laboured argument to prove that it should be the first duty of all governments, national and provincial, to protect the public health by enactments based upon the knowledge that sanitary science has evolved, and to see that all the members of society are benefited by them.

Nations and communities have it in their power to diminish the causes which produce sickness and premature death. From even the partial wise use of this power during the years that are recently past, the average duration of human life is slowly but progressively on the increase. But much, very much, remains to be done. And every measure which relates to the improvement of the sanitary condition of the people generally deserves the earnest support of statesmen, and the favor and hearty support of all.

Provision has been made by the National Government to protect this country at large against the exotic diseases-the diseases to be detected by quarantine and by inspection-threatening from abroad.

The country has been and is so fairly protected from their inroads that everyone takes their absence as a matter of course without stopping to think of the work constantly going on at the outposts of coast and frontier. But it is the diseases we have always with us, the well-known preventable diseases, that produce the greatest destruction of human life, and swell the total of the general suffering and distress in all parts of the country.

Some of these, such as enteric fever, scarlet fever, measles and diphtheria, are left in this country to Provincial responsibility. But there are some other diseases and some other points as to which it seems to me the national power can best be exercised.

Tuberculosis, for instance. This is a disease widespread throughout the whole Dominion, and it cannot be kept within municipal or provincial bounds, if only because the Eastern sufferer is so apt to seek a health resort in the West. The annual death rate from tuberculosis is so high and the financial loss to the country from these deaths and from the illnesses which precede them is so grave a national matter that it seems to me it should not be left to the separate actions of the various Provinces, but should be at least co-ordinated and arranged by the National Government. Sanatoria are good in their way, and would be better if they could be kept for the reception of incipient cases, to be discharged cured to make room for others. The beginning cases, however, are not those that appeal most loudly to the sympathy of the onlooker. And too often, under pressure political, personal, religious and charitable, the few beds of the sanatorium are promptly filled with in

curable cases, and so their highest mission fails. The same amount of money spent in dispensaries, day camps, and the dissemination of pamphlets, leaflets and other literature on the prevention of the disease, would reach and benefit hundreds for each one the sanatorium can aid. The enforcement of notification of tuberculosis also, with the appointment of inspectors to follow up each case where the visiting physician cannot or does not do so, seems to me essentially a national work and responsibility.

The prevention of smallpox also should be distinctly a matter of national sanitation. We are not only threatened with it from the Orient, from Europe, from the United States, and from South America, but from England also, owing to her retrograde legislation nullifying compulsory vaccination by the admission of conscientious objections, and yet not putting smallpox on the list of her quarantinable diseases.

Compulsory vaccination in infancy and compulsory re-vaccination in adolescence should be the national law. By such laws smallpox has been made to practically disappear from Germany. This disease is unknown in her army. In the entire German Empire during the whole of 1906 there were but twenty-six cases of smallpox and five deaths, and these cases were largely imported from neighboring countries. Why cannot we learn from such an object lesson as that, confirming, as it does, the experience of every smallpox hospital, where vaccination keeps the attendants free from the disease?

I would go further still. For the victims of unpreventable infectious diseases I have both sympathy and pity. Smallpox, however, is entirely preventable. For its victims, or for those who are responsible for them, I have nothing but condemnation. Not only would I make vaccination and re-vaccination compulsory, but I would make having smallpox a penal offence. In no other way that is avoidable is one permitted to be or to harbour what is a nuisance and an injury to one's neighbours. An outbreak of smallpox often paralyzes the travel and traffic of a small community. It always injures even the larger ones. It is a distinctly preventable disease. No one has any right to harbor an unvaccinated person on his premises any more than he has to store a supply of dynamite. No one has any right to have it, and every offender in this particular, every adult who has smallpox and the parent or guardian of every minor who has it, should, in my judgment, be sent, as soon as the risk of infection is over, to pick oakum for a term in the common jail for having been guilty of a wanton and quite avoidable nuisance and misdemeanour; or, still better, to work for a similar period

at forced labour in the sanitary improvement of the municipality, as I have suggested for our prisoners before.

Railroad and car sanitation should also come under National Sanitation. Under this heading may be briefly mentioned the prevention of the possible spread of typhoid dejecta along the roadbed, to directly infect or to be blown as dust into neighboring sources of water supply; the use of non-absorbent coverings and curtains; the general use in sleeping cars of the thin, so-called emergency curtains which permit the free passage of air, but not of light; the placing of ice in a jacket around the drinking water, and not in it; the provision of a separate basin, over which alone toothbrushes may be used; the proper ventilation of, and preservation of temperature in, the cars, and their frequent and efficient disinfection; and the abolition of the brushing down of passengers by porters in the midst of the car, whereby the dust from each in turns is distributed over the persons and into the lungs of his neighbours. And this in order that a rapacious porter may be the more sure of the holdup for his tip. The brushing, when required, should be done only in a corridor beyond a swing door.

