Always and everywhere present are the private influences which work against the public health. Individuals and corporations owning foul tenements or lodging-houses resent, by all the evasions inherent in our legal system, every endeavor to eliminate the perilous conditions from which they take their profit. For the precious right to dump refuse into streams and lakes, sundry factories, foundries, slaughter-houses, glue works, and other necessary but unsavory industries send delegations to the legislature and oppose the creation of any body having authority to abate the nuisances.
Purveyors of bad milk decline to clean up their dairies until the outbreak of some disease which they have been distributing by the can brings down the authorities upon them. Could the general public but know how often minor accesses of scarlet fever, diphtheria, and typhoid follow the lines of a specific milk route, there would be a tremendous and universal impetus to the needed work of milk inspection. In this respect the country is the enemy of the city: the country, which, with its own overwhelming natural advantages, distributes and radiates what disease it does foster among its urban neighbors, by sheer ignorance or sheer obstinate resistance to the "new-fangled notions of science." Such men as the late Colonel Waring of New York, Dr. Fulton of Baltimore, and Dr. Wende of Buffalo have repeatedly pointed out the debt of death and suffering which the city, often well organized against infections, owes to the unorganized and uncaring rural districts. Reciprocity in health matters can be represented, numerically, by the figure zero. It occasionally happens that the conflict between private and public interests assumes an obviously amusing phase. The present admirable Food and Drug Department of the Indiana board was not established without considerable opposition. One of the chief objectors was a member of the legislature, who made loud lamentation regarding the expense. Up rose another legislator, all primed for the fight, and asked if the objector would answer a few questions. The objector consented.
"Do you know the W—— baking-powder?"
"Yes."
"Do you know that it would naturally come to the food laboratory for analysis, were such a laboratory established?"
"I suppose it might."
"Do you know that the W—— baking-powder is 20 per cent. clay?"
"No."
"Would it surprise you to learn that it contained a high percentage of clay?"
No answer.
"Are you counsel for the W—— Baking Powder Co.?"
"Yes."
"That's all."
It was enough. The bill passed.
Everybody's health is nobody's business. There, as I see it, is the bane of the whole situation at present. To be sure, epidemics occasionally wake us up. And, really, an epidemic is a fine thing for a city to have. It is the only scourge that drives us busy Americans to progress. It took an epidemic of typhoid, a shameful and dreadful one, to teach Ithaca that it must not drink filth. Only after Scranton faced a thousand cases of the fever did it assert itself and demand protection for its water supply. New Orleans would probably be having (and concealing) yellow fever yet, but for the paralysis of fright which the onset of three years ago caused. Boston's fine system of medical inspection in the schools is the outcome of a diphtheria scare. Smallpox is a splendid stimulator of vaccination; so much so that some of the country's leading sanitarians now advocate the abolition of pest-houses for this avoidable ailment, and dependence upon the vaccine virus alone.
But epidemics are only the guerrilla attacks of the general enemy. It is in the diseases always with us that the peril lies. Tuberculosis, carrying off ten per cent. of the entire nation, and making its worst ravages upon those in the prime of life, is a more terrible foe than was ever smallpox, or cholera, or yellow fever, or any of the grisly sounding bugaboos. Why, not so long ago, three highly civilized States went into quite a little frenzy over a poor dying wretch of a leper who had got loose; whereas every man that spits on the floor of a building wherein people live or work is more of an actual peril, in that one foul act, than the leper in his whole stricken life. The twin shames of venereal disease, blinked by every health board in the country (Detroit possibly deserves a partial exception) are, in their effect upon the race, in blindness, deafness, idiocy, and death so dreadful a menace to-day, that consumption alone can march beside them in the leadership of the destroyers. Typhoid, so easily conquerable, claims its annual thousands of sacrificed victims. And the slaughter of the innocents goes endlessly on, recorded only in the dire figures of infant mortality. To-day, as I write, the whole nation is thrilled with horror at the tragedy of 150 young lives snuffed out in a needless school panic in Cleveland. Had my pen the power, perhaps I could thrill the nation with horror over the more dreadful fact that some 1100 children under five years of age die yearly in Fall River, the vast majority of them sacrificed to bad food and living conditions that might better be called dying conditions. One half of the total mortality of that busy, profit-yielding city is among children under five years of age, two-fifths among children under one year. Does no baneful light shine from those figures?
Yet, over and above the minor discouragements, failures, and set-backs, looms the tremendous fact of a universal and gathering movement. It is still, in any general sense, inchoate, and, except in certain specific relations, invertebrate. But one cannot follow the work of the public health guardians without feeling the cumulative force of progress. As I have said, the newspapers have been a vital element in awaking the public. Associations are being formed the country over for the prevention of disease. There is a steady increase in the power and authority of those officially charged with hygienic control. Makers of deleterious or poisonous foods, and the vultures who prey on the sick through fraudulent patent medicines are being curbed by pure food and drug laws. Milk inspection is saving the lives of more children every year, as meat inspection is prolonging the lives of the poor. Definite instances of progress are almost startling: the fact that Massachusetts has so purified its public waters that for a year there has been no typhoid epidemic ascribable to any public supply; the passage of a radical law in Indiana which forbids the marriage of imbeciles, epileptics, and persons suffering from a contagious or venereal disease; the saving of babies' lives at $10 a life in Rochester by pure milk protected and guaranteed by the municipality; the halving of the diphtheria death rate by the free distribution of antitoxin; the slow but sure and universal yearly decrease in the Great White Plague—all these and more are the first, slow, powerful evidences of national progress.