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Auids could not sterilize it. He is there- than any other one factor. To go into fore preaching against what he believes to comparative consideration of the various be ineffective disinfection, with the hope dangers of urban living is not necessary; of starting a new and effective system of the evident evils of filthy thoroughfares isolating the carrier. Our own Chapin of tell their own story all too plainly. The Rhode Island has conclusively proved that fact remains that our Boards of Health, far better results are obtained in diphtheria health officers and sanitarians can if we ignore things on which the bacilli
expect great or lasting reductions in the promptly die anyhow, and devote our at- mortality rates of the air borne diseases, tention to the convalescents until we are until clean streets are a verity instead of sure they cease to be carriers. All this is
an ideal. The proposition is a many sided of extreme importance, for it shows that
one, and presents problems that must have we allow children to go back to school too the best thought of the engineers, the soon, and permit convalescents generally mechanicians, the contractors, the bacterito spread disease broadcast while theologists, the chemists, the physicians and health authorities are spending time and the sanitarians. Fortunately the developmoney poisoning the dead germs on the
ment of the automobile bids fair to dehouse walls. When Chapin presented his crease the most serious feature of unclean evdence to the Section on Hygiene of the
streets by forcing that noble but none the A. M. A. some years ago, he was amazing- less execrably filthy beast, the horse, into ly misunderstood and denounced, but he is
the background. Few realize it, but it is now coming into his own. We can con- a fact that the feces of the horse are more fidently predict as great a change in pre- dangerous, bacteriologically, than those of ventive methods in every disease as has oc- any other animal; in fact are second only curred in yellow fever, but not until the to human feces in pathogenic possibilities. exact ways of transmission are known. The The automobile is, therefore, helping to sooner this is accomplished the better, for solve other problems than those of transwe have permitted an enormous amount portation, and the probable improvement of disease by our delay in recognizing the in the sanitary conditions of city streets "carriers" and by wasting our time on the that will follow the wider use of autogerms which had died.
mobiles will constitute not the least of the ultimate benefits of the horseless vehicle.
Street cleaning is second only in sanitary importance to the sewage problems The so-called antiseptic barber shop of every large city. Now that practically of to-day is in reality a myth. Even the every self respecting community has in best of the better barber shops fall far operation a sewage system of more or less short of the aseptic precautions that ordiefficiency, the question of how to secure nary common sense would seem to dictate. and maintain clean streets must be taken That this is a fact will be borne out by the up and answered. It is no idle statement simplest investigation one cares to make that unclean streets are more responsible of practically every one of the up-to-date for the propagation of present day diseases shops of to-day. It is not meant to imply
that any of these shops fail to keep their Plague infection of the ground squirrels utensils clean or to use clean linen, but of the Pacific Coast is proving to be a it is meant that a real state of antiseptic
much more serious matter than cleanliness is almost never obtained. Our thought when it was first discovered that knowledge of the need of antiseptic meth
the fiea had carried the bacilli from the ods, raises the question whether or not the
city rats to these country rodents. Dr. use of a common brush, soap and razor is
Colby Rucker, of the Public Health Servnot a fairly frequent source of skin infec
ice, whose efficient work in San Francisco tions, and as a consequence the prime
has been mentioned in connection with the cause in many of the skin lesions constant
Plague crusade of Dr. Rupert Blue, has ly being met. It is not unreasonable to
been organizing a scouting expedition to fear that the shaving stick, brush or razor
determine just how far the infection has used on a person whose face is broken out
spread, and preliminary reports of his work with any of the common forms of eczema,
show a somewhat alarming condition-inacne or the more severe skin lesions, is ex
fected squirrels having been found in widetremely liable to be a factor in the spread of ly separated places in one county with evi
dences that other counties are also involved. such diseases, unless these implements are
Plague is therefore a disease to be expectproperly subjected after each shave to some effective sterilizing process.
ed in human beings for some time to come
in the United States for the bacillus has In many shops, however, the latest
obtained a foothold. As the extermination method of applying soap is now being
of the squirrels is apparently impossible, used. This is in the form of a powder ap
the spread of the disease throughout the plied to the brush that has previously been continent by the squirrels, prairie dogs and wet. Surely a step in the right direction
other rodents, depends solely upon whether for each customer thus has at least his in- they have sufficient tolerance to keep the dividual soap. It may not be feasible to bacilli alive, or whether they will die off so have individual brush and razor always, quickly as to prevent the germs being carbut it is always possible to have these im- ried, as happened in the efforts to kill off plements rendered absolutely sterile before the rabbits of Australasia. It is now use, since this can be easily and effective- known that the bacilli are normal inhabitly accomplished by thorough immersion in ants of certain rodents in Eastern Asia, boiling water.
