Part 20

“Why can’t medical science wipe out the germs?” demanded Mrs. Sharpless. “It’s always claiming to do such wonders.”

“In a few instances it can. In typhoid we fight and win the battle from the outside by doing that very thing. In smallpox, and to a lesser extent in diphtheria, we can build up an effective artificial barrier by inoculation. But, as medical men are now coming to realize, in the other important contagions of childhood, measles, whooping-cough, and scarlet fever, we must fight the disease from inside the individual; that is, make as nearly impregnable as possible the natural fortifications of the body to resist and repel the invasion. That is what school medical inspection aims at.”

“You wouldn’t rank whooping-cough and measles with scarlet fever, would you?” said Mrs. Sharpless incredulously.

“Why not? Although scarlet fever has the worst after-effects,—though not much more serious than those of measles,—the three are almost equal so far as the death-rate is concerned.”

“Surely not!” protested the old lady. “Why, I’d rather have measles in the house ten times, or whooping-cough either, than scarlet fever once.”

“You’re about ten times as likely to have.”

She looked puzzled. “But what did you mean by saying that one of ‘em is as bad as the other?”

“That it’s as dangerous to the community, though not to the individual.”

“Just a little deep for me, too,” confessed Mr. Clyde.

“Yet it’s perfectly simple. Here, take an example. Would you rather be bitten by a rattlesnake or a mosquito?”

“A mosquito, of course.”

“Naturally. Yet a rattlesnake country is a good deal safer than a mosquito country. You wouldn’t hesitate, on account of your health, to move to Arizona, where rattlesnakes live?”

“I suppose not.”

“But you would be afraid to establish your family in the malarious swamps of the South?”

“Certainly.”

“Well, people who die of malaria die of mosquito bite, since the mosquito is the only agency of infection. Thus, it reduces to this: that while the individual rattler is more dangerous than the individual mosquito, the mosquito, in general, kills her thousands where the snake kills one. Now—with considerable modification of the ratio—scarlet fever is the rattlesnake; whooping-cough and measles are the mosquitoes. It is just as important to keep measles out of a community as it is to shut out scarlet fever. In fact, if you will study the records of this city, you will find that in two out of the last three years, measles has killed more people than scarlet fever, and whooping-cough more than either of them.”

“What are we going to do about it?” asked the practical-minded Mr. Clyde.

“Ah, if some one would only tell us that! In measles the worst of the harm is done before the disease announces itself definitely. The most contagious stage is previous to the appearance of the telltale rash. There’s nothing but a snuffling nose, and perhaps a very little fever to give advance notice that the sufferer is a firebrand.”

“Well, you can’t shut a child out of school for every little sore throat,” observed Mrs. Sharpless.

“As to that I’m not so sure,” replied the physician slowly and thoughtfully. “A recent writer on school epidemics has suggested educating the public to believe that every sore throat is contagious.”

“That isn’t true, is it?” asked Mr. Clyde.

“No. Personally I believe that, while a physician is often justified in deceiving his patient, he is never justified in fooling the public. In the long run they find him out and his influence for good is lessened. Yet that sore-throat theory is near enough true to be a strong temptation. Every sore throat is suspicious; that isn’t too much to say. And, with a thorough school-inspection system, it is quite possible that epidemics could be headed off by isolating the early-discovered cases of sore throat. But, an epidemic of the common contagions, once well under way, seems to be quite beyond any certainty of control.”

“Do you mean to say that quarantine and disinfection and isolation are all useless?” asked Mr. Clyde.

“No. I won’t go as far as that. They may exercise a check in some cases. But I will say this: that all our cumbersome and expensive and often harassing hygienic measures in the contagious diseases haven’t made good. Obviously, if they had, we should see a diminution of the ills which they are supposed to limit. There is no diminution. No, we’re on the wrong tack. Until we know what the right tack is, we perhaps ought to keep on doing what we can in the present line. It’s a big, complicated subject, and one that won’t be settled until we find out what scarlet fever, measles, and whooping-cough really are, and what causes them. While we’re waiting for the bacteriologist to tell us that, the soundest principle of defense that we have is to keep the body up to its highest pitch of resistance. That is why I support medical inspection for schools as an essential measure.”

“To repair the children without closing the schools, if I may modify Dr. Goler’s epigram,” suggested Mr. Clyde.

“Exactly. Eventually we shall have to build as well as repair. A very curious thing is happening to Young America in the Eastern States. The growing generation is shrinking in weight and height.”

“Which is almost contradictory enough for a paradox,” remarked Mr. Clyde.

“It’s a melancholy and literal fact. You know, there’s a height and weight basis for age upon which our school grading system rests. The authorities have been obliged to reconstruct it because the children are continuously growing smaller for their years. There’s work for the inspection force!”