Address, “The Conservation of Man”

Dr. Wiley—The National Conservation Congress has at its previous meetings discussed in a most illuminating and helpful way the great problems of Conservation as applied to the soil, to the forests, to the mines, and to the running streams.

I do not suppose it is proper, with an audience of this kind, to refer to earlier papers, but I do believe I am the first person who ever made a public address in this country upon the subject of Conservation, and I am certain, as far as I know, that I am the last one that is making such an address. But as long ago as 1893 and being a very old man, as you have heard, I can remember that far back—I made an address on the conservation of the soil, so I am really the father of the conservation movement in this country as well as of a very fine boy. (Applause.) I miss my dear friend, Gifford Pinchot, whom I love as a brother, but who has fallen into the patent medicine habit and is giving us “absent treatment.” I am not at all sure that he is doing a better work out there than he would be here. In the words of the Scotch poet, “I hae ma doots.” But still we were glad to hear from him and know he has not lost interest because of the strenuous political life he is now compelled to lead.

With this great work, from its inception, I have been in deepest sympathy and have collaborated in such a manner as I could to further it. The work accomplished has produced benefits which are difficult to measure by any standard which can be properly appreciated. The American people have come to believe in the application of a single standard of value and this is a scientific principle with which, as a rule, I would have no quarrel, but unfortunately the single standard which Americans have been taught to value is that which pertains to the almighty dollar. The Conservation Congress, however, has not been blind to the fact that the standards of ethics, health, morality and happiness are of even far greater value than that of money. Nevertheless, in order to present the subject in a manner easily grasped by the American people, attempts have been made to measure the value of health and life by a money standard. As a justification of this, we have the procedures of the courts, based upon statutory enactments, which fix a money value upon life, although in many cases, after mature deliberation, it has been found that the life for which compensation has been asked, was of small value. In like manner, in the treatises which have been written on the public health and its value as a national asset, it has been attempted to portray in dollars the most precious of all human possessions, namely, life. And, in point of fact, it is not wholly unscientific, though undoubtedly unsentimental, to thus value human existence. All useful members of a community render services of some kind, for which payment is made in the coin of the realm. Following one of the established customs of great financial operations, it has been customary to capitalize the human life on its earning capacity, either active or prospective. The infant and the child, measured upon an actual earning capacity, would have practically no value, but this would be an unscientific method of determining worth, because of the fact that the infant and the child represent the necessary preparatory stages of earning capacity. Based upon this fact they both have a real monetary value.

I shall not take up the time of this address with any effort to ascertain the actual values which may safely be assigned to the infant, the child, and the grown-up person. This has been carefully and sufficiently accomplished by other investigators. Abraham Lincoln said that in so far as efficiency is concerned the human race may be divided into three classes, namely, one, those who work effectively; two, those who work to no purpose, and three, those who do not work at all. Judging by rigid standards which have been set up by students of efficiency, class one is probably the least numerous of the three. Class two is composed of well-meaning people who do work, are willing to work, and anxious to work, but who do not know how, and therefore waste their energies. Class three is made up of the idle rich, the idle poor, and that considerable portion of our population incapacitated by disease or otherwise exempt from taking part in any useful employment.

FUNDAMENTAL PRINCIPLES OF THE CONSERVATION OF MAN.

Primarily, in the study of the conservation of human efficiency, that is of man, man himself and knowledge of what he is, and what he has been, within the years in which man has been studied, in a scientific way, is of the utmost importance. Unfortunately, we have not access to a universal system of demography, inasmuch as only a few countries have adopted scientific demography in its entirety. The world descriptions of human life, health, and efficiency are, therefore, exceedingly fragmentary. We are too apt to base our ideas upon personal acquaintance and knowledge of the efficiency of man, than upon a scientific study thereof, and yet, in order to have a proper view of the subject of the conservation of man, the actual state of his health and his capacity for useful labor must engage our attention.

The Division of Vital Statistics of the Census Bureau has done much to furnish the student of humanity with fundamental data, and first of all let us consider what is the expectation of life in the various countries according to the latest authorities which can be secured. The Division of Vital Statistics has prepared the following table, which is to be accepted as the most authoritative which is accessible. No claim is made, of course, for entire accuracy, but it is sufficient to show what the condition was in this country twelve years ago. It is reasonable to suppose that conditions have improved somewhat in the twelve years which have passed since the compilation of the data submitted.

EXPECTATION OF LIFE IN VARIOUS COUNTRIES ACCORDING TO LATEST LIFE TABLES.

