"THE BATTLE OF LIFE."

Star (Christchurch), Issue 5504, 3 March 1896, Page 4

"THE BATTLE OF LIFE."

As president of the Bection in public "health, Dr Springthorpe (of Melbourne) gave an address on Feb. 6 before the spneral body of the Medical Congress. After acknowledging the honour conferred upon him by appointment as president of ao important a section, the doctor spoke as follows : — In the difficult task of searching for a topic worthy your seotional attention, it seemed to me that I conld not altogether miss the mark if I attempted to focus on the camera for the hour that ceaseless, restless conflict in which we physicians play the double part of advisers as well as combatants. For we live in an era when •something much more than examining patientß and concocting prescriptions is expected from professed healers. We niuat lie, above all, skilled in knowledge of the causes of diseases, and both wise and ready in their removal. a physician's view of THE BATTLE OE" LIFE -will, therefore, furnish the subjeot matter •of my address. Whatever our Bohool of thought, few, if any of us, are likely at the present day to forget the material side of phenomena. Yet in generalising about them it is easy to fail to give due prominence to the great fact that they are all fundamentally inter-connected, differing at bottom only in arrangement, not Mnd, •gradually evolved from the one common . source, and governed by the some physical law of the ceaseless flux of atoms^ with eternal conservation, if transformation of •energy. Existing always, so . far as we' know them in connection with certain phases of this same matter, living things in their turn have their material basis, which brings them, too, under the same inherent influence. But they introduce into the problem that new factor, " life," the exact understanding of which baffles modern science as well aa medieval speculation. For Spencer's celebrated definition, " the continuous adjustment of internal to external relations," explains mode, not origin. Nor liave the dualists the field so entirely to tnemselveß as some imagine. The unvaried association of life with matter is a fact that must be accounted for, and though man cannot perform the miracle any more than he can transmute atoms into gold or laser metal, it is yet possible that through phases many and unproduceable the material may in the end proceed to the vital, and life have an ultimate material origin. There are, indeed; those who hope some such solution of the problem, when organic chemistry performs its anticipated task of the synthesis of the albuminoids. Whatever be the ultimate truth, Darwinism has formulated for us the second grand generalisation of the final unity of origin of all the myriad phases of living things, differences in form being due to •onlikenesses in their lives, carried on in onlike environments. Here again, be it remembered, the description is one of manner, not of origin. There is nothing, in my opinion, to prevent this continuous readjustment being the mode in which •design eleoted to proceed. Whether this "be so or not, however, all living phases come under the same general law of CONSTANT STRUGGLE FOR EXISTENCE, with final survival of , the fittest, which, ' indeed, bears a suggestive resemblance to that which underlies all operations of matter. Thus upon both material and vital Bides (if they can be ultimately dissociated) all living things are inextricably , ■•■:'' lound together both in origin and develop__erit,and old asj-rology did but reduce a - scientific truth a„ absurdumwhen it linked human fate with stellar change. The ceaseless atomic flux -and constant' Vital .struggle thus necessitated constitute "the battle of life." By virtue of his position ■man takes his place at the head of the conflict, ahd in his fresh endowments of conscious mentality and free moral sense finds new elements of discord. For him, therefore, above all, life must be a battle - — a battle in which, as we know, success means health, and defeat brings with it "onnecessary 'disease or premature death. As in ordinary warfare, other things being ■equal, the battle is won by the bestselected, best-trained soldiery, so in the battle of life, the issue depends primarily upon heredity and development. The foetus starts with its possibilities conditioned by the potentialities of the sperm and germ cells, each large enough to contain and probably made up of ' . thousands of molecular representatives of every pait of the parent organisms. There is no gift given the young life that can compare with that of HEALTHY PARENTAGE. Yet by. thousands of thousands the in"herited momentum continues towards weakness, and Punch's question " Why ever did you two marry, why didn't you .give a fellow a fair show?" embodies one of the regrets of science as well as one of the jokes of the season. And the sacrilege will continue until the public at large come to know and appreciate its significance. again, represents the progress of inherent activities in response to •environment. For all living things there ia a cycle of growth, development, decay and death, of which inherited possibilities arei the radius and environment the circumference. We are thus brought face to face with the important questions of food, drink, exercise, rest, occupation, and the like, which are as much the essentials to healthy development as they are the common places of physiology. As Solis Cohen puts it, to be well-built the organism must obtain sufficiency of proper material to keep current expenditure within the bounds of re-accumulation, and not impede the conversion of potential energy. into __neti_. Want of requirements, excess of expenditure, depression of activities, how-' ever produced, must tend to a constitutional weakness that is I-ATAL TO THE ' REPRODUCTION OF STRONG CELLS,. and unable to resist the wear and tear of existence, much less withstand external oppression. It is undeniable that in other animals this development is generally well carried out in reliance simply on instinct, "but it will not be denied that in man so many artificial conditions are introduced that some intelligent guidance becomes frequently a necessity. Specially is this the «case with the sexual appetite, and instinct is second only to that of self-preser-vation in importance and scope. ; And yet, though civilisation has accelerated its incidence and delayed its appropriate •satisfaction, the disastrous silence of those qualified to speak leaves in-

