Show 0 has adz ad xa a vil ance dr george E vincent head of rockefeller foundation tells of difficulties HAS BEEN LON HARD PULL notwithstanding prejudice against it are ara now engaged in work in this country progress Is reported now new york it inis has been it alulong long hard pull to raise prevent preventive lye to tile the profession il level of curative medicine 1 there fire arii belll social and eco economic OlIc lacing facing tile alie stud student ent alio ii otherwise Is s willing to enter tile lie public health bervice and there la Is the constant In ellace of political in luter ter ference in the work ork of municipal title mid and national bureaus ut of public health of these things writes tr dr georgo george ua I 1 vincent president ilent ol of the stocke blocke teller in ili tile report of that institution for 1021 1921 since jul july 1 I 1013 the th international health bouril board of tile the foundation tills lins spent lit in its battle against malaria yellow fever hookworm tuberculosis and the like long strides lit in winning intelligent public operation cooperation co by education fin and in scientific research alade a year of great satisfaction although doctor vincent warns that it la Is too early curl to frel feel complacent idea of health revised doctor vincents review of last year notes life changing ideals kucula of health writes advances in ili the cure care raid prevention ol of diseases reflect a shifting of emphasis and a gradual grac luil rei islon 0 oc f the lie idea of health itself aellig aup up find around or 11 1 I cant complain represents a far from stimulating conception of bodily prosperity yet a vertical rather than han it horizontal post tion rs Is ono one criterion the report reverts the lie growing de fiand for trained lenders leaders in public health work burk dietor Do tr vincent proceeds to say in ili tha tin 1 united states there are tit lit present pre ent about persons enraged engaged lit in public health arh work under federal state find municipal or county auspices lit in grout grent britain probably tin an equal ellal ell ll number lire art giving nil their atino to to lie work of preventive medicine tit aliu r in ili the service of governmental nongovernmental non agencies of nil all kinds can call scarcely lie ho but may represent rev ent nearly us its anany more the alf governing dominions i employ emi elui a considerable number of probes loisil loii il in continental iii hu rope health organization has not as na a rule idle reached so si high n degree of level devel opulent is as in tit alie e british isles in ili many tropical countries such us its india java the both curative find and pro pre ventha tire are administered by corps of trained government go eminent laLi in till nil parti of the lie world there Is nil fill ino eating demand for tuen men mid women omen competent to do different kinds of public lit lb health noi york it A fore forecast cust of the he probable number needed during dm ing tile ton ten years icus ic us in the lie united states calls for poisons persons curative branch magnified it Is nut not to be 10 denied that on the w lioto the hest best ability hay has been drafted into tin the 1 service of curative Liin UlM father outlier than of preventive buiu flat tsiun four hundred bundled replies to questions recently put to students no now enrolled it in leading Irad lii american in medical edical schools disclose till i attitude of ignorance iKnoian ic enie act evell antipathy with alth respect to a career in ili public health work ork the hie rea sons sona these young oung tuen men gle give for not considering side si fit at till nil or for deciding against such a life work ork fire are 1 it Is not a socially soc lAll recognized clearly profession gizea caning 2 there are no special for adequate training 3 tent irti and promotion depend not on merit but bill political pull 4 salaries are in meager ineader 5 the private pi hate practice of curative medicine Is more diore reputable independent profitable and aliese young soung men inen are in many respects uninformed and misinformed re rite medicine dicine alnis its already gained tho the status of tl a profF slon and Is making rapid progress in public favor at least two to special tp iclal schools of high rank are offering a thorough and appropriate iraln training ing an ali increasing inci easing number of important posts fire are freeing themselves front froni tile the tram inels of spoils politics the salary received by a health officer of full rank probably exceeds the income of the average private practitioner tit ioner private practice has many id vintages mintages Min excessive overtime and night work vork poor collections the necessity of dunning pat lente little chance to study co constant econ pressure a heavy burden of service competition with quacks und and charlatans irmis to stir surrender render ideals public health service on oil the other liand hand Is fail king if strong appeal to ninny any men inen find monin wol liell of imagination courage lind and social spirit just because it does not anoh most of tiles t things and offers 0 ers man funny tle attractions yet it must bu be admitted tit that at tile the 8 cep undergraduates if an re nor w holly bolly rong