(The “expectation of life” is sometimes known as the “mean after-life time,” “average after-life time,” “mean duration of life,” and “average duration of life.” Data are from the international tables in Statistik des deutschen Reichs, Bd. 299, Siechetafeln; the French Statistique internationale; the English Registrar-General’s Report; Supplement, 1891–1900, and Census Bulletin No. 15, Twelfth Census, Tables for the United States, or rather for that part of it having fairly complete registration of deaths, will be published in connection with the Reports for 1910, now in preparation.)

EXPECTATION OF LIFE IN YEARS.

Males.Females.
AtOneTenAtOneTen
Country or State.Years.Birth.Year.Years.Birth.Year.Years.
England and Wales1891–190044.1352.2249.6347.7754.5351.97
Healthy Districts1891–190052.8759.1354.1655.7160.5354.46
France190145.3153.1049.2548.6955.3451.53
Italy1899–190242.8350.6751.2543.1750.0851.00
Austria1900–190137.7749.1748.2239.8749.3148.54
Belgium1891–190045.3953.5150.3248.8455.8852.78
The Netherlands1890–189946.254.851.749.056.253.0
Sweden1891–190050.9456.2552.7953.6358.0454.61
Massachusetts1893–189744.0952.1849.3346.6153.5850.70
German Empire1891–190040.5651.8549.6643.9753.7851.71
New South Wales189149.60——50.8952.90——53.39
India190123.63——34.7323.96——33.86
District of Columbia (white)190041.6449.3046.3745.7752.8949.90
Massachusetts (white)190044.2953.1350.1547.8054.9651.70
New Jersey (white)190044.0652.0549.2748.2754.4551.59

One of the most remarkable facts presented by the above table is in the marked increase in the expectation of life after the age of one year. In other words, the terrible infant mortality, which prevails in all countries, is so great that the expectation of life at birth is a number of years less than at the age of one year. In England and Wales, the infant mortality decreases the expectation of life at birth, in round numbers by eight years; in France and Italy about the same; in Austria, by eleven years; in Sweden, by six years; in the German Empire, by eleven years; in Massachusetts, by nine years. In the report, of the Bureau of the Census on Mortality Statistics, printed in 1909, and referring to the calendar year 1908, data are collected from seventeen States, the District of Columbia, and seventy-four registration cities, comprising a total of 51.8 per cent. of the total estimated population of the country. The total number of deaths registered in this area in 1908 is 691,574, corresponding to a death rate of 15.4 per 1,000 of population, which is said to indicate a remarkably favorable condition of the public health.

In the mortality statistics for 1910, two years later, the registration area, which included in 1910 an estimated midyear population of 58.3 per cent. of the total population of continental United States, the deaths reported were 805,412, representing a death rate of 15 per 1,000 population. The death rate for 1909 was only 14.4 per 1,000. While these variations are marked, the work has not been carried on for a sufficient length of time to do more than to warrant an expression of opinion that the death rate in this country is generally receding. It varies as shown, on both sides, having decreased very considerably from 1907 to 1909, but increased to a very marked degree in 1910 over 1909. The registration area covers the following States in toto, and some of the principal cities in the other States: California, Colorado, Connecticut, Indiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Montana, New Hampshire, New Jersey, New York, North Carolina (municipalities of 1,000 population and over in 1900), Ohio, Pennsylvania, Rhode Island, Utah, Vermont, Washington, and Wisconsin.

The extension of the system of registration to a larger area and number of population and the improvement in the efficiency of securing data are all to be considered in comparisons of very small periods of time. For one hundred million of population a death rate of 15 per 1,000 indicates a total of 1,500,000 deaths per annum. This figure may be accepted as being sufficiently accurate for all practical purposes at the present time as representing the death rate of today in the United States.

Comparing the United States with other countries and giving the expectation of life at birth as the basis of comparison, we may safely assume that the average expectation of life for the United States is in round numbers 44 years. Comparing this with the other countries we find that Sweden, Holland and New South Wales have a lower death rate than the United States. England, France, Belgium and Holland have almost the same death rate. The German Empire and Austria have a higher death rate. India is the banner country for shortness of life, the expectation of life in India being a little over half that in the United States.

WHAT ARE THE DISEASES WHICH ARE MOST ACTIVE IN CAUSING THE DEATH OF OUR PEOPLE?

In the registration area of 1910, 154,373 infants under one year of age died, in round numbers one-fifth of all the deaths. Assuming the total deaths to be 1,500,000, the number of children dying in the United States every year under the age of one year is 300,000. A striking illustration of the danger of the hot months for children under 2 years of age is shown by the fact that the number of deaths from diarrhœa and enteritis for July and August was 12,535 and 12,565 respectively, while in February the deaths from the same causes were 1,373. From these data it is evident that during the hot two months nearly 1,000 infants under the age of one year die every day in the United States.

