28 Trans. Acad. Sci. of St. Louis 
in preparation reviewed a number of subjects whose 
presentation it seemed might appeal to your interest. 
The list was discouraging, if one were to do each any 
sort of justice. I hasten to assure you that less will be 
attempted. 
Rather let me try to speak carefully of a few things 
that in my own line of work exemplify present medical 
thought and seem less appreciated by people generally; 
also certain generalities resulting from my own personal 
investigations. It is not easy to do and at the same 
time be intelligible, for between the physician and the 
public, the doctor and his patient, even the doctor and 
other scientific men, there is a great gulf fixed—the 
difference in training, manner of thinking and prece- 
dent generally, that results in different positions and 
conclusions. We see only as we have been accustomed 
to see, and reason only as we have been accustomed to 
reason—we are all. specialists in our own lines. 
Perhaps it might be considered that fatigue is the 
greatest single factor in biological degeneration—the 
eonstant pounding that we receive nervously through un- 
happy emotions, anxiety, fear, and hope deferred. The 
physical injury through the mere process of living and 
under which joints stiffen, arteries harden and muscles 
lose their elasticity as we get older—the thousand nat- 
ural shocks, are the greatest factors making for physical 
decadence. These things we know, but we do not pause 
to consider or crystallize in our minds, until in some 
way the facts are shunted to our attention. Rather we 
think of the injury done by alcohol or cigarettes. On 
the other hand, one might contend that a life of sus- 
tained high tension and constant nervous irritation did 
more harm than some alcohol, and that high heels did 
more damage, through making for fatigue and strained 
