Sanitary Science. 
15V DR, J. R. BLACK, OF NEWARK, OHIO. Sanitary Science. 
BY DR. J. R. BLACK, OF NEWARK, OHIO. 
Man’s thoughts in his lowest mental state, move in a very 
limited circle. This circle thrown upon the widest sphere 
o'f thought of a day dwindles to a mere point—a point so 
small that astonishment might well be excited at the fact 
that intelligent beings can be content to think within it. 
From this small point man has advanced slowly upon the 
unknown, upon the wonders and mysteries above him, below 
him, and around him. Beyond his sphere of thought all is 
dark and dreadful; within it, thanks to the illuminating 
power of reason, there is light, more or less of it, to cheer 
and guide him. The illuminating power of the intellect does 
not move uniformly upon the ever widening circle of nature’s 
mysteries; some giant gifted minds throwing light far into 
the darkness which environ it on every side, save on the 
point of advance. A number of such minds uniting in 
projecting knowledge in some special direction carries it tar 
i” advance of the general circle, when owing to the correlations 
a..d dependencies that exist among all its branches, a further 
advance is impossible until the darkness which envelops it- 
to the right and left is dispelled. The light thrown in one 
direction upon the mysteries of natural phenomena, illumines 
collateral fields less or more, so that, while making search 
for the true explanation of one thing, another mystery in a 
related branch of knowledge for which no search was being 102 
Sanitary Science. 
made is unexpectedly made plain. Tlius it is that knowledge 
sought in some directions, is advanced by the force of genius, 
in others, it is advanced by light incidentally thrown upon it 
while seeking to understand another. In the latter category 
must we place Sanitary Science. Like medicine it has had 
no Galen or Harvey, like chemistry no Hay, like astronomy 
no Copernicus or Newton. No brilliant intellects have 
brought sanitary science abreast, far less to the advance of 
sister branches of knowledge: what little progress has been 
recently made being mainly due to light thrown upon it while 
cultivating branches to which it is related. Let any one 
read “Hufeland’s Art of Prolonging” life, written about a 
century ago, and he will be made aware how little real pro- 
gress has been made in knowledge of the ways and mean’s 
through which health is destroyed. Compare the information 
received to-day on chemistry, on physiology, on geology and 
on astronomy, with what it was a hundred years ago, and it 
will be at once apparent that school boys know more of these 
branches now, than scientific men did then ; yet on the subject 
of hygiene even the grey haired physician of to-day may 
read Hufeland with profit. 
A union of causes has served to keep this important branch 
of knowledge in such a state of backwardness. Foremost 
among them is the idea, long prevalent, of the enevitableness 
of the disease. It is assumed either that nature, or nature’s 
God is inimical to man’s healthy existence; and if one or 
the other is at war with our nature, knowledge will not avail 
us. If, for example, the processes of nature, or the wrath of 
the Deity every now and then send forth the agents of disease 
and death, I, with others, can see no more hope of the future 
than the past. But such a deadening fatalistic view, sub- 
versive as it is of all sense of responsibility for the evils 
which befall us, is fast passing away under the light of ex- 
perience and advancing knowledge. The history of the past 
exhibits the that knowledge of the causes of disease has Ohio State Medical Society. 
103 
progressed just as knowledge has in other branches of 
information. In this progression we may also discern an age 
corresponding to that of stone, of brass and ir6n; or more 
oppositely, according to the physical arrangement of Draper, 
an age of superstition, an age of faith, and an age of reason. 
The age of superstition as to the origin of disease prevailed 
everywhere in primitive times, and is continued to this day. 
among all savage peoples. They imagine all their disorders 
to come from some supernatural source, from evil spirits, evil 
eyes and from the anger of their gods. The Indian believes, 
disease to be the work of an evil spirit, the equatorial African, 
that every sick man is bewitched, and when he dies, that the 
one who bewitched him must be instantly put to death, else 
there would be no safety for any one in the tribe. 
Everywhere in ancient times, and at the present day 
among all barbarous nations the offices of priest and phy- 
sician are united. This union had its source in the belief of 
the spiritual origin of disease. The pagans in times of danger 
from pestilence consulted the oracles and frequented, with 
offerings, the temples of Esculapius and Hygeia. Indeed it 
is eminently fit that if diseases arise from spiritual wickedness 
or sin, the work of their alleviation or cure should be entrusted 
to those consecrated as guides in spiritual matters. It was 
not until the beginning of the seventeenth century that the 
supernatural era began to give way, and the populace of any 
nation could be persuaded to take any other than spiritual 
measures to avert the destructive sweep of epidemics. 
The sum of the precautions taken in London, whose 
squalidness and filth Erasmus and Macaulay so graphically 
depict, to guard against oft repeated visitations of the plague, 
was to isolate the houses of the stricken, putting a red cross 
on the doors, with the words, “Lord have mercy on us.” 
Up to that time as Ilenouard remarks, “pestilential epidemics 
had been generally regarded as a scourge from heaven, whose 
progress no human barrier could arrest, and no more efforts 104 
Sanitary Science. 
were made to preserve the people from its ravages than are 
made among Mussulmen.” 
To show that the same idea is yet extant, modified it is true 
by religious faith, it is only needful to refer to the petition of 
the clergy of England to the late Lord Palmerston to appoint, 
in view of a threatened visitation of Asiatic cholera, a day of 
fisting and prayer. This answer well embodies the existing 
state of sentiment upon this point in our ranks. “The best 
course,” said the Prime Minister, “which the people of this 
country can pursue to deserve that the further progress of the 
cholera should be stayed, will be to employ the interval that 
will elapse between the present time and the beginning of next 
spring in planning and executing measures by which those 
portions of their towns and cities which are inhabited by the 
poorest classes, and which, from the nature of things must 
most need purification and improvement, may be freed from 
those causes and sources of contagion, which if allowed to 
remain will probably breed pestilence and be fruitful in death, 
in spite of all the prayers and fastings of a united, but inactive 
people.” 
Every day observation serves to show that we can discover 
no relevancy in health and disease to righteousness and 
wickedness. A man is often seen pure in spirit and in deed, 
and yet a life-time victim to terrible disease : another, vicious 
and wicked, and yet a perfect marvel of health and strength. 
Yet it is quite obvious that while the bulk of mankind believe 
diseases to be sent by a power whose ways are past finding 
out, will it subvert the idea of personal responsibility for 
their productions ; and hence, of faith in the means of avoiding 
them. Every proposition looking to the abrogation of disease 
will thus be regarded as an impossible or impractible scheme, 
and many of the claims of sanitary science will be treated 
with an indifference, or with disdain. 
The age of taith in etiology may be said to have originated 
with Hippocrates. To him is due the honor of separating for Ohio State Medical Society. 
105 
ever the healing art from the ecclesiastical function ; and of 
showing that the source of disease is not supernatural but 
natural. He believed and taught that diseases arise from the 
rotations of the seasons, from regimen and temperament 
producing a ripening of the humors; and that the cause of 
epidemics was to be found in special constitutions of the 
atmosphere. Sydenham and Stohl believed in this secret 
epidemic constitution, and very many medical men of to-day 
yet have faith in its existence. Of course so long as this 
notion prevails will there be skepticism justly, as to man’s 
power to prevent, or exterminate pestilences. 
In no small degree does this view of nature’s responsibility 
for disease, or that there is such a thing as an epidemic 
atmospheric condition also serve to keep sanitary science in 
the background. 
If there really is, what so many virtually claim, an unfitness 
in our natural surroundings to sustain life in a healthful 
manner, the hope of our ever being made free from so much 
disease must indeed be dim. We can not hope in coming 
time to be able to remove the asperities of climate, the 
fluctuations of heat and moisture, the perturbations of elec- 
tricity, the processes of growth and decay, and the rotations 
of the seasons. If these are the prime agencies which serve 
to make the earth an unfit habitation to sustain life in man 
in a healthy manner, then indeed is he doomed to wallow 
in the old substratum of evil. But, on the other hand, it 
the lack of adaptation to our natural surroundings arises from 
a weakening of the body by the infringement of organic 
laws, whereby the external forces gain an ascendancy over 
us which they do not normally possess, then may the hope 
that our race may be relieved from the grasp of disease, be 
warmly cherished. We have only to live accordantly with 
the laws of our being, or, in other words, give the force of 
life in usagood chance, when it will rise superior to disturbing 
causes from without. T might, had I time, enlarge on this 106 
Sanitary Science. 
point, and show, by what seems the most incontrovertible 
evidence, that this constitutes the era of reason in etiology 
and furnishes the true explanation of the apparent unfitness 
of human life to the conditions amid which it isplaced; man 
so impairing and depressing vital action that it is at the mercy 
of conditions perfectly normal. But I have already been too 
long at the threshold of my subject. 
Sanitary science, or the regulations designed to secure 
health, are conveniently divisible into ten rules or laws. 
These laws, it is thought, embrace all the uses man is justified 
in making of himself, as well as the scope of his relations 
to nature, in a sanitary point of view. The exposition of 
each law must be necessarily brief, and far from containing 
all its etiological applications; a labor not required when 
addressing those habituated to reflection on the subject of 
disease. 'Still, it is sometimes needful to jostle imperfect and 
unsatisfactory modes of thinkingsomewhat roughly, especially 
when they have become smoothly and deeply grooved by the 
wear of centuries, else there can be no progress. It is a 
peculiarity of great age to be distrustful of recent improve- 
ments, calling them new fangled devices which seem to bode 
more of evil than of good, or more of error than of truth. 
It is needful that while we are commonly deemed, and perhaps 
justly, the most conservative representative of the healing 
art, that our conservatism should not degenerate into bigotry, 
nor into an undue reverence for the past, but hold fast only 
to that which is indubitably true, and hold lightly to that 
which is uncertain, or merely traditionary, ever ready to 
welcome truth and light whether coming from the obscure 
or the eminent in our profession. 
The first law to which I ask your attention is, breathing a 
pure air. Twenty-five thousand nine hundred and twenty 
times every twenty-four hours does the human chest expand 
and contract so as to draw air into the lungs and throw it out 
again. What goes, or was designated to go into the lungs Ohio State Medical Society. 