The report of the Division of Vital Statistics shows that beginning with the second month of life diarrhœa is the most serious cause of infant mortality. While infantile diarrhœa and its allied disease, enteritis, is the most frequent cause of death among infants, the greatest destroyer of the human race, without respect to age, is tuberculosis, which caused 10.7 per cent. of the deaths from all causes in 1910. Next in importance in destructiveness is found organic disease of the heart, causing 9.5 per cent. of all the deaths. For all ages diarrhœa and enteritis come third in fatality with 7.8 per cent. Close after this comes pneumonia with 6.7 per cent. Kidney disease causes a mortality of 6.6 per cent.

The number of deaths from tuberculosis during the year 1910 was 160.3 per 100,000, or for 100,000,000 people 160,300. The death rate from tuberculosis from 1900 to 1909, inclusive, was 183 per 100,000. Apparently the death rate for tuberculosis is decreasing.

The number of deaths from cancer in 1910 was 76.2 per 100,000, or a total of 76,200; the highest death rate ever recorded from cancer. Evidently the deaths from career are increasing in proportion to the population.

I wish sometimes that every house in this country could be burned to the ground, if the people could escape. Why? Because tuberculosis and cancer are house diseases, and if every house were burned, we would not have them any more—at least until we built new houses. But we can purify our houses, we can live out doors, we can sleep out doors most of the year, and by the teaching and practicing of the principles of hygiene and sanitation we need not burn our houses at all. But people do not know, and worse than that, they do not care. They take no interest in such things. If you were discussing the tariff tonight, the house would not hold the people; if you were discussing trusts, there would be no standing room; but when you discuss this tariff on human life—they are not interested.

Organic disease of the heart: The number of deaths in 1910 was 141.5 per 100,000, which is a very large increase over that of the preceding year of 129.7 per 100,000. The total number of deaths from heart disease was 141,500.

Pneumonia: The death rate from pneumonia for 1910 was 147.7 per 100,000, making a total of 147,700 deaths from this disease. The death rate from this disease increased considerably over that of the preceding year.

Kidney disease: The total number of deaths from kidney disease in 1910 was 99 per 100,000, making a total of 99,000 for an estimated population of 100,000,000. This includes all forms of kidney trouble, nephritis and Bright’s disease.

Typhoid fever: The death rate from typhoid fever was 23.5 per 100,000, a total of 23,500 for the estimated population of 100,000,000.

You older men like me who were in the war know that war is hell—not because you are shot—that is glory; but because you die of disease; and if you will read the military history of the Civil War, so-called (I do not know why, for it was not so very “civil”) you will see that while one man died of wounds, four died of disease, because we did not understand the principles of serum prophylaxis. We are not going to have in the next war four men die of fever where one is killed in battle.

One of the curious features in connection with typhoid fever is that some of the most sparsely settled States show the highest rates of fatality, for instance the number of people dying in Colorado of typhoid fever is 41.9; in Montana, 39.9, and Utah, 37 per 100,000. Only one of the thickly populated States equals this—Maryland, 40.7 per 100,000. Some of the lowest death rates for typhoid fever were found in New Hampshire, 10.7; Massachusetts, 12.4; Rhode Island, 13.6; Vermont, 14; New Jersey, 14.5, and Connecticut, 14.7. Of cities of 100,000 population or over in 1910, Omaha, Nebraska, showed the highest rate, namely, 86.7; Minneapolis, Minn., 58.7; Kansas City, Mo., 54.4; Atlanta, Ga., 50.1; Birmingham, Ala., 49.5; Nashville, Tenn., 48.9; Milwaukee, Wis., 45.7; Spokane, Wash., 45.4, and Baltimore, Md., 42. The lowest rates shown for some of the large cities were those of Bridgeport, Conn., 4.9; Paterson, N. J., 7.1; Cincinnati, O., 8.8, and Cambridge, Mass., 9.5 per 100,000. These cities seemingly are as well protected against typhoid fever as some of the cities of Europe, where death rates are as follows: London, 4; Edinburgh, 2; Dublin, 10; Paris, 7; Brussels, 19; Amsterdam, 7; Copenhagen, 3; Stockholm, 4; Christiania, 2; Berlin, 4, and Vienna, 4 per 100,000. Thus, evidently in such cities as Cincinnati, Berlin and London, death from typhoid fever is no longer a terror.

