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H

TO

MY WIFE

PREFACE

This book has been written in response to a demand for a treatise based upon modern progress in hygiene and sanitation. The work is planned to include those fields of the medical and related sciences which form the foundation of public health work. So far as I know, no other book on the subject covers the broad field considered in this volume. The progress in hygiene and sanitation has been so rapid that the subject of preventive medicine has become a specialty, and its scope has become so broad that the question throughout the making of this book has been rather what to leave out than what to include. The facts here brought together are widely scattered in the literature and many of them are difficult of access; they have been collected for the convenience of the student of medicine and the physician, as well as those engaged in sanitary engineering or public health work.

During twenty-three years of varied experience in public health work it has been my good fortune to have served as quarantine officer, in epidemic campaigns, in epidemiological investigations, and in public health laboratories, at home, on the Continent, and in the tropics. The fruits of these experiences are reflected in this book, which may be taken as representing my personal views gained in the field, in the laboratory, in the classroom, and in administrative offices.

It is wellnigh impossible to prevent or suppress a communicable disease without a knowledge of its mode of transmission. This is the most important single fact for successful personal prophylaxis, as well as in the general warfare against infection; therefore, the communicable diseases have been grouped in accordance with their modes of transference. Each one of the important communicable diseases is discussed separately in order to bring out the salient points upon which prevention is based. The classification adopted is believed to be unique and should prove helpful to those who are especially concerned in the prevention of infection.

The book may be considered in two parts, namely, that which deals with the person (hygiene) and that which deals with the environment (sanitation). The first part includes the prevention of the communicable diseases, venereal prophylaxis, heredity, immunity, eugenics, and similar subjects. The second part deals with our environment in its relation to health and disease and includes a discussion of food, water, air, soil, disposal of wastes, vital statistics, diseases of occupation, industrial hygiene, school hygiene, disinfection, quarantine, isolation, and other topics of sanitary importance, as well as subjects of interest to health officers. All the important methods used in public health laboratories are described.

To have made this book in monographic style with references to authorities for every statement would have resulted in an unwieldy work of impractical size and form. The textbook style has therefore been adopted and citation of authorities for facts that are now well established has been regarded as unnecessary. In this respect it may seem that I have given scant credit to many workers from whose writings I have borrowed results, thoughts, and sometimes words or even sentences. At the end of each chapter will be found a list of references to articles or books that I have especially drawn upon, and I desire to acknowledge my obligations to these sources as well as to refer the reader to them for further study of particular subjects. I have also drawn freely upon my own previous writings and those of my co-workers in compiling this book. The chapter on “Disinfection” is based upon my book entitled: “Disinfection and Disinfectants,” published by P. Blakiston's Sons & Co., Philadelphia, 1902.

I have received generous help from a number of friends and it is a pleasure here to acknowledge especially my obligation to Dr. David L. Edsall for reading and correcting the chapter on “Diseases of Occupation," to Dr. John F. Anderson and Dr. Joseph Goldberger for revising the chapters upon “Measles” and “Typhus Fever," to Prof. George C. Whipple for reading and improving the chapter upon "Water," to Charles T. Brues for many suggestions in the section upon insect-borne diseases, and to Prof. W. E. Castle for a similar service with the section on “Heredity.” Dr. Charles Wardell Stiles has kindly furnished information concerning the relation of parasites to soil. I also desire to express my obligations to Prof. Arthur I. Kendall, Dr. Harold L. Amoss,

Dr. Lewis W. Hackett, Prof. William D. Frost, and Miss Emily G. Philpotts.

It has been my object to give in this volume the scientific basis upon which the prevention of disease and the maintenance of health must rest. Exact knowledge has taken the place of fads and fancies in hygiene and sanitation; the capable health officer now possesses facts concerning infections which permit their prevention and even their suppression in some instances. Many of these problems are complicated with economic and social difficulties, which are given due consideration, for preventive medicine has become a basic factor in sociology.

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