DISTRIBUTED AS SUPPLEMENT TO THE MARCH NUMBER l° arr > (*• i0 < 
 OF THE AMERICAN HEALTH MAGAZINE 
 
 STATEMENT OF 
 
 PROFESSOR FISHER 
 
 Of New Haven , Conn. 
 
 BEFORE THE COMMITTEE ON INTERSTATE AND FOREIGN 
 COMMERCE, HOUSE OF REPRESENTATIVES 
 
 NATIONAL HEALTH LEGISLATION 
 
 FEBRUARY 13, 1909 
 
 PRINTED FOR THE COMMITTEE OF ONE HUN¬ 
 DRED ON NATIONAL HEALTH 
 
 WASHINGTON 
 
 GOVERNMENT PRINTING OFFICE 
 1909 
 
Se !f'cn^n//90JA /F53 
 
NATIONAL HEALTH LEGISLATION. 
 
 STATEMENT OF MR. IRVING FISHER, OF NEW HAVEN, CONN., 
 
 REPRESENTING THE COMMITTEE OF ONE HUNDRED ON 
 
 NATIONAL HEALTH LEGISLATION. 
 
 Mr. Fisher. Mr. Chairman and gentlemen of the committee, I 
 know it will be exceedingly difficult to do anything like justice to 
 so large a subject in twenty minutes. I am very glad of the oppor¬ 
 tunity, however, to present a proposed amendment to the bill, Sen¬ 
 ate 6102, and, if it were possible to have a longer hearing on Monday 
 morning, I know it might be possible to get others of the committee 
 here. Mr. John Mitchell I had hoped might be here, and also Doctor 
 Welch and Joseph Choate and several other members of our com¬ 
 mittee who are interested in this amendment. The amendment is 
 as follows: 
 
 Section 1 . That the President be, and he is hereby, authorized, by order in writing, 
 to transfer, within one year from the passage of this act, for the purposes of economy 
 and better efficiency, the whole or any part of any bureau, office, division, or other 
 branch of the public service, including the Public Health and Marine-Hospital 
 Service, engaged in whole or in part in scientific, technical, or statistical work, from 
 one executive department to another executive department, or to or from the Smith¬ 
 sonian Institution. 
 
 The rest of the bill is a reprint of the other, authorizing the President 
 to reorganize and transfer the health bureaus of the Government and 
 the other technical and scientific bureaus. The part I am interested 
 in as representative of the committee of one hundred on national 
 health is the concentration of the bureaus into one department. 
 
 Mr. Stevens. Will you name those bureaus that you consider 
 are health bureaus that would come within that amendment? 
 
 Mr. Fisher. The Public Health and Marine-Hospital Service is 
 the principal health bureau. That is now in the Department of the 
 Treasury. The Bureau of Pure Foods and Drugs, or the Division 
 of Pure Foods and Drugs, of the Bureau of Chemistry is now in the 
 Department of Agriculture. The department of health of the Dis¬ 
 trict of Columbia is a federal institution in a certain sense, and, per¬ 
 sonally, I would like to see that included. 
 
 Mr. Stevens. You would not include that? 
 
 Mr. Fisher. Yes, sir. 
 
 Mr. Stevens. You have one half of the expense of that paid by 
 the District of Columbia, and that would mix accounting very badly. 
 
 Mr. Fisher. If it were transferred, I suppose the whole expense 
 would be borne by the Federal Government. The object of bring¬ 
 ing that bureau into it is, if possible, to make Washington a model of 
 sanitation, with the idea of stimulating all the health offices of the 
 (3) 
 
4 
 
 country to improve the health organizations. It is not, of course, 
 necessary that the President should make that transfer if it is not 
 deemed wise; but you asked me what the health bureaus were, and 
 I answered } r our question. In the Department of the Interior there 
 is the Government Hospital for the Insane, the Freedman’s Hospital, 
 the Hospital for the Deaf and Dumb, and the Howard University 
 Hospital for the colored, and the Hot Springs Institution, and all 
 those come under the health service of the Government. There are 
 other bureaus, which are not primarily health bureaus, which bear 
 on the public health service also. 
 
 Mr. Stevens. There is the statistical work which relates to health. 
 
 Mr. Fisher. The Bureau of Vital Statistics of the Bureau of the 
 Census deals with statistics of health, although those of us who have 
 looked into it most carefully are of the opinion that it would probably 
 be better not to separate that from the Census, because in making 
 those calculations, for instance, the numerator is the number of deaths 
 and the denominator is the population. 
 
 Mr. Richardson. Is there duplication in the work of these bureaus ? 
 
 Mr. Fisher. Yes. 
 