Measles, which is supposed to be almost a harmless disease, causes a large number of deaths, the death rate for 1910 being 12.3 per 100,000 population, or a total of 12,300 for the estimated population. In some cities the number of deaths by measles was almost as high as that by typhoid fever, notably in Pittsburgh, Pa., 33.1; Providence, R. I., 31.9; Kansas City, Mo., 28.4; Lowell, Mass., 28.1; Albany, N. Y., 23.9; Columbus, O., 23.6; Buffalo, N. Y., 22.1, and Richmond, Va., 21.1 per 100,000. Scarlet fever is not so deadly a disease as measles, since the fatalities per 100,000 for 1910 was 11.6. Death rates from this disease were high in the following cities of 100,000 population or over: Buffalo, N. Y., 53.6; Lowell, Mass., 41.2; St. Paul, Minn., 30.2; St. Louis, Mo., 27.1; Kansas City, Mo., 23.2; Milwaukee, Wis., 22.3; Pittsburgh, Pa., 22.2; Rochester, N. Y., 21.4, and New York, N. Y., 20 per 100,000.

Whooping cough produced as many deaths as measles and scarlet fever, the death rate for 1910 being 11.4 per 100,000 population. Diphtheria and croup produced a death rate of 21.4 per 100,000 population, or a total of 21,400 for the estimated population.

Influenza, or “la grippe,” caused a death rate of 14.4 per 100,000 population for 1910. This disease is less prevalent than for the preceding ten years. The above data are sufficient to show the principal causes of death, old age, unfortunately, being so small a factor as to be almost negligible in the compilation.

It might be interesting to extend these vital statistics to a greater length, but a sufficient number of data have been given to establish some of the fundamental principles which should guide physicians and the sanitarians of the future in their work.

THE MEANS OF AVOIDING AVOIDABLE DEATH.

The question which is now presented for discussion at this Congress is, How can avoidable death be successfully avoided? I have not included in the discussion of this question the deaths by accident, which are lamentably all too frequent in this country. The motor car, the aeroplane, the railway, and the steamboat, still continue their deadly work in increasing violence as our population grows denser. It is easy to understand how the State could do much toward preventing these unfortunate accidents. No doubt concerted action on the part of the States will soon be perfected to prevent so many of the horrible catastrophes, whose descriptions form the principal reading matter, after murder and suicide, in the morning journals. And this leads us to say that murder as a means of ending human life is more prevalent in this country than in any other country of the world, and in consideration of the features which relate to the conservation of man the prevention of murder should receive particular attention.

A study of the above data reviewed in connection with the known etiology of disease, shows clearly where the work of the conservation of man, especially by the prevention of disease, should begin and on what line it should be prosecuted. To this end it is sufficient to call attention to the fact that diseases are naturally divided into two classes: those which are communicated and those which are produced by the conditions of the personal environment. Physicians are pretty well agreed at the present time that disease is rarely inherited, therefore, most of the causes which produce death are those which come from without, or those which are developed from within by improper habits of life. But one may inherit deficient vitality and thus fall an easy victim to an infectious disease. The point for us to consider most particularly in this connection, is to what extent we can prevent these diseases, that is, those which are contracted from without.

EDUCATION OF FUNDAMENTAL IMPORTANCE.

It would be well to classify the efforts which we are making for the prevention of disease in some systematic order. I will begin, therefore, with the one which is the most important of all, and that is education.

In order to secure proper protection for the citizen, he must be made to understand that he needs it. Further than this, it must be made plain that the protection of the individual from communicable disease is not by any means wholly within his own power. Unless the State acts, the individual in many cases is powerless; hence education beginning in the family, continued in the public school, and illustrated in practical adult life, is the most important feature of prophylaxis. Into the details of education I cannot go, but one thing I do with to insist upon, namely, that the child should be taught early, frequently and constantly, that most of the disease he has to fear are like enemies in the dark. I need not refer again by detail to the statistics of mortality, but simply would say that if the diseases which produce some of the most deadly inroads into humanity, such as tuberculosis, measles, whooping cough, scarlet fever, diphtheria, croup and typhoid fever, are solely communicated to the individual from without, they are the diseases which the State must help the individual to avoid. On the other hand, organic diseases of the heart, nephritis and Bright’s disease, are apparently more of a personal character, due either to inherited weak qualities or to errors of diet or faults of metabolism. These are diseases which we should be taught to avoid by strict attention to personal hygiene. They are not, so far as known, communicable, and therefore the State can do little, aside from educational work, towards their prevention. Another disease which may be partly communicated and partly the result of improper nutrition, is enteritis, and especially infantile diarrhœa, diseases which by proper education might be almost wholly avoided.

