Address on Hygiene. 
DELIVERED BY 
Prof. Samuel G. Dixon, M. D., 
AT THE 
Meeting of the State Medical Society, 
WILLIAMSPORT, PA. ERRATA. 
Page 3, Line 20, omit “to be.” 
“ 4, “ 33, for “death” read “deaths.” 
“ 9, “ 19, for “ tonsilitus ” read “ tonsilitis.” 
“ 12, •“ 20, for “ immortality ” read “ immorality. 
“ 13, “ 6, omit “ even.” 
“ 13, last line for “action” read “attacks.” 
“ lfi, line 17, after “legislators” insert “would be” and 
omit “one.” ADDRESS ON HYGIENE. 
Delivered by Prof. Samuel G. Dixon, M. D. 
[At the meeting of the State Medical Society, Williamsport, Pa.] ■ 
It certainly gives me much pleasure to be with you on this 
occasion. I should, however, have enjoyed the visit more had I 
been present simply as a listener and not as a speaker. 
A few days ago when I came to reflect upon the subject selected 
by our able president as the one upon which I was to address you, 
I was not a little perplexed. For me to presume to teach a 
learned body of medical doctors, such as have here congregated, 
regarding the most important branch of medical education, would 
be unpardonable. I can, therefore, only hope by chance to 
refresh your memories upon a few points in sanitary science. As 
a teacher of medical students, I have seen fit to divide the subject 
into Personal, General and Public Hygiene. 
Including under Personal Hygiene:—Inheritance; hygiene of 
various periods of life; prevention of mental, moral and emotional 
diseases; prevention of sexual diseases; hygiene of clothing; 
hygiene of occupation, etc. 
Under General Hygiene:—Hygiene of foods : Practical 
dietetics ; food adulterations, food decompositions ; accessory foods, 
etc , stimulants and narcotics, (intemperance). 
Hygiene of water : Water supply ; potable water ; balneology. 
Hygiene of dwellings : Air; lighting ; heating and ventilation; 
plumbing ; drainage and sewerage. 
Location and soil: Ground air ; ground water ; soil pollution. 
Climatology ; medical meterology ; animal parasites, (examin- 
ation of meats, etc.) ; vegetable parasites, (bacteria). 
Public Hygiene:—Infectious diseases ; school hygiene ; quar- 
antine — means of combating disease; disinfection ; hygiene of 
hospitals, prisons, etc.; vital statistics; legislation of public 
measures ; vaccination, etc. ; disposal of the dead. 
This scheme may appear too comprehensive for a student of 
medicine under our present short graded courses of three years, 
yet, as it is not in the least too general, I would be pleased to see 2 
it introduced into the curriculum of every medical teaching insti- 
tution of our Ke} stone State, and at the same time to have its 
standard well protected by a learned State Hoard of Medical 
Examiners. However much I may advocate this standard in our 
medical schools, I can assure you that my address to you will be 
exceedingly short. I will not presume to air my own erudition 
in a comprehensive lecture on sanitary medicine, as I feel sure it 
would be at the expense of others who are here, I have no doubt, 
to teach us that which has not heretofore been known to the 
medical profession. To avoid inflicting tediousness upon you, my 
fellow members of the State Medical Society of Pennsylvania, 
and for brevity’s sake, I will merely attempt to refresh your 
memories upon a sub-division of my comprehensive scheme of 
preventive medicine, which will be Air. In considering the 
importance of this element to sanitary science, we must recognize 
that man’s surroundings are and ever will be impregnated with 
minute life which will, when brought in relationship with a 
favorable nidus, at least direct either functional or comparatively 
harmless pathological conditions into maladies which nature may 
neither exist under or overcome. Again it would appear, so far 
as we can determine from artificial experimentation, that this 
micro-organic life can per se when introduced into healthy tissues 
disturb the normal affinities of the animal economy. This being 
admitted, we must accept the situation and prepare ourselves for 
war with this minute life by first building up healthy, vigorous 
tissues, for, the instant we permit them to drift from a normal 
condition, they at once offer a nidus where pathogenic organisms 
may feed, grow, reproduce and form toxic substances which will 
so disturb the higher animal organic life as to cause dissolution. 