 Mr. Richardson. Where is the work of the Public Health and 
 Marine-Hospital Service being duplicated by that of any other bureau ? 
 
 Mr. Fisher. General Wyman can answer that question better than 
 I, or Doctor Wiley can answer it better than I, or some of these other 
 gentlemen present. Recently in the milk investigation there were 
 three or four different government bureaus concerned and there were 
 three or four different bureaus recently concerned in the investigation 
 of wells for water pollution in the District of Columbia. I think there 
 were two or three bureaus that overlapped. The purpose of this is 
 to try to coordinate or concentrate, or both, whichever is deemed best 
 after careful consideration. In the case of the Bureau of Vital Sta¬ 
 tistics it seemed to us best to coordinate and in the case of the two 
 bureaus I mentioned awhile ago it seemed best to concentrate. This 
 movement has been going on during the last two or three years and 
 has grown to larger'proportions than a good many people have per¬ 
 haps realized. 
 
 Last week our committee of one hundred on national health, which 
 was originally appointed by the American Association for the Ad¬ 
 vancement of Science, appeared before the Association of Life In¬ 
 surance Presidents in New* York City and presented statistics before 
 the presidents, the actuaries, and the medical boards of the'life insur¬ 
 ance companies, showing that human life in this country could be 
 easily prolonged at least fifteen years by proper improvement in 
 hygienic conditions in the country which are now neglected, and that 
 the saving would be so great that the interest which life insurance 
 companies have would be enough to justify them in putting money in 
 the public-health movement. After the presentation was made the 
 actuaries and the medical boards commended, and they were unani¬ 
 mous in sustaining our opinion, and then the president of the Metro¬ 
 politan, Mr. Haley Fisk, stated that his company stood ready to give 
 to this movement $100,000 a year for the purpose of reducing death 
 claims and increasing health conditions, provided it could be shown 
 that it could be legally expended, and a committee was appointed 
 to ascertain that point. That shows a little of the merits of the case, 
 and since the last meeting of this committee these clippings which I 
 
5 
 
 have here on the table have come into our office in regard to that par¬ 
 ticular matter, which shows the public interest in the subject. 
 
 Mr. Stevens. You are not afraid of being connected in any yellow- 
 dog fund ? 
 
 Mr. Fisher. No. If this bill were amended and passed, it would 
 
 f ive, I believe, greater public satisfaction in this country than any 
 ill that has passed or can pass in Congress this session. That may 
 seem an extravagant statement, but I think I know what I am talk¬ 
 ing about. The public has expected legislation of this Congress, and 
 it seems a pity that this Congress should go out of existence after two 
 years of public agitation and work upon it and no measure of legis¬ 
 lation be enacted. I know the public will be greatly disappointed, 
 and I can speak in behalf of several hundred thousand of the public, 
 and they will say among other things that it is due to the fact that 
 the President was in favor of it. The President has given two mes¬ 
 sages to Congress on this subject. There are four health bills before 
 Congress. 
 
 Mr. Stevens. In all fairness, you ought to have it appear as a part 
 of your remarks also that this committee has examined and reported 
 upon two of those bills. 
 
 Mr. Fisher. Yes, sir. 
 
 Mr. Stevens. And they are now on the calendar? 
 
 Mr. Fisher. Yes. 
 
 Mr. Stevens. We have done our duty. , 
 
 Mr. Fisher. Yes; so far as that is concerned. I did not mean to 
 criticise this committee, but no public health service legislation has 
 yet been enacted. There are four bills which the committee of one 
 hundred are particularly anxious to have passed: One introduced by 
 Mr. Parsons, establishing a child bureau in the Department of the 
 Interior; another a bill appropriating a sum of money for the hygienic 
 laboratory of the Public Health and Marine-Hospital Service; another 
 concerning the salaries of the Public Health and Marine-Hospital 
 Service; and the fourth, to which this amendment is to be attached, 
 No. 6102. 
 
 An amendment has already been spoken of before a subcommittee 
 of this committee by Doctor Reed, who represented the medical side. 
 I am here to represent the lay side. I am not a medical man. It is 
 merely as a business proposition that this public-health movement 
 appeals to me and those who are on the committee of one hundred on 
 national health. It is as an economist and statistician that I have 
 made a study of this subject, having been spurred to it by bitter per¬ 
 sonal experience ten years ago. The movement is nonpolitical, but 
 it is one which has commanded a great deal of attention in politics. 
 It is not uncommon now to hear it spoken of as the greatest move¬ 
 ment in the country. A short time ago, at Baltimore, at a meeting 
 of our American Association for the Advance of Science, after the 
 addresses which Doctor Wyman and Doctor Wiley made, a number 
 crowded around the platform and told us that they believed that this 
 was the greatest movement of the country to-day; and I know, Mr. 
 Chairman, that the representative of Iowa at the government’s con¬ 
 sultation or conference made the same statement. President Roose¬ 
 velt, when the subject was presented to him two years ago, said there 
 was no evidence of popular interest in it, and he could not take a 
 part in it until there was. Five months ago I asked him if he was 
 
