ignorance, vice or virtue, which impinge in their influence upon the cells of the organism. It is difficult to conceive of any force acting upon some cells without acting upon all. If environment acts upon all, then all must meet force with force, and because of this struggle undergo change, that is attain acquired tendencies, which new tendencies, being in the reproductive cells, as well as in the others must be transmitted.

So in this paper we ally ourselves with those who hold that acquired tendencies can be inherited. A very vital premise, as will be seen, for to deny this is to assume that all progress must come only by the slow process of natural selection.

Assuming then that each multicellular organism contains elements which will reproduce a like organism, and that these organisms are constantly subject to forces imping. ing upon them, that we call environment, which forces demanding new functions, will produce new tendencies, we will see what conclusion we can draw.

Does "like produce like?" Not in a reality. No two parents are alike. They both belong to genus homo. They differ greatly in tendency. Their child is unlike the one, and like the other, or is unlike both.

In heredity we cannot consider only the immediate parents, for the child may be physically, mentally and morally unlike both parents, but the counterpart of a grandparent. Or may take some qualities from one grandparent, others from a parent and possess still others which arise away back of either. When we recognize this we are brought against the stupendous fact that our inheritance is the gathered tendencies which have developed through all the forebears, who stretch back through all the millenia of man's existence.

Our heredity is complex. We have two parents, four grandparents. They each in turn were born of two, until by retrogression we find our ancestors coexistent with the hu

man race.

If like produces like, how can we recognize people when recognition depends upon their differences? How does it come that one black sheep will be produced in a carefully herded flock of white ones? Or seemingly common stock produce a fast trotter, or black eye parents, born of others with black eyes produce a blue eye child.

Α woman may from childhood carry through the cells of her body the distinctly male characteristics of her father, such as his beard and his masculine form, and bestow them upon her male offspring. These are apparent contradictions of heredity, but we must remember that the law of variation is coexistent with the law of heredity. These

variations are but expressions of inherited tendencies which have been latent through many generations. The dark sheep, the fast horse, the blue eye have all come from dark sheep, fast horses, or forebears with blue eyes. who have passed their tendencies on in former generations, but which tendencies have been overcome by prepotency.

The individual will inherit tendencies common to all mankind, because he has arisen from this genus of organized beings. These give him his form, his organs, his brain. He will likewise inherit the variations which are characteristic of his immediate progenitors, which will make him resemble them in feature, color, gait, habit, character or mind. These variations may be small and insignificant, or they may be so large as to produce monstrosities. They may amount to only a mannerism of walk or the length of a nose, or they may be such malformations as cleft palate, hare lip, club feet, or idiocy.

But

Variation does not occur so much where a people or a nation live all under the same environment. For the reason: where the surrounding forces are the same all the cells are acted upon by, and react to, these forces until an equilibrium is established. let these forces be diversified. They then act with different power upon the different organisms. The force being varied the reaction is not the same, and after a time the cells must undergo change in accordance with this difference. The result is a variation in function which shows in individuals. The effort to meet and overcome the forces of environment producing the strong, its opposite the weak individual.

Absolute freedom, under law, of individual action in meeting the conditions of environment is the only safety of civilization.

A

To maintain equilibrium by continuing the same environment is to stop progress. field of flowers growing wild, and year after year, subjected to exactly the same forces will show very little variation; change them into a garden, water them, fertilize their soil, protect them from extremes, in fact change their environment, and they will soon react to this change. In attempting to regain a new equi librium they will show marked variations.

Primitive or uncivilized people live under a common environment. All individuals are subject to about the same conditions of life. They find an equilibrium between the reaction of their cells and the action of their environment and progress ceases or is very slow. But put this people under a new environment, they will either succumb to the effort necessary to meet the new forces, or variations will arise which after a time produce a changed people.

80.

