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27 - Evolution of Modern Medicine by Sir William Osler · Evolution of Modern Medicine

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Speaker 1: Section twenty six of the Evolution of Modern Medicine. This
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Speaker 1: is a LibriVox recording. All LibriVox recordings are in the
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Speaker 1: public domain. For more information or to volunteer, please visit
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Speaker 1: LibriVox dot org. Recording by Lurie Wilson. The Evolution of
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Speaker 1: Modern Medicine by Sir William Osler, Chapter six, Rise of
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Speaker 1: preventive Medicine sanitation. When the thoughtful historian gets far enough
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Speaker 1: away from the nineteenth century to see it as a whole,
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Speaker 1: no single feature will stand out with greater distinctness than
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Speaker 1: the fulfillment of the prophecy of Descartes, that we could
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Speaker 1: be freed from an infinity of maladies, both of body
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Speaker 1: and mind, if we had sufficient knowledge of their causes
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Speaker 1: and all the remedies with which nature has provided us.
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Speaker 1: Sanitation takes its place among the great modern revolutions, political, social,
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Speaker 1: and intellectual. Great Britain deserves the credit for the first
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Speaker 1: practical recognition of the maxim cellous popularized supremea elects in
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Speaker 1: the middle and the latter part of the century, a
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Speaker 1: remarkable group of men Southwood Smith, Chadwick, Bud Murchison, Simon Ackland, Buchanan, J. W.
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Speaker 1: Russell and Benjamin Ward Richardson put practical sanitation on a
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Speaker 1: scientific basis. Even before the full demonstration of the germ theory,
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Speaker 1: they had grasped the conception that the battle had to
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Speaker 1: be fought against a living contagion which found in poverty, filth,
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Speaker 1: and wretched homes the conditions for its existence. One terrible
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Speaker 1: disease was practically wiped out in twenty five years of
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Speaker 1: hard work. It is difficult to realize that within the
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Speaker 1: memory of men now living, typhus fever was one of
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Speaker 1: the great scourges of our large cities, and broke out
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Speaker 1: in terrible epidemics, the most fatal of all to the
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Speaker 1: medical profession. In the severe epidemic in Ireland in the
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Speaker 1: forties of the last century, one fifth of all the
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Speaker 1: doctors in the island died of typhus. A better idea
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Speaker 1: of the new cusade made possible by new knowledge is
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Speaker 1: to be had from a consideration of certain diseases against
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Speaker 1: which the fight is in active progress. Nothing illustrates more
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Speaker 1: clearly the interdependence of the sciences than the reciprocal impulse
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Speaker 1: given to new researches in pathology and entomology by the
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Speaker 1: discovery of the part played by insects in the transmission
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Speaker 1: of disease. The flea, the laos, the bedbug, the house fly,
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Speaker 1: the mosquito, the tick have all, within a few years
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Speaker 1: taken their place as important transmitters of disease. The fly
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Speaker 1: population may be taken as the sanitary index of a place.
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Speaker 1: The discovery, too, that insects are porters of disease has
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Speaker 1: led to a great extension of our knowledge of their
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Speaker 1: life history. Early in the nineties, when doctor Thayer and
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Speaker 1: I were busy with the study of malaria and Baltimore,
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Speaker 1: we began experiments on the possible transmission of the parasites,
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Speaker 1: and a tramp who had been a medical student, offered
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Speaker 1: himself as a subject. Before we began, doctor theer sought
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Speaker 1: information as to the varieties of mosquitoes known in America,
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Speaker 1: but sought in vain. There had at that time been
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Speaker 1: no systematic study. The fundamental study which set us on
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Speaker 1: the track was a demonstration by Patrick Manson in eighteen
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Speaker 1: seventy nine of the association of hilarian disease with the mosquito.
