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July 28, 1900


JAMA. 1900;XXXV(4):236. doi:10.1001/jama.1900.02460300038008

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Now that it seems probable that the United States has before it, as a portion of its "white man's burden," serious and possibly prolonged and extensive military operations in China, it is well to face openly some of the sanitary problems it involves. China is by no means a healthy country; over a large part of its extent it supports a dense population, who live in conditions of hardly calculable unwholesomeness, and by their methods of agriculture, thrifty and thorough, but unsanitary, keep their land in a state of a midden heap. The watercourses are practically open sewers. Human life is comparatively cheap in China, and it is probable that the mortality rates of their cities and country districts from gastrointestinal disorders would be found higher than in most other countries, had we any reliable statistics. This is taking into account, also, the immunity they must have acquired during centuries

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