SANITATION AND SOCIAL PROGRESS 633
Scotland sanitation implies statesmanship. It is state medicine, not laboratory medicine, that has re-housed Britain's poor; it is the application of vaccine lymph and the governmental utiliza- tion of antitoxin that have robbed smallpox and diphtheria of their terrors. It is the use, the compulsory use, of tuberculin, and not its discovery, that has purified a meat supply. Lecky had in mind the sanitarian who used his art for the accomplish- ment of needed structural changes in society science as hand- maid to statecraft.
No American historian would have paid such a tribute to the sanitarian. We are not yet in the habit of connecting sanita- tion and sociology. Discussion and responsibility are delegated to the physician, who, himself primarily a student of pathology and disease, tends to emphasize pills rather than public welfare. We laymen, on the other side, think, because the physician is the best possible agent, he makes a safe exclusive guardian of society's health. Councils, legislatures, and congresses pass measures and then turn over the execution of the social will to the physician. Deliberative assemblies have come to appoint public-health committees, but these regard their functions as primarily checks upon the vagaries of enthusiasts or perhaps as burdensome honors. Or perhaps, like the chairman of a public- health committee in the Pennsylvania legislature, they choose
positions on such committees "because there ain't a d thing
to do."
The danger in this excessive specialization is apparent, if the fundamental remedies, like the fundamental motives of sanitary science, lie outside the field of medical science and within that of social science. Legislation is futile unless administrative organs are provided to execute the will of the legislature. Executive officers can do little unless supported by the courts. The attitude of the courts depends, not upon the standards of the physicians, and of text-book writers upon bacteriology, but upon the standards and intelligence of the classes from which courts take their cue. The courts will not permanently admin- ister laws which are opposed by those to whom they owe their existence. In the past the court-sustaining classes have not
