72 PUBLIC HEALTH 



The politician is nearly always the bitterest opponent of sanitary 

 reform, because nearly every order for sanitary betterment touches 

 the pocket of some of his constituents, who immediately run to the 

 politician for relief. How important, then, from the standpoint of 

 practical politics, it is that the party in power (I speak particularly 

 of our cities) should have control of the sanitary officers and use 

 their great authority to help friends and injure political foes. If the 

 politician controls the sanitary officers, he controls the appointment 

 of all subordinates, and soon demonstrates to them that he and not 

 the nominal head of the sanitary office is the man to come to for 

 instructions. When this occurs, the usefulness of a board of health 

 is ended, and its maintenance is money thrown away, if not worse. 

 Then, too, even if the office is not wholly in control of the politicians, 

 they sometimes are able to secure the alteration or even the nulli- 

 fication of important orders, and the inevitable result is injury to the 

 public that private interests may profit. The extension of the civil 

 service law has made the subordinate sanitary officers in many cities 

 independent of politicians' threats if they choose to be; but it does 

 not so favorably affect the more important activities of sanitary 

 bureau heads, who are still too much controlled by the appointing 

 power. There will never be a radical improvement in this condition 

 until our sanitary offices are taken entirely out of politics, and the 

 incumbents appointed for life or during good behavior. 



How to prevent the spread of infection will always be one of the 

 chief problems for sanitary officers, and it continually presents new 

 phases, new difficulties, as the density of population in great cities 

 increases. This is particularly true of our seaboard cities, where 

 there is a constant influx of immigrants, latterly of a class which is 

 ignorant of the rudimentary principles of sanitary living, and of 

 grossly filthy personal habits. These people have been dumped 

 upon our coasts in swarms, several hundred thousand annually 

 coming to New York City alone. Students of the immigration 

 problem state that the more progressive elements of this new popu- 

 lation move westward to take up unoccupied farm-lands, or find 

 work in mines or mills, and that the most ignorant remain in the 

 cities. We of New York can well believe this. After all, the enforce- 

 ment of sanitary laws is bound up in the education of the ignorant 

 and filthy to the objects of such laws; and so it is necessary for the 

 sanitary authorities of New York and other maritime cities to carry 

 on a never-ending campaign of education, in populations constantly 

 renewed at the bottom of the ladder. 



But new peoples are not merely ignorant and dirty; they often 

 bear seeds of disease. The Federal Government has up to this time 

 made no provision for the care of contagious sick immigrants in the 



