of the Southern Atlantic and Gulf ports; established refuge stations for infected vessels; instituted sanitary inspection of vessels, railways coaches and persons at infected ports and places of departure; established a sanitary police of the lower Mississippi, in time of yellow fever at any port or landing place thereon; required thorough cleansing, disinfection and aeration of all houses, river vessels and boats, in which there had been cases of yellow fever. To notice in detail the investigations made by Drs. Chaile and Sternberg in fevers; Drs. Wood and Formand on diphtheria; Professors Remsen and Smyth on the dangers of carbonic oxide and soil gases; Professors Mallet, Martin and Pumpelly, on the organic matter in potable water; Colonel Waring and Mr. Bowditch's report on sewerage and drainage in the United States; Mr. Rudolph Herring's report upon sewerage works in Europe, and many other scientific investigations conducted under the auspices of the Board and their practical results, would require much more space than this occasion affords.

"In 1875 Klebs first described the bacillus of typhoid fever, and again, with Eberth, more accurately, in 1880; in 1884 Koch demonstrated the bacillus of cholera, and Loeffler that of diphtheria; but it is needless to pursue this category, literature with which we are all familiar is filled with it. Equally important to our contention is the relation of these discoveries to measures for their prevention or destruction. Hitherto the use of disinfectants had been an art only and empirical. Certainty of their utility awaited their application to disease germs as a test of their efficiency, and thus disinfection has become a scientific procedure. Steam had been used to a limited extent and had won the confidence of all who used it by its recognized result as an efficient disinfectant, for many years, but it was not until 1884, when Dr. Sternberg reported that by actual experiment it was fatal to all of the pathogenic and non-pathogenic organisms tested, in the absence of spores (with the single exception of sarcina lutea), at a temperature of 143.6°, which placed its use on a scientific basis, that it has since that time been generally accepted.

"Efforts for the protection and purification of water supplies seem to have awaited conditions somewhat analogous to the use of disinfectants-the discovery of disease germs in polluted water. At any rate, it is only since the discoveries of Eberth and Koch that chemists and engineers have become convinced that sewage is unwholesome, no matter how much diluted.

"Allied to the protection of the water supplies is the protection

of milk and other food supplies, which has been a signal illustration of sanitary work, State and local, so extensive and so generally acknowledged as to require no details.

"And what may now be said of the crusade that has but just now begun, as it were, against tuberculosis, omitting any attempts to discuss that phase of it which has been in progress for several years in the destruction of cattle-further than to rivet attention, if possible, to the liability of children to intestinal tuberculosis, and since children are the great milk consumers-to insist upon this fact as a sufficient justification of the destruction of tuberculous cows, and for the most rigid supervision of the milk supply by the sanitary authorities.

"But our present reference is more particularly to Koch's discovery of the tubercle bacillus fifteen years ago. And since the recognition of the communicability of tuberculosis by the inhalation of the baccilli from the dried dust of the sputum of consumptives. the question of how to prevent this danger with the least possible inconvenience to the afflicted is one of the most important problems of practical sanitation. That there are various means adaptable to the different conditions of exposure and the proper care of consumptives, subject to sanitary supervision, every sanitarian. knows. And the salutary results are proven by the diminishing death rate from consumption wherever it has been imposed. The restrictive measures of sanitary authorities in this regard have been an educational force among the people at large. And no persons have become more keenly alive to the danger of tuberculosis sputum than consumptives themselves, who would be the last to afflict in like manner those who are dear to them or other persons. While, therefore, their sensitiveness in this regard should always be respected, the day has gone by-even with them-when such sensitiveness should be an obstacle to the protection of human life. Consumption is no longer regarded as a family disease-much less a community disease-but a personal one; a disease that is ordinarily contracted by inhaling the dust of dried sputum, and above all by persons whose resisting powers are below par from any cause, though no person, however well, can be considered absolutely exempt from the danger of such exposure.

"When we consider that an impure atmosphere is one of the most favorable conditions for the propagation of tubercle bacilli and reflect upon the facility of their reproduction and marvelous distribution, we may well wonder how is it possible to escape them. Indeed, it is impossible. But from the scientific basis on which

preventive medicine rests, we can fight them, and though we may not be able to subdue and conquer them, we can so cultivate our powers of resistance to them as to measurably defy them.

"Stamina is an educational force of primary importance to both body and mind. All understand that a pure atmosphere is essential to the maintenance of health. But, owing to the wonderful facility which the human body possesses of accommodating itself to circumstances, it frequently happens that school assemblies breathe a most unwholesome atmosphere day after day, or perhaps for weeks, without apparently suffering from it, while one after another of the pupils is continually dropping out—overtaken by some epidemic disease.

