only one of the numerous disadvantages which civilization imposes on the race. Sir F. Galton is of the opinion that it would be possible to alter the conditions of life, so that the most prudent course would be for such persons to marry at an early age. If this change in the existing order of affairs could be brought about, says the Medical Record, it would be a long step in the right direction; but it is a question whether stirpiculture applied to the human race could be successfully carried out as things are at present. Physical and mental improvement is greatly needed, and the race would benefit greatly if practical methods tending to this end were devised. Almost all the suggestions advanced have been visionary and impracticable. The inculcation by example, precept, and especially by education of the gospel of health and cleanliness, the repression as far as is possible of criminality, vice and drunkenness, are the means at hand whereby the evils of modern life can undoubtedly be considerably lessened. Perhaps in measures of this nature lies the mental, physical and moral redemption of the race rather than in well-meant but utopian schemes, which offend the intelligence of the people at large and are repugnant to their ideas of freedom. caves, with disgusting mixtures, incredible charms, and unspeakable incantations, where "Fillet of a fenny snake In the caldron boil and bake; Adders fork and blind worm's sting, Lizard's leg and Howlet's wing," formed the basis of decoctions even more inert than repulsive. Her rival was the no less mendacious even if more respectable priest of a pagan deity, about whose shrine nameless vice and diabolical crime masqueraded under a cloak of sacerdotal piety. Little prospect had the averting of death and disease for success where its only helpers were found in the horrid rivalry of warlock lair and pagan purlieu. Little wonder if the mystery of life and the no less inexplicable story of the strange journey to that bourne whence no traveler returns, was studied by but few of the puerile populace who peopled the young and childlike world of the earlier ages. Small prospect, indeed, for the growth of the tiny seeds of medical science planted by the Sage of Cos, the naturalist of the Poecile Stoa, and the tutor of the life-severing Alexander. Nevertheless, watered and tended by the wondrous observer of Ephesus and Rome, by the mystic delvers of the Moors and Saracens, and by the proud prelectors of the great French and Italian Universities, it grew into a sturdy sapling ready to take upon itself the mighty growth of the nineteenth century of the Christian Era. The opening of that century, which has just drawn its glowing head below the mighty horizon of the ages, gave but little promise of the matchless development which the healing art was to take upon itself in the shining days which successively crowded each other into the silent sepulcher of the dead past. And yet medicine was alive. By the patient's bedside, in the quiet laboratory, and under the midnight lamp, with pen and scalpel in hand, with brain and heart under control, facile minds were utilizing the heritage of eighteen Christian centuries and thirty pagan periods in the development of a science which, founded upon altruism and supported by philanthropy and humanity, was destined to excel all human efforts for the relief of the ills of mankind. Depuytren, Beclard, and Laennec were dazzling the world from the arenas of the Parisian Hospitals; Astley Cooper, William Lawrence, and Edward Jenner were in their prime in the great hotbed of Anglo-Saxon learning; While Philip Syng Physick, Valentine Mott, and John Collins Warren were exercising a concerted sway over the medical thought of the Western world. And what magnificent results followed upon the introduction of scientific methods into the study of medicine by these men and their successors! Serum therapy, brought into being by Edward Jenner's casual conversation with a dairymaid, further developed by the isolation of the antitoxin of diphtheria, with numerous other outgrowths, has mastered two of the longest tentacles of Pestilence. Anesthesia, the joint gift of Morton and Simpson, has robbed surgery of its terrors, parturition of its pains, and vastly extended the field for the mechanical treatment of disease. The microscope, with its daughters Pathology and Bacteriology, has developed diagnosis almost to the point of positiveness. Antisepsis, asepsis, and sterilization have given to operative work a surety of accomplishment beyond the fondest dreams of former periods. In countless variety, progress has entered into every phase and factor of human ills. Some affections have been banished from the category of existing diseases. Who in this day fears typhus fever? Where are the ravages of bubonic plague? Where are the dangerous results of the invasion of the bubbling focus of yellow fever by the armies. of the United States? By the wise management of members of the medical corps of the army-to whose labors the world owes a debt of gratitude that can never be paid the yellow specter of the Antilles has been laid to rest. If this has been done at the cost of the martyrdom of several earnest workers, including among them my dear friend and comrade, Paul Clendenin, the cost is all too great, but our sorrow for the loss of that gentle spirit and noble soul may be somewhat modified by the fact that the nation need no longer be in dread of the voracious epidemic which has for centuries raged along her southern shores. And so we set forth upon the twentieth century with an impetus of medical progress that nothing can withstand. The aim of the nineteenth century has been directed toward the cure of disease and the relief of human ailments, but through all its accomplishments the great art of prophylaxis has been growing more and more conspicuous until to-day it is the most prominent feature of progressing medicine. And it is safe to say that while progress in the cure of disease has above all marked the medicine of the nineteenth century, the prevention of disease will be the keynote of the medicine of the twentieth. The leech of the first century often a