in the fear that unauthorized practitioners may give deleterious medicines or advice. And the persecutions once committed to prevent the one evil, countenance the penalties used to put down the other. Contrariwise, the arguments employed by the dissenter to show that the moral sanity of the people is not a matter for state superintendence, are applicable, with a slight change of terms, to their physical sanity also. Let no one think this analogy imaginary. The two notions are not only theoretically related; we have facts proving that they tend to embody themselves in similar institutions. There is an evident inclination on the part of the medical profession to get itself organized after the fashion of the clerisy. Moved as are the projectors of a railway, who, whilst secretly hoping for salaries, persuade themselves and others that the proposed railway will be beneficial to the public-moved as all men are under such circumstances, by nine parts of self-interest gilt over with one part of philanthropy-surgeons and physicians are vigorously striving to erect a medical establishment akin to our religious one. Little do the public at large know how actively professional publications are agitating for state-appointed overseers of the public health. Take up the Lancet, and you shall find articles written to show the necessity of making poor-law medical officers independent of Boards of Guardians by appointing them for life, holding them responsible only to central authority, and giving them handsome salaries from the Consolidated Fund. The Journal of Public Health proposes that "every house on becoming vacant be examined by a com petent person as to its being in a condition adapted for the safe dwelling in of the future tenants ;" and to this end would raise by fees, chargeable on the landlords, "a revenue adequate to pay a sufficient staff of inspectors four or five hundred pounds a year each." A non-professional publication, echoing the appeal, says "No reasonable man can doubt that if a proper system of ventilation were rendered imperative upon landlords, not only would the cholera and other epidemic diseases be checked, but the general standard of health would be raised." Whilst the Medical Times shows its leanings, by announcing, with marked approbation, that "the Ottoman government has recently published a decree for the appointment of physicians to be paid by the state," who "are bound to treat gratuitously all-both rich and poor-who shall demand advice." More or less distinctly expressed in these passages there is an unmistakable wish to establish an organized, tax-supported class, charged with the health of men's bodies, as the clergy are charged with the health of their souls. And whoever has watched how institutions growhow by little and little a very innocent-looking infancy unfolds into a formidable maturity, with vested interests, political influence, and a strong instinct of self-preservation, will see that the germs here peeping forth are quite capable, under favourable circumstances, of developing into such an organization. He will see further, that favourable circumstances are not wanting--that the prevalance of unemployed professional men, with whom these proposals for sanitary inspectors and public surgeons mostly originate, is likely to continue; and that continuing, it will tend to multiply the offices it has created, much in the same way that the superabundance of clergy multiplies churches. He will even anticipate that, as the spread of education is certain to render the pressure upon the intellectual |