is responsible, in damages, for negligence in permitting the spread of a contagious disease from their hospitals. A patient with smallpox, in his delirium, escaped from the guard and communicated the disease to a citizen. Justice Brown, in affirming the verdict. of the lower court, awarding damages to the plaintiff, says: "The railroad company is liable to appellee, Wood, for damages caused to him by reason of smallpox being communicated to him and his family by Dickson (an employe) through the negligence of an agent of the railroad company." "The evidence is suffi * * * * * * the judg cient to show liability of the appellant, and ment is affirmed." (M., K. & T. R. R. vs. Wood et al. [on appeal], S. W. Reporter, Vol. 68, p. 802.) The railroad company enters into a contract with its employes. Each employe is taxed for the support of a hospital, and the amount of the tax is deducted from his wages. In consideration of this the company undertakes to care for all sick or wounded employes. Every government, State and National, enters into a contract with its citizens, either written or implied. Every adult man is required to perform military duty when called on to take arms; to serve on jury; to give testimony in courts; to work on the public roads, and to pay taxes for the support of the government. In return for this he is guaranteed by law protection to his life, liberty and pursuit of happiness, and in the possession of the fruits of his labor. Every safeguard is thrown around these by special enactments by law, and no man, without warrant of law, may invade his premises or touch his person or possessions. But no protection whatever is given him in respect to his health, the dearest interest of all, except as against certain quarantinable diseases, and that is inadequate and unreliable. Preventable disease may enter his home, slay him and his family, and the government raises not a hand or voice to stay the execution. The government is not subject to such suit, but it surely is morally responsible, at least, and it stands indicted before the world today for contributory negligence or unpardonable incompetency for every death from any preventable disease; and surely for the scores of lives lost in camp from preventable disease during the war with Spain. Major Seaman, Surgeon U. S. A., says that for every death in battle or from gunshot wound there were fourteen deaths in camp at home, among those who never reached a battlefield! Is it any wonder young men are loath to enlist in the army where the risk of death from preventable disease is fourteen times greater than in battle.-an army where such neglect or disregard of their ( safety is possible? Or is it surprising that on an alarm of yellow fever, remembering the government's total inability to limit its spread; remembering that at the point of invasion, either through venality, ignorance or neglect of local authorities, generally the disease gains such headway as to be beyond control-the people having no confidence in the ability of the authorities to protect them, shut and bar the doors and guard them with loaded guns? or tear up the railroads in their panic, isolate themselves, and whole communities, thus subjecting some sections to threatened famine, as has occurred more than once in the South. That the representatives of the people's interests should so long have shut their eyes to the dangers of consumption, which are as real and as deadly, though intangible, as would be the invasion of an armed host; that they should shut their ears to the warnings of those whose profession and training peculiarly fit them for knowing and appreciating the dangers to the public health by reason of unsanitary conditions and specific infections, is as remarkable as it is disgraceful. A law to protect the public from poisonous food was antagonized and fought in the Congress of the United States seventeen years! And this apathy, this apparent indifference to the ravages of consumption-the fearful and unnecessary waste of life, is the more remarkable and is accentuated when we recall that seven million dollars are appropriated annually for the health of plants and cattle; two million for the saving of life on the seacoasts, and a million and a half for quarantine against yellow fever, and not a cent, so far as I am aware, is appropriated for prophylaxis of consumption. In Texas we have a system of vital statistics for pigs, but none for the people, as Secretary Smith forcibly puts it. In Texas we have never been able to impress our legislators with the necessity of taking an account of population. I drew up a bill for registering the vital and mortality statistics of the State, and in discussing it with one of the most influential Senators, he said: "I see no necessity for registering births and deaths, nor do I see how the death of babies can affect longevity." Seeing that he was about on a par, intellectually, with a child, I stated the case to him as I would have done to a child. I said: "Suppose one hundred babies are born one day, and all live to be 50 years of age; what is the average age?" He said: "Fifty years." I said: "Suppose fifty die the first year and fifty live fifty years; what is the average length of life of those hundred persons?" He said: "Fifty years." Against such stupidity even the gods are powerless to contend. The bill got through the Senate, but on the last round a Senator of unusual density, whose boast was that he was the watchdog of the treasury, and his watchword was "economy," got in an amendment cutting out the small appropriation necessary to make it effective, and thus the bill was killed; it is inoperative. The registration of statistics of births and deaths is the first essential to reform in sanitation. No laws for the protection of the public health can be intelligently enacted without a knowledge of the causes and number of deaths; and it is a disgrace to the age in which we live and of our enlightened government that no such record is kept in the majority of States. Dr. J. S. Billings says (Bulletin 15, "A Discussion of the Vital Statistics of the Twelfth Census"): "The only States which had (at the time of compilation of the twelfth census) a registration of deaths sufficiently complete to make the death rates worth calculating were: Connecticut, Maine, Massachusetts, Michigan, New Hampshire, New Jersey, New York, and Rhode Island, which, with the District of Columbia, form the group of registration States." * * * "No Southern State, and no Northern State, except