igher than that of fifteen foreign countries for which
statistics were available in 1915, we face a condition which cannot be
neglected. When we find that in Wisconsin this rate was but 6 per 1,000,
and that 68 percent were attended by physicians, and in Kansas it was
but 2.9 per thousand and 95 percent had physicians, while in Montana
only 47 percent were attended, loss of life due to isolation and lack of
medical care is apparent. In sparsely settled regions the solution of
this problem seems to demand the provision of local maternity hospitals,
for the difficulty is primarily one of isolation.

Since medical science has shown that sparkling spring water may carry
the deadly typhoid germ as a result of distant contamination, that wells
are frequently contaminated by nearby privies or barn yards, that
malaria is carried by mosquitoes, and that the house fly may carry
typhoid fever and intestinal diseases of infants, we have come to
appreciate that isolation and pure country air do not insure freedom
from infection, and that sanitation is as important on the farm as in
the city. Indeed the transmission of disease by flies is much easier on
the farm, for too often the manure pile where they multiply is not far
from the house, while in many a city the smaller number of horses and
the cleaning of manure from the streets prevents their increase. The
sanitation of the farm home thus becomes a very large factor in the
health of the rural community. Surveys made by health officers in recent
years have shown the general need of better sanitary provisions and also
the possibility of the direct benefits secured from their improvement.
In Indiana the State Board of Health surveyed nine typical rural
counties taking only the homes on farms and in unincorporated villages.
The average score of 6,124 rural homes in these nine counties was but
56.2 percent, the average for individual counties varying from 43 to 61
percent. In 1914, 1915, and 1916, the U. S. Public Health Service made
sanitary surveys of 51,544 farm homes in 15 rural counties scattered
throughout the United States, but mostly in the South. Its report[55]
states that only 1.22 percent of these farm homes were equipped for a
really sanitary disposal of human excreta, while in one county in
Alabama less than 20 percent of the farm homes had toilets of any kind.
"Sixty-eight percent of the water supply used for drinking or culinary
purposes was obviously exposed to dangerous