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Speaker 1: Many observations had already been made, and were made subsequently
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Speaker 1: on the importance of insects as intermediary hosts in the
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Speaker 1: animal parasites. But the first really great scientific demonstration of
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Speaker 1: a widespread infection through insects was by Theobald Smith now
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Speaker 1: of Harvard University in eighteen eighty nine in the study
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Speaker 1: of Texas fever of cattle. I well remember the deep
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Speaker 1: impression made upon me by his original communication, which, in completeness,
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Speaker 1: inaccuracy of detail, in Harvean precision, and in practical results,
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Speaker 1: remains one of the most brilliant pieces of experimental work
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Speaker 1: ever undertaken. It is difficult to draw comparisons in pathology,
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Speaker 1: but I think if a census were taken among the
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Speaker 1: world's workers on disease, the judgment to be based on
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Speaker 1: the damage to health and direct mortality, the votes would
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Speaker 1: be given to malaria as the greatest single destroyer of
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Speaker 1: the human race. Cholera kills its thousands plagues in its
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Speaker 1: bad years, its hundreds of thousands, yellow fever, hookworm disease, pneumonia,
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Speaker 1: tuberculosis are all terribly destructive, some only in the tropics,
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Speaker 1: others in more temperate regions. But malaria is today as
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Speaker 1: it ever was, a disease to which the word pandemic
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Speaker 1: is especially applicable in this country and in Europe its
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Speaker 1: ravages have lessened enormously during the past century, but in
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Speaker 1: the tropics it is everywhere and always present, the greatest
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Speaker 1: single foe of the white man, and at times in
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Speaker 1: places it assumes the proportions of a terrible epidemic. In
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Speaker 1: one district of India alone, during the last four months
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Speaker 1: of nineteen eight one quarter of the total population suffered
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Speaker 1: from the disease, and there were four hundred thousand deaths,
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Speaker 1: practically all from malaria. The day. The control of this
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Speaker 1: terrible scourge is in our hands, and as I shall
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Speaker 1: tell you in a few minutes, largely because of this control,
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Speaker 1: the Panama Canal is being built. No disease illustrates better
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Speaker 1: the progressive evolution of scientific medicine. It is one of
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Speaker 1: the oldest of the known diseases. The Greeks and Greco
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Speaker 1: Romans knew it well. It seems highly probable, is brought
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Speaker 1: out by the studies of W. H. S. Jones of Cambridge,
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Speaker 1: that impart at least the physical degeneration in Greece and
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Speaker 1: Rome may have been due to the great increase of
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Speaker 1: this disease. Its clinical manifestations were well known and admirably
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Speaker 1: described by the older writers. In the seventeenth century, as
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Speaker 1: I have already told you, the remarkable discovery was made
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Speaker 1: that the bark of the Sincona tree was a specific
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Speaker 1: Between the date of the Countess's recovery in Lima and
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Speaker 1: the year eighteen eighty, a colossal literature on the disease
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Speaker 1: had accumulated. Literally thousands of workers had studied the various
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Speaker 1: aspects of its many problems. The literature of this country,
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Speaker 1: particularly if the southern states, in the first half of
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Speaker 1: the last century, may be said to be predominantly malarial.
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Speaker 1: Ordinary observation carried on for long centuries, had done as
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Speaker 1: much as was possible. In eighteen eighty, a young French
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Speaker 1: army surgeon, Leaverin by name, working in Algiers, found in
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Speaker 1: the microscopic examination of the blood that there were little
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Speaker 1: bodies in the red blood corpuscles amebioid in character, which
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Speaker 1: he believed to be the germs of the disease. Very
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Speaker 1: little attention was at first paid to his work, and
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Speaker 1: it is not surprising it was the old story of
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Speaker 1: wolf wolf. There had been so many supposed germs that
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Speaker 1: the profession had become suspicious. Several years elapsed before Surgeon
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Speaker 1: General Sternberg called the attention of the English speaking world
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Speaker 1: to Laveran's work. It was taken up actively in Italy
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Speaker 1: and in America by councilmen Abbot, and by others, among
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Speaker 1: us in Baltimore. The result of these widespread observations was
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Speaker 1: the confirmation in every respect of Laveran's discovery of the
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Speaker 1: association with malaria of a protozoan parasite. This was step
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Speaker 1: number three clinical observation, empirical discovery of the cure, determination
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Speaker 1: of the presence of a parasite. Two other steps followed rapidly.