6 
 
 then satisfied that there Was popular interest in it, and he said it was 
 one of the real movements of the country to-day. Some of the men 
 who are connected with this movement are Hon. Joseph Choate, 
 Doctor Eliot, Archbishop Ireland, Judge Ben Linsay of Denver, John 
 Mitchell, Doctor Welch, and a number of others. Almost all of the 
 members of the committee of one hundred are men of national prom¬ 
 inence. Of the men of national prominence outside who have taken 
 up the work and indorsed it there are Grover Cleveland, who was 
 among the first, and Mr. Bryan, and President Roosevelt, who wrote 
 two letters to our committee and made several speeches and sent two 
 messages upon it to Congress. I have here these messages, the first 
 sent in 1907 and the second in December, 1908. I will read the last 
 two sentences of one of them: 
 
 The first legislative step to be taken is that for the concentration of the proper 
 bureaus into one of the existing departments. I, therefore, urgently recommend the 
 passage of a bill which shall authorize a redistribution of the bureaus which shall best 
 accomplish this end. 
 
 That was referring to this amendment. Mr. Taft is also thoroughly 
 in favor of it. In a letter written to our committee, he said: 
 
 The American Health League is certainly to be congratulated on its rapid progress 
 in numbers and recognition. It is through such an enlistment of public interest that 
 Congress may be expected to enact the legislation necessary to enlarge the activities of 
 the Federal Government in respect to public health. I hope to live to see the time 
 when the increased efficiency in the public health service—Federal, State, and munici¬ 
 pal—will show itself in a greatly reduced death rate. 
 
 In a letter which I received from him a few days ago from the Canal 
 Zone, he said: 
 
 I think the first thing that ought to be done is to assemble all the bureaus relating 
 to health matters under one head in one bureau, or to assemble them at least in one 
 department. 
 
 He made that same statement also in his letter of acceptance. 
 
 Mr. Richardson. As I understand the amendment which you have 
 just read, the purport and the spirit of it is to transfer these different 
 bureaus relating to health to the Department of the Interior? 
 
 Air. Fisher. The amendment gives the President the authority to 
 make the transfers to such department as he may select, and in such 
 manner as he may choose. It was deemed that that was a technical 
 matter concerning the executive branch of the Government, and that, 
 aided by his advisers in his Cabinet, he could best deal with that. 
 
 Mr. Richardson. That is left to the choice of the President? 
 
 Air. Fisher. Yes. 
 
 Mr. Richardson. He may transfer these bureaus to any general 
 department under the Government? 
 
 Mr. Fisher. Yes. The commission on the organization of scien¬ 
 tific work, to which we asked him to refer this matter and to which 
 he did refer this matter, reported back favoring the Department of the 
 Interior as the department to be used, into which the federal bureaus 
 should be concentrated. I have here the report of the commission, 
 and if it is desired will read it, but it will prevent my saying anything 
 else if I do. We have the indorsement of a large number of small 
 technical scientific organizations, as well as of a large number of 
 larger organizations, including the Public Health Organization, the 
 American Medical Association with 80,000 members, the National 
 Child Labor Committee, and the labor organizations themselves, 
 mcluding the Associated Fraternities of America and the United Mine 
 
7 
 
 Workers of America with a membership of 300,000. I would like to 
 read from John Mitchell’s report a part of the resolution passed by the 
 United Mine Workers of America: 
 
 Whereas one of the fundamental principles of the United Mine Workers of America 
 is “to secure the introduction of any and all well defined and established appliances 
 for the preservation of life, health, and limb of all mine employees,” and another is 
 by legislation looking to the most perfect system of mine ventilation, drainage, etc., 
 to reduce to the lowest possible minimum the catastrophes which from time to time 
 sweep through the mines; and 
 
 Whereas it is a well-known fact that as many accidents in the mines are due to pre¬ 
 ventable causes, so disease is due largely to ignorance of the laws of health or to negli¬ 
 gence in their observance: Therefore be it 
 
 Resolved, That the United Mine Workers of America, in nineteenth annual conven¬ 
 tion assembled, indorse the principles and the work of the committee of one hundred on 
 national health, and urge all members of our union to cooperate in every way possible 
 with the committee of one hundred to bring about the objects which it is formed to 
 promote. 
 