DISEASES OF UNKNOWN GENESIS.

There remain two great causes of human death, namely, cancer and pneumonia, which are still practically beyond control, because of our ignorance of their etiology or our powerlessness to prevent their progress. These diseases are considered communicable, that is, they are induced by specific infection, but the methods and the exact nature of the infecting germs are still subjects of investigation. It is true that we are told of the organism which produces pneumonia, and it is said to be constantly in the mouth of even healthy people, and we read almost monthly of the discovery of the real cause of cancer, but in spite of all this, these diseases remain as a rule unknown in character and are gigantic and terrible enemies which we have to fight in the dark. To one point attention should be called in regard to the increase in such diseases as those of the kidneys and the heart, that are essentially diseases of old age, just as tuberculosis and typhoid fever are diseases of early life. In proportion as we save people from tuberculosis and typhoid fever, just in that proportion will we save men and women who subsequently become victims of old age diseases. Therefore the increase in the number of deaths due to these causes may be an index to the increasing longevity of the people, instead of the opposite.

It is of course a question, which unfortunately we are unable to decide for ourselves, as to whether we should be saved from tuberculosis and typhoid fever for the express purpose of being killed by cancer, kidney lesions and diseases of the heart. Upon the whole I think, however, that terrible as these diseases are, especially cancer, most people would rather die of cancer at 70 than to succumb to tuberculosis at 30. But in the great problem of the conservation of human life we must not lose sight of the fact that many experienced and competent investigators are devoting their whole time to revealing the secret of these dread diseases, which still baffle the skill of the physician. We may hope in the near future that at least pneumonia and cancer may be put upon the same footing as typhoid and tuberculosis, that their actual genesis will be disclosed, and thus the road made clear toward their prevention. It is along these lines that education must go, because we cannot develop a public sentiment for the protection of life and health except by the desire of the people to live and be well, and the education of the youth and the adult is the best method of securing that result. When the people are educated, then we can successfully introduce the other methods of saving human life.

PREVENTION OF COMMUNICABLE DISEASES.

It is a self-evident fact, granting a disease to be of communicable origin by a specific germ, that the disease may be prevented if its victim be protected from infection. In other words, such diseases as tuberculosis, typhoid fever and others of the same character, which are undoubtedly communicated from individual to individual, could be wholly exterminated if the opportunities for communication were destroyed. We may assume, therefore, that all specific diseases due to a specific organism are capable of elimination by the simple exclusion of the organism.

Based on this are the great factors of prevention, namely, quarantine and segregation, which are practically one and the same. It stands to reason that an infected center should be removed or so isolated as to be no longer dangerous. For the same reason the infected center should not be allowed to enter a new community. Based upon this principle our systems of quarantine and segregation should be greatly strengthened. It is not a question of the wishes of the individual in this case; if it were, no ship would be detained and quarantined, and few people would go to a smallpox hospital or tuberculosis sanitarium. The principle of the welfare of the race as superior to the interests of the individual is dominant in these particulars. Tennyson, who foresaw many of the great truths of science, has beautifully presented this principle in his well-known stanza:

“Are God and nature then at strife,

That nature sends such fearful dreams?

So careful of the type she seems,

So careless of the single life.”

In the protection of the public health it will become as much the duty of each State and Nation to provide sanitary detention camps for infectious diseases and rigidly enforce residence therein, as it is to watch the border and establish strict quarantine.

IMMUNITY.

It is evident, however, that it will take a long course of education and almost revolution in the sentiment of the people, to establish a system of segregation and quarantine as rigid and as perfect as that which is outlined. What then is the next best resort? I answer immunization. If we cannot keep the infectious organism from contact with the human body, we should endeavor to make the body immune from its ravages. There are two methods which might be adopted; the one which could be most generally practiced is that of good nutrition, proper housing, fresh air, pure water and pure foods. The child that sleeps in the open and eats an abundance of pure, wholesome foods and takes a proper amount of exercise, will escape most of the diseases of infancy and grow into manhood with a body immune to almost every infectious germ. I need not go into detail in regard to the actual mechanism of immunity to prove the fact that a well-nourished body, sustained by blood of high nutritious power and bearing its untold millions of organisms, armed cap-a-pie to destroy intruders, is a sufficient illustration of immunity. The physiologists will describe to you the nature of the phagocytose opsins, and the hormones by means of which this immunity is secured.

