COLUMBIA LIBRARIES OFFSITE HEALTH SCIENCES STANDARD HX64072983 R A394 An2 state medicine a men RECAP fi^/9 3 well known, however, that the vaccination advocated by Jenner has, like smallpox inoculation, been long since re- pudiated by the medical profession. Jenner's first experi- 84 ment was with swinepox, with which he inoculated one of his ovm children (who afterwards died of tuberculosis). * * * * P. 13. "At first one vaccination was to protect for life; this claim was soon modified and two vaccinations were con- sidered necessary to confer lifelong immunity. The obsti- nacy of smallpox in attacking persons so vaccinated then re- sulted in shortening the period of immunity to fourteen years; later it v/as reduced to seven years, then five, and in the Spanish-American War — as shown by the practice of our army surgeons — six weeks was considered the limit of im- munity." Smallpox Reduction Due to Sanitation. — Dr. C. Killick Millard, Medical Officer of Health for Leicester, England, in a recent book entitled "The Vaccination Question" issued in 1914, calls attention to the decline in smallpox along with such other diseases as the plague, cholera or typhus fever due to sanitation. He says: P. VHI, Preface. "For forty years, corresponding roughly with the advent of the 'sanitary era', smallpox has gradually but steadily been leaving this country (England). For the past ten years the disease has ceased to have any appreciable effect upon our mortality statistics. For most of that period it has been entirely absent except for a few isolated outbreaks here and there. It is reasonable to believe that with the perfecting and more general adoption of mod- ern methods of control and with improved sanitation (using the term in its widest sense) smallpox will be as completely banished from this country as has been the case with plague, cholera, or typhus fever. Accompanying this decline in small- pox there has been a notable diminution during the past decade in the amount of infantile vaccination. This falling off in vaccination is steadily increasing and is becoming very widespread. * * * P. 22. "It cannot be denied that vaccination causes, in the 85 aggregate, very considerable injury to health, most of it only temporary, but some permanent. It is true that the deaths certified as due to vaccination are less numerous now than they used to be, but some deaths still occur every year. * * * During the last decade the deaths from vaccinia have several times outnumbered those from smallpox, vv^hilst if we have regard to the amount of ill-health caused by the two diseases (and putting aside for the moment the question of the alleged effect of vaccination in lessening smallpox) it looks as if vaccinia were becoming, so far as the community is concerned, the more serious disease of the two. * * * P. 185. "The orthodox view, held by most Medical Offi- cers of Health, is that there is a grave danger of smallpox returning in widespread epidemic form and causing a terrible mortality as was the case in the pre-vaccination era. * * * Undoubtedly, many have a genuine fear that if smallpox once succeeded in obtaining a foothold in an unvaccinated com- munity it would spread 'with a rapidity of which we have in recent times had no experience.' I realize that any one who suggests that this view is unduly alarmist incurs a cer- tain measure of responsibility, and I believe that this reflec- tion has hitherto deterred those who might otherwise have been inclined to express a more sanguine view. Personally, having been Medical Officer of Health for thirteen years in a town which, for practical purposes, may be regarded as unvaccinated; living and moving, as I do, amongst a child population 90 per cent of which is unvaccinated, I feel un- able to subscribe to this pessimistic view. I believe that the sanitary condition of the country has been so greatly im- proved, and alternative measures for dealing with smallpox have been so highly evolved, that we shall never revert to the stage of things which existed in the days before vaccina- tion was discovered." Statistics fail to show that the mildness of smallpox in the United States and the small number of deaths caused by small- pox are due to vaccination, according to Assistant Surgeon General John W. Trask of the United States Public Health Service. He says*: "One of the most notable features of the smallpox which has been more or less prevalent in the United States for at least ten years is its extreme mildness and the small number of deaths which it has caused. In 1909 the combined states from which complete reports were received had 19,534 cases with 92 deaths, which was a mortality rate of 0.471 for each 100 cases. In 1910 the rate was considerably higher, but still remarkably low when compared with the rates reported from other countries. * * * * "That the community is protected by vaccination may be true for certain localities, but that the protection thus afforded is general can hardly be maintained. Japan as a nation is probably as well or better protected by vaccination than is the United States, and yet in 1907-1908 there was an outbreak of smallpox in Japan in which 19,101 cases were reported with 6,273 deaths. Vaccination did not there modify the type of the disease to that found in America. In that outbreak among 5,215 smallpox patients 1,527 were found who had never been vaccinated. This is interesting as indicating a relatively small number of unvaccinated individuals. The epidemic was ap- parently one of considerable virulence, the general death rate per 100 being 42.25 among the cases in 1907 and 32.32 among those in 1908, while the deaths among the unvaccinated were 69.4 per 100 cases. Kitasato believes that the virulence of the disease varies and that when it reaches the high point attained in Japan during 1907-1908 individuals who have been previ- ously vaccinated, and even those who have previously had an attack, contract the disease. In this outbreak there were 242 cases in seven prefectures in which the patient had previously had the disease. Of these, 57 died. ^Extracts from "Smallpox in the United States — Prevalence and Geographic Distribution During tha Calendar Year 1910," by John W. Trask, Assistant Surgeon General of the United States Public Health Service in "Public Health Reports," official weekly publication of the United States Public Health Service, June 23, 1911, pp. 944-945. 87 "If the non- virulence of the disease in this country is due to protection by vaccination it would be expected that the mild cases would be found only in those so protected. This may be assumed from the limited information available not to be the case. Records of the vaccination history of all patients would undoubtedly add much to our knowledge of the sub- ject. "That the type of the disease as seen in the United States is due to the protective value of vaccination is sho>vn not to be true for certain localities in which outbreaks of the viru- lent form of the disease have been reported. These outbreaks have occurred at widely separated points extending from Vir- ginia and South Carolina in 1909 to Michigan, Oklahoma, Texas and Oregon in 1910. * * * " Vaccination a Surgical Procedure, Sometimes Followed by Severe and Even Fatal Results. — The following are a few out of a large number of admissions by advocates of vac- cination that severe and even fatal results may follow the use of vaccine virus. Vr. Milton J. Rosenau, Professor of Preventive Medicine and Hygiene in Harvard University, says^ : "However, vaccination is not always a harmless procedure ; it must be looked upon as the production of an acute infec- tious disease, and, although the disease is always mild and trivial, it must not be treated as trifling. The chief danger lies in the fact that we have produced an open wound, which is subject to the complications of any wound. Even a pin prick or a razor scratch may result in death. While the ag- gregate number of deaths resulting from the complications of vaccination may be considerable, the aggregate of the indi- vidual risk is so small as to be disregarded, especially when proper precautions are taken." The New York Medical Journal in an editorial July 17, 1915, said: ^''Preventive Medicine and Hygiene," by Dr. Rosenau, published by D. Apple ton & Co. in 1914. p, 19. 