16 



SCIENCE 



[N. S. Vol. XL. No. 1018 



has been reduced more than half and with 

 scarlet fever and diphtheria the results have 

 been more striking. Within the past ten 

 years the average life has been increased 

 four years. Great epidemics which once 

 devastated continents are no longer known 

 in the more intelligent parts of the world. 

 In fact, it may be said that the death-rate 

 is now an excellent measure of intelligence. 

 In 1911 the death-rate in London was 15 

 per one thousand, while that of Moscow 

 was 27.3. Preventive medicine is the key- 

 stone of the triumphal arch of modern 

 civilization, and its displacement would 

 precipitate mankind into relative barbar- 

 ism. Should the health administrators of 

 any great commercial center fail, for even 

 a few months, to exercise the function of 

 restricting disease, the history of the epi- 

 demics of the middle ages might be re- 

 peated. Great things have been done, but 

 greater tasks lie before us, and their ac- 

 complishment depends on the scientific wis- 

 dom of our profession and the intelligence 

 of the people. Without the harmonious ad- 

 justment of these forces the greatest effi- 

 ciency can not be secured. While the mor- 

 tality from tuberculosis has been reduced 

 half in the past thirty years, we must not 

 assume that the total eradication of this 

 disease will be accomplished in the same 

 number of years. Only the more progres- 

 sive members of the profession have taken 

 the initiative, and only the more intelli- 

 gent members of the community have re- 

 sponded. Intelligence and the sense of 

 moral responsibility must grow as the work 

 proceeds. It remains for all who have the 

 welfare of the race at heart to plan wisely 

 and carry forward courageously the cam- 

 paign against greed, ignorance and dis- 

 ease. 



The sanitarians of this country seem to 

 be in harmony in regard to the general 

 procedures to be followed. These are em- 



bodied in bills recently introduced in the 

 legislative assemblies of a number of states. 

 In New York an excellent bill was passed 

 and its operation is now being inaugurated 

 under the directorship of Dr. Biggs, whose 

 long and effective service in the city of 

 New York demonstrates the wisdom of his 

 selection. I regard it as highly fortunate 

 that the operation of this new and impor- 

 tant law is to be directed by one so well 

 qualified. 



My own ideas are embodied in the "Am- 

 berson bill ' ' of the Michigan legislature of 

 1913. Among the provisions of this bill the 

 following may be mentioned : The state is to 

 be divided into health districts. In each 

 such district a health commissioner is to 

 be appointed for a term of four years. The 

 fitness of the commissioner is to be deter- 

 mined by the State Board of Health after 

 examination. The salary of the commis- 

 sioner varies with the population of the dis- 

 trict, but in most instances would run from 

 three to six thousand dollars. There is to 

 be an additional appropriation for labora- 

 tory expenses and for carrying out the pur- 

 poses of the act. 



It shall be the duty of the health commissionerB 

 to be vigilant in the work of disease prevention and 

 the conservation of the public health, and to en- 

 force all health laws of the state and health ordi- 

 nances of their respective localities, together with 

 all rules and orders of the state board of health; 

 to collect and report to the state board of health 

 morbidity statistics and to make a monthly report 

 of the work done by them in narrative form to 

 the state board of health and in such tabular form 

 as may be prescribed by the state board of health. 

 Copies of such reports shall be retained by each 

 commissioner in permanent record books. They 

 shall make such sanitary inspections and surveys of 

 the district as may be required from time to time 

 by the state board of health or by the city for 

 which appointed, or by resolution of the board of 

 supervisors of each county. They are hereby au- 

 thorized and invested with the power to enter on 

 and inspect private property at proper times in 

 regard to the possible presence, sources or cause of 



