WHAT MEDICINE HAS DONE AND IS DOING FOR THE RACE 437 



suppressed; it Is indeed one of the best examples in medical 

 history of an acute infectious disease which can be prevented 

 by scientific sanitation. 



Prognosis, or forecasting what will happen, is a very impor- 

 tant function of medical men, as it supplies what everyone is 

 anxious to know when illness overtakes them or their 

 relatives. The power of predicting the duration and outcome 

 of a given case of disease depends on several data: first an 

 accurate knowledge of the nature of the illness (diagnosis), 

 secondly on knowledge of its natural history, course and 

 significance, of the comphcations that may occur, the 

 sequelae or results that may follow, and how far treatment 

 can influence it beneficially, and thirdly on acquaintance with 

 the individual patient's constitution, family history, inherited 

 characters, mental traits, previous health and habits of 

 life. Prognosis thus involves problems all of which may not 

 be capable of solution, particularly during the initial stages, 

 and is probably the most difficult part of medicine. It may 

 be vitally important for a man with many responsibilities to 

 know if he must face death at no long interval, and in these 

 circumstances he should share the medical man's honest 

 opinion, but a fatal prognosis must be given only when 

 there is absolute evidence. In cases of doubt an optimistic 

 view is better for all concerned, and even when there is every 

 reason to anticipate the worst, the unasked warning may be 

 harmful, and many patients know, though they do not really 

 wish to be told, what is before them. Of course reticence 

 must not delay or interfere with the proper medical or 

 surgical treatment of the disease. The foretelHng of the 

 physical future of the individual is not confined to conditions 

 of illness, for a medical survey is an essential part of life 

 insurance, and apart from this there is much to be said for 

 the wisdom of a periodic overhaul of the man's body as well 

 as of his business affairs and stock, so that he may be warned 

 in time of any early indications which make it desirable to 

 change his manner of life. 



As a result of the application of statistical methods 

 the occurrence of epidemics can in certain instances be fore- 

 told so that preparations can be made in advance. Thus 

 J. Brownlee (1868- 1927) pointed out that after a pandemic of 