The foregoing may look as though environment superseded the law of heredity. Not "You may break, you may shatter the vase if you will, but the scent of the rose will cling round it still." Your wild rose, transplanted to your conservatory, will produce nothing but a rose, varied by its environment, but still a rose holding to its inherited tendency to return to its original condition of single petals.

A savage may through the centuries become a poet, but it is a man at both ends of the line.

Nations are only relatively superior and inferior, and so possibly with races, but when races of men of different qualities unite it generally destroys the finer qualities of the better one. The common and deep abhorrence of miscegenation of the races is based upon the knowledge of this fact.

Nor can this loss be made good. You can not raise figs from thistles even if it were possible to graft a fig upon a thistle.

Darwin says animals inhabiting wild and mountainous countries cannot be permanently modified by our improved breeds.

These facts are applicable to individuals as well as to races and breeds. "Evil communications tend tc corrupt good manners. With man as well as all life ex omnia ovum. But all eggs are not alike. A child is developed from the union of two microscopic parent cells. These cells after their union divide and subdivide in a most wonderful manner forming the various tissues. Each cell of the new being contains a portion of the initial cell of each parent. The forces of each portion may be not equally divided. In some the mother predominates; in some the father. There is a common mistaken belief among the laity that intrauterine life, the blood of the mother enters the child. The only part of the mother in the child is the single cell from which it develops after fertilization. That fertilized cell of male and female elements contains within its microscopic self all the initial energy for the production of blood, bone, hair, teeth, skin and every tissue. That energy starts the wonderful division and differentiation which in a few months results in the perfect miniature.

Would that women might comprehend more of the beauty of that miracle, which in cold terms is called embryology. Only

a portion, however, of the germ plasm furnished by the parents is utilized in the formation of the body, the remainder is stored up in that body as germ plasm capable of reproducing its kind. Thus man has produced man from earliest history, and will continue to produce nothing else. Having then within us the accumulated tendencies

of our parents, grandparents and forebears indefinite, is it any wonder that we have such composite characters? Good impulses struggling against bad; kindness against cruelty; selfishness following close on the heels of generosity, or love calming the high waves on a sea of hate. These impulses are not transmitted equally. Here some lie dormant, or are so overcome by accumulated opposite tendencies that they are apparently destroyed.

In the diversity of our parentage lies the admixture of tendencies which goes to make for our character. To constantly transmit the same tendencies means to come near an equilibrium; that is, to rest, to lack of progress and finally degeneration. This fact is recognized in the laws of many states forbidding the marriage of cousins. Cousins who marry have fewer ancestors back of them than those who are not consanguineous. Their parents having a common parentage may have taken from those parents similar constitutions, or they may have not. Similar organisms do not produce as fertile nor as stable offspring as dissimilar ones. If cousins are unlike in constitution, tastes and tendencies they may bear children who do. not lack in fertility or vigor. If both, in common phrase, "take after the same side of the house," their offspring, if any, is liable to be sterile, weak, or even degenerate.

The well known tendency in many royal families to degeneracy, is due to their close intermarriage. Instead of their boasted long line of ancestors they really have a shorter one than their subjects. Stock-breeders know that what is called inbreeding gives a weakened and unstable product.

Now let us see into what an apparent contradiction our argument has led us. We have our tendencies accumulated through inheritance from a long line of progenitors. In fact we all have a common heritage. Why then does it make a difference if this common heritage, that is, the accumulated total of all previous tendencies is transmitted through two grandparents as in cousins, or through four grandparents in non-consanguineous marriages. It would make no difference if each ancestor handed down this heritage of accumulated tendencies just as he received. them. But he cannot.

Each one lives in an environment which has an effect upon him. All force must pro. duce reaction; consequently each one's heritage is altered and what he transmits is his accumulated tendencies plus the influence on those tendencies of his environment. He or she increases or subordinates, either for good or ill those tendencies just in proportion as he or she reacts to his or her environment.