slave and always slavish, the practitioner of the tenth century respected and feared for his acquirements, but without social position or personal consideration, the surgeon of the fifteenth century whose surgical work was simply adventitious to shaving and hair cutting, the medical man of the eighteenth century when it was a matter of serious discussion in the medical journals of the period as to whether the physician should not visit his patient by way of the servant's door rather than by the main entrance of his patient's houses-have all given way to the physician of the nineteenth century, scientific in his methods, broad in his acquirements, respected and honored of all men, elevated to the peerage in England and honored by the highest offices in the United States. To what then may medicine and the physician look forward in the twentieth century? What higher status can they ob tain in the community? How much more will they contribute to the prolongation of life and the suppression of human suffering? That the examination of osseous structures and the determination of metallic bodies in living tissues can be accomplished through the discovery, which has immortalized the German Roentgen, is but the beginning of the penetration of opaque tissues by the sight. The isolation of rays which will enable the diagnostician to illuminate and examine any portion of the body at any depth, is only a matter of time and is within the probabilities of the present century. The further growth of the study of microorganisms, their identification, their life-history, and their relation to health and disease, the toxins and the antitoxins developed in connection with them, will at no distant day render possible the early identification of the germs of all disease and the absolute prevention of infection and contagion. The determination and segregation of the causes will afford an easy means of experimentation as to the most ready method of destroying them-and in this manner therapeutics will attain a precision and absoluteness beyond the dreams of a hundred years ago. In the surgery of to-day, operative work would seem to have arrived at high tide, but the twentieth century will not have unrolled many years in its scroll of a hundred before new procedures, bolder applications, and more positive results will have borne it still farther from the domain of doubt toward the goal of certainty. The myriads of other developments that will take place in thousands of different directions, would form a catalogue all too long to be rehearsed at a single time, but that they will pour down into scientific knowledge in an irresistible flood, modifying the entire face of science as they come, is a matter of simple fact and sober reality. The medical man, with his broader field of knowledge and with his greater power to act will increase in influence in the community. The quack will drop out of sight, for the physician himself will be able to perform those hitherto impossible feats of medicine upon his claims to the performance of which the medical charlatan has based his bids for the wealth of the confiding multitude. Under the impulse of this marvelous evolution of medical science, the public will become educated to the realization of the fact that it is better to keep well than to recover from illness, and the physician will become rather a health-adviser that a disease-curer. The doctor who has the fewest sick upon his calling list rather than the man who has the most, will be considered the most successful practitioner; the physician will be paid rather for keeping his clients well than for treating them when they are sick. The sentiment thus created will add to the importance of state medicine and public hygiene. Every city, hamlet and neighborhood will have its health officer, trained in all the minutiae of preventive medicine. and endowed with ample power to promptly suppress every evil which may threaten the health of the community; every county and state will have an experienced hygienist to supervise the sanitation of the country, who will, without fear or favor, sustain and support the work of the local sanitary officials, and not the last important member of the President's cabinet will be the Secretary of Public Health. And so, throughout the twentieth century, the medical profession will march onward in its career of philanthropy, generosity and self-sacrifice, immolating its own opportunities for pecuniary gain upon the altar of unalloyed humanity, and sacrificing its own longings for the comfort and luxury at the stern bidding of hard-visaged Duty. And so, in the twentieth century, through the labors of a devoted profession, as a work sublime in conception, disinterested in execution, and superb in accomplishment, foul pestilence will be wiped off the face of the earth, prolonged pain will have been banished from human existence, and death will again return to its quondam causes of simple decay and natural dissolution. ADJUNCTS TO SPA TREATMENT. WM. ARMSTRONG, in Journal of Bacteriology and Climatology, says: "Aix-lesBains, whose natural waters are of no extraordinary value, has built up for itself a world-wide reputation entirely through the systematic and scientific methods of massage, douching, and electrical applications introduced into its treatment mainly by the skill and energy of the late Dr. Brachet. "At Nauheim the undoubted value of the waters in certain cardiac troubles has been greatly enhanced by the introduction of the effective system of resisted exercises, designed and brought into use by the brothers Schott, aided in some cases by Oertel's method of graduated hill climbing. "Cardiac treatment consists of: (a) Saline or effervescing saline baths; (b) resisted exercises; (c) Oertel's graduated hill climbing. "A gouty subject with cardiac debility or even disease, may be greatly assisted by adjuncts. If the lesion is not very serious, the addition of a few effervescing saline baths on the Nauheim method, or the use of some carefully selected resisted exercises, allows the patient to go through the regular bathing cure with advantage and safety. "If the cardiac trouble is more serious, then the