only occasionally making excursions into
the bodies of rats, and always dying out in The time is surely coming when every
their new homes, incidentally destroying man with ordinary development of the pre
some millions of rats and human beings. cautionary sense will refuse to patronize any barber shop that fails to use reason
The rats are known to have enough toler
ance to spread the bacilli, and it is feared able aseptic and antiseptic methods. As a
our feral rodents will do the same. matter of fact the safety razor deserves all the praise it is given, if for no other rea- The appalling results of contempt for son than that it has helped to deliver many sanitation are illustrated by this wide a man from the dangers of indiscriminate spread of plague bacilli in America. San barbering
Francisco's labor unions elected to the mayorality a fiddler who has since been country and create a menacing situation sent to prison for crimes connected with which may require hundreds of millions his administration. It was he, who, at the of dollars to save our lives, if the infected probable instigation of certain business ground squirrels are not promptly destroymen afraid of publicity, not only denied ed. Neglect or defiance of sanitation is danthe presence of plague in the city, but pun- gerous business, at any time, but to jeoparished those who said there was. At the dize the whole nation for the sake of a litvery time that well directed efforts would tle temporary business, shows that the have completely destroyed the infection, it guilty people are not possessed of sufwas concealed and allowed to spread until ficient common sense and forethought to it began killing the inhabitants. It has be entrusted with the franchise. It is hoped now escaped beyond their borders, and if that all cities will learn a lesson from San the fears of its further spread across the Francisco's crime, elect only “gentlemen”. continent are realized they will be the of proved executive ability and honor to causes of an appalling number of deaths. offices requiring those characteristics and They have at least created a situation full then support the sanitarians in their efforts of menace to the rest of the country, and to protect the community. It is the cheapthe question naturally arises as to whether est in the long run, as common sense one community is to be permitted to should have taught, but in electing the jeopardize others in this criminal manner. notorious fiddler they showed that they Several times in England it has been were not possessed of common sense at found that the rats, near the docks of ships that time. It is quite proper for laboring from plague countries, were infected, but men to organize for their own protection, prompt measures eliminated the danger at but if they aspire to rule as in San Franonce. That could have been done here if cisco, they must not do injury to the health a central health authority had had control. of the country or there will be an
whelming demand for their suppression. The main lesson from San Francisco's conduct is the necessity of electing men of intelligence-attainments and honor- Wisdom from the mouth of babes to positions requiring high executive abil- comes at unexpected times, but it is not ity. All men are not equal, and low mor- anything new for children to prefer an unality is generally a result of low mentality. wise therapeutic nihilism.
Their objecEnglish workingmen for generations re- tion to being dosed is perhaps an animal fused to be represented in Parliament by instinct inherited from ancestors who did anyone except "gentleman"-gentle nothing but rest and starve when ill, alborn. They are now sending their own lowing nature to preserve the most resistrepresentatives and it is hoped the experi- ant. Indeed it is not so long ago that our ment will turn out better than in San Fran- own survival compelled us to kill the sick, cisco, a city which, in spite of its noble and for men had all they could attend to in brave conduct after the fire and earthquake, keeping themselves alive, Perhaps this must accept the contempt of the civilized brutal custom improved the physique of savworld for permitting plague to enter the age races by preventing the procreation of
those who became ill. Some, if not all, body fluids act like champagne which has
ease are of considerable importance. It to do nothing, and sometimes they are has long been known that the longer the right. A little boy, convalescent from
exposure to compressed air, the more whooping cough worried his mother so
gases must be dissolved in the blood and much by an occasional cough, that she
the longer must be the period spent in the said, “My dear boy, what can I do for air lock. Seasonal epidemics have an un
“Just let me alone until I get known relation to the outside temperature well." Could we not take this to heart
and the barometric readings which in and could not all mothers too, in the case
some way influence the escape of surplus of convalescents, without being accused of
gases from the blood. Still, it seems retherapeutic nihilism?