 Mr. Richardson. Would you right there allow me to ask you a 
 question ? 
 
 Mr. Fisher. Certainly. 
 
 Mr. Richardson. Would you not prefer, for instance, that the 
 Bureau of Public Health and Marine-Hospital Service be made a 
 separate department and that it should gather all these related 
 bureaus under it ? 
 
 Mr. Fisher. We have hope that ultimately there would be a sepa¬ 
 rate department; but you will of course recognize, Mr. Richardson, 
 that it would be impossible in this session of Congress to accomplish 
 that; and this was a step in that direction, and I thought it was the 
 first and simplest step. It does not involve any new position or 
 appropriation, and, on the contrary, it has this merit, that it concen¬ 
 trates the health bureaus and puts them together where they can 
 work together and afterwards they can be united into a separate 
 department of health, or the Department of the Interior itself could 
 be recognized and become a Department of Health and Education 
 by taking out of it the bureaus which do not pertain to those subjects 
 and leaving those that do, adding the child bureau and any other 
 bureaus on health that might be legislated later. But this particular 
 amendment is the first simple step, and one that could be passed in 
 this session of Congress, because there is a bill that you have put on 
 the calendar to which it could be attached as an amendment, and 
 it could be passed. 
 
 I would say that we have formed the committee of one hundred 
 and a popular league called the American Health League, which now 
 numbers 23,000 and is scattered through 1,600 towns in the United 
 States in which we have our local and advisory committees, consisting 
 of the most prominent men of those towns. This shows the wide¬ 
 spread interest in it. The only objection that I have ever heard 
 raised to the project is on the part of the state-rights idea, and I will 
 say a word in regard to that. The States have supported this quite 
 as much as those who are interested in the National Government. 
 The state legislature of Ohio has passed special resolutions favoring 
 this work, and planks have been introduced in the state platforms 
 of Ohio and Delaware favoring this, and in both of the national 
 party platforms planks were put in favoring this movement. The 
 one in the Republican platform reads: 
 
 We commend the efforts designed to secure greater efficiency in national public 
 health agencies, and favor such legislation as will effect this purpose. 
 
The Democratic platform, adopted at Denver, stated: 
 
 We advocate the organization of all existing national public health agencies into a 
 national bureau of public health, with such power over sanitary conditions connected 
 with factories, mines, tenements, child labor, and other such subjects as are properly 
 within the jurisdiction of the Federal Government and do not interfere with the 
 power of the States controlling public health agencies. 
 
 The Independence League party adopted an even broader plank in 
 favor of a national department of health, and Mr. Arthur T. Brisbane 
 has warmly supported the movement to protect public health in the 
 Hearst journals. 
 
 In regard to the States, trying to find what the feeling of the state 
 officials was, letters were sent to the governors of the States, and 
 some twenty responded, and among them was only one that was 
 adverse. These replies represented such widely separated States as 
 Massachusetts, Pennsylvania, Alabama, Mississippi, Michigan, New 
 Mexico, South Dakota, Oregon, and Washington. Among these 
 indorsements I will quote from only two, one being the nearest 
 and the other the farthest from our executive office. In his let¬ 
 ter, Governor Woodruff, of Connecticut, said, “I am glad of this 
 opportunity to indorse the work of the committee of one hundred on 
 national health. * * * I consider the question of public health 
 
 the most important one which our country has before it.” Governor 
 Freer, of Hawaii, writes, '‘The people of Hawaii * * * are in a 
 
 position to realize with peculiar force not only the great importance of 
 the subject of health, but also the importance of the cooperation 
 between national, state, and territorial governments in this matter. 
 I wish the committee of one hundred every success.” 
 
 The part of the report of the Conservation Commission relating to 
 public health was written largely by Governor Blanchard, of Louisiana, 
 and if I am not using up my time too fast I would like to read that in 
 full. May I ask if I have a few minutes left ? 
 
 The Chairman. Proceed. 
 
 Mr. Fisher. This reads as follows: 
 
 Since the greatest of our national assets is the health and vigor of the American 
 people, our efficiency must depend on national vitality even more than on the resources 
 of the minerals, lands, forests, and waters. The average length of human life in differ¬ 
 ent countries varies from less than twenty-five to more than fifty years. This span of 
 life is increasing wherever sanitary sciences and preventive medicine are applied. 
 It may be greatly extended. Our annual mortality from tuberculosis is about 150,000. 
 Stopping three-fourths of the loss of life from this cause and from typhoid and other 
 prevalent diseases would increase our average length of life fifteen years. There are 
 constantly about 3,000,000 persons seriously ill in the United States, of whom 500,000 
 are consumptives. More than half this illness is preventable. If we count the value 
 of each life lost at only $700, and reckon the average earning lost by illness as $700 a 
 year for grown men, we find that the economic gain from mitigation of preventable 
 disease in the United States would exceed $1,500,000,000 a year. This gain, or the 
 lengthening and strengthening of life which it measures, can be had through medical 
 investigation and practice, school and factory hygiene, restriction of labor hy women 
 and children, the education of the people in both public and private hygiene, and 
 through improving the efficiency of our health service, municipal, state, and national. 
 
