PRESIDENTIAL ADDRESS. 539 
Even thereafter, the slow struggle continued of the few who knew against the 
many who refused to be taught, and a perusal of any orthodox text-book of 
medicine published between 1875-80—that is, more than a decade after Pasteur’s 
great discovery—will show that the etiology of scarcely a single infectious disease 
had become known, and that medical science was, for example, as ignorant 
of the nature of tuberculosis as we are to-day of the nature of carcinoma. 
Take, as an example, the following quotation from a well-known text-book of 
the theory and practice of medicine published in 1876: ‘It is now, however, 
generally admitted that tubercle is no mere deposit, but, on the contrary, a 
living growth as much as sarcoma and carcinoma are living growths.’ The 
tubercles were the only initial lesion observed, the infecting organism was 
entirely unknown, and the pathologists of this comparatively recent date argued 
at length as to whether tubercles were to be classed as ‘adenomata’ or were 
something sui generis. 
There is a gleam of sunlight for the future in this retrospect at the ignor- 
ance of the past, for, if men were as ignorant regarding tuberculosis thirty-eight 
years ago as to-day they are about cancer, then it may be argued that a genera- 
a hence as much may be known about cancer as is known now about tubercu- 
Osis. 
_ It is particularly important at the present moment, when so much interest 
is being taken in national health, to point out the urgent necessity of allowing 
as little lagging behind as possible to ensue between the making of discoveries 
and the practical application of the results by organised national effort for the 
well-being of the whole community. 
It must sadly be admitted that it is craftsmanship in imaginary danger 
fighting hard for the old methods unchanged which were in vogue fifty years 
ago, that stands most prominently in the way of advance. As great a harvest 
as that which followed the application of the principle of antisepsis in surgery 
awaits the application of the self-same principle in national sanitation to-day, 
but the very profession which ought to be urging forward the new era 
apparently stands in dread of it, and seems to prefer to reap its harvest from 
disease rather than to seize the noble heritage won for it by the research of 
pioneers and so stand forth to the world as the ministry of health. Fortunately 
it cannot be, the bourne has been passed, and there is no going backward. The 
advances that have already been made have awakened statesmen and people 
alike to the needs of the situation, and all have resolved to be disease-ridden 
no longer. The laws of health must be made known to the people at large, and 
schemes laid before them for a national organisation for the elimination of 
disease, Disease is no longer an affair of the medical profession, it is a national 
concern of vital importance. The problem is not a class question, all humanity 
stands face to face with it now in the light of modern research as it never has 
faced it before. It has been realised that disease never can be conquered by 
private bargains for fees between individual patient and individual doctor. 
Research into diseases of unknown causation cannot be subsidised upon such 
individualistic lines, and in the case of diseases of known etiology and modes 
of propagation the passage of disease from individual to individual cannot be 
controlled by such private methods as that of the afflicted individual subsidising 
the doctor for his own protection. Cost what it may, a healthy environment 
must be produced for the whole mass of the population, and the laws of 
physiology and hygiene must be taught not only to medical students, but to 
every child in every school in the country. People cannot live healthy lives in 
ignorance of the fundamental Jaws of health merely by paying casual visits to 
physicians, and no one class in the community can be healthy until all classes 
are healthy. 
The problem of national health is one of peculiar interest to physiologists, 
and to the exponents of those experimental branches of medical science which 
have sprung from the loins of physiology, for it was with them that the new 
science of medicine of the last fifty years arose, and they ought to be the leaders 
of the world in this most important of all mundane problems. 
It is well worth while to consider our opportunities and responsibilities and 
raise the question whether our present system and organisation are the most 
suitable for attaining one of the most sublime ambitions that ever appealed to 
