336 ANNUAL REPORT SMITHSONIAN INSTITUTION, 19 3 5 



this urge can be most effectively served so far as health is con- 

 cerned by making a social matter of a great part of it. Assuring 

 a pure water supply and innocuously disposing of the waste matters 

 of living are things that the individual simply cannot do well. 

 Society can. And the social progression of the urge to survival 

 in the field of health is by no means at an end yet. In two directions 

 we may confidently look forward to great further changes and ad- 

 vances in the rather immediate future. In the first place, whether 

 we or the physicians like it or not, it seems clear that the main- 

 tenance and improvement of individual health is going to become 

 more and more completely a social matter. The basic reasons are 

 two-fold, partly because of the continued normal evolutionary further 

 growth of the same ideas and considerations that have brought us 

 to where we are now regarding public health; partly because of 

 economic and political considerations. The number of persons who 

 at the present time get inadequate medical care because they cannot 

 individually afford to pay for adequate (and lacking it endanger 

 other peoples' health) is so large that as a group they are already 

 in a position politically to demand and get necessary medical service, 

 and may reasonably be counted upon shortly to do so. In the second 

 place it seems reasonable to suppose that advances in medical science 

 are going to continue. The last 75 years — an excessively small 

 fraction of mankind's earthly history— have witnessed more progress 

 in knowledge of disease and its effective treatment and prevention, 

 than was made in all the time that went before. And objectively 

 viewed the rate of advance in medical discovery seems plainly to be 

 accelerating rather than slowing. 



Turning now to the consideration of the social consequences of 

 the urge to reproduce, it is immediately to be noted that the growing 

 consciousness of overcrowding — too many people in the world for 

 comfort — is not the resultant of such simple matters as lack of space 

 in which to build dwellings or to move about, or of inability to 

 produce food enough to satisfy the collective hunger. It is true 

 that the total number of living human beings on the globe at this 

 moment is probably something closely approaching 2 billion. But 

 the gross land area of the globe is about 35 billion acres, so that on an 

 equal parceling each individual man, woman, and child would have 

 between 16 and 17 acres. If the total population of the earth were 

 to be forcibly put upon the smallest of the continents — Australia — 

 there would still be, on an equal division, well over an acre for each 

 individual. Similarly relative to food whatever trouble there is 

 relates to distribution rather than production. Such famines as occur 

 now happen not because there is not enough food produced to feed 

 everyone, but because the complex economic mechanism of getting it 

 to the hungry works imperfectly. 



