Medical Legislation

MEDICAL LEGISLATION, though of great antiquity, has only recently taken a prominent place in the statute books of civilized countries. In the last 20 years, statutes have been passed in many countries creating or reorganizing the central public health authority. The Ministry of Health for England and Wales created by the Act of 1919 took the place of the Local Govern ment Board with all its powers and duties and, as regards public health, also those previously exercised by the Board of Education and other departments. Power was further created to transfer from the ministry duties which were not incidental to health.

Ministries of Health have also been established in Canada (1919), the Union of South Africa (1919), Poland (1919), New Zealand (192o), France (192o) and Rumania (1923). A Depart ment of Public Health for the Commonwealth of Australia was created in 1921, and a General Directorate of Public Health in Spain, by a royal decree of 1922.

Zymotic Diseases.

In Australia, New Zealand and the Union of South Africa comprehensive regulations regarding the notifica tion and control of infectious diseases were included; similar regulations were issued in Austria (1913), the Straits Settlements (1915) Peru (1916), Chile (1918), Sweden (1919), Brazil (1921) and Venezuela (1921). A Polish law of 1920 created the office of special commissioner for dealing with epidemics, and a French decree of 1920 instituted a mobile unit equipped with laboratories.

Vaccination.

By a law of 1914, vaccination against small pox (q.v.) becomes compulsory in Siam whenever the health ad ministrator deems it necessary; in the Straits Settlements (1915) it is compulsory, and re-vaccination also can be made compulsory in the face of danger ; in France (1915) vaccination and re-vac cination can be made compulsory by decree, but (1918) vaccina tion is compulsory for state officials. Chile (1918) has compulsory vaccination in the first, loth and loth years of age; in Venezuela (1921) there is infant vaccination and re-vaccination every seven years, failure to comply barring from a large number of employ ments. In Poland (1919) there is compulsory vaccination for infants, and again at seven years. In Tunis (1922) vaccination against smallpox is compulsory, and also against typhoid, cholera and plague, if there is danger of an epidemic. Uruguay (1923) has compulsory vaccination in the first six months, and again in the loth and loth years. A Polish law of 192o makes vaccination

against typhoid fever and cholera compulsory for doctors, nurses, employees at waterworks and for various others.

Tuberculosis.

Anti-tuberculosis legislation has been put into force in various directions. Tuberculosis schemes and the legis lation involved are discussed in the article TUBERCULOSIS. The Milk and Dairies (Consolidation) Act, 1915, of Great Britain, provided, inter alia, for the registration of dairies and the inspec tion of dairies and herds ; and prohibits the sale for human con sumption of milk from a cow with tuberculosis or other specified diseases of the udder. The Milk (Special Designation) Order, 1922, of the British Ministry of Health instituted the licensing of classes of milk, namely certified, Grade A (tuberculin tested), Grade A (non-tuberculin tested) and pasteurized; and prohibited the sale of milk under a designation to which it is not entitled.

The British Public Health Act, 1925, section 62, authorizes a court of summary jurisdiction to order the removal to a suitable hospital or institution, of any person suffering from pulmonary tuberculosis in an infectious stage, when a source of danger to others, either from lack of proper accommodation or from failure to observe sanitary precautions. In Denmark, laws of 1912, 1918 and 1919 made compulsory the notification of pulmonary and laryngeal tuberculosis by the doctor in attendance.

A Japanese law of 1919 gives power to examine any person whose calling might make him a source of transmission, to forbid the exercise of a particular calling by such, and to forbid or restrict trading in old clothes, old books and other articles which might carry infection. In Denmark, compulsory isolation of infectious cases is also empowered with certain limitations; and laws of 1918 and 1919 provided for the use of public funds to support hospitals for tuberculosis, sanatoria and convalescent establishments. A French law of 1916 instituted public dispensaries for treatment and for giving instruction in anti-tuberculosis measures. A decree of 192o laid down regulations for the establishment, working and supervision of sanatoria. An Italian royal decree, 1919, instituted a central anti-tuberculosis committee, and a Swedish royal decree, 1912, regulated subventions to hospitals for treating tuberculosis.