ered in marrying and giving in marriage! It is not that the disease is inherited, but the vulnerable tissues, the feeble resistive powers, render the offspring an easy prey to the ubiquitous bacillus. This weakness often shows itself by a tendency to become ill from slight causes, a sickliness, not by any means to be confounded with merely a lack of robustness or strength. One organ or part of the body, frequently the mucous membrane, is usually more prone to become affected, and the beginning of the disease can often be traced to an attack of some slight ailment. Not only the children of consumptive parents may show these characteristics, but also those of parents generally enfeebled, or whose ages are widely separated, or who are closely related by blood, or of a mother who has previously borne a number in quick succession. Even when heredity is sound, the same condition is sometimes induced by coddling, by improper feeding, by attacks of acute disease, or by want and distress. In growing children, a bad carriage of body may act injuriously by contracting and deforming the chest. The stooped position which boys sometimes assume in bicycle-riding should be discouraged for this reason.-From "Consumption and Consumptives," by WILLIAM L. RUSSELL, M. D., in Appleton's Popular Science Monthly for January.

THE MILLS LODGING HOUSES.

In the ordinary type of New York lodging house men sleep in great dormitories where there can be neither privacy or decency. In Mr. Mills' hotel each man will be provided with a private room. having a window opening either on the street or on the great interior court. Each room will be comfortably and cleanly furnished. On the first floor will be a magnificent system of baths, laundries where lodgers may wash their own clothing, footbaths, washrooms, etc.; also drying-rooms where men coming in with wet clothing may have it dried for wear in the morning. There will be great kitchens and ample restaurant facilities.

Especial attention will be paid to the social requirements of the men. Commodious and well-equipped reading, writing, games, and music rooms will be provided. In fact, everything possible will be done to make a real home for men, keeping them out of saloons and other evil resorts. There is no doubt that much of the prosperity of the saloons is due to the fact that they are by far more attractive and comfortable than the homes of the poor. It is not at all improbable that the entire cost of healthy, comfortable homes

and lodging houses for the entire working population of New York could be paid for from the resulting saving in the liquor bills and reduced hospital, asylum, charity, and prison expenses.

It is expected that twenty cents a night will be charged for rooms, with baths, laundries, etc., free of charge to guests, and it is believed by the most experienced that on this basis the enterprise will prove a decided financial success.

It is worthy of especial note that Mr. Mills, who has an able and sympathetic coadjutor in his son, Mr. Ogden Mills, is determined that these houses shall be confined to the worthy class of men who need such a home-sober, industrious men of the most limited means. These hotels will not be congenial places for the "tramp" and "bum."-From "Model Lodging Houses for New York," in January Review of Reviews.

CAUSES OF DEGENERACY IN SMALL TOWNS.-In the January number of The American Journal of Sociology Professor Frank W. Blackmar has an illustrated article entitled "The Smoky Pilgrims,' which is a study of a single degenerate tribe in a western city. The importance of such studies is hinted at in the opening paragraph:

It is a popular belief that large cities are the great centres of social corruption and the special causes of social degeneration, while rural districts and country towns are quite free from immoral influences. It is held that the tendency of social life in a large city is downward, and that of country life is upward. No doubt that the congregation of a large population in a city has a tendency to develop in a geometrical ratio certain criminal and pauper conditions which are in marked contrast to those or sparsely settled districts, where life moves less rapidly and over-crowding is less ap parent. Yet the country has its own social evils and social residuum; for while an abundance of fresh air and sunshine may be in themselves redeeming features of social improvement, it takes something more than these to make a healthy social atmosphere. The limits of industry are as certain in the country as in the city, and if more seek labor than are able to find it there is a clear case of economic over-crowding. While this over-crowding is less marked, a man without a place in the world is as much crowded out when the broad fields are before him as in the large city, amidst the rush of hurrying industry. While the country has some advantages over the city in respect to the condition of the poor and unfortunate it may appear after all that social degeneration in the country, if not quite in proportion to the decline in large cities, according to the population, moves with accelerating ratio.-University of Chicago Press.

THE SANITARIAN.

MARCH, 1897.

NUMBER 328.

PREVENTIVE MEDICINE.*

BY GEORGE M. STERNBERG.