local or general application of hot air by the Greville or Dowsing systems, aided by the saline baths or exercises, is most valuable, and the patient may in most instances have also the advantage of drinking the waters. Massage and exercises are (a) wet, and (b) dry. (a) The wet massage is given in the following forms: (1) The Aix douche bath; (2) a modifiIcation of the Aix douche given while the patient reclines in a shallow bath of hot water; (3) the Vichy douche bath. (b) The dry massage, with or without the faradic or constant currents. Swedish massage, movements, exercises, and vibrations; breathing exercises; Zander or mechanical exercises. "The addition of massage to mineral water treatment is acknowledged to be of great value, emptying the lymph spaces and lymphatic channels of their morbid contents, generally stimulating the vital processes, being made more effective by admisistration in conjunction with the soothing. and softening effects of a stream of hot water. "In conclusion the following propositions are put forward: "(1) That as spa physicians have often such limited periods in which to cope with chronic ailments, and as so many of the cases presented to them are complicated in character and refractory to treatment, it is desirable that they should have at command the best methods of approved physical treatment. "(2) That such methods in no way diminish the reputation and value of the natural resources of the spas where they are used, and are, as a rule, much more effective when used in combination with natural baths and waters." "Dr. Leon, in discussion, said, 'No spa could afford to despise adjuncts to bath and water treatment. In cases of insomnia, for which the South Devon Valleys were especially suitable, drugs should be dispensed with altogether, and the soothing effects of baths, mild climate, massage, and other common sense hygiene substituted.'" WHY THE RESTRICTION OF CONSUMPTION IS RETARDED. Ar the annual meeting of the Michigan State Board of Health, May 15, 1902, Hon. Frank Wells, in his presidential address, said: "A century ago Jenner discovered how smallpox could be prevented, and to-day it causes fewer deaths in a year throughout the world than consumption does every day. Twenty years ago Koch discovered the germ of tuberculosis and gave us the key to the prevention of this disease which causes more deaths than any other. What vaccination has done for the restriction of smallpox, the destruction of the sputum of those ill with consumption has done and is doing for the restriction of that disease. "In both of these diseases obstructionists have endeavored to discredit and prevent the application of the measures which science and experience have shown most efficient for their restriction. Had vaccination and revaccination been general there would not have been the present recrudescence of smallpox. Yet there exist those who, notwithstanding the fact that smallpox had been substantially made to disappear by means of vaccination, still object to the application of it as a preventive measure. "There also exist those who, notwithstanding the fact that consumption is diminishing, refuse to co-operate in the only means for checking the progress of this disease which experience has shown to be efficient." * * * "All that is required is that health authorities be furnished with the names and places of abode of persons suffering from consumption, in order that they may supply these victims with information of how they can best care for themselves and avoid infecting their families and friends with the disease. "The knowledge of the names and habitations of consumptives is largely held by physicians. Some report this knowledge to the proper health officials, while many do not. Those who fail are avoiding both moral and legal responsibilities, and should realize that it is their inaction which is retarding the restriction and the eventual eradication of this disease, more than probably all other causes combined." LIFE is too short for a man to try to constitute himself a library of knowledge when the reservoirs of such knowledge are ready to hand when it is needed. PRESENT STATUS OF LIGHT THERAPY. S. BANG (Indian Medical Record, March 12, 1902) says that photobiological researches have established the following facts: 1. The violet and ultra-violet rays produce a specific inflammation of the skin which is different from all other cutaneous inflammations. inflammations. 2. These rays stimulate the body as a whole, chiefly acting in a reflex manner. 3. These rays possess strong bactericidal power. Much has recently been written in regard to the satisfactory results obtained in the treatment of constitutional diseases by light. Astonishing results have apparently been obtained in this manner in the treatment of pulmonary tuberculosis, syphilis, arthritis, diabetes, and a number of other diseases. In most of the cases of such conditions hitherto reported as treated by light, other therapeutic measures and various climatic influences have been brought into play. For this reason it is at present impossible to say exactly what value light therapy possesses when employed in constitutional pathological conditions. That some benefit is to be derived therefrom seems certain, but that in the future it is to work miracles in these diseases is not to be believed. At present it is in local cutaneous and tissue affections that the benefit of light therapy is the most satisfactorily observed. It possesses a specific influence over lupus vulgaris. Of 640 cases of this disease so treated by Bang, 456 were entirely cured. No recurrence has taken place in 130 of these, although from one to five years have elapsed since their recovery. In only eleven cases was it necessary to discontinue the treatment on account of unfavorable signs. Cases of lupus erythematosus, alopecia areata, acne vulgaris, and nævus vascularis have also been treated by this method with good results. The efficiency of light in the treatment of disease is very largely dependent upon the so-called chemical rays of the spectrum. In the majority of cases the heat rays are directly injurious For this reason all apparatus for |