7«6 



NA JURE 



^her many useful suggestions for 



lok is 



U 



'. 1923 



r<.nfr,ill:il.li- ..f rr.inrniinicaMe (ItSeaSCS, IHUCh USci 



UlH 



. tlif •• is L'i\ 



rerestingii 



1 Hi20-2J 



III :il ii ,il \'. li ■ in 



:m1 |.iiIi1i hough 



Uui was seal tcly tu be anli' ip.ttcd. I'lii.li' ii< .ili ii more 

 gencrallv means that part ot .i|)|)!ini !i\ : i( iic uiii< h has 

 b<"f!i uitintlih t (i mil) till- .nhiiini ^t 'if 



oil' ' .ind pul)lii"- health authtiMi n- , w iin nyiiicne, 



alu ■ iiiiost synoin iiHiu^ w ith j)r<\riiii\f medicine, 



in most books on the siihjd t h,i> .1 mure limited con- 

 notation. 



The lael that a book on hygiene and public health 

 should be called " An Introduction to the Practice of 

 Preventive Me<li(ine " is evidence of thf expanding: 

 scope of publi( -health acti\ ities, whi' h .ne iiii iea.>ini;ly 

 embracing every phase and age of life. This beneficent 

 intrusion of medicine — on its preventive side — is the 

 subject of Prof. J'itzGerald's suggestive first chapter, in 

 whicli he lori'casts the arrival of a time when it will no 

 longer be said that " he was so sick he had to have a 

 doctor," but when the physician will be engaged to 

 keep his patient well, by supervision and advice. In 

 view of this, extensive increases of our present services 

 for safeguarding childbearing and childhood, and for 

 periodical examinations at subsequent ages in life, are 

 anticipated. The difference between insurance for 

 medical purposes and prevention is aptly indicated in 

 the words that the monetary and medical benefit may 

 be used wisely or unwisely in the patient's efforts to 

 regain, not to maintain his health. 



Subsequent chapters deal with measures for the pre- 

 vention of communicable diseases, each of some twenty 

 or more diseases being discussed in some detail. Special 

 space is given to the newly adopted measures for secur- 

 ing immunity against diphtheria by the administration 

 of an antitoxin-toxin ; and it would appear that by this 

 means, guided by the Schick test, we have available a 

 possibility of depriving diphtheria of all its power to kill 

 and injure. 



The chapter on tuberculosis contains much valuable 

 information, but the statistics are not very skilfully 

 presented. The essential point is pressed home that 

 success cannot attend anti-tuberculosis efforts unless 

 private physicians take an active part in the campaign, 

 and constitute themselves leaders in the effort to pro- 

 tect human beings against excessive dosage of infection, 

 whether from consumptives or from infected cows' milk. 



The preventive aspects of pneumonia, of cerebro- 

 spinal meningitis, and of acute poliomyelitis are stated ; 

 and although these diseases remain among the least 

 NO. 2822, VOL. I 1 2] 



possible moment aft( r ( \i)o^ iri- to iuk-tiion. 



Considerable space is devoted to rhMnfei ti.m ri-.rrcnr 

 disinfection during the course of a; 

 or scarlet fev( ■ jnised as important, and con- 



siderable detail ; _: as to terminal disinft 1 tlon wlu ji 

 an attack is over. For tlu >e disea-' 

 now recognised that, given tliorough domcatie eleaniin.- , 

 terminal gaseous or liquid disinfection of rooms does not 

 diminish the number of recurrences of infection. The 

 part of the book dealing with general hygiene gives full 

 information as to water supplies, milk, foods, diet, and 

 domestic and communit\- sanitatirn), .m whi'li no 

 special comment is needed. We note, however, that 

 while the importance of movement of air in making the 

 air of a room hygienic is not disputed, it is also pointed 

 out that in conditions of overcrowding active ventilat- 

 ing may increase the danger of infection, by increasing 

 the striking distance of particulate infective n 

 whether as dust, or as spray deri\ed fn^"' ... .1 



The chapter on vital statistics cont.. 

 errors. In England and Wales the geometrical method 

 of estimating inter-censal populations is no longer 

 adopted. No attempt is made to assess the relative 

 value of the various tests employed in determining the 

 health conditions of a commr,nit\ , Sne.-ial .1 aniers 

 deal witli tlie subje.ts o{ mat' 



school hv^iene, public-healtli clinks, and mduitrial 

 hygiene, but these do not call for special comment. 



On p. 673 are given interesting particulars of the 

 amount spent per capita per annum in the various 

 American States on health administration. The 

 " health appropriation ' \arie3 from 30-8 cent- in 

 Penns>lvania to 2-1 cents in Texas, these sums being 

 divisible among the foUowinix subdi\i-^ions of the 

 Public Health Department — En_ . Communi- 