To grow' tissues sufficiently vigorous to destroy these germs of 
disease as they enter the body under ordinary circumstances, we 
will be compelled to call to our assistance each and every hygienic 
measure known to man. We must enforce proper mental and 
moral training, suitable clothing, occupation, diet, bathing, sani- 
tary dwellings, urban parks, proper food, vaccination, and above 
any other one element, pure air. However, as I have already 
stated that I do not intend taking advantage of the privilege 
granted me by this society, I must and will confine myself to the 3 
factor that above all others takes a high position in governing 
health and disease, and at the same time the one most frequently 
lost sight of by both layman and physician. The high place I 
give air as a sanitary factor may be severely criticised, for I do 
not know of any means by which we can measure the influence of 
isolated factors in favor of and antagonistic to the health of 
animal life. I will, however, for my purpose on this occasion, 
venture to place air on a high plane, as our whole vital process is 
dependent upon this element. To appreciate the importance of 
this, the chief factor of organic existence in relation to both health 
and disease, we must ever keep before us, in at least a superficial 
way, the physiological processes dependent upon this mechanical 
mixture. Animal life demands air through the organs of respir- 
ation and transpiration, from the very moment it obtains an 
independent existence, until the last act of life is performed. 
Parkes very truly states that starvation is a matter of days 
without solids, hours without liquids, but of minutes without air. 
We must ever bear in mind, that the air a strong man takes into 
his lungs supplies oxygen to 443,520 ounces of blood every 
twenty-four hours, providing the mechanical mixture is to be made 
up of 20.96 per cent, of oxygen, 79 per cent, nitrogen and .04 
per cent, carbon dioxide. To obtain a full supply of oxygen for 
the tissues through the red blood corpuscles, all the physiological 
functions of respiration must be in health, for this reason we can- 
not entirely overcome inherited inconsistencies. If there is any 
reduction in the required amount of this important constituent of 
the atmosphere, just to that degree of loss do the animal functions 
of the body become impaired and the moment there is an entire 
cessation of the supply of oxygen, life immediately goes out. It 
would seem that the nervous system first feels its loss, then the 
heart, the brain and the digestive system, etc., all become sluggish 
in their respective functions, the results of which are reflected 
upon every cell and fluid in the animal body. Physiological 
combustion is interfered with, and consequently the required 
chemical changes necessary for health do not take place. The 
blood is loaded with debris, and is thereby rendered unable fo 
take up the waste of the tissues, but leaves it as foreign matter 
to undergo chemical changes and form poisons. 4 
Consumption of the lungs is always to be found in great ex- 
cess, both in man and the lower animals, who live in such en- 
vironments as compel the breathing of devitalized air, producing 
sluggishness of physiological action. It is under this condition 
that the digestive secretions are impaired, and the general physio- 
logical combustion reduced so that the body becomes a habitat 
for germs called pathological micro-organisms, and they, with 
their respective methods of digestive processes, effect a breaking 
up of the already weakened affinity of the molecules forming the 
cells and tissues, and in some way or other, these organic chemical 
substances are toxic to animal life. The powerful effect of re- 
peated infinitesimal quantities of these poisons, which are often 
albumoses, is beyond our present knowledge, yet, we have good 
reason to believe that they cause many chronic changes that in- 
sidiously creep upon us, while large doses of them cause death al- 
most immediately. For instance, the subcutaneous injection of 
blood taken from an animal with uriemia produces uraemia in the 
recipient, or in the prevention of their elimination through the ex- 
cretory organs will also produce the same result. Gautier, and many 
others, have thoroughly demonstrated that animal tissues in pro- 
cess of putrefaction and decomposition, invariably elaborate cer- 
tain alkaloids of very powerful toxetic properties. To-day we 
know that these toxic albumens are also formed during the life of 
the animal tissues, and are called leucomaines ; any excess of the 
production of such substances in the animal economy, even in 
most minute quantities would certainly be very dangerous to 
health, were it not for the eliminating organs. This is demon- 
strated by an instance just cited in which the kidneys were ligated, 
and the animal thus affected soon died with symptoms indicating 
a malady that has received the misnomer of uraemia. The pro- 
duction of normal waste is in reality a feature of life. Dr. A. 