 I prepared as a part of the report of the Conservation Commission 
 a special report covering about 200 pages going into all the details of 
 how the saving in life could he effected. I should he very glad to 
 answer questions. I know that I have covered but a small fraction 
 of what I intended to say. 
 
 Mr. Wanger. Professor, was your attention called to the till H. R. 
 9123, of which I hand you a copy? 
 
9 
 
 Mr. Fisher (after examining bill). Yes, sir; I have seen that bill. 
 
 Mr. Wanger. Has your association taken any action in reference 
 to it? 
 
 Mr. Fisher. In reference to this bill? 
 
 Mr. Wanger. Yes. 
 
 Mr. Fisher. No', sir; it has never been brought up. It has not 
 been voted on adversely, but we are greatly interested m the tubercu¬ 
 losis fight ; and we believe that the first step is the concentration of the 
 bureaus which we have provided here. 
 
 Mr. Stevens. Have you met with any antagonism on the part of 
 any of the state boards? 
 
 Mr. Fisher. No, sir; we have the cooperation of the state and 
 territorial boards of health. They have passed resolutions favoring 
 our movement here in Washington. Not very long ago, and about 
 the same time, there was a conference held of all the leading health 
 agencies of the country, and we are all pulling together on the sub¬ 
 ject, General Wyman and Doctor Wiley and all of us. 
 
 Mr. Stevens. Have they encouraged the idea that the jurisdiction 
 of the Federal Government should be extended over such subjects as 
 you have mentioned—the pollution of streams and the investigation 
 of various contagious diseases ? 
 
 Mr. Fisher. The interstate streams? 
 
 Mr. Stevens. Yes. 
 
 Mr. Fisher. Yes. 
 
 Mr. Stevens. They have encouraged that? 
 
 Mr. Fisher. Yes. 
 
 Mr. Wanger. There was a communication received, I suppose 
 pretty generally, by Members of Congress this morning from some¬ 
 body, declaring that the real purpose of the President of the United 
 States and of your association, of yourself and of others, was to make 
 the American Medical Association the czar of health problems. 
 
 Mr. Fisher. Yes, sir. You asked me if we had had any opposi¬ 
 tion. I had forgotten. There have been two pamphlets published 
 opposing the committee of one hundred, one by a man by the name 
 of Zack Shedd, in Denver, and another by the man you have in mind, 
 some one at the Hot Springs Reservation who has a bath house there. 
 
 Mr. Wanger. That was referred to. I thought the article was pub¬ 
 lished here in the city of Washington. 
 
 Mr. Fisher. Whatever you saw probably emanated from one of 
 those two men. They are men that the American Medical Associa¬ 
 tion has attacked as quacks, and they are striking back at the Ameri¬ 
 can Medical Association. One of them asserted that the American 
 Medical Association was to form a medical trust, and was under the 
 thumb of the Catholic Church. Considering the fact that we have 
 Archbishop Ireland as a member of our committee, that does not 
 seem very probable. It is ridiculous to discuss, but I will be glad 
 to go into it as far as it is desirable. I do not know who these men 
 are, but they have displayed utter ignorance as to what we were 
 doing and what we were attempting to do. 
 
 Mr. Ryan. No organized bodies or local boards of health, state or 
 otherwise, anywhere, are opposed to this movement? 
 
 Mr. Fisher. Not that I know of. Do you refer to any that you 
 have heard of? 
 
 Mr. Ryan. No; I have not heard of any. 
 
10 
 
 Mr. Fisher. General Wyman, do you know of any'? 
 
 Doctor Wyman. I do not know of any; no, sir. 
 
 Mr. Stevens. The serious thing with us is how far we ought to 
 deal with this matter of public health and how far it ought to be done 
 by the States. 
 
 Mr. Fishes. That is a question that scarcely need be discussed 
 in regard to this bill, I suppose, as this simply brings together the 
 existing health agencies. 
 
 Mr. Stevens. No. 
 
 Mr. Fisher. You mean what will be the next step? 
 
