State medicine as now understood belongs entirely to modern times. It began in England just before the middle of the present century, when Edwin Chadwick, a barrister, made what has been called his "Epoch-making report" to parliament on the health of towns. By his investigations and report he secured the attention of the government and the interest of the people; laws were passed, and English sanitary work and control were inaugurated. More than fifty years have passed, and England's system of sanitary control, both inland and marine, is a strong feature of her government. The statistics in the Register General's office show that the annual death rate for England and Wales for the ten years 1871-1880, averaged 21.27 per 1,000; while for the period 1881-1890 it was 19.8, a decrease of more than 11 per cent. The former death rate in England was given at 32 per 1,000. The present
STAPLES F. CONCERNING THE PRESENT CONDITION OF STATE MEDICINE IN THE UNITED STATES. JAMA. 1897;XXVIII(15):685–687. doi:10.1001/jama.1897.02440150015002c
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