GENERAL CONSIDERATIONS 19 



own back yard and cellar. Formerly people did not under- 

 stand the value of fresh air and good housing. A contia- 

 gious disease introduced into such unsanitary conditions 

 was like a spark in dry brush. The prairie was soon afire 

 and conflagrations in the shape of epidemics were all too 

 frequent. Many diseases, such as leprosy, typhus fever, 

 and famine fever, were then constantly smouldering in 

 the large cities and often broke out as devastating epi- 

 demics. Now such diseases are practically unknown in clean 

 communities. These changes for the better have come 

 about through cleanUness and the application of the teach- 

 ings of the sanitary sciences. 



Almost all our larger cities now have a fairly satisfactory 

 and clean water supply. The removal of wastes is steadily 

 showing improvement. Sanitary cleanliness is extending 

 from our parks and boulevards into alleys and rookeries. 

 Modern sanitation is very expensive and large cities can 

 better afford the outlay than small villages or isolated 

 country places. It is evidently an economic impossibility 

 for each farmhouse to have a sanitary water supply and 

 have a safe system of disposal of its wastes under expert 

 advice such as the city enjoys. Herein lies one of the great 

 powers for usefulness of the state and county health officer. 

 The sanitarian now reahzes that the next point of attack 

 is the country. 



There is still one weak spot in the city over which the 

 country has a decided advantage and that is the milk sup- 

 ply. In the country it is easy to obtain fresh milk twice a 

 day. The dweller in a large city is fortunate if he gets milk 

 less than forty-eight hours old. Milk when it reaches the 

 consumer in the city is often very different when compared 

 to the same milk used on the farm. The farmer cannot un- 

 derstand why it is that the milk agrees with his baby, but 

 makes the city baby sick. He forgets that the milk he sends 

 to the city is often placed in dirty cans, perhaps rinsed 

 with infected water or mopped "clean" with soiled cloths. 