 Mr. Stevens. No; but in discussing these matters of health and 
 all these agencies that affect health, we run into that constantly. 
 
 Mr. Fisher. What can the Federal Government do? The Federal 
 Government can do two things. In the first place it can administer 
 laws such as those which the Public Health and Marine-Hospital 
 Service administers in connection with the quarantine, with reference 
 to the immigration inspection, the sailors’ hospital, and the other 
 hospitals of the Government, and the pure-food law and the meat- 
 inspection law; and in the second place it can distribute information. 
 Personally I believe the second is more important, distributing good 
 information. As Doctor Welch has said, it is really disgraceful in 
 this country, the lack of vital statistics that we have. We can not 
 tell in anything like the way they can in Europe what the length of 
 life is, what the rate of mortality is, and so forth. We have to guess 
 at it. There are only a few places for the registration area where we 
 have statistics. That is one thing and the distribution of informa¬ 
 tion is another. That would save a great deal of useless duplication. 
 For instance, in regard to tuberculosis the state board of Illinois dis¬ 
 tributes pamphlets similar to those distributed by Massachusetts or 
 any other State which has good health laws. One authoritative 
 pamphlet distributed by the Federal Government would serve the 
 purpose of 40 which are distributed now, and would have ten times or 
 one hundred times the circulation, and far more attention would be 
 paid to it. 
 
 Mr. Richardson. Is it not a fact that there has been a gradual and 
 very beneficial progress in legislation in the last six or eight years on 
 the subject of regulating health, and has it not come to be especially 
 in reference to what you said just now in regard to state rights con¬ 
 nected with the Public Plealth and Marine-Hospital Service? For 
 instance, it was understood clearly that all of the States had entire 
 rights to keep up their detention camps with reference to yellow fever 
 where they lodged people and looked after them and cared for them 
 before they were admitted into the ports. 
 
 Mr. Fisher. Yes, sir. 
 
 Mr. Richardson. The States had a right to do that. Under the 
 legislation that has taken place in the last few years that matter has 
 been amicably adjusted in regard to the rights of all the States, and 
 the Public Health and Marine-Hospital Service, by the consent and 
 with the countenance of the law, has taken possession of almost all 
 those detention camps, and so forth, that the States own, and the 
 Public Health and Marine-Hospital Service is now in a very satisfac¬ 
 tory manner dealing with that great question of yellow fever? 
 
 Mr. Fisher. Yes. 
 
 Mr. Richardson. Keeping it out of the country? 
 
11 
 
 Mr. Fisher. Yes. 
 
 Mr. Richardson. And the States are making no complaint, but on 
 the contrary the States, recognizing the rights that they have, have 
 turned over these matters to the Public Health arid Marine-Hospital 
 Service. Do you not think that that has been efficiently and fully 
 done? 
 
 Mr. Fisher. I think it has. 
 
 Mr. Richardson. With great advantage to the country? 
 
 Mr. Fisher. Yes, sir; and I would say that in the South it has been 
 especially so. We have had the most enthusiastic letters from the 
 South in regard to this matter. The state rights objection does not 
 seem to hold down there. They have regarded public health as a 
 subject in which federal extension would be permissible. 
 
 Mr. Wanger. When Doctor Reed was before the subcommittee he 
 said as follows: 
 
 Doctor Reed. Now, I want to call your attention to the fact that this bill stops with 
 the authorization of certain investigations, and the authorization of certain suggestions, 
 calculated to remedy these conditions. It does not confer upon the United States 
 Public Health and Marine-Hospital Service or upon any other agency known to the 
 United States Government the power actually to deal with these conditions, but only 
 to investigate and suggest and to propagate certain literature, and to that extent we 
 wish to say that it is valuable, and we have no objection to that provision except in so 
 far as legislation covering that point and no other point will have the effect upon 
 Congress of creating the impression that that question has been dealt with by legisla¬ 
 tion, and deferring the legislation which will actually grapple with the situation. 
 Therefore we wish to have inserted following this provision words in effect as follows, 
 “with power to carry such methods into effect.” 
 
 By that he meant the methods of prevention that ought to be 
 suggested. WTiat have you to say as to that? 
 
 Mr. Fisher. Our committee never has passed on that, Mr. Chairman. 
 I think that so far as that extension can be accomplished consist¬ 
 ently, and applying to interstate streams, the committee would 
 probably favor it. But it has not passed upon it, because it did not 
 feel that it ought to attempt too much at first. 
 
 Mr. Wanger. Then, after reading from section 4, Doctor Reed said: 
 
 There they are called upon again to investigate and report upon something that 
 the scientific world has been investigating and reporting on for the last twenty years 
 until the matter is reduced to a demonstration. 
 
