EE SE CR Se a rR) rs Three Million Dollars Spent In Con- servation of Public Health Shows a Saving of Twenty-Three Million Dol- lars to the Commonwealth — Diph. theria, Typhoid and Tuberculosis Give Way Before the Steady Ad- vance of State's Health Officers. EY The precious lives of thou- sande of little children have been spared because the state in its wise beneficence has furnish- ed diphtheria antitoxin to the Typhoid fever is killing 2500 less people per year in Pennsyi- vania than it did four years ago. Tuberculosis now claims 1000 lives less a year in this state. Education and co-operation of the people in health matters, backed by vigorous support of the public press, is helping Com- I missioner Dixon to win out in war against disease. Industries seek states where health records show low death rate. oad) la the last five years the state of Penusylvania has been engaged In conservation work of an extremely important and fundamental kind. With President Roosevelt it believes that the preservation of the people's nat- ural resources should begin with the preservation of the people themselves. The public cannot conscientiously per- mit the wasteful sacrifice of its forests and its other forms of natural wealth, bur even less conscientiously can it permit the wantom sacrifice of its children’s lives. In maintaining a fully equipped state health department and engaging on a large scale in this great warfare against disease, Pennsylvania has tak- en a foremost stand for real modern civilization. The creation of govern- mental agencies for the preservation of the public health marks a new con- ception of governmental responsibil- ity. The work thus far marks only the beginning—merely suggests the good which this department, under the direction of Dr. Samuel G. Dixon, the commissioner, has in view. In the last thirty years the atti. tude of the public towards ill health has radically changed. Until the re- searches of that resourceful genius, T.ouis Pasteur, disclosed the real cauge of contagious diseases, the aver- age man’s conception was practically that which had prevailed in the mid- dle ages. The infections were merely manifestations of the inscrutable wisaom of Providence. expressions of divine wrath; punishments for sinful human kind. Even the scientist re- garded them as fundamental facts of nature, like death itself, which every- one must uncomplainingly accept. Pas. teur. however, in a few masterly ex. periments. brushed aside all this ig- norance and superstition. He showed that all contagious diseases had a clearly defined and obvious origin. They were not mysterious visitations, without tangible cause and insuscep- tible to tangible control. They were caused by an infinitely large universe of infinitely small forms of vegetable and animal life. He demonstrated that the connection between these malevolent micro-organisms and the ensuing disease was as close as that between surlight and heat. And he also immediately drew the inevitable conclusion. If the world were once rid of these organisms, he declared, it would be rid of contagious diseases, “It is now within the power of the world”—such was the deduction whict he drew from his experiments, “to rid itself of all contagious dis. eases.” Setting Pace in Health Work. This was the goal at which Pasteur aimed; that has been the goal at which all movements for improving the people's health have necessarily aimed since. And this was the ulti- matc ambition which led, five years ago, to the organization of the Penn- sylvania State Department of Health, a Pennsylvania in which there shall be no young men and women lan- guishing away with tuberculosis; a Pernsylvania in which no children shall die of diphtheria; a Pennsylva- nia in which there shall be no ty- phoid, nc scarlet fever, no smallpox, no meningitis, no dysentery, no ma- laria—this is the kind of Pennsylvania which the State Department of Health hopes ultimately to create. It does not expect to reach this goal in a year, or ten years, perhaps not in a single generation, but this is the ideal that it has constantly in mind. It re- cognizes the fact that, so long as any of these diseases exist, thelr preva- lonce ig a distinct reproach to the state. It is a reproach simply be- cause the method eliminating them is known. The old theory of government as a power which protects its citi. zens only from foreign foes and native marauders is giving way to new stan. dards of civilization. The greatest enemies to the state are those which are unseen, and the first duty or as enlightened commonwealth is to pro tect its people against them. Other states are gradually rising to this new conception, but Pennsylvania now clearly heads them all, for in no other state is the battle against the common enemy being waged on &3 large a scale as here. The exper: ment, therefore, is not only of ex treme importance to Pennsylvanians, but as an example to the nation anl the world. Does It Pay. Naturally the people are interestel to learn precisely how the large sums | path the state is investing annually in good health is being spent; what are its dividends, as measured in the actual saving of human lives? Is Pennsyl vaniz a richer, a more healthy cormr- monwealth now than it was four yeari ago” Is the average citizen less like ly to acquire a mortal disease—Iless likely to die if he does acquire one? In exchange for its generous appro