PUBLIC HEALTH WORK JORDAN. 609 



manently crippling disorders. In other cases the application of simple 

 corrective or palliative measures may greatly increase the industrial 

 efficiency of the individual. If the defects are not remediable, 

 their detection will at all events prevent the choice of unsuitable 

 occupations, and will indicate desirable lines of education. 



In rural communities, undoubtedly one of the simplest, as well as 

 most important, health protective measures is the adoption, under 

 compulsion if need be, of a safeguarded and standardized form of 

 barrel privy. 1 A corollary hardly necessary to mention is the total 

 abolition of the privy in all thickly settled towns. For lack of such 

 regulations soil pollution occurs, the house fly finds an opportunity 

 to transfer disease germs from excreta to food, and typhoid fever and 

 hookworm disease become constant plagues over wide regions. 



In the campaign against tuberculosis it is perhaps too early to 

 evaluate the numerous methods that have been proposed for lessening 

 or eradicating this disease, but it is already evident that some are more 

 directly repaying than others in proportion to the effort involved. 

 Among the methods for which public funds are legitimately available 

 none is more promising than the provision of sanatoria for advanced 

 cases of consumption. Newsholme and Koch have shown that the 

 general diminution in the death rate from tuberculosis observed in 

 most countries in recent years can be more reasonably attributed to 

 the establishment of sanatoria than to any other factor, and that in 

 addition to its humanitarian advantages, the segregation and proper 

 control of the advanced and dangerously infective cases is one of the 

 most useful methods that can be employed by the community to 

 protect itself against the spread of tuberculous infection. 



Another field in which practical workers are convinced that certain 

 measures have direct efficacy in saving life is -that of infant mortality. 

 It has even been said that for the expenditure of a certain sum the 

 saving of a life can be guaranteed. Certahi it is that in few public 

 health activities is the ratio between effort expended and results 

 obtained so clearly seen. No one doubts to-day that prompt notifica- 

 tion of births, education of the mother through any one of a number 

 of agencies, and special provision for suitable feeding of infants 

 during hot weather are factors that are bound to tell powerfully in the 

 reduction of infant mortality. It may confidently be asserted that 

 the degree of success achieved in this field will be limited only by the 

 amount of endeavor the community is willing to put forth. 



It is impossible at present to apply direct tests of efficiency to some 

 measures that undoubtedly promote health. The influence of 

 playgrounds, public baths, regulation of the hours of labor in extra- 



1 See Public Health Reports for 1910, published by the Public Health and Marine-Hospital Service, 

 articles by Stiles and Gardner, and Lumsden, Roberts, and Stiles. 



38734°— sm 1911 39 



