August 14, 1908] 



SCIENCE 



195 



a call to individual welfare; it is also one 

 of the primal social duties. Next after 

 himself, man owes it to his neighbor to be 

 well, and to avoid disease in order that he 

 may impose no burden upon that neighbor. 

 A normal community can only be made up 

 of normal members, and we are but just 

 beginning adequately to recognize that the 

 tuberculous person or the typhoid patient 

 is a menace to the public health. The Ger- 

 mans have given us that excellent phrase 

 Bacillentrager; and this, for one disease, 

 we have recently translated as typhoid- 

 carriers. It would be well if we went 

 further, and, instead of speaking as we 

 usually do, merely of "consumptives," if 

 we referred sometimes to these as tubercu- 

 losis-carriers. If we could go further yet 

 and refer to syphilis-carriers and other sex- 

 disease carriers, we should do useful service 

 by educating the public to one of the 

 gravest social aspects of public health 

 reform. 



The call of the scientific age to public 

 health is nothing less than a summons to 

 mankind to carefully consider and wisely 

 control the whole physical sphere of human 

 life and activity. And this great sphere 

 falls naturally into two hemispheres: 

 namely, that of the human organism on 

 the one hand, and that of the environment 

 of that organism on the other. The gen- 

 eral public perceives most easily the en- 

 vironment and its significance to health. 

 Plague and pestilence proceeding from 

 without have long been known and dreaded. 

 The cold of winter, the heat of summer, 

 the lightning stroke, a scarcity of food or 

 drink— all these have long since taught 

 man his dependence on his nearer sur- 

 roundings. Sunshine and rainfall, dew 

 and frost, seem more remote and mysteri- 

 ous ; while planets and fixed stars, the moon 

 and the milky way, have influences so un- 

 certain as to connect them with the un- 

 known and the supernatural— inexplicable 



human qualities, such as insanity, being 

 easily regarded as moon madness or 

 "lunacy." Of any appreciation of the 

 physical give and take, the chemical and 

 electrical action and reaction, between man 

 and his environment, our predecessors had 

 little or no idea. The story of Newton and 

 the apple still seems to most unscientific 

 minds absurd and impossible. Even to- 

 day it is not in any broad and accurate 

 form that the public conceives of the en- 

 vironmental aspect of public health prob- 

 lems. The idea has gone forth that water 

 should be pure, but most persons still sup- 

 pose that whatever water flows from city 

 pipes is safe to drink— especially if it is 

 bright and cool. Others, more intelligent, 

 refuse all city water in places known to 

 have impure supplies; yet thoughtlessly 

 drink that very water on cars or steamers 

 departing from such a city, where these 

 have taken on supplies of the impure water. 

 That milk, most ancient and most trusted 

 of all human foods, may carry sickness and 

 death concealed beneath its white and inno- 

 cent-looking mantle, is an idea which 

 spreads but slowly. That contagion may 

 come, not merely on the wings of the wind, 

 but in a cup of cold water or of milk, in 

 the caress of affection, on the hand of pity 

 stretched out to save, upon the penitential 

 garment, or even upon the sacramental 

 communion cup or the broken bread— these 

 ideas, dimly dreamed of in the past, are 

 among the very corner-stones of sanitary 

 knowledge to-day. 



Turning to the other hemisphere of 

 human concern, the organism itself, we 

 enter that province which the medical pro- 

 fession has long made peculiarly its own. 

 The medieval philosophers recognized dim- 

 ly the true relations of organism and en- 

 vironment, but they fell into the pictur- 

 esque error of regarding the human body 

 as a kind of miniature copy of the remain- 

 der of the universe, and especially of the 