m mmmaa^^Kmmm^^aammmmaammmaaammmamaa-m-ma numerable individuals either to become slaves where they might have been masters, or to fall into the meshes of quackery of the grossest kind. I have already taken advantage of two presidential occasions to emphasise this delicate question, and once again I venture to ask the profession to sow broadcast the explanations that carry knowledge, even though they do not of themselves promise complete control. Ignorant or regardless of the vital importance of the foregoing considerations, it is only -when, in the presence of the foe that most individuals even njow think of the battle of life, and enter upon the conflict with a force raised anyw_._re and trained anyhow. The battle, itself ; we now find, has to be waged man against man, inari against other forms of life, and man against himself. THE DOMAIN OF *_Hl*i STRIFE _ of man with man is too well recognised to delay us long. There is no escape frj>m the law of the struggle for existence. Spinoza reminds us that the big fish -wpre created to .swallow the little fish, and the incessan. border warfare of savage tribes shows how well man fulfils his destiny. The civilised followß the same law, though in different manner. Society, to quote again from Spinoza, is simply an organisation of the little fishes to protect themselves, and the strife continues between individuals, classes and races. Agaiiißt such natural law the decrees of statecraft and the educated selfishness of cooperation are but partial and temporary expedients, and, fortunately perhaps, the physician is called in simply to help the .fighter to fight better; whilst in the "battle of the clubs "—the struggle -for practice!— he himself experiences its keenness. Will competition, then, never be restrained except by self interest ? Not perhaps from the material and vital sides, but surely by the development and spread of those higher considerations which some think- are foreign to those lower relationships and depend entirely upon man's peculiar moral endowment. Man's conflict with other forms of life, however^is a subject more pertinent to the physician. As we have seen, the great law of the struggle for existence rules not only individuals bnt species, genera, classes and kingdoms. For his sport, use, or food, man preys upon the lower animals, and, wherever practicable, the latter returns the compliment. In PARASITICISM we find an even closer inter-dependence and strife, each harbouring at its own risk certain organisms which may infect the other — they may be air, food, or drink. It would ' surprise many who have hot carefully studied the question to find how numerous and important are the diseases thus produced, and how large the number of human beings thus affected. For the present, putting on one side the question of germ diseases, man acts as the host of eight protozoans, fifty-one helminths, and twenty-one arthropods. There are reasons, more or less strong, for associating cancer with protozoan invasion. The common round worm, the guinea worm, the anchylostoma, and the megastoma are all found in the intestines of other animals as well as man, and are undoubtedly interchanged from'one to the other. In the different tapeworms, the beef tapeworm, the pork tapeworm, and the hydatid we have alterations of form and effect with the difference of habitat, the mature forms inhabiting the intestine, and the larval condition being assumed in the internal organs. The trichina, again, which is the real • cause of many epidemics, variously described 1 as poisoning, rheumatics, typfcoid 5 typhusyarid formerly as black death and English sweat, exists in man in both developed and undeveloped states, whilst the hog is its peculiar and original host. The disease thus produced is both extensive in amount and varied in manifestation, and though some of the forms at least are well recognised, there is often NEED .OF SPECIAL INQUIRY. . as to their possible presence in ail obscure cases of nervous or intestinal disorder attended with anasmia and emaciation. Besides this interchange of parasites, ahd to a large extent owing thereto, man has. found the lower animals of incalculable use for protection against the still subtler " germ diseases." It would be difficult, for example, to adequately assess the value of the calf in such a safeguard as we have in properly performed vaccination. What, again, could exceed the value of the rabbit against hydrophobia, of the horse in the preparation of diphtheria anti-toxin, of the dog for tetanus anti-toxin, of the monkey in brain localisation, and of the guinea-pig in the settlement of many bacteriological problems of the utmost importance. Vivisection, indeed, is justified by its results, even were sacrifice not the law of life, and killing for food, help, or sport unknown. We are now face, to face