M. Brown very properly said, “Life is a contingent phenomenon 
consisting of partial births and death.” “In the midst of life we 
are in death,” for scientifically speaking, it must be admitted that 
the living body always bears with it the components of the dead 
me. Life only goes on as long as the organic and inorganic work 
together, and to carry on its functions consistently with health the 
normal quantity of oxygen must be furnished the blood in order 5 
to form normal waste. The dissimilation that results from 
over-loading the system with debris because of blood being 
deficient in its carrying powers, often results in production of 
leucomaines. Impure air often contains these toxic alkaloids 
that I have said are produced outside of the living tissues, and 
can be taken into the body through respiration. 
The decaying organic malter in the air of a Russian hut in the 
spring time, after it has been occupied all winter, will, with many 
people, bring on nervousness, indigestion and diarrhoea, and some- 
times typhus fever, either directly or through the agency of mi- 
nute life. I am convinced from my investigations that no one 
living in a normal atmosphere, performing that sort of physical 
exercise calculated to pump a normal quantity of air into the 
lungs, would likely become a victim to typhus fever. Let it be a 
reproductive poison or not, it is, I have no doubt, caused by im- 
pure air, which not only supplies toxics formed outside the body, 
but also permits them to form in the tissues. If our people had 
a bountiful supply of pure air furnished to the lungs, we would 
all, even we bacteriologists, attach less importance to the disease- 
effecting and disease-producing micro-organisms. On the principle 
of resistance, man must protect himself against the deadly work 
of micro-organisms. We cannot directly exterminate them out- 
side the animal body, or as yet see our way clear to overcome 
their pathogenic characters. If they once gain entrance and 
establish themselves in their human abodes, it is a most 
difficult task to successfully battle against their action upon 
the tissues without overcoming the animal economy. For this 
reason, therefore, we must, as I have said, supply the body with 
its required quantity of oxygen to keep up the highest degree of 
vitality in every member. Otherwise the secreting and excreting 
organs will cease to do their full quota of work and the tissues 
will not continue to undergo that constant regeneration that is 
necesssary for health; otherwise the blood can neither carry 
nourishment tu the respective organs nor in turn convey the debris 
to the eliminating viscera. The importance of pure air for the 
health of man must be apparent to us all from the fact that the 
very environment in which the animal kingdom has been evolved 
is most constant in its supply of this mechanical mixture of 6 
oxygen, nitrogen, and carbon dioxide, as they are the constituents 
of the very element that has permitted the present development 
of man and the lower animals. Without it we are a priori in- 
fected by the formation of leucomaines which would otherwise be 
prevented by normal physiological combustion. I believe we 
often find an example of the want of a normal elimination of 
debris in children living in cities. A child, particularly one 
with insufficient chest expansion, that has been taking considerable 
physical exercise in a badly ventilated room, will frequently suffer 
toward evening with what we call growing pains, and at times 
with a slight rise in temperature, while the same child, 
when submitted to like exercise in country air, where it can 
obtain sufficient oxygen, will not be subject to the same painful 
affection. In such cases it is quite probable that the trouble is 
brought about by the inability of the blood to furnish enough 
oxygen to the tissues for it to carry away the debris, and if this 
condition is carried on continuously for some weeks, we will have 
a continued fever due, in all probability, to the formation of leu- 
comaines, or to catarrh of the digestive tract. The physiological 
process of life not only demands the formation of natural tissues, 
but also of normal waste and the moment the eliminating organs 
are called upon to battle with foreign matter, their scope of power 
is limited and the tissues irritated, as for instance, when the kid- 
neys are loaded with uric acid crystals, the results of which we 
are perfectly familiar with. This condition can be overcome if 
we have both healthy lungs and nervous system, the latter to 
transmit normal impulses to the respiratory muscles and thus fur- 
nish the blood with pure air to bring about natural physiological 
combustion. You may limit your patient’s diet tonon-nitrogenous 
food stuff, you may wash him out with the free administration of 
water and you may drug him with any or all of the remedies 
known to the medical profession that have any relaiion to a gouty 
diathesis, and find your treatment of little or no avail, unless you 
have the patient exercise in fresh air. Perfect oxydation of the 
food is the prevention and cure for gout. The changes effected 
by the artifice of man in the normal uniformity of the composition 
of the atmosphere is too significant a fact for us to lose sight of 
when considering a means for the preservation of health and the 7 
cure of disease. Pure air breaks up organic matter and renders 
it both harmless and also useful to each and every form of life 
that has been evolved in its midst. Without its chemical action 
upon inanimate matter, heat and energy would not be pro- 
duced and the world would be without animate things. It creates 
and supports life; therefore, the moment we overload it with im- 
purities, that moment we interfere with its power to maintain 
health. Yet owing to man’s present want of appreciation of 
the necessity of maintaining the purity of this mechanical mixture 
for health, I have never found in his habitations an approach to 
purity in this great life-supporting element. It is mostly de- 
ficient in oxygen, which is replaced by carbon dioxide and carbon 
monoxide, toxic, non-toxic organic, inorganic matter and fre- 
quently by pathogenic micro-organisms. 
