NOVEMBER 26, 1897. ] 
fection in a number of infectious diseases, 
the prevention of soil and water pollution 
for the restriction of typhoid fever, cholera, 
dysentery and other water-borne diseases, 
and, finally, the labors of Pasteur, Koch, and 
Sternberg of our country, in the identifica- 
tion and destruction of disease germs, have 
accomplished a great deal and opened a 
field of preventive inoculations which 
promises other practical results. The 
medical profession speaks of preventable 
diseases, and the Prince of Wales, in his 
opening address at the International Con- 
gress of Hygiene, held in London in 1891, 
very properly said: ‘If certain diseases 
are preventable, why are they not pre- 
vented ?”’? The facts are that whilst the 
scientific physician knows fully well that if, 
for example, the dejecta of every typhoid- 
fever patient were promptly disinfected 
with germicides, typhoid fever would be 
stamped out in the course of a few years, 
he is not in a position to enforce this opin- 
ion by effective laws. 
To illustrate what germicides and auti- 
septic methods have accomplished, let me 
remind you that the mortality from all 
amputations in the Crimean War (1854-55) 
was 63.5 per cent., in our Civil War it was 
still 48.7 per cent., but this percentage has 
steadily fallen until, in 1890, it was only 
6.9 per cent. A century ago the mortality 
from puerperal fever at the lying-in depart- 
ment of the Hotel Dieu in Paris amounted 
to 10%. Semmelweis, in 1847, first insisted 
upon compulsory antiseptic midwifery, and 
since that time the mortality has fallen in 
all well-regulated maternities to less than 
one per cent. Witness, also, the advances 
made in the construction of model hospitals, 
asylums, schools, prisons and industrial es- 
tablishments in relation to light, heating, 
ventilation, etc. 
At the close of the last century the mor- 
tality among the inmates of French prisons 
was 250 pro mille; in the German prisons, 
SCIENCE. 
795 
in the forties, it was between 34 and 60 per 
1,000, while in 1878 to 1882 it had fallen to 
27 per 1,000. 
In the matter of personal hygiene much 
has been done in the way of improved 
dietetics, clothing, exercise, and especially 
in the care and feeding of infants, but much 
remains to be done. 
I will not weary you with a recital 
of what other countries have accom- 
plished in the way of national and local 
health boards, enactment of health laws, 
the enforcement of sanitary police regula- 
tions, laws for the suppression of quackery 
and quack remedies, all of which have con- 
tributed greatly to the sum-total in the field 
of public sanitation. 
While the people of the United States 
were not slow in adopting and originating 
sanitary measures of great value, our ideas 
of personal liberty, guaranteed to us by 
the Constitution, evidently prevented early 
legislation in matters of public health, ex- 
cept in matters of State quarantine, for fear 
that such legislation might affect the per- 
sonal habits of the citizen and lessen his 
freedom of action. At all events, the first 
State Board of Health was established in 
Massachusetts only in 1869,since which time 
nearly all of the other States have followed 
her example. In 1872 the American Pub- 
lic Health Association was organized, and 
numbering, as it does, among its members 
some of the best minds in the profession, 
much good has been accomplished by this 
body and the so-called ‘sanitary conven- 
tions’ in molding public opinion and in 
framing and recommending health laws. 
Measures for the control and restriction 
of contagious diseases have been adopted by 
most of the Health Boards, and a number 
of States enforce compulsory vaccination 
for school children, and have passed laws 
regulating the sale of poisons, and for the 
prevention of food and drug adulterations, 
and the extermination of bovine tubercu- 