"Sanitary work has been not only eminently successful in the promotion of school hygiene in the United States during the era of our consideration, so evident that he who runs may read, but it has concerned itself with eminent success in the promotion of medical education.

"All of our State laws for the prevention of quackery, commonly designated Medical Practice Acts, are chiefly, if not wholly, due to the influence of our State Boards of Health. With special reference to the leading spirit in the promotion of the Medical Practice Acts, the late John H. Rauch, we know of no better description of the relation of such Acts to sanitary work than the summary prefacing the Sixth (1883) Annual Report of the Illinois State Board of Health:

"Boards of Health are created and maintained for the conservation of the interests of health and life. Ordinarily their functions are limited to dealing with sanitary questions; with the removal of the causes of preventable disease and premature death. This Board, however, is also charged with the execution of the Act to regulate the practice of medicine in the State; and thus the medical profession, one of the most important agencies which is concerned with the interests of health and life, is brought within the scope of sanitary legislation. To improve the status of the individual practitioner, and to develop a well-trained and thoroughly educated medical profession, must result in increasing the value of this force in sanitary science and public hygiene; a force which in the nature of things must always exist so long as there are physicians and patients; and the character and influence of which must always hold a direct relation to the tone, attainments, and the competency of those by whom it is exerted.'

"In an address Dr. Rauch delivered as Chairman of Section of

State Medicine, at the session of the American Medical Association in 1886, he submitted certain propositions which he considered germane to needful action of that body in the promotion. of the highest attainable standard of medical education, and in order to give practical effect to them he specifically suggested:

That the American Medical Association should put itself upon. record at that session as recommending the extension of the period of study to four years, and of attendance upon lectures to three full terms, with ample hospital practice and clinical instruction, as the requirements for graduation in medicine.'

"The Association did not so put itself upon record until six years afterward. But Dr. Rauch ceased not to so urge to the day of his death. At the recent meeting of the Association in Denver Dr. Rauch's suggestion was unanimously adopted by special resolutions.

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"Well did Tyndall observe, as a physicist twenty-three years ago: 'If recent theories on the propagation of disease by germs were proved to be correct, and if the laws which govern the propagation or destruction of those germs were known, the art of the physician would be raised from dependence on empirical observation into the position of an exact science. * For never before,' he said, 'was medicine manned and officered as it is now. * On the old Baconian lines of observation and experiment the work is carried on. The inter-communication of scientific thought plays here a most important part. While physiologists and physicians in England and elsewhere were drawing copiously from the store of facts furnished by the researches. of Pasteur, that admirable investigator long kept himself clear of physiology and medicine. The union of scientific minds is, or ought to be, organic. They are parts of the same body, in which every member, under penalty of atrophy and decay, must discharge its due share of duty imposed upon the whole. In observational medicine one fine piece of work may be here referred to the masterly inquiry of Dr. Thorne into the outbreak of typhoid fever at Caterham and Redhill. Hundreds were smitten by this epidemic and many died. The qualities of mind illustrated in Dr. Thorne's inquiry match those displayed by William Budd in his memorable investigation of a similar outbreak in Devonshire. Dr. Budd's process was centrifugal-tracing from a single case in the village of North Lawton the ravages of the fever far and wide. Dr. Thorne's process was centripetal-tracing the epidemic backward from the multitude of cases first presented to the

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single individual whose infected excreta, poured into the well at Caterham, were the cause of all.'

"Finally, my friends, the good time a-coming, announced by Tyndall twenty years ago, has arrived! The sanitary work of the quarter-century of our contention with correlation with the facts it has evoked in conjunction with collateral delvers into the foul soil it has cleansed, into the impure waters it has clarified, into the marshes it has drained, the air that it has screened from malignant organisms are the notes of its triumphant song in praise of sanitary methods. Yours truly,

"T. P. CORBALLY, M.D."

To the foregoing summary by my esteemed associate, to whom I am under lasting obligations for aid in the declared purpose of and for the results achieved by THE SANITARIAN, I have but little to add.

Contemporaneously THE SANITARIAN and "The Popular Science Monthly" (beginning just one year before THE SANITARIAN) have maintained most congenial relations, but time now calls for change of conditions.

Sanitation has

The opposite page is self-explanatory. lost none of its attractiveness to the subject of the picture, by his many years devotion to the means of promoting health and longevity. Quite the contrary, indeed. But all the while Prospect Park has become more and more alluring in the recurring season of fragrant flowers and singing birds, hence he has now arranged for a rest. Has merged THE SANITARIAN with "The Popular Science Monthly," which takes up its rôle.

The retired editor, still being blessed with good sight, promises occasional contributions.

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THE POPULAR SCIENCE MONTHLY,

Sub-station 84, New York City.

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A. N. BELL, M.D.