The carbon dioxide is, of course, the least harmful; it being 
within itself only a negative poison. We do not now believe that 
the 123 persons who died out of the 146 confined for one night ill 
the Black Hole of Calcutta, nor that the 70 passengers who 
died out of the 150 that were fastened in the cabin of the steamer 
Londonderry, with the hatches battoned down, during a 
rough night in the year 1848, were killed by asphyxiation 
from carbon dioxide, but that they perished from the animal 
alkaloids formed out of the organic debris exhaled by the 
lungs and skin into an atmosphere deficient in that great 
purifier—oxygen. Organic matter is also taken into our build- 
ings by soil air, our boots, and in large towns and cities by the 
very air we are compelled to circulate through our dwellings as 
the nearest substitute obtainable for nature’s atmosphere. The 
air of Philadelphia this month is so laden with filthy organic 
matter raised from the dirty alleys, (I say alleys, because they 
are not worthy the title of streets , that when the sun’s rays strike 
it as suspended in the atmosphere of a room slightly agitated, you 
instinctively hold your breath. Not only is this air loaded with 
filth that undergoes a chemical change and forms compound 
poison when retained in rooms deprived of sunlight, and deficient 
in oxygen, but we have also sub-soil air that circulates through 
earth foul with the sewage that leaks through the open walls of 
our conduits. The soil through which this air passes is so polluted 8 
with sewage that when brought to the surface you can smell 
it, with moderate wind some 1000 feet away ; this is the condition 
of the air that circulates through our cellar walls in Philadelphia, 
the average stone of which they are built containing nearly fifty 
per cent, of air, which is constantly interchanging with the sur- 
rounding atmosphere. Again, a large proportion of the floors 
of the hot air chambers of our heating furnaces are built of porous 
earth. What is the effect of this condition of affairs ? Why, the 
air in the hot air chamber is lighter than the filthy sub-soil and 
out door air, therefore, the heavier outside column forces the 
poisonous sub-soil air up through* the floor of your hot air cham- 
ber, filling the space with polluted air; this in turn becomes 
lighter and is forced through the hot air Hues into the living 
rooms to feed the occupants, and we wonder why we are not 
typical specimens of the genus Homo. During the early part of 
this century, Philadelphians were not satisfied with the cess pool 
and sewage filth they could take into their bodies through the 
air. The cess pools and sewers were built with what is called dry 
walls; they are walls constructed simply of bricks, with open 
interspaces. The object was to permit the percolation of the 
effluent through into the surrounding sub-soil. The idea being that 
mother earth was a great and inexhaustible purifier; this, how- 
ever, was too complimentary ; her power was limited, and the 
sub-soil soon became surcharged with filth, and through this pol- 
luted ground they deliberately laid wooden conduits for water 
carriers, which in certain strata of earth soon decayed and became 
very porous, in fact so much so that disease-effecting and disease- 
producing micro-organisms would pass through their walls into 
the stream of water, on its way to the drinking tap in the houses 
of our ancestors. If this condition of affairs existed at present, 
we might be even more apprehensive than we are of the threat- 
ening cholera epidemic. 
