s to-day there are sanitary laws
offering protection against dangers to health, excepting some dangers
not understood until recently, such as child labor, dangerous trades,
lack of safety devices. Adequate local protection, however, will not
become permanent until adequate state machinery is secured.

State health machinery should be of two kinds,--fact-gathering and
executive supervision through inspection. The greatest service of state
boards of health is to educate localities as to their own needs, using
the experience of all communities to teach each community in how far
its health administration menaces itself and its neighbors. In addition
to registration of contagious diseases, facts as to deaths and births
should be registered. State health boards should "score" communities as
dairies and milk shops are now being scored by the National Bureau of
Animal Industries and several boards of health. When communities
persist in maintaining a public nuisance and in failing to enforce
health laws, state health machinery should be made to accomplish by
force what it has failed to accomplish by education.

[Illustration: NATIONAL MACHINERY HAS STIMULATED LOCAL MILK
INSPECTION AND STATE DAIRY INSPECTION]

States alone can cope adequately with dangers to milk and water sources
and to food. The economic motive of farmers has developed strong
veterinary boards for the protection of cattle. Similar executive
precaution must soon be taken by cities for the protection of babies
and adults of the human species. It is far more economical to insure
clean dairies, clean water sources, and wholesome manufactured foods by
state inspectors than by local inspectors. At present the task of
obtaining clean milk and clean water falls upon the few cities
enlightened enough and rich enough to finance the inspection of
community foods. Once tested, it would be very easy to prove that
properly supported state health authorities will save many times the
cost of their health work in addition to thousands of lives.

County or district machinery is little known in America. For that
reason rural sanitary administration is neglected and rural hospitals
are lacking. In the British Isles rural districts are given almost as
careful inspection as are cities. Houses may not be built below a
certain standard of lighting, ventilation, and conveniences.
Outbuildings must be a safe distance from wells. Dairies must be kept
clean. Patients suffering