pristions Pennsylvania has received, firs: of all, a considerable reduction in its death rate. Not so many peoply die here now as died in 1906, the year when the new department began ita organized work. The citizens of Pennsylvania, especially its little chil dren. stand a better chance than they formerly did of reaching mature lifo and a green old age. Mortality sta tistics do not commonly furnish ex- citing reading, but, when considered from this point of view, they make an emphatic personal appeal. Thus, in 1906 and 1907, the death rate in Pennpsylvania per thousand of popula- tion was 16,5; in 1908, it had droppel 0 15.7. and in 1909 to 15.3. At fi'st glance this may not seem a remark. able diminution, but in a state with a population of more than 7,000,000 eve: a fractional decrease is a substantial gain. This appears when one figures precisely what this slight numeric~! drop means in the actual saving of human lives. Had the death rate of 1906 and 1907 prevailed in 1908, pre. cisely 5519 more people would hav? dled than actually succumbed. Had this same rate applied in 1909, insted of the decreased percentage recorded by the Bureau of Health, jnst 838% men, women and children now livin and presumably in good health an! spirits, would have rendered thei: final tribute to nature. In other words these matter of fact statistics, when interpreted in their real relr. tion. to the welfare and happiness n! the state, mean the saving to the stat. of 13,907 lives. Human Lives as State Assets. This fact has an immense person! meening for all people of the state— among these rescued lives might have been your own, your wife's, your child’s; but they also have a val'® which is measurable in dollars and cents. The political economists now recognize that the most valuable kind of wealth is the human life—that hu: man labor is worth at least five times that of all other forms of capital Even the newly landed immigrant, ac- cording to these investigators, has a per capita value of $875; that Is. he adds just that much to the nation’s capital. Professor Irving Fisher. of Yale, one of the foremost American economists, has painstakingly figure’! the financial value to the state of every citizen at particular ages. A new-born infant, says Professor Fish- er. is actually worth $90, while a five. year-old child is worth $950. From this point on his value rapidly ir-| creases: at ten, could he be sold at auction, his market value would be at least $2000; at twenty it would be $4000, and at thirty, $4100. From this point the average human being begins to lose value, in proportion to his de- creasing productivity, until at fifty. Professor Fisher gives him a value of only $700. This same authority places the worth of the average life lost by preventable diseases at $1700. Takiug this as a basis the decreased death rate in Pennsylvania for the last two years represents a money saving of $22,641,900. The state, in other words, is just that much richer-—has just that much more available capital. For its actual expenditure to date of $3,000. 000. including a large portion for per- manent improvements, it has taken in more than $23,000,000. The earnings of the new Department of Health, con- sidered purely from the commercial standpoint, thus represent dividends of mere than 766 per cent in four years. What is the value placed by the av- erage citizen upon his children’s lives —-pot the financial value estimated by the unemotional economist, but the worth in affection, good citizenship and in all that holds the social organi. zation together? Is it good business policy to save the lives of children at $7 apiece? Is it paternalistic and so- clalistic to protect them against dan- gerous infections at the rate of $2 per head? That is what the state of Penn- sylvania is doing now. T%“‘s conserva- tive old commonwealth has reached tha: stage of paternalism where the government will not sit quietly by and watch a little child choke to death with diphtheria when the expenditure of a few dollars from the public treas- ury wil relieve its sufferings and save its life. Saving the Little Ones. For the last ten years the practical remedy for diphtheria has been avail able for the children of prosperous households, but it has not been avail: _able for the poor. Since Von Behring's immortal discovery that the blood serum of a horse which has recovered from diphtheria possessed wonderful gurative properties, and when intro duced into the human organism, would usually destroy the disease, this for- mer scourge of childhood has lost nearly all its terrors. In the old days diphtheria destroyed nearly one-half of all the children it assailed. It would do the same today among the poor in Pennsylvania were it not for the anti toxin which the state provides free. That large numbers of unprotected children have died most shocking deaths in the past for the sole reason that their parents were too poor to afford them anti-toxin, is a melancholy refiection, but these things will not happen in the future. In every corner of Pennsylvania, usually at well known drug stores, there are now stations for the free distribution of anti-toxin, numbering 650. Whenever any poor ‘'s child falls {ll with diphtheria, physician, by making out a proper ication, can secure free all the toxin he needs to effect a cure. Since October, 1905, the Health De- ent has in this way distributed 0,442 packages