Another substitute for the oxygen that our house air frequently 
contains, is, as I have already mentioned, carbon monoxide. This 
gas is a direct and deadly poison, one per cent, of which in a 
confined atmosphere, will unite with the haemoglobin and deprive 
the red blood corpuscles of their power to carry oxygen to the 
tissues, in consequence of which, the nerve centres fail to respond 9 
to stimulation and death ensues. The usual sources of this gas, 
which I believe to be one of the great pre-disposing causes of 
early decay of our faculties, is the production from combustion of 
the substances used for producing heat in buildings for the various 
purposes of man. It is non-odorous and will pass out through 
cast iron, when sulphurous acid gas, which, when present, acts as 
a tell tale, will not escape. Hot air furnaces and stoves for the 
burning of coal are fertile sources of this poison. Yet our city 
fathers in Philadelphia were not satisfied with the small volumes 
of this insidious poison produced and permitted to escape into the 
air of our buildings from this source; they therefore introduced 
water gas into our mains. This gas must contain at least thirty- 
five per cent, of carbon-monoxide, and at the same time has a 
solvent power on a residuary substance that has been deposited in 
our old pipes, from coal gas, which prevented leakage; conse- 
quently during the last year our houses have been deluged with 
this health destroyer There is no doubt in my mind, but, that 
much of the so-called diphtheria in Philadelphia last winter, was 
a tonsilitus caused by water gas poisoning. Our people, however* 
because they are furnished with a better illumination by this gas, 
which is richly charged with carbonaceous material, go on electing 
to office those who are, through ignorance, poisoning our bodies, 
and at the same time burdening us with as heavy a tax as the 
English laid upon our colonial ancestors, by charging for this 
poisonous gas about three times the cost of its production. Defi- 
ciency in oxygen and the excess of carbon dioxide and the addi- 
tions of carbon mon-oxide and organic matter in the air of 
buildings occupied by man and the domestic animals, undoubtedly 
play a most important part in the aetiology of all pathological 
processes, yet, their injury comes so slowly and continuously that 
man does not fully realize the presence of the enemy until too 
late. The people’s medical advisers do, however, realize this con- 
dition, and also the importance of pure air to maintain health 
and to overcome pathological processes; therefore it behooves our 
profession to teach the people, particularly the law makers of our 
land, the necessity of having this element, with which nature has 
so bountifully supplied the organic kingdom, kept pure. Each 
physician should insist upon his patients refusing to endorse any 10 
candidate fox* public office, unless he gives a pledge that he will 
exert himself to have laws made and enforced to bring about a 
higher degree of health. It is as important to compel our people 
to have properly ventilated and lighted houses, as it is to have 
sanitary plumbing, which latter our laws require. As physicians, 
we forget the scope of our power, and neglect our moral and pro- 
fessional duties. It is incumbent upon us to instruct our patients 
how to preserve health, and thereby improve the moral, religious 
and political standard of this, the greatest nation of modern times. 
Ill health is the parent of much that is bad in civilized life, 
and it lies in our power more than it does in those devoting their 
lives to the professions of law and theology, to advance the moral 
condition of our people. There is not a man, woman or child in 
this great State, that is without a physician. He is thrown into 
the most intimate relationships with his patient, and by teaching 
the proper laws of hygiene, he can greatly reduce murder, suicide, 
drunkenness and family feuds. If this be so, why are we not 
doing our duty? The answer must be that sanitary medicine is 
not atti'active; in fact, many of its details ai*e naturally repulsive 
and not profitable to him, and thei’efore the physician shuns it in 
his private capacity, and this is wherein he fails, for it is not as a 
reformer, a legislator, or a scientist, but as a family physician 
that his great power for good in this direction lies. It is in this 
role that the doctor of the present day is at fault; he does 
exert himself to legislate, to exhort his fellow physicians, but as 
the familiar family doctor he fails to take advantage of his power 
to exert a moral influence over his fellow man. The gi’eat phy- 
sician must bridge over the wide gap between science in the 
abstract and medicine as it should be practiced in every day life. 