For the above reason the campaign for pure and wholesome food lies at the very foundation of the protection of the public health. It is a mistaken idea that a food is not to be condemned unless it produces diseases. A food is to be condemned which is in any way so debased as to undermine nutrition and impoverish the blood, and thus open the door of the body to the invitation of every germ that may be coming along the road. Thus the addition to foods of bodies which in themselves are not poisonous or harmful, but which debase the product and make it less palatable or less nutritious, is a crime of the same magnitude as that of adding to the foods poisonous and deleterious ingredients or of suffering it to fall into advanced stages of decomposition.

What a sorry spectacle, in the light of these facts, was presented at the Fifteenth International Congress of Hygiene and Demography at Washington last week, when Professor Long, member of the Remsen Board, which has validated the use of some of these poisons, attempted to justify the addition of an active drug to the food supply of the nation! Such an act was so foreign to the purposes of the Congress as to constitute an unpardonable anachronism. Dr. Long was one of the most enthusiastic protagonists of benzoate of soda in the Federal Court in Indianapolis when those who secured the appointment of the Referee Board in defiance of law sought to force the people of Indiana to eat their adulterated products. The people ask for bread and Dr. Long and his assistants give them a stone in the form of the moribund benzoate.

Of a similar pernicious and mercenary character was the paper presented by Professor Sedgewick, of Boston, in which he urged the use of infected oysters and diseased meats as human foods. Professor Sedgewick was one of the principal witnesses in the celebrated egg case in New Jersey, where he testified that eggs so decomposed as to produce death when injected into guinea pigs were wholly fit for human food if sufficiently disguised in taste and smell by baking! Oysters, according to Sedgewick, should be classified into good, to be eaten raw by the rich, and bad, to be cooked and eaten by the poor. Meats of diseased animals should also be eaten by the poor, unless so badly diseased as to be physically seen to be unsound.

This is the doctrine of modern hygiene according to its prophets Long and Sedgewick. I cannot subscribe to these doctrines. There is plenty of clean food for both rich and poor. To excuse processes of growing food animals, and manufacturing foods which permit and condone unsanitary methods and introduce active drugs into the finished products, stimulates and encourages reprehensible practices, which all interested in the public health should condemn. Happily the Federal courts, both in New Jersey and Indiana, were unconvinced by such specious arguments, and condemned the very processes which were praised and defended before the world’s congress of sanitarians.

The workers for the conservation of man do not yet fully realize the great importance of the food supply of the country as a means of producing immunity of disease. The well-nourished body is clad in armor and bears an impenetrable shield which enables one to march into the midst of dangers and for the most part escape unscathed. All power and ethical spirit, therefore, to the men who are chosen to administer the food laws, in order that they may realize the importance of their office to the health of the people, and the life and efficiency of our citizens. Let them learn to put a heart and a soul into science.

IMMUNITY OF HEREDITY.

We are all familiar with the common phrase, the foundation principle of eugenics, “He inherited a good constitution.” It is undoubtedly true that we come into the world with widely different vitalities. The true principles of scientific immunity to disease therefore lie imbedded in the human life principles of long past aeons. The ideals of eugenics, as formulated by Francis Galton and elaborated by his nephew, the son of the immortal Darwin, are but irridescent dreams. If man is to be bred scientifically, there must be many selected mothers and a very few high grade fathers. The human race is not yet ready to face the problem in the true light of science and contemplate a race of males of which 75 per cent. are eunuchs. This is kako- instead of eu-genics. As long as the heart is whole, men and women with only one lung will fall in love. For untold centuries to come we must be resigned to human race composed principally of scrubs. But there is one principle of eugenics which can be and ought to be put into practice. It has been done partially in some States, especially in Indiana. It should be generally adopted. The degenerate, the vicious and the imbecile should not be allowed to propagate. These are classes of society that have no right to multiply. Before proceeding further in restricting parenthood let us see that individuals of both sexes, criminally vicious or imbecile, are segregated or rendered impotent. And even here only the typically bad cases are to be treated. It would be too nice a question for the jury if there was a doubt of any kind, even inconsiderable. Among those of average intelligence, education should do the rest. Teach those who are physically diseased the duty of celibacy. Persuade and not force them.

INDUCED IMMUNITY.

Another method of securing immunity in the human organism is by the development of some morbid condition of a nature similar to or identical with the disease to be combatted, so as to produce in the system anti-bodies, specifically adapted to fight the particular disease which has generated them. The principle of immunization by this method rests upon the successful experiments, or rather observations, respecting a given virus. Jenner’s observations in regard to smallpox were purely empirical, and it remained for Pasteur to develop a scientific basis of induced immunization. Serum-therapy is by no means half so important as serum-prophylaxis, and here again comes the importance of education, because there is still a very large and respectable body of our citizens who resent any interference on the part of the State with their rights as regards medical relations. It looks almost like tyranny to force a citizen to subject himself to inoculation of any kind when his own belief in the efficacy of the process is hostile and where he resists enforced immunization. But here again the right of the people asserts itself and thus justifies compulsory vaccination. While education can do much to remove this prejudice, we must expect to always have with us those who conscientiously resent inoculation, and condemn all efforts to prevent disease.

