HX64096467 R1 54.K79 T61 Anniversary tribute RECAP ANNIVERSARY TRIBUTE ON HIS Seventietli Birtlidav, MarcK 28th, 1920 f^RANCiS A. TONDORF, S. J PM, D. Columbia Wini\3tvsiitp in tfje Citp of ^etD l^orfe College of ^fjpsficiantf anb ^urgeong Digitized by the Internet Archive in 2010 with funding from Open Knowledge Commons http://www.archive.org/details/anniversarytribuOOtond ANNIVERSARY TRIBUTE TO GEORGE MARTIN KOBER . IN CELEBRATION OF HIS SEVENTIETH BIRTHDAY BY HIS FRIENDS AND ASSOCIATES MARCH 28, 1920 FRANCIS A. TONDORF. S. J.. Ph. D. WASHINGTON. D. C. 1920 7/ . 7G TABLE OF CONTENTS. PART I. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY. THE GEORGE M. KOBER AXXTVERSARV COMMITTEE I-II BIOGRAPHY OF DR. KOBER III-VI OBSERVATIONS ON THE NEGRITOS OF THE PHILIPPINE ISLANDS . Philip Newton. M. D., Assistant Professor of Anatomy, Georgetown Universit\' 1-:M THE INDIAN BRAIN. J. J. Keegax. From the Department of Anatomy, University of Nebraska 25-6:i r THE NASO-ORBITO-ALVEOLAR INDEX. A New Craniometric Method including a Description of a Specially Designed Indexo- meter for Estimating it. JoHX Camerox. Professor of Anatomy, Dalhousie University. Halifax, N. S G.^-Tf) ASPECTS OF THE SKULL. HOW SHALL THEY BE REPRE- SENTED? George Grant Maccurdy, Peabody Museum, Yale Uni- versity 77-82 MULTIPLE BIRTHS AMONG THE CHIXESE. Berthold Laufer, Field Museum of National History, Chicago _ 83-96 RACE SUICIDE IN THE UNITED STATES. Warren S. TnoMPsex, Cornell University 97-146 ANTHROPOMETRY. Ales Hrdlicka, U'. S. National Museum 147-1T4 THE MORTALITY ST.\TISTICS OF INSURED WAGE-EARXERS .\XI) TIlI-:iR FAMILIES. Louis I. Dubli.x. Ph. D., Statiscian ; witii the Collaboration of H!nwix W. Kopk, .Assistant Statiscian. and George H. Va.x Burex. Supervisor Statistical Bureau, Metro- politan Life Insurance Company, New ^'ork 170-186 THI-: XEWEST DISCOVERY OF "AXCIEXT' M.\X iX THE UNITED STATES. Ales Hrdlicka 187-192 INFLUENZA AMONG THE AMERICAN INDIANS. By the Public H ealth Service _ 1 9!!- 1 94 TUBERCULOSIS AMONG THE NATIONS IX THE WEST INDIES 194-190 SEX DETERMINATION 195 MORTALITY OF INFANTS OF Dli-i'KRKXT RACIAL GROUPS 196 CURRENT NOTES 197-198 BIBLIOGRAPHY OF DR. KOBER 199-211 PART II. ANNIVERSARY TRIBUTES. RcprUitcd from Gcorgcto'u'n College Joitniul. Kobcr .lniiic'crsar\ Number. March. lH-iO. BIOGRAPHY OF DR. KOBER. Francis A. Toxdorf. S. J., Ph. D.. Head of the Department of Physiology, Georgetown Medical School 217 KOBER AS DEAN. Wilfrkd M. Barton. M. D., '9:.'. Professor of Therapeutics Georgetown Medical School 2:2.") KOBER AS THE STUDENTS' FRIEND. John A. Foote, M. D., 0(5. Associate Professor of Clinical Medicine, Georgetown Medical School 229 AN APPRECIATION. Llewellyn Eliot. M. D., '74 2:11 TRIBUTE OF THE REV. J. HAVENS RICHARDS, S. J., President of Georgetown University 1888-1898 232 TO DR. KOBER (On the celebration of his Seventieth Anniversary), Verse. Edward F. Mack. A. B., '20 2.'}6 ADDRESS BEFORE THE GEORGETOWN CLINICAL SOCIETY. James A. Gannon, M. D., '06, Associate Clinical Professor of Surgery, Georgetown Medical School 2.37 TO A PHYSICIAN. John A. Foote, M. D., '06 240 A TRIBUTE TO DR. KOBER. From A Pre-Medical Student. (Verse) Thomas E. Mattingly 241 W'ERTH. (A German Poem). Kurt \'oelkner 242 EDITORIAL. Joseph R. Micklkr. Jr.. A. B., '20 _ , 243 CONGRATULATIONS FROM THE SOPHOMORE CLASS :244 COMPLIMENTARY DINNER 245 LISTOFGUESTS 249 INTRODUCTORY SPEECH. Francis R. Hagner, M. D., President Medical Society, District of Columbia 252 OPENING ADDRESS OF THE TOASTMASTER. Dr. John A. Foote - : 252 A TRIBUTE FROM THE MEDICAL SOCIETY. William C. Wood- w.\RD, Health Commissioner of Boston, Mass 254 PRESENTATION OF A COPY OF THE AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY. Profes.sor William H. Holmes. Head Curator Department of Anthropology U. S. National Museum. Representing the Anthropology Society 261 A TRIBUTE FROM THE CIVIC ORGANIZATIONS. Hon. Henry B. Macfarland, Formerly President of the Board of Commissioners of the District of Columbia 263 A TRIBUTE FROM THE WASHINGTON ACADEMY OF SCIENCES. Dr. Robert S. Woodward, President of the Carnegie Institution of Washington 265 A TRIBUTE FORAI THE COSMOS CLUB. Dr. Harvey W. Wiley, Director of Bureau of Foods, Sanitation and Health 267 PRESENTATION OF LOVING CUP. Dr. Charles W. Richardson. Member of the Board of Trustees, American Medical Association, etc., etc • 271 RESPONSE by Dr. Kober 272 SOLDIER, SCIENTIST, PHYSICIAN AND PHILANTHROPIST. (A Poem). S. Adolphus Knopf, M. D 277 CONGRATULATORY TELEGRAMS AND LETTERS 279 PART III. A VINDICATION OF VIVISECTION. PREFACE 287 LECTURE I.— "A VINDICATION OF ANIMAL ENPERIMEN- TATION." Based upon the work of the Rockefeller Institute for Medical Research in New York Citv. Bv Simox Fi.exxer. Director, M. D., Sc. D, LL. D ' 289-301 LECTURE II.— THE LEGAL ASPECTS OF MMSECTION. By WiLLi.vM Creightox Woodw.ard, M. D.. LL. M. Health Commis- sioner of Boston, Mass.. Professor of Medical Jurisprudence George- town University 302-309 LECTURE III.— SOME OF THE ETHICAL ASPECTS OF ANI- MAL ENPERIMENTATION. By Wm. H. Arthlr. M. D.. F. A. C. S. Late Commandant Army ^led'cal School 310-31.5 LECTURE IV.— WHAT ANIMAL EXPERIMENTATION HAS DONE FOR GYNECOLOGY AND ABDOMINAL SURGERY. By TnoM.xs S. Cti.i.ex, M. D. Professor of Clinical Gynecology, Johns Hopkins Hospital 315-324 LECTURE v.— ACHIEVEMENTS pF ANIMAL P:XPER1MENTA- TION IN GENERAL SURGERY. By Georce Tui.ly Vaugh.-^n, M. D., LL. D., F. A. S. Professor of Surgery Georgetown University 324-331 LECTURE VI.— ACHIEVEMENTS OF THE MEDICAL CORPS OF THE ARMY IN PREVENTIVE MEDICINE. By George B. Foster, Jr., M. D., Dr. P. H. Major Medical Corps, United States Army 331-342 LECTURE VII.— THE LABORATOR^' WORK OF THE UNITED STATES PUBLIC HEALTH SERVICE. By A. M. Stimson. Surgeon U. S. P. H. S. Assistant Director, Hygienic Laboratory, Washington, D. C 1.. 342-348 LECTURE VIII— THE ECONOMIC ADVANTAGES DERIVED FROM ANIMAL EXPERIMENT.\TION. By Erxest Chari.es Schroeder, M. D., D. V. M. Superintendent Experiment Station United States Bureau of Animal Industry, Bethcsda. Md 348-362 LECTURE IX.— THE ACHIEVEMENTS OF DENTAL MEDICINE AND ORAL HYGIENE. By Ralph A. Hamh.tox. M. D. Prof- essor of Bacteriologv and Pathology Georgetown University Medi- cal School 3G3-3()8 CONCLUDING REMARKS TO THE COl'RSE OF LECTURES ON VIVISECTION. By George M. Kob':r M. D., LL. D. Dean of the Georgetown L'niversity School of Medicine 368-370 MOR.\L ASPECTS OF VIVISPXTION. A Dgest of the Statement of Rev. Fraxcis A. Toxdorf, S. J.. Ph. D. Professor of Physiology, Georgetown University School of Medicine, before the Subcommittee of the Commmittcc on the Judiciary of the United States Senate on November 4, 1919 ' - 371-372 GENERAL STATEMENT IN PROTEST AGAINST THE ENACT- MENT OF S. 12.58; a Bill to Prohibit Experiments upon Living Dogs in the D'strict of Columbia, before the same Committee. By George M. Kober. M. D.. LL. D 372-377 A PLEA FOR SANITY IN LE(;iSLATION ON ANIMAL EXPFIRI- MEXTATION (With special reference to the Dog). By Mtrrav Gai.t Mottkr, M. D. Formerly Professor of Physiology George- town Universitv Medical School 378-381 Vol. Ill WASHINGTON, JANUARY-MARCH, 1920 No. 1 AMEEICAN JOURNAL OF PHYSICAL ANTHROPOLOGY Published Quarterly ALES HRDLICKA ASSOCIATE EDITORS Professor G. Stanley Hall President, Clark University Dr. E. a. Hooton Peabody Museum, Harvard University Professor George Grant MacCtjrdy Yale University Dr. Charles B. Davenport Carnegie Institution of Washington Profes.sor Franz Boas Columbia University Dr. Clark Wissler American Museum of Natural History Professor J. Howard McGregor Columbia University Professor E, V. Cowdry Peking Union Medical College Professor H. H. Donaldson Wistar Institute Dr. William C. Farabee The University Museum of Philadelphia Dr. George M. Kober Dean of Medical Department, Georgetown University Dh. J. H. ICellogg Superintendent, Battle Creek Sanitarium Dr. Berthold Laufer Field Museum of Natural History, Chicago Professor J. C. Merriam National Research Council Professor A. L. Kroeber University of California Professor A. E. Jenks University of Minnesota Sir Francis H. S. Knowles Victoria Museum, Ottawa ( Domestic, $5.00 Annual Subscription < Canada, $5.25, U. S. currency ( Other Countries, $5.50, U. S. currency All communicntiona and rcniittanocH rdiitinK to (Ik- .I<)urn:il Blimild 1h' uddrcsttcd fo tin- Kilitor, AmericRn Journal >>( Physical .Anthropology, U. S. N.ition;il Museum, SiuithHouiou IiiHlituttun, Washington, D. C. Entered as second class matter, Juno 1 1 , lOIK. ,it the Post Office at WashingtoD, D. C. undci tho Act of March 3, 1879 SCOPE OF THE AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY I. A. Anthkopology in General o. History; Present condition; General B. Research ^. Evolution; Man's Origin; Early Man c. Human Ontogeny: Embryology; Childhood; Adolescence; Decline; Death d. Heredity ; Eugenics e. Man's Variation: Osteology; Teeth; Soft parts; Body proportions; Races; Physi- ological, Mental /. Demography; Vital and Racial Statistics g. Abnormal Classes; Comparative Human Pathology and Teratology X. Anthropological Problems pecuhar to the United States XX. The American Indian II. War Anthropology a. The Peoples at War h. Everything of Anthropological interest connected directly or indirectly with the War III. American Collections o. Status of h. Field work c. Specially important accessions d. Exhibits IV. Anthropometry and Methods in General a. History 6. International Agreements c. Instruments d. Directions e. Sedation; Curves; Biometric Methods /. Illustration Q. Methods of Excavation, Transportation, Preservation V, Speclal Communications and Reports VI. Reviews and Annotated Biblioqraphy VII. Notes and Current Anthropological News a. Special lectures; Miscellaneous h. Appointments, Promotions, Changes c. Deaths; Obituaries THE GEORGE M. KOBER ANNIVERSARY COMMITTEE Dr. George M. Kober, Dean of the Medical faculty, Georgetown University, reached the age of 70 years on March 28, 1920. That the day might not pass without some slight testimonial of the admiration and esteem in which he is held by pupils, friends and co-workers in the many fields of his activities, a number of Dr. Kober's associates met on October 24, 1919, and decided to issue an anniversary publi- cation, dedicated to him. This Organization Committee consisted of Dr. George Tully Vaughan, Chairman; Mr. Felix Neumann, Secretary; Mr. John Joy Edson, Treasurer; and General Robert E. Noble, Dr. Charles D. Walcott, Dr. W. M. Barton, Dr. J. W. Fewkes, Prof. W. H. Holmes, Dr. Walter Hough, Dr. L. O. Howard, Dr. A. Hrdlicka, Mr. Neil M. Judd and Dr. Truman Michelson. Owing to the shortness of the intervening period and to uncertain- ties of publication, it was considered advisable to accept the offer of Dr. Ales Hrdlicka, editor of the American Journal of Physical Anthro- pologj', and issue the first quarterlj- of that Journal for 1920, as the George M. Kober Anniversary Number. Dr. Kober has been an associate editor of the Journal since its -inception. Although Dr. Kober's scientific interests include such divergent subjects as Military Medicine, Occupational and Social Diseases, Hygiene, Tuberculosis, Social Welfare, and Physical Anthropology, the specific character of the American Journal of Phj'sical Anthropology* limited contributions to those bearing directly upon the latter title. Considering the manj' distinguished services rendered by Dr. Kober to the advancement of medical science and to the social welfare of the United States, it is significant to note that appreciation of his efforts is not confined to the District of Cohunbia. The list of names which follows is ample proof that the liomage jiaid Dr-. Kober at this time is nation wide. membefts ob^ the national committee and subscribers to the George M. Koheh Anniversary Number: ABEL, DR. .JOHN J. ADAMS. DR. SAMUKL S. BHitiiiiorc, Mil. \\'iu The zone of demarcation between these groups would become greatly reduced in an extensive series of crania. « Manchester University Museum Publication, No. 68, 1910; also Trans. Nova Scotian Inst. Sd., XIV, Pt. 1, 1916. THE NASO-ORBITO-ALVEOLAR INDEX 69 I placed him with the Chinese and Polynesian crania. Owing to his contracted nasal aperture, however, he occupies a definitely isolated plane, and I have therefore installed him in the upper part of Fig. 3 by himself. I n tse. Oan^ iOlC Fig. 3. Shows Chinese, Polynesian and Eskimo types of skull. The rectangles of the Eskimo and Polynesian types of crania correspond more or less to those de- picted in Fig. 2. The Chinese cranium has been utilized to demonstrate the fact . that the naso-orbito-alvcolar inde.x has a consiilerable range of variation. 70 JOHN CAMERON Representatives of three aboriginal races of the Western Hemisphere have been chosen for Fig. 4, which demonstrates that the relative proportions both of the three horizontal dotted areas of the facial 'pa fa. o Oman nca TloRth UtntRican J ricLian Fig. 4. Representation of the crania of three aboriginal races of the Western Hemisphere. There is a certain degree of correspondence in the relative heights of the three rectangles, which makes them conform more or less to the European- Asiatic type. The nasion-alveolar height of the Patagonian skull is an unusual feature, though apparently not a definite character of this race. THE NASO-ORBITO-ALVEOLAR INDEX C(^f(fcan hiaRo Qlojijcjinal (lustRah^n: Qf?/Cr//?a sma/iian anesia/i Fig. 5. Shows that African negro, aboriginal Tasmanian, aboriginal Austrahan and Melanesian types of skulls give corresponding results when studied by means of this index. The two upper rectangles are approximately squares, while the lower- most show an extreme degree of reduction of their heights, due of course to the prog- nathism in these races. These crania thus display a marked contrast to those of the Euro-Asiatic type. 72 JOHN CAMERON skeleton and of the three rectangles conform more or less to the general European-Asiatic form, or what might be termed the Eurasiatic type. I was much struck by the amount of the nasion-alveolar point height in the Patagonian skull. An examination of this cranial group in the Royal College of Surgeons Museum, however, demonstrated the fact that this did not appear to be a characteristic racial feature. The inter-racial range of variation in the relative sizes of the three rectangles was such that the Eurasiatic races, the Polynesians and the aborigines of the Western Hemisphere were practically on the same level. Thus it appears as if the Eurasiatic types could be linked by this craniometric method with both the American Aborigines and the Polynesians. In a previous communication^ the writer has referred to the fact that the crania of the aborigines of the Western Hemisphere betray some Mongoloid affinities, and a link with the yellow-brown Mongol of Asia is also provided by the Polynesians of the Pacific. In reference to this fact it is important to quote Hrdlicka's remarks on p. 183 of Bulletin N6. 52 of the Bureau of American Ethnology^: "This general American type is more or less related to that of the yellow-brown peoples, wherever these are found without decided ad- mixture with other strains. These yellow-brown people, including the American, represent one great stream of humanity." Fig. 5 demonstrates the fact that the naso-orbito-alveolar index placed the African negro, the aboriginal Tasmanian, the aboriginal Australian and the Melanesian on the same plane. It is interesting to note how the uppermost and intermediate rectangles approximate in all four cases to the outlines of squares, and are therefore about , equal in size, their indices being somewhere in the vicinity of 100. The great feature of Fig. 5 is, however, the great reduction in the height of the lowermost rectangle, due, as previously explained, to the high degree of prognathism in these races. The index for it was there- fore about 200 or even much more (192.5 in the African negro, 199.9 in the aboriginal Tasmanian, 234.5 in the Melanesian and as high as 252.5 in an aboriginal Australian), indicating of course that its height was about one half its breadth — in some cases much less. THE CRANIA OF FOSSIL HOMINID^ On comparing Fig. 5 with Fig. 6, it is evident that the cranium of the Grimaldi youth exhibited fairly consistently the characteristics of 1 Trans. Nova Scolian Instil. Sci., Vol. XV, Pt. 1, 1919. 2 Early Man in South America, 8°, 1912. See also his "Genesis of The American Indian," Proc. XIX Intern. Cong. Amer.-, Wash., 1917. THE NASO-ORBITO-ALVEOLAR INDEX 73 GrIm aldi youth (olcficassd Go-^aQjion J,o Cnahille, (Jlcahde/^t/iql-MousteRian^ Fig. 6. Tracings of the Grimaldi skull (Verneau), the Obercassel skull (Bonnet), and the La Chapelle cranium (Boule). The Grimaldi skull shows the Negro type index. In the Obercassel specimen the index conforms fairly with that of the Euro-Asiatic type. The Cro-Magnon race represents the only example of fossil Hominida? amongst those examined that could with safety be placed in the Eurasiatic category. In the La Chapelle skull it will be observed that the three rectangles are quite different from those of the racial types represented in Figs. 2 to 5. 74 JOHN CAMERON the negro naso-orbito-alveolar index. He could therefore be definitely placed in his appropriate racial position. The indices for the upper- most and intermediate rectangles of his skull were approximately 100, while that for his lowermost rectangle was found to be as high as 233.3 — that is to say, practically the same as that for the modern Melanesian skull cited in the preceding paragraph. The skulls of the Obercassel Cro-magnon man (Fig. 66) and of the "old man" of Cro-magnon, were the only cranial types of fossil Hominidse amongst those examined that could be safely placed in the Eurasiatic category. A study of Fig. 66 will demonstrate the fact that the relative proportions of the three horizontal dotted areas of the Obercassel facial skeleton conform more or less to those of the general European-Asiatic type, while the indices for the three rect- angles likewise consistently follow this result. The application of the naso-orbito-alveolar index to the La Chapelle and Gibralter crania, representing Neanderthal-Mousterian man, provided some interesting results. The great nasal width of these two crania seemed at first sight to render them comparable, to those of the modern negro type, but the height of the lowermost rectangle in both instances at once negatived this impression (Fig. 6c). On examining this figure it will be noted that the three horizontal dotted areas of the La Chapelle skull were almost equal in height, which rendered it quite different from the modern European-Asiatic type or the modern negro type. Moreover the three rectangles were also quite different from those of the modern racial types, for all three were approximately equal in size and were transversely elongated owing to the great nasal width. It is thus clear that the Neanderthal- Mousterian type of skull is one that does not exist at the present day. ENUMERATION OF THE VARIOUS MODES OF APPLICATION OF THE NASO- ORBITO-ALVEOLAR INDEX 1. Calculate the relation of the nasal width to the height of the complete rectangle, that is to say, the relation of the nasal width to the nasion-alveolar height. 2. Calculate the relation of the nasal width to the height of each of the three subsidiary rectangles. 3. Calculate the relation of the square area of the three subsidiary rectangles to each other. For this investigation the crania would all have to be photographed to the same scale of reduction. 4. The relative proportions of the three horizontal areas of the THE NASO-ORBITO-ALVEOLAR INDEX 75 -l-> d TS o a ■i: o o3 o3 v^ 2 76 JOHN CAMERON facial skeleton mapped out in Figs. 2 to 6 could be studied. This investigation might be regarded as accessory to the estimation of the naso-orbito-alveolar index, and so far as I have been enabled to de- termine, promises to provide a new and fruitful field of research. In concluding this paper which is to be regarded entirely as a pre- liminary announcement owing to the comparatively small series of crania examined, and the vast issues that have been introduced, I wish to emphasize the fact that all the conclusions arrived at have been based entirely on this one ''naso-orbito-alveolar" craniometric method. It is quite obvious that one cannot depend upon it alone as a means of classifying mankind. Still, its value as a further means of studying the cranium appears to present certain possibilities. Another reason for this publication is that it may stimulate further study of the comparatively neglected norma frontalis of the skull. ASPECTS OF THE SKULL: HOW SHALL THEY BE REPRE- SENTED? GEORGE GRANT MACCURDY Peabody Museum, Yale University One of the chief handicaps of physical anthropology has been hither- to lack of unity in mode of procedure. This is particularlj^ true of anthropometry and osteometry. In order that the records of each observer may be readily made use of by every other observer, it is imperative that series of measures be uniform and be taken in uniform ways. Many authors have contributed to our knowledge of these subjects. Under the leadership of Broca, the French developed a method that has had a very wide influence. In the so-called Frankfort Agreement, German anthropologists took an important step in the direction of unification. It remained, however, for the International Congress of Prehistoric Anthropology and Archeology held at Monaco in 1906 to place the matter of unification on an international basis. At Monaco the International Commission agreed upon twenty- four measures of the cranium, eight of the lower jaw, and twenty- one of the head. At the next session of the Congress held in Geneva in 1912, a reconstituted International Commission agreed upon forty- nine additional measures of the living subject. It also adopted a technique for the reconstruction of the height by the aid of the long bones; and passed a resolution that for the graphic representation of skulls, anthropologists employ the horizontal plane either of Broca or of the Frankfort Agreement. There remain for consideration at some future Congress measures of the skeleton in general, exclusive of the cranium and lower jaw. There is another matter which it seems to me might well engage the attention of some future international commission; namely, an agreement as to what attitudes to give the skull in representing its five aspects: norma frontalis, lateralis, occipitalis, verticalis, and basilaris. For the front view of the cranium there is but one logical attitude; namely, the vertex up. With this there is already universal agree- 77 Amer. Jo0r. Phyh. A.vthrop., Vol. Ill, No. 1. 78 GEORGE GRANT MACCURDY ment in practice. The same may be said of the rear or occipital aspect. For the lateral aspect, while the rule of vertex up is universally followed, the skull may be and is made to face to the left or to the right — to show either its left side, or its right side. Would it not be well to agree as to which of these two attitudes is preferable? The writer proposes that the left side be chosen for two reasons. In the first place, in paired measures it is already the rule to take the measures on the left side; in the second place, by making the skull face to the left is to follow the rule of the printed page, which one reads from left to right; and finally this position gives us a more natural position of the teeth. Exceptions to this proposed rule might justly be claimed in cases where one wished to present some special feature which occured on the right side only. The problem of choosing the correct attitude for the top or verti- cal view is still more complicated. There are four possible attitudes: face up, face down, face to the left, and face to the right. In all four positions the vertical axis would of course be at right angles to whichever of the two horizontal planes one might select. Since to all intents and purposes, the skull has bilateral symmetry, both sides should be given an equal chance for self-expression. This can be accomplished only by preserving the bilateral integrity of the figure; in other words, by placing the face either up or down. Is there a choice between these two attitudes? Most certainly there is. The face is the front and should be first. The position of the first is at the top not at the bottom. Therefore, in the norma verticalis of the cranium, the face should be at the top. There are, moreover, two other valid reasons for selecting this atti- tude. It brings the right side of the skull on the right side of the page and the left side on the left. In the second place, the cranium gives the appearance of being in more nearly stable equilibrium when resting on the occipital bone than when resting on the nose, the alveolar margin, or even on the brow ridge. The correct attitude for the norma verticalis then is face up. What do we find in actual practice? Authors have made use of all four possible attitudes at random, sometimes employing more than one attitude in the same work. As a rule, however, after choos- ing a given attitude, the author sticks to it throughout the publication. Thus Broca (Instructions Craniologiques), R. Virchow (Crania Ethnica Americana), de Quatrefages and Hamy (Crania Ethnica), Topinard, ASPECTS OF THE SKULL 79 Sir William Flower {J. A. I., X, 157, 1880), Harrison Allen, Martin, and Hrdlicka, to mention only a few autriors, place the face down. On the other hand, in at least certain works of Sir William Turner (Challenger Reports), W. L. H. Duckworth (Anthropology and Morphology), Eugene Pittard (Crania Helvetica), Rivet, E. A. Spitzka, and A. Keith the face-up attitude of the vertical aspect is chosen. These two lists are sufficiently long to show the need for unification. Once the attitude for the norma verticalis is agreed upon, it should not be difficult to unite upon the correct attitude for the basal aspect of the cranium; for if the face-up attitude is correct in the one case, it must be also' in the other case. Here again the practice has been as divergent as it was in respect to the vertical aspect. Those who choose the face-up attitude for the latter are generally consistent and place the norma basilaris face up also, and vice versa. On the other hand, some authors are not even consistent, but alternate be- tween the two attitudes. Having fixed upon the face-up attitude for both the vertical and basal aspects of the cranium, it follows naturally that in illustrating crania sectioned transversely the same attitude should be employed, no matter whether one is viewing the floor or the vault of the endo- cranium. Here again in practice there is both inconsistency and diversity. For example, for the vertical and basal aspects of the cranium as a whole, Broca turns the face down (incorrect), but in his illustration of the floor of the endocranium the face is turned up (correct). In the Handatlas of His and Spalteholz, the face is turned up (correct) in the figure of the floor of the endocranium, while in that of the vault of the endocranium it is turned down (incorrect and inconsistent). In this work both the norma