Preventive medicine.

In the study of medicine in the past centuries the only aim has been to discover methods of curing disease; at the present time a large and increasing amount of study is devoted to the methods of preventing disease.  Preventive medicine is a development of the last few years, and is based almost wholly upon our knowledge of bacteria.  This subject is yearly becoming of more importance.  Forewarned is forearmed, and it has been found that to know the cause of a disease is a long step toward avoiding it.  As some of our contagious and epidemic diseases have been studied in the light of bacteriological knowledge, it has been found possible to determine not only their cause, but also how infection is brought about, and consequently how contagion may be avoided.  Some of the results which have grown up so slowly as to be hardly appreciated are really great triumphs.  For instance, the study of bacteriology first led us to suspect, and then demonstrated, that tuberculosis is a contagious disease, and from the time that this was thus proved there has been a slow, but, it is hoped, a sure decline in this disease.  Bacteriological study has shown that the source of cholera infection in cases of raging epidemics is, in large part at least, our drinking water; and since this has been known, although cholera has twice invaded Europe, and has been widely distributed, it has not obtained any strong foothold or given rise to any serious epidemic except in a few cases where its ravages can be traced to recognised carelessness.  It is very significant to compare the history of the cholera epidemics of the past few years with those of earlier dates.  In the epidemics of earlier years the cholera swept ruthlessly through communities without check.  In the last few years, although it has repeatedly knocked at the doors of many European cities, it has been commonly confined to isolated cases, except in a few instances where these facts concerning the relation to drinking water were ignored.

The study of preventive medicine is yet in its infancy, but it has already accomplished much.  It has developed modern systems of sanitation, has guided us in the building of hospitals, given rules for the management of the sick-room which largely prevent contagion from patient to nurse; it has told us what diseases are contagious, and in what way; it has told us what sources of contagion should be suspected and guarded against, and has thus done very much to prevent the spread of disease.  Its value is seen in the fact that there has been a constant decrease in the death rate since modern ideas of sanitation began to have any influence, and in the fact that our general epidemics are less severe than in former years, as well as in the fact that more people escape the diseases which were in former times almost universal.

The study of preventive medicine takes into view several factors, all connected with the method and means of contagion.  They are the following: