Chapter XVI: Section VIII: The Congress shall have power (6)

These men are here, and we have done mighty little for them. We cannot wonder that they segregate in their rooms at night, after working in the mines all day, and read Socialistic literature which comes from their country. We do mighty little to encourage them to learn the English language; we do mighty little to encourage them to enter into the spirit of true America; we have neglected them all too long—and then we complain that they are not American citizens. I appeal to you as citizens of the United States and of the State of Indiana, to see that everything that is possible is done to make good citizens of these men. Get legislation under which they can work, and the safety problem will take care of itself. (Continued applause.)

President WHITE—The next subject for consideration is “The Prevention of Railroad Accidents,” by Mr. Thomas H. Johnson, consulting engineer of the Pennsylvania Lines, West. I take pleasure in introducing Mr. Johnson. (Applause.)

Mr. JOHNSON—In approaching this subject it will be well to get our viewpoint adjusted to a true perspective and just proportion. Accidents on railways which result in death or injury to persons, are all reported to State and National officials, and when the statistics for the year are compiled and published the total figures are startling, and suggest that the transportation business of the country is conducted at a fearful sacrifice of life and limb. It should be remembered, however, that in no other line of the Nation’s activities are similar complete statistics available.

The only data at hand to show the relation between the numbers killed and injured on railways, and those occurring in other lines of action, are found in a pamphlet issued by the city of Chicago, entitled “Report of the General Superintendent of Police,” from which the following table is taken:

CHICAGO, ILLINOIS.

_Accidents Reported by the Police Department, Year 1911._

Fatal. Non-fatal. Total.
Steam Railway Accidents 187 554 741
Street and Elevated Railway Accidents 106 3,646 3,752
Accidents Caused by Teams and Vehicles 135 2,812 2,947
Accidents Caused by Falling from Windows,
Scaffolds, Porches, etc. 149 2,680 2,829
Bitten by Dogs 4 1,281 1,285
Injuries by Personal Violence 177 2,729 2,906
Overcome by Gas, Smoke or Heat 189 653 842
Scalded or Burned 81 216 297
Various Other Causes 193 1,945 2,138
————— —————— ——————
Total 1,221 16,516 17,737

From this it will be noted that of 1,221 fatal accidents in 1911, only 187 occurred on steam railways, and of 16,516 nonfatal, only 554 are charged against them. Comparing the total accidents, it will be seen that five times as many persons were killed and injured on street railways as on steam railways, four times as many by teams and vehicles, four times as many by falls from windows, scaffolds, etc., and again four times as many by personal violence. Even the dogs come in for having done 73 per cent. more damage than the steam railways. Taking the last two items together, it appears that Chicago’s vicious dogs and more vicious men are nearly six times as destructive of life and limb as are the railways.

While the foregoing figures are for the city of Chicago only, they are indicative of the fact that throughout the country the number of accidents on railways is a mere fraction of those occurring elsewhere, and this fact has been recognized by the accident insurance companies when they issue policies calling for double compensation if the accident occurs while traveling in steam or trolley cars.

If the grand total of accidents on railways appears so startling when presented in concrete figures, what would it be if equally complete figures could be had for the other types of accidents classified in the Chicago report?

And now having cleared the atmosphere in that respect, we will proceed to consider the railway accidents on their own merits.

The Interstate Commerce Commission issues a series of quarterly bulletins of railway accidents. They also issue an annual report of general railway statistics, in which a summary of statistics of railway accidents was included prior to 1910, but which has since been admitted as an unnecessary duplication. The statistics of the annual report have been compiled on a somewhat different basis from those of the bulletins, and the two sets of figures cannot always be reconciled. In compiling the following tables the annual reports prior to 1910 have been followed as being the final word of the Commission.

It should be noted that the statistics of railway accidents are divided into two general classes:

First. Accidents due to the movement of trains, engines or cars, which may properly be called “transportation accidents.”

Second. Accidents not connected with train or car movements, such as happen to shopmen, warehousemen, trackmen handling material, etc., such as are equally occurring in other industries, and which are more properly classed as “industrial accidents.”

This discussion will be chiefly devoted to the first class, as being distinctively “railway accidents.”

PROGRESS IN THE PAST.

The loss of life from railway accidents began with the day of the opening of the first railway in England, in September, 1830, on which occasion a prominent citizen, a member of Parliament, was knocked down and fatally injured, sending a thrill of horror not only through the great throng of spectators, but also throughout the civilized world. That unfortunate accident was not due to any defect in track or equipment, nor to any fault in the operation of the train. It was due to the victim’s failure to appreciate the danger attending the then new and novel mode of transportation, and inadvertently putting himself in a position of danger. It was the forerunner and prototype of many thousands of others which have since occurred through carelessness and sheer recklessness of the victims, and which the railway companies are powerless to prevent.

But as railways multiplied other accidents occurred, which were due to defects of one kind or another in track and equipment, or to inadequate rules governing train movements, and the duties of the several employes. Each accident has been carefully studied as to its cause, and, so far as possible, remedies have been applied. Thus the immense system of transportation as it exists today has been a gradual development from crude beginnings. The light iron rails inadequately secured at the joints have been replaced with heavy steel rails with effective joint fastenings. Train movements have been safeguarded by a well-digested system of rules, uniform on all railroads; by standard forms of train orders with all ambiguities of language eliminated, and by block signals, interlocking and automatic couplers, air brakes and other safety devices. Stoves and oil lamps, with their menace of fire, have given way to steam heating and electric lighting. The inflammable wooden cars are being replaced with steel equipment. In fact, there has been a steady progress from the beginning in the effort to reduce the danger to life and limb.

