506 



SCIENCE 



[N. S. Vol. IAV. No. 1404. 



regarded will surely rise and many causes of 

 dissatisfaction -which now alienate people will 

 tend to disappear. 



It is important that the public be made to 

 realize that although medical practise is very 

 old, scientific medicine is still in its infancy. 

 The public should know something of the 

 great conquests which have been made in 

 recent years in the struggle against disease. 

 It should know something of the role of 

 bacteria in causing diseases, how diseases are 

 spread, and consequently how they may be 

 checked. It should have some knowledge of 

 the achievements of protective inoculation, 

 serum therapy, the relation of knowledge of 

 physiology and pathology in understanding 

 and treating disease, and the general depend- 

 ence of medical science and practise on the 

 development of the fundamental sciences on 

 which medicine rests. It should appreciate 

 that most of these sciences have had their 

 greatest development in relatively recent 

 times, that the cause of public health is 

 dependent upon their further advancement, 

 that we are living in a period of great achieve- 

 ment and promise, and that we may save 

 millions of human lives and endless suffer- 

 ing by the support and encouragement of 

 scientific research. 



Unless the more educated part of the com- 

 munity have some vision of the development, 

 present situation and promise of medical sci- 

 ence, it is apt to be more strongly influenced 

 by the shortcomings of present-day practise 

 than by the wonderful achievements which 

 medicine has actually won. But very recently 

 in our own state, California, the educated 

 public showed itself in danger of being mis- 

 led into supporting legislation in the inter- 

 ests of quackery and even of fanatical op- 

 position to medical research. 



The public health is a public trust. If 

 this trust is not discharged properly, the 

 public will have to pay a fearful bill. The 

 more informed the public becomes, the higher 

 are the standards that will be demanded of 

 those that practise the healing art, the more 

 adequate will be the provisions for public 

 hygiene and sanitation, the more satisfactory 



will be the relations of doctor and patient, 

 and the more generously will investigation 

 be supported. Even among educated people 

 there is sore need of education along these 

 lines. 



But greatly as many educated people need 

 educating, there is a frightful amount of suf- 

 fering and needless death among the more 

 ignorant elements of the community and 

 especially among our large immigrant popula- 

 tion. The recent book of Mr. M. J. Davis on 

 " Immigrant Health and the Community " 

 reveals a general situation that is very bad. 

 Our great immigrant tide lodges mainly in 

 cities where the various nationalities are 

 segregated iu crowded districts where they 

 live under unhygienic conditions. Their 

 death rate as shown by the U. S. Mortality 

 Statistics and the investigations of a number 

 of life insurance companies is markedly in 

 excess of that of the native-born. Their in- 

 fant mortality is high. The studies of the 

 U. S. Children's Bureau have shown that in 

 many towns it is two or even three times that 

 of the native Americans, and that it tends to 

 decrease with greater length of residence in 

 this country. While a certain amount of the 

 enhanced mortality of the foreign-born is 

 due to their low economic status, a larger 

 part of it is due to ignorance in regard to the 

 maintenance of health. Many immigrants do 

 not know English when they arrive and never 

 learn it afterward. The newspapers printed 

 in foreign languages, — and there are over 

 1,200 of them in the United States, — are full 

 of the advertisements of quacks, it being a 

 noteworthy fact that while such advertise- 

 ments have decreased in papers published in 

 English they have greatly increased in papers 

 published in foreign languages. The unin.- 

 structed foreigner who does not distinguish 

 between the regular physician and the ad- 

 vertising quack is swindled out of his money 

 and fails to get competent aid when he is ill. 

 Many belong to Benefit Societies and receive 

 for a small fee the perfunctory service of 

 some lodge doctor. Numbers frequent free 

 clinics and dispensaries where they are rushed 

 through a cursory examination and given a 



