16 



from England — the result of better housing and nutrition, 

 and plain, commonsense methods of sanitation. 



But even when we take account of this qualification of the 

 meaning of the table it is plain that the mortality from enteric 

 fever has steadily diminished throughout the whole period, 

 and this is so even during the war years 1914-1918 (for which 

 years the death rate is calculated only for the civilian popula- 

 tion). One might, at first sight, have expected some relaxation 

 of public health administration during those years of strain, 

 but this has not been the case — the rate of decrease is even 

 greater than it was in the preceding decade. The entire record 

 is a remarkable and very creditable one, and it ought to lead 

 to a renewed appreciation of the medical service as it is 

 organised in this country. It does not, at first, occur to one 

 to reflect that this is the only profession which, by perfecting 

 its work, tends always to render itself unnecessary ! 



It would be worth while, if there were the opportunity, 

 to examine into the measures by which this notable reduction 

 in the mortality from typhoid has been brought about. It is 

 probable that no one line of public health work is to be singled 

 out — for instance, prophylactic treatment only came into 

 general use during the war period and was applicable only 

 in the war services. What we have to thank for the effect 

 noted has been the consistently maintained and always 

 improved public health administration and a general, all-round 

 effort to do all that is possible to minimise the chance that 

 any person whatever in the population might contract epidemic 

 disease, because with modern means of intercommunication 

 the risk of infection has always tended to become greater, and 

 class-distinctions tend to have no significance in this connection 

 — it is all the same to the public health administrator what is 

 the social standing of the patient : the labourer incubating 

 for typhoid and using a privy on a barge moored on Church 

 Scar has just the same " epidemiological value," neither more 



