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one, and one wholly justified when all of the facts are taken into consideration. The medical profession some- times forgets that the Health Board legislates and acts for the whole city, not Purchase Ortho Tri-Cyclen Online for special sections or for individuals ; that many measures which are not demanded or neces- sary in the best portions of the city are required for the well-being of the inhabitants of the tenement-house dis- tricts, and also that special legislation is generally objec- tionable, must be very carefully restricted, and only re- sorted to when it has an absolutely special application. Great discretion has always been exercised in enforcing sanitary measures and the provisions of the Sanitary Code in New York City, and much greater liberty is allowed in private houses than in tenement-houses, because of the lessened danger to the public as a whole. It has never been the policy of the Health Department to interfere in any way in the management of cases of contagious dis- ease occurring in private houses as long as there is no ex- posure of persons outside of the patient's family. The Department requires that such precautions shall be taken as will protect persons outside from possible infection, but in the family the Department does not interfere. This has always been the policy and the course pursued ; but it does not seem to have been fully understood by many of the members of the medical profession. Physicians occasionally criticise the Health Department for indiscretion or want of judgment on the part of its employees. These criticisms are often justifiable, but unfortunately, they are not, as a rule, made directly to the Health Board, so that the facts may be determined and any Purchase Ortho Tri-Cyclen wrongs or defects remedied ; often they are facts made known through the medical journals or through discus- sions in the Ortho Tri-Cyclen Online medical societies, and Ortho Tri-Cyclen Cost thus, only long after the occurrence the Board becomes aware, indirectly, of the cause of the complaint. There are over two hundred physicians in the employ of the Department, all appointed after passing a civil-service examination. Their instructions are always definite, specific, and detailed as regards duties, and all employees of the department are strictly held to account for their actions. Judgment and discre- tion cannot be furnished to its employees by the Health Board, or by any other body. Every possible pre- caution is taken to prevent any just cause for com- plaint, and each and every one is Buy Ortho Tri-Cyclen Online most Cheap Ortho Tri-Cyclen carefully investi- gated, and, so far as is possible, the cause removed and the errors corrected. The Board, however, cannot remedy defects which are not brought to its knowledge. Inves- tigation has also shown in many cases in which complaints have been directly made to the Board that the physicians have been misled by the statements of the patient or fam- ily, or by lack of knowledge of all of the facts in the case. The greatest cause for misunderstanding and complaint arises from the fact that only with rare exceptions can phy- sicians be induced to read the circulars of information is- sued by the Department in regard to its work and the methods pursued. Most of the unsatisfactory results in the work of the bacterioiogic laboratories are due to the failure on the part of physicians to follow specifically the directions Ortho Tri-Cyclen Mg given. It is impossible where examinations are made from several hundred cases each day, as frequently occurs, to attain anything like a reliable service unless the specific and definite directions given are accurately fol- lowed. Still, I think it maybe fairly said, that as a whole the work of the Health Department of New York City dur- ing recent years has deserved and received the commend- ation of the large majority of the medical profession of this city. The duties and reponsibilities of the sanitary authorities with relation to the general public are numerous and com- prehensive. To a very great extent the general welfare Generic Ortho Tri-Cyclen of the community is in their hands. Everything which is detrimental to health or dangerous to life, most broadly in- terpreted, is properly regarded as coming within their province, and so wide should be the construction of the law that everything which improperly or unnecessarily inter- feres with the comfort or enjoyment of life, as well as those things which are detrimental to health or dangerous to life, should become Ortho Tri-Cyclen Price the subject of consideration and ac- tion. Sanitary authorities must protect the community from the individual, " the greatest good to the greatest number " furnishing the first rule of action. They must ensure the safety of the community as a whole, and, so far as possible, of each person in Order Ortho Tri-Cyclen Online it, by protection of the community from its component parts, and then again from each other. The interests of the individual and of the community are often divergent, Ortho Tri-Cyclen Tablets or apparently divergent ; for example, in factories and noxious trades, the observa- Digitized by Google January 8, 1898] SANITARY SCIENCE. 49 tkm of such sanitary precautions as are necessary for the protection of the health Order Ortho Tri-Cyclen of employees often involves serious expenditures which fall upon the owners. Again, the welfare of the Buy Cheap Ortho Tri-Cyclen individual frequently requires such changes in the physical condition of property — tenement-houses for example — as the tenants would not themselves de- mand. In cases of contagious disease it may sometimes be to the interest of the individual to be left in his own home, while the good of the community urgently requires his removal to an isolation hospital. It becomes at once evident, in all such instances and many similar ones, that it is the plain duty of the sanitary authorities to exercise judiciously, but firmly, the autocratic powers given to them by law. Buy Ortho Tri-Cyclen They should not interfere in regulating individual action, at least only to a very limited degree, unless such action involves danger or detriment to the community.
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