107 
is vitalizing, what goes out is life destroying. The mere fact 
of air being expelled once from 'the lungs is prima facie 
evidence of its unfitness again to inspire. Expired air is not 
only richer than ordinary air in carbonic acid, but it contains 
the animal rinsings from six hundred millions of air cells, 
exceedingly destructive to warm blooded life. 
Pure air is the natural food of the lungs, for they consume 
a part of it just as much as the stomach does bread—and 
they need fresh food, not three times a day, but more than 
twenty-five thousand times a day. So essential is this food 
for the lungs, and the motions of the thorax in getting it, to 
life, that the suspension of one or the other for five minutes 
is equivalent to death. An instant contact of the inspired 
air with the air cells so weakens and pollutes it that it is 
driven out as unfit any longer to sustain life, and this, more 
than a thousand times an hour. To show that expired air is 
poisonous, it is only needful to put a mouse in a small air 
tight bottle, when soon the terrible mode of dying which 
destroyed 14G men in a single night in the Black Calcutta 
hole, will be seen. Under natural circumstances inspired air 
is therefore the breath of life, expired air the breath of 
death. 
According to Prof. Parkes a man needs every hour 2,000 
cubic feet of new air. How does, or how was it designed 
that he should get this ? Let us see. Have you ever thought 
of the wonderful mobility of the atmosphere. Its great and 
leading law is motion. It either moves with the swiftness of 
a hurricane, or so gently that you can only detect it by the 
movements of hazy dust, illuminated in shadow by a sun- 
beam. It sweeps away the foulness generated on our streets 
and court-yards a thousand times a day ; it carries off, and 
diffuses your breath of death into illimitable space : to be 
reconverted by the action of the sun upon the cells of 
vegetables into the breath of life. A very important and 
beneficent purpose is thus subserved by this law of never 108 
Sanitary Science. 
ending motion ; preserving man and beast from being envel- 
oped in a halo of foul excretions always emanating from lungs 
and skin. Yet man has done, and is to-day doing his utmost 
to set this law at defiance. He builds himself houses, tight 
of joint, thick of wall, and as impervious to outside air as it 
is possible to make them. His object is to box up tight a 
few hundred cubic feet of air and live in it, the night and 
sometimes the day through. A leaky window frame or door 
crevice is an imperfection and must be remedied. Anything 
like a current of purity from without, anything like air 
motion in a house is a woman’s abomination. 
In this motionless air, men, women and children, immure 
themselves, often from morn till eve, and deem themselves 
and those they hold dear, fortunate in having the privilege 
of breathing and rcbreathing this breath of death the entire 
night. Take the stupefaction of the olfactory nerve away by 
a walk in the pure crisp air of the morning, and then reenter 
the room where you have slept and waked, and its foulness 
will almost stagger endurance. 
Indeed it is a prime object everywhere and among all 
classes of people, in houses private and public, in school-rooms, 
halls, churches, railroad coaches, to imprison a little air—heat 
it—and live in it. Little wonder that under such a system 
man should be sickly—little wonder that with the lungs half 
starved three fourths of the time, they should go into a decline, 
and perish by consumption. As physicians we are very 
careful that the stomach shall have an abundance of good 
pure food, but wholly overlook the needs of half starved 
lungs. We too often forget that every molecule of matter in 
the blood must have its molecule of oxygen, else it becomes 
not only useless but pernicious. 
Children suffer more than adults by lung starvation. In 
proportion to their size they exhale more of the deleterious 
compounds, absorb more oxygen, and breathe from three to 
five thousand times oftener than adults in a twenty-four hour Ohio State Medical Society. 
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period. Hence they suffer more quickly and acutely from 
lung starvation, and perish in immense numbers by convul- 
sions, tubercular-meningitis, scarlet fever and cholera 
infantum. 
The late Dr. Meredith Reese devoted much time to 
investigating the causes of infant mortality in cities; and the 
conclusion at which he arrived was that the rate furnished a 
true measure of air impurity in any given locality. 
For the preservation of health the requirements of this 
law are imperative, just as imperative as that the air now 
momentarily in contact with the air cells of your lungs should 
be ejected, because deprived of some of its life giving pro- 
perties, and charged with some that are death giving. To 
live and breathe in an air which is pure, its natural movements 
must not be arrested. To this end there must be ventilation ; 
or a current of air in some definite direction. The mere 
agitation of that boxed up within impervious walls is not 
ventilation any more than the upward and downward motion 
of water in a stagnant pool by unequal heating, is not a 
current. Ventilation means running air, just as a brook 
means running water. 
The foolish fear of air currents, with the body properly 
protected, is the worst possible for health. With the blood 
pure and strong, no one can take colds : with it impure and 
weak, no degree of care can prevent them; not even a hot 
house uniformity of temperature. And how can any one 
have pure blood by breathing impure air, how can the blood 
be warm and lively without oxygen, or clean and sweet unless 
the 600 million of cells in the lungs are washed out every 
instant with pure air? The lower animals when left to 
themselves always get pure—they do not rebreathe breathed 
air, and they scarcely, if ever, have colds or consumption. 
Rut subject them to human restraints, keep them in close 
houses, and stagnant air, and their colds and diseases become 
wonderfully like our own. 110 
Sanitary Science. 
Some author lias quaintly remarked that when men live in 
reed houses, they are as of oak, when they live in oak houses 
they are as of reed. 
The idea of strength being gotten only through eating and 
drinking has become an overshadowing one. While the 
stomach of invalids is whipped up with stimulants and 
tonics, and loaded with the richest elements the earth affords, 
the needs of half starved lungs are wholly neglected. Such 
persons are usually kept closely in some boxed up stagnant 
air, not only necessarily impure but thin and weak by expan- 
sion. Putting the hand by the inside opening of the key 
hole in any ordinary constructed room makes one sensible 
that air is rushing in from without as if it had been exhausted 
by an air pump from within, near to the point of a vacuum. 
It is also seen that the air in the rooms of invalids is being 
eaten up and contaminated by gas lights, and that deadly 
carbonic oxide gas is exuding from the surface of a red hot 
furnace. The vitalizing influence of sunlight is also carefully 
excluded, and yet surprise is expressed that so much wine, 
iron and food does not ripen into strong red blood and firm 
toned muscle. 
One thing more in regard to the air of houses in midwinter. 
As a rule it is kept far too warm ; the difference between 
the temperature in a house and out of it, is far too great. 
Said an invalid to me not long since—I must leave this 
country—the climate is too changeable—I can not stand it. 
You may think so, was my reply, but you yourself create 
changes of climate which in suddenness and severity exceed 
all of nature’s a hundred fold. How is that ? On the inside 
of your house is the climate of the African desert, dry, hot 
and stifling, on the outside, that of Greenland, damp, cold 
and biting ; and you pass from one to the other a dozen or 
more times every day in an instant of time. With proper 
ventilation in houses there would not be the climate of Cuba 
one moment and that of Canada the next, the proper course Ohio State Medical Society. 
111 
for comfort and health being to clothe the body more, and 
warm houses less. 
In these ways art not only serves to render air impure in 
houses, but it does much to affect the same out of them. 
Especially is this true of towns and cities. Upon a small 
area immense quantities of organic matter are collected, 
which in greater part must sooner or later pass into a state 
of offensive decomposition. With eyes and ears closed, and 
nostrils open, the homes of some families may be told by their 
odor; and no less is the same sense able to distinguish the 
air of a city from that of the country. The sense of smell 
by the way is not simply as some seem to think an organ for 
pleasure, or the reverse, but it is the outpost sentinel of danger 
to the lungs and blood: In delicacy and availability for 
sanitary purposes it is far superior to all chemical reagents. 
There has been much written about the malaria of the 
country, though for one, I have never been able to find much 
evidence of the mal, or bad air about it, but a great deal of 
the mal about the air of towns and cities. We all mind it 
most “when the wind don’t blowfor then nature’s great 
foul air scavenger is at rest. Decaying organic matter lines 
the streets, lies in heaps in alleys and court-yards, fills open 
vaults in the form of ordure, and pollutes the water of every 
gutter. Mingled with the effluvia from all these sources, is 
the foul air from thousands of chimneys, the foreign gases 
engendered in manufacturing, and the whiffs of abominable 
air from filthy abodes. Were it not for the wind which 
sweeps our streets by its almost uninterrupted motion, and 
the law of the diffusion of gases into each other, the malaria 
of cities would blast and wither life like a simoon. 
With houses built so as to be swept by the wind on every 
side, lofty chimneys, wide and scrupulously clean streets and 
court-yards, the most improved sewerage, the removal of 
manufacturing from the vicinage of human abodes; in other 
words, with the sources of impure air on the outside of houses 112 
Sanitary Science. 
corrected, and with pure air secured by thorough ventilation 
in every occupied room day and night, not only would the 
causes of colds, coughs and many fevers be destroyed, but 
the chief cause of the most fatal disease of civilized life, 
pulmonary consumption, would also be destroyed—a disease 
I unhesitatingly affirm arising in ninety per cent of cases by 
depriving the lungs and blood of that upon which they feed, 
and of which nature is so provident—an abundance of good 
pure air. 
The second sanitary law to which I invite your attention 
is 
ADEQUATE AND WHOLESOME FOOD AND DRINK. 
If it should be asked whether mankind think more ot 
living to eat than eating to live, the answer must be in 
favor of the former. Were it the object to eat in order to 
live, we would have little to do in the way of dyspepsia, and 
not many would be seen to die prematurely because ot 
grossly abused digestive organs. 
In this favored land ninety-nine die of over feeding, 
where one does from under feeding. Many of you, like my- 
self, have never seen a case of disease and death arising 
from underfeeding, but have seen hundreds from over feed- 
ing and worn out digestive organs. 
Numerous are the arts to induce over eating. The most 
tempting products of nature are collected from every quarter 
of the globe, subjected, when possible, to some process which 
will render them yet more tempting, and placed on our 
tables in this order: the plainest and least savory first, the 
richest and most savory last. As soon as the appetite begins 
to pall upon the first course, a second, a third, a fourth, and 
even a fifth are appointed to succeed it, each more and more 
tempting so as to provoke and renew desire. In this way 
the sense of satiation is deceived and outwitted, and far 
more food partaken than if such arts had not been resorted Ohio State Medical Society. 
