Popular Science Monthly/Volume 77/October 1910/The Owen Bill for the Establishment of a Federal Department of Health, and its Opponents

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THE OWEN BILL FOR THE ESTABLISHMENT OF A FEDERAL DEPARTMENT OF HEALTH, AND ITS OPPONENTS
By S. ADOLPHUS KNOPF, M.D.

PROFESSOR OF PHTHISIO-THERAPY AT THE POST-GRADUATE MEDICAL SCHOOL AND HOSPITAL, NEW YORK

ANY one who is familiar with the workings of governmental departments of health such as exist abroad, who has seen or experienced the sanitary benefits bestowed upon the people by the Reichsgesundheitsamt of Germany (imperial department of health), the Conseil Superieur de Santé Publique de France, and the similar institutions of most European governments, can not help feeling amazed that any opposition should exist to the establishment of a federal department of health in this country. This amazement becomes all the greater when one considers some of the elements of which the opposition to that measure is composed. There is, for example, the New York Herald, a large and influential newspaper with an honorable career and a brilliant record for advocating everything that is conducive to the public welfare. Only in this particular instance has it allowed itself to become the mouthpiece of principles to which it is in general opposed, that is to say, principles and measures whereby the good of the people at large and the progress and welfare of mankind are hindered, and the lives of individual American citizens endangered. This particular newspaper is independent of any political party, or professional or religious association which might prejudice its point of view, and still it opposes a measure whereby all citizens of the country would benefit. The writer can not help thinking that this powerful news organ has. not informed itself thoroughly of the real purpose and function of a federal department of health, and in its attack upon a large body of men such as compose the American Medical Association, the American Public Health Association, the National Association for the Study and Prevention of Tuberculosis, the American Association for the Advancement of Science and the various medical academies of the country, it is certainly misguided. It is to be hoped that the distinguished editors of the New York Herald will soon see that in their attitude toward the Owen bill they are not on the side of the people but are working against the welfare and interests of the masses.

The principle of the Owen bill, establishing a department of health, has been endorsed by the president of the United States, by General George M. Sternberg, surgeon-general of the army, retired, and Admiral Charles F. Stokes, surgeon-general of the navy, by General Walter Wyman, of the Public Health and Marine Hospital Service, by Dr. Harvey W. Wiley, of the bureau of chemistry, by governors of states, by the Conference of State and Territorial Boards of Health, by the United Mine Workers of America, by the National Grange, by the republican and democratic platforms, and by numerous other organizations.

What is the principle of this bill which is advocated by thousands of men trained in medicine or sanitary science and interested in the public welfare?

Section 7, which embodies the main purpose of the Owen bill, reads as follows: "That it shall be the duty and province of such a department of public health to supervise all matters within the control of the federal government relating to public health and to diseases of animal life."

Section 2 of this bill deals with the unification under a secretary of public health of the various agencies now existing which affect the medical, surgical, biological or sanitary service.

There has recently been formed an organization which calls itself "The National League for Medical Freedom." It has for its purpose to combat the Owen bill; it is opposed to the establishment of a federal department or bureau of health. The name of this organization is certainly, if not intentionally, misleading. It can not claim to battle for medical freedom, for there is not a word in the entire bill which could be interpreted as limiting the practise of medicine to any particular school. Their claim that the establishment of such a bureau of health would have any resemblance to a medical trust is entirely unfounded.

The life insurance and industrial insurance companies which advocate this bill certainly have no desire to limit medical freedom or to repress any system which offers the chance of lengthening human life. These companies do not favor medical partisanship and their sole interest is to prolong the lives of their policy-holders by whatever means possible. Their actuaries state specifically that they believe human life could and would be lengthened by the establishment of a federal department of health.

Lee K. Frankel, Ph.D., representing the Metropolitan Life Insurance Company, is a member of the Committee of One Hundred, appointed by the American Association for the Advancement of Science to further the propaganda for the establishment of such a department. Neither the above-mentioned great newspaper nor any of the leading spirits of the "National League for Medical Freedom," all of whom, I regret to say, have allowed themselves to ascribe the worst motives to the members of the committee, will deny that the names of the officers of this committee show that it is thoroughly representative of the highest type of American citizenship. The officers of the Committee of One Hundred are:

President: Irving Fisher, Ph.D., professor of political economy at Yale University.

