SYMPOSIUM 0^- SAXITATIOX 39 



this by giving" an instance of a city of 20,000 people in Xorth 

 Carolina. On his arrival in the city, he called up five repre- 

 sentative citizens on the telephone, and asked them their opin- 

 ions as to the health of their city. One was a college presi- 

 dent, one was a city official, one a practicing physician, one 

 was a banker and the other a leading merchant. All unhesi- 

 tatingly answered that the health of the city was good. They 

 were then asked. "How many people do you think died in 

 your city last year?" Their guesses ran all the way from 60 

 to 300 deaths a year. As a matter of fact, there were 508 

 deaths, or nearly as many as all their estimates put together. 

 These five representative citizens had no knowledge of the 

 number of deaths that were occurring in their city, and con- 

 sequently, had no idea how many of these deaths were pre- 

 ventable, or whether the death rate was increasing or decreas- 

 ing. 



But what would be the advantage of knowing all of these 

 facts regarding the death rate and the occurrance of deaths, 

 if it were only to satisfy curiosity, or to furrtish scientific 

 data on the subject? \'ery little, if no other end could be 

 served. And this is the reason why laymen and members of 

 legislatures have, until recent years, taken but little interest 

 in this subject. AMiat is the benefit to the community of 

 knowing hoAv many deaths resulted from malaria, or typhoid 

 fever, in a given area in a given time, if it is not possible to 

 use this knowledge for the prevention of disease, and the re- 

 duction of the death rate? In previous generations, when 

 the causes of these diseases were unknown and there was no 

 way of preventing them, mortality reports had only a statis- 

 tical value. But health is today no longer an accident, and 

 disease and death are to a very large extent, controllable. The 

 advance in scientific knowledge in the last forty years, has 

 placed in the hands of the medical profession, positive means 

 for the prevention of many of the diseases which in past gen- 

 erations inflicted the heaviest loss upon humanity. There is 

 no longer any excuse for any community suffering from ty- 

 l)hoid and typhus fever, malaria, yellow fever, bubonic 

 plague, Asiatic cholera, syphilis, gonorrhea, hookworm, diph- 

 theria, and tuberculosis. These diseases are all solved prob- 

 lems from the scientific point of view. The specific cause and 

 the life history of the organism, the means of transmission 

 and the methods of prevention of these diseases are known. 

 Their prevention only requires the practical application of 

 well known and demonstrated facts. The problems presented 

 by these diseases are not scientific at all. but purely sociolog- 

 ical. Typhoid fever is no longer regarded as due to a visita- 

 tion of God. or to a judgment from Heaven. It is due to 



