who are dear to us at home. I am not speaking of the kind father that may be lost to a young dependent family, of the loving mother that cares for them, of the dear child whose place can never be filled in our hearts or homes-I am speaking, mind you, of the mere sordid commercial value of the profession to the community, that is, its value to the community in hard cash-dollars and cents. Let me refer to this somewhat in detail.

It is only a few years since quarantine was one of the most horrible things we could imagine. To-day, practically, quarantine has been almost abolished by reason of the researches and work of the medical profession. We no longer fear cholera, the plague, or yellow fever, or even typhoid fever, as we once did, because we have exterminated the rat, we can quarantine or kill the mosquito, we have corralled the fly, and we are filtering and boiling our drinking water. By the most patient scientific laboratory work all these things have been shown to be needful and efficient as the chief means for the prevention of disease.

But a few years ago a single case of cholera or yellow fever down yonder Bay would have meant the loss of millions of dollars to your merchants; but to-day, as has been shown in your hospitals, cases of cholera, or yellow fever, or even of plague, that might and do occur, scarcely create a ripple of excitement because the community knows that your able medical men have these diseases by the throat. Dr. Reed and his fellow-workers in Cuba have accomplished an epochmaking work. For the first time in one hundred and seventy years Cuba has been made free and kept free from yellow fever, and the merchants of New Orleans, of Mobile, of Norfolk, and of New York are reaping the benefit of this unselfish labor in hard dollars on the credit side of their accounts.

The horrible character of the plague we scarcely appreciate. In the fourteenth century twenty-five millions of human beings lost their lives in Europe alone, and even to-day

among the ignorant people of India over two hundred thousand human beings a year are offered upon the altar of the plague. But we are beginning to see a brighter time. Haffkine's inoculations have diminished the susceptibility of the people by seventy-five per cent. and have diminished the mortality in equal proportions; and I believe that the time is coming when the plague, like yellow fever and small-pox, will be practically wiped out.

Again, we do not appreciate what small-pox was in the past. In the eighteenth century sixty millions of people died from small-pox in Europe alone, and in addition to that almost all the living were left with the ravages of the disease marked upon their persons. Before that memorable day when Jenner inoculated young Phipps, it was as uncommon in the streets of London to see a person not pock-marked, as it is to-day to walk down Broadway and see one who is pockmarked. In Russia alone, in the year of Jenner's splendid accomplishment (1796), two millions of people died from small-pox.

I said a moment ago that I would consider only the sordid commercial value of the labors of the profession to the public. Consider, therefore, what all these millions of saved lives mean in revenue to the State, in revenue to the family, in the prevention of pauperism, in the comfort of human beings: then we begin to appreciate in some degree the value of the services practically of one man, the most magnificent benefactor of the human race that ever lived, Edward Jenner.

In 1890 there were 156,638 unnecessary deaths in our large cities because of defective sanitation. For the ten years from 1886 to 1895 the average death-rate in New York was 25.18. The sanitary reform which followed that year saved in 1895, 3758 lives; in 1896, 7736; and in 1897, 9920-a total of 21,414 in three years. As there are an average of twenty-eight cases of sickness for every death, sanitary

reform in these three years prevented about 600,000 cases of sickness. And who were the chief of the reformers? You physicians. The millions, nay hundreds of millions, thus saved in the last fifty years in this city alone would enrich even the most avaricious of nations.

I need not tell an audience of doctors what has been done in diphtheria, but I may well refer to its results so that you may in turn remind others. It has been done in our day; and it has been done not as a result simply of constant and fruitless trials of various supposed means of cure; it is not simply the work of a shrewd doctor carefully observing symptoms and noting the effect of remedies: but it has been done by exact laboratory work by quiet men who have been working far away from the sick-room with not a single human patient under their care, men who are not practitioners of medicine, but pathologists and bacteriologists, experimenting on rabbits, guinea-pigs, and mice instead of on men and women, and especially dear little children; and thus working unobserved, unheralded, unseen, they have given to the human race a boon second almost to that of Jenner.