Sanitary science is a branch of medicine based upon chemical and physiological knowledge which has been gained by the painstaking researches of a host of investigators who have determined the constituent elements of the air we breathe, the water we drink, the food we eat and the nature of the harmful impurities found in these; it teaches us the difference between healthful indulgence in food, exercise, mental activity, etc., and those excesses which lower the vital resisting power and establish a predisposition to disease. Preventive medicine, which is a broader term, if we regard the beneficent results accomplished, must be placed in advance of therapeutics. Where thousands have been saved by the timely administration of suitable medicines, or by the skilfully performed operation of the surgeon, tens of thousands have been saved by preventive medicine. And preventive medicine is to-day established upon a strictly scientific foundation. If our practice was pari passu with our knowledge, infectious diseases should be almost unknown in civilized countries, and those degenerative changes in vital organs which result from excesses of various kinds would cease to play a leading part in our mortuary statistics. But while our knowledge is still incomplete in some directions, and while individual communities constantly fail to act in accordance with the well-established laws of health and the scientific data which furnish the basis of preventive medicine, the saving of life directly traceable to this knowledge is enormous.

*Abstract from "Science and Pseudo-Science in Medicine" (Science, Feb. 5), read before the Anthropological Society of Washington, December 15, 1896.

Smallpox no longer claims its victims in any considerable numbersexcept in communities where vaccination is neglected; the last epidemic of yellow fever in the United States occurred nearly twenty years ago; cholera has been excluded from our country during the last two wide-spread epidemics in Europe, and its ravages have been greatly restricted in all civilized countries into which it has been introduced; the deadly plague of the sixteenth and seventeenth centuries is no longer known in Europe, and the prevalence of typhus (so-called 'spotted' or 'ship fever') has been greatly limited. Typhoid fever, tuberculosis and diphtheria are still with us and claim numerous victims, but we know the specific cause of each of these diseases; we know where to find the bacteria which cause them and the channel by which they gain access to the human body; we know how to destroy them by the use of disinfecting agents ('antiseptics'); and in the case of diphtheria we have recently discovered a specific mode of treatment which when promptly applied reduces the mortality from this dread disease to a comparatively small figure.

The brilliant success which has attended the carrying out of modern antiseptic methods in surgical and obstetrical practice are too well known to call for extended remark.

Sir Edward Arnold, in an address delivered at St. Thomas' Hospital, upon "Medicine, Its Past and Future," says:

"One of the highest authorities already quoted has furnished a calculation of the salvages of life effected even during the early years of the present reign by the commencing improvements in preventive and curative medicine. In the five years from 1838 to 1842, London with an average population of 1,840,865 persons, had an average annual mortality of 2,557 in every 100,000. In the five years from 1880 to 1884 the average metropolitan population was 3,894,261, and the average annual death rate 2,101 in 100,000. A calculation will show that these figures represent a saving or prolonging of lives during that lustrum to the number of 96,640. The mean annual death rate has now been reduced to a point lower than shown in these figures. It was 22.16 per 1,000 for England and Wales at the commencement of the reign, and it is to-day better than 19.0 per 1,000, while in Her Majesty's army and navy the diminution of mortality apart from deaths from warfare has proved even more remarkable, and in India, where we used to lose 69 per 1,000 yearly, this has been reduced to 16 per 1,000."

HYGIENIC SELF-DEFENSE.*

BY THE REV. RABBI VOORSANGER, SAN FRANCISCO, CAL.

Last summer's agitation by the Board of Health of our city has resulted in an appropriation in favor of that department that exceeds the previous year's appropriation by $30,000. The Board of Health doubtless feels that with this additional money it can judiciously introduce certain reforms, which in the interest of public health are sorely needed.

We shall not inquire whether the generosity of our city fathers was the outcome of their convictions, or the result of public pressure by sensible tax-payers, who insist on this wise and necessary expenditure. We thank the Board of Supervisors. We give their compliance with the members' wishes our public commendation, and we venture to express the hope that our venerable Aldermen may hereafter always understand the wisdom of liberal appropriations for objects that appeal to the good sense of the public, without the interference of public meetings or long-footed petitions.

Just this much by way of prelude or introduction. The public health is a proper subject for public discussion. It is more important than politics. The campaign for gold or the election of a President fades into insignificance before this pregnant subject. Health, sanitation, hygiene are subjects we may hope some day to be deemed as important as the three R's in the curriculum of public education. The secret of public health is the knowledge of every individual to take proper care of himself, who not only desires to live long, but it is his duty to prolong his life; after the commonwealth understands the means of attaining the prolongation of the life of the citizen, we may bow to a community that proceeds intelligently in the path of public duty, which must result in lasting happiness. We should avail ourselves of all intelligent means to live long. Without calling into play the dubious adage that selfpreservation is the first law of nature, we may discreetly say that self-defense is a private and public duty, and an expression of civil virtue. We have learned that a community may defend itself

*Lecture on October 16, 1896.

"Our Public and Private Enemies," at the Temple Emanu-El, San Francisco.