This personal element is what makes our responsibility. It is what takes away from heredity its apparent fatalism. To consider the subject now more specifically, what influence has heredity on the individual in his struggle for existence? Does it affect his physical body in form, size or perfection? his brain and mental powers and his moral qualities? In regard to his body the marked family resemblances of face, form, expression, color of hair, eyes, gait and peculiarities are too strong an evidence to be refuted. The mould and imprint of a grandfather's features on a new-born child have no other interpretation. Can abnormal physical conditions be transmitted? Not directly, but by tendency. Heredity, it must be always kept in mind is only transmission of tendencies.

I have presented at the clinic five brothers, all of whom had six fingers. Their mother was one of four six-fingered children in a family of seven. The grandmother had five fingers, but had a six-fingered brother. No further history could be obtained. If the abnormal physical condition was transmitted directly all would have been six-fingered. Some had missed the tendency.

The tendency to cleft palate, harelip, club feet, abnormally placed teeth, vitiligo and many physical abnormalities runs clearly through families.

Most inmates of our insane hospitals have a family history of different forms of nervous or mental disease and signs of degeneracy. Color-blindness, deafmutism, near or far-sight show in ancestry and posterity.

I merely cite these to show that the tendency to bodily infirmities may be transmitted, and not to prove that the lame, the halt and the blind come directly from such ancestry. You cannot keep too clearly in mind that heredity has to do alone with tendencies. A person with some organic or functional disease of the nervous system may unite with one of phlegmatic temperament and with no tendency to a nervous condition. The stable condition of the one may, by its prepotency, overcome the tendency of the other and a healthy being result. But if that instability or lack of resistance be augmented by union with another of the same tendency the offspring may develop an increased abnormality along the same line, and may be an inferior degenerate, idiotic, epileptic or insane, or be a superior degenerate, as are many artists, poets and musicians.

A drunkard may bear children defective in many other ways than simply a tendency to dipsomania. They will often bear other stigmata of degeneracy. Or on the other hand, through the influence of a good mother the children may inherit those qualities which

make for good. The same conditions hold true in the hereditary tendency to tuberculosis, rheumatism, cancer and a long list of dis

eases.

The prepotency of either parent may give to the child a cell of low or high resisting power. Many life insurance companies will not accept a risk when both parents have. been tuberculous, but will accept him if one parent only has been affected, and the applicant is over thirty-five and healthy.

Why is it that parents can bear one imbecile or one of tuberculous tendencies, or other defective organism in a large family of healthy children? It is because the accumulation of inherited tendencies is not equally bestowed by the parents upon the different members of the family. If they were all children in each family would be alike, for health or vital resistance against the detrimental forces in our environment which we call disease.

Let us consider for a moment why these tendencies are not equally bestowed. There are several reasons: but particularly the parents, either one or both undergo changes themselves for good or ill, for health or disease, for refinement or degeneracy. Have immorality and crime any relation to heredity? "As a man thinketh in his heart, so is he." Our real character is a reflection of our thoughts. No one can for long, keep from his face or unconscious actions the reflection of selfish, base and evil thoughts. God will bring every act into judgment and every secret thing, whether it be good or whether it be evil. What we are going to eventually be we are rapidly becoming through the action of our mind. No one can doubt the effect of emotions, either sudden or prolonged, upon cellular structure. We cannot conceive of part of the cells being affected without all, including reproductive cells.

Criminal statistics show that children born in the older years of criminal parents, have a stronger tendency to crime than the ones born in their younger years. In a large state reformatory report, among the boys who were classed as having absolutely no suscepti bility to moral influences 86% were born of parents of criminal tendencies who were 35 years and over at the time of the boy's birth. This suggests that as the tendencies of mind, which lead to crime, become more fixed they are more readily transmitted. The offspring has inherited moral qualities which either tend him direct to crime, or provide him with less resistance to temptation.