Without a moi'al influence over his patients, he cannot l’eflect the 
full power of his scientific knowledge. 
In no other profession is the adviser brought into such intimate 
relationship with his fellow creatures when they are susceptible 
to advice, unless it be the spiritual advisei*, whose duties too often 
come when the life in question is about to be closed. At the 
word of the physician families separate for years, men give up 
their trades and vocations. Their domiciles are moved to higher 
elevations, or to the seashore. Therefore, if we have it in our 11 
power to bring about such radical changes as these in the habits 
of our patients, why is it that our homes, factories, mills, vehicles, 
hospitals, places of amusement, etc., etc., are so poorly supplied 
with pure air? Again, why is it that our cities in this great 
State are permitted to be built up so closely? Where are our 
urban parks, gardens and play grounds, which are necessary to 
keep up the average standard vitality of this great nation? I 
say nation, because it is made up of individual men and women, 
its power being simply the sum total of the force of the indi- 
viduals, that go to make it up, and the more thickly the 
inhabitants are settled the lower is the degree of health. 
It has been said that all things being equal the health 
of a population is in inverse ratio to its density. The 
only way to overcome this rapidly increasing evil of huddling 
together is by opening to the people, public gardens and open 
spaces and wide boulevards. A wide avenue is now proposed in 
Philadelphia, which would not only give the city, as it were, an 
additional lung, but it would make a short and attractive walk 
and drive to the greatest city park in the civilized world. I have 
heard it spoken of as an ornamental luxury, but I believe it is a 
crying sanitary necessity, which if once demonstrated to our lay 
people by its physical opening would in a short time be followed 
by a request to the authorities for others of a similar nature. Out- 
side of a better sewage system and a mechanical filtration of 
Schuylkill water, I know of no other more crying need in that 
great city of our State, than air spaces and vegetation. 
The way in which our towns are being closely built up is 
disgraceful to our city fathers and reflects somewhat upon the 
medical profession. Too many poorly ventilated public school houses 
are, at present, being erected on contracted spaces, without any 
gardens or play grounds, where the brains of the present genera- 
tion are overworked and the body starved and poisoned for want 
of pure air and physical exercise. To pass one of our public 
school houses in Philadelphia at noon and see the pale-faced children 
playing on the damp brick pavements beteeen two high walls, 
shutting out the rays of the glorious sun, makes one blush with 
shame for the ignorance of our people. While to enter many of 
our school houses during session, soon benumbs one’s brain. During 12 
the last winter young girls in our normal school fainted’for the 
want of oxygen. The remedy for this deplorable condition of 
things is largely in the power of the medical profession. If each 
doctor in this community would teach his patients the importance 
of pure air, there would be such a universal demand that those 
holding public office would be compelled to grant us better venti- 
lation in public and private buildings, give us wider streets, more 
small gardens, less water gas, better sewage, cleaner streets, and 
less smoke and lower buildings, which latter would permit the 
sun’s rays to strike the foundations of the buildings on at least 
one side of the streets. The recent structures in the large cities 
in this country are monuments of ignorance of our people, that 
our descendants will censure us for in time not far off. Our 
streets will soon be but caverns such as the half civilized man 
lived in centuries ago, mere fissures between great walls of stone 
and bricks, damp, sunless and dirty, a sine qua non for disease 
germs. Less steam from the factories, locomotives and engines 
should be demanded. These improvements would lead to a de- 
crease in the mortality of youth, in crime, drunkenness and im- 
mor ality, and to a marked raising of our standard of mental 
power. 
To-day it is a crying shame to our intelligent classes to analyze 
the air in our medical teaching institutions. Only a few years 
ago Dr. Kerlin made a series of important examinations of the 
hygienic condition of the air in the lecture rooms of Medical 
Hall of the University of Pennsylvania, with the result of show- 
ing 17 per cent, of our index of impurities, or in other words, 
the carbon dioxide raised from four parts in 10,000 to seventeen 
parts in 10,000. While six parts in 10,000 represents the maxi- 
mum of impurities in ordinarily well ventilated rooms, seven in 
10,000 is detectable by the sense of smell. 