But accidents continue to happen, partly because the rapid growth of traffic and the demand for greater speed are creating new conditions, partly because materials have hidden defects and the human machine is not infallible, and partly because discipline has been largely subverted through the attitude of the brotherhoods of employes.

In order to show in a general way what has been accomplished, the average figures for the five-year period from 1889 to 1893, inclusive, have been compared with the corresponding figures for the years 1907 to 1911, inclusive, with the following results:

Ratio of passengers carried to one killed has increased 35.5 per cent.

Ratio of employes to one killed has increased 54.7 per cent.

This shows a very decided gain in the twenty-two years covered by the record.

The number injured cannot be compared in the same way, for the reason that in the later years the reports include large numbers of minor injuries of a more or less trivial nature, which were not included in the earlier reports, but which the Interstate Commerce Commission now requires to be reported, thus swelling the number injured out of all proportion to the earlier reports. Under the present rules, if a passenger lets a window sash bruise his finger, and it is brought to the attention of any of the train crew, it must be reported, and enters into the final statistics with as much weight as the loss of an arm or a leg.

CAUSE AND PREVENTION.

In the Accident Bulletin for June, 1910, pages 10 and 11, there are given detailed statistics of twenty-six “prominent train accidents” with the causes of each. They embrace thirteen collisions and thirteen derailments, resulting in sixty-two killed, 306 injured, and a property loss of $261,584. The causes assigned may be grouped under fifteen heads, as follows:

Excessive speed, 5; ran by meeting point, 2; failed to flag, 5; disobeying orders, 1; misunderstanding orders, 1; failure to receive orders, 1; conflicting orders, 1; signal light out and engineman failed to stop, 1; broken rail, 2; explosion of boiler, 1; spreading of rails, 1; washout, 1; trestle failed, 1; insufficient ballast, 1; defective temporary junction of new and old rails, 1. Total, 26.

These fifteen assigned causes may be summarized thus:

Failure of persons, 18; failure of boiler, 1; failure of track and structures, 7. Total, 26.

Of the seven failures of track and structures, the two cases of “broken rails” and one “washout” may be considered unavoidable. The remaining four cases in that group, viz., “spreading of rails,” “trestle failed,” “insufficient ballast” and “defective temporary junction of old and new rails” were preventable, and could have occurred only from neglect of those charged with their care and maintenance.

The one case of “explosion of boiler” may have been due to defective material, or to negligence of the engineman.

We find, therefore, that in this group of accidents, twenty-two were preventable, three unavoidable and one doubtful.

Of the unavoidable, the “washout” may be dismissed as being beyond the control of human agencies, but the “broken rail” calls for further consideration.

Rail failures are generally due to chemical or physical defects, not entirely under control of the manufacturer, and not discoverable by inspection of the finished rails. Under the present practice the manufacture of rails is watched at the mill by the railway company’s inspectors. Specimens from each heat or melt are tested under a weight of 2,000 pounds falling fifteen feet to twenty feet. If the test piece breaks the steel is regarded as too brittle, and the rails from that heat are rejected. If it does not break, but the deflection exceeds the prescribed limit, the steel is too soft, and those rails are accepted as seconds, to be used only in yards and side tracks. All test pieces which do not break under the foregoing drop test are then broken and examined for internal defects. If defects are found, further tests are made, and the heat rejected in whole or in part, on the extent of unsoundness disclosed.

But herein lies a difficulty. Internal defects can only be found by breaking the rail. A rail broken is past usefulness. Hence that form of inspection cannot be applied to every rail; and as we can only test a limited portion of each heat, some defective rails must inevitably be passed and get into track. Complete statistics of all rail failures on a large proportion of the railways of the United States have been collected by the American Railway Engineering Association for several years past. These reports have been collected and classified as to the several causes, the results being printed in the publications of the Association. They show that the rails which fail annually are less than one eighth of one per cent. of the rails laid. This indicates fairly successful inspection, and would be quite satisfactory were it not that a single failure may result in such horrible consequences.

Five years ago (1907) as the result of several conferences between a committee of the American Railway Association and the rail manufacturers, a systematic study of the subject was undertaken, with a view to ascertaining the cause, and if possible, the prevention of rail failures. This research work was placed in charge of the Rail Committee of the American Railway Engineering Association, who engaged the services of a competent expert, who devotes his whole time to the work, furnishing freely of their materials and facilities at the mills. The line of investigation includes studies of the effects of variations in composition; in time in the bath; in time in the ladle; in manner and rate of pouring; in size of ingot; in rate of reduction at each pass; in temperature of the metal when rolled; in the effect of different alloys, etc. The field of investigation is broad and complicated. Much progress has been made, but much remains to be done. It is hoped, however, that success will ultimately be reached, and the rail failures in service be reduced to the lowest possible minimum. Certainly the railway engineers and the manufacturers are making every effort to accomplish that result.

Of late the adoption of some form of automatic stop has been suggested, and more or less urgently advocated. But let us consider: Referring again to the list of causes of the twenty-six accidents, such a device would have been called into play only in one case, that of running by a signal when the light was out. It could have had no influence on any one of the other twenty-five cases. Furthermore, it has been the experience the world over that emergency devices, resting in “innocuous desuetude” for long intervals of time, usually fail to work when the emergency arises. It may be said that it should be some one’s duty to see that the apparatus is kept in working order. Very true. But therein is a reversion to ultimate dependence on the human factor with its attendant weakness and frailties.

