(2) Apart from state action, voluntary organizations formed to attack specific diseases, by spreading popular knowledge of preventive measures, and pushing legislation for their enforcement, offer much promise.  The Anti-Tuberculosis League can already point to a ten per cent decline in the death rate from that plague in the decade from 1900 to 1910. [Footnote:  For methods and results consult the Secretary of the National Association for the Study and Prevention of Tuberculosis, 105 East Twenty-second Street, New York City.  Free literature is sent, and information furnished on request.] But while in New York City alone nearly thirty thousand fresh victims are seized by the disease every year, a voluntary organization cannot hope to cope with the situation; the power and resources of the State are needed.  The congestion of population, and the lack of proper light and air, which are the greatest factors, perhaps, in the spread of the scourge, must be attacked by legislation.  So typhoid must be fought not only by vaccination, but by legislation insuring a pure water supply, proper sewage disposal, and the protection of food from contamination.  Measures necessary to eradicate that pest, the house fly, must be enforced, the mosquito must be as nearly as possible exterminated, streets and yards must be kept clean, the smoke nuisance abated, the slaughtering of animals and canning of food sharply regulated, sanitary conditions enforced in homes and factories.  One of the prerequisites to any marked improvement will be the “taking out of politics” of the public health service and making it an expert profession.

(3) Another service that the community must eventually, in its own interests, provide, is free medical attendance, by really competent physicians, wherever there is need.  Without referring to the suffering and anxiety spared, the expense of this service will far more than be saved the State in the prevention of illness and premature death.  The most careful medical inspection of school children, including attention by experts to eyes, ears, and teeth, is of utmost importance; all sorts of ills can thus be averted which the parents are too ignorant or careless to forestall. [Footnote:  Consult the literature of the American School Hygiene Association (Secretary T. A. Storey, College of the City of New York).  L. D. Cruickshank, School Clinics at Home and Abroad.  Outlook, vol. 84, p. 662.] It is earnestly to be hoped that the present chaos of medical education and practice will be soon reduced to a better order; that practitioners who prefer manipulation or mental healing, for example, will, instead of forming separate and antagonistic schools, unite their insight and experience with the main stream of scientific therapeutic effort.  The quacks who delude and murder hordes of ignorant victims must be, so far as is practicable, severely punished; and adequate physiological and medical education should be required for all practicing healers, whatever methods they may then choose to employ.