In studying the aetiology of disease, we must not permit our- 
selves to be persuaded that bacteriology has given us le mot 
d’enifjme. Micro-organisms undoubtedly have the power, when 
introduced into the circulation of healthy animals, of producing 
certain diseases. Yet I feel convinced that in tuberculosis, and 
many other germ diseases, that they, in a large majority of in- 
stances, only change an already unhealthy condition into one 13 
definitely and fatally morbid. Normal tissues supplied with pure 
air, have great power to resist germs taken into the body through 
either the digestive or respiratory tracts. This conclusion is 
reached from the fact, that I have found guinea pigs and rabbits 
yielded much more readily to inoculations by tubercle bacilli 
when even confined in cages, kept in the cellar under a city lab- 
ratory, than they did when kept in my animal house situate in 
the country and so arranged as to have a large volume of pure 
air circulating through it both day and night. To avoid tuber- 
culosis, we must recognize the predisposed habit of the individual 
and have him live in pure air, and not breathe a deoxidized at- 
mosphere, or air loaded with fibrous matter or spiculated dust, or 
air impregnated with the products of combustion of coal, or the 
escape of water gas, or a high percentage of humidity, or air that 
has been robbed of the sun’s rays. This last is not the least im- 
portant, it not only prevents dampness, but destroys poisons, such 
for instance, as the woorara snake poison and bacteria. If such 
environments are not avoided, a lower and lower vitality will 
creep on insidiously, inch by inch, until a pathological condition 
becomes recognizable both to the victim and his medical adviser. 
At this stage, if not before, a nidus has been formed which is 
quite susceptible to the action of pathogenic minute life, and 
should the patient not be removed from the environment that 
predisposed him to the attack of the germs, his resisting powers 
will be still further reduced. It may, however, be discovered 
early enough to not only prevent a greater degree of susceptibility, 
but by proper hygienic conditions, the tissues in many cases will 
return to that degree of health not suited to the lives of micro- 
organisms. 
I do not mean to undertake to weigh the exact power of 
germs to break up the affinity of normal tissues, when brought 
into contact with them in what we may call the natural wray, to 
differentiate it from an artificial method. I do intend, however, 
to say that we can maintain by the aid of pure air and proper 
physical exercise the integrity of animal function to a degree that 
renders the tissues much less liable to the attack of micro-organ- 
isms. We must girdle ourselves with an armor of general good 
health if wre wish to resist the action of minute life. The preven- 14 
tion of premature death, disabled physical and mental faculties, 
forms a far more comprehensive question for the physician than 
does curative medicine, at the same time we must recognize that 
preventive and curative medicine are inseparable. While we are 
gathered together in convention, we all advocate hygienic meas- 
sures, admitting them to be paramount to the more fruitless task 
of the so-called curative side of medicine, yet, I fear we are in 
preventive medicine too much like many of our Sunday Christians, 
who believe in the theory, yet, forget its practical workings by 
the time the business houses of Monday morning open for trade. 
The physician of to-day who has been taught and believes in pre- 
ventive medicine, too often empirically accepts disease as an ex- 
isting condition and treats it accordingly until alleviated or cured. 
This stage reached, he considers his work done until called in 
again, upon his patient becoming ill, probably with the accumu- 
lation of the evils of impure air and other unhygienic conditions. 