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Speaker 1: Another Army surgeon, Ronald Ross, working in India, influenced by
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Speaker 1: the work of Manson, proved that the disease was transmitted
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Speaker 1: by certain varieties of mosquitoes. Experiments came in to support
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Speaker 1: the studies in ideology. Two of those may be quoted.
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Speaker 1: Mosquitoes which had bitten malarial patients in Italy were sent
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Speaker 1: to London and there allowed to bite mister Manson, son
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Speaker 1: of doctor Manson. This gentleman had not lived out of England,
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Speaker 1: where there is now no acute malaria. He had been
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Speaker 1: a perfectly healthy strong man. In a few days following
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Speaker 1: the bites of the infected mosquitoes, he had a typical
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Speaker 1: attack of malarial fever. The other experiment, though of a
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Speaker 1: different character, is quite as convincing. In certain regions about
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Speaker 1: rome in the camp and Theia, malary is so prevalent
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Speaker 1: that in the autumn almost every one in the district
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Speaker 1: is attacked, particularly if he is a newcomer. Doctor Sambon
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Speaker 1: and a friend lived in this district from June first
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Speaker 1: to September first, nineteen hundred. The test was whether they
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Speaker 1: could live in this exceedingly dangerous climate for the three
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Speaker 1: months without catching malaria if they used stringent precautions against
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Speaker 1: the bites of mosquitoes. For this purpose, the hut in
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Speaker 1: which they lived was thoroughly wired and they slept under netting.
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Speaker 1: Both of these gentlemen, at the end of the period
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Speaker 1: had escaped the disease. Then came the fifth and final
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Speaker 1: triumph the prevention of the disease, the anti malarial crusade,
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Speaker 1: which has been practiced by Sir Ronald Ross and has
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Speaker 1: been carried out successfully on a wholesale scale in Italy
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Speaker 1: and in parts of India and Africa. Has reduced enormously
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Speaker 1: the incidents of the disease. Professor Chelley of Rome, in
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Speaker 1: his lecture room has an interesting chart which shows the
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Speaker 1: reduction of the mortality from malaria in Italy. Since the
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Speaker 1: preventative measures have been adopted. The deaths have fallen from
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Speaker 1: above twenty eight thousand and eighteen eighty eight to below
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Speaker 1: two thousand in nineteen ten. There is needed a stirring
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Speaker 1: campaign against the disease throughout the southern states of this country.
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Speaker 1: The story of yellow fever illustrates one of the greatest
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Speaker 1: practical triumphs of scientific medicine. Indeed, in view of its
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Speaker 1: far reaching commercial consequences, it may range as one of
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Speaker 1: the first achievements of the race. Ever since the discovery
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Speaker 1: of America, the disease has been one of its great scourges,
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Speaker 1: permanently endemic in the Spanish main often extending to the
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Speaker 1: southern States, occasionally into the North, and not infrequently it
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Speaker 1: has crossed the Atlantic. The records of the British Army
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Speaker 1: in the West Indies show an appalling death rate chiefly
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Speaker 1: from this disease. At Jamaica for the twenty years ending
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Speaker 1: in eighteen thirty six, the average mortality was one hundred
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Speaker 1: one per thousand, and in certain instances as high as
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Speaker 1: one hundred seventy eight, one of the most dreaded of
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Speaker 1: all infections. The periods of epidemics in the Southern States
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Speaker 1: have been the occasions of a widespread panic with complete
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Speaker 1: paralysis of commerce. How appalling the mortality is may be
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Speaker 1: judged from the outbreak in Philadelphia in seventeen ninety three,
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Speaker 1: when ten thousand people died in three months. The epidemics
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Speaker 1: in Spain in the early part of the nineteenth century
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Speaker 1: were of great severity. A glance through Larosia's great books
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Speaker 1: on the subject soon gives one an idea of the