of anti-toxin. It has 19.929 sick people, mostly chil ren, who, but for the state's inter- «nation, would have been neglected. In the old days about 10,000 of these chil ren would have died; as a matter of et, only 1725 died. Nearly all those who died were children who did not receive the anti-toxin until the late stages of the disease. The detailed statistics of the department show that the earlier the sick child receives the antitoxin, the greater his chances of ; recovery. These facts should empha- size the pressing need, in all cases, not only of anti-toxin treatment, but of this treatment at the earliest pos- sible time. The department has also thoroughly tested the powers of anti- toxin as an immunizing agent. Diph- theria, as every one knows, is one of the most virulently contagious dis- eases. It travels like lightning from the sick to the well. In the crowded homes of the poor, many of them ideal culture tubes for the growth of the microbes, its virulence is especially marked. The department in three years has immunized with anti-toxin 14,527 persons, nearly all children. who had been exposed to the disease. Of these only 251 acquired it—a little more than one per cent. The Stato Department of Health's free distribu- tion of antitoxin to the poor, there. fore, has saved over 8000 lives at an avernge cost of seven dollars each and prevented contagion in several thou- sands of cases at on average cost of two dollars. Battle Against Tuberculosis. In its attitude towards the great problem of tuberculosis, the state gov. ernment also shows this keen sense of responsibility for the safety of the people. The department of health re gards all the tuberculosis poor as in a large sense the wards of the state. Its efforts, in the first place, are to pre- vent them from falling victims to this insidious disease, and in the second. to assist materially In curing those who have become infected. The death rate from tuberculosis in thie state has fallen from 134 to 120 per one thousand of population In four years. This means a saving of 1060 lives annually. In the matter of tuberculosis, how- aver, the death rate tells only a small part of the story. Any work in im- proving conditions must be funda- mental, and. it will necessarily take many years before extensive results are obtained. What the department has done has been to lay the founda- tion of comprehensive attack. From its laboratory investigations of the tubercle bacillus to its especially equipped sanatoria, there is no as- pect of the disease that it does not study and combat. It aims to enter at every stage into the life of the tu- bercuious poor. To many citizens the stat government is more or less of an indefinite idea; they seldom come inte contact with it as a living, acting entity; if you are once stricken with tuberculosis, however, especially if you are poor, the commonwealth of Penn- syivania becomes physically manifest in your daily lives. In the medical in- spection, in the physician and in the purses the state ceases to be an eco- nomic abstraction and becomes a kind, helping, fostering personality. The Dispensaries. if you are stricken down and cannot afford proper medical attendance, there is always near at hand a .cee tu- berculosis dispensary, established for precisely cases of this kind. There are many thousands of patients in the state who are still able to be about and to foliow the daily routine, per- haps even to support their families. The 114 tuberculosis dispensaries are of especial assistance to this class. The dispensary physicians have treat- ed 21,227 patients and actually cured 712, while the condition of 2649 has so greatly improved that the arrest of the disease is almost assured. Here the sick man or woman is received by a professional nurse, who makes a complete first-hand investigation of the case. By questioning the patient she learns all the details of his family history, his occupation, his financial resources, his surroundings, at home or at work—the latter particularly for the purpose of protecting his intimates and associates from infettion. This in- formation she records for the use of the physician, and the department. She follows up this preliminary talk by an inspection at the patient's home. Here her administrations amount to a liberal education in the treatment of tuberculosis. She instructs the patient as to the proper handling of himself— how he must dress, how he must eat and sleep, and tells him of the well known ways of building up the nat- [Continued on page 7.] Ea. Medical. : i I HH Ew 7% pr i 1 FE 5 il £2 i il EF H 4 i 5 : i | | £ i 5 The Century Magazine “The Outlook” says that it is promising artists, and, in season and out of season. Urged upon a people engrossed in busi- ness. Ee eonsnEss and competency in public ce. i Justice to authors. Wholesome conditions in the crowded parts of cities. The larger educational opportunities for i Can any home in America afford to be without THE CENTURY IN 1910? Single copies, $.35, Subscription, $4.00 a year. THE CENTURY CO, 55-5 Union Square, New York. For the Boy or Girl You Love there is a great happiness which can easily bestow. For the Fairy of Happiness lie Spen toevery boy an) girl St. Nicholas The Great Treasure House of Happiness Single copies 25¢c. Yearly Subscriptions, $3.00. 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Significant historical Pennsylvania newspapers