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to. The results are that far more nutriment is taken into the 
blood than there is use for; the energies of the stomach, 
overstrained, soon fail, begetting dyspepsia and derange- 
ments of the liver and bowels. All the organs engaged in 
so much taking in and giving out of aliments being put to 
it day and night, are overworked, and become liable to 
torturing derangements, death beginning its work- in and 
through them. To any one who thus overworks his digestive 
and excretory organs, never was better and pithier advice 
given than that of Abernethy to a rich and dyspeptic noble- 
man, “to earn a shilling a day and live on it.” There seems 
to me good ground for the opinion that an undue importance 
is attached to nurturing the body through the stomach. There 
is scarcely a medical writer who, when treating upon the 
diseases of the poor does not refer to deficient alimentation 
as a most prolific cause. Because they are deprived of many 
of the luxuries of the rich, a hasty sympathetic judgment is 
apt to conclude that that must be a cause of their illness. 
But what are the evidences of underfed bodies? Are not 
lean and stunted physiques the most patient ? And are not 
their opposites, or large and stout bodies accepted as conclusive 
of sufficient nourishment when the horse or the ox is seen in 
such state? Look at the physiques of the poor, foreign as 
well as domestic, and as a rule, are they not larger and 
stronger than those of the rich? It is on account of other 
habits and surroundings that the health of the poor is often 
destroyed. The air they breathe is commonly very impure— 
their clothing insufficient, their habits irregular, vile and 
dissolute, 
Relative inadequacy of food is more commonly a cause of 
disease, as, in a too great sameness in viands from meal to 
to meal and day to day. The lack of fresh vegetables all 
know generates scurvy, and with children the lack of earthy 
phospates, disease of the bones. 
Considering the uses made of aliments by the animal 114 
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economy they may be divided into the carbonaceous and 
nitrogeneous, or the heat and tissue making foods. The 
inhabitantsof the arctic regions require a large preponderance 
of the carbonaceous, and those of the tropical regions a large 
preponderance of the nitrogeneous. Capt. Hall resided for 
several years among the Esquimaux, and during the entire 
time had excellent health, which he attributed to eating raw 
blubber after the style of the natives, and sipping oil in lieu 
of tea or coffee. On the other hand in tropical regions rice, 
fresh vegetables, lean beef and acid fruits are what the natives 
subsist upon ; and are besides, what experience has shown best 
conduces to the health of those who migrate to the torrid 
from the temperate zones. 
Now, we of the temperate zone have some polar and some 
tropical experiences each year; which, upon the theory of 
the uses to which foods are put in the body must require 
unequal portions of the carbonaceous and nitrogeneous. Is 
this fact recognized and acted upon in its sanitary bearings? 
Do we eat in winter more of the carbonaceous and less of the 
nitrogeneous than in summer ? I opine the custom and habit 
rule the conduct in this matter flu* more than craving or 
science. So long as this is the case will there be so much of 
what is called billiousness, and the necessity each spring for 
carthartics to thin the dark and rich blood of winter, and thus 
prepare it for the season of fervid heat. 
In reference to the wholesomeness of foods I shall no 
doubt be considered at variance with prevailing views. 
During the vernal season immature vegetables so far from 
being injurious are really necessary and wholesome. Observe 
how nature prepares the animal kind for the heats of summer. 
Then their nourishment is weak, laxative and watery, just 
as, on the other hand, in autumn, it is rich, strong and 
fattening. But man thinks he knows better, and must eat 
as much bacon, lard, butter, etc., in spring and summer as Ohio State Medical Society. 
115 
in winter, despite all the unheeded cravings—the mute 
appeals of nature, for something immature, green or sour. 
Then again, wholesomeness and palatability are too often 
confounded. If some article of food is well cooked it is 
wholesome, if ill cooked, unwholesome. Now, the true 
purpose of cooking is to commence the process of digestion, 
coagulating the albumen, transforming starch into dextrine 
and rendering food granules more tender and susceptible to 
a speedy action of the gastric juice. Undue refinements, by 
grinding, sifting, boiling, clarifying and condensing—though 
they may render food more palatable, increase the labor of 
digestion—the process of reducing fruits by prolonged boiling 
with sugax-, to preserves, or into marmalades or butters, ren- 
ders them very savory, and serves to make them keep well 
out of the stomach, as well as to keep well in it. A certain de- 
gree of naturalness in food is" essential to proper alimentation 
and to easy and quick digestion. Take in illustration our art- 
fid mode of managing the wheat kernel. The grinding is well 
enough, it saves labor for the jaws and teeth, but to separate 
the ingredients into a fine and palatable part, and into a 
coarser and more unpalatable part,—the latter to be rejected 
and thrown before swine, is at least to say, that the most 
perfect form of food for man is after all very imperfect. But 
experience has shown nature’s wisdom and man’s ignorance, 
for by rejecting the outer shell with its layer of phosphates 
three important objects which contribute to the welfare of 
the body are lost. 1st. For easy and quick digestion a certain 
degree of coarseness in foods is essential. Flour, of an 
impalpable fineness can not readily be penetrated by the gastric 
juice. The pharmaceutist is aware that in extracting the 
medical virtues of substances by alcohol—one of the most 
penetrating of liquids—fine powdering impedes, instead of 
facilitates the process. So it is with foods made any finer 
than what the molars are capable of effecting. 2d. By casting 
aside the branny covering with its shell of phosphates, the 116 
Sanitary Science. 
growing bones of the young, anti the brain, hair and skin are 
often deprived of adequate nourishment, producing disease 
or deformity in some form. When reason or custom thus 
misleads, an underlying instinct sometimes directs, as in the 
invincible desire now and then seen among the young to eat 
lime or clay. 3d. By separating all the coarse bran from 
the fine flour,—the residuum after digestion is so small and 
compact that the bowel does not receive its needful stimulus, 
and so becomes torpid in its excretions, and sugglish in its 
movements. Costiveness, headaches, and piles arc the com- 
mon results. The habitual use of Graham biscuit, brown 
bread, or cracked wheat, has according to my observation 
done more for habitual constipation than all the vaunted 
remedies of the materia medica. 
In no one thing is the difference between civilization and 
barbarism more marked than in the management of foods. 
The barbarian takes his meat and drink very much as it is 
prepared for him by nature ; the man of culture as modified 
in a thousand ways by art. And this art is commonly 
directed to a single o'ject: the ministration to the sense of 
deliciousness. The object at our tables is not so much to eat 
what will meet the needs of the body, but what will give 
the greatest amount of piquant enjoyment, thus caring more 
for the means than the end. Not a little of our civilization 
is thus pure sensualism, or practical epicurianism, theoretically 
detested and denied. The consequences are that we are 
almost a nation of dyspeptics; while our savage neighbors 
either too ignorantor indolent to seek after our keen palatine 
pleasures, or content with nature’s delicacies, hardly know 
what indigestion is. In body and limb they are splendid 
examples of physical development, they need not, as we do 
annually, millions of gallons of bitters for the stomach, and 
an army of dentists to keep their teeth in order. 
No one with a bad digestion can long preserve good teeth. 
A furred tongue, and bad taste each morning, are sure Ohio State Medical Society. 
117 
indications of depraved secretion and nutrition in the mouth ; 
and is it to be expected that teeth nurtured amid disease, 
and bathed with unhealthy secretions can long retain their 
beauty and life? 
The sanitary rule of drinks is a simple one—pure water. 
How to obtain this are more questions of will and engineering 
skill than of hygienic import. A popular fallacy, one that 
even prevails to some extent in medical ranks, is that because 
the drinking of impure water seldom produces immediate 
disease that it is not therefore very harmful. A like notion 
prevails by the way, in reference to breathing impure air, 
eating unwholesome food, the use of tobacco and moderate 
indulgence in ardent spirits. Some do one or the others for 
years, and yet have no serious illness. But the same may be 
said of opium and arsenic eating, or in fact of any deleterious 
habit. The gourmand, the masturbator, the tight lacer, the 
sedentary, the one with brain or body overworked, and the 
most uncleanly person may live so for years without active 
disease; though this by no means proves that no harm is 
resulting, or will result. 
When disease shall appear depends upon the intensity of the 
cause and the resisting power of the constitution. An intense 
application of any of these causes no one can long resist, but 
the strong longer than the weak. In this everything depends 
upon inheritance ; if a strong constitution like a rich patri- 
mony is inherited, reckless dissipation will bring about, only 
more slowly the bankrupt condition. The poor in constitution, 
like the poor in purse, become bankrupt in a year or two ; the 
rich in constitution or purse can run much longer. But reach, 
a time all such certainly will, when there will be no more to 
spend, and for the rest of their days they will lament their' 
folly, and eat in barren repentance the bitter fruits they have 
sown. The young and vigorous in answer to remonstrances 
about imprudent eating or drinking gaily say such things do 118 
Sanitary Science. 
not hurt them. Wait and see. In a few years when they 
ought to be in their prime, what do we behold but poor, 
pallid, lank, complaining, miserable wrecks, and yet dissipa- 
tion did them no harm! They realize the force of the old 
adage “that every man is either a fool or a physician at forty 
and become wise only when it is too late to save. 
It may be laid down as a law, that infringements not 
punished at one end of life are sure to be at the other. The 
organs most abused are the ones through which disease and 
death enter the body ; and the history of a man’s life may 
be usually read through his mode of dying. 
As medical men the bearings of stimulating drinks upon 
health need more definite settlement. The moderate use of 
such beverages, it is alleged by not a few authorities is not 
inimical so health. And the diligence with which some 
apologize for their use, or seek after some important object 
they are capable of accomplishing in the animal economy, 
leads one to suspect that they arc not unbiased in their judgment 
by the gustatory sense. 
It is claimed for spirituous drinks that they serve to arrest 
retrograde metamorphosis, but in health cui bono ! Is not 
cell metamorphosis the ultimate process we are able to 
perceive, upon which life itself depends. Arrest cell change, 
and death results, make it a little slower or faster than the 
physiological standard and disease ensues. What then is 
the advantage save under exceptional circumstances of inter- 
fering with it with alcohol. If it is an efficient and economical 
retarder of waste in the body, surely the farmer ought to 
avail himself of it in fattening his stock. But it has been 
experimentally determined that after the influence of alcohol 
upon cell change passes off metamorphosis is just as much 
accelerated as it was previously retarded. Where then is the 
gain, and what good can arise by interfering in this way with 
physiological change ? 