88 "The next step, after cleansing the patient, was the investi- gation of the virus. It was found that bacteria of many sorts were present constantly. The attempt was then made to de- crease the number and experiments showed that mixing the virus with concentrated glycerine and keeping it in the re- frigerator for two or three months caused a great reduction. The spores that might be present, however, were not affected, while the activity of the virus was impaired considerably This method of preparation, nevertheless, is what is com- monly employed today; infections are not numerous, but the percentage of 'takes' may not be as great." In a later editorial, December 11, 1915, the New York Medical Journal said: "Tragic events, especially if preventable in any degree, which jeopardize a procedure of such vast importance, should receive most earnest attention. "Tetanus following vaccination is an event of just this char- acter. All available evidence, both clinical and experimental, justifies the belief that infections of this kind are not due to the vaccine virus per se, but occur subsequently, and are at- tributable to later contaminations of the vaccination wound. In ail justice, however, it must be admitted that experience also teaches, despite all contrary evidence, that vaccination wounds, at least in children of certain ages, are unduly prone to such infections. The reasons are not apparent. "At least two valuable points may be suggested for all to follow. First, however, trivial the operation of vaccination may seem, we should always remember that it is a surgical procedure, sometimes followed by severe and even fatal re- sults. It should therefore be done with all possible care, cleanliness, and attention. Second, if tetanus unfortunately develops, it should not be forgotten that the prompt adminis- tration of tetanus antitoxin, in sufficient quantity, and by the proper routes may result in saving a life." Compulsory Vaccination Fostered by Commercialism. — The following extracts from a book by Mr. Chas. M. Higgins 89 throws an interesting light on the extensive commercialism back of compulsory vaccination. Mr. Higgins says^: "The latest official reports show that there are now ninety- nine concerns licensed by the U. S. Government to manufac- ture vaccines and serums for both human and animal uses! These ninety-nine concerns have a capitalization of about fifty millions or more. One of the largest of these manufacturers, located in Detroit, has a capital of ten millions, while another large concern located in Philadelphia has a capital of two millions. "The two great epidemics of Foot and Mouth Disease, or virulent cowpox, in this country in 1902 and 1908 were caused by the vaccine virus of two of these ninety-nine vaccine manu- facturers; and these epidemics resulted in great mortality to animals and mankind, as already shown, with a loss of mil- lions of dollars to the Government and people of the United States ; but no recompense has ever yet been made, so far as I know, to the Government or people by these vaccine com- panies for this great damage, and I ask your particular at- tention, Mr. President, to this important point. "Now, to give a list of all the medical societies in the United States and their membership figures would take too much space here, as their names and numbers are 'legion' ; but I can give some figures which will include the chief National So- ciety and the chief State societies in the leading State of New York as follows : Members American Medical Association 43,000 Medical Society, State of N. Y 8,000 Associated Physicians of Long Island 503 Brooklyn Medical Association 300 Medical Society of Kings County 950 Harlem Medical Association 400 ^Horrors of Vaccination Exposed and Illustrated — Petition to the President to Abolish Compulsory Vaccination in the Army and Navy," by Cbas. M. Higgins, Brooklyn, N. Y. 1920y 90 Members Medical Association, Greater City of N, Y 750 Medical Society of County of N. Y ^... 3,709 N. Y. Academy of Medicine 1,400 "This table, while including only a partial list of medical societies in the United States, comprises some of the largest and most influential societies of the dominant or allopathic school, active in the national field and in our own local field of New York State. Now each State in the Union has a similar group of local or State Societies and these several State societies combined with the big National societies and with the ninety-nine vaccine companies form, obviously, a most gigantic medical, political and commercial interest behind the medical evil of compulsory vaccination. Of course, a great many doctors of this dominant school are advanced and pro- gressive enough to oppose all compulsory vaccination; but doctors of this type unfortunately seem to be a minority, at present, in the dominant vaccine school of medicine. On the other hand, a large majority in almost all of the other schools of medicine are strongly opposed to vaccination, particularly to all forms of compulsion. "A glance at this list of medical societies already given, with its startling membership figures, combined with the ninety-nine vaccine companies, must convince any thoughtful man of the dangerous size and organization of these medical and vaccine interests, which obviously have more or less of a joint interest to force their vaccine operations and products upon the people as much as possible by compulsory laws, and otherwise, and whose joint profits are obviously in direct proportion to this use. "Now, no other profession has anything like the large and well organized membership and corresponding political power and influence of the medical profession in the body politic. Indeed, few, if any, trade or business organizations can com- c^are with the medical profession in this respect, and this 91 medical power is further greatly increased beyond that of any other profession, trade or business in being in practical con- trol of our most important Departments of Public Health and Vital Statistics all over the country, so that in advocating and practicing the dangerous barbarism of compulsory medi- cine this medical power can easily deny and conceal the actual effects of this dangerous medication on human health and life in our vital statistics. * * * '» EXISTING LAWS AND REGULATIONS Vaccination against smallpox, typhoid and paratyphoid fever are compulsory in the United States Army and Navy. The United States quarantine regulations, 1910, provide that persons coming from localities where smallpox is pre- vailing, shall not be allowed entry without vaccination, unless they