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Speaker 1: enormous importance of the disease in the history of the
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Speaker 1: Southern States. Havana, ever since its foundation, had been a
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Speaker 1: hotbed of yellow fever. The best minds of the profession
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Speaker 1: had been attracted to a solution of the problem, but
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Speaker 1: all in vain. Commission after commission had been appointed with
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Speaker 1: negative results. Various organisms had been described as the cause,
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Speaker 1: and there were sad illustrations of the tragedy associated with
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Speaker 1: investigations undertaken without proper training or proper technique. By the
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Speaker 1: year a hundred. Not only had the ground been cleared,
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Speaker 1: but the work on insect born disease by Manson and
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Speaker 1: by Ross had given observers and important clue. It had
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Speaker 1: repeatedly been suggested that some relation existed between the bites
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Speaker 1: of mosquitos and the tropical fevers, particularly by the remarkable
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Speaker 1: student not of Mobile and the French physician Baupurthi. But
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Speaker 1: the first to announce clearly the mosquito theory of the
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Speaker 1: disease was Carlos Finlay of Havana. Early in the spring
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Speaker 1: of nineteen hundred, during the occupation of Cuba by the
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Speaker 1: United States, a commission appointed by Surgeon General Sternberg, himself
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Speaker 1: one of the most energetic students of the disease, undertook
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Speaker 1: fresh investigations. Doctor Walter Reid, professor of bacteriology in the
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Speaker 1: Army Medical School, was placed in charge. Doctor Carroll of
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Speaker 1: the United States Army, doctor Agramonte of Havana, and doctor
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Speaker 1: Jesse W. Lazer were the other members at the Johns
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Speaker 1: Hopkins Hospital. We were deeply interested in the work, as
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Speaker 1: doctor Walter Reid was a favorite pupil of Professor Welch,
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Speaker 1: a warm friend of all of us, and a frequent
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Speaker 1: visitor to our laboratories. Doctor Jesse Lazier, who had been
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Speaker 1: my house physician, had worked with doctor Thayer and myself
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Speaker 1: at malaria, and gave up the charge of my clinical
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Speaker 1: laboratory to join the commission. Many scientific discoveries have afforded
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Speaker 1: brilliant illustrations of method and research, But in the work
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Speaker 1: of these men, one is at a loss to know
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Speaker 1: which to admire more, the remarkable accuracy and precision of
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Speaker 1: the experiments, or the heroism of the men officers and
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Speaker 1: rank and file of the United States Army. They knew
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Speaker 1: all the time that they were playing with death, and
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Speaker 1: some of them had to pay the penalty. The demonstration
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Speaker 1: was successful beyond peradventure that yellow fever could be transmitted
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Speaker 1: by mosquitoes, and equally the negative proposition that it could
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Speaker 1: not be transmitted by fomites. An interval of twelve or
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Speaker 1: more days was found to be necessary after the mosquito
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Speaker 1: has bitten a yellow fever patient, before it is capable
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Speaker 1: of transmitting the infection. Lazir permitted himself to be bitten
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Speaker 1: by a stray mosquito while conducting his experiments in the
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Speaker 1: Yellow Fever hospital, bitten on the thirteenth. He sickened on
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Speaker 1: the eighteenth and died on the twenty fifth of September,
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Speaker 1: but not until he had succeeded in showing in two
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Speaker 1: instances that mosquitoes could convey the infection. He added another
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Speaker 1: to the long list of members of the profession who
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Speaker 1: have laid down their lives in search of the causes
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Speaker 1: of disease. Of such men as Lazir and of Myers
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Speaker 1: of the Liverpool Yellow Fever Commission, Dutton and young Manson
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Speaker 1: may fitly be sung from the noblest of American poems,
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Speaker 1: the tribute which Lowell paid to Harvard's sons who fell
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Speaker 1: in the War of Secession. Many in sad fa faith
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Speaker 1: sought for her. Many with crossed hands sighed for her.