Michigan, had any satisfactory system of registering deaths at the time the data were collected." * * * [There are, however, more or less correct systems of registration in operation in many of the larger cities in the non-registration States, but the rural population is not represented.] It should be compulsory. Every State should pass laws compelling a registration of its vital and mortuary statistics; and provision should be made for tabulating and publishing them. Without it the U. S. Census Bureau can never compile definite and reliable statistics; a large part of its work at present is therefore a little better than a more or less intelligent guess. Every advance in science, the discovery of every truth, has to fight for recognition against blind bigotry, ignorance and prejudice. It is truly remarkable how near we have often been to discoveries of priceless value, how many glimpses we have had of precious truths, yet their recognition has been thwarted by unreasonable opposition, or it has been established only after long and bitter controversy. It is now recognized that air, light and pure water are the life essentials, the people are beginning to understand that "night air" and cold air and cold water, are not poisonous, and that the principal, if not the only chance, for the recovery of a - consumptive is that he should "return to nature,"-live out of doors and sleep out of doors; and since the King of England endowed a great sanatorium for the hygienic treatment of consumption, and paid Dr. Latham $2500 for the best paper on the subject, the establishment of out-door sanitaria has become popular and successful. New York State has reason to be proud of her typical institutions, one at Saranac and another, under military discipline, in Sullivan county. Dr. Latham's motto was: "Give him air; he'll straightway be well." And yet, sixty-six years ago, when George Bodington (in England) insisted on the importance of a generous diet and a constant supply of pure air, and propounded the terrible "heresy" that cold is never too intense for a consumptive patient; and when, in 1855, fifteen years later, Dr. Henry MacCormack, the father of the late Sir Wm. MacCormack, published a book on somewhat similar lines, and in 1861 read a paper before the Royal Medical and Surgical Society in which he advocated what are now established principles, Bodington's book met with much bitter and fierce opposition, and eventually the disapproval of his methods became so universal that patients were driven from his sanitarium, and Bodington, I believe, was finally sent to a lunatic asylum as a crazy man. The members of the Royal Society refused to pass the usual vote of thanks to Dr. MacCormack, because they thought the paper was written by a mono maniac. It is only by prevention that the disease can be controlled and finally exterminated, and by hygienic measures that it can be cured. The means necessary to the first are so simple and easily used,-if enforced by authority,-that they should be instituted at once. The infective principle is disseminated in the sputa and other secretions of the patient. This, if destroyed, would render the patient impotent for harm; for the disease is in no sense "contagious," but is highly infectious. The popular impression prevails very generally, unfortunately, and it is upon the authority of those who should know better, that the disease is "catching," like measles and scarlet fever. It grows out of a confusion of terms. It is remarkable that words are used as synonyms that have, often, widely dif ferent meanings. "Contagious" and "infectious," and "communicable" are generally accepted and used as meaning the same thing, and yet there is a difference in many ways between a "contagious" disease and a "communicable" disease. A disease may be communicable without being contagious, as are typhoid fever, cholera and consumption. But all these are communicable and infectious in the sense that the poison (bacilli) thrown off by the patient in the secretions and excretions may and do infect, and hence com-municate the disease to well persons. I repeat, and wish to emphasize it consumption is a communicable disease, but it is in no sensecontagious; that is, it can not be "caught by contact." That is the meaning of the word. It is not possible for a sound, healthy person,. coming in contact with a consumptive body, to acquire consump-tion. Nevertheless, upon the authority of the Surgeon General of the Marine Hospital Service of the United States, backed by that of the United States Treasury Department, of which the Marine Hospital Service is a sub-department or bureau, the fiat has gone out that upon a construction of the public health laws by the Attorney General, consumption is a "contagious disease, dangerous to the public health"; and in June, 1902, the Superintendent of Immigration of the United States issued an order, based upon this deci-sion, that all consumptive immigrants, without distinction, rich and poor, big and little, shall be excluded from the shores of the United States. Previous to this order the Board of Immigration, after having received the opinion of the Health officer of the port, had some discretion; and it was possible to admit child afflicted' with consumption, accompanied by healthy parents, or a consumptive wife along with her healthy husband, for instance; but under this ruling every consumptive must be sent back. This involves the separation of parents from child, or husband from wife,-thedisruption of whole families. And upon this ruling the authorities of California, a little later, turned back a distinguished judge from the South Pacific Islands, who was journeying to Europe, because he was suffering from pulmonary consumption, and refused to let him even cross the continent! Consumption is not a quarantinable disease; but the California people advise that consumptives be excluded from the State or held permanently in lazarettos. Such action would be unwise, irrational, inhuman. It would be worse than the shotgun quarantine of former years. It would create a panic in the public, and unjustly put a stigma upon thousands of good citizens and desirable immigrants, suffering from an acquired and curable disease. The consumptive is not a danger to be shunned and fled from, like the plague. He is not a leper, "un-clean," to be avoided upon all occasions. He can be rendered harmless by the observance of simple and rational measures, and many will recover under proper hygienic conditions and environments. |