So too with the offspring of parents who yield themselves to baseness, sensuality and venality. Many acquired diseases can be con

veyed directly through the parental body to their offspring.

In most diseases the tendency alone exists, but some whose results on the physical the physical economy are most disastrous can be conveyed direct. These are what we as medical men always have in mind when we speak of hereditary diseases.

What we need to realize more is that a parent with a definite disease or an indefinite, complex of nervous symptoms, or a system debased by degenerating moral life may give birth to a child with no direct reflection of the parent's condition, but just as surely marked with a devitalizing tendency. The rheumatic bears a choreic child, the sensualist an idiot, the hysteric brings out one of feeble resistance; all having a constitution of diseased weakened vitality to in turn convey its weakness to its own.

But now all the accumulated tendencies growing in our lives, with the current sweeping one tendency close to the surface or deeper down, with some latent and some apparent, what can be hoped for as a means to elevate mankind? What can be done to promote a body with a better vital resistance. It is mainly in the manner in which each individual responds to his environment. A recent author advocates as a remedy, "the surest, the simplest, the kindest, the most humane means for preventing reproduction among those we deem unworthy of this high privilege is a gentle, painless death, administered not as a punishment, but as an expression of enlightened pity for the victims and as a duty toward the community." This is impracticable, unwise and inhuman. All of us in the end

strike a balance for good or evil. With most of us it is almost a balance. We cannot positively forecast the future of any individual. Notwithstanding statistics and almhouse reports, or prison and asylum records we cannot say where latent tendencies may spring forth from among evil that will work for good.

If through education and environment an individual is made to understand his responsibility and the necessity to meet and overcome the evil forces within or about him, or to elevate those forces that make for strength, he will do his little to correct the condition. Too much cannot be taught concerning the possibility of inherited tendency. Men and women should more fully understand that the physical, mental and moral condition of their grandchildren begins with them. Cupid, it is true, is blind, but if a portion of the openeyed wisdom which stock men display in the production of horses, cattle and even dogs was applied to the selection of parents and to the conception and production of children so

ciety would sooner find that "the sun browned world a man would breed."

"Blood will tell," but if good blood which has been accumulating the tendencies of enlightened physical, mental and moral perfection for generations is mixed with that with the stigmata of degeneracy, it is difficult to forecast which blood will tell.

Procreation is an individual act. Its result will depend upon the fight each individual makes against his tendencies and upon his own effort to provide a home and social and civil environment which will gradually make for the betterment of tendencies which have been and will continue to be transmitted to that vast army of posterity which will be climbing "up on the world's great altar stairs which slope through darkness up to God."

PUBLIC HEALTH.*

D. C. BROCKMAN, M. D.

OTTUMWA, IA.

THE chief source of revenue of the State is the products of labcr. Anything that reduces the ability to labor is a menace to the welfare of the state, in that it reduces the income or earning capacity of the people. health is the chief hindrance to labor, hence is the most serious menace to the material

prosperity of the human race.

Ill

Each of the above propositions is axiomatic; so is the statement that public health is the most important subject from an economic standpoint, to be considered by the people.

The loss of time, labor or earning capacity by preventable diseases and death, is appalling to the student of economics.

By preventable diseases we mean the conlosis, typhoid, scarlet fever and other fevers, tagious and infectious diseases, as tubercudiphtheria, smallpox, cholera and all forms These diseases are of epidemic diseases.

all preventable, and are the result of carelessness-yes, criminal carelessness on the part of some one.

If it were not for this group of diseases, the average human life would be greatly increased. These diseases are being prevented, and must continue in the future to a greater degree, be prevented by the medical profession, through the agency of sanitary science, and in this way public health conserved.

Through the influence of sanitary science the longevity of the human race has been

Public address delivered before the second annual meeting of the physicians of the First Councillor District of Iowa at Fairfield, Ĩa., January 26, 1606.

increased in a little over a century, from 23 to about 45 years.