with that part of the battle which it has been THE DISTINCTIVE GLORY OF MODERN SCIENCE to have discovered, and to some extent already to regulate. Not unnaturally, perhaps, it has become too much the custom to regard all microbes as injurious, forgetful of the fact that there is another side to these activities, as is exemplified in their being Nature's scavengers, and earth's fertilisers, bakers of man's bread, brewers of his beer, makers of his vinegar and flaVourers of his wine, butter and cheese. Indeed, without the presence of friendly germs in his intestinal' flora, his food would not be peptonized, and ih the midst of plenty he would starve. Another common error is the supposition that the invasion of the germ necessitates the production of the disease. This is no doubt true in certain cases, such as anthrax and certain pyococci, but it is generaßy the constitutional state rather than the presence of the germ which determines the extent of infection, the issue of the fight. Hence, while doing all that is possible to prevent invasion and even ATTEMPTING TO KILL .THE GERM so far as is possible without injuring the combatant tissues, it is still more important to fortify the outposts by promoting the healthy condition of the mucous membranes and bathing them in* healthy secretions, and to build up the naturaL resisting power of the organism as a whole. And as the resisting power varies, so also does the virulence of the germ, both towards aggravation and towards attenuation. Nor is the struggle simply between man ' and germ ; it rages equally between germ and germ, and mixed infection is by no means uncommon. As Sander Brunton graphically reminds s: "Even amongst these minute organisms the struggle for existence and the survival of the fittest exists. When two microbes are growing together one may choke or destroy the other, just as weeds in a garden may choke the flowers. On the other hand, successive generations of the microbe may render the soil unsuitable for another, just as decaying alga* and mosses may furnish mould in which higher

I— _—-— —« ' - plants can grow. The struggle takes place also between the disease germs and the cells of the. organism which they have invaded. This has been beautifully shown by Metschinkoff in the Daphne, ,where the process of the cells EATING UP THE MICROBES, or the microbes destroying the cells, can be actually observed under the microscope. It is impossible to see one part of a microbe half -digested whilst the part outside remains unaltered, without believing that this process of phagocytosis iaone of great importance. At the same time, it bears about the same relationship to the total struggle that a bayonet charge bears to a modern battle. The main part of the fight is really carried on at some distance by deadly weapons, by bullets in the case of the soldier, and by ferments, poisonous albumoses, and alkaloids on the part of the cells, and microbes." Even this description by a master hand is not altogether complete. It says nothing of the immunity that may be artificially built up for a limited period by various manipulations of the germs themselves, and of the anti-toxines which the system throws out in its hour of peril, which, strength for strength, are the exact chemical antidotes to the toxines, and the recent application of which in various disorders has been the crowning therapeutic triumph of the century. We are thus prepared for the perhaps surprising fact that it takes two factors — germ and susceptible organism — to produce the disease, and that the germ alone may be present in mucous membranes, tissues, air, •food, or drink without any necessary appearance of the disease. Oh the contrary, there cannot be disease in the absence of the germ. THE LIST OF DISEABES thus produced is a long and weighty one. It would include tubercular disease, typhoid, diphtheria, cholera, measles, influenza, scarlet fever, whooping cough, small-pox, ague, pneumonia, erysipelas, puerpural fever, ophthalmia, septicemia, leprosy.with probably hydrophobia, syphilis, and rheumatism. The bacteriologist is thus an essential assistant to the physician, and the help of the skilled veterinary surgeon cannot be overlooked without serious danger to the public health. Is there, then, any prospect of the sanitary millennium, when infections disease shall be no more ? We must first have dealt satisfactorily with all disease germs without, we must be able to control entrances and exits, or we must have become able to confer , RACIAL IMMUNITY. Then, and not till then, will the plague be stayed. Even now we have by no means 'surveyed the whole battlefield. Man is something more than a harmonious entity, needing only healthy ancestry, sound development and natural resisting powers, scientifically fortified. His organism is more Complex than the continent of Africa, with its myriad inhabitants, manifold interests and- internal rivalries.' A single blood cell (of which there are five millions in every cubic millimetre) may contain some half a billion molecules in constant process of building up and breaking down, and in ceaseless interchange with their fellows of the fixed cells, the body heat being' the measure of the amount of / barter. Internal derangement, as .well as external irritation, may at any time rise to A MOLECULAR CORROBOREE, that may degenerate into an actual battle, wherein fever represents the heat of the struggle, pain the prayer of the nerves for succour, and discomfort or disease the outcome of the local engagement. . How large a. share of the minor conflicts of life is thus originated is well-known to us all. 