markable that the state of the weather
should have the least effect if the workCaisson disease seems destined to be of
man has gotten rid of the surplus gas be
fore he leaves the chamber. It is said increasing importance because the prog
that light exercise aids the escape of gases, ress of civilization and the congestion of population are creating more and more
as we would suspect from the increased
circulation of blood. Workmen are often need of tunnels and bridges, the construc
prostrated as a result of the exercise tion of which requires the laborers to
taken after leaving the locks, and it seems work in compressed air at great depths.
a wise precaution to compel light exercise The cause and prevention of the disease
during decompression but complete rest are well known and yet, in spite of all pre
for a short time after emergence. cautions, cases continue to be produced
The last thing discovered is the fact and show the need of further investiga
that big or obese men suffer more often tion. It seems a simple matter yet there
than the little or spare. (Boycott and Daare curious accidents proving that it is far
mant, Journal of Hygiene, Sept. 1908.) from simple and that there are individual
This is no doubt due to the greater diffias well as seasonal variations in suscepti- culty of getting rid of the gases in the bility. Under compression more gases bodies of the bigger men. Such workare dissolved in the blood and if decom
men must therefore spend a longer time pression is rapid, these gases must escape in the air locks and the pressure must be as when a champagne cork is withdrawn,
reduced more slowly than for the others. and the bubbles of gas in unyielding cavi
Perhaps big men should be excluded from ties press upon nerve tissue, and arteries,
such employments. As the disease is causing paralysis which may be temporary really a traumatism and absolutely incurif the gas is reabsorbed or permanent if able after the damage is inflicted, preventhe tissues are lacerated or lose vitality. tion must be carried to the greatest Prevention is merely such slow decom
extreme, though it must be confessed that pression that the gases escape by the lungs men will always take unwise risks and and do not bubble out elsewhere. The that cases will always occur.
The minor details of administration, the
financial questions and the initiative of sciWHY WE ARE WHAT WE ARE—THE
entific work have been confided to the PROPER FUNCTION OF THE Council where frank suggestion, free disMEDICAL SOCIETY.1
cussion and prompt action are secured. The
results come before the Association for REYNOLD WEBB WILCOX, M. D., LL, D., criticism and approval or rejection. In Formerly Professor of Medicine at the New this way, the time of the meeting, valuable York Post-Graduate Medical School and for professional betterment, is not enHospital; Physician to St. Mark's
croached upon. A high standard of memHospital.
bership has been insisted upon, predicated Ten years ago matters in the medical upon the ascertained reputation as a profession were pursuing the even tenor of gentleman and as possessing scientific their way; there were no clouds above the attainments, and, further, as legitimately horizon. No important question was agita- practising some branch of the art and sciting the medical mind. No recent revolt ence of medicine. It was at the outset beagainst the existing order of affairs had lieved that five hundred should be the limit created animosities. But in this medical
of membership, but a waiting list of men calm those who thought, and not only amply qualified by character, education and thought, but acted, believed that the time accomplishment, made it necessary to set had arrived when a new organization should seven hundred and fifty as the number bebe formed which should attempt to reach a yond which this Association may not go. higher ideal than that which had either been With a membership of character and posiconceived for or attained by a medical tion, selecting a representative Council imbody. An aristocracy of membership as
bued only with a purpose to faithfully carry well as the highest standard of scientific out the wishes of the Association, we have achievement was the end toward which been singularly free from the scandals their efforts were exerted. Incidentally, which have fostered animosities in the social intercourse should occupy an im- larger societies, and which have brought the portant position, and that a new fraternity profession into general disrepute from their should comprise the five boroughs of the having been noticed and unfavorably comgreater city.
mented upon in the lay press. It is unTo accomplish these results a method of likely that our harmony will ever be disgovernment was adopted which should be turbed by this cause. representative in constitution, deliberative No less careful attention has been directed in plan but efficient in action, which should toward the scientific work of the Associeliminate the personal and the partisan, but ation. Topics have been carefully chosen which should be effective in carrying out the upon which the papers would either elucihigh ideals of the founders of this Associ- date the newer problems of medicine or ation.
present real advances in the subjects in
which the interest is always vital. The limPresidential Address, delivered Feb. 21st,
itations have been such that the major im1910, before the Medical Association of the Greater City of New York.
portance would appeal to those working in