154 



sciu:ncu. 



[Vol. \^I1I., No 184 



the census, no doubt includes many cases which 

 were not trae tubercular phthisis. It is reported 

 as causing 12 per cent of all the deaths, or more 

 than any other single cause. In England and 

 Wales, in 1880, it caused a little over 9 per cent of 

 all the deaths. Such wholesale ratios are, how- 

 ever, of little interest or value. There are very 

 great differences in the liability to this disease in 

 different parts of the. United States, as the map 

 (chart iii.) makes evident ; and it is from a study 

 of the causes of these differences in the data de- 

 rived from large masses of people, combined with 



sumption and that of pneumonia (chart iv.) is 

 very striking. Here, again, we find that race 

 peculiarity is an important factor in the problem, 

 the proportion of deaths from pneumonia among 

 the colored being much greater than it is among 

 the white. 



While we must consider the difficulties in the 

 way of the improvement of the science and art of 

 medicine, difficulties due to ignorance, to indo- 

 lence, to conflict of interests, and to the eternal 

 fitness of things, the existence of such difficulties 

 is not a matter to be bemoaned and lamented oyer. 



Chart IV. — showing the distribution- of deaths fkom pneumonia as compared with deaths from known causes. 



clinical histories and experimental laboratory 

 work, that we have good reason to hope to obtain 

 knowledge, not only of the causes of this disease, 

 but of better methods of prevention and treatment 

 than are now at our command. It causes a greater 

 mortality among the Irish than in other white 

 races, and, perhaps, a greater mortality among 

 the colored than among the white. 



Next to consumption, pneumonia is reported as 

 causing the greatest number of deaths in the 

 United States during the census-year, giving a 

 ratio of 8.3 per cent of all deaths, as against 4.8 

 per cent in England and Wales in 1880. Here, 

 again, the local disti-ibution of deaths is interest- 

 ing, and the contrast between the map of con- 



These obstacles are the spice of life, the incentives 

 to action, the source of some of the greatest pleas- 

 ures which it is given to man to experience. As 

 each man has special opportunities and duties, if 

 he can only recognize them, so it is with guilds, 

 with professions, and with nations. I have tried 

 to indicate to you some of these opportunities 

 which are presenting themselves to my colleagues, 

 your brothers, in the lands beyond the sea, and I 

 hope that I shaU not be considered rash, or vain- 

 glorious in saying that I believe they will so 

 use those opportunities as to" return compound 

 interest for what they have received from the 

 storehouse of our common inheritance. 



John S. Billings. 



