seems strange that there should be any opposition to measures which have been proved so beneficial and which are among the things which distinguish us from a lower civilization. Indifference is probably the greatest evil with which we have to contend. This requires hard work to overcome. It is the same stupid lethargy as is seen in the political affairs of the city, the failure to attend caucus, the absence from the polls, which leaves the city in the hands of unscrupulous bosses and permits graft. It is so much easier to bask in the sun than to labor in the sweat of one's brow; it is pleasanter, perhaps, to keep aloof, Far from the madding crowd's ignoble strife. It is so much trouble to be bothered with what does not directly come to us; there's nothing in it for me, is altogether too popular a cry. We are apt to shut our eyes against a painful truth and listen to the song of the siren till she transforms us into beasts. Superstition and prejudice have some small part in it. These can only be overcome by enlightenment education. The demagogue, assertive, loud-mouthed, ambitious to be heard and to be a leader, to gain a following, has quite a large part in it. Against him there is no hope, no remedy, except to cut him off altogether from gaining any adherents. When one falls another rises. Argument is useless, he will not listen to reason. The politician, keen and crafty, seeking his advancement by whatever means, buying votes either with money or by deals with his colleagues, trimming his sails to catch the popular breeze, following no higher spring of action than policy and no higher motive than self, has a part in it. A year ago, while we were sitting in our meeting, the Legislature, not far away, but too far to feel any influence from us, had nearly decided to abolish compulsory vaccination, and the bill was saved by only a few votes. There is a chance of relief from the politician. The ballot is in the hands of the people and just here is where the medical profession should make its influence felt upon the State. Education of the people will overcome every one of the oppositions I have named. The educating must be done by those who are themselves edu cated in these matters members of this Society. the physicians of the State, you, the It will be comparatively easy in times of epidemics when the plague is among us, striking indiscriminately. Then men will gladly seek refuge in that which they had before derided. But our aim is to keep the disease away from us altogether. We can stay the plague; it has been done time and again. When there is no danger, indifference comes and we lie supinely on our backs until our enemies have bound us hand and foot. We must not wait for the plague or the smallpox, or the cholera, or the yellow fever, for each person afflicted then becomes a source of infection, scattering broadcast the contagion, and the pestilence, indeed, walketh in darkness. Those who know must teach. This means not the physician alone, although it belongs to him primarily, but the scientist, the philanthropist, the layman as well. The physician must be in the van. And unless the teaching is not only as we visit the sick but in our walk and conversation, not only in our professional ministration, but in all our life, unless it is constant and persistent, we shall not utterly overthrow the enemy. Vaccination does stop the epidemic of smallpox. Boiling the water we drink and using the utmost sanitary precaution in the care of the discharges will prevent the appearance or the recurrence of typhoid fever. The occurrence of this disease is a crime; it is owing to the criminal carelessness of some one. Teach it to the nurses, teach it to the patient, proclaim it in print, enact it in your laws, live it in your lives. Something is wrong among us when every legislative year the room of the Committee on Public Health and Safety is swarmed and the Committee itself is overrun with men making wild and astoundingly incredible assertions, using history which is very profane, having consciences which manifest themselves only in scruples; fearing vaccine lymph drawn from the humble calf as if it was fraught with living death, but making no complaint against antitoxin drawn from the noble horse, deaf to the information that the serum treatment is the advance and the advancing treatment of the day; unwilling to make a little sacrifice for a great gain, incapable of being convinced by argument. Something is wrong among us when one of our legislators, elected to protect the people, a man so high in council as to aim to be its highest officer, and striving for a seat in the Senate of the United States, barters away his vote on vaccination, the safety of the people, for a promise of support in gaining an office for himself. For there is all the difference in the world, says Mr. Steffens, between the man whose action springs out of the hot convictions generated under his own hat, and the man who weakly sells out his own convictions for the cash or the favor of another person. The man who uses a public office for a selfish purpose prostitutes his position and debases himself. The empire over ourselves, says Madam Roland, is the finest of empires, that of which the conquest costs us most and the possession of which is the sweetest. There is a cure for the politician - defeat him at the polls. And that is a part of the influence of the medical profession upon the State. It is not the business of the health officer alone to attend to these matters. His work lies along the enforcement of the law after it is made. Our work is higher because it