COMMUNITY DEFENSE OF NATIONAL VITALITY 321 



beginning of what must be done if we are to check the insidious influ- 

 ences which prepare the ground for the tubercle germ. 



Final!}', the veterans of our army, who have resisted all earlier at- 

 tacks, are exposed to their own peculiar dangers. Diseases of the heart 

 and arteries, Bright's disease, and cancer together carry off 300,000 

 men and women every year, and we are face to face with the sinister 

 fact that while at every other point of the battle line we are at least 

 holding our o^vn, these diseases of later life appear to be actually on 

 the increase. Yet in any individual case, we know that the appropri- 

 ate advice as to the hygienic conduct of a defective bodily mechanism 

 would prolong life, often by many years. 



If we really want to prevent preventable diseases, we must supply 

 the machinery, the fortifications and munitions of war to use against the 

 enemy. We must install effective water purification plants and ade- 

 quate systems of sewerage and sewage disposal. We must provide 

 infant welfare stations in the proportion of one for every 20,000 of the 

 population, if the death rate of infants is to be effectively reduced. 

 We must have adequate systems of medical school inspection and school 

 nurses, not one for each 2,500 school children, but one for every 1,000, 

 if our young soldiers of peace are to come to maturity in full vigor and 

 free from physical defects. We must build contagious-disease hospitals, 

 with a capacity of one bed for every 2,000 of the population. We must 

 provide tuberculosis hospitals with a capacity of one bed for every 1,000 

 of the population for the cure of early and the isolation of advanced 

 cases of this disease, and corps of visiting nurses to find incipient cases 

 and secure proper care for patients in the home. 



It is the health officer who must ultimately furnish expert guidance 

 and leadership for the public health campaign. One of the most un- 

 fortunate aspects of the present situation is that too often the public 

 distrusts its natural sanitary leaders, and sometimes the health officer 

 is so blind to his opportunities that other agencies must perforce step 

 into the breach. The most substantial progress can only be made, how- 

 ever, when constructive initiative and legal authority are conjoined. It 

 is essential that the task of officering the army of the public health 

 should be entrusted only to trained and experienced experts, qualified 

 by knowledge and disposition for their work. Having obtained such 

 men, the local and state departments of health must be given adequate 

 powers and liberal appropriations. Fifty cents per capita should be a 

 minimum for the city, and twenty cents per capita for the state, if the 

 organization of the general health campaign is to be efficiently main- 

 tained. 



All this will cost money — perhaps five or ten times what we are 

 to-day devoting to our national defense against diseases. The United 

 States spends each year three hundred millions of dollars for protection 