verticalis and the norma basilaris of the entire cranium are correct (face up). It often happens that a basal view (hard palate) of the upper jaw alone is wanted. In such a case, there should be no hesitancy in selecting the same attitude it would have if attached to the cranium; namely, the face-up attitude, which happens to be the one suggesting the more stable equilibrium. Notwithstanding, some authors do just the opposite thing, especially those who arc in the habit of turn- ing the cranium face down. What is true of the upper maxilla is likewise true of the lower jaw. It should be represented in the same position it would have if in natural contact with the cranium. It should rest on the condyles and angles 80 GEORGE GRANT MACCURDY with the chin (symphysis) up for both the basal and the alveolar as- pect. With its lateral aspect, chin to the left would take precedence over chin to the right. That which is good form for the brain case is also good form for fK T- The Five Aspects of a Skull from the Rh6ne Valley, Switzerland. Hori- zontal plane of Broca. (After Eugene Pittard.) ASPECTS OF THE SKULL 81 the brain. It should be allowed to assume the same attitudes it would have if kept unmolested in the cranium. For the skull as well as the brain, or even the dissected head, a simple rule of procedure may be expressed as follows: Vertex up, face to the left, face or front up. If this rule is a good one for anthropologists to follow, there is no valid reason why it should not be followed likewise by zoologists and paleontologists, especially where the requirements are similar to those in man. In respect to the rest of the skeleton, the same general rule should hold. If so, then there is need of unification of practice both past and present. In so far at least as the genus Homo is concerned, this would mean that segments of the skeleton or disarticulated bones should be repre- sented in the attitude they would have if articulated, that is to say, in their normal position in life. The clavicle would thus be represented in a horizontal position, limb bones in a vertical position. If any other than a superior-surface-up attitude is required for a vertebra, for ex- ample, it should be represented with the anter,ior aspect up and the posterior aspect down, no matter whether the view be from above or from below. Or if a segment including vertebra, ribs, and sternal junction be represented, the ventral or front portion should be up and the dorsal down. When it comes to the hands and feet, valid arguments may be adduced for two opposite attitudes. It might be well, therefore, to employ each under given conditions. When the hand or foot bones are shown in connection with the lower arm or leg bones, let the phalanges point downward. This would be in conformity with a previously formulated general rule. On the other hand, if the arti- culated bones of the foot alone be shown, let it be with the toes up and the heel down, both for the sole aspect and the reverse. This would be following the rule that the front should take precedence over the back. The same attitude might well be chosen for the articu- lated bones of the hand alone; since this would be in conformity with the attitude selected for the articulated foot bones and would have the added advantage of making it possible for an observer to orient his own hand with the figures on the printed page, thus immensely facilitating comparison and observation. MULTIPLE BIRTHS AMONG THE CHINESE BERTHOLD LAUFER Field Museum of Natural History, Chicago INTRODUCTION The Chinese Annals contain not only records of human events, but also of unusual natural phenomena which left a deep impression upon the minds of the contemporaries. In the early days of historiography, when occurrences were chronicled day by daj^ and year by year, the two categories of human and natural events were noted indiscrimi- nately, merely in the chronological succession as they happened. In the introduction to the Shu king we read, for instance, "The king's uncle, the prince of T'ang, found ahead of grain, two stalks in different plots of ground growing into one ear, and presented it to the king." In the Bamboo Annals (Chu shu ki nien) this feature is still more conspicuous: solar eclipses, meteoric falls, earthquakes, droughts, ex- traordinary phenomena in the growth of trees, appearance of a fung- hwang (so-called phoenix), rain of particles of earth, unusual thunder- storms, and other phenomena are there on record, being interspersed with the record of imperial and military affairs. Beginning from the Annals of the Former Han Dynasty {TsHen Han shu), a novel depart- ure from the old practice was instituted in as much as the natural events were detached from the general narrative to be relegated to a special section, entitled "Records relating to the Five Elements" (Wu king chi). The majority of official annals has adopted this practice. These chapters contain most interesting information, not for the historian, but for the scientist, and therefore merit close study. They give detailed lists, with exact reference to date and place, of great catastrophes, such as famines, droughts, locust-pests, inunda- tions, hail-storms, landslides, earthquakes, conflagrations, excessive cold, electric storms in the winter, etc., abnormal phenomena and monstrosities in domestic animals. and human beings, cases of insanity, abnormal customs and practises, etc. It is to this department of records that we owe our principal information on a subject which has not yet been discussed, — the frequency of multiple births among the Chinese. . 83 Amer. Jour. Phys. Anthrop., Vol. Ill, No. 1. 84 BERTHOLD LAUFER In ancient times, under the Chou dynasty, the officer presiding over the people (se min) was obliged to keep a register of the population. All individuals were recorded from the age when the teeth appear. A separate count was taken of males and females; every year, the number of births was added, while the number of dead was taken off the register (cf. E. Biot, Le Tcheou-li, Vol. II, p. 353). We cannot but regret that documents of this character have not survived. No allusion to twins or other plural births is made at that period. The chapters Wu hing chi of the two Han Annals contain no records of multiple births. The Wei shu gives a single case of a quadruplet birth. Triplets, but only two cases, are first recorded in the Books of the Tang Dynasty, and there is a long list of them under the follow- ing Sung dynasty. There is one case of triplets of early date, not on record in the Annals, but in the Sou shen ki, written by Yii Pao in the early part of the fourth century, who reports that "in a.d. 243 there was a woman who gave birth to three sons." I have not embodied this case in my statistical review of the matter, as the work in question is a Taoist book of marvels, and as the extant edition presents merely a retrospective make-up (cf. Wylie, Notes on Chinese Literature, p. 192). While triplet and quadruplet births are mentioned in the Annals with comparative frequency, they hardly trouble about twins, save a few cases of united twins. This omission may indicate one of two possibilities: either twin-births were too common to attract much attention, or were too rare to be worthy of notice. This alternative cannot be decided without a solid foundation of statistical material, which unfortunately we do not have. At the outset I am not dis- posed to assume, on a merely empirical basis, a high degree of fecundity of the Chinese woman or a relative frequency of twins; for it is a common experience of our time that personal opinions and impressions along this line are seldom, if ever, upheld by the results of statistical research. Restraint in this case is the more commendable, as in regard to twin-births in Annam we have the following observation of Dr. A.-T. Mondiere ("Monographie de la femme annamite," Memoires de la Societe d'anthropologie, II, 1875, p. 474): "Les grossesses doubles sont excessivement rares chez la femme annamite. Sur les 153174 naissances que j'ai relevees sur les cahiers des villages de toute la Cochinchine de 1872 a 1877 inclus, je n'ai trouve que 15 accouche- ments de jumeaux. Soit 1 sur 10211 naissances. De plus, un arrondissement particulier, celui de Bentre, semble avoir ce privilege, MULTIPLE BIRTHS AMONG THE CHINESE »0 car sur 15 accouchements gemellaires il en a 9 a lui seul, c'est-a-dire 60 pour 100. Les six autres arrondissements (sur 19) qui en ont presente: Bien-hoa, Chau-Doc, Saigon, Soctrang, Tan-an, Tay-ninh, n'en ont eu chacun qu'un seul cas, en ces six annees. D'apres ce que les autorites cambodgiennes m'ont declare, les jumeaux seraient plus frequents chez eux, et d'une fagon assez sensible, mais ils n'ont pu me fournir de chiffre exact." A real investigation of the problem in question is impossible for the present, as we lack any vital statistics for the Chinese Republic. Nevertheless I venture to hope that the facts and observations given below will be of some interest to anthropologists. In order to critically balance the data furnished by the Chinese Annals, it would be indis- pensable to have reliable birth statistics for China, to know the birth- rate for the different provinces, and to depend on good records showing the total number of plural births for at least a decade. In default of such material in the mother-country I anticipated to receive at least some data from those countries outside of China with a large Chinese population, although it must be taken into account that social and economic conditions of the Chinese abroad are different and that, above all, Chinese emigrants hardly ever take their families along, but intermarry, when settled, with women of other nationalities. I have not yet been able to obtain relevant statistics from the British, French and Dutch colonies; but what' I have found thus far is not very encouraging. The Birth Statistics for the Registration Area of the United States for 1915 (Washington, 1917) give a total of 74 births (33 males and 41 females) among the Chinese for that j^ear, but nought else. According to a communication of Dr. William H. Davis, chief statistician in the Bureau of Census, Washington, D. C, there were, in the years 1915-17, 309 births among the Chinese in the registration area for births in the United States (California not being admitted to the registration area is not included), only one pair of twins appearing in this total. The State of California gives in its vital statistics only the number of births and deaths of its Chinese populace, without touching the question of plural births. In 1916 there were 425 births (compared with 727 cases of death); in 1917, 419 births (compared with 818 cases of death) among the Chinese of California (Twenty- Fifth Biennial Report of the State Board of Health of California for the Fiscal Years from July 1, 1916, to June 30, 1918, Sacramento, 1918, pp. 201, 203, 205, 207, 224). The statistics of Mexico contain merely 86 BERTHOLD LAUFER the number of Chinese living in the various provinces, the total, as taken in the third and last census of 1910, being 13,118 men and 85 women = 13,203 (Estados Unidos Mexicanos, Boletin de la Direccion General de Estadistica, Num. 5, p. 37, Mexico, 1914), but no tables of births. A literal translation of all cases of triplet and quadruplet births, as they are chronicled in the Annals, has been prepared by me. In every case, the exact date, the name of the family, the social status of the father, and the place where he lived are given ; also the distribution of sex in each birth is indicated. As this material would be unin- telligible without the use of Chinese characters, it is here omitted. Readers interested in this phase of the work may be referred to the New China Review of Shanghai, in which the complete article will be published. For some of the bibliographical references mentioned on the following pages I am under obligation to Dr. A. Hrdlicka, Curator of Physical Anthropology in the U. S. National Museum of Washing- ton. UNITED TWINS The Chinese Annals have preserved a few cases of twins grown together at birth. In this case, the question naturally is of twins produced from a single ovum. In the fourth year of the period Kien-hing (a.d. 316), under the Emperor Min of the Tsin dynasty, a woman of the family Hu, when she was at the age of twenty-five, the wife of Jen Kiao, a minor official (clerk) in the district of Sin-ts'ai (prefecture of Ju-ning, Ho- nan), gave birth to female twins grown together in the region of the abdomen and the heart, but separated above the breast and beneath the navel. — Sung shu, Ch. 34, p. 28. In A.D. 487 (under the Emperor Wu of the Ts'i dynasty), the wife of Wu Hiu, one of the people of Tung-ts'ien in Wu-hing (now Hu-chou fu, Che-kiang) gave birth to male twins grown together below the chest down to above the navel. — Nan TsH shu, Ch. 19, p. 16b. In the fourth month of the third year of the period Yi-fung (a.d. 678), King-chou (Kan-su) presented the Court with two infants the hearts of which were connected, but each with a separate body. Formerly it had happened that the wife, nee Wu, of Hu Wan-nien, a soldier of the guard in the district Shun-ku (Kan-su), gave birth to twins, a male and a female, whose breasts were connected, but who, for the rest, had individual bodies; when separated, both died. At a subsequent birth it was thus again. The twins were boys, and were MULTIPLE BIRTHS AMONG THE CHINESE 87 brought up. In the above mentioned year they had reached the age of four years, and were presented to the Court. — T'ang shu, Ch. 36, p. 21. In A.D. 1610, the wife of Li Yi-ch'en of Fan-ki (in Tai-chou, Shan-si), nee Niu, brought forth two girls with their heads and faces grown together, but with separate arms and legs. — Shan-si Vung chi ("Gazet- teer of Shan-si Province")- Two Chinese twins grown together, born in 1887, were shown by Barnum and Bailey in 1902, and at that time were still unseparated and well. Cf. R. Virchow, Xiphodymie (Z. Ethn., 1891, pp. 366-370). The modern Gazetteers occasionally record the birth of twins, not, however, on account of any special interest attached to the fact itself, but merely in order to emphasize the interest in the vitality of twins (cf. W. A. Macnaughton, The Longevity of Twins, Caledon. M. J., X, pp. 127-129, Glasgow, 1915). The following examples from the Gazetteer of Hwa-yang (Hwa-yang Men chi, Ch. 43, p. 4) will suffice to illustrate this feature. The wife of Chu Ch'ang-hwa, nee Lin, had 14 sons, among these 2 pairs of twins, who did not die prematurely, but are still alive. The wife of Chung Se-kin, nee Tsou, had 9 sons, among these one pair of twins still alive. The wife of Chung Chao-k'in, nee Chang, had 9 sons, among these one pair of twins still alive. The wife of Li Ch'ao-kung, nee Lin, had 8 sons, among these one pair of twins still alive. TRIPLETS Following is a summary of the Chinese data. For the period of the T'ang dynasty (a.d. 618-906) only two cases of a triplet birth are on record in the Annals. In a.d. 775 a woman of the family Chaiig gave birth to one male and two females, and in a.d. 905 triplets (males) were born by the wife of P'eng Wen, one of the people of Ju-yin in Ying-chou (Ngan-hwi or An-hwi Province). For the Sung period the data of triplet births are fuller than for any other dynasty. From a.d. 960 down to a.d. 1150 we have a total of 110 cases, listed with exact dates, family and place names, father's social status, and sex distribution in each triplet birth. For the time from a.d. 1023 to 1126 no list of names is given, but merely a statistical record which covers several reign-periods of emperors. It is here reproduced in tabular form. BERTHOLD LAUFER Records of Multiple Births in China, 1023-1126 Period Years Quadruplets (Males) Quadruplets (3 Males, 1 Female) Triplets (Males) Triplets (2 Males, 1 Female) Total 1023-68 1068-83 1084-99 1100-26 46 15 16 27 2 1 2 1 1 44 84 18. 19 1 1 47 86 21 20 Total 104 6 1 165 2 174 Quadruplets total 7 Triplets total 167 While the prececiing cases are not recorded in the way of vital statistics, but solely as unusual events, the above table conveys the impression of embracing a fairly accurate register of all multiple births (save twin births), which took place within the span of a century. The proportion of quadruplet to triplet births in this period is 1 : 23.86. The total of triplet births on record during the Sung epoch, accordingly, is 110 + 167 = 277. The total of quadruplet births during the same period is 7 (as shown by the above table) + 7 (recorded in the following section) = 14. The proportion of quadruplet to triplet births for the entire period of the Sung is 1:19.78; while the proportion for the entire period of Chinese history here considered (473-1643) is 1:10.8. This calculation is based on a total of 324 triplets and 30 quadruplets. There are no multiple births on record in the chapter Wu king chi of the Kin ski. The Yiian shi (Chs. 50-51), covering the period from 1260 to 1367, contains only 15 cases of triplets (all males), recorded under the years 1261, 1265, 1273, 1285, 1291, 1297, 1300, 1327, 1328, 1335, and 1363. In the years 1273, 1297, 1335, and 1363, two cases are listed for each year; and it is of especial interest that in two in- stances we have two cases of triplets in the same family, the interval between the two being in either case given as three years. According to Dr. Puech, to whom we owe excellent studies on the causes , of multiple births, the more children a woman has had at close intervals, the more she will be inclined toward these physiological anomalies. Three women admitted in the St. Petersburg Midwives' Institute between 1845-59 in their fifteenth pregnancy had triplets, and each had triplets three times in succession (J. M. Duncan, Fecundity, p. 71). For the period of the Ming dynasty (1368-1643) we lack official records ; but the section jen i of the T"w shu tsi dCeng gives a list of 30 cases of triplet births, extracted from the provincial and local Gazet- teers, and covering a period from 1404 to 1626. In 1413, 1515, and MULTIPLE BIRTHS AMONG THE CHINESE 89 1520, two cases are recorded in each year. In view of the fact that this material is extracted from a number of scattered books, it cannot lay claim to completeness; the figure 30 is certainly much removed from reality, but even if multiplied by 3 or 4, it is left far behind the total of the Sung period. On the whole, the impression prevails that the number of multiple births has steadily been on the decrease from the days of the Sung. This would agree with an anthropological theory to the effect that the phenomenon of multiple births in man represents a survival of or reversal to his former animal state and that with the advance of civilization the number of such births is liable to decline. There is a correct biological viewpoint in this hypothesis, but it does not account for all facts connected with the phenomenon, and, above all, conflicts with given data and statistics. It is not brought out by the vital statistics of any European country that the frequency of plural births is on the decline; on the contrary, in France, for instance, it is surprisingly high (see below). Further, if that theory were correct, we should naturally anticipate to find the greatest number of multiple births among primitive tribes, which for all we know is not the case. Hardly a century has elapsed that records of plural births have been taken in Europe, and this period is too short to allow us to indulge in much speculation on the subject. According to the Statutes of the Manchu Dynast}^, it was decreed in 1663 that in the case of a triplet birth or a twin birth of a boy and a girl, if it should occur among the people of the Eight Banners, a special report should be submitted to the Board of Rites; if it should occur in the provinces, the governor of such province should report to the Board of Rites, which would have to forward it to the Board of Finance, the latter to grant a premium of five piculs of rice and ten pieces of cloth. In 1674 it was ordered that a special report should be made solely in the case of male triplets, but not in the case of twins or female triplets. In 1684 an edict ordained that in the case of male triplets the Board of Rites and the Board of Finance should submit a joined report to the Throne, and that rewards should be authorized in accordance with law. This benevolent attitude toward the energetic propagators of the race was not an innovation of the Manchu, but a heritage of the Ming; for under the Ming we are fre- quently informed of special grants of food, cloth, and even paper money, made to these involuntary heroes from public funds. It may hence be inferred that under the Manchu regime a register of male triplets was kept, and presumably is still preserved in the 90 BERTHOLD LAUFER archives of Peking. If it should ever be published, the fact must be borne in mind that female triplets were not officially reported. Meanwhile we are thrown back for that period on the local and provincial Gazetteers, which in the chapter on untoward or abnormal events sometimes record cases of plural births. To cite a few instances of this kind in the period of the Manchu dynasty, — the Gazetteer of Ju-chou in Ho-nan (quoted above) enumer- ates four cases (all males), which occurred in 1770, 1785, 1824, and 1833. In 1797 a triplet birth occurred in Hwa-yang (prefecture of Ch'eng-tu, Se-ch'wan) ; the case was reported to the throne, and by imperial favor, a picul of rice was granted to the father, Yang Kwo-yli (Hiva yang Men chi, Ch. 43, p. 3). The Gazetteer of Mong-chou (prefecture of Hwai-k'ing, Ho-nan) cites only two cases for the years 1682 and 1736. Most Gazetteers which I have looked up are dis- appointing: thus the Gazetteer of Shen-si Province {Shen-si fung chi) contains only two cases of triplets, recorded for the years 1470 and 1729. In the Gazetteer of the Prefecture of Sung-kiang, three cases of triplets are recorded between 1367 and 1640 (according to D. J. Macgowan, Cosmical Phenomena Observed in the Neighborhood of Shanghai, Journal China Branch R. As. Soc, II, 1860, p. 74). The data of the Chinese certainly are defective, and cannot entirely satisfy the anthropologist. We miss, for instance, data concerning the ages of mother and father and order of birth in triplet deliveries {rang chronologique de V accouchement of the French statisticians). Above all, we should desire information as to the vitality and fecundity of the offspring. What the Chinese may boast of, however, is the fact that they possess lists of plural births for periods of the past when nothing of the kind was ever attempted in any country of Europe. In the vital statistics of France, plural births have been recorded only from 1858; and in no country of Europe did they receive any attention before the nineteenth century (in Berlin from 1825). The sum of 277 triplet births for the Sung and 324 for the time from the T'ang to the Ming inclusive may seem a high figure to the uninitiated; in fact, however, it is strikingly low. During the four years 1907-1910 there was in France a total of 327 triplet births; 91, 93, 68, 75 in the respective years, making a mean average of 81.75 per year (Statistique general de la France, Statistique du mouvement de la population, Paris, 1912, p. 56). There were, accordingly, more triplet births in France during those four years than in China in the MULTIPLE BIRTHS AMONG THE CHINESE 91 course of many centuries. Or, to cite another example, in the period 1835-47, there were in Bavaria 1,050 triplet, 56,062 twin, and 3,413,763 normal births. The frequency of triplets varies in different years and in different countries. In 1855, triplets were produced in Scotland by 11 mothers out of 92,300 births; that is, one in 8,391. Triplet births in Scotland from 1855 to 1901, a period of 47 years, numbered 644, and averaged 116 per million confinements (C. J. Lewis and J. N. Lewis, Natality and Fecundity, p. 62). I do not go any further into the question of the frequency of triplets in Europe and the proportion of triplets to twin and normal births, as the Chinese data are not com- parable, and as figures of total births are lacking for the Sung period. Judging from bur experience, it must be stated, however, that the Chinese data can hardly be complete; but there is no way of correcting or adjusting the figures, which we are simply compelled to take for what they are worth. The reader should not forget that the material furnished by the Chinese Annals is not intended as statistics, but merely as a record of extraordinary events in human life. In order to give a certain perspective to the number of multiple births, some data concerning the population may follow here. According to the calcu- lations of E. Biot C'Memoire sur la population de la Chine," Journal asiatique, 1836, p. 461), the population of China under the Sung totaled 43,388,380 in the year 1021, and rose to 100,095,250 in 1102; again in 1223, it amounted to only 63,354,005 (in consequence of the loss of northern China to the Kin). These figures, in all probability, are too high; for they are estimated on the number of families given in the Chinese records, the assumption being made that the mean average of the number of individuals in a family is 5, which, in my opinion, is too high a figure. The total number of triplets recorded for the T'ang and Sung periods is 279. The distribution of sex in this number is as follows: 273 all males, that is, 97.8 per cent; 4 consisting of 2 males and 1 female, that is 1.4 per cent; 1 consisting of 1 male and 2 females, that is, 0.04 per cent; and only one consisting of 3 females (0.04 per cent). Again, the 15 triplet births of the Yiian dynasty and the 30 of the Ming are all males exclusively. The above percentages perhaps give an approxi- mate clew to the actual frequency of sex in triplet births, as far as China is concerned. C. J. Lewis and J. Norman Lewis (Natality and Fecundity, p. 61, London, 1906), who base their remarkable study on the birth registers- of Scotland for the year 1855, during which year there were 11 triplet 92 BERTHOLD LAUFER births in that country (3 males, 5; 3 females, 3; 2 males and 1 female, 3), offer the following conclusion in regard to the distribution of the sexes: ''There is a strong probability that in any given occurrence of triplets the children will all be of the same sex, either all males or all females. If the same ratio held in other nations and in other years, it would amount to a law of triplet production that in over 70 per cent of cases the newly-born children are all of the same sex." In the period from 1858 to 1865, there were in France 1,005 triplet and 4 quadruplet births; among the former, there were 280 entirely males, 218 entirely females, 256 consisting of 1 male and 2 females, and 251 consisting of 2 males and 1 female. The number of twin births during the same period amounted to 83,279; of these 28,056 were two males, 26,310 two females, and 29,363 consisting of one male and one female (A. Puech, Annates d'hygiene puhlique, XLI, 1874). Of the 277 triplets recorded for the Sung period, the social standing of the fathers is given in only 110 cases, while the remaining 167 cases are merely recorded as chronological-statistical events. Among the 110 cases, the social status of the fathers is distributed as follows: Percentage Rural population 85 76.7 Field-laborers 1 1.1 Workmen 1 1.1 Soldiers 22 20.0 Petty officials 1 1.1 Total 110 100.0 In the Ylian period, 14 common people and 1 soldier share in the 15 cases of triplets placed on record. In the Ming period, 28 common people and 2 soldiers assume responsibility for 30 cases of triplets recorded. It will thus be seen that the bourgeoisie, inclusive of officials, gentry, and merchants, has no share in these records. Peasants and laborers, of course, formed the majority of the populace; but there is no reason why triplet births, if they had occurred in the upper classes, should not have been reported or recorded. In arranging our data according to families, we arrive at the result that the members of the families Li, Wang, Chang, and Liu, take the uppermost rank. The male Li reach the score with 16^ + 1'*, while two female Li figure with 2*; in the years 986 and 996 respectively we have two male Li participating in triplets. The record of the Wang is 13^ -f- 2^ (plus one female Wang P); the Chang follow with 93 -I- 2\ plus two female Chang (2^), and the Liu with 9^ -\- V, two MULTIPLE BIRTHS AMONG THE CHINESE 93 members of this family being conspicuous in the same year (1016). This does not mean, of course, that these four famihes are more prolific than others, but is merely the index of the fact that they are the most numerous and the most widely spread. The share of the members of the Yang family is expressed by the figure 6'', that of the Chao by 5^ (plus one female Chao P), that of the Cheng by 4^ (plus one female Cheng 1*). The Fung, Sie, and Sii have a 3^ to their credit; the Wei reach the mark 2^ + 1^, the Kwo 1^ + 1*, while the Chu, Hou, Kao, Mong, and Tung, can only boast of 2^ each. All other families are represented but once. These figures certainly have a mere relative value, and do not allow of any far-reaching inferences. It is assumed by anthropologists that the tendency to multiple births is frequently hereditary, both in the male and female line, more frequently in the former than in the latter; and there is no doubt that heredity is a potent cause in the perpetuation of plural births. In the case of triplets and to a still higher degree of quadruplets the hereditary tendency is particularly striking. Quadruplets often issue from parents who were multiples themselves. Female twins often give birth to twins. During the 61 years covering our records 1-109 (= 109'^), the high- water mark is reached in the year 991 with 9^, and there is only this one year that offers such a record. There are two years (998 and 1015) with 7\ two years (995 and 996) with 5^ 4 years (982, 983, 1014, and 1016) with 4^, 8 years with 3^ and 11 years with 2^. In the remaining years there is but 1'^ or 0^. In the Yiian period we have four years with 2^. QUADRUPLETS There is a total of 30 on record, the first in a.d. 473, the last in a.d. 1608, a span of 1,136 years. In this total of 30, 4 quadruplets fall to the lot of a single woman. Twenty-five out of the number of 30, that is 5/6 or 83.33 per cent, consist of males exclusively. The remaining 5 are distributed as follows: 3 cases consisting of 3 males and 1 female (10 per cent), 1 case being 2 males and 2 females (3.33 per cent) and 1 case being 4 females (3.33 per cent). In 1907 two quadruplet i)irths in France produced 5 males and 3 females; in 1908 there was one quadruplet birth of 4 boys; in 1909 three quadruplet births produced 10 boys and 2 girls; and in 1910, there was one quadruplet birth of 2 males and 2 females (Statistique du mouvement de la population, p. 56). 