The foregoing list of accidents embrace only a few of the more prominent “collisions” and “derailments.” But there are other forms of accident, as shown in the following statistical tables copied from the Interstate Commerce Commission Annual Report for 1909:

ACCIDENTS RESULTING FROM THE MOVEMENT OF TRAINS, LOCOMOTIVES, OR CARS.

_Interstate Commerce Commission Annual Report, 1909._

=========================+====================================
| Employes.
+————————————————+———————————————————
| | Switch Tenders,
KIND OF ACCIDENT. | Trainmen. | Crossing Tenders
| | and Watchmen.
+———————+————————+—————————+—————————
|Killed.|Injured.| Killed. | Injured.
—————————————————————————+———————+————————+—————————+—————————
Coupling or uncoupling | 137 | 2,271 | 4 | 35
Collision | 205 | 1,973 | 1 | 10
Derailments | 184 | 1,186 | | 10
Parting of trains | 7 | 233 | | 2
Locomotives or cars | | | |
breaking down | 9 | 159 | | 2
Falling from trains, | 295 | 4,433 | 1 | 56
locomotives, or cars | | | |
Jumping on or off trains,| 84 | 4,135 | 6 | 64
locomotives or cars | | | |
Struck by trains, | 243 | 577 | 72 | 79
locomotives or cars | | | |
Overhead obstructions | 47 | 775 | | 6
Other causes | 133 | 13,376 | 9 | 243
+———————+————————+—————————+—————————
Total | 1,344 | 29,118 | 93 | 507
—————————————————————————+———————+————————+—————————+—————————

=========================+====================================
| Employes (Continued).
+————————————————+———————————————————
| |
KIND OF ACCIDENT. | Station Men. | Shopmen.
| |
+———————+————————+—————————+—————————
|Killed.|Injured.| Killed. | Injured.
—————————————————————————+———————+————————+—————————+—————————
Coupling or uncoupling | 2 | 2 | 1 | 17
Collision | | 1 | 1 | 23
Derailments | | 2 | 1 | 6
Parting of trains | | 1 | |
Locomotives or cars | | | |
breaking down | | | | 6
Falling from trains, | | | |
locomotives, or cars | | 30 | 2 | 65
Jumping on or off trains,| | | |
locomotives or cars | | 24 | 4 | 59
Struck by trains, | | | |
locomotives or cars | 21 | 25 | 41 | 89
Overhead obstructions | | | | 4
Other causes | 2 | 121 | 14 | 465
+———————+————————+—————————+—————————
Total | 25 | 206 | 64 | 734
—————————————————————————+———————+————————+—————————+—————————

—————————————————————————+————————————————————————————————————
| Employes (Continued).
+————————————————+———————————————————
KIND OF ACCIDENT. | Trackmen. | Telegraph
| | Employes.
+———————+————————+—————————+—————————
|Killed.|Injured.| Killed. | Injured.
—————————————————————————+———————+————————+—————————+—————————
Coupling or uncoupling | | 7 | |
Collisions | 18 | 132 | | 7
Derailments | 13 | 64 | |
Parting of trains | 1 | 2 | |
Locomotives or cars | | | |
breaking down | 2 | 10 | |
Falling from trains, | | | |
locomotives, or cars | 13 | 159 | | 7
Jumping on or off trains,| | | |
locomotives or cars | 16 | 130 | | 13
Struck by trains, | | | |
locomotives or cars | 353 | 412 | 8 | 12
Overhead obstructions | | 4 | |
Other causes | 25 | 882 | | 34
+———————+————————+—————————+—————————
Total | 441 | 1,802 | 8 | 73
—————————————————————————+———————+————————+—————————+—————————

—————————————————————————+————————————————————————————————————
| Employes (Continued).
+————————————————+———————————————————
KIND OF ACCIDENT. | Other | Total.
| Employes. |
+———————+————————+—————————+—————————
|Killed.|Injured.| Killed. | Injured.
—————————————————————————+———————+————————+—————————+—————————
Coupling or uncoupling | 11 | 50 | 155 | 2,382
Collisions | 27 | 163 | 252 | 2,309
Derailments | 10 | 117 | 208 | 1,385
Parting of trains | 1 | 12 | 9 | 250
Locomotives or cars | | | |
breaking down | 1 | 1 | 12 | 178
Falling from trains, | | | |
locomotives, or cars | 36 | 234 | 347 | 4,983
Jumping on or off trains,| | | |
locomotives or cars | 22 | 261 | 132 | 4,686
Struck by trains, | | | |
locomotives or cars | 187 | 345 | 925 | 1,539
Overhead obstructions | 5 | 20 | 52 | 809
Other causes | 83 | 1,340 | 266 | 16,461
+———————+————————+—————————+—————————
Total | 383 | 2,542 | 2,358 | 34,982
—————————————————————————+———————+————————+—————————+—————————