The terrible epidemics of plague-cholera, smallpox and typhus fever, that formerly carried off over two-fifths of the race, are now almost unknown in civilized lands. Diph theria has been robbed of its terror, the "great white plague" is being besieged by thousands of zealous warriors, and must soon surrender.

Thus, one after another of the death dealing diseases are being rendered hors de combat, but there is much work to be done yet. As our able essayists have shown you tuberculosis must yet be overcome. Pure food must replace the sophisticated stuff we now consume, and a thousand other abuses must be corrected before we can lay down our arms and say the victory is won.

Heretofore our dangers have been mostly with foreign foes, but from this on we must look more to the enemy within the citadel. Not only the criminal venality that is to be seen every where-the spirit that disregard the right or even the lives of other, when by sacrificing them money can be made by the ccmmercial pirates that infect every corner of our civilization, but we must as well ever watch the traitors who lose no opportunity to retard the work being done by sanitary science, as instanced by one judge in our enlightened state who really ruled that vaccination was not efficacious against smallpox, or when we remember that recently, a chief justice of North Carolina place upon record a discussion in which he regards the regular medical profession as a conscious less, selfseeking class of men, whose sole purpose in securing legislation that requires applicants for license to practice the healing art, to show themselves possessed of some knowledge of the fundamental principles of disease, anatomy, physiology, etc., was corrupt and venal, and breathed only the coarse spirit of commercialism and trades unionism.

The asininity of such so-called jurists can only be accounted for by assuming that they are either under the influence of some Mephisto-Judas who promises to perform miraculous cures with "new remedies and methods not known to the regular medicine doctors," or else are suffering from a transient attack of that form of insanity that is ever trying to prove "that which is, is not," that material does not exist, etc.

Science has ever had to meet and refute these senseless, lopsided demigogues, and probably always will.

When we consider what has been done for humanity by sanitary science, that they themselves enjoy freedom from these epidemics through this agency alone, it seems

strange that with stupidity far greater than that exhibited by the meek, long-eared animal they imitate, that they still stand up and butt their head against such a wall of truth. Charity impells me to attribute their folly to ignorance, and that, the only hopes for them, is through the enlightening influence of such public meetings as this, where they may become aware of the stupendous work that is being done by our noble profession to prevent and cure disease.

While there are score of subjects that need to be discussed before the people on such occasions as this, I feel that we cannot strike a better blow for public health, than to show the people some of the dangers of what a recent writer terms "The Great American Fraud," and the resulting vicious, dangerous habit of daily drugging that has taken possession of so many Americans; a habit that is causing more deaths, more mental and physical disease, public ill-health, than almost any disease you can name. In fact, if you will exclude tuberculosis and the social diseases, you cannot name any two, or even three diseases that cause as much evil as does this reckless, senseless, constant dosing.

Would that we had more editors as fearless, as courageous, with the good of humanity so much at heart, as have the editors of Collier's Weekly and the Ladies' Home Journal -the missionary work they are doing today in exposing the dangers and frauds in the manufacturing, the advertising and selling of these nostrums is far-reaching and doing immeasurable good.

The great trouble with the press today is, it is subsided by the nostrum venders. The gigantic trust stipulate with the publishers, with whom they contract for advertisements, that nothing shall be said by their paper against patent medicine, that if they allow any such thing to be published, it will nullify their contract; and since the trust pays the American press about $50,000,000 a year, we are not surprised that they are very silent about the injury done by these vicious compounds.

The American people pay annually over $100,000,000 for so-called patent medicines, less than one-tenth of which is expended in their manufacture; about $50,000,000 of which is paid for advertising, and the other $40,000,000 is profits to the sharks that make and sell them, we realize something of the magnitude of the business. But the monetary side is the least dangerous aspect of the fraud.

The damage is shown by the thousands of permanently injured digestive and nervous systems due to the baneful influence of the stuff. The more than thousands of opium, co