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ind surgical cases. Many hospitals in a community indicate much sickness 
and especially sickness of preventable kinds. What our cities need is not 
more hospitals but a thorough cleaning up, and shall one add that our 
cities sheuld also prevent smoke clouds? Smoke means waste, besides de- 
struction of life, as alrendy mentioned. 
The plant breeder is constantly seeking to eliminate the unfit. But 
man can not proceed on the same plan regarding his own kind. He does 
not wilfully seek the destruction of those not adapted. He tries to make 
the environment favorable so those who are apparently unadapted will 
survive. Nature is of course constantly weeding out the unadapted and 
the mortality rate of crowded cities is something terrific compared with 
lite under simple country conditions. By giving the inhabitants of the 
large city pure water, good food, good air and clean homes the conditions 
for existence are at once made favorable. 
Every now und then we read of cities that are seeking a slogan; 
what they want is one to indicate that they are growing bigger. A good 
slogan for nearly all of our American cities would be, “Let us clean up,” 
or, “Not bigger but cleaner.” Perhaps the best reputation that any city 
could acquire is “A city that cleans up.” When the people once realize 
What clennliness means cur cities will be radically different from what 
they are today. 
From what is said above it may perhaps be seen that the cries of 
Race Suicide, Back to Nature, and Back to the Simple Life have a good 
foundation. 
Our Academy has a Committee on The Restriction of Weeds and Dis- 
euses (“Diseases” was added on my recommendation). For the past two 
years I bave been chairman of this Committee but, I am sorry to say, when 
at the annual meetings a call for reports was made I had nothing to re- 
port. Perhaps I ought to explain. For the past year and a half I have 
been working on a manuscript, in fact on two manuscripts, dealing with 
common ill health and the peed for cleaning up. One of these volumes is 
intended for the public and the other for physicians. The problem I am 
especially interested in as most of you know is to give the people good air, 
air free from dust and smoke. Until these two volumes are out I do not 
feel like taking up the subject pubiicly. But I feel that this is a subject 
that should be taken up dy the Academy, perhaps at first in a small way, 
eradually enlarging. We must interest the people. Saiitation can not be 