—————————————————————————+————————————————+———————————————————
| | Other Persons.
| Passengers. +———————————————————
KIND OF ACCIDENT. | | Trespassing.
+————————————————+———————————————————
|Killed.|Injured.| Killed. | Injured.
—————————————————————————+———————+————————+—————————+—————————
Collisions | 69 | 2,379 | 13 | 49
Derailments | 17 | 2,426 | 32 | 69
Parting of trains | | 47 | 3 | 3
Locomotives or cars | | | |
breaking down | | 2 | | 1
Falling from trains, | | | |
locomotives or cars | 37 | 425 | 413 | 732
Jumping on or off trains | | | |
locomotives or cars | 81 | 1,503 | 445 | 1,688
Struck by trains, | | | |
locomotives or cars; | | | |
At highway crossings | 2 | 3 | 112 | 211
At stations | 30 | 67 | 365 | 334
At other points along | | | |
track | 1 | 12 | 3,371 | 2,037
Other causes | 12 | 2,715 | 190 | 635
+———————+————————+—————————+—————————
Total | 249 | 9,579 | 4,944 | 5,759
=========================+=======+========+=========+=========

—————————————————————————+————————————————+———————————————————
| Other Persons.
|————————————————+———————————————————
KIND OF ACCIDENT. |Not Trespassing.| Total.
+————————————————+———————————————————
|Killed.|Injured.| Killed. | Injured.
—————————————————————————+———————+————————+—————————+—————————
Collisions | 25 | 447 | 38 | 496
Derailments | 6 | 287 | 38 | 356
Parting of trains | | 13 | 3 | 16
Locomotives or cars | | | |
breaking down | 1 | 4 | 1 | 5
Falling from trains, | | | |
locomotives or cars | 13 | 72 | 426 | 804
Jumping on or off trains | | | |
locomotives or cars | 11 | 120 | 456 | 1,808
Struck by trains, | | | |
locomotives or cars; | | | |
At highway crossings | 621 | 1,619 | 733 | 1,830
At stations | 66 | 183 | 431 | 517
At other points along | | | |
track | 79 | 143 | 3,450 | 2,180
Other causes | 47 | 1,030 | 237 | 1,665
+———————+————————+—————————+—————————
Total | 869 | 3,918 | 5,813 | 9,677
=========================+=======+========+=========+=========

Referring to the column of totals under the head of “Employes” you will note the large number of killed and injured in coupling or uncoupling cars; this in spite of the fact that all the equipment is fitted with automatic couplers, intended to prevent just those accidents.

The next two items, “Collisions” and “Derailments,” are also large, both as to employes, passengers and others, and we have already seen that in the former list eighteen out of twenty-six were due to “failure of persons.” Referring again to that list it will be further seen that sixteen of the eighteen were due to failure of the persons in charge of the trains, which justifies us in assuming that a similarly large proportion of these totals are due to like causes.

Please note also the large numbers, running through all these classes of persons, opposite the items “Falling from trains, locomotives or cars” and “Jumping on or off trains, locomotives or cars.” These may all be charged to the carelessness of the victims.

So, also, those “Struck by trains, locomotives or cars” nearly all of these are chargeable to the fault of the parties themselves.

“Other causes” are also prolific in casualties, but the data at hand does not disclose the extent to which they are chargeable to carelessness of victims or others, to preventable or to unavoidable causes.

Your attention is also directed to the very large numbers of killed and injured while “trespassing” on the railway property. Some of these belong to the great army of tramps infesting the country, but the largest part are people of the communities along the lines, who persist in using the tracks as a public thoroughfare. In most of the States there are laws on the statute books which are adequate to prevent this if duly enforced, but it seems impossible to get such enforcement. On the lines with which the writer is connected, efforts have been made in the past to break up this practice, but without success. Parties arrested by the railway company’s police and taken before the local magistrate have been released without punishment or only assessed a nominal sum to secure to the magistrate his fees. A rigid enforcement of these laws, and similar action as to jumping on or off locomotives and cars in motion (as is done in Europe) would eliminate approximately one-half the total killed and one-fourth the injured.

Here is a field in which the railways alone are helpless, but where much can be accomplished by legal enforcement, supported by strong popular approval. Without the latter, little aid can be expected from the average country justice or city magistrate.

INDUSTRIAL ACCIDENTS.

The first man to publicly call attention to the need of organized effort in this direction was Mr. R. C. Richards of the Chicago and Northwestern Railway, in his booklet “Railway Accidents, Their Cause and Prevention,” published in 1906. The seed thus sown has taken deep root, for at the present time nearly every leading railway in the country has an organized safety committee, whose duty it is to make regular periodic inspections to see that work places and tools are in safe condition; that yards, tracks, stations, buildings and grounds are clean and properly lighted; that shop machinery is protected by safeguards over gearing and other exposed moving parts, and that men are taking proper precautions for the protection of themselves and others. They report upon conditions which they feel can be improved, investigate accidents with a view to preventing repetition, and recommend improved methods of work to reduce risk of accident.

The Northwestern, after the first sixteen months, showed a decrease of 23.7 per cent. in deaths, and 29.8 per cent. in injuries, compared with the previous period of the same length. On the Pennsylvania Railroad the result of the first eleven months was a decrease of 63 per cent. in the combined number of deaths and serious injuries. These results are most gratifying, and demonstrate the usefulness of such close inspection and watchfulness.

IN CONCLUSION.

Accidents due to washouts, and to hidden defects in material are in the main unavoidable, though the former may sometimes be avoided by increased care and watchfulness during and after storms, and it is hoped that the latter may be materially reduced through the investigations now in progress in steel making.

Accidents due to imperfectly maintained track can be avoided by better maintenance, or by reducing speed to correspond to the conditions of the track. Speed and track conditions are inter-dependent factors.