This may be pecuniarily profitable to the medical man, and 
might warrant the ignorant to attribute our laches regarding pre- 
vention to be entirely toward that selfish end. This, however, 
would be very unjust. We must account for the customary neglect 
of hygiene by the fact that both preventive and curative medi- 
cine were hidden in darkness for thousands of years, and, there- 
fore, the conservative, cautious and wise physician, with a full 
realization of his ignorance, only interfered with nature when 
stimulated to act by the appeals of an acute sufferer, thence the 
habit. To-day this should not be so, we do not regard disease as 
a visitation of the Almighty God, inscrutable in character. We 
sufficiently understand many of the predisposing and exciting 
causes to guide our fellow man through life free from the hereto- 
fore unknown poisons, to a much more satisfactory degree than 
some of our forefathers, who believed themselves capable of curb- 
ing the wrath of God by the administration of their empirical 
remedies. This good fortune of ours, however, comes to us from 
the fact that in all ages of medicine our profession has been be- 
sprinkled with ambitious minds, who have labored to discover the 
cause of ill health and methods to prevent disease, and now the 
time has arrived for us to come to a full realization of what has 
been demonstrated regarding man’s power to prevent disease and 15 
adopt asour motto venienti occurite morbo. Hasten to meet the coming 
disease Those factors essential for prevention oftentimes prove 
essential for cure—which fact is not recognized by but few of our 
practitioners. For instance, we frequently know of a physician 
who is called in to see a patient, who correctly diagnoses the case 
as one of typhoid fever, and then simply applies his knowledge of 
the healing art; oftentimes with as little success as if he had 
been administering to a person with symptoms of lead poisoning, 
who was at the same time continuing the use of water impreg- 
nated with the poison. He seldom interests himself to investi- 
gate and remove the source of poison, but frequently orders the 
patient on a milk diet, the very vehicle that first carried the 
poison. I conceive it, however, to be our duty to at once invest- 
igate the water, food and air supplies, and thereby cut off’ all 
external source of further poisoning. 
The healing art and preventive science are a part and parcel 
of each other. The cure of disease must be imbued with a pre- 
ventive element. Scurvy certainly demonstrates this assertion to 
be true, as in the treatment of this pathological condition we see 
the cure emerges directly and exclusively from the preventive 
treatment, and I have no doubt that as our knowledge increases, 
this principle of physiological treatment, as opposed to compli- 
cated and disturbing drugs, will be more clearly recognized. 
If some move is not accomplished ere long, to establish better 
hygienic conditions, and our people taught to appreciate that 
education of the body is almost of equal value to culture of the 
mind, the bodies of our people will be starved, and the normal 
brain become morbid. The now great American nation will be 
forced to take a second place regarding health, ability and 
morality, while she will rank high in immorality. 
It is a sad mistake, to centralize our attention upon the culti- 
vation of the brain as if it were a separate organism, entirely 
independent of the physical body, and it depends upon our pro- 
fession to form a public opinion favorable to the supply of pure 
air and physical exercise, particularly to the poorer classes, and 
this I exhort you to, as nothing else will maintain the high 
standard in our future generations that has been handed down to 
us by our forefathers. 16 
Fellow physicians, upon reform in sanitary matters depends the 
future of this promising nation. Our Government has its Secre- 
tary of State, of the Navy, of War, of Agriculture, of the 
Treasury, while the richest treasure of all to mankind, health, is 
absolutely ignored. Why do we not have a Secretary of Health? 
This is a disgrace to us as a people, and indirectly a reflection 
upon our profession, for we undoubtedly have it in our power to 
better this state of affairs, if we would insist on our patients and 
their families paying more attention to sanitary matters. 
Knowing, as a physician does, how important health is to 
human success and happiness, our efforts cannot be too great to 
maintain it. The present year is one of more than usual import- 
ance with the dire disease, cholera, close to our shores Yet, with 
the individual exertion of each physician in this State to main- 
tain cleanliness and to stimulate those trusted with quarantine, 
we should not only prevent the entrance and spread of this 
disease, but faced by such an enemy, the legislators reminded one 
of the vast importance of a good code of sanitary laws, and vote 
liberal appropriations for the execution of the same. 
The following words of the late Dr. Richardson should be ever 
kept in mind : 
“Cleanliness covers the whole field of sanitary labor. Clean- 
liness, that is purity of air; cleanliness, that is purity of water; 
cleanliness, in and around the house; cleanliness of persons; 
cleanliness of dress; cleauliness of food and feeding; cleanliness 
in work ; cleanliness in habits of the individual man and woman ; 
cleanliness of life and conversation ; purity of life, temperance, 
all these are in man’s power.” 
“ How small of all that human hearts endure, 
That part which laws of kings can cause or cure, 
Still to ourselves in every place consigned, 
Our own felicity, we make or find.”