﻿544 
  ANNUAL 
  EEPORT 
  SMITHSONIAN 
  INSTITUTION, 
  192*7 
  

  

  The 
  task 
  of 
  applying 
  hygiene 
  naturally 
  falls 
  under 
  three 
  heads: 
  

   1. 
  Public 
  hygiene, 
  i. 
  e., 
  hygiene 
  through 
  governmental 
  health 
  agen- 
  

   cies; 
  2. 
  semipublic 
  hygiene, 
  i. 
  e., 
  hygiene 
  through 
  other 
  institutions 
  

   (this 
  includes 
  school 
  hygiene, 
  industrial 
  hygiene, 
  and 
  the 
  hygiene 
  

   of 
  life-insurance 
  companies) 
  ; 
  and 
  3. 
  individual 
  hygiene, 
  i. 
  e 
  ., 
  

   hygiene 
  through 
  the 
  voluntary 
  effort 
  of 
  the 
  individual. 
  

  

  PERIODIC 
  MEDICAL 
  EXAMINATIONS 
  

  

  The 
  first 
  of 
  these 
  three 
  is 
  the 
  particular 
  job 
  of 
  the 
  members 
  of 
  

   this 
  association. 
  But 
  their 
  task 
  is 
  much 
  larger 
  than 
  that; 
  it 
  should 
  

   include 
  an 
  interest 
  in 
  the 
  other 
  two, 
  and 
  especially 
  the 
  third. 
  

  

  The 
  individual 
  must 
  be 
  taught 
  to 
  practice 
  individual 
  hygiene. 
  He 
  

   can 
  be 
  stimulated 
  to 
  do 
  so 
  by 
  periodic 
  medical 
  examinations. 
  At 
  

   the 
  recent 
  meeting 
  of 
  the 
  American 
  Medical 
  Association 
  at 
  Dallas 
  

   the 
  president 
  in 
  his 
  address 
  stressed 
  this 
  more 
  than 
  anything 
  else. 
  It 
  

   has 
  been 
  advocated 
  occasionally 
  for 
  over 
  half 
  a 
  century 
  (24). 
  Doctor 
  

   Dobell 
  (8) 
  of 
  England 
  advocated 
  it 
  in 
  1860, 
  Doctor 
  Bares 
  (9) 
  of 
  

   France 
  in 
  1902, 
  Dr. 
  George 
  M. 
  Gould 
  (10) 
  advocated 
  it 
  in 
  1900. 
  Dr. 
  

   Burnside 
  Foster 
  advocated 
  it 
  in 
  1908 
  before 
  the 
  Association 
  of 
  Life 
  

   Insurance 
  Presidents, 
  following 
  my 
  own 
  address 
  advocating 
  life 
  

   extension 
  by 
  life-insurance 
  companies. 
  All 
  of 
  these 
  authorities 
  de- 
  

   veloped 
  the 
  idea 
  independently, 
  but 
  it 
  was 
  not 
  given 
  any 
  wide 
  prac- 
  

   tical 
  application 
  until 
  the 
  establishment 
  of 
  the 
  Life 
  Extension 
  Insti- 
  

   tute 
  in 
  1914, 
  when 
  as 
  the 
  outgrowth 
  of 
  these 
  efforts 
  and 
  of 
  the 
  coop- 
  

   eration 
  of 
  Gen. 
  William 
  C. 
  Gorgas, 
  ex-President 
  Taft, 
  Dr. 
  Eugene 
  

   L. 
  Fisk, 
  and, 
  most 
  of 
  all, 
  Harold 
  A. 
  Ley, 
  we 
  founded 
  the 
  Life 
  Ex- 
  

   tension 
  Institute 
  through 
  which 
  this 
  ideal 
  of 
  periodic 
  medical 
  exami- 
  

   nations 
  has 
  been 
  made 
  real. 
  The 
  chief 
  objective 
  was 
  to 
  harness 
  up 
  

   the 
  profit-making 
  motive 
  of 
  the 
  life-insurance 
  companies 
  with 
  the 
  

   task 
  of 
  lengthening 
  human 
  life. 
  

  

  After 
  six 
  years' 
  experience, 
  during 
  which 
  the 
  Metropolitan 
  Life 
  

   Insurance 
  Co. 
  used 
  the 
  service, 
  its 
  statistical 
  department, 
  under 
  

   Doctor 
  Dublin, 
  cast 
  up 
  accounts. 
  The 
  results 
  were 
  so 
  astonishing 
  

   that 
  the 
  actuarial 
  department 
  and 
  the 
  medical 
  department 
  refused 
  

   to 
  believe 
  them 
  until 
  forced 
  to 
  do 
  so 
  by 
  going 
  over 
  the 
  records 
  for 
  

   themselves. 
  The 
  three 
  departments 
  then 
  united 
  in 
  a 
  report 
  showing 
  

   that, 
  as 
  a 
  consequence 
  of 
  expending 
  $60,000 
  on 
  medically 
  examining 
  

   6,000 
  people 
  within 
  six 
  years, 
  the 
  Metropolitan 
  had 
  gained, 
  through 
  

   premiums 
  of 
  people 
  whose 
  lives 
  were 
  extended, 
  $120,000. 
  In 
  other 
  

   words, 
  this 
  life-insurance 
  company 
  had 
  made 
  100 
  per 
  cent 
  on 
  its 
  

   investment. 
  

  

  This 
  research 
  was 
  carried 
  forward 
  by 
  Dublin 
  to 
  cover 
  a 
  total 
  

   period 
  of 
  nine 
  years 
  and 
  showed 
  an 
  average 
  reduction 
  of 
  18 
  per 
  

  

  