have had a previous attack of the disease or have been vaccinated recently. The laws in regard to compulsory vaccination are being repealed or changed in so many states that a digest of the laws now in force would be unrehable a few months hence. The laws now in force range all the way from providing for compulsory general vaccination, in certain cases, to mak- ing compulsory vaccination unlawful. Some states provide that the state board of health may require vaccination in time of epidemic if it is thought to be necessary ; some states pro- vide that local health authorities may, when deemed neces- sary, adopt measures for general vaccination. Vaccination or quarantine of exposed persons is provided for, either by law or regulation in a number of states. Several states make vac- cination a condition to admission to the public schools. The Pennsylvania law includes all public, private, parochial, Sun- day or other schools. In a number of states vaccination of school children is made optional with local authorities, and laws passed in a few states provide that unvaccinated chil- dren may be excluded from the public schools for a specified period during epIdemicSa 92 Compulsory Vaccination Forbidden. — In 1907 the follow- ing law was passed by the State of Utah : "Hereafter it shall be unlawful for any board of health, board of education or any other public board, acting in this state under police regulations or otherwise, to compel by reso- lution, order, or proceedings of any kind, the vaccination of any child, or person of any age ; or making vaccination a con- dition precedent to the attendance at any public or private school in the state of Utah, either as pupil or teacher." — Section 1113x26 of the Compiled Laws, 1907, of the state of Utah. In the early part of 1919 an Act was passed in North Da- kota providing that "No form of vaccination or inoculation shall hereafter be made a condition precedent, in this state, for the admission to any pubHc or private school or college, of any person, or for the exercise of any right, the performance of any duty, or the enjoyment of any privilege, by any per- son." Compulsory vaccination is either illegal in a number of other states or permitted only under specified conditions. In an analysis of the laws and regulations relating to vac- cination in force in the United States, J. W. Kerr, Assistant Surgeon General of the United States Public Health Service, says : "As to the practical enforcement of the existing provisions, no opinion can be expressed. Health authorities of various states admit that, owing to general apathy or lack of funds, vaccination is seldom systematically enforced, except perhaps in the case of school children." Why North Dakota Abolished Compulsory Vaccination. — The law passed in North Dakota was the outcome of a Supreme Court Decision in that state a short time previous in the case of Lawrence F. Rhea vs. Board of Education of Devil's Lake. The court in that case held that the Board 5f Health was not authorized to issue an order denying to children the right to attend the public schools except upon condition of being vaccinated where it appears that there is 93 no prevailing epidemic of smallpox and no imminent danger from this disease reasonably anticipated; that school officers were not authorized to exclude children for non-vaccination, in the absence of a showing of danger due to the existence of smallpox in the community or reasonably imminent ; that children were not to be excluded from schools on the sole ground of non-vaccination. The opinion of the Supreme Court written by Justice Bird- sell was to the effect that the North Dakota Board of Health and the Board of Education of Devil's Lake, acting under a regulation of the State Board of Health, had exceeded their authority in attempting to make vaccination a requirement for admission to the public schools. It held that the board of health was not the public prosecutor. That "Even the public prosecutor could not compel vaccination." Justice Robinson also agreed with the opinion of the court but wrote a separate opinion of his own. The separate opin- ion by Justice Robinson is a strong denunciation of compul- sory vaccination and special attention is called to the following extracts from his opinion in the case of Lawrence F. Rhea vs. Board of Education of Devil's Lake, N. D., September Term, 1918: "The non-vaccination of children — is it a cause for exclud- ing them from the public schools in a state where smallpox does not prevail, and where the sickness and death resulting from vaccination would far exceed that now resulting from smallpox — that is the question. We must consider not only the statutes, but also the origin and nature of smallpox. It is a disease which originates in filth, the crowding of people together, the lack of pure air, good food and good sanitary conditions. It prevails and becomes epidemic only in coun- tries where the population is dense and the sanitary conditions are bad. It was in such countries, and in days when sanita- tion was unknown, that the doctrine of vaccination was promulgated and adopted as a religious creed. Gradually it spread to other countries where conditions are so different 94 that vaccination is justly regarded as a menace and a curse. And where, as it appears, the primary purpose of vaccination is to give a living to the vaccinators. In this great northwest the disease has never prevailed to any considerable extent and it has never become epidemic. Hence, were vaccination to become general, it would be certain to cause the sickness or death of a thousand children where one child now sickens and dies from smallpox. Of course a different story is told by the class that reap a golden harvest from vaccination and the diseases caused by it. Yet, because of their self-interest, their doctrine must be received with the greatest care and scrutiny. Every person of common sense and observation must know that it is not the welfare of the children that causes the vac- cinators to preach their doctrines and to incur the expense of lobbying for vaccination statutes. * * * * "England, with its dense population and insanitary condi- tions, was the first country to adopt compulsory vaccination, but there it has been denounced and abandoned. In the city of Leicester vaccination has long since been tabooed, and there, because of special regard for cleanliness and good sani- tation, the people fear no smallpox. But in Prussia, Ger- many, and other such countries, the light shineth in darkness and the darkness comprehendeth it not. "In the book of Dr. Peebles on vaccination there are statistics to the effect that 25,000 children are annually slaugh- tered by diseases inoculated into the system by compulsory vaccination. It is shown beyond doubt that vaccination is not infrequently the cause of death, syphilis, cancer, consumption, eczema, leprosy and other diseases. It is shown that if vac- cination has any tendency to prevent an attack of smallpox, the remedy is worse than the disease. "In the last printed circular of the Board of Health it is said: 'Compulsory vaccination is required in the schools of this state this year for the first time in history. The com- pulsory vaccination law has been on the statute books for 95 several years and it has never been enforced because of a seeming unpopularity with a certain class of persons.' "For the months of July, August and September, 1917, the circular gives the number