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Speaker 1: But these our brothers fought for her at life's dear peril,
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Speaker 1: wrought for her, so loved her that they died for her. Fortunately,
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Speaker 1: the commander in chief at the time in Cuba was
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Speaker 1: General Leonard Wood, who had been an army surgeon, and
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Speaker 1: he was the first to appreciate the importance of the discovery.
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Speaker 1: The sanitation of Havana was placed in the hands of
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Speaker 1: doctor Gorges, and within nine months the city was cleared
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Speaker 1: of yellow fever, and with the exception of a slight
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Speaker 1: outbreak after the withdrawal of the American troops, has since
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Speaker 1: remained free from a disease which had been its scourge
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Speaker 1: for centuries. As General Wood remarked, Reed's discovery has resulted
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Speaker 1: in the saving of more lives annually than were lost
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Speaker 1: in the Cuban War, and saves the commercial interests of
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Speaker 1: the world a greater financial loss each year than the
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Speaker 1: cost of the Cuban War. He came to Cuba at
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Speaker 1: a time when one third of the officers of my
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Speaker 1: staff died of yellow feace, and we were discouraged at
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Speaker 1: the failure of our efforts to control it. Following the
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Speaker 1: example of Havana, other centers were attacked at Vera Cruz
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Speaker 1: and in Brazil with the same success. And it is
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Speaker 1: safe to say that now, thanks to the researches of
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Speaker 1: Reed and his colleagues, with proper measures, no country need
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Speaker 1: fear of paralyzing outbreak of this once dreaded disease. The
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Speaker 1: scientific researches in the last two decades of the nineteenth
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Speaker 1: century made possible the completion of the Panama Canal, the
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Speaker 1: narrow Isthmus, separating the two great oceans and joining the
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Speaker 1: two great continents, has borne for four centuries and evil
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Speaker 1: repute as the white Man's grave silent upon a peak
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Speaker 1: of Darien, as stout Cortes with eagle eye had gazed
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Speaker 1: on the Pacific. As early as fifteen twenty, Salvedra proposed
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Speaker 1: to cut a canal through the Isthmus. There the first
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Speaker 1: city was founded by the conquerors of the New World,
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Speaker 1: which still bears the name of Panama. Spaniards, English and
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Speaker 1: French fought along its coasts. Touett, the founder of the
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Speaker 1: Bank of England, took his ill fated colony Raleigh. Drake Morgan,
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Speaker 1: the buccaneer, and scores of adventurers seeking gold found in
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Speaker 1: Fever an enemy stronger than the Spaniard. For years, the
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Speaker 1: plague stricken Isthmus was abandoned to the Negroes and the
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Speaker 1: half breeds, until in eighteen forty nine, stimulated by the
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Speaker 1: gold fever of California, a railway was begun by the
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Speaker 1: American engineers Tauton and Troutwine, and completed in eighteen fifty five,
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Speaker 1: a railway, every tie of which cost the life of
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Speaker 1: a man. The dream of navigators and practical engineers was
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Speaker 1: taken in hand by Ferdinand de Lesseps in January eighteen
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Speaker 1: eighty one. The story of the French Canal Company is
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Speaker 1: a tragedy unparalleled in the history of finance, and one
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Speaker 1: may add in the ravages of tropical disease yellow fever
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Speaker 1: dysentery typhus carried off in nine years nearly twenty thousand employees.
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Speaker 1: The mortality frequently rose above one hundred, sometimes to one
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Speaker 1: thirty one forty, and in September eighteen eighty five it
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Speaker 1: reached the appalling figure of one hundred seventy six point
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Speaker 1: ninety seven per thousand work people. This was about the
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Speaker 1: maximum death rate of the British Army in the West
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Speaker 1: Indies in the nineteenth century. When in nineteen four the
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Speaker 1: United States undertook to complete the canal, everyone felt that
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Speaker 1: the success or failure was largely a matter of sanitary control.
