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American Medicine

H. EDWIN LEWIS, M. D., Managing Editor.

PUBLISHED MONTHLY BY THE AMERICAN-MEDICAL PUBLISHING COMPANY.
Copyrighted by the American Medical Publishing Co., 1910.

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Health conservation is almost as important to the American people, it would seem, as the conservation of the country's forests, water power and mineral supplies. If there is any part of our national resources more vital to the welfare and progress of the nation than the health of the people, we do not know it. Until recently, however, one would never suspect from any attention given to health matters by our national legislators, that the health of the American people was of any importance whatsoever. It is true that the various State legislatures have been meeting many sanitary and medico-sociologic problems with a good deal of sound judgment and common sense, and doubtless the local disposal of many public health questions has made the national proposition less insistent.

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equivocably opposed to the creation of a separate department of health. In a letter to the Committee of One Hundred, Mr. Roosevelt gave his reasons for opposing the department idea, and suggested as a substitute, grouping of all public health agencies under one head. Realizing the comparative futility of attempting to secure legislation for a department of health in the face of President Roosevelt's objections, everything was held in abeyance for a while. Both of the great political parties incorporated public health planks in their 1908 platforms and although that of the Republican Party was emasculated for some unknown reason, the promise of definite organization of all agencies under one head was plainly given by the politicians of both sides. President Taft came into office with great enthusiasm. Divers questions of great moment have engaged his attention. Opinions are somewhat divided as to the results he has been able to accomplish. Many are inclined to criticise the comparative lack of achievement, and it is perhaps true that the program as laid out by the President has been only partially completed as yet. But one thing is certain. President Taft himself has not been

The Pure Food and Drug Act focussed attention on the need of national legislation along specific lines, and straightway agitation for the development of a department of health began to make itself felt. Several organizations, notably the American Medical Association and the Committee of One Hundred of the American Association for the Advancement of Science took the matter up, and an active propa- to blame. He has worked heroically to ganda was soon under way. President Roosevelt's attitude, however, promptly threw cold water on the whole movement, for he expressed himself as being un- the politicians. The President has shown

keep his pledges for constructive legislation, and if he has failed, or his plans have been deferred, the fault lies at the door of

himself a

prolonging of human life, and the general augmentation of human happiness may not be calculable in dollars and cents. But the gain will be none the less tangible, and the uplifting influence will be promptly shown on every phase of living.

strong man, capable and courageous in every way. The country may rest secure in his honesty of purpose and the broad liberality of his viewpoint. His methods may lack sensationalism, and he may seem over judicial in his relation to many matters, but let us take the deepest possible satisfaction in the fact that he is safe, sane and thoroughly human. The nation was never in more dependable hands.

The demand for the creation of a department with a secretary in the Cabinet, instead of the formation of a bureau to become an integral part of some already existing department, is well voiced by Senator Owen's bill. The importance of the health of the country is too great to have the details of its conservation prejudiced or handicapped as they assuredly would be by

President Taft's attitude on public health questions is that of an intelligent, broadminded man who has from necessity as well as from inclination posted being restricted or confined to the activities

himself rather fully. This being so, there should be little or no doubt as to the position he will ultimately take on the proposition to create a national department of health. Senator Owen's bill places the matter fairly and squarely before Congress. If our national legislators will be as ready. to ascertain the opinions of their constituents on this great problem as they were concerning the tariff, there can be little uncertainty as to the result. The American people the thinking classes-are keen for a national department of health. To be sure, there is a well defined sentiment for economy in governmental expenditures, but every thoughtful person knows that a department of health will repay fourfold every dollar it costs. In fact, such a department will prove a substantial earning force almost from the beginning, and be able to swell the national revenues in an infinite variety of ways.

Obviously the Obviously the

greatest returns from the utilization of governmental resources in the prevention and cure of disease will come from the saving in time, labor and expense. The resulting gain to the American people by the increase of human health, the saving and

of a bureau. With the evolution that public medicine, including modern sanitation, hygiene and food and drug matters, is already undergoing, a Secretary of Public Health is bound to be one of the most influential and useful officials in our system of government. This emphasizes the necessity that will arise-if the project goes through-of selecting such a secretary and his immediate assistants with the utmost care and wisdom. Officials connected with a national health department must necessarily have exceptional authority, with opportunities for the use as well as the abuse of power that will mean either unlimited good or far reaching harm.

Politics Must be Kept Out of a National Department of Health. It is bad enough for the other departments to be pawns on the chess board of national politics, even though following as high ideals as they unquestionably do. The health needs of the people are too sacred, and the problems presented are too intimately associated with the fundamental principles of Christian civilization to permit the slightest taint of selfish interest. The questions that will

necessarily arise in the execution of public health laws, requiring the nicest discrimination, the greatest moral courage, and above all the broadest humanity, emphasize the problem that will be presented to the President in organizing the personnel of such a department-if Senator Owen's bill becomes a law. Thank God, we have a President who appreciates scholarly attainments, but more than this, true manhood, as defined by personal integrity, individual resourcefulness, and the possession of high ideals. It is earnestly to be hoped therefore, that his keen appreciation of men will enable President Taft to avoid the greatest menace in the situation-the medical politician.

The medical politician is one of the most detestable creatures on earth. The one great factor that has delayed passage of a comprehensive national health law and the creation of a national department of health has been the selfish bickering of the medical politicians. Personal aggrandizement and self gain have been so patently the moving force in the past, that our wide awake congressmen have instantly grasped the situation and the whole question has been prejudiced and its urgency discounted proportionately. With apparent zeal and enthusiasm in humanity's behalf, year after year an appeal has been made to Congress; but with few exceptions the loudest and most strenuous advocates have been unable to hide their hypocrisy and selfishness, and the fundamental good of the proposition has, therefore, been obscured by the all too evident aims of the promoters. As a further drawback, active opposition has been constantly exerted by medical men whose positions and interests would be jeopardized by a change in the existing health laws. This opposition has been also

actuated by selfish interests, but in all fairness it must be admitted that it has been honest and not hypocritical in its expression. Finally, there have been countless other adverse influences directed against any proposed national health law by those whose interests were best served by secrecy, the absence of legal supervision, and the continued ignorance of the people.

So take it all in all, it is little wonder that American health matters have remained so long in a state of obsolescence. The situation until recently has been one of constant shame to the medical profession, shame that the active advocacy of the health laws favored by every earnest physician and honest citizen should have been left so exclusively with the "self seekers!"

The better organization of the profession has changed the old order of things completely, and the present demand for a department of health as voiced by Senator Owen's comprehensive bill is practically the demand of a united profession. The American Medical Association as it stands

today with its state and county affiliations is one of the most powerful organizations and fundamentally one of the greatest forces for good in the country. It has crystallized the sentiment for pure food and drugs, and shown to the country-especially to the legislators-that the medical profession are earnest and sincere in their desire for a national department of health; that American physicians are heart and soul in favor of all legislation that will promote the public welfare; and that to the medical profession there is no interest so sacred as that of the health of our American people.

The great American Medical Association has its own dangers, most of them internal and the product of its phenomenal

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