The opinion once entertained that alcohol furnishes fuel Ohio State Medical Society. 
119 
for the heat making process in the body, has been shown to 
be erroneous. It is expelled from the body as alcohol, its 
elements unused and unuseable. The glow of heat which 
succeeds imbibition is not, as the thermometer has demon- 
strated, due to an increase of temperature, but is probably 
produced by the benumbing, tingling quality of the alcoholic 
poison upon the nerves. As Dr. Parks remarks the testimony 
of arctic explorers is singularly unanimous that alcohol nota- 
bly diminishes the power of the body to endure intense cold. 
The testimony of British army surgeons—among whom 1 
may mention Inspector General Sir John Hall—and of 
Americrn surgeons, to be found in the Sanitary Memoirs of 
the rebellion, are against the use of spirits by the soldiers as 
a health promoting measure. Indeed it is difficult to 
understand upon what principle or law the health of the 
healthy can be preserved by imbibing a poison. Its use when 
there is disorder, or the elements of death at work in the 
system is another matter. 
That alcohol is a poison there can be no well grounded 
doubt. The degeneration of tissue to which it gives rise, the 
hob nail liver, and the tremor with delirium are sufficient 
evidences. There would be no difficulty in gaining assent to 
this, were the primary effects of alcoholic drinks not so agree- 
able. Even the secondary effects, the nausea, vomiting and 
headache so commonly following inebriation, would be deemed 
sufficient evidence of poisoning had they arisen from drinking 
some particular kind of water, or some not very agreeable 
substance. 
An erroneous notion, widely disseminated, is that the greater 
prevalence of delirium tremens now, than during a period 
yet within the memory of the living, arises from the great 
extent to which it is alleged the adulteration of liquors is 
carried. The fact is apparently forgotten that no poison save 
alcohol is capable of giving rise to this particular form of 
disease; as well as, that in the rural districts the disease is 120 
Sanitary Science. 
perhaps as rare as it ever was. I ask you, who have practised 
among intemperate farmers, if the disease is not exceedingly 
uncommon-. The ability of the country man to resist alcoholic 
poisoning better than the townsman comes from his otherwise 
better habits—the pure air lie breathes, the out-door exercise, 
and his superior stamina of constitution. 
All the poisons to which mankind have become addicted 
have one effect strikingly characteristic. The use of water 
for twenty years does not increase the craving for it, no1’ 
does the taste grow by use for a peach, an orange or a lemon. 
But those addicted to tobacco, to spirituous drinks, to arsenic, 
to opium, to hasheesh, find that the desire for them increases 
in intensity; leading to greater and greater excesses until the 
will and judgment are wholly subjugated. The same is true 
though to a minor degree, of tea and coffee; their worst 
tendencies however being in producing that state of the 
nervous system which renders the enticements of stronger 
stimulants, a part of our ntaure. What stronger evidence 
could we ask, that the use of such substances is unnatural 
and deleterious, leading those who yield to temptation on to 
their own destruction. 
The third sanitary law is, 
ADEQUATE OUT-DOOR EXERCISE. 
The stock breeder in raising young kine and horses is very 
careful they shall have the freedom of the field, and perform 
very little forced labor of any kind, until their growth is 
complete. He is very well aware that much confinement 
renders them tender and liable to disease, that much labor 
stunts their growth, spirit, symmetry and perfection of 
development. It is a proper subject for lament that the 
application of a little of the like common sense is not made 
by humans in raising their young. 
A child, as soon as it begins to walk, has an instinctive 
and almost uncontrollable desire for free out door activity. 
It is upon this that our vaunted system of “training a child Ohio State Medical Society. 
121 
in the way it should go/’ is first expended. There is thought 
to be something bad in the restless, fidgety, noisy, whooping 
boy and girl. They must be taught to be quiet, to stay in 
the house, and behave like some quiet demure old woman. 
The model child is a quiet child, an old-acting young child. 
To this standard fathers and mothers strive to bring their 
children. The noisy, rollicking boy is the horror of nervous 
women, and the romping, loud laughing girl is considered 
exceedingly rude and ill behaved. The repression of childish 
playfulness, which a mother can not accomplish at home, is 
attained in the school room, and this is often a motive for 
sending noisy boys and girls under the dominion of the 
teacher. The usual physical effects are soon displayed. The 
diminishing appetite, the paling cheek, the thinning flesh, the 
frequent headache, and the marked falling away of spirit or 
liveliness is regarded as evidence of taming down, but which 
tell a tale of cruel and injurious restraint, and which in the 
young of domestic animals would create solicitude as to their 
thrift, health and growth. 
The strong yearning of the young for an active out door 
life has a most beneficent purpose—the making of vigorous, 
symmetrical and healthful bodies. The’venerable Erasmus 
Wilson wrote, ‘‘Youth, it can not be too often repeated, is 
the time for storing strength, both physical and moral, and 
every act which can in any way impede or frustrate this all- 
wise-intention of nature will tend to lay the foundation of a 
weak and imperfect body, and shorten the days of its 
possessor.” 
The significance of the falling away of health, strength 
and vigor are quite different in youth from what they are 
in adult life. In such cases in youth, there is not only an 
arrest of the strong process, but a using up of a slender stock 
on hand, there is a going backward at the only time that a 
going forward is possible; while in adult life there is no 122 
Sanitary Science. 
arrest of development, there is no arrest of accumulation, 
but a simple using up of that on hand. 
The disregard of this requirement for the best physical 
development, works out an amount of suffering for the 
human family beyond computation. Trained up so as to 
make bodies frail and tender, and nerves large and susceptible, 
every rude breeze elylls, every touch bruises; and, with 
women especially, life is made up of moments of exciting 
pleasure, and hours of depressing misery. Women can be 
found by the thousand who have not had perfect health during 
an entire week for a score of years. In large part is this 
produced by their hot-house indolent habits, by faulty 
training during their expanding years. The forced and 
prolonged quietude of the school room, and the repression of 
playfulness by vain and shortsighted mothers, lie at the 
foundation of the evil. The protracted deadening inaction 
of our school system ; its exclusive straining attention to 
brain, and total disregard of bone, muscle, blood and lung, 
urgently need reform. 
The benefit from mental training does not depend upon 
the time devoted to it, nor upon the perfection of muscular 
inaction, but upon the intensity of the attention. And how 
can this be obtained with back and limbs aching by long 
continued constraint. Not one of you could think connectedly 
or deeply under such circumstances, and how much less 
should it be expected of restless boys and girls, whose inher- 
ent desire for motion and intolerance of confinement is so 
much greater? The stupid fashionable vanity of compelling 
children to sit like statues, in long continued unbending 
uprightness causes the vertebrae to ache, to inflame and finally 
to ulcerate from the steady weight and severity of the pressure 
on each other. Examine the poor beast that drags the canal 
boat, and its shoulders will be found either to be raw, or 
scarred with what has been rawness. The cause of this 
more than with other kinds of draft, arises from the steadiness Ohio State Medical Society. 
123 
of the pressure upon the shoulders. So is it with the 
steadiness of the pressure upon the bones of the spinal 
eolumn in children of the school-room—whose bones arc as 
yet imperfectly developed; resulting in crooked spines and 
deformity for life. But, it is not alone in undue action of the 
body in the school-room that disorders arise, over action of 
the brain is also prolific in diseases. The latest dcvoloping 
organ, the brain is forced forward, the earliest developing 
part, muscular activity, is forced backward. The nutrition 
which should be expended in material brain growth, is spent 
under a task master in forced mental work, producing childish 
precocity and adult inanity. A compromise must be effected 
between the requirements of the physical and mental systems 
if we wish to have anything like healthful, strong and 
long-lived men and women. 
For the preservation of the health and strength in adult 
life, out-door exercise is only second in importance to what 
it is during the period of growth. The organization of our 
social system unfortunately tends to prevent this. One class 
of men may be said to do all the thinking, another all the 
acting; one gets overmuch muscular labor, the other too 
little. The one is pale in blood, thin in flesh, turgid in 
brain, quick in nerve ; the other is ruddy, muscular, cumbrous 
in bone and point, slow and dull in brain. The farmer inured 
to severe out-door labor from childhood up, seems a marvel of 
ponderous strength, yet the showing is mainly on the exterior, 
and is often as striking as it is deceptive. The interior 
organs—the evolvcrs of the force, having been put to it all 
their days to make up for waste on the outside, do not possess 
an abundance of reserve energy. After a hard day’s toil 
these interior parts often throb with excitement by their 
efforts to supply the waste from without. The digestion of a 
full supper is frequently from this cause impossible, and every 
attempt at deep and connected thought is futile. It is 
otherwise with young men raised in towns and cities. With 124 
Sanitary Science. 
them there has not been a monopoly of energy for the exterior ; 
these organs of generative force have had time and oppor- 
tunity to gain in growth and power. Thus it is, that the 
son of toil does not have interior organsof production adequate 
to his exterior organs of expenditure—while with those of 
towns, who have not toiled wearily all their days from morn 
till eve, the ratio is just the other way. From this cause 
during the late rebellion, to the surprise of many, the soldiers 
from towns and cities displayed—if I may be permitted the 
use of the turf phrase—more bottom than those from the 
rural districts. 
The lack of sufficient out-door exercise among American 
women is perhaps the most influential condition which has 
rendered them unusually tender and frail, and their beauty 
so short-lived as to have made it proverbial. Secluded in 
warm, close, darkened rooms, nine-tenths of their days, and 
nourished on rich and concentrated viands, they bloom in 
early spring, and wither and die in what ought to be the 
summer of their lives. The plant always in a calm, and in 
a hot-house uniformity of temperature, and the plant always 
in a storm, are not normal productions. The one is 
rough, angular, scarred and scraggy, the other is over soft 
and fragile. How easy the latter is to bruise, how tender to 
every rude touch, how susceptible to chilling winds, how 
soon it blooms, withers and dies. Just so is it with Ameri- 
can women. The maid of one year is. with difficulty recog- 
nized in the mother of the next, and for a single year of 
pleasure or of a forced untimely beauty, they have a dozen 
of withered repulsiveness. This premature breaking down 
and chronic ill health has been popularly attributed to the 
climate, true to the acquired bend of the mind to lay the 
blame for our ailments on anything or everything save our- 
selves. To vivify the blood and cause it to tingle in the 
nerves with exuberant life; to knit the flowing globules 
into firm muscle, bestowing not only a lasting and charming Ohio State Medical Society. 