of persons dying from disease, thus: "Smallpox 1 "Consumption 72 "Typhoid 6 "Diphtheria 18 "And so it appears that smallpox is the least dangerous of the infectious diseases. With proper care no person dies of smallpox and the disease gives the patient and his descendants more or less immunity from other diseases. * * * Child vaccination in a state where smallpox does not prevail, it is a barbarism and it is the duty of the child growers to rebel against it. 4: * 4c 4( "Fmally, the proper safeguard is by sanitation. The chances are that within a generation vaccination will cease to exist. It will go the way of inoculation, bleeding, purging and salivation. The vaccinators must learn to live without sowing the seeds of death and disease." CHAPTER IX FAILURE OF MEDICAL CONTROL WHERE MOST COMPLETE AN INDICTMENT OF STATE MEDICINE "It is apparent that it is more dangerous to be a soldier in peace- ful United States than to have been on the firing line in France. From the statistics so far available, the death rate in the military camps is higher than among the civil population, even in similar age groups. The mortality in New York and Chicago, for in- stance, shows that the death rate in the Army is more than double that of the civi] population of the same age group. There is also the possibilitv that when allowances are made for the fact that defectives have been eliminated from the Army, and that these poor 'risks' swell the civil death list, the corrected margin will be still further increased in favor of the civil population." — Dr. Victor G. Heiser in the Journal of the American Medical Association, De- cember 7, 1918. THE failure of so-called "preventive medicine" measures in the past to offer any real protection, as experienced in our Army and Navy during the recent world war, as ex- perienced in the nationwide campaign against tuberculosis and in the drastic measures instituted during the influenza epi- demic in 1918, should serve as a warning against the estabhsh- ment of state medicine; and emphasize the importance of giving greater attention to sanitation and living conditions in public health work. EXPERIENCE IN THE ARMY As previously stated vaccination against smallpox, typhoid and paratyphoid fever is compulsory in the United States Army and Navy. Reference has already been made under Chapter VIII to the dangers following the use of smallpox virus and the lack 97' of sound proof that vaccination offers any protection what- ever against smallpox. The dangers in the use of typhoid vaccination are brought out by Dr. D'avis and Dr. Woodruff in the following. Dr. D. J. Davis in the Journal of the American Medical Association for February 24, 1912, said : "We should remember that any substance that will, in a healthy individual, cause headache, nausea, insomnia and an increase of temperature of two or sometimes three degrees, etc., as the typhoid vaccine may do in the doses used, must be considered a powerful toxin. Consequently, it is reason- able to assume that certain changes, such as myocardial de- generation, vascular changes, kidney degenerations, etc., might easily result, though they may be manifested only at a much later period of life. And perhaps the consequences might be much more severe should the vaccine be injected into an indi- vidual who was at the time suffering from renal, cardiac or other lesions. At any rate, it would seem inadvisable to use the vaccine previous to a careful physical examination." The following extracts are taken from a lengthy article by Lieut-Col. Qias. E. Woodruff, M. D. (U. S. A. Retired), entitled 'Tuberculosis Following Typhoid Fever", which ap- peared in the January, 1914, number of American Medicine: "Le Tulle tells me that all serums and vaccines will cause incipient cases to get rapidly worse. He has particularly no- ticed this in giving the antitoxins of diphtheria and tetanus. * * * (Monde Medical, December 5, 1912.) Chante- messe, of Paris, informs me that he has seen two cases of rapid tuberculosis develop a few days after anti-typhoid vac- cination, and he warns particularly against using it where tuberculosis is suspected. :): >|c ^ :{< "In respect to non-tubercular diseases made worse by ty- phoid, Vincent (ibid) mentions many which are adversely affected by anti-typhoid vaccine; and Spooner (ibid) says that every latent or chronic non-typhoidal disease is made worse 98 by it and though there was prompt recovery as a rule some 'accidents' occurred. The instructions as to the vaccine em- phasize the caution not to use it if there is any sign of disease or debility. Prendergast gave the vaccine to four diabetics to reduce the sugar (N. Y. Med. Rec, Jan. 3, 1914). One developed tubercle bacilli in the sputum six weeks after treat- ment, dying on the ninth day after the last dose. "Since the above article was put in type, Dr. Ralph Matson, Director of the Portland Open Air Sanatorium, has written that seventeen per cent of his cases give a history of previous typhoid, and that he estimates that the tuberculosis is a direct sequence in ten per cent of all his cases. Two recent cases attributed their tuberculosis to typhoid vaccine received when in apparent perfect health. They volunteered the information without question on his part." In the American Army during the recent world w^ar sanita- tion was the very best tliat sanitary skill could make it, but where sanitation was neglected as in the following instance the fact that the soldiers had been inoculated against typhoid and paratyphoid did not prevent them from contracting the^ disease. The following extracts are from an article by Walter D. McCaw, Colonel, Medical Corps, Chief Surgeon, appearing in "Public Health Reports", the official weekly bulletin of the United States Public Health Service, for March 3S, IDlD: P. 60.5. "In, view of the appearance and continued inci- dence of fevers of the typhoid-paratyphoid group in many units of the American Expeditionary Forces during the past five months, it is deemed essential to review this subject at the present time, particularly from the viewpoint of early diagnosis, prevention, and control. "The occurrence and distribution of typhoid-paratyphoid in our troops has constantly and continuously been brought to the attention of all medical officers serving with the American Expeditionary Forces through the medium of the weekly bul- letin of diseases. It would appear, however, that many offi- 99 cers have utterly failed to grasp the significance of these re- ports-and warnings, a fact which may be due to a false sense of security under the popular belief that vaccination against typhoid and paratyphoid gives a complete immunity even in the midst of gross insanitary conditions. * * * P. 606. "In July, 1918, a replacement unit consisting of 248 men from Camp Cody, N. Max., reached England with ty- phoid prevaihng extensively; 98 men, or 39.5 per cent, had typhoid and the case death rate was 8.43 per cent. * * * P. 607. "(c) In August, 1916, a small but severe epi- demic occurred in a detachment of Engineer troops stationed at Bazoilles. In this unit 15 cases of typhoid occurred, with a death rate approximating 10 per cent. * * * "(d) During the Chateau-Thierry offensive diarrheal dis- eases were very prevalent in the troops engaged — approxi- mately 75 per cent. It was demonstrated bacteriologically in this area that the prevailing intestinal diseases were simple diarrhea, bacillary dysentery, typhoid, paratyphoid A and B * * * "(f) Following the offensive in the Argonne sector, ty- phoid and paratyphoid began to be reported from practically all divisions engaged in that offensive. * * * More than 300 cases of typhoid-paratyphoid may be attributed to the Argonne offensive. Eight hundred and seventy-four typhoids and paratyphoids have been reported in the American Ex- peditionary Forces since October 1, 1918. * * *" From a physical standpoint our soldiers were the very pick of the nation. . They were taken from the most rugged years of human life and from these all who were in any way subject to dis- ease were eliminated. They were then put into active out- of-door life, rigidly supervised and in addition were abso- lutely turned over to the allopathic medical profession -who in- jected into their blood all the "preventatives" at present in favor. There was no restriction ; no choice and no resistance. 