450 



SCIENCE. 



[N. S. Vol. XXIV. No. 615. 



bodies, and to a better treatment of their 

 patients' diseases when recognized. 



The physician or surgeon commonly ren- 

 ders a personal service to an individual, 

 sometimes for a pecuniary recompense, but 

 often without money compensation. He is 

 often a trusted adviser in the most intimate 

 family concerns. Births and deaths alike 

 bring the physician into the home. In 

 rendering these services he must be tender, 

 sympathetic, considerate, pure-minded and 

 judicious. There will always be need, cry- 

 ing need, of the physician and surgeon in 

 this sense, and for these functions; and 

 whatever else the regular education of the 

 physician provides in the future, it must 

 provide all the elements of the best train- 

 ing for the practising physician who is to 

 treat diseased or crippled human bodies, 

 and give advice about the sudden and the 

 chronic ills which afflict humanity. So 

 much will continue to be demanded of all 

 good medical schools; but much more they 

 must do. 



The progress of what we call civilization 

 exposes human beings more and more to 

 the ravages of disease. When savages come 

 in contact with men called civilized, they 

 invariably suffer from diseases new to 

 them. When a rural population crowds 

 into cities, it falls a victim of diseases iromk 

 wMcli in the country it had been exempt. 

 When hundreds of thousands of people 

 huddle into small areas, and create there 

 smoke, dust and noise, they suffer not only 

 from new diseases, but from the exacerba- 

 tion of diseases not wholly unknown to 

 them in their rural condition. Under such 

 unfavorable conditions of residence and 

 labor the human body degenerates in many 

 respects, and, losing vigor, becomes in some 

 respects less able to resist the attacks of 

 disease. 



Against these bodily evils which result 

 from civilization the physician has thus far 



struggled chiefly by treating more or less 

 successfully the numerous individuals who 

 are attacked by disease. Doubtless the 

 treatment of sick and injured persons has 

 substantially improved; but, nevertheless, 

 the death-rate in our cities diminishes slow- 

 ly, and the heavy economic losses which 

 result from disease and premature death 

 continue. Moreover, the improvement of 

 treatment in hospitals and private practise 

 has been accompanied by a great increase 

 in the cost of treatment ; so that the charges 

 upon the community resulting from sick- 

 nesses and injuries have within the last 

 thirty years rapidly mounted, and these 

 heavy charges are, after all, incurred for 

 the palliation of evils already suffered, and 

 not for the prevention of such evils. > Again, 

 in different parts of the habitable globe 

 mankind has been exposed for centuries to 

 dangers more or less localized; in one re- 

 gion to the attacks of venomous reptiles, in 

 another, of fierce carnivora, in another, to 

 the ravages of flights of insects which de- 

 vour every green thing, in another, to the 

 constant presence of formidable diseases. 

 Por the most part, the human race has 

 learnt how to exterminate the offending 

 creatures, or at least to limit their ravages ; 

 and where grave infectious diseases are al- 

 ways present in greater or smaller degree, 

 or frequently recur, a considerable propor- 

 tion of the population becomes in some 

 degree immune to them. Mankind is now 

 in face of enemies which are not localized, 

 but which, on the contrary, are carried all 

 over the habitable globe on the ubiquitous 

 routes of travel and commerce. The worst 

 of the new enemies are minute, multitudi- 

 nous and mysterious in that their relations 

 and connections are unknown; they infest 

 many of the animals with which man is 

 associated, or pass into man from the ani- 

 mals and plants of which he makes use. 

 Untrammelled dissemination of noxious 