125 
contour, but vigor and elastic grace to every movement, dailv 
exercise and exposure to the shining sunlight and pure air 
are indispensible. 
English ladies of rank understand this, and think noth- 
ing of walking their four or five miles a day, while our 
ladies in town and country would think such a thing “per- 
fectly dreadful ! ” 
The fourth law is, 
ADEQUATE AND U N CO N ST R AININ G COVERING FOR THE 
BODY. 
The relation of clothing to health is confined to four 
points: 1st. Its sufficiency, ‘id. Uniformity. 3d. Ease 
and Lightness, and 4th. Unconstraint. 
A useful lesson may be learnt from nature as to the proper 
mode of covering for the body. Take that of the horse as 
a familiar illustration. ft is light, easy and uniform overall 
parts. In spring and summer it is light and thin, and in 
winter thick and shaggy. When the weather is warm the 
hairy covering lies flat and limp, when cold it is erect and 
furry; the precise states affording the least and the greatest 
protection from cold. The body is not thickly covered one 
hour and uncovered the next, it is not cramped by 
tight covering at one point, while at another it stands awav 
from the body from two to twenty inches; nor are the neck 
and shoulders ever bared while the waist and loins have a 
triple thickness. 
In reference to the sufficiency of clothing no absolute rule 
is enjoin able. Individual sensation is undoubtedly the best 
guide—though this, as all know, is very much under the 
control of habit. With plenty of wholesome food and pure 
air the slighter sensations of cold are not productive of dis- 
ease. Like the feeling of hunger it is natural and harmless, 
but to feel cold all the time, like feeling hungry all the time, 
clearly denotes inadequatencss. The habit of clothing in- 126 
Sanitary Science. 
funts and children thinly with the view of hardening them 
is a pernicious one. At this period of life the system is ten- 
der and capable of but small resistance; while a constant drain 
of heat from within stunts the growth,and hinders the develop- 
ment of that strong vitality, which in manhood rises super- 
ior to all external changes. 
Notwithstanding the importance of uniform covering for 
the body, it is systematically disregarded. Pride and a slav- 
ish subservience to fashion require that parts of the body 
warmly clad at home, are to be thinly clad, or even bared on 
the street, or at a social gathering, without any reference to 
external temperature. Even the superior hardiness of the 
beasts of the field could not long withstand such artful 
habits and exposure. Parts habitually open to cold like the 
face and hands acquire, through increased vascularity, su- 
perior resisting power, just as parts subjected to unusual 
friction or great pressure, acquire, through a horny hardness, 
superior resisting power—and to apply cold like friction or 
pressure, to tender and bare parts, will be followed by dis- 
ordered results. 
Lightness and ease of clothing for the body are not minor 
matters. All of nature’s models in which a high degree of 
protection is requisite, are of this character. The fur of the 
beaver, the down of the Orkney duck, combine in a remark- 
able degree lightness, ease and warmth. Man has not even 
creditably imitated, much less excelled, nature in this matter ; 
but in making his fabrics for warmth strives to make them 
as firm, close, smooth, or highly dressed as possible; than 
which a more effectual mode to diminish their protective 
quality could not be adopted. Observe the domestic fowl 
taking to its perch during the most intense cold of winter, 
and instead of drawing human like its protective covering 
close to the body, it shakes its feathers out loose or erect 
from the body. Long, fine, loose, and thick fibres are the 
true models for warmth, and in manufacturing garments for Ohio State Medical Society. 
127 
protection, instead of carefully removing the nap, the great 
care should be to preserve and increase it. Three pounds of 
wool thus wrought into a garment, would be far more pro- 
tective than ten made into hard, firm, smoothly dressed 
cloth. The weakly would not then be borne down by the 
weight of dense, heat-conducting clothes, and they would 
not be in a shiver three-fourths of the time; for it ought to 
be remembered that the ability to carry a great mass of 
clothing is usually in an inverse ratio .to the necessity for 
it. Clothing which constrains the natural movements, or 
impedes the flow of blood, is a frequent source of disease. 
Tight, badly fitting boots or shoes, by impeding the flow of 
blood, and bringing severe pressure on a few points of tfie 
foot, developes, as is well known, those painful and deforming 
excrescences, corns and bunions. Tight, unyielding hat 
bands in the same way hinder the flow of blood in the peri- 
cranium, and so on all the parts above the band—with the 
assistance of confined and overheated air, destroys its beauty 
and life. 
But the worst form of constraint to natural movements comes 
of tight lacing. There, the parts involved are essential to 
vitality, and in addition to suffering, there is a serious inter- 
ference with the fundamentals of organic life. Tight stays, 
by hindering the motions of the lower ribs, and obstructing 
the circulation in the Avails of the thorax, cause atrophy and 
weakness in some of the respiratory and spinal muscles, and 
often to such a degree that Avornen Avhen Avithout this artifi- 
cial support, feel their Aveakness so greatly that they are 
perfectly miserable. Still more important is the interference 
Avith the motions of the stomach, the expansion of the thorax 
and the impaired circulation and nutrition of the liA'cr and 
adjacent organs. The action of the heart is sometimes 
temporarily overcome, as in fainting, the loAver edges of the 
lungs gorge, the stomach emits croaking sounds, the nose 
purples, the boAvels are pressed doAvnwards, the Avomb falls, 128 
/S uni to ?•// *S' deuce. 
and sangufying is imperfectly performed. Following these 
immediate effects are others more remote. W hile abound- 
ing in youthful energy and elastic vigor—internal organs 
are not apt to become fatally deranged by this vicious cus- 
tom. Still their nutrition and strength are impaired ; and 
as soon as there is a drain of strength from any other cause, 
ns by maternity, or by advancing years, disease of the im- 
paired organ is almost certain to become manifest. From 
this cause very many women decline and die after the first 
child-birth. The organs whose function it is to elaborate 
blood being scarcely equal to the requirements of one life, 
succumb when required to elaborate plastic matter for two. 
Hence, women who have long been tight lacers are either 
exceedingly thin, weak and wan, unable to walk a furlong 
at a time, or some intractible disease seizes the maltreated 
organs, hurrying many mothers into untimely graves. Did 
the evil cease with themselves, ignoring of such conduct 
would not be so dark and damning. Bringing children into 
the world, feeble in frame aud weak in constitution, is a ter- 
rible evil. That such is a result of ti ght 1 acing it is only 
needful to recall the fact that the organs which suffer bv the 
constraint are those engaged in the elaboration of blood. 
Enfeeble or impair this process, and how can the mother el- 
aborate an abundance of excellent blood wherewith to nur- 
ture into a strong life the embryotic germ. It stands us in 
hand even as physicians to remember Sir \\ m. Hamilton’s sage 
remark that “constitutions are not made, they grow they 
grow by and through the quality of the life in the parent 
cells, and the quality of blood furnished by the mother. 
The sanitary law next in order is, 
THE EXERCISE OF THE SEXUAL FUNCTION ONLY FOR, 
AND NO INTERFERENCE WITH THE NORMAL FUNCTION 
OF REPRODUCTION. 
Between man and the beast of the* field there is this strik- 
ing difference, the latter attains its highest good through the Ohio State Medical Society. 
129 
direct insight of instinct—a quality which seldom errs, 
and is non-progressive, while man can only attain his 
th rough reason—a quality very liable to err, and eminently 
progressive. An animal’s nature is a law unto self, it can- 
not do otherwise than conform to it, while man’s nature is 
not a law unto itself, and he can act in consonance or disson- 
ance to ascertained law. Hence, as Bushnell maintains, 
man is truly a supernatural being, obeying or disobeying 
natural law as to him seemeth best. But while he has this 
freedom, he is also aware that in this very freedom is con- 
tained the measure of his responsibilitiy. The reasoning 
faculty informs him that if he does certain things, evil re- 
sults, and if he does certain other tilings, good results; so 
that in a moral point of view, though he has the power he 
has not the right. 
These differences, the manner and results of certain 
courses of conduct, are well illustrated by the reproductive 
act. Were it not for the pleasure attending co-habitation, 
the earth would soon become an uninhabited globe. The 
reproduction of species is forever insured by the powerful 
attraction of sensual impulse. Animals cannot disobey it, 
neither can they deviate from the periodical times for its ex- 
ercise; they never co-habit when reproduction is impossible, 
neither can they evade the end in the use of the means; in 
short, with them pleasure and reproduction or the means and 
the end are inseparable. With man it is different; he can, 
and he does separate the means from the end ; he can and he 
does co-habit when reproduction is impossible, he does evade 
the end, and he practices sexuality when he pleases, pleasure 
not reproduction being the great end in view. Perhaps 
some may think this one of the prerogatives of rational 
beings, a privilege vouchsafed to the possessors of a God-like 
nature. I shrink from considering such a desecrating view 
of the objects of our superior nature, much less to think the 
High Ruler ever designed our greater light to show us the 130 
S'an Hat •// Sc ten re. 
way to depths of carnality of which the lower animals are 
happily incapable. What would we think of any species of 
the inferior animals which seemed to live only to practice 
sexual intercourse to the full limit of their ability without 
the possibility of reproduction; and practiced it through the 
entire period of pregnancy, bringing forth their young 
loathsomely diseased? Would we not execrate and extermi- 
nate such foul creatures from the face of the earth ? And, 
if this would be the effect of such a disgusting exhibition of 
sensuality in the lower animals, what ought it to be consid- 
ered in him who was made in the image of his Creator? 
Let its practicers and defenders answer. 
