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Article
April 10, 1897

CONCERNING THE PRESENT CONDITION OF STATE MEDICINE IN THE UNITED STATES.

JAMA. 1897;XXVIII(15):685-687. doi:10.1001/jama.1897.02440150015002c
Abstract

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

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