 Mr. Fisher. I think that Doctor Reed overlooked one thing there, 
 that the kind of investigation that General Wyman must have had in 
 mind as to the pollution of interstate streams was specific investiga¬ 
 tion, as with regard to the Ohio River, for instance. It is true that 
 for twenty years the medical men and scientists have been investi¬ 
 gating pollution of streams, how far the pollution will carry before it 
 is obliterated, and so on; but investigation of the specific pollution of 
 specific streams, as I understand it, is the purpose here. The investi¬ 
 gation would be local; it would be intended specifically to state that 
 this particular stream is in need of attention, and to call attention ta 
 that would effect a great deal of reform by directing public attention 
 to local legislation as well as national legislation. 
 
 Mr. Wanger. Then Doctor Reed said: 
 
 Therefore we wish to have inserted, following the language that I have read, ending 
 with the word “pollution,” the following language: 
 
 “To formulate and enforce necessary regulations for the protection of all streams 
 and waterways within the jurisdiction of the United States Government from all 
 forms of contamination deleterious to the public health.” 
 
12 
 
 Now, has your association taken any action with reference to that 
 proposition? 
 
 Mr. Fisher. No, sir. 
 
 Mr. Wanger. You do not assume any attitude toward it at this 
 time ? 
 
 Mr. Fisher. No, sir; beyond what I have just said. 
 
 Mr. Wanger. Are there other persons here who desire to be heard 
 at this time on this public health problem? 
 
 Mr. Fisher. I might add one way suggested, that the Government 
 has already made a good beginning; for instance, in these bulletins 
 distributed by the Government. 
 
 Mr. Wanger. You mean distributed by the Public Health and 
 Marine-Hospital Service, or by other agencies? 
 
 Mr. Fisher. One by the Public Health and Marine-Hospital 
 Service and another by the Bureau of Animal Industry on the hook¬ 
 worm disease in the South, which has been studied by the Public 
 Health and Marine-Hospital Service. It is one purpose of this bill 
 to permit the extension of that campaign in the South. The hook¬ 
 worm disease is the explanation of the poor white in the South. He 
 is lazy because he is anaemic. He has only 20 per cent of white 
 corpuscles in his blood, and that is because he has this hook-worm 
 disease; and that disease can be overcome, according to the report 
 of the Public Health and Marine-Hospital Service, at a cost of about 
 60 cents in the case of each individual, and it would be easily possible 
 for the persons down there who are suffering with this disease to get 
 rid of it, and for the Public Health and Marine-Hospital Service to 
 stamp that disease out and raise the efficiency of the poor white in 
 the South just as it has been done in the case of the people in Porto 
 Rico. I was talking with the governor of Porto Rico some time ago, 
 and he said that the efficiency of the people there has been more 
 than doubled by that very means. 
 
 The Chairman. Are there other gentlemen who desire to be heard? 
 
 STATEMENT OF MR. GEORGE SHIRAS. 
 
 Mr. Shiras. Mr. Chairman, it happens that while I am a member of 
 the committee of one hundred I am also chairman of the committee on 
 legislation, and the questions by Mr. Stevens and Judge Richardson 
 as to the legal questions that may be involved as to federal and state 
 powers are very intricate constitutional questions which Have arisen 
 and will continue to arise for a long time. As chairman of the com¬ 
 mittee on legislation, I have gone into those questions in the last few 
 years and have prepared a brief of 200 pages, attempting to draw the 
 line where it is possible between the state and federal power, where it 
 is entirely distinct and where it is concurrent, and, as Professor Fisher 
 has already suggested, the particular amendment here does not raise 
 the constitutional question which may sooner or later come up in 
 regard to some of these measures, and which probably was discussed 
 fey you gentlemen in regard to the original bill here; that is, with 
 regard to the control of the Federal Government over the pollution of 
 interstate streams. I have an extensive brief on this subject, but that 
 bill has met with your approval and is on the calendar, and we did not 
 think it was necessary to bring any legal questions before you now, 
 but we thought we would submit this matter on its merits. I will 
 mention the fact, however, that I have looked into this thing, and if 
 
13 
 
 now or hereafter in the hearings you gentlemen, whose time is very 
 much occupied with other duties of this committee, not necessarily 
 relating to public health, either privately or as a committee desire me 
 to do so, I will be very glad to lay before you any information I have 
 as the result of these three years of investigation. I simply want to 
 state to you that this committee of one hundred through its committee 
 on legislation has not gone ahead blindly, ignoring the question of legal 
 and constitutional objections. 
 
