January 30, 1914] 



SCIENCE 



153 



understands his own responsibility in the 

 matter and appreciates the high sense of 

 honor displayed by his patient. A young 

 woman for like reasons has delayed her 

 final answer to the man who has asked her 

 hand in order that the doctor might pass 

 upon her ease. Here is the doctor's old 

 friend, William Stone. Mr. Stone is in the 

 early fifties. He has been a highly success- 

 ful, honorable business man, has accumu- 

 lated a sufficiency and enjoys the good 

 things which his wife prepares for the 

 table. A careful examination of the urine 

 leads the doctor to caution Mr. Stone to 

 reduce the carbohydrates in his food. Mr. 

 Perkins, a lawyer who throws his whole 

 strength in every case he tries, and of late 

 has found himself easily irritated, shows 

 increased urinary secretion and a blood 

 pressure rather high. A vacation with 

 light exercise and more rest is the preven- 

 tive prescription which he receives. Mrs. 

 WiUiams, after being examined by Dr. 

 Smith, undergoes a slight operation under 

 local anesthesia, and is relieved of the first 

 and only malignant cells found in her 

 breast. Eichard Roe, who is preparing for 

 a long journey, is vaccinated against ty- 

 phoid fever, a disease no longer existent in 

 Dr. Smith's city since pollution of the 

 water has been discontinued. John Doe, 

 who is a mineralogical expert and wishes to 

 do some prospecting in high altitudes, has 

 his heart examined. There are numerous 

 applicants for pulmonary examination. 

 This is done by Dr. Smith and his assistants 

 in a most thorough and up-to-date manner, 

 and advice is given each according to the 

 findings. It has been many years since Dr. 

 Smith has seen an advanced case of pulmo- 

 nary tuberculosis and the great white 

 plague will soon be a thing of the past. 

 Every body goes to a physician twice a year 

 and undergoes a thorough examination. 

 The result of this examination is stated in 



a permanent record and no two consecutive 

 examinations are made by the same physi- 

 cian, in order that a condition overlooked 

 by one may be detected by another. Cases 

 of doubt or in which there is difference of 

 opinion are referred to special boards. The 

 average of human life has been greatly 

 increased and the sum of human suffering 

 has been greatly decreased. Preventive 

 has largely replaced curative medicine. 

 Tenements are no longer known; prostitu- 

 tion and, with it, the venereal diseases have 

 disappeared; institutions for the feeble- 

 minded are no longer needed, because the 

 breed has died out; insanity is rapidly de- 

 creasing because its chief progenitors, alco- 

 holism and syphilis, have been suppressed. 

 These and many other pleasing visions 

 come to Dr. Smith in his dream, from 

 which he is startled by the ring of the tele- 

 phone at his elbow. The call says : ' ' Come 

 quickly to Pat Ryan's saloon at the corner 

 of Myrtle and Second. There has been a 

 drunken row. Bring your surgical instru- 

 ments. ' ' Then the smiles which had played 

 over the face of the doctor in his dream 

 were displaced by lines of care and he went 

 forth into the darkness of ignorance and 

 crime. 



There are many Dr. Smiths and they 

 have been seeing pleasing visions in their 

 dreams and meeting with stern realities in 

 their waking hours. Nearly fifty thousand 

 Dr. Smiths constitute the American Medi- 

 cal Association which is expending thou- 

 sands of dollars annually in trying to so 

 educate the people that unnecessary disease 

 will be prevented. The doctors are asking 

 that the work of the national, state, muni- 

 cipal and rural health organizations may 

 be made more effective, that the knowledge 

 gained in the study of the causation of dis- 

 ease may be utilized. The world has seen 

 what has been done in Havana and on the 

 Canal Zone, how yellow fever and malaria 