94 BERTHOLD LAUFER For 7 cases no personal data are on record; in a single case of the Ming period the father's social status is not indicated. In the remain- ing 22 cases we find 2 soldiers, 1 falconer, and 19 common people, in all probability, farmers. Again, we accordingly meet here with the same social status of the parents as in the case of triplets. As to the relative proportion of quadruplet to triplet births, see above, p. 50. Pliny (VII, 3, § 33) records the example of a quadruplet birth of two males and two females toward the end of the reign of Augustus and ascribed to Fausta, a Plebeian woman of Ostia (Fausta quaedam e plebe Ostiae). QUINTUPLETS It is striking and worthy of especial mention that the Chinese Annals do not record a single example of a quintuplet birth; at least I have failed in tracing any. Both Aristotle and Pliny were convinced of such an occurrence. Aristotle (Historia animalium, transl. of D'Arcy W. Thompson, p. 584b) states: ''Some animals produce one and some produce many at a birth, but the human species does sometimes the one and sometimes the other. As a general rule and among most nations the women bear one child at a birth; but fre- quently and in many lands they bear twins, as for instance in Egypt especially. Sometimes women bring forth three and even four chil- dren, and especially in certain parts of the world. The largest number ever brought forth is five, and such an occurrence has been witnessed on several occasions. There was once upon a time a certain woman who had twenty children at four births; each time she had five, and most of them grew up." Pliny (VII, 3, § 33) has it that in the Peloponnesus a woman was delivered of five children at a birth four successive times, and that the greater part of these survived (Reperitur et in Peloponneso quinos quater enixa, maioremque partem ex omni eius vixisse partu), — perhaps the same event alluded to by Aristotle. Nijhoff, in his interesting study " Vijflinggeboorten" (Groningen, 1904, 4°) has fully described and figured a case which came under his notice. He further reviews from literary records 29 more cases of quintuplet births, one of which only seems to be of doubtful authen- ticity. Cf. also S. Shishido, The Birth of Five Infants at One Parturi- tion (Iji Shinbun, Tokyo, 1901, pp. 433-438). SEXTUPLETS In regard to sextuplet birth, I have found only two cases on record. According to the Gazetteer of Chi-li Province (Ki fu Vung chi), it was MULTIPLE BIRTHS AMONG THE CHINESE . 95 in 1574 that a woman of the people of Fei-hiang (in Kwang-p'ing fu, Chi-li) brought forth six children at one birth. The name of the woman and the husband is not given. The other case is reported in the Sii KHen shu (Ch. 5, p. 8), a record of Kwei-chou Province, written by Chang Chu in 1805. In a certain village of western Kwei-chou a woman, nee Wang, gave birth to six sons at one time, both children and mother being well. The author, however, had this merely from hearsay. Xijhoff (p. 66) reports the case of a sextuplet birth in a peasant family at Castagnola near Lugano (Italy) in 1888 (4 males, 2 females, who were alive at the time of birth, but died in a few seconds) and another from Alburi on the Gold Coast in Africa after Dr. H. Vortisch of the Basle Mission. In the latter case a Negro woman is said to have been delivered of 5 boys and 1 girl, who for lack of care died shortly; the woman stated that it was her fifth deliverance, at the second she had twins, at the third quadruplets, and at the fourth triplets. An Italian woman, who in the fifth month of pregnancy miscarried, expelled six foetuses; the truthfulness of this report is generally conceded (J. Parvin, Science and Art of Obstetrics, 3d ed., p. 161). Other cases of sextuplet delivery are described in the Boston Medical and Surgical Journal, XXXV, 2, 1847, and by J. W. Kerr and H. Cookman (Med. Pres. and Circ, LXXV, p. 537, London, 1903: five boys and one girl). Cf. also Shishido, Examination of the Records of More than Five Infants at a Birth (//i Shinbun, Tokyo, 1901, pp. 1897-1901). SEPTUPLETS The Gazetteer of Chi-li Province (Ki fu Vung chi) has it on record that in 1527 a woman, nee Ch'en, of Ho-kicn (Chi-li), was delivered of seven girls at one birth, but that none of them survived. According to Trogus, there was a case of seven children at one birth in Egypt (Et in Aegypto septenos uno utero simul gigni auctor est Trogus, Pliny, VII, 3, § 33). Cases of septuplet birth are mentioned by Roy (Couches avec 7 foetus, in Revue medicale franqaise et etranghe, Paris, 1877, I, p. 225); cf. also R. C, Multiple Pregnancy with a Vengeance (Med. Rec, LXIII, p. 267, New York, 1903). It is reported in verso on a tombstone of Hamoln that on January 9, 1600, two boys and five girls were born to Thielc Roemer and Anna Breyers. The tombstone is adorned with a sculptured scene which shows six babes in swaddling-clothes on a pillow, while the lucky (?) father holds the seventh on his arm toward the Savior. Nijhoff 96 BERTHOLD LAUFER (p. 71-72), who has reproduced the tombstone, holds that the question is here of a veritable fact, as at that time no mockery was made of religious subjects. I am far from sharing this opinion. It is well known that the Germans have displayed a great deal of fun and humor on their epitaphs, collections of which have been made. The tomb- stone itself does not suffice to bear out the historicity of the case. It would be necessary to trace it in the parish-register, death-Jists, or any other documents in the archives of the town of Hameln; but this evidence, as far as I know, has not yet come forward. A case of eight children at a birth, as far as I know, is nowhere on record, but the following curious passage occurs in the book "Cos- mographie de Levant" (p. 114, Lyon, 1554) by F. Andre Thevet d'Angoulesme: "Non seulement ce pais abonde en fruits, et herbes: mais aussi en fleurs odoriferentes, Les femmes y sont tant fecondes, qu'elles engendrent communement trois, et quatre, et bien souvent huit enfans: et encores qu'ils naissent au huitieme mois, ils vivent: ce qu'aucuns attribuent a la bonte du Nil: Outreplus elles surengen- droient, (comme Pline raconte d'une femme d'Alexandrie) ce qui n'est pas tant signe de merveille, que argument de fecondite." Thevet is doubtless influenced by the passage of Pliny, and is somewhat in- clined toward exaggerations. I doubt very much that a case of octoplets has ever come under his actual experience: his statement is generalized, but no reference is made to a specific case. The preceding article discloses the fact that a department of vital statistics, either in connection with the Government or as a private enterprise, is urgently required for China. The motive which princi- pally guided me in writing this notice was to demonstrate by a concrete example the necessity of founding such an institution. It goes without saying that a statistical research into the population of China would mean a considerable advance of our knowledge, from which the econ- omists and sociologists all the world over might learn and benefit, and that the Chinese would yield the most fruitful material for all problems of heredity and eugenics. It is particularly genealogical research that could be carried on in China with most promising results. Another problem which is much on my heart is that of longevity and the average duration of a generation among the Chinese and Japanese; and if nothing interferes, I hope to make a small contribution to this question in the near future. RACE SUICIDE IN THE UNITED STATES WARREN S. THOMPSON Cornell University The question of the relative rates of increase of the population of old native stock and of that of immigrant stocks is one which has attracted the attention of anthropologists and students of our population move- ments for half a century or more. Studies of population movements in New England made more than fifty years ago showed that the birth rate among the people of native stock had been falling steadily since 1800, and that the Irish immigrants and their descendants were rapidly supplanting the old native stock. More recent data show that the same process is still going on, only now it is the French Canadians, the Italians, the Slavs and the Jews that are supplanting both the old native stock and the earlier immigrants of Nordic stock from the British Isles, the Scandinavian countries and Germany. Before we can proceed to a discussion of the questions involved in this process of substitution, we must examine the facts of population increase in various parts of the United States, in order to ascertain how far it is true that the old native American stock and the earlier immigrants are rapidl}' dying out and being supplanted by newer immigrants. EVIDENCES OF RACE SUICIDE The Registration Report of Maine for 1910 showed that the three counties in that state having the highest percentages of native stock had the lowest birth rates and also that the death rate exceeded the birth rate, while in the state as a whole the birth rate exceeded the death rate by 4.55 persons per 1,000. The Registration Reports also show that for some years past the number of marriages among the foreign born in Maine has been about 29 per cent of all marriages, while the children born to foreign born parents constitute about 40 per cent of all children born. A comparison of Auburn, a city of about 16,000 inhabitants of predominantly native stock, with Lewis- ton, a city of about 27,500, having a large French Canadian element, shows that in 1915 the former had a birth rate of 17.4 and the latter 97 AMF.n. JouH. Phy8. Anthroi'., Vol. III. No. 1. 98 WAEREN S. THOMPSON a rate of 27.3. The death rate is somewhat higher in Lewiston than in Auburn, but when allowance is made for this fact the former has a rate of natural increase more than twice as large as the latter — 10.5 and 4.6 respectively. In a study made several years ago, Kuczynski^ found that the mar- riage rate was much higher among the foreign born in Massachusetts than among the native born, and also that the birth rate of the former was much higher than that of the latter. According to his calculations the birth rate was 63 per 1,000 native-born "female adults," and 124 per 1000 foreign-born "female adults," during the fifteen-year period 1883-1897. He also pointed out that according to the state census of 1885, 20.18 per cent of the native-born married women had no children, while only 13.27 per cent of the foreign-born married women were childless. This same census showed, too, that the average number of children born to a native married woman was 2.69, while the average number born to a foreign married woman was 4.53. Numerous other studies confirm the general belief that in the north- eastern states the native population is being supplanted by the foreign- born population and their descendants. Hoffman^ says : "Engleman, as the result of his analysis of New England genealogies, shows that while in 1800 the average number of children was 6.1, it had decreased to 4.6 by 1830, to 3.3 by 1860, 2.5 by 1872, and for the upper classes of Boston to 1.8 by 1900." In a footnote on page 678 of this same article Mr. Hoffman states that an original investigation into the facts of American ancestry from published genealogies shows that the average number of children per family in the period 1700-1750 was about seven; 1800-1850 about five; 1850-1900 less than three. To confirm the conclusions justified by the facts found in genealogies he also gives data from the Rhode Island State Census of 1905 showing: (1) That only 71.6 per cent of the native women 15-45 years of age were married, while 82.5 per cent of the foreign women in the same group were married; (2) that the average number of children born to a native white woman was 2.06, while to a foreign white woman it was 3.35 (twenty years earlier the figures were 3.49 and 5.38 respectively); (3) that the proportion of native married women with one child was 23.4 per cent, while that of foreign married women was 16.4 per cent; (4) that only 19.8 per cent of the native married women had more than three children, while 38.7 per cent of the foreign married women iKuczynski (R. R.)— Quart. J. Econom., 1901, XVI, 1-36, 141-186. * Hoffman (Frederick L.) — Decline in the Birth Rate. A'". Am. Rev., 1909, CLXXXIX, 675-687. RACE SUICIDE IN THE UNITED STATES 99 belonged to this class; and (5) that at the age of 25, 39.0 per cent and at the age of 30, 29.1 per cent of the native married women were childless, while for foreign married w^omen at the same ages the per- centages were 25.6 and 15.9 respectively. A study made by the registrar of vital statistics for Michigan^ on the "fecundity of marriage by nativity" in that state, shows that for the twenty-year period ending with 1894 the number of children born per marriage where the mother was native was 3.2, and that where the mother was foreign both it was 5.6. The Registrar con- cludes that Michigan is rapidly following Massachusetts and other eastern states in its population movement and that within a short time its native population will be submerged by immigrants and their descendants. He quotes the following from the State Census as being in entire agreement with the conclusions he would draw from his own study of birth rates among the native-born and foreign-born classes : "Of the 53,228 children tabulated, the parents and grandparents of 10,880 were all native, and the parents and grandparents of 20,080 were all foreign-born. The former number is 1.20 per cent of the native inhabitants with native parents, and the latter is 3.72 per cent of the foreign-born with foreign-born parents. The latter number is 1.8.5 times the former." A recent investigation of the size of the families of the graduates of eight eastern women's colleges and one co-educational institution,^ shows that the average number of children born to those who have children in 2.1. This figure is somewhat too low because it includes many of the graduates of recent years who have been married but a short time and who, therefore, are not through child-bearing. The average number of children born to graduates in classes prior to 1880 who have married and have had children is 2.9; to those in classes between 1880 and 1890, 2.8 children; and to those in classes between 1890 and 1900, 2.6 children. Inasmuch as it is not safe to assume that the graduates between 1890 and 1900 who were married and had had children were through child-bearing in 1915, when the investiga- tion was made, wc shall probably not make a very grave error if we assume that their final average will be approximately the same as that of the graduates between 1880 and 1890— viz., 2.8. This same investigation shows that of the graduates prior to 1880 only 80.7 per cent of those married had had children; of those in ' Twentij-cighlh Registration Report, Michigan, 1894. 2 Van KJeeck (Mary),—/. Ass. Colleg. Alum., May, 1918. 100 WARREN S., THOMPSON classes between 1880 and 1890 only 77.7 per cent; and of those in classes between 1890 and 1900 only 78.3 per cent. Thus we see that the graduates of these colleges who marry and raise families have scarcely enough children to replace themselves and their husbands in the next generation, to saj^ nothing of the 20-22 per cent who marry and have no children and the 40-50 per cent who do not many. If we take for granted that there is a bachelor for every unmarried woman among college graduates the situation might be expressed as follows: Out of each 1,000 men and women belonging to this class 400 do not marry, of the 600 married couples 120 are childless, leaving 480 who have children with a total of 1,344 children born to them, of whom approximately 1,150 live to reach the average age of college graduates. A few of these will die before they reach the customary age of marriage. It is, therefore, a conservative estimate to say of this class as a whole, that deaths are to births as 2000 : 1100, or 20 : 11.^ It is very clear that this class is not sustaining itself and that the conclusions arrived at by the studies cited above certainly hold true for this particular group of the native population. An investigation made by the Immigration Commission several years ago still further confirms the general belief that the native population is being rapidly supplanted by the immigrant stocks. In this investigation it was found that in ^ Rhode Island the average number of children born to native white women of native parentage, married ten to nineteen years, was 2.5, while the average number born to white women of foreign parentage, married ten to nineteen years, was 4.5; for Cleveland the figures were 2.4 and 4.3; for Minneapolis 2.4 and 3.8; for certain rural counties in Ohio 3.4 and 4.5; and for certain rural counties in Minnesota 3.4 and 5.2, respectively. After one has examined a number of studies such as those referred to above, he is likely to feel that it is only a matter of a few decades (with immigrants coming as rapidly as they were before the war) until the older stocks, Celtic, Teutonic and Scandinavian as well as Anglo-Saxon, will be supplanted by the newer Latin, Slavic and Hebrew stocks. The evidence submitted is seemingly overwhelming. It will be noticed, however, that most of the data upon which these studies are based have been gathered from the northeastern states — largely ^ The death rate used in the above calculation is the extremely low one found by this study to exist in this class — viz., that only 13.0 per cent of the children of graduates prior to 1880 had died by 1915. RACE SUICIDE IN THE UNITED STATES 101 from New England. The question naturally arises, therefore, whether the population movements of this section of the country are typical of those taking place elsewhere. It seems to the writer that the probabilities are against this being the case. The social and industrial conditions in the northeast are so entirely different from those in most other sections that it would be strange if the population movements there were the same in nature and extent as they are in other parts of the nation. The northeast is a relatively denselj^ settled area in which manufacturing and commerce are the predominant interests, while agriculture is the predominant interest in most of the other states. Again, the population of the northeast is much more heterogeneous than that of most other sections. Not only did the northeast retain its due share of immigrants before 1890 but it has retained most of those who have come in since that time, for the newer stocks which occasion so much concern to most writers on race suicide are to be found mostly in the northeast and a few large cities along the Great Lakes. Since this is the case it becomes necessary, in order to study popula- tion movements, to classify our population not only on the basis of state of residence but also on the basis of type of work done. For this purpose I have adopted the Census classification of urban and rural. I believe that if we can measure the relative rates of increase in these groups as well as in the different states we can arrive at a more accurate notion of population movements in our country. If we had good statistics of births and deaths for all states and their minor civil divisions, we could tell what the natural increase is in cities, counties and even townships, as well as in the state as a whole. By using the data of the Federal Census in connection with data from the vital statistics of the states, we could compare the rate of growth in political units having populations chiefly composed of different stocks. Unfortunately only a few states have comprehensive birth statistics and these must be used with many reservations. For one thing, there is good reason to believe that the data for the rural districts are more defective than those for the cities, so that a comparison between the rates of growth in these two classes on the basis of pub- lished vital statistics is fraught with danger. In addition to this difficulty all places having less than 10,000 people are classed as rural in the federal reports on births, while only those having less than 2,500 are so classed in the decennial census. Furthermore, the birth rates and death rates for intercensal years are based on estimates of popula- 102 WARREN S. THOMPSON tion and are liable to a considerable error with regard to an_y particular city, county or state. Lastly, the age and sex distribution in different areas are so unlike that crude birth rates and death rateis tell us but very little regarding the fecundity of women in these different areas. In view of these facts the writer has prepared some tables from data given in the Federal Census of 1910 which he believes will show the most significant population movements in the United States better than such birth statistics as we now have. The general method used in the preparation of these tables — that of showing the proportion of children at certain ages to women of child- bearing age — is one which Professor Wilcox has made familiar to all those interested in our population problems. It is not claimed that these tables show us the exact rates of increase in the urban and rural populations of the different states, but merely that they will enable us to determine with fair accuracy what groups are contributing most children to the next generation. This is all we need to do in a dis- cussion of race suicide in the United States. For the phrase race suicide has never been used by those conversant with population facts to refer to a low rate of natural increase, but rather to the fact that the children contributed by one nation or class to the next generation were relatively fewer than those contributed by another nation or class. The natural consequence of such a situation is that the nation or class with a low child-contributing rate is supplanted sooner or later by a nation or class with a higher child-contributing rate. In the United States the serious question is, whether the people from northern and western Europe — British, Scandinavian and Teu- tonic — are being supplanted by those from southern and eastern Europe — Mediterranean, Slavic, and Hebrew — and not whether the natural increase of the nation as a whole is sufficiently high. There seems to be little doubt that the rate of natural increase for the nation as a whole (i.e., annual excess of births over deaths per 1,000 of the population) is as high as that of most civilized countries. RACE SUICIDE IN THE UNITED STATES 103 Table I — Showing the Proportion of Children to Women in the United States, the Geographic Divisions and the States: also the Proportion OF Women ant) of the XATm; Born of Native Parents in the Total Popu- lation of these Different Areas No. Children Percent of Total Under 5 Yrs. No. Children Population Percent of Totai Geographic Area per 1,000 5-9 Yrs. per Comprised by Population Women 15-44 1,000 Women Women 15-44 Native Born of Yrs. 15-44 Yrs. Yrs. Native Parents United States: whites Urban 382 341 25.4 41.9 Rural 603 555 21.2 64.1 New England States: Urban 384 345 25.7 33.9 Rural 458 437 1 20.4 69.8 Maine: Urban 388 359 24.3 65.1 Rural • 493 458 ; 20.2 78.9 New Hampshire: Urban 385 353 24.7 41.0 Rural 428 409 20.3 71.5 Vermont : Urban 392 370 24.1 54.3 Rural 489 472 20.0 73.6 Massachusetts : Urban 376 336 26.2 30.8 Rural 412 399 21.3 58.6 Rhode Island: Urban 390 428 349 396 25.7 21.0 28.2 Rural 66.2 Connt:cticut : Urban 405 363 25.2 33.1 Rural 450 441 20.3 56.4 Middle Atlantic States: Urban 402 351 26.2 34.4 Rural 518 477 21.2 67.0 New York: Urban 379 332 26.9 27.2 Rural 420 407 21.2 66.1 New Jersey: Urban 420 374 25.8 33.6 Rural 440 382 22.4 58.7 Pennsylvania: Urban 433 373 25.4 45.8 Rural 599 534 20.9 69.2 East North Central States : Urban 382 523 340 506 25.9 21.3 41.7 Rural 66.5 Ohio: Urban 370 324 26.1 51.0 Rural 500 478 21.4 79.6 Indiana: Urban 361 335 25.7 67.8 Rural 503 493 21.7 87.0 Michigan: Urban 395 347 25.6 35.5 Rural 535 i 513 20.7 50.8 104 WARREN S. THOMPSON Table I — (Continued) Geographic Area No. Children Under 5 Yrs. per I.OCO Women 15-44 Yrs. No. Children 5-9 Yrs. per 1,000 Women 15-44 Yrs. Percent of Total Population Comprised by Women 15-44 Yrs. Percent of Total Population Native Born of Native Parents Illinois : Urban 388 529 398 562 344 582 353 598 335 526 328 583 384 716 355 618 361 581 367 567 393 678 401 447 366 516 299 390 646 410 703 465 716 342 507 369 557 317 548 319 602 325 508 303 549 325 607 326 563 321 534 339 525 354 604 344 455 348 505 279 353 599 359 615 395 620 26.1 21.8 25.4 20.8 26.4 21.3 26.1 20.3 25.9 21.8 27.2 21.6 26.9 20.6 25.9 21.2 26.3 21.7 25.7 21.5 26.4 21.5 25.1 21.8 26.4 22.2 27.4 26.5 21.6 26.3 21.0 26.3 21.4 32.3 Rural 68.4 Wisconsin: Urban 28.5 Rural West North Central States : Urban Rural MlNNESOT.