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Speaker 1: The necessary knowledge existed, but under the circumstances could it
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Speaker 1: be made effective? Many were doubtful. Fortunately, there was at
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Speaker 1: the time in the United States Army a man who
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Speaker 1: had already served an apprenticeship in Cuba, and to whom,
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Speaker 1: more than to any one else was due the disappearance
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Speaker 1: of yellow fever from that island. To a man, the
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Speaker 1: profession of the United States felt that could doctor Gorges
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Speaker 1: be given full control of the sanitary affairs of the
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Speaker 1: Panama zone the health problem, which meant the canal problem
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Speaker 1: could be solved. There was at first a serious difficulty
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Speaker 1: relating to the necessary administrative control by a sanitary officer.
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Speaker 1: In an interview which doctor Welson I had with President Roosevelt,
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Speaker 1: he keenly felt this difficulty and promised to do his
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Speaker 1: best to have it rectified. It is an open secret
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Speaker 1: that at first, as was perhaps only natural, matters did
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Speaker 1: not go very smoothly, and it took a year or
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Speaker 1: more to get properly organized. Yellow fever recurred on the
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Speaker 1: Isthmus in nineteen four and in the early part of
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Speaker 1: nineteen five. It was really a colossal task in itself
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Speaker 1: to undertake the cleaning of the city of Panama, which
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Speaker 1: had been for centuries a pest house. The mortality in which,
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Speaker 1: even after the American occupation, reached during one month the
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Speaker 1: rate of seventy one per thousand living. There have been
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Speaker 1: a great many brilliant illustrations of the practical application of
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Speaker 1: science in preserving the health of a community and in
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Speaker 1: saving life. But it is safe to say that, considering
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Speaker 1: the circumstances, the past history, and the extraordinary difficulties to
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Speaker 1: be overcome, the work accomplished by the Isthmian Canal Commission
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Speaker 1: is unique. The year nineteen five was devoted to organization.
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Speaker 1: Yellow fever was got rid of, and at the end
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Speaker 1: of the year the total mortality among the whites had
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Speaker 1: fallen to eight per thousand, but among the blacks it
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Speaker 1: was still high forty four. For three years, with a
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Speaker 1: progressively increasing staff, which had risen to above forty thousand,
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Speaker 1: of whom more than twelve thousand were white, the death
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Speaker 1: rate progressively fell. Of the six important tropical diseases, plague,
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Speaker 1: which reached the Isthmus one year, was quickly held in check.
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Speaker 1: Yellow fever, the most dreaded of them all, never recurred.
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Speaker 1: Berry berry, which in nineteen six caused sixty eight deaths,
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Speaker 1: has gradually disappeared. The hookworm disease ankylostomiasis has steadily decreased
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Speaker 1: from the very outset. Malaria has been taken as the
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Speaker 1: measure of sanitary efficiency throughout the French occupation. It was
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Speaker 1: the chief enemy to be considered not only because of
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Speaker 1: its fatality, but on account of the prolonged incapacity following infection.
