MUNICIPAL HYGIENE. 139 



and the grosser possibilities in some measure controlled. The enforce- 

 ment of greater cleanliness in public buildings and conveyances, a bet- 

 ter system for the notification and control of cases of infectious dis- 

 ease — a matter in which American municipalities are notoriously lax — 

 provision of adequate hospital facilities for the reception and care of 

 patients suffering from infectious disease are among the measures which 

 would unquestionably reduce the city death rate from the infectious 

 diseases. Above all, a thoroughgoing system of medical inspection of 

 schools should be introduced. Nearly all the infectious diseases are 

 most prevalent and most fatal among children of school age, and it 

 would seem as if this were a highly important field in which the ener- 

 gies of municipal health authorities should be exercised. In some 

 cities, as in Boston and Chicago, school inspection has been introduced 

 with successful results, but lack of funds for the purpose has prevented 

 a general and thorough adoption of the system. It would seem as if 

 no reasonable expenditure should be allowed to stand in the way of this 

 important public health measure. If money is available for safeguard- 

 ing the public health in any way, it ought to be available for this pur- 

 pose. If necessar}% the school year should be shortened to secure the 

 funds needed. The saving to the community of the expense of 

 earing for cases of even the minor and less dangerous infectious dis- 

 eases should constitute an effective financial argument for the general 

 adoption of school inspection. It is perhaps significant that the grow- 

 ing unwillingness on the part of many of the most intelligent and 

 public-spirited members of the community to send their children to the 

 public schools is based on the great liability of the children to contract 

 infections under existing conditions. The removal of this grave draw- 

 back to the public school system would in itself seem an object worth 

 striving after. 



If a small fraction of the money now expended under compulsion 

 for over-elaborate and unnecessarily complex systems of plumbing were 

 devoted to measures better calculated to prevent the spread of con- 

 tagion, the city death rate from infectious diseases would be materially 

 lessened and would not so largely exceed the country death rate from 

 the same causes, as is at present the case. The campaign against 

 infectious disease in cities should not be conducted, with antiquated 

 methods and along lines not countenanced by recent investigation, but 

 should take advantage of the most recent scientific discoveries and 

 above all should be carried on with a full understanding of the nature 

 and degree of success that may reasonably be expected from the meth- 

 ods it is applying. 



Municipal hygiene, then, to be worthy of the name should not con- 

 fine itself to combating only the most dreaded or most dramatic forms 

 of disease, but after a scientific study of the whole problem of city life 

 should enter upon a carefully planned and systematic endeavor to re- 



