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much more than epidemic diseases as truly preventible. 
The influence of favourable or unfavourable sanitary condi- 
tions is also plainly shown in such diseases as phthisis, 
diarrhoea, and dysentery, scrofula, various pulmonary com- 
plaints, convulsive disorders, and, to some extent, in the 
whole range of diseases that produce our excessive infant 
mortality. The true meaning of the term ‘preventible’ 
mortality is fully given by Mr. Simon in his preface to Dr. 
Greenhow’s Inquiry. Briefly stated it means “all local 
excuses of fatality that are due to local circumstances of 
aggravation.” (p. viii.) 
The excessive mortality from a large group of diseases 
other than epidemic in their character may then be greatly 
diminished, partly by public sanitary work and still more 
by improvements in domestic hygiene amongst the poor — 
such as sanitary associations and medical oflicers of health 
may by degrees be able gradually to teach. 
It may fairly be asked then of sanitarians, where is the 
proof of your ministry ? 
The range of preventible mortality is greater than Mr. 
Baxendell supposes, but it has not been prevented — to what 
must this result be attributed ? Mr. Baxendell seems in- 
clined to question the utility of the costly sanitary works 
that have been undertaken of late years ; but an examina- 
tion of the local details that make up the total mortality 
will soon show that, in places where these works have been 
thoroughly carried out, a very distinct effect upon the mor- 
tality has been produced, and that the stationary condition 
of the total death-rate is mainly caused by the increasing 
mortality in places that have not been thus cared for. 
It is indeed difficult for anyone acquainted with the 
history of the science of public health to see the necessity 
for any defence of sanitary works — seeing that in some foi*m 
or other they have led to the entire disappearance of some 
diseases, and to the great amelioration of others — and that 