Accidents due to jumping on or off trains in motion, and to trespassing, can be and should be eliminated by a rigid enforcement of existing laws, or the passage of new ones, if those on the statute books are found to be inadequate. As already stated, this would save one-half the annual deaths and a large proportion of the injured.

Substantially all of the casualties in coupling and uncoupling cars are due to carelessness of the men themselves, and the same may be said of most of those due to falling from or being struck by trains, locomotives or cars. It is difficult to suggest a remedy for this, or to formulate a course of procedure to reform the men in this respect. Recent and prospective legislation affecting the employers’ liability will not be conducive to increased carefulness, but will rather tend to foster carelessness.

Train accidents due to error, negligence or incompetence should be corrected by proper discipline. But the administration of discipline is restrained and obstructed by the brotherhoods, whose officers claim the right to be present at all investigations, and the discipline ordered must meet their approval. They contest suspension and dismissals by appeals to higher officers who have no personal knowledge of the men, and use every means at their command, even to threatening a strike, to prevent the order from being carried out, often with success, all of which is subversive of discipline.

It is not a comforting thought that, when you, here assembled, disperse to your homes, some of you may place your lives in the hands of a man who is retained in the service through intimidation, rather than fitness and merit.

There can be no remedy for this while unprincipled demagogues and politicians, catering for votes, continue to appeal to class prejudice, and while the sympathies of the people, public officials and arbitrators seem to be arrayed against the railways.

President WHITE—We have now something else very interesting, and the next speaker will only keep you fifteen minutes. I now take pleasure in introducing Mr. A. B. Farquhar, of York, Pa., who will speak on “Vital Statistics and the Conservation of Human Life a National Concern.” He knows his subject; he knows it by experience; he has been through it; and he has met the classes, met the conditions he speaks of. He has a message to give you that is well worth hearing.

Mr. FARQUHAR—Mr. Chairman, Ladies and Gentlemen: Yes, I have been interested in this subject for perhaps seventy years of the seventy-five years of my life. I am very much interested in the work done in Pennsylvania. I shall refer to that, as is proper in a man sent as a delegate to this Congress by the Governor, and I believe it is a good example to other communities.

Vital statistics are usually assumed to cover only the number of births and deaths occurring in a given territory within a given time, a subject not attractive to the general reader, but this address will be devoted more particularly to the objects for which and the agencies by which such statistics are assembled, which is far more important and interesting, especially as it includes the social questions they resolve for us. “It is sometimes said figures rule the world; but this at least is true, that they show how it is ruled.” To this saying of a wise man may be added that they also show how it might be or should be ruled; they best illustrate “philosophy teaching by example,” because most precise and definite in form of presentation. They are of most use when applied to the most important interests of mankind, and have no higher function than in bearing their part in safeguarding the nation’s health.

For its vital statistics the Federal Census Bureau has always had to depend on data collected by local agencies, and of the imperfection of those agencies, and especially the large territory for which there were none—no attempt to keep the official record of births and deaths, it has loudly complained. Notwithstanding the commendable efforts that have been made throughout the country to supply deficiencies by State legislation, so much remains yet to be done that a census report, as late as 1907, showed less than half the population of the country, and only a third of the States in number, within the registration area. But the movement has been forward, and it is gratifying to note that the most significant step in advance was made by Pennsylvania, in a law creating a state department of health and fixing its duties in 1905. Until then that commonwealth was said to have “the poorest registration of any of the Eastern States,” though its first law for the purpose had been passed fifty-four years earlier; but “it had in 1906, the first year of the operation of the new law, an effective registration of births and deaths practically as complete as that of any registration State in the country, and far superior to the majority.” The best point about the law of 1905, and its most significant difference from that of 1851, is that it is executed. Obedience is no longer optional, but compulsory. Authority under it is centralized in the hands of the Governor, Attorney-General and Commissioner of Health, and practically for most purposes in those of the Commissioner.

The total appropriations for work under this department since 1905 have been $9,286,080. The number employed by its various divisions is 3,625. Of this number there are 1,170, nearly one-third of the total force, who are local registrars in the vital statistics service.

With what is so large a force to occupy itself? The 1,170 registrars receive all birth and death certificates and issue all burial permits (to which registration is a prerequisite), and the bureau has also charge of marriage certificates, filed with it by the clerks of county courts. The medical inspection division establish quarantine under direction of the county inspectors, see to placarding houses and disinfecting them after cases of communicable disease, guard against the sale of milk from premises where any such diseases are found, and represent the department in co-operation with local health boards. Supervision of the medical inspection of schools forms also an important part of the duty of these officers, some 300,000 children having been examined during the past school year. At the free tuberculosis dispensaries, with which the department has provided the large centers of population, the indigent receive free medical advice and necessary supplies. The commissioner has supervision, by the act creating the health department, of all systems of public water supply and of public or private sewage disposal. Detailed plans must be filed with the department, and no new construction can be done until the Governor, the Attorney-General and the Commissioner have approved the plans. The biological products division distributes, through 656 stations in all parts of the commonwealth, free antitoxin to the poor. The stations are located as impartially as practicable.

