1 883.] 
On Sanitary Reform . 
587 
of public health and the reduction of disease, he has ex- 
tracted by his [philanthropy so much money from his own 
pocket. It is evident, indeed, that there are to be found 
noble examples of integrity and self-sacrifice in the medical 
profession ; but, on the other hand, it is to be feared that 
these are qualities which do not always commend themselves 
to local Trustees, or enhance the claims of candidates for 
their appointments. But whether this be the case or not, it 
cannot be said to be just to the inhabitants of a district that 
their sanitary condition should be dependent on the very 
slender chance of these qualities operating pro bono publico 
in any individual. We require not only that such positions 
should be given to men whose character and attainments are 
above suspicion, but that either some system of better 
checking from the Central Authority be devised, or that 
these positions be held for shorter periods, to prevent the 
development of that spirit of autocracy and local wire-pulling 
which become here, as in other departments of social organ- 
isation, the destruction of progress and philanthropic 
exertion. The present system seems to hang too much on 
a single thread. The matter of public health is of too great 
moment to be so treated ; and those ratepayers who desire 
improvement deserve consideration equally with the mere 
cheese-paring economists, whose fancied frugality proves too 
often the greatest extravagance. That economy is required 
in those who manage public concerns is unquestionable ; but 
the true, intelligent economy, which alone deserves the 
name, is rather the management of force and the wise appli- 
cation of it, than the reduction of appliances and the mere 
negation of expenditure. 
This is a question for ratepayers to consider. Let them 
not forget that what is worth doing is worth doing well. 
Both the people and the press are bound to do their part in 
arousing and encouraging those to whom management of 
sanitary matters has been committed. The work is one 
which eminently demands united aCtion ; and it is certain 
that sluggishness and apathy are the blameworthy causes of 
untold disease, vice, and moral degradation. Contrasted 
with the work of these subtle yet potent factors of social 
misery, the ruin effected on the battle-field sinks into com- 
plete insignificance. 
It would be an extravagant allowance to take an average 
of 5000 men per annum as the slaughter of Englishmen in 
battle ; but, according to Dr. Maclagan,* 20,000 is about 
* See article in Nineteenth Century, November, 1879 — “ Is Typhoid Feve 
Contagious ? ” 
2 Q 2 
