ABSTRACT
For a century or more medical care in hospital had been regarded, as the education of children was always regarded in the United States, as a responsibility for which the community should in some form provide. The practice of medicine has been altered by changes in its science and in society. A more significant way in which the early nineteenth century saw the establishment of a state health bureaucracy concerned smallpox. In February 1832, the Cholera Prevention Act gave powers to abate nuisances and to provide nurses and medicines for the sick poor. The legal system is satisfied by enforcing money payments for loss of arms, legs, eyes, life. The associated National Assistance Act of 1948 abolished the Poor Laws but kept the idea of coercive medicine in the provision that people could be confined to hospital where they were found to be incapable of looking after themselves.