\: Urban Rural Iowa : Urban Rural Missouri: Urban Rural North Dakota: Urban Rural 35.9 51.2 58.5 29.2 26.7 58.2 58.8 55.0 85.5 37.7 27.0 South Dakota: Urban Rural Nebraska: Urban 51.5 40.6 51.8 Rural Kansas : Urban Rural 54.6 70.3 71.8 South Atlantic States: Urban 54.2 Rural 62.2 Delaware : Urban 52.9 Rural 72.7 Maryland: Urban 50.7 Rural 67.9 District of Columbia: White 50.4 Virginia: Urban 59.4 Rural 65.7 West Virginia: Urban 74.8 Rural 87.8 North Carolina: Urban 61.2 Rural 68.4 RACE SUICIDE IX THE UNITED STATES 105 Table I — (Continued) Geographic Area No. Children Under 5 Yrs. per 1,000 Women 15-44 Yrs. No. Children 5-9 Yrs. per 1,000 Women 15-44 Yrs. Percent of Total Population Comprised by Women 15-44 Yrs. Percent of Total Population Native Born of Native Parents South Carolina: Urban 441 379 26.2 49.6 Rural 702 603 21.9 42.7 Georgia : Urban 418 372 1 26.6 52.4 Rural 727 639 21.4 53.5 Florida : Urban 437 387 25.7 37.1 Rural 683 607 21.1 54.8 East South Central States : Urban 378 696 349 619 26.7 21.6 54.4 Rural 67.2 Kentucky: Urban 340 669 325 609 27.0 1 . 21.6 58.2 Rural 88.8 Tennessee : Urban 366 335 27.2 57.2 Rural 671 ' 599 21.9 80.4 Alabama : Urban , 453 398 26.0 49.8 Rural 752 651 21.3 56.2 Mlssissippi: Urban 427 390 ' 26.1 46.7 Rural 727 641 1 21.5 41.5 West South Central 1 States : Urban 405 384 26.0 58.4 Rural 729 658 21.2 67.7 Arkansas : Urban 396 371 26.5 61.0 Rural 754 653 21.2 69.5 Louisiana : Urban 391 385 26.2 43.8 Rural 765 699 21.0 48.2 Okl.\homa: Urban 421 379 25.5 76.0 Rural 735 658 1 21.0 79.8 Texas: 1 Urban 405 388 ; 26.1 59.5 Rural 708 651 I 21.3 69.1 Mountain States: Urban 382 350 1 25.5 51.9 Rural 641 564 I 19.9 57.8 Montana: Urban 378 570 340 505 24.7 18.7 40.3 Rural 44.7 Idaho : 375 347 24.4 62.7 Rural 674 598 19.9 62.5 Wyoming: 1 Urban 396 348 22.6 51.7 Rural 629 528 18.2 56.8 106 WARREN S. THOMPSON Table I — (Continued) No. Children Percent of Total Under 5 Yrs. No. Children Population Percent of Total Geographic Area per 1,000 5-9 Yrs. per Comprised by Population ■Women 15-44 Native Born of Yrs. 15-44 Yrs. Yrs. Native Parents Colorado : Urban 321 307 26.9 56.9 Rural 593 525 20.6 62.1 New Mexico: Urban 425 409 26.2 74.0 Rural 679 609 20.8 78.8 Arizona : Urban 439 385 24.5 42.1 Rural 634 545 19.4 39.6 Utah: Urban 515 445 24.3 42.5 Rural 792 693 19.9 48.9 Nevada: Urban 290 279 25.6 49.8 Rural 425 366 18.6 41.8 Pacific States: Urban 301 271 25.7 46.9 Rural 509 480 19.9 54.8 Washington : Urban 335 303 24.6 48.7 Rural 566 529 19.6 54.2 Oregon: Urban 288 263 , 25.5 55.4 Rural 524 507 20.0 67.5 California : Urban 290 261 26.2 44.4 Rural 469 439 20.0 50.0 THE PROPORTION OF CHILDREN IN THE RURAL AND URBAN POPULATION The above data throw considerable light on the child-producing rates of women in the rural and urban populations of the United States and its constituent parts. In the United States as a whole the white women^ of child-bearing ages in the rural districts had 221 more children under five years of age to each 1,000 than the women of the urban districts — i.e., each 1,000 rural women 15-44 j^ears of age had about 58 per cent more children under 5 living at the time of the census than the women in the urban districts. The actual numbers of women and children in these two classes are well worth giving. There were 10,382,634 women in this age group in the urban districts having 3,966,957 chil- dren under 5, while there were only 8,877,985 women in the same age group in the rural districts but they had 5,355,957 children under 5. Although there were only 85.5 per cent as many women in the ^ The discussion will refer only to the white population unless negroes should be specifically mentioned. Table I gives data for white population only. RACE SUICIDE IN THE UNITED STATES 107 rural districts as in the urban yet they had 35 per cent more children. If the women in the urban districts had had as many living children under 5, per 1,000, as the women in the rural districts they would have had a total of about 6,261,000 instead of only 3,966,957. Not only in the United States, as a whole, was the proportion of children to women larger in the rural districts than in the urban districts, but this was also true for every state in the Union. In the New England states the difference was not large — a little over 19 per cent — and in Massachusetts it was only 9.6 per cent. In some states, however, the difference was over 80 per cent — 86.5 per cent in North Dakota and 83.3 per cent in Tennessee. THE URBAN POPULATION In the urban population the proportion of children is generally between 300 and 400 to 1,000 women of between 15 and 44 years. In a few states of the northeast, in most of the southern states and in a few of the mountain states it exceeds 400. In only one state — Utah — does it exceed 500, while in two states only — California and Oregon — and the District of Columbia, is the proportion of children less than 300. In spite of several exceptions, I believe one is justified in making the following general statement regarding the proportion of children in the urban population of the different states : Those states in which the white population is mostly of the older stock — the southern states — have the largest proportion of children; those states having a considerable percentage of newer immigrants in their population — mainly in the northeast — have the second largest proportion of children; next come those states in which older immi- grants predominate — e.g., Wisconsin and Michigan — and lastly those states in which old native stock and the older immigrants seem to be pretty nearly equal in numbers. In view of these facts there can be no doubt that the newer immi- grants who live chiefly in the cities of the northeast and in those of tiie Great Lakes region are contributing by far the largest increment to our urban population year by year by an excess of births over deaths. THE RURAL POPULATION In sharp contrast to the great uniformity in proportion of children to women in the urban population is the wide variation in the propor- tion of children in the rural population — from 412 in Massachusetts to 108 WARREN S. THOMPSON 792 in Utah. In general, the proportion is smallest in those states of the northeast where agriculture is of least importance and greatest in the south and southwest where agriculture occupies the attention of almost the entire white population. The states in the middle west and west have, as a rule, a larger proportion of children than the states of the northeast but a smaller proportion than those of the south and south- west, and in most of these states the proportion of the population engaged in agriculture is greater than in the states of the northeast but smaller than in the states of the south and southwest. The full significance of the relatively high proportion of children in the rural population becomes clear when we consider this fact in connection with the data in the fourth column of Table I. In prac- tically every state the rural population contains a much greater proportion of native born of native parents than the urban population. Of the rural white population over three-fourths is native born of native parentage, while only about four-ninths of the urban white population belongs to this class. Furthermore, the one-fourth of the rural population which is of foreign stock is composed chiefly of Teutonic, Scandinavian, Irish and English immigrants and their chil- dren, so that the bulk of our rural population is of the same general strain. In view of the facts adduced above there seems no good reason to fear that race suicide is taking place in the whole of the United States. The older native stock is not yielding its place to the newer immigrants except in the cities of the northeast. It is the rural population ap- parently which is destined to supplant the city population. Although the newer immigrant women who live very largely in the cities have a higher birth rate than the native women with whom they come into competition, yet they do not have as high a birth rate as the rural women. Moreover, they soon succumb to the influences of the city environment so that their birth rate becomes lower. In the investiga- tion of the Immigration Commission in Rhode Island it was found that of white women of foreign parentage under 45 years of age and married 10-19 years, 7.2 per cent of the first generation had no children and 10.5 per cent of the second generation, while in rural Minnesota the percentages were 2.6 and 2.8 respectively. The average number of children born to women of these groups in Rhode Island was 4.7 in the first generation and 3.9 in the second generation, while in rural Minnesota the averages were 5.5 and 4.7 respectively. This same investigation also showed that the percentage of childlessness among RACE SUICIDE IN THE UNITED STATES 109 the immigrant women of certain cities, married 10-19 years, was greater than among the native women, married the same length of time, in certain country districts. Table II — Showing Number of Children under 5 Years of Age per 1,000 M.vRRiED, Widowed or Divorced White Women 1.5-44 Years of Age; also Percentage of these Women ake op All Women of these Ages in the Urban and Rural Populations of the United States ant) its Geographic Divisions. Census 1910 Geographic Area Percentage Married, Widowed or Divorced Women 1 5-44 are to all Women 15-44 Number of Children Under 5 to 1,000 Married, Widowed or Divorced Women Urban Rural Urban Rural United States 57.8 53.9 56.7 59.2 57.4 i 58.4 ■ 59.8 1 63.9 ' i 63.6 I 61.6 ! 64.6 63.8 62.7 63.2 62.0 63.7 66.5 69.5 70.6 67.6 660 714 709 645 599 672 632 633 601 489 933 New England . . . . ' Middle Atlantic 718 827 East North Central 828 West North Central South Atlantic East South Central 937 1066 1047 West South Central Mountain Pacific 1050 907 754 It may be argued against the position taken here that the reason the proportion of children is higher in the country than in the city, is because the percentage of women of child-bearing ages in the total population is much smaller in the rural districts than in the cities (see column 3 of Table I), and also that the percentage of married women is higher in the rural districts than in the cities (columns 1 and 2 of Table II). These facts cannot be disputed but they do not prove that country women do not raise more children than city women. They merely point to two of the reasons why the proportion of children to women is larger in the country than in the city. Table II, columns 3 and 4, shows that when allowance is made for the fact that the percentage of women is smaller in the rural districts than in the cities and also for the fact that more of them marry, the proportion of chil- dren to women is still much larger in the rural districts. In the United States as a whole 1,000 married women between 15-44 years, living in the country, have 41.3 per cent more children under 5 than 1,000 city women. In New England alone there is practically no difference in the number of children per 1,000 married women 15-44 in the rural and urban districts. In the Middle Atlantic States the difference is 16.6 per cent, in the East North Central States it is 28.4 110 WARREN S. THOMPSON per cent, while in all other sections it is over 50 per cent. The married women of the urban districts constituted 51.1 per cent of all married women but they had only 42.5 per cent of the children under 5. Thus we see that the facts regarding the proportion of children to married women also support the conclusions drawn from Table I. It is the women in the rural districts who are raising the greater part of the children of the next generation, and these women are largely of the same basic stock as that by which the nation was originally constituted. The facts regarding where the children of the United States are found show beyond question that so far as race suicide is a fact it is confined to certain classes of the urban population, and to the rural population of a few states where urban industrial life is so predominant that its influence is strongly felt even in the rural districts. It is due to the fact most people have only studied the movements of population in a few states where urban industrial life is almost universal that there is such widespread misapprehension of the real situation. I would not be understood to overlook the likelihood that the older stocks in this country may be supplanted by the newer immigrants. But, in my judgment, this will not come about by the immigrant mother raising more children than the mother of older stock (so long as the newer immigrant women live in cities and the women of older stocks live in the country), but rather by there being more women of these newer stocks than of the older stocks — i.e., immigration may be so large as to swamp the older stocks. The influx of people from other countries is, in many respects, a separate problem from that of race suicide and will only be touched upon in this paper where necessary. DIFFERENCES IN DEATH RATES IN THE URBAN AND RURAL POPULATION The following table gives in very brief form the best data available regarding the differences in the death rates of the urban and rural population r^ This table shows that the death rates for both sexes are consider- ably higher in the city than in the country. There is one exception. Women at the age of 20 have a slightly lower death rate in the city than in the country. Moreover, there is no doubt whatever that these 1 All places having under 8,000 population in 1900 and under 10,000 population in 1910 are considered rural. As will be pointed out below this method of determining urban and rural tends to exaggerate the death rate in the rural population. These data are compiled from "United States Life Tables" published by the Bureau of Census, 1916. RACE SUICIDE IN THE UNITED STATES 111 data understate the difference in death rates because the population of all places having between 2,500 and 10,000 is included with the rural population and in the northeast such places are usualty manu- facturing towns. In these small manufacturing towns the living conditions are often as bad or even worse than they are in the large cities and so including these towns with the rural districts would undoubtedl}' raise the death rates of the latter. NuJiBER OF Deaths per Annuji per 1000 Persons Living at Different Ages: Original Registration States :i 1910 (Whites Only) Males Females Urban Rural Urban Rural Under 1 year of age During tenth vear 133.80 2.88 103.26 2.17 4.31 5.33 6.90 10.24 21.19 48.79 111.23 2.52 3.82 6.08 8.58 13.74 28.65 59.16 84.97 1.88 During twentieth year During thirtieth year During fortieth jear During fiftieth year During sixtieth year During seventieth year 4.49 6.83 11.61 18.34 ' 36.07 69.42 3.97 5.44 6.53 9.43 18.72 45.12 Some studies of infant mortality made by the U. S. Children's Bureau show beyond question that the death rate of infants under 1 year is much smaller in the open country than in cities. In Water- bury, Conn., the infant mortality rate (the number of children dying during the first year of life per 1,000 born alive) was found to be 122.7; in Saginaw, Mich., it was 84.6; in Brockton, Mass., it was 96.7; in Johnstown, Pa., it was 134.0; and in Manchester, N. H., it was 165.0. In a rural district in Montana the infant mortality rate (approximate) was found to be 71; in a rural district in Kansas it was 40; in a low land rural district in North Carolina it was 48.1 for the whites and 64.4 for the negroes. The North Carolina report says:^ "A comparison of the findings of these rural surveys with the findings of infant mortality studies in cities and towns, tends to con- firm the impression that rural conditions are distinctly more favorable than urban conditions to infant life." All of the mortality reports issued by the Census Bureau confirm this view. In Massachusetts ' The original registration states are chiefly in the northeast. * Rural Children in Selected Counties of North Carolina, Children's Bureau Pub. No. 33, 1918, 37. 112 WARREN S. THOMPSON the infant mortality rate for the "Registration Cities" was 102, while in the rural part of the registration area of Massachusetts it was 92. ^ But this is not a fair comparison, because many people who are living under urban conditions are included with the rural population. A fairer comparison will be between the rate of the registration cities and that of the rural area in those states where the rural area includes the largest proportion of population really living in the open country. In the cities of the registration area in 1915 the infant mortality rate for white childi;en was 102, in the rural part of Michigan it was 78, while in the rural parts of Minnesota (the most representative agri- cultural state in the registration area) it was only 67. Although, as was mentioned above, the incompleteness of the registration of births (the Children's Bureau has found over 10 per cent of the births un- registered in all of the cities where it has made investigations) renders these rates highly inaccurate, yet they are of vahie for purposes of com- parison,- and when considered in conjunction with the other data given above, show beyond doubt that the chances of a baby living through the first year are from 50 per cent to 100 per cent greater in the country than in the city. The studies of the U. S. Children's Bureau also show that the infant mortality rate of children born to foreign mothers is generally much greater than of those born to native mothers. In Saginaw, Mich., the infant mortality rate of children born to native mothers was 70.5, while of those born to foreign mothers it was 127.6; for Waterbury, Conn., the rates were 97.9 and 134.8 respectively; for Johnstown, Pa., 104.3 and 171.3; for Manchester, N. H., 128.1 and 183.5; and for Brockton, Mass., 101.5 and 92.0. Brockton- is the only city in which the infant mortality rate among the children of natives was higher than among the children of foreigners. Of this situation the report on infant mortality in Brockton says: ''Few, if any, New England manufacturing cities have shown similar results." ^ In the study of the families of the graduates of women's colleges referred to above it was found that the infant mortality rate was only 45. 1 The rural part of the registration area includes all places of less than 10,000 inhabitants as well as the open country. ' If the situation in Kansas is at all typical of that in other states the com- parison between infa;nt mortality rates in the city and country on the basis of registra- tion reports is in favor of the city for it was found that unregistered births were much more common in the country than in towns. 3 Infant Mortality: Results of a Field Study in Brockton, Mass., Children's Bureau Pub. No. 37, 1919, 56. RACE SUICIDE IN THE UNITED STATES 113 The facts given above justify the conclusion that in the United States, as a whole, the infant mortality rate of children of native mothers is not more than 55 to 65 per cent of that of children of foreign mothers. Reasons for a Larger Proportion of Children to Women in THE Rural Districts than in the Urban Districts The reasons which explain the fact that there is a larger proportion of children to women in the country than in the city are of two kinds: (1) those which explain the lower death rate in the countrj^, and (2) those which explain the larger average number of children born to country women. reasons for a lower death rate in the country The investigations of the U. S. Children's Bureau enable us to say with considerable certainty why the infant mortality rate is lower in the country than in the city. One of the chief causes of death among infants is found to be gastric and intestinal diseases. These diseases can be avoided to a large extent by proper feeding. The following quotation shows that country babies fare better than city babies in this respect:^ "If the feeding history of these country babies in Kansas is compared with that of the city babies of native mothers in Johnstown, Pa., and Manchester, X. H. — the first two cities where this study was made by the Children's Bureau — and in Akron, Ohio, the larger of the cities of the Middle West, we find that exclusive breast feeding is much more common through the first nine months in this Kansas county than in any of these (with the exception of the last three months in Akron), and, conversely, that artificial feeding is even more markedh* absent. Since breast feeding, especially in the early months, is proved and acknowledged to be an im- portant factor in protecting a baby's chance of life, this fact of the unusual prevalence of breast feeding probably accounts, in part at least, for the low death rate among this group of country babies." Quotations might be made from other reports to the same effect but there is no need to accumulate evidence on this point. Another class of important causes of death among infants is diseases of early infancy and malformations which include premature birth, congenital debility, injuries at birth, etc. In Waterbury, 31.6 per cent of all infant deaths were due to conditions existing before the birth of the child or to injury and accident at birth; of those that ' Maternity and Infant Care in a Rural County in Kansas. Children's Bureau Pub. No. 26, 1917, 42. 114 WARREN S. THOMPSON died under two weeks, 72.7 per cent dies from these causes. It has been proved conclusively that many deaths from these causes are preventable if the mother has good prenatal care and the services of a skilled obstetrician during confinement; and the investigations of the Children's Bureau show that rural mothers generally have better care than mothers among the poorer classes in our cities. The social and economic causes which underlie these and other medical causes of infant deaths cannot be discussed here. Suffice it to say that poor housing, low wages, work of the mother outside of the home, ignorance, etc., all contribute to a high infant death rate and that their influence is felt more among the workers of our cities than in the open country. Out-of-door life of country people is an important cause of their lower death rate. We have no way of measuring the influence of this factor on the health of people; but the results of the physical examina- tions for the first draft show that those states which are most typically agricultural had a larger percentage of physically qualified men than those states which are most typically industrial and commercial. In Kansas 77.22 per cent of those examined were physically qualified; in Nebraksa 79.85 per cent; in South Dakota 85.87 per cent; and in Iowa 77.82 per cent. These are all typically agricultural states in which the city population is relatively small, so that boys from the farms constituted a very large percentage of all those examined. On the other hand, in Massachusetts only 64.52 per cent of those examined were physically qualified; in Connecticut 53.70 per cent; in New York 69.47 per cent; and in Pennsylvania 53.33 per cent. These states are largely urban, most of the people being engaged in manufacturing, commerce and mining. The writer believes that much of this difference is due to the greater healthfulness of the outdoor life of country people. He is well aware that the country home and its surroundings are often subject to criticism from the standpoint of health. In spite of deficiencies, however, he believes that the average country home is a more healthful place to live than the average home of a working class family in the city, and that the better class of country homes are more healthful than the better class of city homes. At its worst the country has no counterpart of tenement life in the big cities and shanty life in mining camps and mill towns; at its best the country has homes superior in healthfulness to the homes of the wealthy. The proof of this latter statement is to be found in the fact that wealthy city people actually spend a great deal of their time away from their city homes out in the country. RACE SUICIDE IN THE UNITED STATES 115 Another reason for the lower death rate in the country is the fact that people there are closer to a pure food supply. Country people still prepare for themselves much of what they eat. They kill their own poultry, pork, and veal to a large extent. They can much of the fruit and vegetables they use during the winter besides having an abundance of fresh vegetables during the season. Many kinds of fruits and vegetables can be stored so that they are available, prac- tically fresh, during a large part of the year. It may seem to many that our present system of distribution makes it possible for the city dweller to have just as good a quality of fresh food as the farmer and that, therefore, the difference in kind of food used by these groups is not an important cause of difference in death rates. It is true that it is possible for the city dweller to have just as good a quality of food as the farmer, but as a matter of fact only the well-to-do secure the best quality. Fresh, whblesome food in sufficient amount is bej^ond the means of the majority of city dwellers. If one doubts this let him read the reports of cit}'^ health commissioners and of the physicians emploj^ed by school boards to make examinations of the children; or, let him spend a few hours in the more densely populated parts of any moderate-sized or*large city and watch the poor buying their food. Another phase of this situation in the city is that those who have the means to secure an abundance of the best food ai;e usually those who lead more or less sedentary lives. These people, as a rule, do not take enough exercise to use up their food and get rid of waste matter. The