 Mr. Adamson. If we would limit the scope of the bill dispensing 
 with the distributing of information we would not run any risk of 
 trouble from any such cause. I have tried for some years to enunci¬ 
 ate the doctrine that we could avoid all trouble that might arise by 
 eliminating everything relating to the distributing of information. 
 
 Mr. Shiras. I think if you limit it not only to the jurisdiction of 
 the Federal Government now, but what it ought to exercise in the 
 future—of course I know your time is limited here, and I do not care 
 about bringing that up except in the way of a suggestion to this 
 committee, that this committee of one hundred, through its commit¬ 
 tee on legislation, has gone carefully into this in regard to the pending 
 bills and those on the statute books and the one which will have to 
 follow. This is the foundation we are laying here, and I want you 
 to feel that we are not ill prepared, but the committee has been 
 working for several years on these matters. I think it is well to tell 
 this committee that if they think there are doubtful questions 
 involved, we at least are endeavoring to meet them, after having 
 made an investigation, and I desired to make the statement that we 
 have gone very fully into those questions. I only state this for the 
 information of the committee. 
 
 Mr. Wanger. If that is all there is on that subject, the committee 
 may pass to other matters. General Wyman, do you desire to make 
 any statement ? 
 
 STATEMENT OF DR. WALTER WYMAN, SURGEON-GENERAL 
 PUBLIC HEALTH AND MARINE-HOSPITAL SERVICE. 
 
 Doctor Wyman. Mr. Chairman, I did not expect to say a word, 
 but some one has asked me to express my opinion in regard to the 
 committee of one hundred. I think they have stirred up interest in 
 a matter that is helpful to the public-health interests of the country. 
 I wish to express myself in that way. 
 
 Mr. Stevens. But do you think it would be advisable at this time 
 to attempt a better- 
 
 Doctor Wyman. I had my hearing, you know, before the com¬ 
 mittee, and I am a bureau officer, and all that I wished to say at the 
 present time was simply that I wished to express my gratification at 
 the interest in public health laws and the harmony of the public 
 health bodies in regard to this. 
 
 Mr. Stevens. You do not wish to disturb the harmony? 
 
 Doctor Wyman. No, sir. 
 
 Mr. Wanger. Doctor Wiley, do you desire to say anything? 
 
14 
 
 STATEMENT OF DR. HARVEY W. WILEY, CHIEF OF THE BUREAU 
 OF CHEMISTRY, DEPARTMENT OF AGRICULTURE. 
 
 Doctor Wiley. I am very much in the same position that Doctor 
 Wyman is in. I am in entire sympathy with the work of the com¬ 
 mittee of one hundred and the great work which it has in view, which 
 it has started and proposes; and also I would be personally in favor, 
 and officially if permitted to do so, of any operation which would make 
 the public health work of this country more effective and at the same 
 time less extravagent. I think the two could be brought together. 
 While I am in the same position that General Wyman is in, and I 
 can not make any recommendation, I want to state that I sympathize 
 with the efforts of these men in the committee of one hundred through 
 their organized representatives to do everything that is possible to 
 improve the efficiency of the health service. I think that it is the 
 natural desire of man to live, whether he is doing much good or not. 
 It is a human desire. And it is right to live as long as possible and to 
 make our lives more efficient and useful by good health while we do live. 
 
 Mr. Adamson. jrand you have got to be the judge as to whether you 
 are doing any good or not, have you not ? 
 
 Doctor Wiley. Well, we differ in our opinions as to that. 
 
 Mr. Ajdamson. And pure food will be very conducive to longevity? 
 
 Doctor Wiley. Pure food and pure drugs, which I have charge of 
 in interstate commerce, I think would be very conducive to long life 
 and happiness and contentment. 
 
 Mr. Adamson. And if a man has the idea that foods are full of all 
 sorts of things, so that he loses his appetite and can not eat them, they 
 do not hurt him, then? 
 
 Doctor Wiley. The appetite will return if he works hard enough. 
 
 Mr. Fisher. May I add one word? 
 
 Mr. Wanger. Certainly. 
 
 Mr. Fisher. I was much interested in the hearing in regard to the 
 matter of wireless telegraphy and also as to the proposition before 
 this committee with regard to safety appliances. These are detailed 
 in the general programme for the good of the nation. The saving of 
 life at sea and on land is only a small per cent of the saving that is 
 possible. There are 2,000 deaths every day that are unnecessary— 
 cases in which death could be postponed indefinitely and useful lives 
 could be continued. 
 
 Mr. Adamson. The committee of one hundred is a committee of 
 general jurisdiction, is it, Doctor? 
 
 Mr. Fisher. We have no jurisdiction; our function is only advi¬ 
 sory. 
 
 O