XXX INTRODUCTION*. 



and it should not be forgotten that many diseases that we are powerless to cure 

 might be readily and completely stamped out. A few years ago an attempt was 

 made to estimate the undoubted preventible mortality from disease. A comparison 

 was made between the death-rate of the healthiest registration districts of England 

 and those the least healthy, and the diseases were then ascertained from which the 

 excessive mortality arose. It was proved most conclusively that these diseases 

 might be so reduced in frequency as to bring down the death-rate of the now 

 unhealthy districts to the level of the healthy. First and foremost among 

 preventible diseases is rickets, which, either directly or indirectly, is one of the 

 most fatal maladies of infantile life. The causes of rickets are poorness of the 

 mother's blood, errors in diet, and more especially overcrowding of the bed-rooms. 

 Every doctor knows that not a single child ought ever to die from rickets or its 

 consequences. If we could only provide the poor with light, airy, well-ventilated 

 rooms, we could soon stamp out not only rickets, but many other diseases. The 

 rich are directly interested in the welfare and sanitary condition of the poor, for the 

 fever which carries off the millionaire in his palace has probably grown and gained 

 strength in the wretched dens which, sad to say, are too often the only habitation 

 of those who earn their daily bread by the sweat of the brow. 



Then again, syphilis is a preventible disease, and it is indirectly the cause of 

 many deaths. Many a case of so-called liver disease, or Bright's disease, or brain 

 disease, is in reality dependent on a syphilitic taint contracted perhaps years and years 

 before, in the days of youth and passion. Delirium tremens is a preventible disease, 

 and even gout is in a large proportion of cases dependent on preventible conditions. 

 Of course, the diseases which are due to the injurious influences consequent on the 

 exercise of certain trades are to a certain extent preventible. Many diseases are 

 caused by ignorance of sanitary laws and neglect of the most simple rules relating to 

 food, air, clothing, light, and exercise. One constantly meets people accomplished 

 and highly educated, who would be ashamed to be ignorant of classical and 

 mathematical knowledge, but who do not know even enough to maintain their 

 bodies in a healthy condition. This ignorance of sanitary laws is by no means 

 confined to those who in other respects are uneducated. Over and over again, we 

 find towns springing up under the fostering care of rich and influential proprietors, 

 without any other mode of drainage than the collection of the filth of each house 

 into its own cesspool, and with no other supply of water than that obtained from 

 surface pumps. 



Now a word or two about treatment. Concerning medicinal treatment, it must 

 be admitted that then- is still in certain quarters considerable scepticism. Curiously 

 enough, this want of faith is met with not so much in thcsa who take medicine as 

 in those who prescribe it. The greatest sceptics are the consulting physicians. 

 Your family practitioner would laugh you to scorn if you were to say you did not 

 believe in medicine and serve you right, too. What, then, is the explanation of 

 this scepticism among hospital physicians 1 Fortunately, it is not far to seek. You 

 must remember that the majority of people do not care to consult a physician unless 

 they have something serious the matter with them. If they have only some trivial 

 affection they go to the general practitioner, and regard a consultation aw a derniet 



