the community the consequences that would otherwise follow their ignorance and neglect. In other words, the quality of a public water supply ought easily to be better than the average water supply that would be obtained by the average citizen for himself under rural conditions. If the real situation is sometimes otherwise it is not because impure water is one of the necessary and inevitable accompaniments of city life, but because the city has failed to avail itself of the superior resources at its disposal.
The matter of water supply is not the only respect in which the city should possess a practical advantage. The opportunities for speedy and efficient treatment of many acute diseases are greater in a large and compact community than in one sparsely settled. Well-equipped hospitals and dispensaries, the most expert surgeons, the best trained nurses are all most likely to be found in the centers of population. Many city families have experienced the increased anxiety and danger that accompany a case of serious illness occurring when the family is away for the summer in a little country town. The careful nursing and the timely and expert treatment which even those in moderate circumstances can command in a large city are quite out of the reach of the majority of rural dwellers.
In addition to the advantages that accrue to the city dweller from opportunities for a particularly efficient treatment of disease in general, there are certain specific instances where early diagnosis and prompt treatment of a particular malady may suffice to turn the scale in favor of the patient. A notable example is presented in the case of diphtheria. All the larger cities and most of the smaller ones have in recent years provided themselves with well-equipped municipal laboratories in which microscopical and cultural examinations are freely made at the request of any physician. By the utilization in this way of the best modern appliances and methods and of experienced and specially qualified service, it is possible in the majority of cases for the physician to discover within twenty-four hours whether his patient is infected with the virulent diphtheria bacillus or is merely suffering from an ordinary and only remotely dangerous sore throat. The importance of an early diagnosis in the case of diphtheria is supreme for the reason that the administration of the diphtheria antitoxin is most likely to prove successful in the early stages of the disease. The antitoxin can not repair any damage that may have been done to the tissues of the body, ]jut can only neutralize and render harmless the diphtheritic poison that is circulating in the blood. If the presence of a true diphtheritic infection is not recognized until late in the course of the disease the injection of the antitoxin may have little influence upon the outcome, since the heart and other organs may have suffered irreparable injury before the nature of the disease becomes understood. It is of the utmost importance, therefore, for the physician to