What has been accomplished by all this equipment, discharging all these functions, cannot be completely told; a few figures may be given, with a result here and there, and the rest left to estimate of probability. For example, the statement that 6,724 patients were admitted to the Mont Alto Sanatorium in the four years 1907–1911 certainly indicates the magnitude of the problem, and the importance of giving it the best attention we can. It is perhaps a little more significant that 58,004 patients have been treated in the department’s tuberculosis dispensaries since they were organized. The activity of the sanitary engineering division is clearly shown in its recorded count that up to June, 1912, 40,447 private sources of stream pollution had been abated on notice from the department. One hundred and eleven modern sewage-disposal plants have been built or are in process of building, 306 municipal and private sewer systems are under construction in accordance with plans approved by the health department. Ninety-seven modern water filtration plants have been or soon will be constructed under State approval. It is worth while to connect with this fact another even more gratifying: the death rate from typhoid fever in Pennsylvania, which was, in 1906, 565 per million inhabitants, had fallen to 206 per million in 1911. As a final instance, the death rate from diphtheria, a little over 42 per cent. in untreated cases, has been reduced in the average of the 35,111 cases treated with antitoxin between 1905 and December, 1911, to 8.07 per cent., or less than one-fifth. Further, a certain district having been set apart for the trial of 5,000 units, instead of the usual 3,000, as an initial dose of diphtheria antitoxin, the death rate in that district has now shown a reduction to 4.22 per cent.

This story is not told for the mere satisfaction of praising our Keystone State or its faithful and capable public officers, though for that, too, it affords opportunity. Its function is to point a moral, to indicate a course of treatment of the subjects of vital statistics and public health, which, as Pennsylvania’s experience leads me to believe, may well be applied to a wider field than Pennsylvania. It is not by accident that the association of statistics of births and deaths and marriages, with a State office for the promotion of public health, has come into favor at the same time in so many parts of the country. The force of example is something, to be sure, as is also the circumstance that a physician is usually at hand, when a birth or death occurs, that he is apt to know what there is to tell about the occurrence, that he is apt to know how to report, and that the State health office is one to which a physician might naturally address himself. But more important than these considerations is the value of birth and death records in the conservation of the people’s health. From the greater or lesser number they show the favorable or adverse effects of accompanying conditions can be judged, and a conclusion reached as to how such conditions should be regulated. Nor could any condition be more important to regulate than those affecting health. The people’s health is its most precious asset. Dr. Wiley says he “would rather be a strong, vigorous man without a dollar than a sickly millionaire,” and thus indicates the pecuniary value of health to an individual. Multiplying that value by the number of the population, the amount becomes fairly appalling.

We have a department of agriculture expending vast sums—nearly fifty millions in the last decade—in improving the soil, improving the growth of vegetation, improving the health of animals, and no department to do anything to improve human health. We spend $700,000,000 a year for past and imagined future wars, and pay no attention to the 700,000 calculated above—a larger number dying every year, unnecessarily from disease, than bullets have slain since the continent was discovered. As we are reminded by Dr. Dixon, our Pennsylvania health commissioner, we are spending millions a year for the protection of our forests and water supply and other natural resources, but it is no credit to our intelligence that while guarding these material interests we allow man himself, without whom all else is worthless, to remain unguarded.

Yet it is a mistake to say that we do and have done nothing; what has been done is greatly to the credit of mankind, only it has not been enough. Jenner’s discovery and his application of it has left no excuse for smallpox anywhere. The president of the board of health in Mexico assured me that compulsory vaccination had freed his city of smallpox; and the Japanese health authorities, since their enforcement of compulsory vaccination, have ceased altogether to look upon the presence of smallpox as a source of danger. It is no longer a scourge in the Philippines and Cuba. Similar to the work of Lister in antiseptic surgery is that of Pasteur and Koch in various germ-diseases, of King and Carroll and Lazier in mosquito-transmission of infection. With the elimination of the Stegomyia mosquito, yellow fever is no longer dreaded; Havana and the gulf ports are as safe as anywhere; and the construction of the Panama Canal has become possible—as, but for the discoveries by Carroll and Lazier (or their rediscovery of Dr. King’s discovery) it never could have been.

From the brilliant successes attained in the directions just indicated, we seem to see that the most important thing for us is to know; we are to find our safety in knowledge. When we know that malaria is inoculated by the bite of the mosquito Anopheles, and yellow fever by the mosquito Stegomyia, that typhoid fever is fed to us, in a large proportion of cases, from the feet of the house-fly, that the fearful bubonic plague is inoculated by the bite of a flea infesting the rat, we have already traveled more than half way to deliverance. We can drive off the mosquito, or, by oiling the puddles, prevent her from hatching; we can “swat the fly,” or abate the manure-heaps and other filth from which it draws its unblest being; and, if we can not catch the flea, we can make war upon its host, the rat. If, as is computed, within the last 2,000 years 2,000,000,000 people have fallen victims to the bubonic plague, it is enough to justify wholesale enlistments in a grand rat-hunt.

Half a century ago people were afraid of night air, and closed their windows at night. It is hard to guess how many lives might have been saved by opening those windows. We are told that the average duration of human life has doubled in the last 200 years. Whatever gain there has been is due, more than anything else, to more knowledge.

The case of pure air as against contaminated air is but one way of putting the general case of cleanness against foulness. Bad air has the same vices that attach to dirt in other forms; one of the uses of more knowledge is to be able to detect dirt in all forms, however concealed or disguised; and another is to discover the best means of sweeping it away. Our ancestors used to drink water from pools and wells that were sinks of organic filth, to worship in churches built over an array of corpses in all stages of putrefaction, to wear the same suit of leather clothes, day and night, till they fell apart or the wearer outgrew them—all because they knew no better. They had no conception of the disgust with which such habits were to be regarded by a more educated posterity. Now the golden rule of health is “Wash you—make you clean!” It is not enough to make, or even to keep, the children’s faces clean; we must look no less to the cleanness of the lung passages, of the alimentary canal—yes, of mind and heart also.

