222 



wise affect the public liealtli in a spectacular and demonstrable way. It 

 has frequently been observed that the decrease in death rate following these 

 specific improvements is greater than would lie expected. For example, a 

 clean water supply may always be expected to lower the mortality of 

 water-borne diseases, chiefly gastro-iiitestinal diseases. In many instances 

 it has been found that the general death rate is lowered more than can 

 be explained by the typhoid component and that diseases of the respiratory 

 tract are reduced. This may be explained by supposing that diseases 

 other tlian intestinal may be water-borne, or it may mean that the general 

 vital resistance of the people of the community is raised by more abun 

 daiit use of a luirc water. When a C(Himumity reaches that stage of 

 .sanitary enlightenment and common-sense cleanliness that it demands 

 proper disitosal of its wastes and pro\ides for a pure i)ublic water, 

 we may expect t'nat other less si)ectacular saiiitiiry reforms are being 

 practiced, -;o tliat there are a nr.mber of contributory causes to im- 

 proved health. Thus the general resistance tonus and the public's hygiene 

 practice is a significant health factor. Providing sufficient and clean 

 public toilet facilities: ((Hivenient. nuniei-ous and sanitary drinking foun- 

 tains, and tb.e abatement <>{' the barbaric, disgusting lialtit of jiuitlic spitting 

 are jjlain civic duties, and are factors in the consei-vatinii of human life 

 and happiness. 



We would recdiiniiend : 



1. KegeJiei'.-itioii and exteiisidii of pulilic toilet facilities, especially 

 emphasizing the need of proper care <>f i)iiblir toilets. The most perfectly 

 constructed toilet will 1)0 unsanitary in a short time if not effi<-iently cared 

 for. A score card iiiigiit Ik- used in insiiectioii to give a iiicfure of the con- 

 ditions and to indicate imiirovement from time to time. I havi' devised 

 and used such a score card effectively. 



2. The final condemnation of the ])ul>lii- diinking cup. es])ecially in 

 schools. One of the lessons in hjgiene in schools might well be flevoted to 

 teaching children bow to make their own paiier drinking cujis, the teacher 

 furnishing them witii cleai; paper of c<inveuieiit size and shape throughout 

 the year. Soda fountains ai-e culpable and there should be legislation or 

 action of some kind against the present soda fountain and glass, a public 

 drinking cup. 



8. The extension of our anti-spitting and anti-saliva campaign, includ- 

 ing the dissemination of information relative to the more direct and dan- 

 gerous modes of transfer of nasal and oral secretions. 



