THE OUTLOOK OF PUBLIC HEALTH WORK 



redundant and confused with religious observances, un- 

 doubtedly made for better health of those observing them, 

 under the conditions then obtaining. Is this public health 

 or personal hygiene? In so far as it represents an attempt 

 by authority to influence the members of the population 

 to avoid disease by personal practices, it is public health 

 work, but the practices themselves will be found to be very 

 largely of the nature of personal health habits. 



In contrast to this may be cited the huge engineering 

 undertakings of the ancient Romans, which had a sanitary 

 and salutary effect, whether we may be able to trace the 

 intent or not. The aqueducts, bringing presumably purer 

 water from relatively uncontaminated sources, and the 

 cloacae in turn removing the dangerous wastes, were 

 essentially public health works. 



It would perhaps be difficult to cite any very significant 

 improvements in public health until within the past two 

 hujidred years. Quarantine procedure, attributed to the 

 mediaeval Italians, must, in its original form, have been 

 an uneconomical and dubiously efficient measure. It 

 consisted in holding the personnel of suspectedly infected 

 vessels on board for forty days before permitting landing. 

 It was assumed that by this time all the susceptibles would 

 be dead or recovered. 



The past two centuries, however, have been character- 

 ized by very rapid progress in both knowledge and practice. 

 Edward Jenner in 1798 laid the basis for the control of 

 smallpox, a disease which in his day disfigured or blinded 

 most of the population whom it did not kill. Specific 

 immunization, therefore, commonly regarded as among the 

 most recent weapons against disease, was really among the 

 first to be rationally and widely applied. The epidemio- 

 logical approach, also, whose modern revival with im- 

 proved technic is often mistaken for its beginning, was 

 successful during the middle of the nineteenth century in 



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