Morally and esthetically, there is nothing in relation to which the duty to be clean is more stringent than the reproductive function. The source of the greatest work in all God’s creation, the human race, ought more than all else to be pure; and the necessary condition of our endowing the earth in coming ages with a better human race than it now has, or has ever had, is that we provide that coming race with the best kind of parentage. The quality of the next generation is determined by the quality of this generation; it will be in most respects as we make it, clean if brought forth in purity, foul if engendered in foulness. And the truth so strikingly evident in the moral and esthetical view is even more clear in the view we are here taking, that of the race’s health. To sexual impurity, by the testimony of the best physicians—the illustrious Dr. Osler for instance—more physical degeneration is due than to any other one cause. Dr. Prince A. Morrow, president of the Society of Sanitary and Moral Prophylaxis, estimates the number constantly ill from syphilis in this country—although that number has of late been considerably reduced—as still no less than 2,000,000. The syphilitic poison is communicated by inoculation—a contagion that has no danger for us so long as held at a respectful distance; and the essential point in guarding against it is to preserve that distance. Like the venom of the rattlesnake it is best known in a knowledge of its lurking places. It was first recognized in Europe, some time in the fifteenth century; and it came from the Orient, not of its own initiative, but because Europeans went after it and fetched it. Similarly now, a man does not have it unless he goes after it. There is nothing in the whole range of human disorders that shows more emphatically than this, the feebleness and inadequacy of the best possible cure as compared with prevention. Knowledge seems all that is needed for complete prevention; any young man, having more than the resolution and self-control of an infant or an idiot, ought to require nothing more than an elementary acquaintance with a few facts that should be at the command of every instructor of youth, to insure his leaving the syphilis and gonorrhea factory permanently alone. If their baleful function were made clearly known to those who most need to know it, the entrance door to every such temple of moral and physical ruin would carry to the eyes the sign that greeted those of Dante: “All hope abandon, ye who enter here”—a prospect whose unrelieved blackness looks even darker when contrasted with the brilliant glory of the hope relinquished. It is a law of our human constitution that the richest, deepest, keenest joys that life has for us are those that come from the contrast of two sexes. Even when that contrast is hostile, there seems to be some pleasure in it; but immeasurably more when it is an incident of ardent attraction. Byron in one of his earlier poems thus puts it:

“Devotion wafts the mind above,
But Heaven itself descends in love;
A feeling from the Godhead caught,
To wean from self each sordid thought;
A ray of Him who formed the whole;
A glory circling ’round the soul!”

It is too well known that the poet’s own loves, in after years, were not always of this ideal quality; but no one ever better set forth the exalted possibilities of the sex sentiment, to which the continuance of life on earth is due. But the worst, we are often reminded, is the corruption of the best, and it is another possibility of the same sentiment that it may urge a man to blast his whole future by incurring an incurable disease, and sadder yet—too often to involve others, tender and innocent lives, in his own condemnation. If more knowledge can ward off such a grisly fate, it is surely inhuman cruelty not to supply that knowledge, however disagreeable the duty may appear. When clearly seen as a duty it will be no longer disagreeable.

While making this call for more knowledge of vital truths primarily on account of the young men, since it is in the vast majority of cases the man who tempts, the man to whom the outcast woman owes her fall, it would be the wildest folly to stop with one-half of the rising generation. The future of the race is too dependent on its mothers to excuse or permit the neglect of any preparation of them for motherhood, which health in its fullest sense may demand.

Most of the great questions of health in its widest sense, of health as a public concern, resolve themselves into resisting the entrance of this or that species of bacterial germs into the body. The essential distinction between Mother Earth, that bringeth forth flowers and fruits, and grass for our herds, and dirt or filth, the especial opprobrium of the hygienist, is that the latter carries germs of bacteria. Cleanness, in the hygienic sense, is freedom from pathogenic germs; and when the doctors tell us that the marked improvement in health conditions recently observable in Germany and Switzerland, and pre-eminently in Sweden, is due to their exceptional attention to cleanliness, they use the term with particular reference to the provoking causes of preventable sickness. Not only is the death rate from the acute diseases in those lands rapidly falling off, but diseases of the chronic class are beginning to yield to the inculcation of better habits among the people.

We are by no means without instances in this country, of death rates reduced by preventive methods, as shown for young children in our largest cities after the introduction of pasteurized milk. Deaths have been thus spared for that peculiarly helpless class of sufferers, to the extent of fully 50 per cent. in some districts—in large measure through the well-directed activity of one public-spirited New York merchant. But we have much to do in other lines, and we have only begun to free ourselves of the typhoid fever incubus. As late as fourteen years ago there were 11,000 cases of that infection in the camp at Chattanooga, with 800 deaths. In the entire Spanish war the deaths of our soldiers from diseases, it was calculated, were thirteen times as many as from wounds in battle—the diseases mostly, like the Chattanooga typhoid, of the preventable kinds.

Loss of life by preventable accidents, on railways, in factories and mines, is too closely associated with that by diseases to be here omitted, though entitled to much fuller treatment than we can here afford. The deathroll from this cause is still disgracefully large in this country, far surpassing any country of Europe; but there are signs already of diminution. For instance, one steel factory, reporting 43 accidental deaths among 6,000 employes in 1906, showed only 12 fatalities in a payroll of 7,000 in 1909, safeguards having been introduced in the meantime. This instance is very good, so far as it goes, but we need to make much more progress in the same direction.

