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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.
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