is to create the public opinion which is to make and to sustain the law. Public opinion is the highest tribunal, beyond which and from which there can be no appeal, and I am pleading for the creation of that opinion which shall lead to the protection of health and the prevention of disease. Nor can this duty be evaded; it cannot be shifted on to another. Each one of us lives, the center of a circle, and all the circles swung from different moving centers, include the whole. In no other way can it be done. The moment a man gets an infectious disease, he becomes a source of danger. He may scatter the infection in a crowd; he may communicate it to an individual; you yourself may sit beside him in the public conveyance; your child may wait upon him, entering at the back or at the front door of your house; and he may be innocent because he may not know. Nor is it all that he is a source of infection. A sick person is a burden to the State, whether because he keeps a bread-winner from work by caring for him, or, whether he, a producer, is himself kept from work. It is given to us to guard our patients from exposure, to tell them when they are in danger, to render them immune, to protect them against the indifferent, the careless or the ignorant. Our patients means the State. Every man owes a duty to the State; every educated man also owes a larger duty and is the better able to perform that duty as his perception is clearer and his intelligence more comprehensive. It is well to keep continually before communities the causes of these diseases and the methods which science has devised to prevent them; that the germs of disease are to be destroyed; that the germ-producing field is the sick person and that those sick with contagious diseases must be quickly watched and the disease germ not be allowed to spread; that no place is a healthy place in these times and under our conditions, without continuous care and the co-operation of the health authorities and the community itself. Keep it before the people that it is the duty of the public to apply sanitary measures all the time; that sickness costs more than health, both as to the individual and the community; that the germ theory of disease has been firmly established by scientific investigation; that the prevention of such disease must be brought about by applying scientific methods and that the co-operation of the community is required. Keep your patients informed why certain of the sick must be isolated, why disinfection should be used in certain cases (as the dejections of typhoid fever), that epidemics are unnecessary and expensive both to the families of the sick and to the business interests of the community; that in a large number of bacterial diseases, the inciting germs have no breeding places outside the bodies of those men or animals which are their victims and that if all materials from these be at once destroyed by heat, by fire, by chemicals or in any other way, all danger of transmission is destroyed. The new work is largely along the line of tuberculosis. The researches of the laboratory have established the fact that a bacillus is the cause of this disease. The investigations have been carefully made and the result is scarcely questioned. Clinical investigation has disclosed the fact that the disease is curable; observation and practice have shown that it is preventable. It will give great courage to the afflicted; it may prevent despair in many to know that the disease is not inherited. These facts have been urgently and constantly put before us by bulletins from boards of health, by lectures, by articles in leading magazines and by the secular and religious press. It has been hard for everybody to believe these things, but the truth has been demonstrated in private, in hospital and in sanatorium practice. Theory and practice here harmonize, and while we would clamor at the vault of the treasury for further appropriations for public use, we would have every consumptive's home within the State, his sanatorium where he could sleep out of doors. There is no charm for the consumptive in the Adirondack hills aside from their natural beauty. Colorado's air is not lifegiving any more than is Connecticut's. Nor is California the golden gate to him. Whose cheek has bloom That is but mockery of the tomb. Its fruitful soil, its balmy air, its wealth of fruit and flowers, its saw-like Sierras, have no charm to stay the germ. The hills of our own State are as efficient or can be made so. We want to teach these things to our people — that health can be found by good living; that help from this dread disease is in the open air wherever that may be; upon the abandoned farm, upon the hill side, at the very door of one's own home. There is another form of disease which is increasing so rapidly, which has come to be so frequent and which is making such demands upon the State that some attention must be paid to it. For we are not ourselves when nature, overcome, The medical profession makes as large claim for congratulation for its triumphs here as in any of its fields. It is only a hundred years since William Tuke, the Quaker philanthropist of York, founded his asylum and secured the enactment of proper laws for the treatment of the insane. It is less than a century since Philip Pinel, with his own hands opened the dungeons and let out into the sunlight and fresh air, the poor lunatics who had been considered as demons and whose treatment had been worse than that of the criminal. Connecticut has now come to a point where she must struggle with the problem of the care of the insane |