100 Everything the medical authorities would like to have the opportunity to do to the civilian they had the authority to do to the soldier and they did it. The Reports of the Surgeon General of the U. S. Army for 1918 and 1919 containing statistics of the health condi- tions of the United States Army for the calendar years 1917 and 1918 respectively shows very conclusively that medical control when put into practice means more cases of sickness and death instead of less. The death rate of American troops in all countries was 4.5 in 1910 and increased to 6.3 in 1917. For enUsted men, American troops in the United States the death rate from disease for 1918 was 21,93. These men were stationed in this country so that exposure from battle was not a factor. To compare favorably with the death rate of the civil popula- tion in the same age group in this country the death rate of soldiers in the United States should have been many times less than it actually was. In fact, it was higher than the death rate of the population as a whole in the registration area in the United States in 1918, which was 18. The total number of admissions to hospitals for diseases for the year 1918 for enlisted men of the American Army amounted to 2,326,632 cases. For enlisted men the highest admission rate was in 'the United States. It was 1,293.62 per 1,000 men, the total number of cases being 1,694,954. In other words, as an average every enlisted soldier in the United States had to go to the hospital once and some of them twice during the year 1918 on account of sickness. The total number of days lost from disease for the year 1918 was 40,692,302. This is equivalent to 111,486 men re- maining idle throughout the year at the expense of the Gov- ernment on account of illness. The loss of time among sol- diers in the United States in 1918 amounted to 24,812,769 days. Adding the discharge rate of 84.68 per 1,000 of soldiers in the United States to the death rate of 21.93 it would mean a 101 total of 106 men out of every thousand soldiers in the United States who were unable to serve because of illness or death. To this number also should be added a part or all of the 51.88 per 1,000 non-effectives. EXPERIENCE IN THE NAVY The failure of medical control during 1918 was just as com- plete in the Navy as in the Army. According to the Report of the Surgeon General of the Navy "all preventive measures which seemed logical, either from a priori reasoning or because of seemingly good effects claimed for them elsewhere during the year or in previous epidemics, were tried in the Navy." In spite of this, the death rate in the naval forces ashore in the United States in 1918 for Influenza and pneumonia (all forms) was 18.77 per 1,000 while that of the population gen- erally in the United States in 1918 for the same diseases was 5.83 per 1,000 and 18 per 1,000 for all diseases. Notwithstanding compulsory vaccination against smallpox, typhoid and paratyphoid in the Army there were 768 cases of typhoid in 1918; 624 cases of smallpox; 73 cases of para- typhoid A. and 34 cases of paratyphoid B. The number of admissions in the army in 1918 on account of typhoid vaccination was 23,191 and the number on account of vaccinia was 10,830. In 1917 there were a total of 19,608 admissions on account of typhoid vaccination -and vaccinia. This would make a total of 53,629 soldiers who were made sick for the two years directly ascribed to typhoid and small pox vaccination. The compulsory medical treatment and supervision to which the soldiers and sailors were subjected was not only the cause of many of them being sent to the hospital but may account for the low resisting power of the soldiers and sailors whereby so many of them became ill from influenza, tuber- culosis and other diseases. 102 TUBERCULOSIS CAMPAIGN A FAILURE Campaign Founded on Fear. — The popularizing of knowledge of the tubercle bacillus, as stated in an editorial in the Journal of the American Medical Association, January 3, 1914, referring editorially to an address by Dr. E. R. Baldwin of Saranac Lake, has given rise to widespread fear among physicians, nurses and the laity. It says: "He points out the need of applying a check to phthisiopho- bia, which 'has had no check from the time the knowledge of the bacillus was popularized. Cornet's dust experiments first gave the impulse to a fear, followed by Flugge's droplet in- fection, which has aggravated the solicitude felt by physicians and nurses, and which has been gradually spread to the laity.' Not until the recent researches, briefly considered in the fore- going, have we had a proper understanding of the great power of defense of which the average adult is capable, although not a few careful clinical observers have pointed out evi- dence that thei constantly exposed husbands and wives with consumptive mates show no such morbidity as a high degree of contagiousness would necessarily produce, and the inci- dence of tuberculosis in physicians and nurses in tuberculosis hospitals is not indicative of a ready infection with the omni- present bacilli." Dr. Thomas J. Mays of Philadelphia has written a num- ber of articles reviewing the failure of anti-tuberculosis cam- paigns in the past which were founded on the basis of regis- tering consumptives and treating them as the subjects of con- tagious diseases. In an article in the New York Medical Journal for September 26, 1914, he says: 'Tn America this movement started in the early nineties and swept over the country like a tidal wave. Being thus fairl)/ launched, and in order to make itself at least more conven- tional, it adopted the tactics of the Grand Duke of Tuscany when he consulted the Florence School of Medicine concern- ing- this same question in 1754; and sought ofificial recogni- 103 tion from the College of Physicians of Philadelphia, the old- est, most renowned, and most celebrated medical institution in America. The college, like its predecessor the Florence school, rejected the proposal and instead passed the follow- ing resolution: 'The College of Physicians of Philadelphia believes that the attempt to register consumptives and to treat them as the subjects of contagious disease would be adding hardship to the lives of these unfortunates, stamping them as outcasts of society. In view of the chronic character of the malady, it could not lead to any measures of value not other- wise obtainable.' "This resolution was at that time regarded by the friends of the crusade as a marked retrogression, and as a bar to the achievement of a wonderful boon to humanity, but when