ible
evidence can be found in every medical library. The mortality
statistics of different countries tell the same story. A single
example shows the general experience: In seven provinces of the
Philippine Islands there were 6,000 deaths annually from smallpox
alone. In his 1906 report, Dr. Victor G. Heiser, Director of Health in
the Islands, describes how drastic measures were taken to stamp out
the disease. Under his direction practically three million one hundred
thousand persons were vaccinated. The following year, instead of 6,000
deaths from smallpox, there was not one.

For 13 years the Board of Education has had upon its books a rule
requiring vaccination as a prerequisite to admission to the schools.
That rule has never been adequately enforced. In July, 1914, City
Ordinance 32846-B was passed, one section of which reads: "No
superintendent, principal, or teacher of any public, parochial,
private school, or other institution, nor any parent, guardian, or
other person, shall permit any child not having been successfully
vaccinated, nor having had smallpox, to attend school." Although
passed a year ago, that ordinance has not yet been enforced. Exact
figures cannot be secured, but it is probable that there are in the
Cleveland schools today more than 50,000 unvaccinated children. For
each of these the superintendent, principal, teacher, and parent may
be held liable to a $200 fine, 60 days imprisonment, or both.

FUTURE DEVELOPMENT

Compared with other large cities, Cleveland has an unusually good
system of medical inspection. Where other cities are still struggling
with details of organization, record keeping, and the like, Cleveland
is ready to lead the way into new and immensely important fields.

Medical inspection includes four fields of endeavor: prevention of
epidemics, discovery and cure of physical defects, provision of
healthful surroundings, and formation of correct habits of thought and
action in regard to health. The first two are concerned with remedying
present conditions, and here Cleveland is doing excellent work. The
latter two provide health insurance for the future. In these,
Cleveland has made a beginning but should carry her efforts far in
advance of anything now attempted.

Thirteen years ago a crusade was started against the common drinking
cup. Today there is not a school in the city which is not supplied
with sanitary drinking fountains, and the common cup is a thing of the