What we want is systematic effort, by some powerful consolidated agency, to promote the conservation of human life. We have no need to find fault with any of the organizations now engaged in furthering that end, several of which are doing good work. We may gratefully acknowledge the aid of the various medical societies, “regular” and “irregular”—though we take the liberty of wishing that they might fight the common enemy a little more and each other a little less. We may also welcome the assistance of the life insurance companies, notably the Equitable and the Metropolitan, whose managers clearly realize how their interests are involved. Whatever lengthens the average term of human life is a factor operating to increase their dividends and to reduce the cost of insurance to their policyholders. It is worth while to note, at this point, that the majority of life insurance officers are strong advocates of the formation of a national bureau or department of health.

Still more do we owe to the activities of State and municipal boards of health, which do more good because they have more power. Where properly supported they have done a great work, at obstructing the spread of epidemics by quarantines and other methods of isolation, at curing pollution of water supply, at instituting improved sewer systems, at bettering the general food supply by inspection of markets. You have just heard a condensed account of the activities of one of our best State health departments, that of Pennsylvania. You will infer from what that department has done in seven years what might be done by a national bureau or department, with powers and field of operation extending over the entire country.

The movement for a bureau or department of health, national in its scope, has been most actively advanced in Washington by Hon. Robert L. Owen, Senator from Oklahoma. His bills call for a department, and he gives strong reasons for the view that such an organization would, while that of a bureau would not, suffice for the national governmental activities in behalf of the public health. President Taft strongly urges a “Bureau of Public Health,” and plainly intimates a preference for the bureau plan. The “Committee of One Hundred on National Health,” formed by the Association for Advancement of Science, in 1906, with Prof. Irving Fisher as its president, originally contemplated a department whose head should be a member of the President’s cabinet, but it has in its recent publications adopted the alternative phrase “bureau or department,” which course is here followed, because there is manifestly nothing to gain by keeping up a contest on the point. The memorial prepared by the committee of one hundred proposes for a national department of health certain functions, as follows:

1. Administration—Including the national quarantine work, and whatever regulation of interstate commerce might affect human health, such as meat inspection and enforcing the food and drug act.

2. Co-operation—The work of assisting State, county and city health agencies, after some such fashion as the National Department of Agriculture co-operates with State agricultural colleges and institutions.

3. Research and Investigation—The work of obtaining needed scientific information concerning the cause and prevention of diseases that now shorten or impair human life; this would include a study of accidents, of poisonous manufacturing trades, of hygienic conditions in schools, etc., just as yellow fever was studied in Cuba, as the hookworm is now to be studied under private endowment, as the work of the Pasteur Institute was conducted under French government support.

4. Education—The work of supplying to the country scientifically established data on matters pertaining to health, such work as is done by the “publication division” in most of our governmental departments; thus rendering available for practical use the work of research and investigation. The countries in which is found the most rapid reduction of the death rate are just those (Sweden for example) in which the spread of a knowledge of hygiene is widest.

Of these functions the mere statement is a most powerful argument for the bureau or department suggested. It only remains to remove a few misunderstandings. One objection, for example, is powerful in many minds—that such a centralized office must necessarily be the organ of a particular medical school, and must so give that school—the one denominated “regular,” for example—an unfair advantage, unsuited to a government of liberty and equality. To this it may be frankly replied, that the primary objects of the new office being the four just stated (administration, co-operation, investigation, education), it would aim to collect and diffuse the greatest attainable amount of accurate knowledge on the subject of health; and that if it found a larger quantity of better knowledge in one school than in another, it would be false to its trust if it did not spread that knowledge accordingly. Personally, the writer finds it hard to believe that it could treat a school that taught the unreality of disease, or the surpassing value for all kinds of disorders, of drugs, of a narrow range of characteristics, on an exact equality with schools that deal with facts as they find them; but he heartily agrees that the citizen ought to enjoy the liberty of choosing his own medical advisers, so far as he does not endanger life or health by so choosing.

There are other objections to organized national work for health, many of them from a so-called National League for Medical Freedom, the most active workers in which have been shown to be interested in one or another kind of proprietary medicine, backed by some “mental healers,” and by associations of druggists who object to the “pure food and drugs act” of 1906. Several homœpathical State societies have repudiated that “league for freedom,” and have emphatically attested their approval of the proposed bureau or department of health; this, notwithstanding their well-understood grievances against “regular” practitioners. Some of the best informed among the osteopaths and the Christian Scientists are pronouncing similarly; and so, if the disavowals keep on, the League of Medical Freedom may soon be left with only those who seek freedom to dope their victims with drugs that enslave; stupefy them—infant and adult—with opium and thinly disguised alcohol, and generally to reverse the progress of a century. But, since it is estimated that $75,000,000 a year are expended by our fellow-citizens for patent medicines, it is easy enough to see how they must regard a national department which is to improve the sanitary conditions of the country, show people how to care for health, stop the sale of poisonous nostrums and impure foods, and end the career of opium under the name of “soothing syrup.” Their profits would be gone, and of course they disapprove and protest.

Altogether, the cause of a national bureau or department of health is commended, both by those who favor and those who oppose it. It could not ask better advocates than the distinguished men who heartily favor it, on the congressional or the collegiate stage; nor more suitable adversaries than those constituting the League for Medical Freedom.