Secretary: Edward T. Devine, Ph.D., LL.D., professor of social economy, Columbia University, and secretary of the New York Charity Organization Society.

Vice-presidents: Rev. Lyman Abbott, D.D., LL.D., emeritus pastor of Plymouth Church, editor of The Outlook; Jane Addams, A.M., LL.D., founder and head worker of the Hull House Settlement, ex-president of the National Conference of Charities and Correction; Felix Adler, Ph.D., professor of political and social ethics, Columbia University, leader of the N. Y. Society for Ethical Culture; James B. Angell, A.M., LL.D., professor of modern languages and literature and president emeritus of the University of Michigan; Joseph H. Choate, LL.D., D.C.L. (Oxford), diplomat and United States senator; Charles W. Eliot, A.M., LL.D., president emeritus of Harvard University; Pit. Rev. John Ireland, LL.D., archbishop of St. Paul; Ben. B. Lindsey, judge, reformer and author, Denver, Colo.; John Mitchell, president of the labor union of America; William H. Welch, M.D., LL.D., professor of pathological anatomy, Johns Hopkins University.

Need I say anything in defense of the Committee of One Hundred after having given the names of its officers?

Direct and most unkind comments, not to use a stronger term, have been directed especially against one vice-president of the committee representing the medical profession. I refer to Dr. William H. Welch, M.D., LL.D., president of the American Medical Association. Those who know Dr. Welch and even those who only know of him, would justly think it absurd if I should see the need to say even a word in defense of this master of medical science. To us it is indeed difficult to understand that there would be any man or woman in this land capable of speaking ill of Dr. Welch. There is no name in the medical world which is more honored in this country and abroad, no medical teacher more admired, no one who has a larger following than this Johns Hopkins professor of pathology, and no physician more beloved and looked up to as representing all that is best and noblest in the profession than Dr. Welch. If there is any man in the American medical profession who is unselfishly devoting his high intelligence, his time and his means to the public welfare it is Dr. Welch. Gladly do we acknowledge him as our leader.

To accuse the president and members of the American Medical Association of selfish motives in advocating the establishment of a federal department of health is absurd. If there ever was an unselfish movement inaugurated, it is this one. It is a movement by physicians for the reduction of disease, which ipso facto means a movement against their financial interests.

The writer is a member of the regular profession; he nevertheless would not wish for a moment to limit the freedom of any citizen to choose his physician from some other school or cult, providing the individual assuming the function and responsibilities of a physician had the training necessary to prevent him from endangering the life of his patient by lack of medical knowledge or skill.

The official mouthpiece of this "National League for Medical Freedom" is Mr. B. O. Flower, who has had heretofore the reputation of a fighter for everything involving the spiritual, social and physical progress of humanity, and it is inexplicable to many of his admirers how he can lead a movement opposed to the improvement of the health of the nation. The vast majority in the ranks of this so-called "league," though they may be well-meaning, noble, and earnest, are not men and women who have toiled patiently for years in order to acquire the thorough scientific medical training which enables one to assume that great responsibility of the care and treatment of the sick. They are unable to appreciate the inestimable value of federal help in preventing disease. These people are blindly following certain individuals who designate the regular profession as a medical trust, and accuse the thousands of noble men and women who are devoting their lives to the alleviation of human ills of a desire to monopolize medical practise. The establishment of a federal department of health would mean pure food, pure medicine, control of plagues and epidemics, the advancement of medical science and through it the improvement of the health and increase of material wealth of the nation. It is said that many of the individuals opposing the Owen bill are commercially interested in the manufacture of drugs or patent medicines, of which latter the American people swallow about $200,000,000 worth annually. Whether it is true or not that the National League for Medical Freedom is backed financially by drug manufacturers and patent medicine concerns, I am not prepared to say; yet even these men have nothing to fear from a federal department of health if the drugs they put on the market are pure and the claims made for patent medicines do not delude the public or endanger its health. The element which clamors most loudly for medical freedom is composed in many instances of men and women who have attended one or two courses of lectures or got their "degrees" without any training at all, and have developed into "doctors" and "healers" in a most remarkably short space of time.