farmer, on the other hand, may eat very heartily but his active life renders him less likely to suffer from over-eating. The writer has often been impressed with the fact that in the cities one sees large numbers of soft flabby men while in the open country one seldom sees such a man, the farmers being generally lean and hard. The relative security of the farmer's position is another reason for a lower death rate in the country. He is not harrassed by the un- certainty of his job and income, as a great proportion of the salaried and wage-earning classes in the city. He does not need to fear that some machine will be invented to take his job, nor that he will be turned off in hard times because of lack of work. There is no danger that his industry will move away from him, forcing him to take up some new work or spend all of his savings in moving his family to a new home, nor do strikes and lock-outs affect the farmer in any appre- ciable degree. Furthermore, the farmer does not have to compete with an ever renewed supply of immigrant laborers having a lower 116 WARREN S. THOMPSON standard of living. This does not mean that the farmer does not have his "hard luck" just as the city laborer does, but that is not likely to force him into such dire straits as it does the latter. If crops are a failure the whole neighborhood feels it, but no farmer is likely to lose his position as a farmer because of that. He receives a temporary set-back but he is in little danger of being forced to rely on public charity to see him through. As a result of this greater security of life the farmer should be, and it is reasonable to believe is, less subject to worry than the city man, and that worry affects health is unquestionable. Country people are also less affected by accident and occupational diseases than city people. One proof of this is found in the fact that it is the practise of companies selling insurance to the working classes in cities to charge them a much higher premium than they do farmers and those in other occupations. Of a total of 1,222 fatal industrial accidents reported to the Canadian Department of Labor during 1918 only 36 or 2.9 per cent were in agriculture. In 1917 the per- centage was 3.2. About two-fifths of the male population in Canada is engaged in agriculture. If further proof is needed that accidents are a cause of higher death rates in the city than in the country it may be found in almost every volume of the Monthly Labor Review. In the metal mines in 1916 there were 3.62 fatal accidents per 1,000 of 300-day workers; in 1917, 4.44; while there were 250.64 accidents all told in 1916 per 1,000 of 300-day workers; and 240.97 in 1917. Coal mining is even more deadly (4.25 fatalities per 1,000 of 300-day workers in 1917) while train service, steel work and quarrying take from 2 to 4 per 1,000 of 300-day workers each year The fatal accidents in industry, however, do not contribute so largely to the general death rate of city workers as the lesser accidents whose effects are not directly felt. Even with compensation from the employer, the city worker's family is more likely to become destitute when his wages cease than is the farmer's when he suffers injury. The farmer has more resources to fall back upon. His family is still an economic unit, in which each member, from a very early age, can contribute something to the welfare of the whole, while in the city this is not the case. In a pinch, the farmer boy, with the help of his mother and sisters, can keep things going while the father is unable to work. And if the farmer's family is unable to get along without aid the neighbors will usually see them through. Friendly aid of his neighbors has saved many a farmer from the worry of wondering how RACE SUICIDE IN THE UNITED STATES 117 he was going to care for his family during the ensuing winter. It is almost impossible for people who are neighbors in the modern industrial community to render one another sufficient aid, as country neighbors do, even if they were disposed to do so. Still another cause of the lower death rate in the country is what may be called the lower tension of competition in the rural districts. This manifests itself in a variety of ways. Among men engaged in brain work (executives of all kinds and professional men) there is an intense competition for preferment. Most of these men are animated by the desire to "make good." There is, generally, a position just ahead for which they are striving. Usually there are several com- petitors for each job so that a man must be continually on the alert. There is no place where he can stop and relax, for if he does some one will step ahead of him and get the coveted prize. Besides most men in these groups have a real struggle to make their incomes cover the standard of living which they feel is essential to their success. Among laboring men there is a somewhat similar process going on. There is the never-ending conflict of the skilled artisan with the machine designed to do his work; there is the constant change in methods and processes to which the man who has become settled in his habits finds it difficult to adjust himself; there is the competition between the skilled and unskilled worker as new machines are invented ; there is the competition between native worker and the immigrant with alow standard of living; and, finally, there is the competition between men and women. All this struggle to keep one's place is almost un- known in the country. The farmer may become old-fashioned and work with inferior stock and tools but yet he can hold on and make a fair living. He has little need to fear some younger man or some immigrant can crowd him out if he does not care to go. And yet in many farming communities there is enough competition to keep the farmer truly progressive. Another way in which the keener competition in the city manifests itself is in the attitude of women towards dress and home equipment. The continuous incitement to dress well and to vie with one's neighbors to which most of the better classes of city women are subject is very largely lacking in the country. In the city the success of the husband and the social position of the family are judged very largely by the outward show its members make. So "good dressing" and the like are indulged in not merely for the satisfaction of personal vanity, but also because they are the assertion of the right to and the means 118 WARREN S. THOMPSON of attaining a definite social position in the community. It is almost inevitable that this should be so where neighbors and friends only- know one another superficiall5^ The country woman, on the other hand, does not need to assert her claims to a social position for the family by means of dress and other externals. Her neighbors know whether her husband owns his farm and whether he lends or borrows money. She cannot impress her neighbors with outward show. In addition, the security of her position and, in many cases, the substantial prosperity of the family, render her more or less indifferent to the outward show of things. In view of these differences in living conditions in the country and the city the writer believes that the former is more favorable to health and that it will remain so for a prolonged time if not perma- nently. The eugenic and anthropological value of this is self-evident. Reasons Explaining the Larger Average Number of Children Born to Country Women The reasons explaining the larger average number of children born to country mothers are of two classes: (1) biological; (2) social or psychological. biological causes Herbert Spencer believed that as civilization increased the repro- ductive capacity of the human species decreased. If this were true one might explain the whole difference between the city and the country, as regards the size of families, by saying that the city has a higher civilization than the country and consequently the reproductive capacity of its inhabitants is lower. But Spencer's dictum is not yet accepted by biologists. No definite proof has yet been discovered that the inherent reproductive capacity of man is affected adversely by the more complicated social environment of the city as compared with the country. What appears to the writer to be the nearest approach to proof of Spencer's position — the fact that many women cannot conceive although physicians can discover no definite cause of this inability — is generally explained, by the physicians themselves, as due to the fact that these women probably use all their vitality in some other way. It is supposed that excessive fatigue and nervous debility may so reduce a woman's vitality that the organs of reproduc- tion will not function properly. The point of importance here is that inability to reproduce is due to some individual pathological RACE SUICIDE IN THE UNITED STATES 119 condition and not to any decline in racial capacity as Spencer supposed. There are a large number of specific reasons why reproduction is impossible to some people. There are women who have malformations of the genital organs that render conception impossible. Of practically the same effect as malformations are accidents and pathological condi- tions of various kinds which create a mechanical or chemical obstruc- tion in the path of the spermatozoon so that it cannot reach the egg. In men temporary impotency may result from certain practices designed to prevent conception. If such practices are continued too long permanent sterility may possibly result. There is much dis- agreement among experts regarding the general effects of birth restric- tion upon the health and vitality of people who practice it. As I read both sides of the discussion I am convinced that those who believe birth control leads to the physical deterioration of the race are thinking primarily of the use of abortifacients,' while those who contend that birth control does not harm the health of those who practice it are thinking of the use pf methods which prevent concep- tion. So far as I am able to judge from the evidence both are nearly right. Abortion and the use of crude methods of preventing concep- tion lead to dire results while the use of the better methods of pre- venting conception probabty have few or no harmful effects. The combined effects of the causes enumerated above in lowering the birth rate are, however, less than those of venereal diseases. There is much difference of opinion among doctors as to what proportion of sterile marriages are sterile because one or both parties are suffering from venereal disease. There seems to be no doubt, however, that the effects of venereal diseases on the birth rate are even greater than their effects in causing sterility. This is the case because sj^philis does not generally render conception impossible but renders it unlikely that a healthy or normal child will be born, while gonorrhoea spreads to the more remote genital organs of the woman, rendering her sterile. Dr. Prince A. Morrow states that "in private practice the mortality of infants born of syphilitic mothers is from 60 to 65 per cent. In hospital practice it is elevated to 84 or 86 per cent." Other investi- gators give even higher percentages. Certain it is that a syphilitic mother has very little chance of having any of her children live, to say nothing of having them grow into normal boys and girls. Syphilis is deadly to the race; and gonorrhoea is scarcely less so because it produces such a high percentage of sterility. About one marriage in every eight is sterile and many physicians believe that 120 WARREN S. THOMPSON most of these are due to gonorrhoea. Even those who estimate the percentage conservatively, believe that 40 to 50 per cent of these sterile marriages are caused by gonorrhoeal infection. Dr. Morrow says: "Abstraction made of every other possible factor of sterility and minimizing gonorrhoea as a predisposing agent to the lowest possible degree, yet there must remain a vast contingent of stefile marriages which are caused directly and solely by gonorrhoeal infec- tion." Thus it is not unlikely that about five or six marriages in every hundred are sterile as a result of venereal diseases, and several more in each hundred may produce only a single child before sterility sets in or abortion and stillbirths ensue and thus reduce the birth rate. The question now arises as to the relative importance of these different biological causes in the rural districts and in the city. Un- fortunately we have no definite data on this subject. In regard to malformations of and accidents to the genital organs resulting in sterility there would seem to be little difference between the country and the city. But the writer believes that all the other causes listed above operate more strongly to reduce the birth rate in the city than in the country. General nervous debility is more often a result of the tense urban life than of the slower and more placid rural life. Practices designed to prevent conception are far more widespread in the city than in the country. Lastly, but of greatest importance, venereal diseases are more common in the city than in the country. Just how much more common we may be able to tell when the complete reports of the Provost Marshal General for the period of the war are issued. In an indirect way the data on sterility of women collected by the Immigration Commission confirm this opinion. The percen- tage of women, married 10-19 years, bearing no children, was found to be about three times as great in the cities as in the rural districts. This was true of women of foreign parentage as well as of women of native parentage. If complete sterility of married women is generally involuntary, as many physicians believe to be the case, we are certainly justified in concluding that these biological causes are much more important factors in reducing the birth rate in the city than they are in the country. SOCIAL OR PSYCHOLOGICAL CAUSES When all due allowance is made for the fact that the death rate is higher in the city than in the country, and also for the fact that biological causes operate more strongly to reduce the birth rate in the RACE SUICIDE IN THE UNITED STATES 121 cit}^ than in the country, we must seek still farther to find the most important causes of the larger proportion of children in the rural districts. In the writer's judgment the social forces operating in a community are the most important causes determining the birth rate. They are the forces moulding and shaping the attitude of mind. They determine the aims and purposes of the men and women of the community. In order to understand these forces which underlie the attitude of people towards the rearing of children, it will be necessary to divide the population into several classes. I have divided the city population into four classes on the basis of family incomes because I believe that the different social conditions for these four classes lead to different attitudes towards bearing and rearing children. Consequently^ the extent of voluntary control of the size of the family varies in these different classes. These four classes are: (1) The poor, those having an income of less than $1,000 to $1,200 a year. The class is composed chiefly of unskilled workers ; (2) The comfortable, those having an income of from $1,200 to $2,200. Most skilled workers belong to this class, also many people engaged in mercantile and commercial pursuits; (3) The well-to-do, those having incomes ranging from $2,200 to $6,000 or $7,000. Most professional men and men in executive posi- tions in industry and commerce belong to this class; (4) The wealth^', those with incomes of $7,000 or over. Capitalists and those on the road to become capitalists belong to this class. (These income limits are purely arbitrary and not too much importance should be attached to them. Obviously, many people belong to more than one class during their lives.) The rural population will be treated as a single separate class. THE INFLUENCE OF RELIGION ON POPULATION GROWTH Before proceeding to a study of the forces operative in these dif- ferent economic classes it will be well to inquire briefly into the in- fluence of religion upon the birth rate, inasmuch as religion knows no class lines. Protestantism has concerned itself but little with this matter and its influence is practically negligible. Protestant churches may not sanction birth control but the subject is rarely discussed by their minister^ either in public or in private and the opinions of the ministers, if expressed, would have but little influence. The over- whelming majority of Protestant people consider such matters as their private affairs and would brook no meddling by the clergy. In 122 WARREN S. THOMPSON the Roman Catholic church, on the other hand, if one can put credence in common reports, the priests frequently exhort their parishioners (chiefly in private) to use no means to restrict the size of their families. How closely this advice is followed it is impossible to tell. Even a comparison between the size of families of Catholics and Protestants would not enable us to draw any definite conclusions. It is altogether likely that Catholics, as a group, have larger families than Protestants but it does not follow that their religion is the cause. A large propor- tion of the Catholics in America belong to the poorer classes (recent immigrants) and this rather than their religion may be the cause of large families. After some years of observation I am inclined to believe that as Catholics pass into the upper classes the size of their families is determined by the same social forces as are operative among other members of these classes and that well-to-do Catholics do not have larger families than the well-to-do among the Protestants. The Jews, like the Catholics, are generally supposed to be greatly influenced by their religion to raise large families. Again my observation leads me to believe that it is the economic and social status of the individual Jew rather than any general religious attitude that determines the size of the family. In my judgment, therefore, in the United States religion is not a very important factor in determining the birth rate. It serves only to assure some of those who would have large families anyway that they are doing what is pleasing to the Lord. THE POOR CLASS In the first class there is but little voluntary limitation of the size of the family. The two most important reasons why this is the case, are: (1) The people in this class do not know how to limit their families, (2) they do not care a great deal about limiting them, because they do not feel the burden of a fairly large family as keenly as people in the higher classes. There can be no doubt that the poor would practice voluntary limitation of families much more than they do if they knew how. But as yet the laws forbidding the dissemination of such knowledge are quite successfully enforced against the poor. (In my judgment this is the only class of the population which the laws prevent from securing this knowledge and they bid fair to become ineffective even against them in a short time.) They have only been effective this long because this class depends largely upon free agencies for such medical attention and nursing as it secures, and because the members RACE SUICIDE IX THE UNITED STATES 123 have no personal friends among doctors, nurses and others, who might tell them how to limit their families. I believe, however, that even if the poor knew how to limit their families as generally as members of other classes, they would not put their knowledge into practice to the same extent. It is the customary thing among the poor to look forward to the economic aid of the child as soon as he or she can be put to work. In the sweating industries mere babies often add their pittance to the family income by "helping mother" with her work. Even where child-labor laws and school laws are well enforced, the parents can count on the aid of the children as soon as they are fourteen or fifteen years old. Not only does the child of poor parents cease to be a direct burden upon the parents very early, but there are usually several years in which it contributes more than its "keep" to the family income. Thus a family of four or five children may render the parents substantial aid for ten or fifteen years or even longer. The parents very generally expect to get back the cost of the child before it strikes out for itself and the}^ usually succeed. It may seem to many people that this attitude towards children is exceptional and is not a very important factor making for large families. I feel certain, however, that this attitude towards children is very general among poor people. The parents themselves were brought up to expect to go to work as soon as they were able and they expect the same of their children. The experience of those who have to do with the enforcement of child-labor laws shows that people in the poorer classes want their children to leave school and go to work at a very early age and that the children are quite willing to do so. This is the usual attitude of poor people the world over. Hard conditions of life and simple forms of work make it necessary and possible for children while yet very young to help their parents and it is customary for them to do so. Old-world ideas brought over by the immigrants also work in the same direction. The peasant economy of Europe has a place for the labor of the child and only too often the immigrants see no reason why the child should not go to work as young in this country as he would in the old country. Many times the child begins to assist the parents at their work long before it is permitted to work regularly. It can do this quite easily, because both men and women do unskilled work. When' the time comes that the child can leave school, it finds comparatively little difficulty in getting the same kind of a job as father or mother or a similar one. Children whose mothers work at home in the sweated 124 WARREN S. THOMPSON trades can acquire all of the skill needed to do an}'^ of the work by the time they can leave school. When the boys are too big to work at the sweated trades they are able to go to the wharves with their fathers or do rough labor on construction work or any other of a thousand jobs which require no special preparation. I would not imply that boys and girls in this class always do the same kind of work as their parents, but I do believe that the great majority of them do work of the same general nature. I should say that the boy whose father is a longshoreman and who himself becomes a deliveryman is staying in the same general class as his father. Similarly the boy who does the unskilled labor in a new subway is following in the steps of his father who is the janitor of a tenement. We are too apt to forget that only a small proportion of children can ever rise from the general class into which they are born. I have many times been amazed at the utter lack of ambition among the children of unskilled laborers. But when one canvasses the situation carefully, one finds nothing in this attitude of children to cause surprise. They have been brought up to expect to go to work at an early age, their parents never tried to instil into them the desire to better their lot. They have attended schools where no mention was ever made of occupations open to them, or if occupations of different kinds were brought to their attention, no efforts were made to inspire in them a desire to get into better occupations than those of their parents, and they have not been prepared to enter such occupations if the desire for them was implanted. In a word, every- thing in the life of the child of the poorer classes tends to press it into the mode of life of its parents while almost nothing urges it to a different mode of life. There are forces at work now, however, which seem to me to be bringing about a change in the attitude of parents in this class towards their children, and also to be breaking down the passive acceptance by children of the role chosen for them by their parents. More stringent child labor laws, better enforced, are making the children dependent upon their parents for a longer time and thus rendering it less economically advantageous for them to have relatively large families. Going hand in hand with the movement to prevent too early work among children is the movement for vocational guidance and occupational training. In so far as these movements arouse ambition in the children of the poorer classes and supply the training to help them realize their ambitions, we may expect to see them RACE SUICIDE IN THE UNITED STATES 125 become less and less an economic asset to their families. As this takes place, there is not the least doubt but that the birth rate will fall. It may well be that the effects of these movements on the birth rate in this class will not be very marked in this generation, but they will be in the next. Those who have themselves risen from the poor class will want to maintain their, new standards and give their children at least as good a start as they themselves had, and those who wanted to rise, but were unable, will hope that by having only a fair-sized family they can give their children such advantages that they can rise. Thus the effects of better education and a longer period of childhood and preparation are certain to bring about a reduction of the birth rate. It is not likely, so far as I can see, that the poorer classes will ever have as low a birth rate as the other classes. There will always be those who must do the unskilled work, of the community and their ^ children will, for the most part, take their places with the minimum of preparation allowed by law. Under such conditions the children of this class will naturally cease to be an expense to the family sooner than the children of the higher classes, and they will be able to add something to the family income for several years before striking out for themselves. Thus in spite of greatly improved conditions children will always be more valuable economically to the poorer classes in the city than to the other classes. Another reason why I do not believe that the birth rate of the poor class will ever fall as low as that of the higher classes is that the poor class will always contain a greater proportion of improvident ne'er-do- wells than the other classes. People who never look to the future, who make no plans for their own lives, who care little what becomes of their children, will always have large families. No matter how widely the knowledge of birth control may be disseminated people who are shiftless, improvident and perhaps sub-normal will never restrict the size of their families to any appreciable degree. In this class marriages take place at an earlier age than in the other classes. The unskilled laborer roaches the age of full earning power by the time he is twenty years old and will draw his highest wages between that time and the age of forty-five. This means that he can reason- ably expect to care for a family at a nuich earlier ago than the men of most other classes. The woman of this class, therefore, marries