Why is such negligence on the part of physicians not punished? Because health officials dread to offend the medical profession. In this respect, however, a vast improvement is coming about. Pennsylvania, Maryland, Indiana, Massachusetts, Minnesota, Wisconsin, and other States are not afraid to prosecute and fine delinquents; nor are a growing number of cities, among them Boston, New York, Rochester, Providence, and New Orleans. The great majority of such prosecutions, however, are for failure to notify the authorities of actively contagious diseases, such as scarlet fever, diphtheria, and smallpox. _"Business Interests" and Yellow Fever_ Epidemics are, nevertheless, in the early stages, often misreported. If they were not--if early knowledge of threatening conditions were made public--the epidemics would seldom reach formidable proportions. But--and here is the national hygienic failing--the first instinct is to conceal smallpox, typhoid, or any other disease that assumes epidemic form. Repeated observations of this tendency have deprived me of that knock-kneed reverence for Business Interests which is the glorious heritage of every true American. As a matter of fact, Business Interests when involved with hygienic affairs are always a malign influence, and usually an incredibly stupid one. It was so in New Orleans, where the leading commercial forces of the city, in secret meeting, called the health officer before them and brow-beat him into concealing the presence of yellow fever, lest other cities quarantine against their commerce. And "concealed" it was, until it had secured so firm a foothold that suppression was no longer practicable, and the city only averted a tremendously disastrous epidemic by the best-fought and most narrowly won battle ever waged in this country against an invading disease. [Illustration: THE SCAVENGERS OF CHARLESTON, SOUTH CAROLINA] It is interesting to note, by the way, that this epidemic, with its millions of dollars of loss to the city of New Orleans, might have been averted at a comparatively small cost, had the city fathers possessed the intelligence and foresight to adopt a plan devised by Dr. Quitman Kohnke, the city health officer. New Orleans gets its drinking water from private cisterns. Each of these is a breeding place for the yellow-fever-bearing mosquito. Dr. Kohnke introduced a bill a year before the epidemic, providing for the screening of all the cisterns, so that the mosquitos might not spread abroad; and also for the destruction by oil of the insects in the open pools. The total cost would hardly have exceeded $200,000. But there was no yellow fever in the city then; the public had recovered from its latest scare; and the bill was voted down with derision. I suppose the saving of that $200,000 cost New Orleans some forty or fifty million dollars in all.