Since, because of lack of care and proper supervision, grave disorders and disease and sometimes death result from the practice of inoculation, the State owes a special duty to its citizens in seeing that all forms of inoculation materials, no matter what their nature may be, are of the purest and best. Of course, the thought presents itself that induced immunization is only a confession of inability to protect the health by isolation of the invading virus. It is something like the pasteurization of milk, which is a mute tribute to insanitary conditions, uncleanly cows, and long keeping; but here it seems that there is no choice left. The impossibility of complete isolation, at least for many years to come, is apparent, and hence the desirability of general immunization becomes obvious. The successful inoculation which has lately been accomplished against typhoid fever is another promise of what the future may bring in the way of immunization by induction. Meanwhile it is the part of wisdom for those who seek the public welfare by the conservation of life to urge both prophylaxis and immunization, in the hope that the infecting centers will become so few and so remote that good nutrition, and all that it implies in a sanitary way, will eventually become a sufficient protection against communicable diseases.

THE SUPERVISION OF DRUGS.

Hand in hand with the supervision of our food supply, we should not forget the control of drugs. I am far from believing that drugs are an efficient remedy for all human ills; in fact, I am convinced that they are not. They are at best only adjuncts, except in those cases where specifics have been discovered, as in the case of quinine and malaria, and the arsenic compounds, which have proven so useful in combating syphilis. But without discussing the efficiency of drugs, I think we will all admit that as long as they are articles of commerce they should be pure and of constant strength. To this end we should support, with all our enthusiasm and ability, the efforts which are made to perfect the pharmacopœia, and to standardize and purify the drugs of commerce.

THE CONSTANT THREAT OF PROPRIETARY MEDICINES.

In this connection I cannot refrain from alluding to one of the greatest dangers of drugs, and that is, their indiscriminate use by the laity. The fakers that pretend to find sovereign remedies for every disease, through the medium of the newspaper and the periodical, of the postal card and the circular, inflame the minds of the people and induct them into indiscriminate drugging. One can generally, by taking up a paper in any locality and scanning its columns even carelessly, see the wonderful vogue of these fakes and crimes. Such falsely praised substances as Peruna, Kilmer’s Swamp Root, Duffy’s Malt Whiskey, and the whole brood of wretched specifics, serve to illustrate the great danger to which we are subjected. But the worst of it all is that through the carelessness of physicians, and sometimes through their criminal pretentions, habits are formed for certain drugs, such as cocaine, opium and its products, chloral and alcohol, which enslave their victims, weaken their vitality, and invite disease. I think I do not exaggerate it when I say that the drug habit, no matter how induced, is a menace to the American people. No matter how slight the ailment or how easily controlled, the first advice and the first act is to “take something,” no matter what, or whoever may recommend it, for every imaginable ailment. The effect of this continual drugging upon the human body is more easily imagined than described. The nerves and stomachs of our people are gradually succumbing to the bombardment of pills, pellets and powders. For the sake of gain every possible influence is brought to bear upon the American people to increase the consumption of drugs. The danger is so imminent and so acute that it is hoped that through the means of education a public sentiment may yet be awakened in this country which will protect our people against all these nefarious concoctions. I would not for a moment in any way curtail the right of citizens to consult accredited physicians, no matter to what so-called school they might belong; but it is the duty of the State, as an additional safeguard, to the health and life of our people, to see to it that no one sets himself up as a physician unless he has qualified himself in the fundamental principles of anatomy, hygiene and physiology, to understand the human body and its operations. We are too prone to tolerate physicians who tell you that the blood which supplies the brain passes into the cranium altogether through the canal of the spinal cord. Charlatanry, quackery, and ignorance in the practice of medicine should be rigidly suppressed. The people of the nation who have freedom of choice should not be left helpless victims of avarice and ignorance.

DANGERS OF STIMULANTS.