relatively early and has more years in which to bear children than the woman of any other class in tho city population. Divorce, too, is less 126 WARREN S. THOMPSON frequent in this class than in the others. This adds to the average length of the child-bearing period of the woman of the poor class. In spite of the fact that all these things tend to keep the birth rate of this class high its rate of natural increase is not so high as might be supposed for its death rate is high, as has been shown above. THE COMFORTABLE CLASS In the second class, voluntary limitation of the family is widely practiced, though it is by no means universal. There are many people in this class who look upon their children in much the same way as those in the first class. In so far as this is the case, there is no need to dwell upon the motives at work. But there are also many influenced by motives that lead to the desire for a small family. The skilled laborer who believes in the restriction of output and in the limitation of union membership can readily see the advantages in limiting the size of his family. If it is a good thing, from his stand- point, to control the amount of labor available for doing certain kinds of work then it is a good thing not to raise more children than he can find places for in his own trade or other trades of the same grade. A great many skilled mechanics have small families for no other reason than that they believe this the most effective method of restricting the amount of labor and therefore of raising wages. Many other people in this class raise small families because they hope to be able, thereby, to give their children better opportunities to rise into the higher classes. Many and many a family can be found among skilled laborers and clerical workers putting forth its utmost efforts to give at least one of the children a better start than its father had. In such cases, the child instead of becoming an economic asset at fourteen or fifteen years of age becomes an increas- ingly heavy economic burden in the years after he leaves the common school. Not only is the child a charge for a much longer period, but in the degree that the parents are successful in launching him upon his career in a higher class, they must expect to forego any return on their investment, for it takes so long to attain even a moderate degree of financial success in these higher classes that parents seldom live to see their children achieve it. Of equal effect with ambition for one's children in causing restriction of the size of the family is ambition for oneself. There are many men in this class who feel that children would be a hindrance to them in attaining a higher position. There are also many women who have KACE SUICIDE IN THE UNITED STATES 127 social ambitions or who desire to continue their work outside the home after marriage. In either case children are not wanted and voluntary limitation of t|ie family is practiced. Since, however, personal ambi- tion, incompatible with the raising of a fair-sized family, is much more common in the third class than in this, I shall not discuss it further here. The lack of training for women in homemaking, which is so prevalent among all classes of city women, perhaps, shows its effects most markedly in this class. The girls usually leave school after they have finished the grades or early in their high-school course and work for several years in factories, stores or offices before they are married. The work they do is very largely unskilled and requires little thought or close attention. In many factories they repeat a single simple process over again and again until it becomes purely mechanical. In the stores onh^ a few ever learn more than the simple mechanical parts of salesmanship. Even in offices as stenographers and filing clerks, their work is but little less mechanical than in factories and stores. In any event the work of the girl who expects only to work until she gets married very seldom offers much opportunity for her to develop responsibility, self-reliance or foresight. Instead of pre- paring girls for homemakers, such work as they do induces careless habits and an indifferent attitude towards work of all kinds which is demoralizing in the extreme. These girls never learn to regard work as the normal and proper condition of life. They do not know what it means to find work interesting and to put the best of themselves into it. They rather come to regard work as a necessary evil to be endured for a given length of time daily either because they must work to live or because they need the money to have a good time outside of working hours. The girls are not primarily to blame that they so regard their work. The organization of our industrial system is such that most girls never get a chance to do work that is interesting to them nor do they ever have their attention called to the opportunities for self-expression in their work. It is not the least surprising, therefore, that these girls have never developed the qualities which make a successful and happy wife and mother. Such qualities as patience, economy, foresight, good taste and adaptability — essentials to a happy life under all conditions — are not to be acquired with the taking of the marriage vows; they must be developed slowly through the years. In my judgment the work of theso girls not only does little to help thorn develop such qualities, but often actually aids in developing other 128 WARREN S. THOMPSON traits of character which unfit them for home life, e.g., carelessness, shirking, selfishness, irresponsibility and vulgarity. The woman who looks upon her daily life in the home as she looked upon her day's work in the factory or store before she was married is quite certain to find little there which will compensate her for I'aising a family. When this attitude towards the home exists, when all the good things of life are thought to lie outside of the daily routine of home life, family limitation will be practiced if the woman knows how. Although the birth rate in this class is considerably lower than in the first class I believe that the rate of natural increase is not much different, for the death rate is also lower. But it may well be that in recent years with the improvement of^the public health agencies administering to the poor the rate of natural increase of the poor has come to exceed that of this class Unfortunately we have no very conclusive evidence on this point. THE WELL-TO-DO CLASS In the third class voluntary restriction of the size of the family is almost universal. In addition, late marriages and celibacy contribute to a very low birth rate. The motives leading to late marriage and celibacy do not need much special attention because they are the same, in general, as those leading to the rearing of small families among those who are married. It may be that the ease and comfort in which both bachelor men and women can live in the cities are motives which of themselves lead many to forego marriage, but I believe that ambition in various forms is the most potent motive leading to celibacy, as it is to family restriction. Most professional and managerial positions offer abundant oppor- tunities for advancement to capable, wide-awake, energetic, men and women. Honor and wealth are the rewards of diligence in these positions. The ambitious young man who goes into business hopes soon to leave the well-to-do class and join the wealthy as do many who go into the professions. There are many others in the professions who do not care to leave this class, but rather who are ambitious to gain recognition through scholarly or artistic work, which is more dear to them than wealth. In either case — in seeking honor or wealth, or both — personal ambition is the dominating motive in life and has a great deal of influence upon the size of the family raised. The young man in business who sees vistas ahead in which he may exert power through wealth has little time or inclination to give himself RACE SUICIDE IX THE UNITED STATES 129 to his family. He may be quite willing to meet the expenses of a relatively large family; but he is so immersed in his work that he is likely to forget to be human. He probably expects his wife to shoulder the entire burden of worry and care at home, so that he will not be distracted from his work. The wife soon becomes weary of bearing her burden alone and is ready to take measures to prevent it from becoming greater. So it is that the ambition of the father lies at the basis of family restriction in many cases. Again the father may feel that he needs all the money he can pos- sibly save to further his business plans and so takes means to prevent the coming of children. He. often feels also that he will be hampered in his freedom of movement by even a fair-sized famil3^ Then there is always the element of chance in business, and a man may not be willing to give hostages to fortune until he can be reasonably sure that he can redeem them. In the professions the situation is much the same, with the exception that the goal is more often recognition of some kind than mere wealth. Better than wealth to a lawyer may be the appointment to the Supreme Bench, better than wealth to a physician may be the discovery of some new means of aiding mankind, better than wealth to the engineer may be the successful completion of some public work, e.g., a Panama Canal, better than wealth to the scholar may be the writing of an essay which will inspire good thoughts and noble ambitions in his fellows. But the way to success in the pro- fessions is slow and laborious, and even a moderate-sized family may make the ascent much slower and more difficult. There are also numerous cases in this class in which the man marries so that he may increase his acquaintance among men who may be of help to him through the social activities of his wife. Many such marriages are childless, while many more have only a single child. It is quite likely, however, that only a small proportion of the women who spend much of their time and energy in social life do so with the object of furthering their husbands' interests; most of them have social ambitions of their own. The care and expense of even a single child will seriously curtail the social activities of a woman of this class and so, many t^mes, children are sacrificed to social ambitions. Children tie a woman to the home rather closely for a good many years if she gives them a true mother's care. They are also expensive. No doubt the woman in this class very often has to make a choice between another child and some cherished object which will further her social ambitions. An automobile, a new home, new furniture or 130 WARREN S. THOMPSON more expensive clothes will each and all enhance one's social position and keep one before the attention of one's friends, while another child will withdraw one from their attention for a considerable time and make it more difficult to appear so well in their eyes. "Only too often the temptation of the easy and immediately pleasant way out over- comes them and they shirk the real duty of a woman. Like the mistrained or untrained of the lower classes, women of this class who "go in for" social life see no satisfaction to be derived from the daily routine of the home. The dearest objects in life lie elsewhere. Nowhere among their friends and acquaintances do they encounter any disapprobation of the frivolous, meaningless lives they are leading, for they are all of a feather. If it is to women of this type that the charge of parasitism, so often heard now-a-days, refers, it is very largely justified. Again there are many women in this class who want a "career." They want to be independent economically and socially. Some of these women do not marry, but more of them do marry, although relatively late. Of those who do marry, many regard their work essential to the highest self-respect and self-development and therefore find no place in their lives for the bearing and raising of children. Happily there is a reaction, in late years, from the extreme type of feminism prevalent about a generation ago, which taught that for a woman to be dependent on a man for support was disgraceful and not to be tolerated by any woman of strong character. But by no means are all the women of this class of the type that would prefer not to have children. The majority, without doubt, are women who find a satisfying existence in simple home life. But even such women do not desire large families, for they find the raising of children in the city a task of ever-increasing difficulty. The results of a recent investigation will show the correctness of these statements. The Delineator for October, 1919, published the results of a question- naire sent to the graduating classes of a number of women's colleges. To the question: If you follow a professional or business career, would you attempt marriage and motherhood in addition, if you met the right man? 235 replied, yes, 302 replied, no, and 26 said they would attempt marriage but not motherhood. To the question : Provided you could not have both marriage and a business or pro- fessional career, which would you sacrifice? 522 replied they would sacrifice a career, 51 that they would sacrifice marriage and 22 were undecided. To the question: How many children do you want? RACE SUICIDE IN THE UNITED STATES 131 the replies were: None— 10; One— 4; Two— 76; Three — 163; Four — 179; Five — 55; More than five — 63. As I have watched the child life of the cities, especially among this class of people, I have often wondered that they tried to raise children at all. Children are not wanted in most apartment houses in desirable sections of the city, nor will single houses be rented to families with children if those without can be secured. Open places for play, close at hand, are generally lacking, while a private yard where one's children hold undisputed sway is almost unknown. Thus the naturally venturesome spirit of youth has no place in which to express itself in ways useful to the child and not troublesome to others. On the other hand, the opportunities to get into mischief seem to be unlimited. Our cities today seem to be organized for the repression of the natural life of the child rather than to encourage its normal expression. Don't! Don't! You must not! Get out of the way! What are you doing here? are apparent everywhere, while. Come on! Take part! Enjoy yourself! Here is a place for you! are scarcely visible anywhere. Because of these conditions it is not unlikely that, in this class where standards of living are high and income not sufficient to permit of much help in the home, one child causes more work and worry than several in the lower classes. But aside from the care and expense of raising children while they are comparatively young, parents in this class generally have to provide for their children for a much longer period than those in the lower classes. At the age the child of the poorer classes begins to be self-supporting the child in this class begins to make greater demands upon the economic resources of its parents. Prevision and foresight are well developed in these people and consequently the}^ make definite plans, so that their resources will meet their own needs and provide a good start in life for their children. Expenses during high school, college, technical school and possibl}' even for a year or two while getting a foothold in some profession, generally strain the family resources to the limit when the family is small. Therefore a large family is not desired. The desire for travel is another motive often leading to the restric- tion of the size of the family in this class. It needs no argument to show that children make travel more difficult both from the standpoint of expense and from that of leisure. Each child born increases the normal expenses of the family and makes it more difficult for the parents to take their children with them or to leave them behind 132 WARREN S. THOMPSON when they travel. Thus with the growth of the family the likelihood of being able to travel decreases. Therefore, where there is a strong desire to travel, a "trip" very often is chosen as the alternative to another child. The desire to attain culture is also a motive leading to family restriction in many cases. A certain amount of leisure and freedom from harassing care are necessary to the development of a cultured personality. A large familj^ of children or even a moderate-sized family is apt to make the work and the worry of maintaining class standards so difficult that one will have little energy or inclination for anything beyond the daily routine. The realization that this is likely to take place causes many people to raise only one or two children. They feel that the sacrifice of self-development involved in rearing more is too great. We have no very extensive data bearing on the birth rate and death rate in this class, but such data as we have seem to justify the conclusion that there is no natural increase. My own belief is that this class does not produce enough children to keep up its numbers, but we must await further investigations before we can be positive on this point. THE WEALTHY CLASS There is no sharp line dividing the fourth class from the third either in regard to the motives leading to family restriction or the rate of natural increase. Family limitation is almost universal in the fourth class and ambition, in one form or another, and love of ease are the most powerful motives leading to it. This class is quite small, comprising not more than a few hundred thousand families (judging from the federal income tax returns). The great majority of the men belonging to it are men having incomes near the lower limit. Most of these men hope very soon to increase their incomes and are struggling desperately to rise. Nowhere in our population is the competition more strenuous than between men who have attained some measure of success and whose appetite for it is, therefore, insatiable. These men are "climbers" in their lines and very often their wives are social "climbers." Thus the chief interests of both husband and wife lie outside the home and children are re- garded as a burden. Such people have no real home life and do not care enough for it to stop scrambling for position. The husband only too often thinks of his wife as the means to a larger acquaintance RACE SUICIDE IN THE UNITED STATES 133 among people who may be able to help him along and the wife regards the husband and home merely as necessary incidents to respectability. The result is that their families almost never comprise more than two children and very often none at all. These "climbers" have neither accumulated wealth nor do they have very assured positions in society. They have therefore nothing definite to bequeath to their children. They have no pride of family urging them to leave descendants to carry on the familj^ name and traditions; they have no definite position in the community, which they can be assured of transmitting to their children. These people are themselves adrift, they know not whither they are bound, and many of them feel, in their more serious moments, that life is so un- certain and there is so little worth while to be got out of it that they will save trouble all around if they have no children. On the other hand, among the wealthy, whose position is assured, there is a certain amount of pride in one's family, leading them to rear children to carrj^ on the family name and fortune. They have not only wealth but a much-coveted position in the community which they can command for their descendants. This portion of the wealthy class probably more nearly reproduces itself than the "climbing" portion. Undoubtedly the sheltered lives of ease and luxury led by many girls in the wealth}- class and even by some in the well-to-do class disincline them to undergo the hardships of bearing and rearing a family. To a girl who has been brought up in the belief that her own whims and desires are of prime importance and that all values are to be judged by these pampered inclinations it is often inconceivable that she should deliberately do anything to bring herself pain and work and worry and probably even deprivation of some customary luxuries. Such girls brought up apart from the stern realities of life are not cap- able of judging values aright. They know little of the feelings and values which grow up naturally when men and women struggle side by side, help to bear one another's burdens, share sorrows as well as joys and, above all, live close to the great streams of simple, work-a-day humanity. Women whose only passion is for ease and luxury lose tpuch with humanity and substitute for true human values those of a small and highh- institutionalized class. It is especially' unfortu'nate that the women of this class do not rear moderate-sized families, because they are so widely imitated by the women in other classes. 134 WARREN S. THOMPSON THE REASONS FOR THE HIGH BIRTH RATE IN THE COUNTRY There is no need of dividing the rural population into classes in order to study the causes of the relatively high birth rate in the country. The great majority of people living in the country have incomes (counting what they use directly from the land) about the same as those in the comfortable class in the city. There are some people in the rural population who are really poor and there are a few who belong to the well-to-do and wealthy classes but these two extremes (not taking the negroes into account) comprise only a very small proportion of the whole. For this reason and also because I believe that all classes of people in the country, in spite of considerable differences in their incomes, think in much the way same regarding the size of their families, I shall speak of the farmer and non-farming rural population as belonging to a single class. The women raised in the country have been trained to be home- makers. The changes which have been referred to above as unfitting many city girls to become good homemakers have not affected the country to any great extent. The country girl learns to help her mother about the home almost as soon as she can walk. There are numberless little tasks that she can do before and after school hours. If she happens to be an older child she gets training in caring for the younger children. She learns to make butter, care for the chickens, and to raise a garden as well as to cook and keep house. She never lacks for work about the home during vacations and after she has finished the country school. She grows up with the idea that her place in the world is to be a wife and mother. She never learns that the world offers almost numberless opportunities to women to do things outside the home. When the time comes for her to marry she knows what is expected of her and she is trained to the task. The country woman who keeps house and does the work usually connected with housekeeping on the farm never needs to feel that she may be an economic hindrance to her husband as many city women must. She knows, as her husband too often does not, that she is helping to make the farm pay. Her garden and chickens and butter and her daily economies constitute a positive contribution to the welfare of the family greater, in all probability, than that of many city women who work outside the home. A farm is commonly a partnership affair on its producing side, but as in most other industries the "boss" is able to distribute the product according to his desires rather than in accordance with the principles of justice. RACE SUICIDE IN THE UNITED STATES 135 The fact that the woman is such a direct economic asset on the farm probably accounts for the greater proportion of married women in the country and the earlier marriages there. Both of these things help to keep the birth rate in the country relatively high. Children, too, are generally of economic value on the farm earlier than they are in the city. There are many kinds of tasks both for boys and girls on the farm which do not injure their health but which help to keep the work going smoothl5\ The bringing in of fuel, the care of calves and colts and pigs, errands to and from the fields, the assistance with the garden, all can be done by boj^s and girls, without injury to health, outside of school hours and during vacations. Be- sides the boy can even help with the field work by the time he is ten or twelve and be aU the better for it, so long as he does little but drive a team hitched to light machinery. He can also help with the lighter parts of the heavier chores — the care of horses and cattle. The girl in addition to her chores outside the house can be of use to her mother in the house in a hundred ways and if not overworked will in no wa}'- be injured. I am fully aware that many country children are over- worked and underplayed, but I do not believe that such a state of affairs is at all general. If it is, however, it only goes to prove that country people find children more economically valuable than I have supposed they are, therefore, more willing to have good-sized families. In the country both boys and girls work at home by the side of their parents. Because of this they very soon learn that both father and mother arc working for the same ends and that they are helping their parents to attain these ends. There is thus developed a unity of interest in the family in the country which is very often lacking in the family in the city. Because of this close personal contact between parents and children while at work, there is less danger that the morals of the country children will be corrupted. I would not be understood to say that, morally, all is as it should be in the country — far from it — but there is less chance that the average country boy will become utterly good-for-nothing than that the city boy will. I am quite convinced that the fact parents and children spend much time working together in the country has a wholesome influence on the children in teaching them habits of steady application and thrift, while the fact that parents and children are together so little in the city has, in general, a demoralizing effect. This brings it about that parents in the country have less reason to fear for the future of their children and are therefore more willing to raise good-sized families. 