Except by popular agitation and education our health authorities can do little more than call attention to these apalling figures, and cortrast the $5,000 appropriated annually to protect the health and lives of the 2,240,000 people of Kentucky with the hundreds of thousands expenɑed as a matter of routine for the support of the courts and other departments certainly no more important.

Similar Condition in the Nation.

And this is as true in national health affairs, both military and civil. On account of lack of authority for medical officers, we lost 16 of our soldiers from disease for every one of them killed in battle during the Spanish-American war, and 85 out of every 100 of them were inmates of our military hospitals, and we stand confronted with the same disastrous experience should another war occur next year. With equal rank and authority for its medical officers with those of the line, except in the actual presence of the enemy, Japan lost but one of her soldiers from disease for every four killed in battle, during the much more severe and protracted war in Manchuria, and but 15 of every hundred of her men were in the hospitals. Turning to civil life it is found there is an average of 1,500,000 deaths in this country every year, with 4,200,000 sick, involving the comfort and well being of 5,000,000 homes and 25,000,000 people. After a careful study of these figures Prof. Fisher and other political economists tell us that more than a third of this annual sick and death rate, a tax upon the resources of the nation almost beyond belief, is caused by diseases which are distinctly and practically preventable. About 150,000 of these deaths every year are from tuberculosis, 50,000 from typhoid fever, and the balance from other like diseases which should be considered a reproach to our civilization. As an argument in favor of peace we are told that 210,000 men lost their lives in both armies as a result of battle during the five years of the war between the states. As an even stronger argument in favor of better health laws and methods of living it should be known that during the last five years 750,000 people have lost their lives in this country from tuberculosis alone, 250,000 from typhoid fever, and 6,500,000 from other diseases which ought not to have occurred. In striking contrast with this reckless disregard of health and life, which has no parallel in any other progressive nation, it should be a cause of shame to have to record that, within the last ten

years the U. S. Department of Agriculture has expended $40,000,000, and it is now proposed that $250,000,000 more be appropriated, to prevent tick fever in cattle, cholera in hogs and chickens, scab in sheep, pests to crops and trees, warning farmers as to the danger from frosts. and blizzards, and for the protection of other money and commercial interests, while in all of our history medical men have never been able to induce those in authority to lift a hand or spend a dollar to protect the homes of the people, the men, women and children, more valuable than all other interests combined, from the domestic pestilences which levy an annual tax upon them just as real and for heavier than that imposed for all governmental purposes. In this connection it may be both interesting and profitable to inquire the basic conditions which will account for the indifference or passive resistence of legislators and other officials, local, state and national, which made such neglect of these vital interests possible, and the public sentiment which tolerates or endorses them in doing so.

Wide-Spread, Deep-Seated Prejudice Against Doctors.

Most people are very much attached to their own family physician, but few of them think or speak kindly of other members of the profession, and as a rule this is but a reflection of the way a majority of the physicians of most communities think and speak of each other. As a member and secretary of this Board for more than a quarter of a century I have represented public health interests before every session of our General Assembly, and during many of these years before the Congress at Washington. In all of my earlier experience with these bodies in securing legislation, and before the courts in enforcing such laws, I was constantly confronted, even in the case of men who were fair-minded and broad about other matters, with a distrust, bias or prejudice against the medical profession and whatever it proposed or stood for which paralized all such efforts. It gradually developed that this could nearly always be traced to local dissensions between the physicians of the community in which the member or official lived, or that his confidence in the profession as a whole had been destroyed by the unwise, short-sighted and usually groundless criticisms of his competitors by his family physician. As a natural result it was found that while the individual doctor stood high in the estimation of a few people, his patrons, the profession as a whole occupied a very low place in public

esteem. A broad study of medical history showed that this evil had cursed the profession, and the people dependent upon us in all these matters, for centuries, as it had the clergy and all the other seggregated callings. Members of the legal profession live in the aggregate and in harmony, and for this reason mainly has been dominant in public affairs to an extent not true of all the other vocations combined.

Why the Profession is Entitled to Public Confidence.

