June 16, 1905.] 



SCIENCE. 



911 



not only saved the lives of thousands of 

 citizens, but has also caused the population 

 to increase to a point much beyond any 

 which it would have reached had the city 

 continued to use, unpurified, the sewage- 

 polluted water of the Merrimac River. A 

 demonstration of this sort shows how easily 

 the diminishing increase of population un- 

 der a lower birth rate may sometimes be 

 counteracted without resort to that fish- 

 like spawning which seems to be the only 

 remedy of those who are terrified by 'race 

 suicide,' so called. Moreover, it is hardly 

 necessary to point out that such a dimin- 

 ishing death rate means a far more rapidly 

 diminishing morbidity rate — in other words, 

 it means a heightened working efficiency 

 of the population as a whole, and it must 

 not be forgotten that for most of the results 

 obtained in the scientific purification of 

 water supplies we are indebted to the sci- 

 ence of engineering. 



On the other hand, we must observe that 

 engineering science, so far as water puri- 

 fication is concerned, is as yet only in its 

 infancy and by no means thus far alto- 

 gether satisfactory. In the United States, 

 for example, in the last two or three years 

 a number of epidemics of typhoid fever 

 have resulted from the defective operation 

 or construction of municipal filters, and 

 while mvich has been done, it is clear that 

 much still remains to do. In this connec- 

 tion it should be said that public health 

 science in the United States suffers con- 

 stantly and severely from an unsatisfac- 

 tory condition of the science and art of 

 administration or government in many 

 American cities. Public health works are 

 too often neglected, delayed, mismanaged 

 or built at extravagant cost, to the sanitary 

 and economic damage of the people as a 

 whole, and the tendency is far too common 

 to place the care and operation of costly 

 devices or systems in incompetent hands. 



I can not here dwell, as long as I should 

 like to do, upon the mutual relations of 

 public health science and the sciences of 

 legislation and administration. Speaking 

 of my own country alone, I must confess 

 that we are still very deficient in the appli- 

 cations of these sciences. We have not 

 even a national board of health, although 

 we have, fortunately, in the Public Health 

 and Marine Hospital Service a strong sub- 

 stitute for one. The peculiarities of our 

 democratic and republican government 

 have hitherto made it impossible for the 

 people of the United States to secure either 

 from federal authorities or from more 

 local sources that measure of paternal sani- 

 tary and hygienic protection which they 

 ought to have, and it is the duty of every 

 American worker in this field to bend his 

 energies toward a better organization of 

 the public health service in every direction, 

 municipal and state as well as national. 

 The appointment in 1886 of a distinguished 

 hydraulic engineer to membership on the 

 State Board of Health in Massachusetts 

 marked an epoch, so far as America is con- 

 cerned, in both sanitary legislation and 

 administration. This appointment was a 

 formal recognition on the part of the public 

 of the necessity of a larger proportion of 

 engineering science in matters relating to 

 the public health, and the results have justi- 

 fied the new procedure. It is now, for- 

 tunately becoming less rare in America to 

 secure the services of engineers upon such 

 boards and there can be no question that 

 participation of the expeil laity with med- 

 ical men is likely to be extended, probably 

 far beyond our present ideas. 



In a notable discourse before the Inter- 

 national Medical Congress at the Centen- 

 nial Exposition held at Philadelphia in 

 1876, Dr. Henry P. Bowditch, of Boston, 

 one of the pioneers of hygiene and sanita- 

 tion in America, divided the century then 