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Speaker 1: In nineteen six, out of every one thousand employees there
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Speaker 1: were admitted to the hospital from malaria eight hundred twenty
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Speaker 1: one in nineteen seven, four hundred twenty four in nineteen eight,
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Speaker 1: two hundred eighty two in nineteen twelve, one hundred ten
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Speaker 1: in nineteen fifteen fifty one in nineteen seventeen fourteen. The
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Speaker 1: fatalities from the disease have fallen from two hundred thirty
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Speaker 1: three in nineteen six to one hundred fifty four in
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Speaker 1: nineteen seven, to seventy three in nineteen eight, and to
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Speaker 1: seven in nineteen fourteen. The death rate from malarial fever
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Speaker 1: per one thousand population sank from eight point four nine
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Speaker 1: in nineteen six to zero point one point one in
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Speaker 1: nineteen eighteen. Dysentery, next to malaria, the most serious of
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Speaker 1: the tropical diseases in the zone, caused sixty nine deaths
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Speaker 1: in nineteen six, forty eight in nineteen seven, in nineteen
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Speaker 1: eight with nearly forty four thousand, only sixteen deaths, and
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Speaker 1: in nineteen fourteen four But it is when the general
22:33
Speaker 1: figures are taken that we see the extraordinary reduction that
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Speaker 1: has taken place. Out of every one thousand engaged in
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Speaker 1: nineteen eight, only a third of the number died that
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Speaker 1: died in nineteen six, and half the number that died
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Speaker 1: in nineteen seven. In nineteen fourteen, the death rate from
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Speaker 1: disease among white males had fallen to three point one
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Speaker 1: three per thousand. The rate among the two thousand, six
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Speaker 1: hundred seventy four American women children connected with the Commission
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Speaker 1: was only nine point seven two per thousand. But by
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Speaker 1: far the most gratifying reduction is among the blacks, among
23:09
Speaker 1: whom the rate from disease had volunto the surprisingly low
23:12
Speaker 1: figure in nineteen twelve of eight point seven seven per thousand.
23:17
Speaker 1: In nineteen six it was forty seven per thousand. A
23:20
Speaker 1: remarkable result that in nineteen eight, the combined tropical diseases malaria,
23:26
Speaker 1: dysentery and barry berry killed fewer than the two great
23:30
Speaker 1: killing diseases of the temperate zone, pneumonia and tuberculosis, one
23:34
Speaker 1: hundred twenty seven in one group and one hundred thirty
23:37
Speaker 1: seven in the other. The whole stories expressed in two words,
23:42
Speaker 1: effective organization and the special value of this experiment in
23:47
Speaker 1: sanitation is that it has been made and made successfully
23:52
Speaker 1: in one of the great plague spots of the world.
23:55
Speaker 1: Month by month, a little gray covered pamphlet was published
23:57
Speaker 1: by Colonel Gorgis, a court of the Department of Sanitation
24:02
Speaker 1: of the Isthmian Canal Commission. I have been one of
24:05
Speaker 1: the favored to whom it has been sent year by year,
24:08
Speaker 1: and keenly interested, as I have always been, in infectious diseases,
24:12
Speaker 1: and particularly I malary and dysentery. I doubt if anyone
24:16
Speaker 1: has read it more faithfully in evidence of the extraordinary
24:20
Speaker 1: events made in sanitation by Gorgis, I give a random
24:24
Speaker 1: example from one of his monthly reports. Nineteen twelve, in
24:28
Speaker 1: a population of more than fifty two thousand, the death
24:31
Speaker 1: rate from disease had fallen to seven point thirty one
24:34
Speaker 1: per thousand. Among the whites it was two point eight zero,
24:39
Speaker 1: and among the colored people eight point seven seven. Not
24:42
Speaker 1: only is the profession indebted to Colonel Gorgis and his
24:46
Speaker 1: staff for this remarkable demonstration, but they have offered an
24:50
Speaker 1: example of thoroughness and efficiency, which is one the admiration
24:54
Speaker 1: of the whole world. As J. B Bishop, secretary of
24:57
Speaker 1: the Ismine Canal Commission, has recently said, quote, The Americans
25:02
Speaker 1: arrived on the Isthmus in the full light of these
25:04
Speaker 1: two invaluable discoveries the insect transmission of yellow fever in Malaria.
25:10
Speaker 1: Scarcely had they begun active work when an outbreak of
25:13
Speaker 1: yellow fever occurred, which caused such a panic throughout their
25:17
Speaker 1: force that nothing except the lack of steamship accommodation prevented
25:21
Speaker 1: the flight of the entire body from the Isthmus. Prompt
25:24
Speaker 1: intelligent and vigorous application of the remedies shown to be
25:28
Speaker 1: effective by the Mosquito discoveries not only checked the progress
25:32
Speaker 1: of the pest, but banished it forever from the Isthmus.
