lation. In January, 1911, a passed assistant surgeon was detailed to one of the mine rescue cars of the Bureau of Mines to make studies of the diseases of miners in West Virginia. In May of the same year the Chief of the Division of Zoology was detailed with a mine rescue car to study hookworm among miners, and an assistant surgeon was assigned to the mine rescue car at Pueblo in order to give advice regarding sanitary and medical matters and to make investigations of hygienic conditions in mines and of the influence of gases.

In 1912 a medical officer was detailed to the Department of the Interior to assist the Bureau of Education in the supervision of measures relating to the medical and surgical relief of the natives of Alaska.

The Public Health Service Since 1912. It has been shown in the preceeding pages how the work of the Public Health and Marine Hospital Service had grown from the operation of hospitals for the benefit of seamen until this organization was administering foreign and interstate quarantine, making medical inspection of immigrants, and conducting general investigations in the field of hygiene and preventive medicine. Work relating to health was also being conducted by other bureaus of the government. The enforcement of the pure food and drug law had been placed in the hands of the Bureau of Chemistry of the Department of Agriculture; the federal inspection of meats entering interstate commerce was made by the Bureau of Animal Industry of the Department of Agriculture; in 1902 the Bureau of the Census was specifically authorized to collect vital statistics in registration areas.

The Act of August 14, 1912, and the events leading to it. Notwithstanding the progress that had been made, a strong sentiment had been developing for more extended activity on the part of the federal government in order to reduce the human and economic waste resulting from the spread of preventable diseases. In 1904 the American Association for the

Advancement of Science appointed a committee of one hundred to take such action as might be necessary to improve the health of the nation. Under the leadership of Prof. Irving Fisher this committee organized an extensive campaign to focus attention on the advantages of better supervision of health problems.

In 1908 both the major political parties took notice of this movement in their platforms. The Republican platform did not go further than to declare that "we commend the efforts designed to secure greater efficiency in national public health agencies and favor such legislation as will effect this purpose." The Democratic platform was more specific and contained the following recommendation: "We advocate the organization of all existing national public health agencies into a national bureau of public health, with such power over sanitary conditions connected with factories, mines, tenements, child labor, and other subjects as are properly within the jurisdiction of the federal government, and do not interfere with the power of the states controlling public health agencies."

"45

In 1908 President Roosevelt appointed a commission consisting of Charles D. Walcott, J. R. Garfield, W. L. Capps, William Crozier, and Gifford Pinchot, to study the organization of the scientific work of the government. On November 13, 1908, this commission made a report to the President recommending that all bureaus relating to the public health be transferred to the Department of the Interior.40

President Roosevelt, in his last annual message to Congress on December 8, 1908, made the following recommendations:

It is highly advisable that there should be intelligent action on the part of the Nation on the question of preserving the health of the country. Through the practical extermination

45 61 Cong., 2 Sess., S. Doc. 637, p. 5.

46 Hearings before House Committee on Interstate and Foreign Commerce on bills relating to health activities of the general government, 1910, p. 23.

in San Francisco of disease bearing rodents, our country has thus far escaped the bubonic plague. This is but one of the many achievements of American health officers; and it shows what can be accomplished with a better organization than at present exists. The dangers to public health from food adulteration and from many other sources, such as the menace to the physical, mental and moral development of children from child labor, should be met and overcome. There are numerous diseases, which are now known to be preventable, which are, nevertheless, not prevented. The recent International Congress on Tuberculosis has made us painfully aware of the inadequacy of American public health legislation. This Nation can not afford to lag behind in the world-wide battle now being waged by all civilized people with the microscopic foes of mankind, nor ought we longer to ignore the reproach that this government takes more pains to protect the lives of hogs and of cattle than of human beings.

The first legislative step to be taken is that for the concentration of the proper bureaus into one of the existing departments. I, therefore, urgently recommend the passage of a bill which shall authorize a redistribution of the bureaus which shall best accomplish this end.

