136 POPULAR SCIENCE MONTHLY. 



the community the consequences that would otherwise follow their 

 ignorance and neglect. In other words, the quality of a public water 

 supply ought easily to be better than the average water supply that 

 would be obtained by the average citizen for himself under rural con- 

 ditions. If the real situation is sometimes otherwise it is not because 

 impure water is one of the necessary and inevitable accompaniments 

 of city life, but because the city has failed to avail itself of the supe- 

 rior resources at its disposal. 



The matter of water supply is not the only respect in which the 

 city should possess a practical advantage. The opportunities for 

 speedy and efficient treatment of many acute diseases are greater in a 

 large and compact community than in one sparsely settled. Well- 

 equipped hospitals and dispensaries, the most expert surgeons, the best 

 trained nurses are all most likely to be found in the centers of popula- 

 tion. Many city families have experienced the increased anxiety and 

 danger that accompany a case of serious illness occurring when the 

 family is away for the summer in a little country town. The careful 

 nursing and the timely and expert treatment wliich even those in mod- 

 erate circumstances can command in a large city are quite out of the 

 reach of the majority of rural dwellers. 



In addition to the advantages that accrue to the city dweller from 

 opportunities for a particularly efficient treatment of disease in gen- 

 eral, there are certain specific instances where early diagnosis and 

 prompt treatment of a particular malady may suffice to turn the scale 

 in favor of the patient. A notable example is presented in the case of 

 diphtheria. All the larger cities and most of the smaller ones have 

 in recent years provided themselves with well-equipped municipal lab- 

 oratories in which microscopical and cultural examinations are freely 

 made at the request of any physician. By the utilization in this way 

 of the best modern appliances and methods and of experienced and 

 specially qualified service, it is possible in the majority of cases for 

 the physician to discover within twenty-four hours whether his patient 

 is infected with the virulent diphtheria bacillus or is merely suffering 

 from an ordinar}^ and only remotely dangerous sore throat. The im- 

 portance of an early diagnosis in the case of diphtheria is supreme 

 for the reason that the administration of the diphtheria antitoxin is 

 most likely to prove successful in the early stages of the disease. The 

 antitoxin can not repair any damage that may have been done to the 

 tissues of the body, ]jut can only neutralize and render harmless the 

 diphtheritic poison that is circulating in the blood. If the presence 

 of a true diphtheritic infection is not recognized until late in the 

 course of the disease the injection of the antitoxin may have little influ- 

 ence upon tlie outcome, since the heart and other organs may have suf- 

 fered irreparable injury before the nature of the disease becomes under- 

 stood. It is of the utmost imijortance, therefore, for the physician to 



