With the beginning of the twentieth century, preventive medicine is entering upon a new era. We are now confronted by a set of problems which are different in many respects from the problems so successfully attacked by the great masters of preventive medicine of the last century, and which call for the application of different preventive measures. The objects which Edwin Chadwick, John Simon, and our other great forerunners of the last century, sought to attain, and which to a large extent they did attain, may, I think, not unfairly be described by the phrase “ civic cleanliness.” They sought to provide pure water supplies ; to remove refuse and filth from the vicinity of human beings by establishing improved systems of drainage and sewerage, and better methods of dust collection ; to provide open spaces and wider streets; to pave streets, yards, etc.; to raise the sanitary standard of building construction; to provide proper burial grounds ; to regulate offensive trades ; and to abate the smoke nuisance and the pollution of rivers. Of course we all know that they did very much more than this. Their work was too great and its effect too far‐reaching to be described by any single phrase. Still, I think it not unfair to say that, broadly speaking, we may regard the attainment of civic cleanliness as the great object of cur public health administration in the nineteenth century. It cannot be said that this object has been wholly attained. In a country whose capital is still supplied with something like filtered sewage as drinking water, it is obvious that there is much yet to be done to secure civic cleanliness. But the point is that any further progress in this direction must, or should, take place on the lines already laid down by our predecessors. Their methods of civic sanitation have stood the test of experience, and all that is wanted is a further development on existing lines. It is otherwise with the new problems that now press for solution. These are problems of a different nature, and demand new methods of treatment, although the principles underlying the methods will be found, probably, to be the same. Preventive medicine in the nineteenth century was chiefly occupied with problems of civic cleanliness ; in the twentieth century we are confronted with the problems of personal hygiene, and the three problems of this kind which appear to me to call most urgently for solution at the present time are: (1) The problem of infantile mortality; (2) The problem of school hygiene; (3) The problem of the milk supply.
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