Why there should be any failure of the medical profession, as a whole, to be understood by the general public, it is difficult to see. The general public is composed of individuals, each of whom has a feeling of trust, affection, and possibly of veneration for one or more members of the medical profession. Why then does the public, as an aggregation of individuals, allow itself to become suspicious of the medical profession, an aggregation of physicians? Why does the public abhor and obstruct the physician in his study of anatomy, dissection, and autopsy on the human body? Why is there so much suspicion of the motives and work, as well as denial of the benefits which accrue to humanity from animal experimentation, when it must be apparent to any right-thinking individual that the extension of a physician's knowledge is possible only by such means? Why must doctors from time to time be themselves forced to urge the necessity of making every hospital a teaching and research institution? A moment's thought would convince anyone that if this be not done, and if medical knowledge be allowed to die out with this generation, there will be no skilled men available for the hospitals and patients of the future. It must also be patent to all that the patients themselves cannot possibly receive such effective care in a hospital in which medical research and teaching are not fostered. Why should the burden of maintaining a high standard of entrance to the profession and of preventing incompetent and untrained persons from assuming the responsibility of physicians rest solely on the medical profession, when the object is the protection of private citizens and public health?
The physicians of the United States are now thoroughly organized. The public should rejoice in this, since it is an attempt to neutralize the narrowing effect of isolation and to foster an exchange of information which physicians offer freely to each other and publish broadcast to the world (applause). County and State associations are affiliated with the American Medical Association, which numbers in its membership over seventy thousand doctors. Just as the individual physician's concern is the care of his patient, so that of the organized medical profession is public health and welfare.
The medical profession is, as a rule, underpaid, but members spend their hard-earned-money and a large portion of their time in efforts to benefit humanity, individually and en masse. It is the people's concern to demand a broad education and a thorough scientific training of all students and practitioners of medicine, public and private. It is to their interest to see that every possible facility is afforded for teaching and that a rigid standard of teaching, examination, degree conference, and licensure is maintained. Nothing is more exasperating to the physician of high ideals, whose length and breadth of sacrifice is known to none, than to hear the sneer directed at his profession for its effort to protect the public. The time has come when the medical profession is in a position to demand that the people exercise discrimination and protect themselves.
One of the first steps toward the betterment of our public health conditions is the coordination of the existing Federal agencies in Washington, of which we are all so proud. When no logical reason can be advanced in explanation of further delay, it is very discouraging to realize that this important matter has been postponed. At the 61st Congress, various bills were introduced, including that of Senator Owen. In support of these bills appeared those who by special training and long experience are recognized at home and abroad as the highest authorities on public health. The whole country is waiting to see what action her representatives will take to protect her most precious asset.
With your permission, I should like to cite some sixteen reasons why the people of the United States should have a department of health at Washington, which were published by the Committee of One Hundred of the American Association for the Advancement of Science:
1—To stop the spread of typhoid fever through drinking sewage-polluted water of interstate streams.
2—To enforce adequate quarantine regulations so as to keep out of the country plague and other similar pestilences.
3—To supervise interstate common carriers, in so far as without such supervision they prove a menace to the health of the traveling public.
4—To have a central organization of such dignity and importance that departments of health of States and cities will seek its cooperation and will pay heed to its advice.
5—To influence health authorities, State and municipal, to enact reform legislation in relation to health matters.
6—To act as a clearing-house of State and local health regulations, and to codify such regulations.
7—To draw up a model scheme of sanitary legislation for the assistance of State and municipal health officers.
8—To gather accurate data on all questions of sanitation throughout the United States.
9—To establish the chief causes of preventable disease and unnecessary ill-health.
10—To study conditions and causes of disease recurring in different parts of the United States.
11—To correlate and assist investigations carried on in many separate and unrelated biological and pathological Federal, State and private laboratories.
12—To consolidate and coordinate the many separate Government bureaus now engaged in independent health work.
13—To effect economies in the administration of these bureaus.
14—To publish and distribute, throughout the country, bulletins in relation to human health.
15—To apply our existing knowledge of hygiene to our living conditions.
16—To reduce the death-rate.
In 1912 there will meet in Washington, on the invitation of the President and Congress of the United States, the International Congress of Hygiene and Demography. This Congress meets triennially in the capitals of the world, and brings together the leaders in health conservation who are officially delegated by the governments of all civilized countries. We have many things to show them of which we can be justly proud. Our Federal, State, municipal and other official health organizations, however, leave much to be desired: and it behooves us, in the few months still at our disposal, to prepare to show the visiting nations our methods and successes. We need many other things, but due recognition and coordination of our Federal health mechanism is the first step which, if we have taken it before the meeting of this International Congress, will best enable us to profit by the experience of the world's experts there assembled.
Nature has been prodigal in her gifts to our Nation. In no respect has she been kinder than in opportunities for health and efficiency. Her very prodigality has rendered us careless and extravagant. It is high time that Americans do as well for themselves in health protection at home as they have done for themselves and others in Cuba, the Canal Zone, Porto Rico, and the Philippines (applause). This demands the creation and maintenance of official organizations to amplify, extend, and ultimately replace the work of our voluntary organizations whose lack of authority prevents their complete success, and whose continuance is an admission of popular inertia and official incompetence. (Applause)