The New York herald., 1922-07-23
Delth Rates Falling.

"The application of part of this
knowledge by men of Imagination
and organizing ability" said DR.. Vim
cent, has been a boon to mankind.
The presence of smallpox is now a
disgrace to any civilized community
or country; cholera and plague have
disappeared from the leading ma
tons; typhoid fever has been enor-
mously reduced; malaria and hook
worm disease are giving ground; yell
low fever is being narrowly re-
stricted; typhus is practically un-
known among a cleanly people; the
fear of diphtheria has been largely
allayed. Such victories as these, to-
gether with advances in general
sanitation, higher living standards,
more attention to individual health
habits, have resulted in steadily fall
ing death rates in all the more pro-
gressive countries.
But it is too early to feel COM
placent. Only a beginning has been
made. Many diseases still battle the
health authorities. The average in
dividual remains relatively ignorant
and negligent of sanitary science
and personal hygiene. Almost all
physicians are still too exclusively
concerned with the individual aspect
of disease.
Stages in the progress of preven-
tive medicine are distnguishable.
First comes control of the physical
environment through pure water,
milk and food supplies, adequate
sewage and refuse disposal systems,
improved housing, heating and ven
tilation. Then follows control of dis
eases other than those whose causes
are water and food born. Various
forms of occupational hazards and
maladies are also attacked. Concern
for the welfare of mother and child
is a prominent feature at this stage.
The third stage emphasizes the vital
part which personal hygiene plays.
1T is roughly estimated that so
per cent. of the maladies which pro-
duce the total death rate cannot be
directly controlled by the sanitarian.
He must persuade individuals TO con-
form to the laws of health and to
report promptly the first sign that
anything is amiss."
DR.. Vincent also stated that a
fourth phase, just beginning to
emerge, has to do with economic.
social and mental influences.
Income. standard of living, op-
! portunities for social intercourse and
recreation" he said, "all have i'm
portant relations to individual and
community health. Mental hygiene,
which is coming to be recognized as
a part of public health, deals with
problems of defects and delinquency
in children and criminality in adults.
with nervous and mental disorders,
with the classification, treatment and
custodial care of the feeble minded
and insane"
Regarding changing ideals Of
health, DIR. Vincent says advances in
the cure and prevention of disease
reflect shifting of emphasis and a
gradual revision of the idea Of
health itself.
Being up and around or Il can't
complain represents" he said, "a far
from stimulating conception of bod
lily prosperity. yet vertical rather
than a horizontal position is one
criterion. Freedom from conscious
pain would seem to be almost the
obvious starting point for any useful
standard of health, yet even this may
be misleading. There is a growing
demand for a positive conception
which in the individual registers it
self in a keen sense of physical and
mental vigor, joy of living"
In the education of school children
and of the general public in hygiene
and pubic health the attempt is
being made, according to DIR. Vincent,
as never before to form health
habits. Health plays, health clowns
and fairies have been added to the