THE OUTLOOK OF PUBLIC HEALTH WORK 



latter to apply its scanty funds where they would do more 

 good. 



The revelations of bacteriology and parasitology opened 

 up a vast field of research and endeavor, which has been 

 intensively and very profitably tilled ever since. In fact, 

 in spite of all that we know about the importance of other 

 causes of disease — nutritional, toxic, psychic — it still 

 seems fortunate that the infectious causes should have 

 been the first to have been intensively studied by scientific 

 methods. Most diseases present vicious circles, or a series 

 of vicious circles. Infection leads to disease, disease to 

 poverty and ignorance, possibly to crime; poverty and 

 ignorance predispose to malnutrition, toxaemias, and 

 psychic depression; and these, in turn, predispose to infec- 

 tion. The circle could be represented in various ways and 

 could be amplified ad infinitum, but this illustrates what is 

 meant. The most vulnerable point in this circle still appears 

 to be the infection link. Its elimination has not been 

 accomplished, but a very decided impression has been made 

 in the short space of roughly half a century. A general 

 death rate cut in half indicates that a powerful influence 

 has been at work. 



As has been hinted, the conception of the proper scope of 

 health work has undergone a progressive broadening. 

 Without relinquishing research or control measures in 

 sanitation and communicable diseases, it has passed on to 

 the consideration of other important aspects. The food of 

 the masses has become recognized as a determining factor 

 of no small importance to their health. The discovery of 

 the vitamins gave as much impetus to activity along this 

 line as the recognition of the role of bacteria did to that 

 concerned with infection. For, although there might have 

 been some degree of actual starvation among a submerged 

 portion of the population, it was not the deficiency in 

 calories which caused a rather widespread state of malnutri- 



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