public ignore 1 norence norn nce ee and indifference invidious comparisons lack of sound tr alving in ili ninny many officials prejudice against ina n enforcement delay tile full appreciation of what pre matiie bentive means ineatia to society soc leti the establishment of adequate schools lina has been a recent event A few disheartening instances of pull tampering alth ith health departments have occurred of late it Is also true that the level of pay Is too low lien even the tie few highest salaries suffer stiffer painfully in with the annual incomes of leading IrIv ute consultant and surgeons politics must ele DC kept out A greater i tuter blure abare of popular ml ad larger freedon from control close perso nul relations with ampre individuals it deeper sense of profession goniu iii pride probably am anre the portion of tit tin practitioner of cura live the cry co Is frequently heard that tills this governmental service or that fiust tip hi t liken aitken out of politics in ill one M tills Is absolutely essential to ehl clency blenc cl enc A public function alch which calls calla for te lit arul expertness Is hopelessly handicapped it if it ile be treated treat etl us its tile he spoils of ii 41 political boss or of a vic victorious torl party machine to no public service does tills 1104 apply more strikingly t bu n to it a department of health tile the t corts torts art made to influence appointments promotions salaries policies dinv inv enforcement by political pressure for individual or party ends the lit demoralization or of the work begins the rhe dorrer degree to which such things air are poi elble la Is uti index of tho the intelli Int eill gence spirit and character ot of a om coal cullity mul lIty yet lit in another tit the original im lo ahing calling of politics cS public health ought alti ays to 0 o lu IL in ill politics 1 lie guarding guardin of health of the people la a tusk and responsibility one or of the essential of tl it successful health officer Is the ability to explain ills his policies so us as tu to via support for them reviews college work the report leport goes on oil to review tile the worl ork of the public health department lit at colitis fo litis hopkins university harvard tile the of tin I 1 1 an and 1 I new york university uhei then writing or of the establishment of preventive and in clinics where service might be had at moderate cost doctor vincent says an ali experiment in ill meeting tills this dc it intend was aa begun by b the cornell university medrial school in ili new york city alt in Nove niber 1921 idl 1 with tile the cua coa operation of i it special committee of the united hospital fund the work it tills this committee which la Is helping fig t to a improve liu prove standards of dispensary man mail argement nud and service sen ice la is supported by br the lie rockefeller foundation I the int tint deficit of the cornell clinic demonstration stra tiou which Is expected to become self supporting was waa underwritten under written by tills coma committee littee the essentials of tile plan are 1 medical surgical find and specialist service by well cl trained young doctors doctora who iho tire are paid for their work vork 2 by tho the college faculty 3 instruction of medical students in the clinic 4 appointments point ments with alth patients tunde by telephone or post to avold waste in ili voting 3 clinics lit in addition to d y V session open two evenings 11 acci week I 1 ir r the lie of patients elli amplo plo 1 I 1 during the day la 6 it charge of 1 1 t fir sr anell call laboratory examinations f id xray X ray platen plate it at cost a complete dag bostle examination fur for patients 0 ferret berred b by physicians for nn fill ulve vo f fie e 0 of if 10 on the lie lay day the cl tile 0 I 1 eneal persons presented pre themselves themi there hns has been it steadily growing graving patronage ever since an in n creasing number of doctors doctor CJ 1 linao I ave brought brou glit patients for diagnosis und and con coh hult retreat of yellow fever tile the report cites the r tr qt of yellow fever in those sectors ec tors where it gaii been beef an all ever present threat for it fit least two centuries tit tonj supreme sav sao ninda in tills 1 baffle tile against yellow fever by dr jesse jcsse lizear find dt dr howard ii cross Is doted the stu 1 born fight Ina larla hookworm tind find tuberculosis to Is reviewed anil the fight made by dr henry hanson li south Alli erlea agal list yellow fevig first ding diagnosed nosed us its acute lun larla Is set forth telling in ili deball af pf I 1 r doctor conk cirl lit foil of fish s II 11 tr the war upon tile Inos mosquito qUito carrier tile the result was Illi ally plis lied cd reads tile the report hy bentli ing two loc local it site species cles of fesh to dj enill the eggs und find the larvae of tile ma m quito an attempt in the lie beginning it af tit ohp to tench teach tile the people af 0 o prevent breeding on nil their own failed everything hod had to ile be done 13 1 the lie mosquito squad it ans that by distributing fist two to foill foier senall fish asli to n container holding api to fifteen gallons the problem wilb simplified by about 75 per cent tle 7 ish flah distributed in this dilvo conquered i the epidemic A |