136 WARREN S. THOMPSON Another way in which the unity of interest is developed in the family in the country is through the discussion of family affairs in the home. Most of the things of a local nature that the farmer and his wife are interested in can be discussed with profit before the children. From the time the children are ten or eleven years old they can understand something of the problems of farm management and household management and they are also interested in what is going on in the neighborhood. In fact, the children very often have something to contribute that is of interest to the parents. Thus the whole family grows up within the same circle of interests and every member feels that he is included in any discussion or conversation that may arise. How different is the situation in the city! The business man comes home from the office or store with weighty matters on his mind and he finds it impossible to relieve himself by talking to the whole family, or even to his wife, because the thing absorbing his attention is highly technical. He finds his wife and children talking about neighborhood or school matters of which he knows little or nothing. So the family instead of being brought into closer unity by a mutual understanding of one another's interests is divided and the members may feel rather indifferent towards one another. Modern city life seems to me to have an increasing tendency to diversify the interests of the members of the family rather than to centralize them as rural life does. Country life, therefore, makes it easier to keep alive personal interest in human beings than city life does. Definite personal interests — interest in wife and children, interest in school and church, interest in neighbors — take up a goodly share of the farmer's thought. He does not become engrossed with entirely impersonal matters as the city man is apt to. He must deal directly and humanly with people at almost every turn, while the city man deals more and more with things directly and people only indirectly and technically. But even if the farmer becomes engrossed with things, e.g., the extension of his acres, he yet hopes that he will have the children to help him till these new acres and to whom he can leave them, so that after all it is a family interest he is looking out for. I am quite certain that the more human and personal nature of the life of country people as com- pared with that of city people makes them willing to raise larger families. Another reason for large families in the country is that it is easier to raise a good-sized family there than in the city aside from the fact RACE SUICIDE IN THE UNITED STATES 137 country children early become an economic asset. The "barefoot boy with cheek of tan" is to be seen wherever one goes in the open country and usually his little sister is with him. The clothes may be soiled, the faces and hands dirty, but it is usually the "clean dirt" of the open country — the mud from the creek, the dust from the road or the stain of fruit and berries — not the foul slime from the gutter which one sees on the children in the poorer parts of our cities. The country child always has a big playground at hand. In this plaj'ground are wagons and buggies, cultivators and plows, machinery and tools, cattle and horses, all of which call for careful attention and invite to manipulation. Many are the months and even years which the child can spend in playing with things which he will later want to use in his work. . If the children are not in the farm yard at play the mother ma}' be quite sure that they are safe wherever they are. Besides, she knows all the neighbors' children and knows whether or not they are good companions. The dressing of the children for school so that they will look respec- table is not the trying task it often is in the cit3^ Cleanliness and comfort are the two chief standards of respectability and they may be attained quite easily in the country. Colored dresses for the girls, with big aprons; overalls and blue shirts for the boys, with black stockings and heav}'- shoes for both, are sufficient for their require- ments, and, for my own part, I think they look very well. Furthermore, country children do not have the continual entice- ments to spend money that the city children have. They do not see the gaudy display of toys and candies in the store windows on their way to and from school and, recently, the brilliant-colored lithographs of the "movies." If the country boy wants a sled he probably makes one, thus saving money and learning something useful. Country children learn to amuse themselves rather than to ask papa for money to pay to be amused and this can not fail to relieve the country mother of much worry, because while amusing themselves around the home they are not very likely to get into serious mischief. We must all agree, I think, that it costs less, in money, in work, and in worry, to rear a child in the country than in the city, and for this reason country people are more willing to rear them. Moreover, the relatively secure economic position of the farmer makes him and his wife more willing to raise a good-sized family. The industrious farmer, either renter or owner, is practically certain 138 WARREN S. THOMPSON of a fair living. Panics and hard times do not affect him as they do the industrial worker. Dissatisfaction of the capitalist manufacturers over a new tariff schedule does not throw the farmer out of a job nor render his living precarious, as it may the city worker. In fact the farmer is more or less immune from the most of disturbing conditions connected with modern industry. Of course, he occasionally loses a crop. But now-a-days when the farmer raises a number of different crops he very seldom has a total failure in all of them. For these reasons a farmer does not need to worry whether he will be able to feed and clothe his family, as many men in the city do. He can be practically certain that he will be able to meet the ordinary exigencies of life without a great deal of hardship to himself and his family. Because of this feeling of security of position the farmer has less reason than the city man to feel that he is giving irredeemable hostages to fortune when he has a large family. We have seen that in the city many people limit their families because they feel that they can not otherwise give their children the best opportunities. This motive to family limitation has very little influence in the country. The farmer generally regards his duty to the child as fulfilled if he allows him to complete the country school. He is quite sure that the boy who amounts to anything can shift for himself if he has a common-school education and has learned habits of stead}' application. In the environment of the country most farmers come to believe that the schooling which was good enough for them is good enough for their children. Only a few make plans for the better education of their children which involve saving and preparing years ahead. This is not because the farmer does not want his boy and girl to have as good opportunities as other boys and girls, but rather because the only opportunities he knows about are on the land and he does not see how an expensive education can help the boy to raise better crops. The average farmer little realizes how many opportunities are open to the young man with a good education which are closed to the one with only a common-school training because he does not realize the growing complexity of modern life. Therefore the farmer finds no reason to limit his family in the hope that he may thereby be able to give the smaller number of children an expensive training for their life work. In the past, too, the farmer has known that there were good oppor- tunities farther west if his family was too big to settle on the home place, and so he felt little anxiety over the future of his children. RACE SUICIDE IN THE UNITED STATES 139 Even when the boy prefers to go to the city rather than to go west the farmer feels little doubt about his ability to compete with the city boy. He firmly believes that his boy can take care of himself wher- ever he may go. He also knows that the boy who works at home until he is twenty or more years of age owes him little economically for his ''keep" and he does not feel that either his situation or the future of the boy would be much changed by rearing a smaller family. THE OUTLOOK FOR THE FUTURE In the opinion of the writer there is little danger that the newer immigrants will supplant the older stocks by any natural process of population growth. If they supplant the older sifccks it will be because adequate restrictions are not placed upon their entrance into this country. The future racial constitution of this country can be deter- mined by prompt adoption of simple legislative enactments for this purpose. If, however, nothing is done and matters are allowed to proceed as in the past, the situation may soon be beyond control. Should the time come when our whole population of Nordic stock is subjected to the same severe competition with immigrants as our city population has been for some time past, no amount of legislative action or exhortation will prevent the rather rapid conquest of the United States by peoples from southern and eastern Europe. General Walker long ago pointed out the fact that our population growi;h, as a nation, had been influenced very little by immigration. He believed that the competition of immigrants with older stocks so reduced the birth rate of the latter that the immigrants just about made up the loss. There can be no question that the opportunities which people see for themselves and their children to gain a good living determine the size of families to quite an extent. Since native men and women have seen less and less opportunity as competition with immigrants increased, and even a moderate amount of ambition has led them to restrict the size of their families until the older stocks in our cities are dying out. Ambition of country people has been more moderate than that of city people and the opportunities they coveted for their children have not been subject to the same competition from other groups and so the native stock on the farms has gone on increas- ing at a good rate. At present most of our large cities are peopled by stocks different from the prevailing stock of the open country. The city people are an amorphous mass of humanity wliose purposes and aims are not 140 WARREN S. THOMPSON understood b}' country people. Nor are the farmers understood by the mass of city dwellers. These groups are mutually suspicious. They have no common historical background and few common aims and purposes. The suspicion and distrust of one another feeds upon social differences and mutual lack of understanding. Just how much of this suspicion and distrust is due to racial differences and how much to the natural antagonism of agricultural and commercial and manu- facturing interests, I shall not attempt to say. I believe, however, that the different racial elements in these groups make mutual under- standing more difficult and may lead to some rather serious conse- quences when both groujDs become better organized. If immigrants are allowed to come practically without restriction, as before the war, the racial differences between these groups will become still more marked and the possibility of misunderstandings thereby increased. THE EUGENIC SITUATION From the standpoint of eugenics the effects of our present popula- tion movements merit careful consideration. Is it eugenically desir- able that our population should continue to increase most rapidly in the country and in the poorer classes in the city, while the well-to-do and wealthy classes increase very slowly if at all? In what ways, if any, is this process leading to a survival of the unfit? Our rural population, as a whole, is of good eugenic value. The people are hardy, energetic and of good habits. Their hereditary capacities are in general good and sound. Their average of ability is high. I am well aware that there are many biologically degenerate families and neighborhoods in the country but they form only a very small proportion of the total rural population. Aside from these biologically inferior people, who should be prevented from propagating their kind, the relatively rapid rate of increase of the rural population is eugenically desirable because it adds a large increment of good stock to our population year by year. Certainly, so long as the increase of our population comes most largely from the country we need have no fear that the quality of the stock is deteriorating. The poorer classes in the cities are also of good stock although, in my opinion, they contain a slightly larger percentage of hereditary degenerates than the rural population. Poverty is not, as so many are accustomed to think, prima facie proof of inferiority. In most cases it is a result of lack of opportunity rather than of lack of ability. In the very nature of the case, however, the percentage of those who KACE SUICIDE IX THE UNITED STATES 141 lack ability is larger among the poor than among other classes. The indolent, the incompetent and the good-for-nothing drift into the poor class as naturally as a stone sinks to the bottom of the pond. The question of the mental capacity of our recent immigrants who belong chief!}" to this class is one which I cannot discuss here. I wish to say, however, that no convincing proof has ever been offered to show that they are essentially inferior to the older stocks. Moreover, I have never found a person knowing any group of them well who does not believe that they are of sound stock and of good average capacity. It seems to me, then, that this class, as a whole, may be said to be of good heredity and that we need not fear deterioration of our popula- tion because of its relatively rapid increase. It should not be forgotten, however, that there is a certain small percentage in this class that is biologicalh' unfit. The people in this small group constitute a menace not only to the standards of the poor class, but also to the well-being of^the whole community and conse- quently should be treated as wards of the state and should be segre- gated so that they cannot propagate. The real hereditary degenerates of the nation are found chiefly in the rural population and in the poorer class in the city. So far as can be judged from numerous special studies these unfit are increasing at a rather rapid rate, although not as rapidly as the normal members of these classes. Year by year the number of incompetents who cannot be raised to normal conditions of living by the improvement of their environment is increasing. Thus we find a steady absolute, if not relative, growth of the lowest stratum of the population. Contrast this with the situation found at the other extreme — among the well- to-do and the wealthy. In the upper economic classes there is no natural increase of popula- tion, but in all probability a decrease from year to year. It was shown above that the graduates of women's colleges were only rearing about enough children to replace themselves, to say nothing of their husbands. There is very good reason to believe that this is true of the upper economic classes as a whole. These classes contain a high average of ability. Most men who belong to them have risen from a lower economic class. They have proved by their rise that they have more of certain kinds of ability, on the average, than other members of the classes from which they rose who had equal oppor- tunities. They have shown adaptability, energy and initiative above the mean. 142 WARREN S. THOMPSON It may be objected that many are born into these classes and there is no proof that they have more than average ability. The latest developments in our knowledge of heredity show us that the hereditary qualities of people pass from generation to generation with but little change. The cases of the children of the wealthy who do not amount to anything furnish no proof that they do not have good capacities. They merely prove that their training, perhaps their health, and the environmental influences by which they have been surrounded, were bad and unwholesome. I recall reading in Montaigne the opinion that princes usually learned nothing well except the management of horses. He explained this as due to the fact that the people about them always flattered them and gave way to their caprices and re- quired nothing thorough of them, while horses made no distinction between princes and commons and consequently they were forced to learn the management of horses thoroughly. The children of our upper classes are much like princes. They are seldom subjected to adequate discipline and it is rather a wonder that so many of them turn out well than that many are utterly useless. I think there can be no serious doubt of the fact that the members of the upper classes, whether they have risen into them through their own efforts or were born into them, have a somewhat better heredity than the average of the population. It should be remembered that we are considering the average of ability in these upper classes, for there are no doubt in them indi- viduals of very ordinary capacities and some few who are biologically degenerate. There are those who become members of these classes by the merest chance, having no merit of their own entitling them to distinction of any sort. Then there are those whose financial success is due to certain qualities — callousness, ruthlessness, indomitable ambition for wealth, selfishness, greed and brute force — who should not, in the interest of the general welfare, be in positions of importance and power. But in spite of the presence of many people in the upper classes who are of very ordinary capacity I believe that the average of ability in these classes is somewhat higher than in other classes. If this is true, then it is a very serious matter that these classes do not reproduce themselves. One objection often raised to a democratic country is that the breaking down of class lines is likely to lead to the depletion of the best stocks. It would seem that this is now happening •in the United States. We pride ourselves on the fact that people with initiative, energy, ambition, imagination and good minds can rise RACE SUICIDE IN THE UNITED STATES 143 from the most hmnble conditions to positions of wealth and influence in the upper classes. This very ease of rising tends to extinguish much of our best ability in a single generation. A man from the poor class, with no family traditions to uphold, and therefore, with no concern for the future of his own family, struggles to rise. He suc- ceeds in attaining wealth or prominence or both. He has not more than three children at most and often none. His family soon dies out and his ability is lost to the nation. This process is going on with great rapidity at the present time and in my judgment is the most serious phase of race suicide. However large the supply of excellent ability in the lower classes from which the upper classes may draw, this process of obtaining leaders cannot go on indefinitel}^ without weakening the nation. In view of what has been pointed out above I would take issue with those who believe that the rate of increase of the nation, as a whole, is not sufficiently large — who believe that a more rapid rate of popula- tion growth is all that is needed to prove that our people still possess the vigor of their ancestors. There is no doubt in my mind that our population is increasing as fast as it can be provided with the means of maintaining a good standard of living. It is a serious matter, how- ever, that the lowest class, the biologically unfit, is steadily increasing while the better stocks are dying out. If the upper classes were to raise fair-sized families — four or five children — the national birth rate would be raised but slightly and yet the good capacities and abilities of these people would be saved to the nation. There is little doubt, moreover, that if the children of these classes were raised in fair-sized families they would get better training and discipline for life than they now do. What can be done to encourage the upper classes to raise fair-sized families? Certainly nothing can be done by legislation. Birth con- trol has come to stay and bounties for large families will only be accepted by the improvident — the very class which should not be encouraged to raise a numerous progeny. A general hue and cry about our low birth rate will be of no effect. The problem is one of developing standards of life in the upper classes which are not incompatible with the raising of a family of four or five children. This will involve a simplification of present standards. There is neither time nor energy for good home life and all of the external activities now engaged in by people of these classes. The raising of a family of moderate size involves a choice of a home life 144 WARREN S. THOMPSON with much unobtrusive sacrifice in preference to a Hfe with a large amount of personal gratification and a minimum of responsibility to others. Certainly the choice of the former requires some fortitude when one belongs to a class where the latter is regarded as the only normal life. If any great change is to be wrought in the habits of the upper classes it must come from the examples set by those who believe that life is a serious matter and should not be frittered away in doing solely those things which make for their common personal gratification. If any considerable number of wealthy people so conducted their home life and their business affairs that other members of the upper classes were convinced of their serious moral purpose, they would imitate them and we should have little need to deplore the dying out of our better stock. Along with the return to a more simple life we need to develop a just pride of family. We probably cannot go very far in this direction until we are more mature. A family must have back of it some genera- tions of solid achievement and a well-developed tradition before pride in it will be a powerful motive leading to the rearing of children. A young people living in an age when all things seem transitory will have little of the better sort of family pride. Such as we have is often arrogant and is scarcely more than snobbishness. This has led many earnest people to feel that concern about one's family — past or future — is undemocratic. But we shall probably never get the best out of the people in our upper classes — biologically through their children and socially in direction of national development — until they do develop a just pride in famil3^ So long as one is thinking merely of himself and the swath he can cut in the present generation his best energies are quite likely to be directed to the accumulation of the tangible evidences of his success and to the display of these in a conspicuous manner. In such a scheme of life children are more or less of a nuisance and consequently are sbunned. If, after the present standards of the upper classes have undergone a simplification and a just pride in family has developed, there should prove to be any considerable number of people in them who will not participate seriously both in the life of their own day and in that of the future, through the raising of children, it is perhaps just as well that they should die out. Certainly such people will be failures in a larger social sense as well as biologically and they probably would have nothing to contribute to the progress of mankind. One may look upon the dying out of those who worship the God Mammon as RACE SUICIDE IN THE UNITED STATES 145 nature's kindly provision for ridding tlie world of the over-ambitious, egotistic elements who have missed the true goal of living. SUMMARY A study of the population movements in the United States shows that the older stocks (Teutonic) are dying out in many places and are being supplanted by the newer immigrants. In Massachusetts, Rhode Island and other states in the northeast this process of substitu- tion has already gone very far. In some classes, e.g., graduates of women's colleges, deaths are almost twice as numerous as births. A comprehensive view of the situation throughout the nation shows that it is chiefly in the cities the old stocks are not holding their own. City life seems to be unfavorable to the raising of even moderate-sized families among all except the poor. In the rural districts, on the other hand, children are numerous and the rate of natural increase is much in excess of that of the urban districts. If it were not for immigration a few generations would find most of our city people tracing their descent back to the rural population of today. This would, no doubt, greatly simplify our population problems of the future for the rural population of today is largely of old (Nordic) stock. The rural population has a higher rate of increase than the city population, (1) because it has a lower death rate, and (2) because, on the average, the women give birth to more children. The death rate is lower in the country because of its generally superior health condi- tions. The families of country people are larger than those of city people both because they want more children, consequently practicing birth control less, and because involuntary restriction is a less im- portant factor in the country. If one divides the city population into four classes: the poor, the comfortable, the well-to-do, and the wealthy, he will find that the last two classes almost universally limit the size of their families voluntarily where involuntary sterility, due to venereal diseases and other biological causes, does not render this unnecessary. In the comfortable class voluntary restriction is quite common but in the poor class it is little practiced. Thus race suicide becomes a problem in eugenics and anthropology. Is it desirable to have our natural population increase come chiefly from the rural districts and the poor class in the cities? Although the vast majority of people in these classes are biologically sound yet 146 WARREN S. THOMPSON most of the biological degenerates in our population also belong to these two classes and at present they are propagating almost as rapidly as the sound stock. The upper classes — well-to-do and wealthy — probably do not propagate themselves, to say nothing of adding to the population. These classes contain much of the best ability in our population. To have them die without leaving fair-sized families is a serious matter. It means that much of the superior ability of the nation is used up in each generation. Able men and women rise into these classes and fail to propagate, thus eliminating their superior qualities from the population. If this process continues for any length of time it is bound to be harmful to the nation. The only chance of changing the attitude of the upper classes towards raising children lies in changing their standards of living. They must live more simply. Ambition, love of ease and love of luxury must be moderated and humanized before the members of these classes will be willing to raise fair-sized families. A just pride of family must also be developed among the people in these classes so that they will feel they have something worth passing on to the next generation. The subject of the effects of these conditions on the physical standards of the American people will demand future attention. ANTHROPOMETRY ALES HRDLICKA E. — Osteometry Anthropometry of the skeletal parts (outside of the skull) is a fertile and fascinating field in which much as yet remains to be exploited and even explored. It is, moreover, a large field, which few workers may hope to cover in its entirety. Every bone of the body presents sexual, racial and individual variations, many of which remain to be thoroughly studied; and some of these features, according to indica- tions, possess a very considerable phylogenetic and racial importance. Investigations on the skeleton are for the most part of a more recent date than those on the skull or those on the living", and have been largely the work of anatomists. Descriptive observations, such as those on the sexual characteristics of the pelvis, or those on the perforated humerus, pilasteric femur, platycnaemic tibia, etc., preceded and accompanied measurements. The first serious attempt at osteometry was made essentially in France, and the first system of measurements was developed by Broca and his pupils in Paris.