SANITATION ON FARMS FREEMAN. 657 



of the work he is going to be called on to do. Then, with the coopera- 

 tion of the physician, working in the practice of one physician at a 

 time, he visits the individual farm, talks with the head of the family, 

 or better still, with the mother, points out the children Avho are prob- 

 ably infected, gets specimens, leaves literature, suggests treatment, 

 and refers them to the family physician. In this way, within a com- 

 paratively short time, he would cover the territory of the physician 

 with whom he is working, secure a few object lessons of treatment, 

 prepare the physician to take care of the cases when they come, and 

 would thus start the current toward the physician. He also inspects 

 schools, gives public lectures and demonstrations, and in general agi- 

 tates the question until every one in the community is thoroughly 

 acquainted with the facts regarding the disease. 



This detail work so far has been very successful in some States. 

 The patients who are treated recover so rapidly and exhibit such 

 marked imj^rovement as to constitute an unanswerable argument for 

 the truth of the contentions of inspector and physician as to the im- 

 portance of the disease. 



The whole community rapidly becomes interested in the subject; 

 the worst cases are soon treated and the mild cases come later; and 

 with the spread of the truth regarding the prevalence of the disease 

 and methods of its spread comes the desire for better sanitary condi- 

 tions. 



The amount of territory which can be covered by an active man in 

 this way is very large, and, though we have not exactly determined it, 

 we estimate that four or five badly infected counties can be cleaned up 

 in a year's time, and that then the inspector may be moved to a fresh 

 district. In this way four or five years should see a State thoroughly 

 canvassed for hookworm disease, and the extermination of the disease 

 should be in the way of accomplishment. 



The work in connection with the hookworm will undoubtedly yield 

 an extra result in typhoid fever equal in value to that from hook- 

 worm, and we believe that the successful carrying forward of the 

 present campaign will result in a marked reduction in rural typhoid. 

 In addition — and by no means least important — the demonstration of 

 the practical benefits of systematic and scientific work in rural dis- 

 tricts afforded by a successful campaign of this character will place 

 preventive work on a new and firm basis before the country people 

 and should render the systematic and permanent extension of this 

 work, embracing all diseases, easy of accomplishment. 



We believe, therefore, in conclusion, that present rural sanitary 

 conditions must not be allowed to continue; that the problem must 

 be attacked in detail; that detail work will' yield tremendous benefits 

 both in contribution to our present knowledge regarding the transmis- 

 sion of many diseases and in the actual prevention of thousands of 

 unnecessary cases of preventable diseases. 

 97578°— sm 1910 42 



