conditions often shameful beyond expression. The
solution of the problem is not very difficult.
What has been done elsewhere can be done here.
It is not so much in the cities, though here too the
death rate is still high, but in the smaller towns
and rural districts, in many of which the sanitary
conditions are still those of the Middle Ages.
How Galen would have turned up his nose with contempt
at the water supply of the capital of the Dominion
of Canada, scourged so disgracefully by typhoid fever
of late! There is no question that the public
is awakening, but many State Boards of Health need
more efficient organization, and larger appropriations.
Others are models, and it is not for lack of example
that many lag behind. The health officers should
have special training in sanitary science and special
courses leading to diplomas in public health should
be given in the medical schools. Were the health
of the people made a question of public and not of
party policy, only a skilled expert could possibly
be appointed as a public health officer, not, as is
now so often the case, the man with the political
pull.
(7a) Connecticut.
It is a long and tragic story in the annals of this
country. That distinguished man, the first professor
of physic in this University in the early years of
last century, Dr. Nathan Smith, in that notable monograph
on “Typhus Fever” (1824), tells how the
disease had followed him in his various migrations,
from 1787, when he began to practice, all through
his career, and could he return this year, in some
hundred and forty or one hundred and fifty families
of the state he would find the same miserable tragedy
which he had witnessed so often in the same heedless
sacrifice of the young on the altar of ignorance and
incapacity.
In a population of about one million, seventeen
hundred persons died of tuberculosis in this state
in the year 1911—a reduction in thirty years
of nearly 50 per cent. A generation has changed
completely our outlook on one of the most terrible
scourges of the race. It is simply appalling
to think of the ravages of this disease in civilized
communities. Before the discovery by Robert Koch
of the bacillus, we were helpless and hopeless; in
an Oriental fatalism we accepted with folded hands
a state of affairs which use and wont had made bearable.
Today, look at the contrast! We are both helpful
and hopeful. Knowing the cause of the disease,
knowing how it is distributed, better able to recognize
the early symptoms, better able to cure a very considerable
portion of all early cases, we have gradually organized
an enthusiastic campaign which is certain to lead
to victory. The figures I have quoted indicate
how progressively the mortality is falling. Only,
do not let us be disappointed if this comparatively
rapid fall is not steadily maintained in the country
at large. It is a long fight against a strong