The accumulated experience of centuries conclusively 
shows that whenever man converts what was designed as a 
means into an end, harm or evil ensues. We have already 
seen that this is the result of our studied efforts to turn 
palative pleasures into ends, instead of the simple means of 
existence. The same is true of the misuse of the procrea- 
tive organs. Solitary indulgence, of course, precludes any- 
thing like reproduction, and its evil results are too well 
known to need enumeration. Then excessive and promis- 
cuous intercourse without the possibility of reproduction is 
extrendy fruitful in disease. Mankind are the only beings 
that have the unhappy distinction of being scourged by a 
host of sexual disorders. Even attempts of curious students 
to propagate the syphilitic virus among the inferior animals 
have failed. The only violator is with propriety the only 
sufferer. Dysmenorrhea, amenorrhea, menorragia, leucor- 
rhea, and malpositions of the generative organs are in the 
female of very common occurrence. Bumstead is of opinion 
that by excessive venery and other debilitating causes gon- 
orrhea may originate independent of contagion and among 
women strictly virtuous. When the behavior of the animal 
male and female to each other during impregnation is com- 
pared with that of h nutans, it is enough to make us blush Ohio State Medical Society. 
131 
for our kind. What we in derision misname an animal pro- 
pensity we praetice to an extent unknown to them. The 
male animal seldom insults the female during pregnancy, and 
when he does, the latter defends herself with ferocious zeal. 
It is for man to outdo the animal in animal indulgences, to 
out-Herod Herod, and prostitute the body to the single serv- 
ice of sensuality. All classes and conditions in society prac- 
tice this thing, even those who are so unmerciful and free in 
their denunciation of promiscuous prostitution. Coition for 
any other purpose than reproduction, or with the design of 
evading it, or at such times when it is impossible, is prosti- 
tution, no matter whether committed within or without the 
ban of marriage. It is for the medical profession to teach 
in this thing a higher and purer conduct, a higher and purer 
morality. 
There may be and often is doubt upon laws claiming to be 
divinely promulgated, whether they are so or not, but con- 
cerning the origin of the law of means to ends, and of the 
evil results which ensue when infringed, there can be no 
doubt. The stigma of disorder or disease is but the hand- 
writing of an occult and just power for laws infringed, their 
judgments silent and self-executing. 
Coition during impregnation is a frequent cause of abor- 
tion and leucorrhea. Upon the offspring, especially in moth- 
ers of a nervous temperament, it is fraught with evil. It 
tends to give the child a stupid, auimalized expression, and 
predisposes to convulsions and that terrible disease, worse 
than death, epilepsy. Excessive venery will produce epi- 
lepsy in the adult, and is it to be presumed that the tender 
and susceptible embryo can escape such a tendency, such a 
predisposition, when every quality it possesses grows from 
those of its parents ? 
For the only creatures capable of infringing this law there 
is the terrible distinction of affliction by syphilis. You will 
agree with me that this is the most horrible disease with 132 
Sanitary Science. 
which we are acquainted, pervading every globule of infected 
blood, almost irradicable, and descending through, with mit- 
igated infamy and corruption, to offspring. Innocent chil- 
dren carry with them through life the brand of the disease 
in a peculiar formation of the front teeth, and are besides 
possessed of a taint that dooms them to derangement from 
the slightest causes to more or less suffering, disease or de- 
formity, with the chances of being cut off' in early life. 
Not content with the largest indulgence of the sexual pas- 
sion solely for the pleasure afforded, or with the design of 
avoiding its consecrated end, man with wicked purpose lays 
violent hands upon the results of sexual union. We are all 
well aware, not only by frequent applications for, but by the 
fearful results which often arise from abortions, that the 
wilful destruction of fetal life is far greater than is commonly 
supposed. It exceeds all other forms of murder at least 
seventy per cent., and with the destruction of fetal life there 
is every now and then that of the mother. Ovid long ago 
sung of the latter : 
“ But righteous vengeance oft their crimes pursues, 
And they are lost themselves who would their children lose ; 
The poisonous drugs with mortal juices fill 
Their veins, and undesigned themselves they kill, 
Themselves upon the bier are breathless borne, 
With hair tied up which was in ringlets worn.” 
Thanks to the out-spoken condemnation of criminal abor- 
tions by the best of our profession, its commission can rarely 
be laid at our door. To Dr. Storer and the American Med- 
ical Association is due the credit of a popular awakening 
upon this subject. The title of his essay, “ Why Not?” 
aptly expresses the usual response of married women to the 
remonstrances of the physician against its performance. 
And, truth to tell, these remonstrances are usually of no 
avail, for when a woman once gets her mind down to the 
idea of being rid of her unborn offspring it is usually found Ohio State Medical Society. 
133 
that where there is a will there is a way. They even learn, 
as you all know, to perform the operation on themselves or 
on each other, else through some patent nostrum, advertised 
with the significant caution not to be used during pregnancy, 
or else they procure the services of some low-bred well- 
known charlatan who adopts the destruction of fetal life as 
his speciality. The untoward influence of abortions upon 
health are too well known to need elaboration. When life 
is not immediately destroyed, the shock is often such that it 
is never fully overcome. Doubtless every one of you knows 
of one or more subjects of this violence who have not, since 
its date, seen a well day. Especially are the organs of repro- 
duction liable to suffer; either the uterus or its neck remains 
in an abnormal state, and, as Dr. Storer remarks, toward the 
decline of life those who have suffered from abortions are 
more liable than other women to that terrible disease, cancer 
of the womb. 
The sanitary law next in order is 
A HABITATION IN THE CLIMATE FOR WHICH THE CON- 
STITUTION OF THE BODY IS ADAPTED. 
It is a popular notion that mankind are by nature cosmo- 
politans. Taken as a race, they unquestionably are so; take 
them in species, and they are as much bound to a region as 
are the beasts of the field. W ere it not for the artificial pro- 
tection which they are capable of employing, the parallel 
would be perfect. Take a man or an animal, native of some 
tropical region of the earth, to England or the northern 
States of America, and under like circumstances one will 
not survive much longer than the other. Dr. Copland states 
that the negro suddenly transported to England seldom lives 
two winters in it. On the other hand, Dr. Boudin testifies 
of the French in Algeria that they would soon become ex- 
tinct but for emigration. The same is true of the English 
in Bengal and the Antilles. Says Dr. Aitken, “ When an 134 
Sanitary Science. 
Englishman is placed in the most beautiful part of Bengal 
or Jamaica, where malaria does not exist, although he may 
be subject to no attack of acute disease, but may live with a 
tolerable degree of health his three-score years and ten, he 
nevertheless ceases to be the same healthy individual he 
once was, and moreover, his descendants degenerate. He 
complains bitterly of the heat, his plump, plethoric frame 
becomes attenuated, his blood loses fibrine and red globules, 
both mind and body become sluggish, gray hairs and other 
marks show that age has come on prematurely, the man of 
forty looks fifty years old, the average duration of life is 
shortened (as shown in life insurance tables), and the race in 
time would be exterminated if cut off from fresh- supplies of 
emigrants from the home country. The European in the 
Antilles struggles with existence, a prey to fever and dysen- 
tery. He is unequal to all labor, becomes wasted and wan, 
and finally perishes. . . Our army historians tell us that 
our troops do not become acclimated in India. Length of 
residence in a distant land affords no immunity from the 
diseases of its climate. A thousand strong men form this 
year a regiment; a year passes, and one hundred and twenty- 
five new recruits are required to fill up the broken column, 
and eight years have come and gone, and not a man of the 
original thousand remains in the dissolving corps.” The 
oldest regiment in India, the Bombay tufts, stationed there 
since the time of Charles I, has never been able, although 
marriages arc encouraged, to raise boys enough to supply the 
regiment with drummers and fifers. In the face of such 
facts, of which many others equally explicit might be ad- 
duced, is it not clear that a removal to a distant climate for 
which the constitution of the body is not adapted, is an in- 
fringement of the conditions for perfect health? 
A change of climate is often a therapeutical agent of great 
power. The inroads of disease frequently throw the system, 
so to speak, out of tune with the conditions amid which it is Ohio State Medical Sucieli/. 
135 
placed, and a change is beneficial when it tends to restore 
the lost harmony. But, like all other therapeutical agents, 
what serves to restore the health of the sickly also destroys 
the health of the healthy, far more being affected in the 
latter than in the former way. The most influential agent 
of climatic conditions is heat. The relative degree of hu- 
midity, altitude, winds, and electric disturbances also have 
important powers over physiological action. The conditions 
favorable to health and life of the indigines of the poles or 
the north temperate zones are destructive to the indigines of 
the tropical, and vice versa. The struggle between the two 
does not extend beyond the third generation, the end not 
being in adaptation but in extermination. Now, such being 
the result of extreme climatic changes upon the healthy, the 
question arises, what is the result of changes less extreme? 
As the struggle is not decided by extermination, it is reason- 
able to suppose that it may on that account be more pro- 
tracted, there being less inequality between the constructive 
and destructive conditions. This lack of adaptation is, in 
my opinion, the real cause of some diseases usually attributed 
to malaria, or, in other terms, they are due to our malposi- 
tion in climate, and not to malaria. It does not harmonize 
with our knowledge of nature’s operations to aver that the 
unfitness of external conditions to human health arises from 
the fault of nature. It is a well-known fact that animal 
and vegetable life, not interfered with by art, are almost free 
from disorders and disease, and that in proportion as they 
arc put by men amid abnormal conditions do they become 
sickly. It is wholly owing to these artful conditions that 
infections and contagious diseases are originated among ani- 
mals, spreading among them, under favorable circumstances, 
far and wide. The transposition of vegetable forms to zones 
for which they are not adapted is, as all know, a very com- 
mon cause of sickly life in them. The mildew which attacks 
the English gooseberry, the rust on wheat, and the short, 136 
Sanitary Science. 
sickly life of many ornamental shrubs, far removed from 
their native habitats, are recognized as arising from trans- 
position to soils and climates not adapted to their healthy life. 
It is not assumed that nature generates a special poison de- 
structive to their growth, thrift, and life, as it is with refer- 
ence to some of the diseases which attack man. W ere the 
causes which prove so fatal to the intertropieal inhabitant 
when suddenly deputed to the climate of England only 
localized, there would be precisely the same grounds for be- 
lieving the cause to be a malaria, as there is for supposing 
the cause to be a malaria which proves so fatal to the indi- 
gines of the extreme temperate when removed to an inter- 
tropical region. And, when we examine the local conditions 
which prove so fatal to the northern emigrant, it is found 
that as we approach the tropics there are local climatic con- 
ditions not found in more temperate regions. For example, 
the remarkable diurnal variations of heat often reaching 30°, 
and occurring almost every diurnal period, are never found 
north of 45th parallel. Nor is this local climatic peculiarity 
limited to its heat range ; from the same cause there are great 
variations in atmospheric humidity, relatively dry during the 
heat of the day, damp and foggy during the chills of the 
night; and so certain forms of animal and vegetable life can 
maintain in such places, or in rice swamps and jungles, 
healthful, protracted lives. So only certain races of the 
human kind can live in such localities and maintain health- 
ful, protracted lives. The insalubrious conditions are pre- 
cisely the same in each case, a lack of adaptation by living 
amid them through a period which spans many generations. 