President Taft repeatedly recommended the development and unification of the health activities of the federal government. In his first annual messages submitted to Congress on December 7, 1909, he called attention to this subject in the following words:

For a very considerable period a movement has been gathering strength, especially among the members of the medical profession, in favor of a concentration of the instruments of the National Government which have to do with the promotion of public health. In the nature of things, the Medical Department of the Army and the Medical Department of the Navy must be kept separate. But there seems be no reason why all the other bureaus and offices in the General Government which have to do with the public health or subjects akin thereto should not be united in a bureau to be called the "Bureau of Public Health." This would necessitate the transfer of the Marine Hospital Service to such a

bureau. I am aware that there is wide field in respect to the public health committed to the States in which the Federal Government can not exercise jurisdiction, but we have seen in the Agricultural Department the expansion into widest usefulness of a department giving attention to agriculture when that subject is plainly one over which the States properly exercise direct jurisdiction. The opportunities offered for useful research and the spread of useful information in regard to the cultivation of the soil and the breeding of stock and the solution of many of the intricate problems in progressive agriculture have demonstrated the wisdom of establishing that department. Similar reasons, of equal force, can be given for the establishment of a bureau of health that shall not only exercise the police jurisdiction of the Federal Government respecting quarantine, but which shall also afford an opportunity for investigation and research by competent experts into questions of health affecting the whole country, or important sections thereof, questions which, in the absence of Federal governmental work, are not likely to be promptly solved.

In March, 1910, Senate Bill 6049, providing for a Department of Public Health, under the supervision of a Secretary of Public Health was introduced into the Senate. This bill proposed to make it the duty of the new department "to supervise all matters within the control of the federal government relating to the public health and to diseases of animal life," and to transfer to it "all departments and bureaus be-· longing to any department, excepting the Department of War and the Department of the Navy, affecting the medical surgical, biological or sanitary service, or any questions relative thereto." Specific provision was made for incorporation in this department of the Public Health and Marine Hospital Service, the medical officers of the Revenue Cutter Service, of the Pension Office, of the Indian Service, and of Soldier's Homes, all hospitals, the Bureaus of Entomology, Chemistry, and Animal Industry of the Department of Agriculture, and the emergency relief service of the Government Printing Office. This bill found many warm advocates, but it also encountered determined opposition. Other bills introduced

about the same time proposed creating an independent establishment for public health work, changing the name of the Public Health and Marine Hospital Service to the Public Health Service, and the creation of a Bureau of Health in the Department of Commerce and Labor. Beyond holding public hearings Congress took no action on any of these bills. 47

In his second annual message, transmitted to Congress ✔ December 6, 1910, President Taft again recommended the creation of a single bureau to deal with health activities, in the following words:

In my message of last year I recommended the creation of a Bureau of Health, in which should be embraced all those Government agencies outside of the War and Navy Departments which are now directed toward the preservation of public health or exercise functions germane to that subject. I renew this recommendation. I greatly regret that the agitation in favor of this bureau has aroused a counteragitation against its creation, on the ground that the establishment of such a bureau is to be in the interest of a particular school of medicine. It seems to me that this assumption is wholly unwarranted, and that those responsible for the Government can be trusted to secure in the personnel of the bureau the appointment of representatives of all recognized schools of medicine, and in the management of the bureau entire freedom from narrow prejudice in this regard.

In May, 1912, the President transmitted to Congress a report of the Commission on Economy and Efficiency on government services pertaining to public health, in which it was recommended that provision be made by law for a public health service which should be an independent establishment

47 For text of Senate Bill 6049 and papers advocating it see 61 Cong., 2 Sess., Senate Doc. 637. See also Hearings before House Committee on Interstate and Foreign Commerce on bills relating to health activities of the general government, 1910, 651 pages; Hearings before Committee on Public Health and National Quarantine U. S. Senate on Bill. S. 6049, to establish a department of health and other purposes, 1910, 130 pages.

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