greatest number. Personal liberty may be enjoyed to the fullest extent when that liberty is exercised in right doing; but it must be retrenched when used in contempt of right and law.

Civil laws made for the regulation, preservation, and advancement of society are beneficial to the individual and to the public through individual compliance and co-operation, and oppressive only as a consequence of their resistance and infraction. The aim of sanitary law is beneficent. It instructs, commands, and forbids. Its observance tends to prevent disease, reduce sickness, and lessen suffering, and thus adds to the robustness of a people, to their strength, activity, and prosperity. Its violation tends not only to inflict injury upon the individual, but also upon the community at large. Hence, the necessity for its stringent administration. A healthy people are, as a rule, the dominating, progressive, civilized people; and conversely a sickly and enervated people lose their power, sway, and leadership, and cease to progress. The law of the survival of the fittest has no better exemplification.

The noblest work of this era is that which pertains to the prevention of disease, and the wisdom and knowledge of the greatest minds are being taxed to consummate this humane object. One of the best evidences of the activity, zeal, and determination to control, restrict, and prevent disease which is propagated from person to person, from people to people, and from country to country, is the frequent assembling of representative international congresses, held to promote this great object. A magnificent exemplification of the grand results of intelligent and concerted action directed for this object is seen in the successful barring out of cholera from our shores in the seasons of 1892 and 1893.

But the foundation principle of success lies, after all, in the acknowledgment, appreciation, and performance by communities of their duties and obligations in maintaining the highest standard of local health by all of the vast array of means that modern knowledge has placed at their disposal. Such recognition of duty and enforcement of its behests is the secret of success in preventing the origin and spread of epidemic diseases, which may not only afflict their own citizens, but be propagated and spread from hamlet to hamlet, from State to State, and from country to country. It may be narrowed down still further by placing the responsibility upon the family and even upon the individual. As a well-known author has tritely said, "If the personal agency

in the prevention of disease could be made perfect, all else would sink into mere nominal position, or would, at least, consist of mere formal administrative labor."

But such universal faultlessness in the performance of duty has not been attained, and hence, the necessity of local and central administrative labor for the enforcement of measures of selfdefence against internal and external harmful agencies, such as are directed against all dangerous communicable diseases of that form which tends to become epidemic. The people must be coerced if they will not be persuaded and educated into compliance with health-protective measures.

While the general health of the community indicates the quality of its sanitary laws and the degree of efficiency of their administration, the death-rate from the so-called preventable diseases is looked upon as a more reliable reflex of these important characteristics of local government, and for this reason, these diseases, being more amenable to measures of prevention, are placed under official supervision and management. The local government assumes, for the public good, the direction of measures for their restriction and suppression, and is, therefore, responsible for the results in proportion to its vested authority and means.

In order to meet this great responsibility there must be careful and explicit instruction of the public in their individual duties, and insistence on their performance and on the rigid performance of duties by administrative officers, assisted by all means of cooperation and the appliances necessary to aid the individual and to supply his needs as well as those of the public.

The early recognition and prompt notification of all cases of contagious and infectious disease is of paramount importance, in order that these cases shall be placed at once under official supervision. The proper care, nursing, and treatment of the patient must be insisted upon for the individual's sake and for the protection of the public. These comprehend in general what is required to be done.

Most important among these requirements, so far as the public health is concerned, are isolation, disinfection, and, in the case of variola and diphtheria, vaccination and inoculation. The exceeding importance of these measures must be taught the people, and, in addition, the government must be prepared to act when there is personal failure to comprehend and apply such essential meas

ures. While a part of the community can be relied upon to faithfully and intelligently co-operate in the performance of these duties, there is a portion that uniformly fails to comprehend their importance, and hence, the authorities must supplement the deficiency by undertaking to conduct this work themselves. Vaccination should be insisted upon, better in advance than at the time of an outbreak, and thus prevent the outbreak. A compulsory law is humanitarian. In its absence, the imposition of disabilities works to advantage.

Disinfection in the private home is apt to be insufficiently performed, for the reason that the proper appliances do not exist for satisfactorily conducting this work. Hence, the necessity for the authorities to supply disinfecting plants for the use of the public, and to insist upon their use whenever there is a suspicion of failure on the part of the people to efficiently conduct this procedure themselves; and also to conduct the work of house-disinfection by trained officials.

It is not always possible to isolate cases of dangerous communicable diseases in the private home, and for this reason it becomes obligatory on the part of the authorities to provide hospitals for the treatment of the sick as, under the circumstances, it is advisable and justifiable to remove them from their homes for isolation and treatment. No community, however small, should be without the means of providing for the public care and treatment of cases of contagious and infectious diseases, for it constantly occurs that, for the want of such facilities, disease is propagated from person to person, and from family to family, thus often giving rise to an epidemic which might have been prevented by the exercise of ordinary foresight. And these hospitals, no matter how unpretentious in size, should be well located, complete in their construction and appointment, and thoroughly well adapted for the comfortable and satisfactory care and treatment of the sick. It is too often the case that such institutions are mere makeshifts for an emergency, incomplete, uncomfortable, and foreboding-looking structures, badly located and not too well managed and appointed, and unsuitable in every way for the object in view. No wonder that the dread of removal to such places causes opposition and resort to every means to thwart the sanitary officer. When the government interferes and compels removal from the private home, it assumes the obligation of guarding carefully the patient's health and of providing every