To be sure, the effects of such malpositions are very differ- 
ent in vegetable and lower animal life from what they are in 
human life. But are not the more complicated effects on the 
latter easily explicable by their more complicated organiza- 
tion and modes of living? The pith of the argument, then, 
is simply this: that by a removal to a climate where the Ohio State Medical Society. 
137 
change is most extreme, a succession of disorders and speedy 
extermination are the results, and by removals to climates 
where the change is less, the struggle to maintain health and 
life in a natural manner is less severe and more protracted ; 
and that some diseases, such as those ordinarily attributed 
to malaria, really arise from this cause or from conditions to 
the indigines perfectly normal, to the foreigner abnormal. 
The next sanitary law is : 
PURSUITS WHICH DO NOT CRAMP OR OVERSTRAIN ANY 
PART OF THE BODY, OR SUBJECT IT TO THE ACTION 
OF IRRITATING OR POISONOUS SUBSTANCES. 
I cannot here enter into details on all the ways in which 
this law is infringed. The principles which underlie the 
matter I shall endeavor to set forth in a very summary 
manner. The increased subdivision of pursuits in recent 
days, while it contributes to excellence in results, undoubt- 
edly tends to the production of disease. The special educa- 
tion of one sense, or of one class of muscles, necessarily im- 
plies disuse of the others. Now, we all know that training 
and use, to be normal, must be diversified. \\re see men 
with large hands and arms, and thin, spindling legs; we see 
men with large, ruddy, lithe bodies, and men with small, pale, 
and languid ones; in each there was cause, for development 
is not a thing of chance or of accident. The tailor and the 
shoemaker, by their inactive indoor pursuits and cramping 
position, interfere with the action of the organs which elab- 
orate blood, and hence as a class are thin, pale, or tinted 
with a bilious hue. On the other hand, public speakers and 
actors strain the vocal organs, heart, and blood circulation, 
gymnasts the muscles, literati the brain ; such exclusiveness 
in action of particular parts leading to disuse, atrophy, and 
hebetude of other parts. In this way the harmony, inherent 
strength, and symmetrical development of the body as a 
whole are subverted, causing one part to fail and die before 138 
Sanitary Science. 
other parts, and so produce all the throes and agony of a 
violent, untimely death, or the death by disease. 
Concerning the injurious effects of irritating and poison- 
ous substances, I need not detain you, all being aware that 
stone-cutters, steel grinders, and workmen in lead, copper, 
and mercury are exceedingly liable to be carried off with 
diseases appropriate to their occupations. 
On the eighth law of sanitation, personal cleanliness, 
the requirements are so obvious and well understood, and, 
having nothing to say that has not already often been 
said, I may properly pass to the ninth law, or 
TRANQUIL STATES OF THE MIND AND ADEQUATE REST 
AND SLEEP. 
That intellection and emotion have very important influ- 
ences over the welfare of the body all students of medical 
science are well aware. Still it amounts in very many in- 
stances more to a theoretical recognition than a practical 
maxim. The correlations of the physical and mental forces 
are, it seems to me, not sufficiently appreciated. AVitliout 
going as far as Vogt, who maintains that the brain secretes 
thought as the liver does bile, there are no clearly settled 
facts which contravene the doctrine that long continued and 
intense mental action drains the system at large of its ener- 
gies, this not unfrequently to such an extent as to interfere 
with the proper performance of the functions in other parts. 
Not only may there be an arrest of secretion, as in the stom- 
ach, but the secretion itself may by intense emotion be greatly 
depraved, as in the mammary gland, and act like a poison 
upon the nursing child. 
An over eager intensity in pursuit is, as travelers tell us, 
an American characteristic. Especially is this true of the 
residents of cities where rivalry and ambition stimulate ex- 
ertion to a most intense degree. A severely worked nervous 
system tends to bring on various nervous derangements, to Ohio State Medical Society. 
139 
wear out that part prematurely, and to diminish the tone and 
size of the organs devoted to nutrition and locomotion. We 
may attempt to fire up flagging tonicity by iron, strychnine, 
and phosphorus, but with emotion at a constant high pres- 
sure working power, with corroding care, like dry attrition, 
wearing away the nervous structure, the benefit must be not 
only transient but illusory. 
By all writers upon longevity is tranquil states of the 
mind spoken of as one of it most common belongings. A 
fast life is known to be incompatible with a long one, but 
those whose maxim in youth is a short and sweet life, usually 
find, when it is too late, that the result is not only short, but 
sharp and bitter. 
Sleep is the rejuvenation of nervous power, the winder up 
of mental force, which gives a good running power for the 
day. Unless this is gained, the whirl of molecular action in 
the brain is too great and prolonged; not made by an outlay 
of periodical accumulation, but by reserve capital. Of course 
the result is as disastrous vitally as such a course would be 
financially. Hugh Miller and Charles Dickens are noted 
and lamented examples of those who have made, to use an 
emphatic phrase, an extravagant outlay of brain power and 
broke it. But for one who kills himself thus, dozens so im- 
pair their energies that they linger on in torture, in inca- 
pacity, or imbecility for years. The great pity is that no 
timely warning voice is raised to teach men how they ought 
to use themselves. There are some seventy thousand of us 
in the United States engaged in the attempt to mend the 
breaks or the effects of the misuse, but scarcely one whose 
life is devoted to the instruction necessary to enable man- 
kind to avoid them. I cannot believe that many in our 
profession do not desire to see the human family redeemed 
from the slough of disease into which they have sunk. In- 
fluenced by interest like others, physicians have yet, when- 
ever clearly iirtheir power, risen above it, and advocated strin- 140 
Sanitary Science. 
gent measures for the prevention of disease. Nor should it 
be a matter of surprise that they have not accomplished 
more in this respeet, for the grand current of their education 
and their time is so monopolized in diligent efforts to cure 
disease, that little leisure is found for thinking and teaching 
how to avoid it; besides, their efforts are usually opposed by 
all the ignorance, conceit, and cupidity of the community. 
Moreover, in teaching men how to avoid disease, to know 
is one thing, to practice another. I am firmly of opinion 
that all disease arises from ignorance of how we ought to 
use ourselves, or, when we know, wilful disregard of this 
knowledge. All the best of our race, when they know any 
course of conduct to be wrong and fruitful in evil, will strive 
to avoid it, while the worst will give no heed. Disease, de- 
formity, and untimely death are, according to this point of 
view, the result of ignorance and disobedience; they are na- 
ture’s punishments, therefore, as well as her modes of weed- 
ing out the worst and preserving the best of our race. Let 
us see to it, we who are able to communicate information, 
that only the disobedient succumb to her inexorable laws, or 
only those who know and yet do not, while those who are 
diligent inquirers after truth and virtue may not stumble on 
in darkness, but be enabled so to guide their behavior as 
that they and their children may prosper and multiply and 
their days be long. 
The tenth and last law is 
NO INTERMARRIAGE OF NEAR BROOD RELATIONS. 
When the stock raiser wishes to increase and perpetuate 
qualities peculiar to a certain stock, he is careful to breed in 
and in. It is found that by selecting the best males and 
females for multiplying a certain stock, the excellencies of the 
progeny are intensified, though when long continued, a deli- 
cacy or tenderness of constitution is apt to arise. If human 
beings were as perfect in development and as free from in- Ohio State Medical Society. 
141 
herited taints as animals usually are, the same method would 
undoubtedly yield the same results. But not being so, and 
scarcely one in ten thousand who has not inherited some 
taint or weakness in some particular organ or part, it arises 
that in and in procreation intensifies the faults or weakness 
just as it does the excellencies. When a husband and wife 
are not consanguinated, the weakness or taints in each seldom 
affect the same part, or in the same way ; the weak lines in 
one may be crossed in the offspring, so to speak, by strong 
lines in the other; but when of the same blood, the weak in 
one is not crossed by the strong in the other; the taint or 
weakness falls upon the same part, and hence its intensifi- 
cation in progeny. By whatever mode it is attempted to 
explain the injury which results by close blood intermar- 
riages, there can be no doubt of the fact. 
Dr. Bemiss, in an elaborate paper on this subject before 
the American Medical Association, gives the following sta- 
tistics : In 833 blood intermarriages, the total children were 
3,942, of which 1,134 were defective, 883 died early, 145 
deaf and dumb, 85 blind, 98 deformed, 308 idiotic, 38 in- 
sane, 60 epileptic, 300 scrofulous. Dr. Howe, in a report 
presented to the Legislature of Massachusetts, ascertained 
the parentage of 359 idiots, and one twentieth of them were 
the offspring of blood intermarriages; and all sorts of defects, 
such as deafness, insanity, etc., in about a similar ratio. 
Dr. Nathan Allen, in an excellent monograph on the inter- 
marriage of relations, gives the following facts bearing upon 
this point: A certain family of wealth and respectability 
have intermarried for many generations, until there cannot 
be found in the three families a sound man or woman. 
Dr. Buxton, of Liverpool, states that in 170 families thus, 
109 of them had each one deaf and dumb child, 38 had two 
such children, 17 had three, 3 had four, one family had six, 
another seven, and another eight. 
Dr. Cadiot states that out of 54 such marriages 14 were 142 
Sanitary Science. 
barren, 7 produced children which died before arriving at 
adult age, and 18 produced scrofulous, rickety, consumptive, 
deaf and dumb, or idiotic children. 
Many more figures of a like import might be adduced 
were it needful, but I take it that your minds concede the 
disastrous effects arising from the infringement of this law, 
and that our State authorities would show greater wisdom, 
philanthropy, and economy if they would endeavor to prevent 
the increase of these melancholy deformities of mind and 
body, instead of simply caring for them in our ever growing 
and crowded asylums. Civil law more extended than its 
present range concerning blood intermarriages is needed, but 
above all should our young men and women be well taught 
that such marriages may be productive of the most terrible 
and melancholy results to offspring of which any conception 
can be formed, and so serve to prevent that affection, yea, 
even the thought of it, which leads to the marriage rite. 
