838 



SCIENCE 



[N. S. Vol. XXXIII. No. 857 



task. The whole question of the control of 

 germ-carriers is one that needs more care- 

 ful study with a view to determining the 

 actual results of the methods adopted. 

 Prom this point of view, inspection of 

 school children, especially at the begin- 

 ning of the school year, is probably to be 

 classed as a highly profitable activity, al- 

 though it is to be wished that fuller and 

 better-studied statistics were available. 



Inspection of school children is highly 

 valuable, also, in detecting various common 

 congenital or acquired defects. If the de- 

 fects are remediable, their early discovery- 

 may avoid development into permanently 

 crippling disorders. In other cases, the 

 application of simple corrective or pallia- 

 tive measures may greatly increase the 

 industrial efficiency of the individual. If 

 the defects are not remediable, their detec- 

 tion will at all events prevent the choice of 

 unsuitable occupations, and will indicate 

 desirable lines of education. 



In rural communities, undoubtedly one 

 of the simplest, as well as most important, 

 health protective measures is the adoption, 

 under compulsion if need be, of a safe- 

 guarded and standardized form of barrel 

 privy.' A corollary hardly necessary to 

 mention is the total abolition of the privy 

 in all thickly settled towns. For lack of 

 such regulations soil pollution occurs, the 

 house-fly finds an opportunity to transfer 

 disease germs from excreta to food, and 

 typhoid fever and hookworm disease be- 

 come constant plagues over wide regions. 



In the campaign against tuberculosis it 

 is perhaps too early to evaluate the numer- 

 ous methods that have been proposed for 

 lessening or eradicating this disease, but it 

 is already evident that some are more 



' See Public Health Reports for 1910, published 

 by the Public Health and Marine Hospital Service, 

 articles by Stiles and Gardner, and Lumsden, 

 Eoberts and Stiles. 



directly repaying than others in propor- 

 tion to the effort involved. Among the 

 methods for which public funds are legiti- 

 mately available none is more promising 

 than the provision of sanatoria for ad- 

 vanced cases of consumption. Newsholme 

 and Koch have shown that the general 

 diminution in the death rate from tuber- 

 culosis observed in most countries can be 

 more reasonably attributed to the establish- 

 ment of sanatoria than to any other 

 factor, and that in addition to its hu- 

 manitarian advantages, the segregation 

 and proper control of the advanced and 

 dangerously infective cases is one of the 

 most useful methods that can be employed 

 by the community to protect itself against 

 the spread of tuberculous infection. 



Another field in which practical workers 

 are convinced that certain measures have 

 direct efficacy in saving life is that of in- 

 fant mortality. It has even been said that 

 for the expenditure of a certain sum the 

 saving of a life can be guaranteed. Cer- 

 tain it is, that in few public health activi- 

 ties is the ratio between effort expended and 

 results obtained so clearly seen. No one 

 doubts to-day that prompt notification of 

 births, education of the mother through 

 any one of a number of agencies, and 

 special provision for suitable feeding of 

 infants during hot weather are factors that 

 are bound to tell powerfully in the reduc- 

 tion of infant mortality. It may confi- 

 dently be asserted that the degree of suc- 

 cess achieved in this field will be limited 

 only by the amount of endeavor the com- 

 munity is willing to put forth. 



It is impossible at present to apply direct 

 tests of efficiency to some measures that 

 undoubtedly promote health. The influ- 

 ence of playgrounds, public baths, regula- 

 tion of the hours of labor in extra-arduous 

 industries and the like is real if it can not 

 be accurately determined or estimated. 



