beginning of what must be done if we are to check the insidious influences which prepare the ground for the tubercle germ.
Final!}', the veterans of our army, who have resisted all earlier attacks, are exposed to their own peculiar dangers. Diseases of the heart and arteries, Bright's disease, and cancer together carry off 300,000 men and women every year, and we are face to face with the sinister fact that while at every other point of the battle line we are at least holding our own, these diseases of later life appear to be actually on the increase. Yet in any individual case, we know that the appropriate advice as to the hygienic conduct of a defective bodily mechanism would prolong life, often by many years.
If we really want to prevent preventable diseases, we must supply the machinery, the fortifications and munitions of war to use against the enemy. We must install effective water purification plants and adequate systems of sewerage and sewage disposal. We must provide infant welfare stations in the proportion of one for every 20,000 of the population, if the death rate of infants is to be effectively reduced. We must have adequate systems of medical school inspection and school nurses, not one for each 2,500 school children, but one for every 1,000, if our young soldiers of peace are to come to maturity in full vigor and free from physical defects. We must build contagious-disease hospitals, with a capacity of one bed for every 2,000 of the population. We must provide tuberculosis hospitals with a capacity of one bed for every 1,000 of the population for the cure of early and the isolation of advanced cases of this disease, and corps of visiting nurses to find incipient cases and secure proper care for patients in the home.
It is the health officer who must ultimately furnish expert guidance and leadership for the public health campaign. One of the most unfortunate aspects of the present situation is that too often the public distrusts its natural sanitary leaders, and sometimes the health officer is so blind to his opportunities that other agencies must perforce step into the breach. The most substantial progress can only be made, however, when constructive initiative and legal authority are conjoined. It is essential that the task of officering the army of the public health should be entrusted only to trained and experienced experts, qualified by knowledge and disposition for their work. Having obtained such men, the local and state departments of health must be given adequate powers and liberal appropriations. Fifty cents per capita should be a minimum for the city, and twenty cents per capita for the state, if the organization of the general health campaign is to be efficiently maintained.
All this will cost money—perhaps five or ten times what we are to-day devoting to our national defense against diseases. The United States spends each year three hundred millions of dollars for protection
