preventives.

Statesmanship as well as professional ability is expected of physicians
in the leading European cities, more particularly of those connected
with health departments. There it is not felt that a medical degree is
of itself a qualification for sanitary or health work. After the
professional course, physicians must take courses in preventive hygiene
and in health administration. Medical courses include such subjects as
vital statistics, duties of medical officers of health, sanitary
legislation, state medicine.

The needless cost for one year of "catching" diseases in New York City
would endow in perpetuity all the schools and lectureships and journals
necessary to teach preventive hygiene in every section of this great
country. That city alone sacrifices twenty-eight thousand lives
annually to diseases that are officially called preventable. The yearly
burial cost of these victims of professional and community neglect is
more than a million dollars. When to the doctor bills, wages lost,
burial cost of those who die are added the total doctor bills, wages
lost, and other expenses of the sick who do not die, we find that one
city loses in dollars and cents more every year from communicable
diseases than is spent by the whole United States for hospitals and
boards of health.

Many diseases and much sickness are preventable that are not
communicable. Indigestion due to bad teeth is not itself communicable,
but it can be prevented. One's vitality may be sapped by irregular
eating or too little sleep; others will not catch the trouble, although
too often they imitate the harmful habits. Adenoids and defective
vision are preventable, but not contagious. Spinal curvature and flat
foot are unnecessary, but others cannot catch them. Preventive hygiene,
however, should teach the physician's duty to educate his patient and
his community regarding all controllable conditions that injure or
promote the health.

In the absence of special attention to preventive medicine new truth is
forced to fight its way, sometimes for generations, before it is
accepted by the medical profession. So strong are the traditions of
that profession and so difficult is it for the unconventional or
heterodox individual to retain the confidence of conservative patients,
that the forces of honorable medical practice tend to discourage
research and invention. The man who discovers a surgical appliance is
forced by the ethics of his profession