THE Health Commissioner of the metropolis, Dr. S. S. Goldwater, received a letter from "the president of a large manufacturing corporation, well known for its business efficiency and progressiveness," and which disclosed "an intelligent appreciation of the possible usefulness of the periodic physical examination of large groups of employees." This prescient president learned of three cases of tuberculosis among his 130 employees, which fact has led him to consider the question of requiring a physical examination of all his employees, an examination adequate to determine the general state of health of each, to protect those who are well against the risk of contagion to which they should not be exposed, and to guide him in helping those employees who are not in good health and who may require aid. With this humane object in view he wrote asking the Commissioner if there is any provision making for such inspections, either by the City or the State authorities, and, if so, how he might engage for them. He was answered that the Health Department of the City of New York is without funds for such work; but it "strongly urges employers, whenever possible, to institute such examinations for the benefit of their employees and with the latter's consent."

It is entirely possible for such examinations to be instituted. And when this wise president finds the way, as he certainly will,

No. XI

it will be shown him that at least twentyfive per cent. of his employees are sick men-that is if they are average workmen. And as everyone who is wise and humane is sure to benefit by these fine qualities, this president will by such examinations find the service rendered him by his employees enormously increased in economic ways.

In this relation we emphasize the work of the Life Extension Institute in New York City, which we considered in the number of THE GAZETTE of May last. This Institute is chiefly philanthropic, for although a very moderate fee is charged the income is chiefly expended for improving its service and extending it, so far as possible to all civilization. Its board of directors is made up of men whose lives have been dedicated to public welfare and others noted for business capacity of the highest order. ExPresident Taft stands at its head. General Gorgas is its Chief Sanitary Adviser. Professor Irving Fisher of Yale heads its Hygiene Reference Board. Such gentlemen as these serve without compensation in the "work of human salvage."

Efficiency is the business slogan of the twentieth century thus far-an inspiring slogan; none better, except one, as we shall

see.

And yet ideal efficiency is not going to come anywhere near realization if we do not understand that the human machine cannot be really efficient if its various parts

(its organs and tissues) are not sound, well adjusted to one another, properly fuelled (with wholesome meat and drink), not strained beyond its factors of safety, and running smoothly.

In fact any kind of efficiency that does. not call for human health, will never be anything but a spurious efficiency, economically disastrous.

So the efficiency slogan, to be effective, has got to be a kind of sub-title to the Life Conservation slogan, the greatest idea which twentieth century medicine has thus far evolved.

It is worse than useless, it is criminal ignorance, to expect ideal human efficiency in the face of such facts as the following: Every third or fourth among us had been dying, between fifteen and forty-five, life's economically most productive years, of tuberculosis. There are trades-stone-cutting, for example-in which eighty-five per cent. of the workers between twentyfive and thirty-four die of consumption.

There are hundreds of dangerous trades conducive to consumption. Volumes could be written-whole libraries, indeed, have been written on this phase alone of the

subject of economic inefficiency, I can only indicate here the waste-almost too great to be grasped by the mind-resulting from our sufferance of this entirely preventable disease.

One among eight of our women dies most cruelly of cancer, after dreadful sufferings through many months, several years; many such unhappy women have kept working until this physical impairment has made them give up their tasks. Apart from the human anguish here connoted, what an economic loss is this.

Of twenty thousand people who applied. for life insurance, imagining themselves in sufficiently good health to get policies, forty-three per cent. were found to have some kind of heart or kidney or artery ailment; and were either turned down abso lutely or were assessed higher premiums than ordinarily.

Six hundred and fifty thousand working people-and who among us is not a worker -die annually when they have no business dying, die long before their time, of preventable diseases.

Medical annals teem with such depressing facts.

AMONG the many things in modern civilization that tend to impair the human vision is improper illumination, natural or artificial.

Poor lighting is bad; at least equally bad is too intense light. Dr. Ellice M. Alger, of New York; reminds us that the human eye is but an expanded portion of the brain; also that vision is an exceptionally tender and complicated function. Any organ exercised well within its limits tends to increase in power and facility, whilst if overworked it becomes less and less fit for any work at all. A man habitually using his eyes in strong light decomposes his "visual purple" faster than it can be regenerated. Even normal, healthy eyes are strained by overuse especially under unfavorable con

ditions and in lowered health; and as most eyes are abnormal, or at least not normal, the individual has to cope with not only a bad environment and lowered health, but also his inherent optical defects. With the many modern methods of commercial lighting by gas and electricity the composition of light as well as of its intensity has become important for the ophthalmologist to consider. In the days of oil and candle. light the question was simply one of quantity, the quality being generally soft and benignant. But modern lighting, whether of gas or electric is often so intense as to be extremely fatiguing, and worse; these means of illumination also contain many more of the violet and ultra violet rays of the spectrum, which are useful in light