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hospitals and pulling them in charge of doctors who chew and smoke but 

 by teaching the people t he necessity, i he importance, of clean air. 



Tlie ills of civilization '-all for more civilization. The man who ie con- 

 stantly seen with a cigar in his mouth or whose elothes reek with tobacco 

 surely does not represent the highest type. The people have suffered much 

 at the hands of the tobacco using doctor, usually a robusl individual who 

 uses tobacco because he gets ease. He does not understand the ills of his 



patients, and so they apply elsewhere; as a consequence he has all sorts of 

 competitors. There are all sorts of isms and pathies, with new ones spring- 

 ing up. 



Here should come a review of several papers relating to high blood pres- 

 sure, a very interesting subject, especially in the light of coniosis. What 

 causes a rise in blood pressure, and how can it be reduced'.' Why do seemingly 

 robust men drop off suddenly and prematurely? I have at times discussed 

 these things with physicians who smoke and who in their ignorance advised 

 me also to smoke or to become accustomed to bad air Conditions, to become 

 acclimated, or, to put it in still another way. to develop an antitoxin, an 

 antitoxin that will enable one to live under unsanitary conditions. 



A physician constantly speaks of Case Reports.* In the course of time 

 some of my own short case reports have developed into biographies. They 

 cover a series of years. At first one may be greatly in doubt as to inter- 

 preting facts, but in time one see- the reason. For instance. I have in mind 

 a physician who for a number of years practised in a small country town; he 

 made long drives; he had perfect health; he did not use tobacco nor alcohol, 

 had no desire for either. Then he removed to the heart of a medium sized 

 city, that means he exchanged good ah' for bad air. fie began to feel bad; 

 the symptoms of dust infection appeared, finally to such an extent that he 

 was almost disabled. I advised him to get out; others advised him to stay 

 and become accustomed, become adapted. We use the term adaptation to 

 a great extent, but if you look at it properly adaptation comes about in the 

 race, phy!ogenetk,ally. not ontogenetically. The unadapted are constantly 

 killed off. This doctor concluded to follow the advice of the many rather 

 than of the one. In time he did develop an "anti-toxin." He even took 



*To quote illustrative case reports in a short paper is not satisfactory; one cannot 

 go into details and there is a danger of a reader drawing wrong conclusions in the 

 absence of details. Often brief case reports are worse than none, and one may hesitate 



to give any at all. 