Such, in my estimate, are the laws appertaining to the 
preservation of health, apart from what is ordinarily under- 
stood by prophylaxis. The application of these infringe- 
ments in the elucidation of the causes of disease has been 
necessarily brief, and more suggestive than thorough. Closely 
studied and minutely applied, in all their diversities and 
complexities, they will, it is opined, be found to cover nearly 
the entire field of the ultimate etiology of disease. More- 
over, I regard their infringements as the essential factors in 
nearly every morbid process. The light their study is capa- 
ble of shedding upon the causes of disease is invaluable. 
Medical literature, it must be acknowledged, is exceedingly 
meager and indefinite upon this head. Even with infection, 
malaria, and cold, the three grand factors, how vague arc 
the ordinary conceptions of causes! Patrons ask, “ Doctor, 
what is the cause of croup ? ” and the answer is, cold. “ What 
is the cause of lung fever, of rheumatism, of tubercular men- 
ingitis, of bronchitis, of peritonitis?” and the answer is the Ohio State Medical Society. 
143 
same, cold. Now, the lack of logical precision, not to speak 
of the absurdity of such a way of thinking, is shown by the 
diverse effects of a wave of cold air sweeping over a conti- 
nent. Upon one, it is said to produce this disease, upon an- 
other that, but upon the greater number it produces no ill 
effects whatever, but just the opposite, i. e., the cold air 
braces and invigorates. Now, a cause, in the proper mean- 
ing of the term, cannot produce opposite effects; i. e., disease 
is one, and better health is another. The true cause of such 
diverse effects is within, and is produced, immediately or re- 
motely, by a violation of one or more of the laws of health. 
Remove or obliterate these, and man would be as free from 
what is termed the bad effects of cold as the animals around 
us, and he would become, as he ought to become through his 
superior insight, the most healthy, instead of being, as he 
now is, the most sickly of beings. 
ft is well known that man’s physical condition has under- 
gone considerable improvement within the last two hundred 
years. The causes of some pestilences have been destroyed, 
the average duration of life has been increased, the scourge 
of the seas is no more, and the causes of the only wide- 
spread and fearful epidemic of recent times, the Asiatic 
cholera, are now within our power. Budd, Parkes, Harris, 
and Pettenkoffer admit in some German cities, in Southamp- 
ton and New York, that cholera was stamped out and did 
not become epidemic, though the germs were imported again 
and again for several months, as in New York, and into a 
population extremely favorable to infection; so that hence- 
forth the responsibility for the presence of Asiatic cholera 
must rest wholly with municipal authorities. 
I might further instance the particulars of the remarkable 
exemption of the federal troops, in occupation of New Or- 
leans for three years, from yellow fever, wholly due to the 
wise and rigid enforcement of sanitary measures, had I time, 
but 1 feel compelled to ask your indulgence to the following 
striking passage from Prof. Parkes: 144 
Sanitary Science. 
“ The history of sanitary science affords many striking in- 
stances of the removal of disease to an extent almost incred- 
ible, but no instance is more wonderful than that of the West 
Indies. Formerly, service in the West Indies was looked 
oil as almost certain death. It is not fifty years since the 
usual time for the disappearance of a regiment of 1,000 
strong was five years. Occasionally, in a single year a regi- 
ment would lose 300 men, and there occurred from time to 
time epochs of such fatality that it was a common opinion 
that some wonderful morbid power, returning in cycles of 
years, some wave of poison swept over the devoted islands, as 
sudden, as unlooked-for, and as destructive as the hurricanes 
which so sorely plague the 
‘Golden isles set in the silver sea.’ 
What gave countenance to this hypothesis was, that some- 
times, for months or even for a year together, there would 
be a period of health so great that a regiment would hardly 
lose a man, But another fact less noticed was not so consistent 
with the favorite view. In the very worst years there were 
some stations where the sickness was trifling, while, more 
wonderful still, in the worst stations, and in the worst years, 
there were instances of regiments remaining comparatively 
healthy, while their neighbors were literally decimated. 
And there occurred also instances of the soldiers dying by 
scores, while the health of the civil inhabitants in the im- 
mediate vicinity remained as usual. 
“ If any thing more were wanted to show the notion of an 
epidemic cycle to be a- mere hypothesis, the recent medical 
history of the West Indies would prove it. At present this 
dreaded service has almost lost its terrors. There still occur 
local attacks of yellow fever, which may cause great mor- 
tality, but for these local causes may be found; and apart 
from these, the stations in the West Indies can now show a 
degree of salubrity almost equally, in some cases surpassing, 
that of the home service. Ohio State Medical Society. 
145 
“ The causes of the production and the reasons of the ces- 
sation of this great mortality are found to be most simple. 
It is precisely the same lesson which we should grow weary 
of learning if it were not so vital to 11s. The simplest con- 
ditions were the destructive agents in the West Indies. The 
years of the cycles of disease were the years of over-crowding, 
when military exigencies demanded that large garrisons 
should hold the island. The sanitary conditions at.all times 
were, without exception, infamous 
“ It was held to be the climate, and the climate, as in other 
parts of the world besides the West Indies, became the con- 
venient excuse for pleasurable follies and agreeable vices. 
In order to do away with the effects of this dreaded climate, 
soihe mysterious power of acclimation was invoked. The 
European system required time to get accustomed, it was 
thought, to these climatic influences, and in order to quicken 
the process various measures were proposed. At one time it 
was the custom to bleed the men on the voyage, so that their 
European blood might be removed, and the fresh blood 
which was made might be of the kind most germane to the 
W est Ind ies. At other times an attack of fever (often 
brought on by reckless drinking and exposure) was consid- 
ered the grand preservative, and the seasoning fever was 
looked for with anxiety. The first statistical report of the 
army swept away all these fancies, and showed conclusively 
that instead of prolonged residence producing acclimatization 
and lessening disease, disease and mortality increased regu- 
larly with every year of residence. 
“ The progress of years has given us a different key to all 
these results. It is now fully recognized that in the West 
Indies, as elsewhere, the same customs will produce the same 
results. Apart from malaria, we hold our health and life 
almost at will.” * 
* Parke’s Practical Hygiene, pp. 51(6, 538. 146 
Sanitary Science. 
. AVitli the single exception of vaccination, all the sanitary 
triumphs of man over disease have been achieved by a better 
observance of some of the ten laws of health ; and, consider- 
ing that there is scarcely one in ten thousand who does not 
violate one or more of these laws every day of his life, what 
may we not hope for were they all faithfully obeyed? The 
eradication of taints, the abrogation of deformities, the dying 
the death of pure old age, euthanasia, instead of the violent 
law-breaker’s death, the death of disease, the prevention of 
so much suffering, misery, and gloom, of idiocy, of insanity, 
of blindness, and of imbecility; such results, grand as they 
are, are not any more for man to do for himself than he has 
done with the elements around him. He is their master, the 
minor ruler of the world causing his thoughts to vibrate 
through the mighty deep, analyzing the constituents of the 
sun and stars, and concentrating nature’s forces within the 
hollow of his hand, saying to them, do this, and it is done. 
And yet, commander as he is over external things, he com- 
mands not himself; regulated as he is by law in his dealings 
with nature, the uses he makes of himself are lawless! 
Hence, his disasters, his sickness, his pitiable personal 
condition. 
In the year 1864, in our two most populous cities, no less 
than 1,210,356 of the world’s rulers lay groaning and suf- 
ering, many to die in fearful misery, and in the grossest cor- 
ruption. 
But a better day is dawning, a day when man will use 
himself by law, as he now uses the forces of nature, when he 
will clearly perceive that if he does not use himself accor- 
ding to law the results are quite as disastrous as when he 
attempts to use the external forces of nature, without refer- 
ence to their laws ; when instead of thousands being engaged 
in efforts to remove effects, the thousand diseases by which he 
is afflicted, their main labor will be in showing how to avoid 
causes, and our race will then be able to grow up strong, pure, Ohio State Medical Sucieti). 
147 
and symmetrical in body, the uses they make of themselves 
ruled by reason and reason by law. 
The world moves, science progresses, and man is more 
than ever the monarch of all he surveys. But progression 
cannot always move in one direction; there are limits, and 
in the future, as in the past, investigation will turn back, 
double on itself, if I may be allowed the expression, and accom- 
plish things hardly dreamed of to-day. And I predict that 
in turning from the grand triumphs over outward nature 
investigation will be concentrated upon man’s deplorable 
personal condition, and carry it, in process of time, to as 
great triumphs over the evils by which it is assailed as in- 
vestigation has now carried man’s command over external 
nature. It is for us, as medical men, to give the first impe- 
tus, and afterwards to direct and mould this new vein of 
progress for the accomplishment of this beneficent end, full 
in faith of the observation made by that profound philoso- 
pher Descartes, that “ if it be possible to perfect human 
nature the means must be sought in the study of medicine.” 
Heretofore, and even up to the present moment, the prin- 
ciples and practices of hygiene have been too much left to 
itinerant charlatans. The regular medical profession have 
not displayed great zeal and readiness in disseminating its 
truths. In the wide road over which the millions throng, 
physicians have too long hung upon the rear, skilfully ap- 
plying balm to the wounded and relief to the distressed, in- 
stead of acting as guides and monitors to the advance, 
awakening thought in the giddy and headlong multitude, how 
they can avoid pain, disease and untimely death. The signs 
of a more auspicious period, a period of progress in man’s 
personal condition, are everywhere apparent. In some of 
the leading medical colleges of the world, within the last 
decade, chairs have been organized, devoted to improvement 
and instruction in hygiene; the public mind is eager, nay, 
hungry, for hygiene knowledge, and let me ask, why the 148 
Sanitary Science. 
halls devoted to the exposition of sr nitary science may not 
in coming time be thronged by hundreds and thousands 
seeking to know the proper uses they can make of them- 
selves so as to avoid pain and disease, instead of, as in the 
clinical departments of to-day, seeking how they can be rid 
of their numerous diseases and live.