viewed in the light of the stern and unbending facts of past history, of how this cold-blooded movement ostracises mil- lions of our fellow countrymen at the present day; of the millions more who are to share the same fate; of its respon- sibility for the increased death rate of this disease during the last dozen years ; it reads like an inspired prophecy." Value of Sanatoriums Overestimated. — In line with the anti-tuberculosis campaign which was founded on the basis of registering consumptives and treating them as the subjects of contagious diseases the various state legislatures have been besieged with requests to authorize the expenditure of mil- lions upon millions of dollars for sanatoriums. That sana- toriums have failed to show better lasting results than prop- erly conducted home treatment is the opinion of Dr. Maurice Fishberg, Clinical Professor of Tuberculosis, New York Uni- versity and Bellevue Hospital Medical College, in a recent book by him entitled "Pulmonary Tuberculosis". He says: P. 507. "In the available institutions there is hardly place for 5 per cent of the existing proper cases. To provide ac- commodations for all suitable cases in the United States, sev- eral billions would have to be invested in buildings and equip- ment, and then at least $100,000,000 annually for mainte- 104 nance. Even the most enthusiastic of those engaged In the campaign for the control of tuberculosis are not hopeful of ever raising such enormous funds. . . P. 508. "It can be stated v/ithout fear of meeting proofs to the contrary that, on the whole, sanatoriums do not show better lasting results than properly conducted home treatment. In this country, hardly any State or municipal sanatoriums have published satisfactoi-y reports with comparative statistics showing the results attained as compared with a similar group of patients treated in their homes. The most competent com- pilations of statistics have been published by Lawrason Brown and Pope about the discharged patients from Saranac Lake, and by Herbert Maxon King of the Loomis Sanatorium. To be sure, Brown shows that five, ten, and even eighteen years after discharge some of the patients were found alive and even efficient at their occupations. But the average life of the consumptive outside of the institution, under any mode of treatment, has been found to be between six or seven years. Stadler reports that five years after the onset of the disease one-half of tuberculous patients are found who are able to work without sanatorium treatment. There are similar sta- tistics available for other countries, and I have no doubt that in the United States we would find conditions the same. King's conclusion as to the value of the sanatorium treatment is that his inquiry 'clearly demonstrates the uncertainty of apparent immediate results of treatment.' " Statistics Fail to Show Any Favorable Results from Anti- Tuberculosis Campaign. — Notwithstanding the fact that millions upon millions of dollars are annually expended in the campaign against tuberculosis for the medical examination and treatment of tuberculosis patients and for a nation-wide propaganda explaining medical theories regarding the disease little or no progress can be shown due to the campaign. This is admitted by George Thomas Palmer of Springfield, Illi- nois, in an article entitled "The Need for a Broader Program in the Campaign Against Tuberculosis," published in "The 105 American Review of Tuberculosis," a monthly publication issued by the National Tuberculosis Association, Baltimore, Md., for July, 1919, in ^vhich he says : P. 268. "The optimistic answer, so commonly employed by popular health educators and propagandists, to the effect that the mortality from tuberculosis has been decreased 25 per cent during the past fifteen years, during which the or- ganized warfare against the disease has been in operation, is not so satisfying or convincing as it appears. . . "The first tuberculosis society created in the United States was that established in 1892 at Philadelphia. This may be taken as the beginning of the organized campaign in the na- tion. During the succeeding twenty years, or up until 1911, the death rate per 10,000 of population in American cities decreased from 23.8 to 16.6, or a decrease of 30.25 per cent. "But unfortunately for the enthusiasts who argue only from statistics, during the preceding twenty years, from 1872 to 1891, and entirely prior to the first adoption of an American tuberculosis program, the rate per 10,000 of population had fallen from 33.9 to 24.5, or a decrease of 27.47 per cent. In other words, the rate of decrease during the first twenty years of anti-tuberculosis propaganda, over the preceding twenty years, was something less than 3 per cent. P. 269. "In fact, Hoffman pointed out, from such statis- tics as vv^ere available, that in the cities of New York, Phila- delphia and Boston, the tuberculosis death rates had quite steadily declined for a period of one hundred years, from something over 450 per 100,000 of population in 1812 to less than 200 per 100,000 in 1911, the more decided decrease be- ginning about 1881, or eleven years before the first organized tuberculosis work in America; but, incidentally, at about the time of Koch's discovery of the tubercle bacillus. P. 271. "Coincident with the descending curve in tubercu- losis mortality, people were living cleaner, better and more wholesome lives and interest in general health was steadily in- creasing. While we were passing through our early hysterical 106 fear of infection, in our frenzied battle with the tubercle bacil- lus, and were awakening from our over-colored dreams of short cuts to cure, scores of medical and social agencies were coming into life trying to solve the problems of better living and of better health. What part these agencies have had, since 1882, in shaping the downward curve of tuberculosis mortality, is beyond accurate determination. Our thoughtful conjecture is that it has been large, and so believing, we must consider to what greater extent these forces and agencies may be em- ployed in continuing that curve which is still too far from the bottom of the scale." Failure of Medical Control in Influenza Epidemic. — The "Illinois Health News," the Official Monthly Bulletin of the State Department of Public Health of Illinois for December, 1918, published a letter written by an Illinois health officer ridiculing the various proposed measures for the control of influenza offered by the physicians in charge of or employed by health departments. The letter, which is written as a joke, reflects the manner in which physicians generally in charge of health departments made the most drastic regulations that the public would tolerate for the alleged prevention of in- fluenza, one health officer claiming that one thing was of value and the next ridiculing the method proposed by the first and recommending something else. The following is the article in the "Illinois Health News" referred to: P. 216. "An Illinois health officer, who attended the re- cent sessions of the American Public Health Association in Chicago, to learn better methods of handling influenza in his community, wrote the following letter home to his ever-sym- pathetic friend, the town druggist: "Dear Bill: The evening 'session is just over. From eminent scientists whose names are known all over Elk jaw County I find that influenza ain't influenza, but had better be designated as the