June 16, 1916] 



SCIENCE 



851 



Quarantine of individuals afflicted with com- 

 municable disease represents one of the earliest 

 and most arbitrary of public health measures. 

 The stoning of a leper to keep him away from 

 a community without regard to the welfare 

 of the leper himself is not, however, to be re- 

 garded as a sign of a high stage of civilization. 

 We reach a higher stage when special provi- 

 sion is made for the care of lepers isolated 

 from the community for the good of the com- 

 munity. We reach a still higher stage when 

 earnest eilorts are made to discover remedies 

 for the cure of the disease such as are now 

 being made by the federal health service. If 

 such remedies are discovered and applied, both 

 lepers and the community at large will profit. 



The legal aspects of the matter are well 

 summarized in a decision of the Wisconsin 

 Supreme Court as cited in " Communicable 

 Diseases : An analysis of the laws and regula- 

 tions for the control thereof in force in the 

 United States," Public Health Bulletin No. 62, 

 by J. W. Kerr and A. A. Moll. 



The right of a state through its proper officers 

 to place in confinement and to subject to regular 

 medical treatment, those who are suffering from 

 some contagious or infectious disease, on account 

 of the danger to which the public would be ex- 

 posed if they were permitted to go at large is so 

 free from doubt that it has rarely been ques- 

 tioned (State V. Berg Northwestern Eeporter, p. 

 347). 



The federal public health service has charge 

 of the restrictions imposed upon individuals 

 afflicted with disease who desire to enter the 

 United States from outside and is required to 

 cooperate with local health authorities in en- 

 forcing regulations to prevent the spread of 

 contagious and infectious diseases from one 

 state or territory to another. 



In connection with the medical inspections of 

 immigrants, medical officers are required, among 

 other things, to certify to the diseases observed by 

 them and to render opinions, whenever requested, 

 as to the curability of a loathsome contagious or 

 dangerous contagious disease affecting the wife or 

 minor child of a domiciled aUen, and to supervise 

 the appropriate treatment. In addition they are 

 required to supervise or conduct the treatment of 

 all detained aliens. 



In the various states of the union the num- 

 ber of diseases for which quarantine is re- 

 quired by law and the extent of the quarantine 

 differ greatly but it is fairly generally recog- 

 nized that in cases where strict quarantine is 

 required the public is under obligations to fur- 

 nish treatment at least to individuals not able 

 to pay for medical service. The quarantine is 

 compulsory, the treatment is not necessarily so, 

 but both may properly form a part of the pub- 

 lic health service. At times special care has 

 been taken to emphasize the fact that indi- 

 viduals thus receiving medical service at pub- 

 lic expense are not thereby made paupers. 



Private agencies may cooperate with public 

 health officials in the warfare on disease 

 through treatment of individuals. The vari- 

 ous anti-tuberculosis associations are accom- 

 plishing much in their efforts not only to edu- 

 cate the public as to proper precautions to be 

 taken to prevent the spread of this disease 

 but also in their support of measures for the 

 establishment of sanatoria for the treatment 

 of incipient cases and homes for the isolation 

 of advanced cases. The effective work of the 

 Rockefeller Sanitary Commission in coopera- 

 tion with various boards of health in the south 

 for the eradication of hookworm disease is an 

 example of where medical treatment of indi- 

 viduals in the ordinary use of that term has 

 played an active part in public health work. 



Various steps have been taken to give state 

 aid to physicians in their treatment of indi- 

 viduals in order that the public health may be 

 promoted. Examples are to be seen in the 

 distribution of diphtheria antitoxin free either 

 for all cases or more frequently for all indigent 

 cases. Vaccines for smallpox and typhoid 

 fever are distributed in a similar way for the 

 prophylactic treatment of individuals, from 

 which in turn the community profits. Public 

 health laboratories established to give aid in 

 diagnosis to physicians in private practise are 

 becoming of increasing importance from the 

 standpoint of public health. It is thus that the 

 first steps are being taken in control of venereal 

 diseases. 



In public health work we have, on the one 

 hand, engineering problems into which dis- 