'Again, just as the three parties to the United Kingdom were long at open variance, and even now are by no means always in accord, so the three strands which unite to form, the human kingdom often disagree among themselves. The physicial may, and frequently does, make war upon the mental, the mental upsets the physical ; both re-act upon the moral, and the moral throws all into confusion. The internal battles which accompany hysteria, hypochohdriaisis, insanity and ill-balanced temperaments, and which produce dissatisfied athletes, mental cranks and moral faddists, who shall describe ? It is impossible to pass over in silence that portion of the battle which is waged in the very heart of the nature — the spiritual conflict. It seems to me at anyrate more reasonable to assume that in ultimate ontology the material and the vital are but expressions of the spiritual rather than that the spiritual is their efflorescence, and that in man the spiritual endowment is a something superadded from without, rather than a phase gradually evolved from without. ' And just as in these latter, days we have arrived at the grand generalisation of ultimate identity of all the divers phases of matter, and also of life, so we are now able logically to proceed to the still grander generalisation of the ultimate identity of afl forms of spirit in the External Supreme Spirit, of whom man's special endowment is but A PARTICULAR UNDEVELOPED PORTION, with power of development, need of environment, and manifold forms of expression. Whatever, however, be its origin, we still find that it has inter-relationships with the material and the vital, so that there are material causes for spiritual unrest and material factors in spiritual well-being. In addition, whether from the external introduction of what is known as "evil," or, as appears to me more probable, from conscious misuse of the inherent power of choice, and, the necessity of development, struggle aihd effort are the necessary concomitants of spiritual life, and are found naturally to vary in amount in different individuals. In time the struggle spreads outside the individual, and, under the form of persecution or forcible* proselytism, invades the already troubled nature of others. From the importance of the issues involved, the nature of the factors concerned,, this battleground is necessarily the greatest of all. Its discussion and regulation however, are so generally outside the province of the physician that I shall be readily excused from pursuing this portion of my subject further. Still we will all do well to remember its materal inter-relationship, and find therein a frequent reason for wise interference ; and fortunate, and often trebly useful, must be they who either have the gift or, by personal experience have won themselves the "right upon this highest plane of all to attempt that readjustment which means . health. One caution, however, upon this INTERNAL STRIFE as a whole. We should never forget the danger of sanctioning or attempting to produce a fictitious harmony by the use of one or other of the various stimula-sedatives. The apparent satisfaction is so great and so easily obtained. But it is not thus that

sound re-adjustment is scoured or that broken laws are avenged. Such paUiatwes must ever rank secondary to the endeavour to satisfy the requirements in a natural manner, and to bring the individual mto accord with a satisfactory environment. Administered in place of such an attempt, the end is bound to be physiological bankruptcy; and abuse is widespread because the fool's paradise so obtained is so much more easily acquired than the slow regainment which follows sustained effort. Such is the battlefield in which we are called to. take part ourselves, and also to assist others. The important practical point is how assistance can be best given. Perhaps the answer can best be found m considering the question from the standpoints of the public, the physician, and the State. Since the fight is one of conscious, responsible beings, capable in themselves of independent action, and acting largely according to their extent of knowledge, the spread of sanitary inf ormation is of simply incalculable importance.—! [. Hear, hear.) Ignorance is without doubt the mother of an untold amount of PREVENTIBLE DISEASE. Such portions, therefore, of the sanitary domain as are matters of individual action should be made matters of primary education, and be included in the curriculum of study by every boy and girl. (Applause.) How much longer shall such be taught the heights of mountains of no importance to them, and parts of speech that are dead but unfortunately not buried— (laughter)— and yet be left in ignorance of the importance of heredity, the requirements of sound development, the dangers to health and hew to avoid them, and similar everyday health factors? (Hear, hear.) It is a great gratification to me that I have been in Victoria associated with the introduction of such teaching, into the State school— (applause)— and college curricula and its certification, in case of . competency, by authorities such as the local health society ; and if I have stated my case in a way that carries conviction I venture to hope that one outcome of this Congress may be the inclusion by your educational authorities of similar teaching amongst the subjects of study in your primary and secondary schools. (Applause.) In addition, the creation of a sanitary atmosphere that will surround individuals and permeate^ households is a matter of scarcely less importance. To this end the initiation and combined activity of suoh bodies of earnest and trained sanitarians as constitute HEALTH SOCIETIES, the St John