X-disease. It is transmitted entirely through the mouth by way of camp kits and the reason face masks are valuable is because they keep your fingers out of your 107 mouth. At the same time, it ain't what I jtist said ; but is due to droplet infection from coughing and sneezing for which reason one city overcame the infection by everybody wearing masks while in another town where everybody wore masks the disease was worse than if they hadn't. Face masks are a sure preventative except where they are not, in which case they are all piffle and the same is true with closing up every- thing some places, stopping the disease by general closing and others making things much better by keeping everything wide open. One guy from the south said that closing churches didn't prevent crowds in Chicago ; but did in Alabama. Noth- ing was said about closing up crowds of two after meeting which is a close contact problem in our town. Vaccination was found of great value in 231 communities and not worth a whistle in 232 with one man not voting. The meeting is going to hold over and we are going to pass resolutions. Just after the meeting adjourned, I met Joe Patchen, in the hard- ware business in Dallas. He had been having a session a few stories below in the hotel. He says the only question he had to solve was whether ice skating was chiefly in tights or for tights. He looked the part, and has an easy job. "Sincerely yours, "Abe. "P. S. — Please wire me fifty. I don't dare draw on the health department since I have spilled all I knew since com- ing here and am now a sanitary vacuum, if you know what I mean. "Second P. S. — Resolutions just passed by special commit- tee. I am back where I was before. Never mind wiring. I can come home at once and have money enough for that." The various measures adopted by health officers for the al- leged control of influenza are not looked upon by the public as a joke. The closing of churches, theaters and schools; regulations in many cities requiring everyone to wear a mask while in public places, and the segregation of large numbers of persons interfered with business and with the normal pur- 108 suits of the individual in such a manner as to constitute a serious charge against persons responsible for such measures unless it can be shown that they were necessary. The Journal of the American Medical Association Novem- ber 2, 1918 in referring to the measures taken in the District of Columbia to combat the epidemic mentions, "the declara- tion of the District of Columbia as a sanitary zone; making influenza a reportable disease and requiring the segregation of persons suffering with it; closing of schools, churches, the- aters, and other places of public assemblage," etc. and says, "In spite of all this the impression is current that the epi- demic has simply burnt up all the available susceptible fuel and has passed on to new areas." It is . worth noting, that in the smallest commonwealth in the United States where the citizens cannot protest effectively against public control, having no vote, which little com- monwealth had the direct cooperation of the great Public Health Service, no protection to the public is observable. In- deed, it had one of the worst records in the entire country. In New York City, where according to Dr. Royal S. Cope- land, Commissioner of Health of that city, he permitted peo- ple to go about their ordinary affairs as usual, the death rate from influenza and pneumonia during the influenza epidemic of 1918 was only 14.4 per thousand population as compared to 20.8 per thousand population in Washington, D. C. and 25.8 in San Francisco, both of which tried a number of ex- treme and irrational measures for the prevention of influenza. CHAPTER X THE CONSTITUTION A PROTECTION AGAINST STATE MEDICINE "We hold these truths to be self evident: That all men are created equal; that they are endowed by their Creator with certain unalien- able rights; that among these are life, liberty and the pursuit of happiness." — Declaration of Independence. THE fact that the Constitution of the United States con- tains a great many provisions to protect the rights of the people is of great importance as a protection against medical encroachments on the rights of the people. The United States Constitution is above Congress, the courts and the President. It is the fundamental law which fixes and determines the form of government that exists under it; defines and limits the powers of that government and directs its executive, legisla- tive, and judicial maintenance and action. The government and all its branches deriving power and authority soley from the Constitution, can only do what that Constitution gives authority to do as provided in Article IX and X as follows: "The enumeration in the Constitution of certain rights, shall not be construed to deny or disparage others retained by the people. "The powers not delegated to the United States by the Con- stitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people." One of the purposes of the Constitution as specified in the preamble is to "secure the blessings of liberty to ourselves and our posterity." The first amendment to the Constitution is the culmination of the struggle for religious freedom in this country. It says: no "Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof, or abridg- ing the freedom of speech, or of the press ; or the right of the people peaceably to assemble, and to petition the government for a redress of grievances." The fourth amendment is a protection against the entrance of the home and unreasonable searches and seizures. It reads: "The right of the people to be secure in their persons, houses, papers and effects, against unreasonable searches and seizures, shall not be violated, and no warrants shall issue, but upon probable cause, supported by oath or affirmation, and particularly describing the place to be searched, and the per- sons or things to be seized." Amendment No. 5 specifies that no person shall be "de- prived of life, liberty or property, without due process of law." Section 1, Amendment No. 13, is a protection against medi- cal slavery as well as any other form of involuntary servi- tude. It says: "Neither slavery nor involuntary servitude, except as a punishment for crime, whereof the party shall have been duly convicted, shall exist within the United States or any place subject to their jurisdiction." LIBERTY HIGHLY PRIZED BY OUR FOREFATHERS The Declaration of Independence which was adopted July 4, 1776, declares : "We hold these truths to be self evident: That all men are created equal; that they are endowed by their Creator with certain unalienable rights; that among these are life, liberty and the pursuit of happiness. That to secure these rights, Governments are instituted among men, deriving their just powers from the consent of the governed, that when ever any form of government becomes destructive of these ends^ it is the right of the people to alter or to abolish it.'