A few years ago the physicians of this country were aroused to the enormity of this evil, to its disastrous effects upon both the profession and the people, and probably never in all history did a reform so sweep a vocation as the one for the elimination of this curse of discord did ours, and to-day, regardless of schools, sects or pathies, ours is rapidly becoming one of the most harmonious of the callings. This unrecognized evil had existed so long, however, that it had built up a wall of public sentiment, a more or less fixed habit of thought with the people, which did not disapear with the removal of the cause, and is almost as pronounced as it was a generation ago. The heroism of the profession during epidemics and on the field of battle in all lands and ages, its broad charity in the care of the poor of all countries, its demonstrated practical usefulness in making it possible to forever abolish cholera, yellow fever, bubonic plague, malaria, tuberculosis, typhoid fever and the other pestilences and double the span of human life and happiness, and that in doing these things hundreds of the leaders of the profession lost their lives and now lie in unmarked graves, has as yet made little perceptible change in this sentiment.

Health and Medical Boards More Important than Courts.

Had physicians been as harmonious and as wise as were the lawyers during the constructive period of our government, health and medical boards would have been as much a part of its warp and woof, local, state and national, as are the courts. They ought to have been. because they are more important, just in proportion as health and life. are far more important than mere property interests. We are the only one of the great nations without a central health department. Such a branch of the government at Washington, endowed in proportion to

the power and wealth of the country and the vast interests involved, engaged every day in every year in such research work as would develop the cause and means of prevention of cancer and other diseases not yet understood, with such a comprehensive system of collective investigation as would gather and utilize the facts in regard to the cause of every case of sickness and every death in all parts of the country, and discharging the other proper functions of such a department, is just as much a necessity as the Supreme Court, if the people are to have the protective benefits of modern scientific knowledge.

State, County and City Boards.

For the same reasons, a state board of health, with properly equipped and endowed laboratories to search out the causes of disease peculiar to our own section and climate, and with its members or a trained corps of inspectors and lecturers so supported and with the tenure of office so secure that they could devote their entire lives to their duties, going not only from county to county but from school district to school district in such an educational campaign as would give modern health and life saving knowledge to every teacher, pupil and home. And a real, live board of health in each county and city is as much a necessity of modern life, and can and should be made of as much practical importance to the people, as any court of the jurisdiction could possibly be.

What Order of Man a Health Officer Should Be.

That the county or city health officer may be able to train and equip himself for it as his life work, the office should be taken out of politics once and forever, and the tenure should be made to depend entirely on his devotion to duty, as shown by his comprehensive grasp of and constant improvement in sanitary conditions and the gradual reduction of the sick and death rate. He should be not only an up-todate doctor but in addition should be a graduate from a recognized school of sanitary science, as is uniformly required in all other countries where such work is being done with the greatest benefit to the people. He should have such a salary that he can devote his entire time to the duties of his office. The vocation of health officer and medical practictioner are absolutely incompatible, and it is only a question of time when they will be made. so by legal enactment. It would be just as fair and reasonable to ask the judge to support his family by the practice of

law during his term on the bench as to expect any health officer to do effective work and practice medicine at the same time. If he did his duty he would have no time for practice, and experience everywhere has shown that if he does it as required by modern knowledge with his patrons he would soon have no practice if he had the time. With special training and the devotion of his entire time to his duties as fundamental requirements, and without which real, effective, sustained health work and results are not to be expected, he should have at his command a properly equipped practical laboratory to which any citizen may bring specimens of water, food, expectorated matter, or any other thing suspected as a source of danger to his family, for analysis at public expense. He should have trained inspectors charged with the systematic supervision of dairies, bakeries, slaughter houses and meat shops, groceries and other sources of food. supply and should personally visit and join hands with the teachers in securing proper lighting, heating, water-supply, drainage and especially such ventilation of schools as will protect the health and lives of the children.

The Medical Inspection of Schools.

Next in importance to these conditions in schools, particularly their water supply and ventilation, which are a reproach in most of the school houses of Kentucky, is the systematic examination of every pupil in every school is to the bodily health. When this work was undertaken in New York four years ago 66 per cent, in Philadelphia 64 per cent and in many schools in smaller cities and country districts from 18 to 40 per cent, of the children were found to have enlarged tonsils, adenoids, defective vision, hearing, nutrition or such other physical infirmities as to make the millions of dollars yearly devoted to their education largely a waste. Many of these children had been considered. mental defectives and incorrigibles by the teachers, who at once. came to the front rank as soon as the diseased conditions were removed. In Japan which so excelled us in the protection of its soldiers, 2,000 medical men devote their entire time to this work. New York City employs 150 physicians, who visit each public school every day after 9 o'clock to examine those children set aside by the teacher as requiring attention. Chicago employs nearly 100 medical men in the same. way, who, during the school year ending in June, 1908, examined 406,919 pupils. Under state law, Massachusetts provides for such in