If temperance be a thing to be secured by legislation, that legislation may well be national. Nothing certainly injures health more than the diseases of the various organs that are affected by improper food and the abuse of spirituous liquor. With regard to improper food, as far as quality is concerned, national sanitation has already taken hold of matters connected with the adulteration of food and drugs, and the inspection of meat for export, although not yet that of meat for our own home use.

With regard to the liquor traffic: Of all temperance legislation, the most temperate and, therefore-to my mind-the most likely to gain the desired end is that known as the Gothenburg system. The elimination of private profit upon the sale of spirits, and the commission upon the sale of non-intoxicants, are, of course, the essential points of this most excellent system, with the introduction and extension of which in England the name of His Excellency our Governor-General is so closely connected.

I cannot pass from the subject of national sanitation without referring still in my individual capacity, not in my official oneto the resolutions that have been passed annually since 1902 by this Association, urging upon the National Government the collecting together of national matters medical and sanitary-now scattered amongst the various departments-into a Department of Public Health under one of the existing Ministers. In connection with such a department there should, in my judgment, be a national

bacteriological laboratory, with branches for the supply of vaccine and of the various sera and antitoxins. These should be prepared and tested by men on salary and without any personal interest in their sale. And they should be issued bearing the Government stamp as a guarantee of purity and reliability, and marked with a date limit of efficiency. The general practitioner throughout the country would then know just what he is using, and both he and his patient would be much better protected than they are at present. Moreover, in such a national laboratory there might well be bacteriologists and chemists engaged in original research. This country should rise above the position of hanging on to the skirts of other nations and waiting to hear from them. It is fully time that in such a national laboratory Canada also should have her investigators taking their part in forwarding the advances of science. In such a National Department of Public Health there would be no interference with Provincial rights, only a domestic rearrangement for greater efficiency. On the contrary, one of my dreams is the creation of a national board or council of public health, composed of the occupier of the federal office I now hold and of a representative from each of the Provincial Boards of Health, to meet at the Capital from time to time to advise the National Government in public health questions affecting the country at large. Advice and recommendations from a council so composed should carry more weight with the Dominion Government, and with the people, than those of any one sanitary advisor, be he ever so able and ever so experienced.

Departments of Public Health already exist in some countries. They are being actively striven for in Great Britain, in the United States, in Mexico and in Cuba. That we will ultimately have one in Canada I in no wise doubt.

THE EPOCH OR ERA OF INTERNATIONAL SANITATION.

Within the last generation the idea has been spreading that those nations that are most active in sanitary and hygienic movements are really dependent on each other for complete success. This idea has found expression in international official conferences such as those of Venice, and London, and Paris; in the international congresses of hygiene and demography; in such international conventions as those of the Republic of North and South America; of those on tuberculosis; in such international societies as the American Public Health Association, which embraces the United States, Canada, Mexico and Cuba, and in the general international exchange of health news and bulletins.

International agreement, as a recent writer has pointed out, or even a declaration of policy to ameliorate the local conditions that cause disease, so that no people should be allowed to live without sufficiency of pure air and light, pure water and pure food, good drainage and sewerage; in other words, except under the healthful environments of man which are his inalienable right-such an agreement would furnish objective employment of national thought and energy, and by the substitution of one energy by another detract by so much from the consideration of armament and war. It has been suggested that in the search by peace congresses for measures to be recommended to The Hague Tribunal for consideration as measures towards universal disarmament, or partial disarmament, or arbitration, or peace, such international sanitation as I have alluded to above might be included as tending directly and indirectly towards the full or partial abolition of war.

It is devoutly to be hoped that in the process of evolution of international sanitation the time may be not far distant when it may be possible that there shall be Canadian medical officers responsible to the Dominion Government in every port of emigrant departure for this country in Europe and in the Orient. The action of such a body of men in vaccination, disinfection and careful inspection before departure would lighten the work of quarantine and immigration officials on this side. And, what is far more important, it would remove to a great extent the chances of outbreak of disease during the voyage, thus lessening the risk of infection for all classes of persons upon the vessel. It would benefit the shipping interests greatly both in time and in money. Moreover, it would obviate the hardships which must necessarily accrue in many cases from the sending back of undesirable immigrants from the port of arrival in this country.

In conclusion, I would say that I cannot hope that I have told you anything new this evening. The truths of sanitation are well established and well known. We cannot plead now as in the days of Hosea the Prophet when it was written: "The people are destroyed for lack of knowledge." But these truths-like others— require iteration and re-iteration, line upon line, line upon line, precept upon precept, precept upon precept, here a little and there a little.

The best I can hope for is that I may have in some small degree presented to you some old thoughts in new settings. And I may, indeed, be well content if anything that I have said tends to make these truths-ever old and ever new-sink more deeply into your minds and memories, and if, by so doing, I may have advanced