FLASHBACK TO 1924: Common Sense & Truth In Public Health

A regular feature looking back at what was being printed nearly 100 years ago in the Bristol Daily Courier. This week’s entry comes from the July 31, 1924 edition of the newspaper.

Common Sense & Truth In Public Health Endeavors

By Thomas W. Jackson, Medical Director of Bucks County

Disease-causing conditions in a community are generally curable or removable. Common sense, which is community sense, is perhaps the largest factor in achieving this cure.

Preventive Medicine knows no denominational or sectarian separations. It desires from the members of the medical profession, as its agents, loyal support and assistance quite as much as it desires conformance with the health laws by every citizen.

The warfare against disease and disease-producing conditions is perpetual. It will never be finished. There is no permanence of correct conditions unless effort be constant and continuous.

Then, too, the impossible must not be expected. Our limitations must be admitted. Our abilities to combat communicable diseases are not equally effective.

For example: of the infections, the filth diseases—largely acquired by ingestion (taking into the mouth with food or drink)—are both theoretically and practically preventable; so too are the parasitic and insect-borne diseases. Now let us take a look at another class of ills. The most battling of all are the infectious respiratory diseases, a large and important group which prevail everywhere, sometimes sporadically and sometimes in epidemics—and here we must temporarily admit failure of control. We say “temporarily” for no one doubts the ultimate conquest of these death-dealing diseases. We must, however, concentrate our effort upon this problem, avoiding the spectacular and declining to accept the unproven claims of the faddist, the enthusiast or the charlatan.

A few facts related to the prevention of the infectious respiratory diseases may well be emphasized here.

1. Individual isolation is an efficient protection.

2. Experience has shown that ventilation alone is far from being an effective safeguard and whatever the value of fresh air may be from the therapeutic standpoint, ventilation along must not be depended upon to prevent the spread of the infectious respiratory diseases.

3. Spray infection through the mucous droplet, projected into the air and – far more important – received fresh and swarming with living bacteria directly upon the mucous membrane of mouth, nose or eye of another person, through means of speech, cough, sneeze, song or other vocal effort usually in crowds or groups of people—is by far the most fruitful method of communicating these infectious respiratory diseases. The indirect method, by contact of intermediate objects soiled with the mucous or salivary secretions of persons, is not to be compared, from the danger standpoint, with the direct droplet method of infection. Incorrect teaching to the contrary has been given much publicity in the public press and even in health journals of recent years and needs to be met with contradiction; for which there is ample scientific warrant.

4. Any mechanical obstacle which intercepts the flight of droplets (such as a gauze mask placed over the face of a patient, or a handkerchief interposed by a sneezing person) is useful in whatever degree it really intercepts the droplets.

5. In all diseases propagated by spray or droplet infection, efficient surface disinfection is called for and this means knowledge and technique on the part of the physician, nurse or public health agent who performs it. The methods known as “sanitary cleaning’’ are considered adequate and effective if performed with thoroughness.

Fumigation, as ordinarily performed, is far less valuable.

Out of recent experience and observation has arisen the realization that certain diseases, hitherto considered unrelated, are alike in the manner of their acquisition. A few years ago we would hardly have considered measles as a respiratory disease, as a disease of adults, or indeed as a serious malady but today there is general acceptance of the fact that it is primarily a respiratory infection and that its complications and sequels, nearly all of them respiratory complications, give rise to a heavy death rate.

It would not have occurred to us that cerebrospinal meningitis Is primarily a respiratory Infection or that mumps, diphtheria, the primary pneumonias, influenza, tuberculosis and Scarlet fever may be grouped together. Yet upon a moment’s consideration It will be evident that these diseases and others are all acquired through the gateways leading to the upper respiratory tract. This realization gives us an important clue to prevention.

The recognition of fundamental principles by the public is more important than an understanding of details important to doctors, nurses and health officers. We should be careful to apply close scrutiny to the popular public health articles which appear from time to time in public prints, endeavoring to separate the wheat of truth from the chaff of untruth or half-truth. Without guidance this is not always an easy matter but it is a safe rule to distrust the sensational, highly colored accounts of new’ cures and marvelous medical discoveries. Far too much positive misinformation of the public escapes contradiction today.

An advertisement from the July 21, 1924 edition of the Bristol Daily Courier:

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