DR. J. MERCIER GREEN
HEALTH OFFICER OF CHARLESTON, SOUTH CAROLINA, WHO STAMPED OUT A SMALLPOX EPIDEMIC AND REFORMED THE CITY'S WATER SUPPLY
"What can I do about it?" asked the clergyman. "Mr. Blank's death was said to be from pneumonia; but that was only the final cause. He had been consumptive for a year."
"Warn the new tenants," I suggested, "and have them ask the Health Board to disinfect."
More than a year later I met the clergyman on a train and recalled the case to him. "Yes," he said, "those people thought it was too much trouble to disinfect, particularly since the reports did not give tuberculosis as the cause of death. Now their child is dying of tuberculosis of the intestines."
In this case, had the death been properly reported by the dead man's physician, as the law required, the City Board would have compelled disinfection of the house before the new tenants were allowed to move in. The physician who obligingly falsified that report is morally guilty of homicide through criminal negligence.
In Salt Lake City, in 1907, 43 deaths were ascribed to tuberculosis—undoubtedly a broad understatement. And in the face of the ordinance requiring registration of all cases of consumption, only five persons were reported as ill of the disease. By all the recognized rules of proportion, 43 deaths in a year meant at least 500 cases, which, unreported, and hence in many instances unattended by any measures for prevention of the spread of infection, constituted so many separate radiating centers of peril to the whole community.
Why is such negligence on the part of physicians not punished? Because health officials dread to offend the medical profession. In this respect, however, a vast improvement is coming about. Pennsylvania, Maryland, Indiana, Massachusetts, Minnesota, Wisconsin, and other States are not afraid to prosecute and fine delinquents; nor are a growing number of cities, among them Boston, New York, Rochester, Providence, and New Orleans. The great majority of such prosecutions, however, are for failure to notify the authorities of actively contagious diseases, such as scarlet fever, diphtheria, and smallpox.
"Business Interests" and Yellow Fever
Epidemics are, nevertheless, in the early stages, often misreported. If they were not—if early knowledge of threatening conditions were made public—the epidemics would seldom reach formidable proportions. But—and here is the national hygienic failing—the first instinct is to conceal smallpox, typhoid, or any other disease that assumes epidemic form. Repeated observations of this tendency have deprived me of that knock-kneed reverence for Business Interests which is the glorious heritage of every true American. As a matter of fact, Business Interests when involved with hygienic affairs are always a malign influence, and usually an incredibly stupid one. It was so in New Orleans, where the leading commercial forces of the city, in secret meeting, called the health officer before them and brow-beat him into concealing the presence of yellow fever, lest other cities quarantine against their commerce. And "concealed" it was, until it had secured so firm a foothold that suppression was no longer practicable, and the city only averted a tremendously disastrous epidemic by the best-fought and most narrowly won battle ever waged in this country against an invading disease.