As was shown by the report of the Pædiatric Society not long ago, the mortality of diphtheria has fallen from 40 to 8.8 per cent. In the laryngeal cases, before the introduction of the serum treatment, the mortality was 73 per cent. and the recoveries 27 per cent. Since that time precisely the reverse has been the case; the mortality is now 27 per cent. and the recovery rate 73 per cent.!

And yet there are actually people who reject vaccination and try to prove that the serum treatment of diphtheria is of no use!

In the little town of Plymouth, Pennsylvania, a town of 8000 people, a few years ago on its outskirts occurred one case of typhoid fever, in winter, with snow on the ground. All the dejecta of that patient were thrown out upon the snow. When the warm springtime came and the rain fell, it washed

the poison from this patient into the reservoir which supplied the town of Plymouth with water. As a result, 1200 cases of typhoid developed-nearly one-sixth of the entire population-and the town was almost desolated. We have had a somewhat similar experience in another Pennsylvania town, at Butler, when the water-supply was contaminated; and you have seen in this State some of the flower of your young men cut off at Ithaca for the same reason. And all of this was preventable!

When the medical profession has shown you what can be done in the way of preventing typhoid fever, I ask you whether it is not of enormous commercial value to the public, to say not one word of its philanthropic value, in the saving of so many valuable lives?

In 1892, an epidemic of cholera broke out in the town of Hamburg; 18,000 people were smitten down with the disease and 7614 died. Lower down on the river Elbe, where the sewage of Hamburg was added to the other impurities of the river, in Altona, a town continuous with Hamburg, there were but 516 cases. Why? Because Altona had a thoroughly efficient filtration plant and Hamburg had not; yet the researches of the medical profession had shown that proper filtration of the water-supply filtered out all the germs of cholera. Which would have been the cheapest plan-to spend a few millions of dollars on a good filtration plant, or to smite its commerce with a blight for months, at a cost many fold that of the filtration plant? You note that I say nothing of human lives and human woes. The grim satire is completed when I add in addition to the immense cost to its commerce Hamburg had to build the filtration plant after all. I need not refer to any other than this one instance of a single disease to establish the value of the work done chiefly by the researches of the medical profession. The engineer, the architect, other professions, the public-spirited citizens who are in control of municipal affairs, deserve large credit, all of them; but,

after all, you gentlemen and your confrères in the medical profession are the backbone of this humanitarian progress.

Malaria was formerly thought to be the result of the decomposition of vegetable matter, and that it originated in low-lying swampy land. In Italy alone to-day more than half a million acres of land are entirely waste and desolate because of this dread, disabling disease. On the Adriatic Railway it cost the company one million francs per annum to take care of their sick, due to malaria; but now, thanks to the investigations of medical men, we know perfectly well that if you shut out the mosquito you shut out malaria as well as yellow fever. The warning will be heeded by this country when we dig the Panama Canal. Then, I have no doubt, you will see a splendid object lesson in sanitation, which will carry conviction to us all of the money value of medical research in the saving to the country, to you and to me, of millions of dollars and of thousands of lives.

Of tuberculosis I need scarcely speak, for we all, alas, know its ravages in our homes and hearts. We are on the verge of an equally beneficent improvement in its treatment. In Germany the cure of even ten per cent. of its victims, it is estimated, on a moderate money value of the daily labor of those who recover, will add two millions of dollars annually to the resources of the State. Are not such money results a generous percentage of income from a moderate endowment? And human lives and human happiness cannot be reckoned in dollars and cents.

In military hygiene and sanitation the money return is equally promising. In the British fleet in the West Indies in 1726-I am stealing from a recent address of one of your New York doctors, you see out of a force of 4750, 4000 died as a result of bad sanitation. On the West African cost the mortality was 69 per cent. Civil War 20 per cent. of the armies in spite of all the outcry that there was,

During our own were sick. But

partly just and