and the grosser possibilities in some measure controlled. The enforcement of greater cleanliness in public buildings and conveyances, a better system for the notification and control of cases of infectious disease—a matter in which American municipalities are notoriously lax—provision of adequate hospital facilities for the reception and care of patients suffering from infectious disease are among the measures which would unquestionably reduce the city death rate from the infectious diseases. Above all, a thoroughgoing system of medical inspection of schools should be introduced. Nearly all the infectious diseases are most prevalent and most fatal among children of school age, and it would seem as if this were a highly important field in which the energies of municipal health authorities should be exercised. In some cities, as in Boston and Chicago, school inspection has been introduced with successful results, but lack of funds for the purpose has prevented a general and thorough adoption of the system. It would seem as if no reasonable expenditure should be allowed to stand in the way of this important public health measure. If money is available for safeguarding the public health in any way, it ought to be available for this purpose. If necessary the school year should be shortened to secure the funds needed. The saving to the community of the expense of caring for cases of even the minor and less dangerous infectious diseases should constitute an effective financial argument for the general adoption of school inspection. It is perhaps significant that the growing unwillingness on the part of many of the most intelligent and public-spirited members of the community to send their children to the public schools is based on the great liability of the children to contract infections under existing conditions. The removal of this grave drawback to the public school system would in itself seem an object worth striving after.
If a small fraction of the money now expended under compulsion for over-elaborate and unnecessarily complex systems of plumbing were devoted to measures better calculated to prevent the spread of contagion, the city death rate from infectious diseases would be materially lessened and would not so largely exceed the country death rate from the same causes, as is at present the case. The campaign against infectious disease in cities should not be conducted, with antiquated methods and along lines not countenanced by recent investigation, but should take advantage of the most recent scientific discoveries and above all should be carried on with a full understanding of the nature and degree of success that may reasonably be expected from the methods it is applying.
Municipal hygiene, then, to be worthy of the name should not confine itself to combating only the most dreaded or most dramatic forms of disease, but after a scientific study of the whole problem of city life should enter upon a carefully planned and systematic endeavor to re-