Ambulance Association, sanitary associations, and the like, become hygienic duties and privileges. The tracts, wall sheets, publications, lectures, examinations, certificates, and exhibitions— such as concern our Australian Health Society I have pleasure in introducing to your esteemed notice — cannot but be productive of a great amount of good. And I venture to commend such for the public enlightenment to all those who' are in a position to help. For the good does not stop short with individual strengthening, and it is only by the spread of such knowledge amongst the masses that municipal authorities become alive to the sanitary problem/and sound progress is made by laws which are no longer too much in 'advance of public understanding. With this spread of sanitary knowledge there is needed also a widening of the sphere of the physician's influence, for extended professional performance must^accompany the broadening of public conception. THE PHYSICIAN'S USEFULNESS must necessarily extend, far beyond the remedial treatment of the sick. It will be more arid more recognised /that he is the trained servant of Naiture, able to do more preventively than curatively, and more valuable by his advice than his drugs. It is true that a section of the profession already act upon this conception of their duty, but it is no less true that they form the exception rather than the rule, and that their efforts are still liable to be misunderstood or unappreciated. . Yet the conception of the physician who can point out shortcomings, of inheritance, defects in development, mistakes in environment, and avenues of danger is after all the correct one. It would be difficult to over-estimate the gain to health if the public generally were educated up to the level of expecting, and the profession of imparting, wise advice upon these and* kindred matters. As one example only of many, take the great question of tubercular disease, the disease so wide in its range that Playfair suggests the possible extinction of the human race. __om an inquiry extending over several years, and now embracing several hundreds of cases, I am able to report that only a nominal percentage of those who have come under my notice had ever received any instructions whatever as to the necessity of DESTROYING THE IN-ECTIVENESS OF THE' ' . SPUTUM, and thus prevent the disease from spreading to those in contact with the patient. And I know, unfortunately, of a large number of instances in which, after neglect in this essential precaution, one or more previously healthy members of the family fell victims to. the disease. Again, how many children suffering frorii intestinal disorders are still allowed to drink unfiltered water and unboiled milk? How many sufferers from rheumatism are never told to wear wool next the skin? How many cases of neuralgia never know .they would be cured by change of residence ? The list might be indefinitely prolonged. Only by the inclusion of hygiene amongst the subjects of professional examination, and the progressive recognition of the doctrine that preventive medicine is superior to all else, will the profession generally fit itself for this extension of duties. It is satisfactory to : note that , progress is. being made along both these lines, tinder the complex conditions of modern -civilisation,, however, even the best combination of individual knowledge and professional advice finds itself utterly unable to cope with the dangers that are constantly arising, and A STATE DEPARTMENT OF HEALTH becomes as essential as a State department of police, marines, and soldiers.—(Applause.) Everywhere, this is now more or less recognised, and the only points in dispute are the manner and limitations of this State regulation. There are those who. find the best settlement of the problem in the comple nationalisation and even internationafisation of health, and certainly the tendency for some time to come must be in the direction of enlarging and strengthen^ ing the part taken by the State in these . directions. But whether they wUI ever proceed, or even deserve to proceed, in AngloSaxon communities to the extent of entirely superseding the present voluntary system of disease regulation may well be doubted, and forms part of that still greater question of communism versus individualism, which, fortunately perhaps, does not call to us for settlement. Leaving, however, the problems of the position of the private practitioner, the growth of clubs and dis-. pensaries; and the great sea of hospital relief to be dealt with as seems best by progressive development and THE SURVIVAL OF THE FITTEST, there are still the great public questions of the registration and notification of disease,! adulteration of food and drink, nuisances, surface conservancy, drainage, nightsoil, house construction, infant life protection, and regulation of industries which imperatively demand State control.— (Applause.) And since Salus populi supremo, lex, it is not too much to say that the State which neglects to deal officially with these matters fails to perform one of its fundamental protective duties. — (Applause.) To my mind the proper attitude to take up was well exemplified