In addition to drugs, as commonly considered, the people of our country are also subjected to imminent dangers in the use of stimuli, which have no food value and which induce activities that are beyond the power of the system to sustain. I refer especially to such beverages as tea, coffee, and alcoholic drinks and the manufactured articles containing their active principles, such as coca cola and all the great army of “olas,” and to tobacco, as an illustration of additional dangers to which we are likely to succumb. In spite of the fragrance of the coffee, and the aroma of the tea, and the flavor of the rum, and the dreams of the pipe, I am inclined to the belief that it was a sad day for humanity when these things were first brought to the attention of man. In so far as intellectual development is concerned, I find the nations of antiquity, and especially the powerful nations of Greece and Rome, developed to be leaders in architecture, masters of painting and sculpture, and geniuses in poetry and expression, without the aid of any of the stimuli which the artist, the poet and the writer are supposed to depend upon today.

It would indeed be a happy day for the community if all of these stimuli, as appetizing as some of them are, could be relegated to the scrap heap, and the art of their use forever lost. (Applause.) Meanwhile, we all understand that this Utopian condition is at present impossible, and hence we must content ourselves with education and with legal control to prevent the abuse of these bodies and to eliminate the injury which they have done. Temperance may always be practiced, even where prohibition fails. It is therefore the duty of every one concerned with the public health to urge the extremest moderation in the use of tea, coffee, tobacco, and alcoholic beverages, in the hope that the injuries which have already been wrought may be avoided in the future, and temperate indulgence take the place of unbridled consumption until the day of final elimination arrives.

SUMPTUARY LAWS.

In the interest, therefore, of the public health and the lengthening of life and increasing the efficiency of man, we must bring ourselves to the point of acknowledging that the State should control things which in themselves are injurious and unnecessary must be established. In other words, the individual’s rights, so dear to every lover of freedom, the cardinal principle of democracy, must give way to the public good. No one has any right to practice any habit, or induce others to do so, which in itself is likely to prove injurious to humanity. I would leave to the individual the largest freedom in everything that is good, and restrict his activities to the lowest minimum in everything that is bad. I would not make of man a machine, nor would I desire that he should live in an environment which in any way would tend to affect his evolution and progress injuriously, and so I preach what seems to me the only solution of all these evils—education, temperance, legal restriction of abuse, and leave the rest to the manly part of humanity.

If I can in my life just put one nail in the coffin of quackery and false medicine, I will not have lived in vain; if by my voice I can get one man or woman interested in a healthy way of living, my work will not be in vain; if I can save one infant from premature death, my life will be well spent.

I believe when you conserve a man physically you conserve him mentally and morally, and then sin and sorrow and suffering will pass. There are only two learned professions in the world that are necessary—one is agriculture and the other is teaching. If you feed men right and teach them right, there will be no law breaking, and hence we will need no lawyers; there will be no sickness, so we will need no physicians; and when you have a country that is so happy as to have no law breakers or sick people, you will not need anybody’s help to get you into heaven, so we can do away with the ministers. (Laughter.)

THE PROLONGATION OF LIFE.

What is in sight in the way of prolonging human life? I have briefly laid down what seems to be the fundamental principles of the conservation of man and the prevention of disease. If this plan can be carried out, is there any hope to be offered to man of greater freedom from disease and a longer life? I answer unhesitatingly in the affirmative. Why should we be content with an average life of 44 years? There is historical evidence to show that man’s greatest activities are developed with experience and that the age between 60 and 70 is more productive for one who has lived in accordance with nature. It is shown from statistics that we die sixteen years before we reach the maximum usefulness of man. I would like to see more old age. I would like to see more men and women with gray hair and more wrinkled faces than I can see today. To all this, objection may be made that a place must be made for the young man and young woman; that the old man and woman keep the young from development and usefulness. But to this I reply, that there is infinite opportunity for good work offered to all. If we can secure a race free from disease, endowed with all those qualities of mind and body which make for human efficiency, we need not ask that every one become eminent and wealthy, but each can perform the duties which come to him in a way to develop a uniform excellence of the human race. We have room in the country for millions of people. We welcome the infant and the child, but let us keep the man and woman. There is room for all.

This is my message to you tonight—the conservation of man—not only his health, but his life, the most precious possession man has. (Applause.)

Col. John I. Martin—I move that the fullest acknowledgment and thanks of this gathering be and are hereby tendered to Dr. Wiley for his very interesting and splendid address.

The motion was seconded by many delegates and carried unanimously.

After announcement by the Secretary, the Congress adjourned until 9:30 o’clock Wednesday morning.

[FOURTH SESSION.]

The Congress convened in the Murat Theater, Indianapolis, on the morning of October 2, 1912, and was called to order by President White.

President White—I want to take this occasion to state that there is a child’s welfare exhibit richly worth seeing. It is an education in itself and is installed at the Capitol building. Every one should embrace the opportunity of seeing it.

The audience will now arise while the Rev. Dr. Harry G. Hill, of Irvington, invokes Divine guidance.