Because the American Medical Association has always advocated a thorough medical education, is pleading constantly for pure drugs, is opposed to quackery, patent medicines and nostrums, its 40,000 members are considered a medical trust. Yet it is in the ranks of this very American Medical Association that are found the greatest number of unselfish devotees to preventive and curative medicine. It is within this association that are found the men who have added the greatest glory to the medical and scientific reputation of this country. America's greatest surgeons—Marion Simms, Gross, Sayer, O'Dwyer, Bull—were members of this association. McBurney, Jacobi, Stephen Smith, Welch, Osier and Trudeau have graced this association by their membership for nearly half a century. The heroes in the combat against yellow fever—Reed, Lazare and the hundred of others who have devoted their best energies and knowledge and often sacrificed their lives for the sake of medical science—were members of the American Medical Association.

One of the most illustrious members of the American Medical Association is its former president, Col. William C. Gorgas, of the U. S. Army, chief sanitary officer at Panama, an adherent to the regular school. It is thanks to the genius, the scientific and thorough medical training of Dr. Gorgas that the formerly deadly Isthmus of Panama has now become as sanitary a region as any. A great patriotic enterprise, important to commerce and the welfare of nations, was made possible by this man. He has labored and is constantly laboring for the establishment of a federal department of health because he knows the inestimable benefit which such a department would bestow upon the nation.

Whatever advance has been made in medical science in America or in Europe has been made by scientifically trained men or by physicians not without but within the ranks of the regular profession. The greatest benefactors of mankind are those who diminish disease by prevention and cure. As another illustrious example of medical benefactors, may I be permitted to cite that great trinity of scientific giants who through their labors have accomplished so much in reducing disease and lessening human misery in all parts of the globe? They are Pasteur of France, Lister of England and Koch of Germany; all of them aided their governments by direct participation in the governmental health departments. We are still mourning the death of perhaps the greatest of the three—Robert Koch. I do not believe that there is, even in the camp of our opponents in this so wrongly called "League for Medical Freedom," a single intelligent individual who will deny the inestimable benefits which Koch has bestowed upon mankind through his discovery of the germs of tuberculosis, of cholera, of the spores of anthrax, of tuberculin, and through his many other equally important scientific labors. Yet, had it not been for the Imperial German Reichsgesundheitsamt, which is the equivalent of the institution we are striving for—a federal department of health—Koch never would have been able to devote his life, energy and great genius to those important discoveries through which thousands of lives have been saved in all civilized countries during the past few decades. It was while working in this governmental institution, which is doing exactly the work the Owen bill asks the federal department to do, that Koch discovered the tubercle bacillus and the bacillus of cholera. Because of the discovery of the comma bacillus, we no longer have those fearful cholera epidemics which formerly decimated our own and other countries. This disease can now be easily diagnosed and by proper quarantine its mortality can be reduced to a minimum. And what shall we say of the progress that has been made in the fight against tuberculosis because the federal department of health of Germany enabled Koch to do research work and thus discover the bacillus of tuberculosis to be the primary and only direct cause of the disease? As director of the hygienic institute and member of the Reichsgesundheitsamt he inaugurated that wonderfully effective campaign against tuberculosis whereby the mortality from this disease in Germany has been reduced to nearly one half of what it was prior to the discovery of the tubercle bacillus.

Under Koch's inspiration and guidance and in the same institute many great scientific discoveries of incalculable value to humanity were made. Foremost among them are the works of Ehrlich, one of Koch's most celebrated pupils, who recently gave to the world a new remedy which promises to prove a specific in an affliction from which mankind has suffered for centuries.

As co-worker in the Kaiserliche Gesundheitsamt and the Institute for Infectious Diseases, affiliated therewith, we must also mention Behring, the discoverer of the anti-diphtheritic serum. Thanks to the discovery of this serum thousands of young lives are now saved which would formerly have fallen victims to the terrible disease known as malignant diphtheria. This was made possible by the opportunity given to the workers in the Reichsgesundheitsamt and Imperial Institute for Infectious Diseases.

Can there be any better argument in favor of the establishment of a federal department of health?