at the International Sanitary Exhibition just closed at Paris. In proposing the health of the President of the Republic, the Dean of the Faculty of Medicine referred to faulty sanitation as a public danger, and urged the passing of a Public Health Act. The president of the Cabinet Council, in reply, held that it was the duty of the State to say to sanitarians : " Show us what to do and we will do it." And as an instance of a great community now prepared to act upon such expert advice, I can refer you to the proposed BANITART REFORMS IN INDIA, which seem destined to create a new era in sanitation in that vast and densely populated peninsula. At the Indian Medical Congress held at Calcutta in January, 1895, in an exceptionally able paper entitled " The Medical Profession in India, its Position and its "Work," Mr Ernest Hart laid down the outlines of a scheme for the reorganisation of the sanitary services in India. Supported by the local authority, Dr Simpson, the health officer of Calcutta, a resolution in their favour was unanimously passed by the Congress, and presented to the Secretary for Home Affairs of the Indian Government, and the speedy and welcome result is the announcement that the Government is prepared to deal with the question along the lines suggested. The lines themselves are so admirable that they will bear transplanting even to Australia. In the first place, there j were to be local sanitary departments, each under a special sub-committee of the looal municipal council, and with a medical president and SPECIAL LOCAL SUBSIDY FOR SANITARY WORK ONLY, with, .in addition, a health officer, an engineer, and sanitary staff as .required, their duties being conserVancy, . water supply, building regulations, drainage, registration of births and deaths, vaccina,tion, stamping out of infectious disease.; and informing provincial authority by weekly reports as to the prevalence of cholera, smallpox, or other dangerous disease. Above these local sanitary organisations are placed provincial sanitary departments for the different great provinces, which, when a federated Australasia comes, might aptly represent the different colonies. These are to be provided each, with a sanitary commissioner, an assistant sanitary commissioner, a sanitary engineer, and a president (who is to be a high Civil Service official), travelling agents (such as sanitary inspectors, veterinary surgeons), scientific agents, trained professors and assistants in the Government laboratory for bacteriological, chemical, agricultural work, &c, and general sanitary investigations requiring laboratory facilities. The duties of these provincial departments are to institute special investigations at any | particular spot on any particular subject ; to make by-laws and amend sanitary laws ; to j INVESTIGATE DIBEASES ! of men, animals, and plants; to analyse water, &c. At the head of all comes the Imperial Sanitary Department, consisting of a sanitary and an assistant sanitary commissioner, a medical statist, a veterinary commissioner, a sanitary engineer, and a Minister of Health as President, with a seat in the Viceroy's Council. The department is provided with a laboratory, with trained experts. Its duties are to advise the Council and Viceroy on all important health matters; the collection and publication . of information upon epidemic diseases, both within and without; the right of asking -the Provincial Governments what, they propose to do and have done in checking or inquiring into diseases affecting man, animals or plants in their provinces; the arranging that all administration reports be drawn up on a uniform plan for ready reference ; the acquiring of aE information regarding the movements of emigrants, coolies, &c, and advising and requiring the Provincial Governments to take proper precautions, the consideration of new sanitary laws, &c. The whole scheme constitutes such A SPLENDID AND IMPOSING EDIFICE for the proper State regulation and prevention of disease that it seems to me that this Congress would do well to bring the conception ih its completeness and suggestiveness under . the notice of our colonial Governments and, through them, under the notice of our Federal Council. — (Applause.) It is scarcely becoming that. Australasia should lag behind India in a matter of this individual and national importance. Here must end, however, my imperfect Bketch of life's battle and its waging. Enough, however, has been said to show that the part that may be taken by our profession in the extension of knowledge, THE CREATION OF A SANITARY ATMOSPHERE, the imparting of specific advice, and administrative or scientific work, is a noble and inspiring one. And amidst all the drawbacks and -disappointments which at times press so heavily upon us, it is more than probable that with Sir James Paget we can claim for our calling from amongst all the sciences " the most complete and constant union of those three qualities which have the greatest charm for pure and active minds— novelty, utility and charity"; and that we can compete with the world, not where wealth is the highest evidence of success, but "in the nobler ambition of being counted among the learned and the good, who strive to make the future better and happier than the past." Thus it is granted us by our labours to promote the gradual approach of that sanitary millennium when heredity shall be counter-balanced, development progress harmoniously, external attack cease from troubling, and internal disquiet be at rest ; until, in the fulness of time, there shall be left only that last enemy whose name is Death. Then, were man only the perfection of the vital, the coping stone of the material, naught, 'tis true, would remain but the redistribution of atoms, THE REINCARNATION OF THE VITAL, and the oblivion of personality. But such negation neither scientific leader nor scientific laureate finds himself compelled to accept. On Huxley's tomb is deeply graven the trust that survives a true agnosticism, and from Tennyson's grave still breathes the century's crowning message of hope and faith. (Loud and prolonged applause). _____________