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close of the eighteenth century—the time of Howard the 
philanthropist—that any settled and intelligent inquiry was 
made into the causes of epidemics, and along with such inquiry 
organised effort to combat disease began. ‘These efforts have 
already had immense results. Cholera has been stamped out of 
this country. That dreadful scourge typhus has been traced to its 
source, and is being chased from the midst of well regulated 
communities. Jail fever has practically disappeared and our 
prisons are now huge sanatoriums, the small drawback, making 
constant residence compulsory, being the one inconvenience 
which at present attaches itself to a lengthened stay in these 
health resorts. 
Again, the improvements made since the time of Howard in 
surgical appliances, and especially in the use of antiseptics and 
anesthetics, mark a new era. While on a visit to Norway in 
the spring of 1890, I saw a system of disease repression in full 
operation which set me thinking, and was the cause of this paper 
being written. Leprosy still lingers in Northern Europe. To 
stamp out this disease, the Norwegian Government rigidly 
isolates all those who are so afflicted. I had several times to 
pass the leper hospital. We saw patients sitting in the garden 
or strolling about the grounds, and marked the ravages this 
fearful disorder was inflicting upon them. But. the evident care 
taken by the authorities to make these “ pitiables.” as comfortable 
as circumstances would permit, and the certainty that a wise 
interference with personal liberty was in all probability effectually 
preventing infection and stamping out leprosy, reconciled me to 
the arbitrary measures adopted. Since the above visit I have 
frequently asked myself are civilised nations doing all that might 
reasonably be expected to extirpate from their midst preventible 
and contagious diseases? Disease can be successfully attacked 
by two distinct methods. Indirectly by sanitation—open spaces, 
healthy home conditions, and reasonable hours of labour; and 
directly, by care and attention to the sick, and above all by strict 
supervision and rigid restriction in all contagious cases. Cholera 
and leprosy are still common in our great dependency, India, 
and the plague itself is not unknown within or near some of our 
Eastern possessions. I hold that the time has arrived when an 
intelligent and systematic effort to minimise, if not to entirely 
abolish, preventible and contagious diseases, should be made by 
every nation which aspires to be placed within the pale of 
civilisation. Allow me for a minute or two to draw your 
attention to criminal and common neglect on the part of parents 
and scholastic authorities in England with regard to children’s 
diseases—whooping cough, scarlatina, and measles. Every 
possible care should be taken with children just recovering from 
an attack of any of the foregoing complaints to prevent them 