25:35
Speaker 1: In this way, and in this alone, was the building
25:38
Speaker 1: of the canal made possible. The supreme credit for its
25:42
Speaker 1: construction therefore belongs to the brave men surgeons of the
25:46
Speaker 1: United States Army, who, by their high devotion to duty
25:49
Speaker 1: and to humanity, risked their lives in Havana in nineteen
25:53
Speaker 1: hundred to nineteen one to demonstrate the truth of the
25:56
Speaker 1: mosquito theory. Unquote. One disease has still a special claim
26:01
Speaker 1: upon the public in this country. Some fourteen or fifteen
26:05
Speaker 1: years ago, in an address on the problem of a
26:07
Speaker 1: typhoid fever in the United States, I contended that the
26:11
Speaker 1: question was no longer in the hands of the profession.
26:14
Speaker 1: In season and out of season, we had preached salvation
26:17
Speaker 1: from it in volumes which filled state reports, public health journals,
26:22
Speaker 1: and the medical periodicals. Though much has been done, typhoid
26:27
Speaker 1: fever remains a question of grave national concern. You lost
26:31
Speaker 1: in this state in nineteen eleven from typhoid fever, one
26:35
Speaker 1: hundred fifty four lives. Every one sacrificed needlessly, every one
26:40
Speaker 1: a victim of neglect and incapacity. Between twelve hundred and
26:45
Speaker 1: fifteen hundred persons had a slow, lingering illness. A nation
26:50
Speaker 1: of contradictions and paradoxes. A clean people by whom personal
26:54
Speaker 1: hygiene is carefully cultivated, but it has displayed in matters
26:58
Speaker 1: of public sanitation, a carelessness simply criminal. A sensible people
27:03
Speaker 1: among whom education is more widely diffused than in any
27:07
Speaker 1: other country. Supinely acquiesces in conditions often shameful beyond expression.
27:13
Speaker 1: The solution of the problem is not very difficult. What
27:16
Speaker 1: has been done elsewhere can be done here. It is
27:20
Speaker 1: not so much in the cities, though here too the
27:22
Speaker 1: death rate is still high, but in the smaller towns
27:25
Speaker 1: and rural districts, in many of which the sanitary conditions
27:29
Speaker 1: are still those of the Middle Ages. How Galen would
27:33
Speaker 1: have turned up his nose with content at the water
27:35
Speaker 1: supply of the capital of the Dominion of Canada scourged
27:39
Speaker 1: so disgracefully by typhoid fever of late There is no
27:42
Speaker 1: question that the public is awakening, but many state boards
27:46
Speaker 1: of health need more efficient organization and larger appropriations. Others
27:51
Speaker 1: are models, and it is not for lack of example
27:54
Speaker 1: that many lag behind. The health officer should have special
27:58
Speaker 1: training in sanitary science, and special courses leading to diplomas
28:03
Speaker 1: and public health should be given in the medical schools.
28:07
Speaker 1: Where the health of the people made a question of
28:09
Speaker 1: public and not of party policy, only a skilled expert
28:13
Speaker 1: could possibly be appointed as a public health officer, not,
28:17
Speaker 1: as it is now so often the case, the man
28:20
Speaker 1: with the political poll. It is a long and tragic
28:24
Speaker 1: story in the annals of this country that distinguished man,
28:27
Speaker 1: the first professor of physics in this university in the
28:30
Speaker 1: early years of last century, doctor Nathan Smith, in that
28:34
Speaker 1: notable monograph on Typhus Fever eighteen twenty four, tells how
28:39
Speaker 1: the disease had followed him in his various migrations from
28:43
Speaker 1: seventeen eighty seven, when he began to practice, all through
28:46
Speaker 1: his career, and could have returned this year in some
28:50
Speaker 1: one hundred and forty or one hundred and fifty families
28:53
Speaker 1: of the state, he would find the same miserable tragedy
28:56
Speaker 1: which he had witnessed so often, in the same heedless
28:59
Speaker 1: sacrifice the young on the altar of ignorance and incapacity
29:04
Speaker 1: in the section twenty six