* Ill The early settlers of this country who had suffered bitter per- secution because of the intolerance shown them, placed a high valuation upon "life, liberty and the pursuit of happiness." When the subject of liberty was being discussed in the Vir- ginia convention, Patrick Henry declared: "Is Hfe so dear or p^ace so sweet as to be purchased at the price of chains and slavery? Forbid it. Almighty God! I know not what course others may take, but as for me, give me liberty, or give me death." We live in a country rich in experience, reminding us of the value of liberty. Abraham Lincoln, whose memory is so dear to all American citizens, understood the meaning of the word liberty. The Gettysburg address of President Lin- coln, which has become a classic not only in American ora- tory, but Tn the oratory of the world, refers to liberty in the opening sentence. It says : "Fourscore and seven years ago, our fathers brought forth on this continent a new nation, conceived in liberty and dedi- cated to the proposition that all men are created equal." LIBERTY IN JEOPARDY The subject of medical legislation is no longer a subject of interest to only a few people. Medical inspectors have invaded the public schools with lectures on disease germs, compulsory vaccination where possible, constant examina- tions of the throat, heart and lungs, and demands for the re- moval of the tonsils and other alleged defects when in many cases at least there was no justification for such removal. They are asking for compulsory medical examinations of adults in many cases and are making it difficult to obtain em- ployment without their permission. They are isolating people under the theory that they are "disease carriers," or subject to tuberculosis. The measures which are being advocated under the pretense of protecting the public health reach into all the relations of human life. The liberty of all the people in this and future generations is thereby jeopardized. 112 THE CITIZEN'S DUTY The Constitution of the United States is a protection against medical slavery, but the people must insist upon this protec- tion if they are to maintain it. The efforts of Assistant Com- missioner of Education Enright of New Jersey to interpret, according to a Trenton dispatch some years ago, the clause in a statute referring to the subject of vaccination, "may exclude from schools" as meaning "shall exclude from schools" is a good example of how a statute or thel Constitution may be misinterpreted if the people fail to insist upon their rights. There has never been a time in the histor>' of the United States when it was more important to keep in mind the words "eternal vigilance is the price of liberty" than now and a duty rests upon all American citizens to see that medical free- dom is established and maintained. INDEX Alabama 16, 17 Allopathic Medicine 40 American Association for La- bor Legislation 22 American Medical Association 16, 24, 89 Antitoxin (See also Toxin Antitoxin) 97 Appendectomy 42 Appropriations 11, 28 Army, U. S 16, 35, 39, 96 Bacteriophobia 49 Baldwin, Dr. E. R 102 Blood-letting 40, 41 Blue, Dr. Rupert : 16 Boards of Health 4, 15 Boston 49 Brady, Dr. William 69 Braisted, William C 16 Brooklyn (N. Y.) Citizen 5 Burr, Dr. Charles W 70 Bushnell, Dr. George E 67 Cabot, Dr. Richard C. 61, 65, 75 California 11, 17, 22 California Board of Health Bulletin 68 Card-Indexing Everybody 23 Carnegie, Andrew 40 "Carriers" 17, 32 Children's Bureau 72 Chiropractic 56, 57, 60 Christian Science 60 Commercialism 22, 82, 88 Compulsory Health Insurance.. 22 Compulsory Medicine 14, 31, 49, 75, 88, 92, 96 Connecticut 17 Constitution, U. S 14, 20, 77, 109 Copeland, Dr. Royal S 108 Davis, Dr. D. J 35, 97 Declaration of Independence....l09 Department of Health (See National Department of Health) Diagnosis 60, 65 Diphtheria ....32, 47, 50, .76, 97 District of Columbia 108 Dixon, Dr. Samuel G 14 Draft Figures 73 Drake, Dr. C. St. Clair 36 Draper, Andrew S 83 Eclectic Medicine 57, 60 Educational Requirements 63 Enright, Assistant Commis- sioner of Education 112 Epilepsy 45 Evans, Dr. W. A 27, 38 Examinations (See Medical Examinations) Face Masks -49, 107 Fads In Medicine 42 Family Income 9 Favill, Dr. H. B 27 Fear 4, 49, 70, 102 Fishberg, Dr. Maurice 103 Fisher, Prof. Irving 21 Foot and Mouth Disease 89 France, Senator Joseph 1 23 Furstman, Dr. J. M 38 Germ Theory 4, 30, 49, 102 114 Gettysburg Address Ill Gorgas, W. C 11, 26, 57 Green, Dr. Frederick R 3, 17 Harris, Dr. Louis 1 36 Health Boards (See Boards of Health) Health Insurance (See Com- pulsory Health Insurance) Heiser, Dr. Victor G 8, 96 Hektoen, Dr. Ludvig 62 Hemenway, Dr. Henry B 20 Henry, Patrick HI Higgins, Chas. M 88 Higher Living Conditions....8, 106 History of Medicine 40 Hodge, Dr. J. W 49, 50 Hoffman, Frederick L., LL. D 2 Homeopathy 40, 58, 60 Illinois Health News 106 Illinois Medical Journal 28 Indiana - — 1'' Infant Mortality (See also Maternity and Infancy Care) 9 Infantile Paralysis 5 Influenza 68, 101, 106 Iowa - 17 James, Prof. William 56, 57 Japan • 86 Jenner, Edward 83 Journal of the American Med- ical Association 2, 22, 47, 52, 60, 76, 102, 108 Kansas — — 17 Kansas State Board of Health Bulletin „ 9 Kerr, J. W 92 Kinsella, Dr. Ralph A 33 Knowles, Morris 15 Lancet-Clinic 25, 69 Laws 17, 49, 91 Liberty 109, 111 Lincoln, Abraham „ Ill Locomotor Ataxia 44 Louisville (Ky.) Courier- Journal 6 Massachusetts — 12 Maternity and Infancy Care..9, 28 Mays, Dr. Thomas J „....102 McCaw, Walter D 39, 98 Mclntire, Dr. Charles 4 McLaughlin, Allan J 21 Mechanotherapy 57 Medical Certificate Before Marriage 17 Medical Examinations 17, 22, 36, 50, 65 Medical Practice Acts 17, 56 Medical Teachings..4, 17, 29, 49, 71 Meigs, Dr. Grace L 72 Michigan 17 Millard, Dr. C. Killick. 84 "Millions Upon Millions" 21 Myers, Dr. Park L. 49, 53 National Department of Health 18, 27 National Education Associa- tion 26 Naturopathy 57 Navy, U. S 16, 101 New Jersey ~ 17, 112 New York - „ 17 New York City. 36, 108 New York City Department of Health 34 New York Evening Post 77 New York Medical Journal..71, 87 New York Sun....~ . 6 Nevada ~ 17 Non-Allopathic Systems 40 115 North Dakota 17, 92 Nottingham, M.A. Ph.D., LL.D ....- 65, 79 Opsonic Index 63 Oregon ~ 17 Osteopathy 56, 57, 60 Palmer, George Thomas 104 Pennsylvania 11 Peterson, Dr. Frederick 43 Phthisiophobia 103 Physical Education 28 Pitcairn, John 83 Police Power 21 Poverty 9 Preventive Medicine 29 Public Health Service ....„ 10, 16, 21, 47, 108 Ravenel Dr., Mazyck P 30 Rest Cure 45 Rhea, Lavi^rence F. vs. Board of Education 92 Robinson, Justice 93 Rosenau, Dr. Milton J 87 Rucker, W. C 1 Rural Districts 73 Sanitation 6, 11, 37, 81, 84, 98 Sanatoriums „ 49, 103 Schick Test 47 Sectarianism _ 57 Shaw, Dr. Henry L. K 33, 37 Showalter, William Joseph 7 Simon, Charles E 17, 33 Smallpox 83 Smallpox Inoculation 82 Soper, George A. _ 6 State Medicine _ 1, 14 Sterilization of Criminals 17 Stripping School Children 69 Styles in Medical Legislation.... 17 Tetanus 88 Tonsils and Adenoids 46, 62 Toxin Antitoxin — 47 Trask, John W 86 Trephining 45 Tuberculosis 8, 49, 67, 97, 102 Typhoid Fever 7, 17, 39, 98 Utah 93 Vaccination Against Small- pox 17, 49, 83, 101 Vaccination Against Typhoid 17, 39, 97, 101 Vaccines and Serums....31, 43, 97 Van Derslice, Dr. J. W 18 Vaughan, Dr. Victor C. 21, 39 Wallace, Professor Alfred Russel 83 Washington - 17 Washington, George 41 Webster, Daniel 14 White, Dr. Joseph A. 33 Wisconsin _ 17 Women's Clubs 36 Woodruff, Lieut.Col. Chas. E. 97 Youth's Companion 71 Zeisler, Dr. Joseph 43, 62 ^COLUMBIA UNIVERSITY LIBRARIES This book is due on the date indicated below, or at the expiration of a definite period after the date of borrowing, as provided by the rules of the Library or by special ar- rangement with the Librarian in charge. DATE BORROWED DATE DUE DATE BORROWED DATE DUE "■"■'' ' ' on*? m 1 o^i« i 0£ ,0 2. W '■^ jini* \^ 1 \ . 1 C2a(1 140) Ml 00 COLUMBIA UNIVERSITY LIBRARIES 0041076877