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United States, and practically no one with any ideas as to lines along which an
investigation into disease causation or prevention, might be carried out, need fail
to find a place in which he can carry out his work and the money necessary for
carrying it out and supporting himself while he is engaged upon it.
As a result, in this School of Hygiene at Baltimore there are laboratories
almost innumerable and workers engaged in studies that may or may not prove
to be epoch-making.
Here, for example, there is working Dr. McCollum, who discovered so much
about the vitamines that everybody has heard of, and out of which so many
food and drug producers hope to make a fortune.
Also there is a Professor Raymond Pearl, a famous biologist and statistician,
who is working out various problems in connection with the duration of life in man
and the conditions that affect it, using for the purpose a kind of fly which has an
average duration of life in days similar to that of man in years. One fact that he
had made out that particularly interested me was that while great overcrowding
amongst the flies in his colonies definitely shortened life a certain amount appeared
to be beneficial and certainly not harmful. Practically the same has been proved
to be the case with man.
I have rarely enjoyed anything so much as the talk we had from Professor
Pearl, but on the whole I would rather spend my time trying to look after the
health of the people in Ward 3 and the Borough generally than acting as physician
to or High Commissioner of a large number of fly colonies.
Apart from these two investigators and teachers there is a very large staff
in the school, amongst them a young Canadian who received his first instruction in
Public Health at Middlesex Hospital from myself. Largely because he was anxious
that I should do so I gave a lecture to the students in the school on some differences
between the English health methods and those in vogue in the United States.
I noted amongst the students several Japanese and Chinese, as well as a number
from South America, Canada, etc., foreigners, indeed, forming the bulk of the
students in the school.
While in Baltimore we had the opportunity of meeting the Mayor of the City
and of going over some of the public health work with the health officer or rather
Commissioner of Health, who I was interested to find, received his medical
education at Edinburgh University. The city is a large one with a population of
about 800,000, and the work seems to be fairly well covered though there is very
much more specialization than would be the case in a town of this size at home.
One of the gravest troubles here as in other towns is with diphtheria of which they
have a large number of cases every year. This they are endeavouring to fight, in
some areas at any rate, by methods similar to that adopted in the case of smallpox,
by immunizing children against it. The great difference in the procedure, however,
is that instead of seeking, as we do in smallpox, to immunize everybody they first
try to find out such as are liable to take the disease and immunize only these. The
results, they believe, have been fairly satisfactory, but there is still a considerable
amount of disease which may, I imagine, be due to the fact that isolation of
patients is carried out at home and not in hospital as with us.
Speaking generally the States, or such as I have visited, are very poorly
provided with isolation hospital accommodation and to me, accustomed as I am
to the excellent arrangements made by the Metropolitan Asylums Board, this
appears deplorable and to make the proper dealing with infectious diseases almost
impossible. That it is cheaper from the point of view of the authorities is doubtful
and that it is more inconvenient for the ratepayers is certain.
The water supply of Baltimore is very good, but like much of the water in the
States I have visited it is doctored with chlorine for safety's sake and tastes of the
chemical.