^ Since the early seventies a whole series of valuable contributions to the subject of bone study and osteometry have been made,^ and 1 See Broca (P.) — Sur les proportions, relatives du bras, de I'avant bras et de la clavicule chez les Negres et les Europecns. Bull. Soc. d'Anthrop. Paris, 1862, III, 162-172; ibid., 1867, 2 ser., II, 641-653. Hamy (T.)— Recherches sur les propor- tions du bras et d'avant-bras aux differents ages de la vie. Rev. d'Anthrop. Paris, 1872, 79. Topinard (P.) — Elements d' Anthropologie Generale, 8°, Paris, 1885. 2 Bello y Rodriguez (S.) — Le f6mur et le tibia. These, Paris, 1909. Biimuller (J.) — Das menschliche Femur. Phil. Diss., Miinchen, 1899. Bertaux (T. A.) — L'humerus et le f6mur considdrfe dans les especes, dans les races humains, selon le sexe et selon Tagc. These, Lille, 1891. Fischer (E.) — Die Variationen an Radius und LHna des Menschen. Z.f. Morph. A Anthrop., 1906, IX, 147. Lehmann-Nitsche (R.) — Ueber die langen Knochen der sudbayerischen Reihengriiberbevolkerung. Phil. Diss., Miinchen; and Beitr. z. Anthrop., & Urgesch. Bayerns, 1894, XI, H, 3 & 4. Livon (M.)— De I'omoplate. These MH., Paris, 1879. HrdUcka (iUe§)— Physical Anthropology of the Lenape or Delawares, and of the eastern Indians in General. Bxdl. 62, Bur. Am. Ethnol., Wash., 1916. Pfitzner (W.)— Bcitriige zur Kenntniss des menschlichen Extremitatens-skeletee. Morphol. Arh., 1892, I, 516; 1893, II, 93. Rollet (E.) — La mensuration des os longs des membres. Thhse 7tUd., 147 Amer. Jour. Phys. Anthkop., Vol. Ill, No. 1. 148 ALES HRDLICKA * much work in this hue, particularly in the United States, is as yet un- published. The repeated discoveries of skeletal remains of early man have in particular stimulated research in this direction. Not- withstanding all this, however, we are still far from a satisfactory grasp of the evidence which the bones embody. The reasons are, in the first place, that the gathering of skeletal material has always lagged behind that of the skulls, so that even today most anthropologi- cal collections are relatively poor in that respect, which hinders com- prehensive and conclusive investigations. Besides this, the bones of the skeleton present many features and correlations the study of which demands large series of specimens, and in many cases also the presence of all the important constituents of the skeleton or the bones of the two sides of the body, conditions which are realizable with difficulty even among the Whites, not to speak of other peoples. The field will long remain, therefore, one of a very considerable importance, and no pains should be spared to develop the technique of osteological ex- amination. The scheme here presented rests on the same principles as those presented before for anthropometry and craniometry. It utilizes the most useful procedures of other scholars, supplements these where extensive individual experience warrants, leaves aside every- thing superfluous or of value only in special studies, and aims at the utmost simplicity. INSTRUMENTS The matter of osteometric instruments has already to some extent been dealt with in the section on Craniometry (Vol. II, 1919, p. 50). The essentials are few. They are the Broca's osteometric board (pi. 1), the small compas glissiere and for a few measurements also the large sliding compass; but other instruments may be needed for special investigations. Lyon, 1889; Intern. Monatschr. cfc Anat., 1889, VI, 345. Soularue (j\I.)— Recherches sur les dimensions dcs os et les proportions squeletiques de rhomme. Bull. Soc. d'Anthrop. Paris, 1899, Scr. 4, X, 328. Turner (Sir Wm.) — Report on the human crania and other bones of the skeletons collected during the voyage of H. M. S. Challenger, 1873-6: II — The bones of the skeleton. Challenger Reports, Zool., 1886, Pt. XLVII. Verneau (R.) — Le bassin dans les sexes et dans les races. Thlse Med., Paris, 1875. Volkov (Th.) — Variations squelettiqucs du pied ches les primates et dans les races humaines. Bidl. Soc. d'Anthrop. Paris, 1903, Ser. 5, IV, 622; 1904, V, 1, 201. Waldeyer (W.)— Das Becken. Bonn, 1899. Wetzel (G.)— Volumen und Gewicht des Knochens als Massstab flir den phylogenetischen Entwicklungsgrad. Arch. f. Entw. d. Organismen. 1910, XXX, 507-537. ANTHROPOMETRY 149 c3 / / 150 ALES HRDLICKA The osteometric board is too well known to need special description ; but for the original accessory square the writer uses a block of light wood (see pi. 1), which offers certain advantages. The block is 9.5 cm. high and 4.5 cm. thick, while its length equals the breadth of the board. For description of instruments used on special occasions the student should consult the original sources.^ BLANKS The matter of blanks in osteometry presents some difficulties on account of the many distinct bones each of which requires its own blank. An outline of a blank such as used for general purposes by the writer will be given separately with each bone. Such blanks may be made by the student himself, and their scope may be enlarged as demanded by the needs of the occasion. As they are they represent what invariably we should know of each of the bones. observations: typical bone variants in form Before proceeding to the measurements, attention should be given to the important subject of bone variations in shape. Each of the long bones, and also the scapulse, first rib, etc., present a variety of forms which are reducible to definite types, and the fre- quency of these types differs from race to race. In the remainder of the skeletal parts similar variations occur, but they are less classifiable. The whole subject is of very considerable anthropological, phylo- as well as ontogenetic, importance. In the long bones the part that varies most in form is the shaft; in the scapula it is in the contour of the bone.^ Bones of less conse- quence will be considered on other occasions. 1 Besides the Memoirs of Broea and the textbooks of Topinard and Martin, see : Emmons (A. B.) — A study in the variations of the female pelvis. Biometrica, 1913, IX, 34-57. Garson (G.)— Pelvimetry. J. Anat. & Physiol, 1882, XVI, 106-134. Frassetto (F.)— Lezioni di anthropologia, 1911-1913. Hepburn (D.)— A new osteo- metric board. J. Anal. & Physiol, 1899, XXXIV, 111. Matthews (W.)— An apparatus for determining the angle of torsion of the humerus. J. Anat. & Physiol., 1887, XXI, 536-8. Russell (F.) — A new instrument for measuring torsion. Am, NaL, 1901, XXV, 299. ^ For original reports on tlxis subject see Hrdlicka (Ales) — Study of the normal tibia. Am. Anthrop. 1898, XI, 307-312; Proc. Ass. Am. Anal, 11 Sess., Wash. 1899, 61-66. A further contribution to the study of the tibia, relative to its shapes. Proc. Ass. Am. Anal, XII & XIII Ses. Wash. 1900, 12-13.— Typical forms of shaft of long bones. Proc. Ass. Ayn. Anat., XIV Sess., Wash. 1901, 5.5-60. Also Bull. 62, Bur. Am. Ethnol., Wash. 1916. Consult also: Manouvrier (L.) — La platycn^mie ANTHROPOMETRY 151 Long Bones: The form of the shaft of the long bones is best differenti- ated at or near the middle of the bones, in adult individuals. Variation in these shapes is greatest in the Whites. There are considerable racial and other group differences in the relative fre- quency of the different types of the shaft of the various bones; no one type, however, occurs exclusively or is completely absent in any of the human groups now existing. Some of the shapes are common to the anthropoid apes, and others occur far back in the animal kingdom. The bones of the lower extremity show more numerous and better defined differentiations of form than those of the upper extremity. Of the individual long bones, the fibula presents the greatest variety of shapes; then follow in the order named, the tibia, femur, humerus, ulna, and radius. Perfect representations of the various types of each bone are found whenever large collections are examined, but the less perfect and less clearly distinguishable types are alwaj^s more common. Besides there is always a considerable percentage of bones which present intermediary or indefinite, and a small proportion which show com- bined forms. The form of shaft common to all the long bones in man is the pris- matic (No. 1). The outline of the cross-section of a shaft of this type approaches the equilateral triangle. This type is also common in apes, and more or less modified in lower mammals. The base of the prism is formed in the tibia, fibula, and humerus by the posterior surface; in the femur by the anterior surface; in the ulna by the in- ternal, and in the radius by the external surface of the bone. In whites this type of shaft is most frequent in the humerus and tibia. In the fibula it is more or less modified by the narrow anterior surface of the bone. The nearest modifications of type 1 are types of shaft Nos. 2 and 4. Type 2 occurs principally in the tibia, fibula and humerus; and is characterized by the obliquity of the posterior surface of the bone. The outline of the cross-section is a lateral triangle, a half lozenge (more or less). Type 4 occurs in all the long bones, and is charac- chez rhonirne et chez les .singes. Bull. Soc. d'Anthrop. Paris, 1887, Ser. 3, X, 128. — • M^moire sur la platycn6mie fhez I'hoinmc ct chez les anthropoids. M6m. & Bull. Soc. d'Anthrop. Paris, 1888, Sdr. 2, III, 469. — £tude sur les variations morphologiques du corps de femur dans I'espece humaine. Bull. Soc. d'Anthrop. Paris, Sdr. 4, IV, III; Rev. d'tcole d'Anthrop. Paris, 1893, III, 389. And Graves (Wm. W.)— The scaphoid scapula. Med. Record, May 21, 1910; Wien. klin. Woch., 1912, XXV, No. 6; J. Cutan. Dis., etc., April, 1913; and others on same subject. 152 ALES HRDLICKA ANTHROPOMETRY 153 terized by the presence of a distinct additional surface on the shaft. The formation of the surface differs in the various bones. In the tibia the additional surface results from a division into two, by a vertical ridge, of the posterior surface; in the femur it is the anterior, in the radius the external, and in the ulna the posterior surface, which occasionally, through the influence of a vertical ridge, shows a forma- tion of a distinct additional plane; in the humerus, finally, a new, anterior surface results occasionally by the broadening out of the anterior border of the bone. The cross section of the shaft in these cases differs fi'om lozenge shape (more or less) to a more even quad- rangle. A special class of modifications of the form of the shaft is that where one or more surfaces of the bone show a pronounced concavity. We find such types (3, 3a, 3b,) particularly in the fibula, but also in the tibia, ulna and radius. In the fibula the concavity affects es- pecially the external, but also the internal, and occasionally both the external and internal, and even the posterior surfaces; in tibia the character is observed on the external, and in the ulna and radius mainly on the anterior, flexor, surface. Types 5, 6, e and r, are widely differing forms of the shaft of some of the long bones; all these types have, nevertheless, two features in common, and that is an indistinctness or complete absence of one or more of the borders of the bone, with marked convexity of two or all the surfaces. Type 5 occurs occasionally in the tibia and frequently in the radius. It is marked by the convexity of the posterior tibial and external radial surface, and by indistinctness of the internal and sometimes also the external border in the tibia and the anterior and posterior borders in the radius. In both bones, but particularly in the tibia, this type of form represents a deficiency in the differentiation of the bone. Type No. 6 occurs in the tibia, femur and humerus. The shaft is plano-convex. Types e (elliptical) and r (round, cylindrical) are found in the femur. The condition of flatness in long bones occurs quite independently of the shape otherwise of these shafts. Flatness is not only found in the tibia, but also in the fibula (lateral), in the femur (antero-posterior of whole shaft, and, independently, antoro-postcrior of the upper part of the shaft, below the minor trochanter), and in the humerus (lateral). The flat femur (whole shaft) occurs almost exclusively in whites and independently of the flatness of other long bones. It is a 154 ALES HRDLICKA ^S. "^ / ^^ V fei N' (a ANTHROPOMETRY 155 rare and possibl}^ abnormal condition. A flat tibia is often accom- panied by a flat fibula, and not seldom also by a platymeric (flat in upper part) femur. The scapula presents three main shapes or types, namely, the triangular or wedge-shaped; the bi-concave, with its axillary and especially vertebral border concave (the "scaphoid" scapula of Graves) ; and the convex, with its vertebral border markedly convex. Causes. — The shape of the bones is influenced by heredity, stage of development, sex, muscular activity, size of body, and pathological conditions. Heredity: There are reasons to believe that certain types of bones run in families; and essentially through differences in heredity there are marked differences in the relative frequency of occurrence of the various types in different races. Stage of life: During fetal life and early childhood, the shapes of bones are fewer in n>umber, and do not always correspond to the shapes the bones will eventually have in the adult. Differentiation advances with age and the shape of a bone is probably not fully stabilized, particularly as to fluting, before advanced adult life. ^ex: The male bones show on the whole a greater differentiation of shapes than the females; also, some types of form are more common in one sex than in the other. Most, if not all these differences, may, however, be due to differences in muscular activities. Race: The modern cultured Whites show more variation in shape of bones than the Indians, and the Indians more than the Negro or Negrito. The causes appear to be partly hereditary and partly occupational. Muscular activity: Muscular peculiarities and muscular activites of the individual exercise a potent influence in modifying the shape of the bones. Size of the body: The largest and the smallest bones of any variety show in general less differentiation than the average; and weak bones show more uniformity than the stronglj^ developed. Pathological: Very prolonged undernourishment or vitiated state of blood dining fetal life or childhood may undoubtedly affect the general development as well as the shape differentiation of bones; but no proof exists that special pathological states are responsible for any special form-types of individual bones. The sum of the observations points to the fact that the principal causes of the various shapes of the shafts of the long and bodies of 156 ALES HRDLICKA other bones must be sought for, first, in original differences in the attachment of the various muscles on the shafts; and second, in an unequal development and work of the individual muscles during child- hood and adolescence. The original differences in attachment, some of which can be clearly seen on the bones, are in all probability partly hereditary, partly early acquired conditions. The manner in which the differentl}^ attached or differently developed muscles affect the shape of bone must of course be largely if not entirely mechanical. ADDITIONAL OBSERVATIONS In addition to shape, the bones of the skeleton offer an array of highly interesting points for observation, and many of these, as already mentioned, are of phylogenetic importance. Of these, the main ones will be included in the blanks to be given. MEASUREMENTS Blank: Humebus Tribe Locality Observer . Right Left Cat. No. Length Max. Diam. Major (a) Dlam. Minor (b) C-^) Observations ; Shape of Shalti Perforation of Septum^ Supra- condyiar Special PathO' logical 1 Type 1 = prismatic; £, 2a = lateral prismatic {2 = posterior surface facing backward and inward; 3a = posterior surface facing backward and outward); 4 = quadrilateral (anterior border broadened out to a distinct fourth surface); 6 = plano-convex; i = intermediary' or indistinct. ^ pp = pin point; sni = small; m. = medium; I = large. When double or multi- ple, state so. ' None ( — ); rough trace = r. t.; ridge: sUght, medium, pronounced (r. sl-m-pr); tubercle: slight, or medium {lb. sl-m); process: 1/3, 1/2, 2/3, etc., complete {pr. 1/3, Jl/2, 2/3, etc.). Notes. — The length is taken on the osteometric board. Apply head to the vertical, take hold of bone by left hand, apply block to distal extremity, and raising bone slightly, move up and down as well as from side to side until maximum length is determined. ANTHROPOMETRY 157 Diameter major at middle. — C. g. Determine mid-point of shaft on osteometric board and mark with pencil. Diameter minor at yniddle. — Apply fixed branch of sliding compass to the antero-lateral surface at middle and take measurement. Radius Tribe Locality . Right Observer . Left Cat. No. Age Length Max. Shape' Anomalies iPathological Radio — Humeral ] Index2 Note: Maximum length is taken in same way as that of the humerus , Ulna Tribe Locality . Right Observer . Left Cat. No. Sex Age | Length j Shape^ Max. Pathological Note: Maximum length is taken in same way as that of the humerus. ' 1 = prismatic; 2 = flexor surface concave (fluted); 5 = external surface con- vex, borders indistinct. J. Length of Radius x 100 Length of Humerus ' i = prismatic, 2 = flexor surface concave (fluted) ; 4 = quadrilateral (posterior) surface divided into two, so that the shaft presents four distinct surfaces, borders and angles. 158 ALES HRDLICKA Femur Tribe Locality Right Observer . Sex Age Length Blcondylar Length Max. Humero- femoral Index' At Middle: Cat. No. Diam. Antero- posterior Maxim. Diam. Lateral Index2 {Continiied) Left At Upper Flattening: Observations: Dlam. Lateral Maxim. Dlam. Antero- posterior Minim. Index' Shape ol Shaft* Third Condyle^ Linea Aspera* Anomalies Patho- logical Notes: The bicondylar length of the femur is taken by adjusting both condyles to the vertical part of the osteometric board and applying the block to the other extremity. The length maximum of the femur is measured in the same way as the maximum length of other bones (see under Humerus). The antero-posterior diameter at middle (middle of shaft determined and marked beforehand) is the diameter maximum. The lateral diameter at middle is taken so that the linea-aspera reposes on the stem of the sliding compass midway between the two branches of the same while these are applied to the bone. 1 Length of Humerus X 100 Bicondylar length of femur 2 Diam^at^^OO. Diam. ant .-post. 3 Diam. minium X 100. Diam. maxim. * Type 1 = prismatic ; 4 = quadrilateral (anterior surface divided by a vertical ridge in two) ; r = cylindrical (juvenile); e = elliptical; pc = plano-convex. 6r = ridge; o. t. = oblong tuberosity; r. t. = round tuberosity; d = depression; All: slight, moderate, or pronounced. «sl., mod., pron. ANTHROPOMETRY 159 In plano-convex and related femora the shaft is so deformed and the linea-aspera so displaced, that the measurement of the diameters is impractical and should be omitted. Circumference of the shaft at middle as taken by some observers and contrasted with the length of the bone gives data of some value for sexual identification; but the same may be done with the mean of the two diameters. Tibia Tribe Locality . . Right Observer . Cat. Sex Age Length Length Tibio-femo- No. (Less Spine) Maxim. . ral Indexi At Middle: Dlam. Antero- posterior Max. (a) Diam. Lateral (6) (^) {Continued) Left Observations: Pathological: Shape* Peculiarities Curvature Exostoses Other - 1 Notes: To take the ordinary length of the tibia introduce the spine into the orifice provided for this purpose in the vertical part of the osteometric board, apply outer parts of the condyles to the vertical outside of the orifice, let body of the bone repose on the horizontal part of the board, and apply block to the most distant point (mal- leolus). ' T X 100 Bicond. I. of femur 'Typo 1 = prismatic; 2 = lateral prismatic; 3 = external surface concave (fluted); 4 = posterior surface divided in two; 6 = posterior surface convex, in- ternal border indistinct; 6 = plano-convex (gorilloid). 160 ALES HRDLICKA It is also useful to take the maximum length of the tibia. This is secured by placing the spine within the orifice as with the previous measurement, applying the most prominent point of the condyles to the vertical, taking hold of the body by the left hand and moving the bone from side to side as well as slightly upward and downward, while holding the block applied to the malleolus, until the maximum length is determined. Fibula Tribe Locality . . '. Observer Right Left Cat. No. Age Length Max. Shape' Pathological Scapula Tribe Locality Right Observer . Cat. No. Age Height Total (a) Height Infra- splnous (6) Breadth Index:'' Total Index: Inferior' Type* Notes: The total height of the scapula is obtained by measuring in a straight line the distance from the superior to the inferior angle. 1 1 = Ordinary quadrilateral, approaching prismatic; anterior surface nearly absent to moderate; posterior surface facing directly backward or nearly so. 2 = Lateral prismatic; posterior surface facing backward and inward; medial surface much less in area than lateral; anterior surface narrow to broad. 2a = relation between medial and lateral surface reversed, the latter being the narrower. 3 = medial surface fluted; 4 = lateral surface differentiated into two surfaces; 6 = lateral surface fluted; 6 = both medial and lateral surfaces fluted; 9 = all three surfaces deeply fluted. ' c X 100 a ' c X 100 •I Type: 1 = triangular; 3 = biconcave ("scaphoid"), axiUary and vertebral borders concave; 6 = convex, vertebral border convex. ANTHROPOMETRY Scapula 161 (Continued) Left Observations: Sbape of Su- perior Border! Notch2 Vertebral Border* Axillary Border* Anomalies Fatbological ^ The infra-spinous height is the height from the inferior angle to a point at which the spine transects the vertebral border of the bone. To determine this point hold scapula in left hand with dorsal surface up in such a way that the eye can follow the prolongation of the spine to the axillary border. Mark the mid point of the juncture of the spine with the border (and not the lower or upper limit). The breadth of the scapula (c) is the diameter from the middle of the outer (dorsal) border of the glenoid cavity to the point where the spine intersects the vertebral border. (Broca, P. — Sur les indices de lon- gueur de I'omoplate chez I'homme, les singes et dans la serie des mammiferes. Bull. Soc. d'Anthrop., 1878, Ser. 3, I, 66.)^ Sternum' Tribe Locality . Observer . Cat. Sex Age Total Length No Length of Man- (Less ubrium Xiphoid) («) (m) Manubrial Index 100 \ / mxi Maxl- j Number mum Thick- ness of Body of Rib Facets Anoma- lies Re- marks 1 1 = horizontal, at right angle, or near, with coracoid; 3 = moderate obliquity upwards, angle 5.5-80; 3 = pronounced obliquity, angle near 45; 4 = semiquadrate; 6 = semicircular; 6 = wavy. 2 1 = none; 2 = slight; 3 = moderate; 4 = nearly a foramen; 5 = foramen. '1 = straight; 2 = concave; 3 = convex: sUghtly — moderately — pronouncedly. * 1 = straight; 2 = teres process slight; 3 = moderate; 4 = pronounced. ' Were it not for the amount of work done with this breadth, it would be i)referable to take that from the slight depression or roughness in the middle of the glenoid fossa to the spine-point, for the borders of the fossa are liable to some irregularities of development, besides which the mid-glenoid point is the more .suitable in measure- ments of scapula; of various animals. « Consult : Anthony (R.) — Notes sur la morphogenie du Sternum chez mammiferes. 162 ALES HRDLICKA Notes: The length of the sternum as well as that of the manubrium is best measured on the osteometric board; the breadth and thickness of the bone are measured with the sliding compass. The thickness of the body should be measured between the facets for the ribs. Among the anomalies are to be observed especially the foramen or defect in the lower part of the bone, and the occurence of episternals. The relative proportions of the manubrium and body of the sternum show sexual as well as group differences; and the same may be said in regard to the fusion of the manubrium with the body of the bone. Clavicles' Tribe Locality . Right Observer . Left Cat. No. Age Length Maximum Conoid Tuberosity Strength^ Curvature' Notes: The length of the clavicle is best determined on the osteometric board, but may also be measured by the small or the large sliding compass. The comparison of the length of the clavicle with the length of the humerus (claviculo-humeral index) is useful as an indication of the relative development of the thorax. The acromial extremity may in rare cases be separated; a few other anomalies may also occur. Bull. Soc. d'Anthrop. Paris, 1901, II, 19^3. Dwight (Thos.)— The Sternum as an index of sex, height and age. J. Anat. & Physiol., 1890, XXIV, 527-535. Krause (W.) — Ueber das weibUche Sternum. Intern. Monatsschr. f. Anat. & Physiol., 1897, XIV, 21-32. Parker (W. J.)— Structure and development of the Shoulder Girdle and Sternum in the Vertebrates. Roy. Soc. Publ., Lond., 1868. Paterson (A. M.) — The human sternum. Liverpool, 1904; also Brit. Med. J., 1902, II; and J. Anat. & Physiol, 1900, XXXV, Pt. 1. 1 Consult Pasteau (E.) — Recherches sur les proportions de la Clavicule. These mid., Paris, 1879; also Parsons (F. G.) — 'On the proportions and characteristics of the modern English Claricle. J. Anat., Lond., 1916, LI, 71-93. 2 SI = slender; m = medium; str = strong; ynas = massive. ' SI = slight; m = medium; pron = pronounced. ANTHROPOMETRY RiBSi Tribe Locality . Observer . 163 Cat. No. Age Number Present Anomalies Fractures and Pathological Ist Rib Shape.- Notes: In skeletal material obtained from older graves the ribs are seldom all present and in good condition; nevertheless their examina- tion should not be neglected. Cervical, supernumerary, bifid, bici- pital and fused ribs are of special interest; and other anomalies may occur. The first rib deserves special attention, particularly as to its shape. The development of the scalene tubercle may also be noted on the first rib. Spine' Tribe Locality. Observer . Cat Sex. No. Age Atlas: A noma- Re- lies marks Other Cervical: Num- Anoma- ber I lies Re- marks Num- ber Anoma- lies Re- marks Num- ber A noma- Re- lies marks » Bardeen (Ch. R.) — Costo-vertebral variation in Man. Anat. Am., 1900, XVIII, 377-382. Hrdlicka (Ale§) — Contribution to the Osteology of Ribs, Proc. Ass. Am. Anat., XIV Sess., Wash., 1901, 61-68. Tredgold (A. F.)— Variations of Ribs in the Primates with especial reference to the number of sternal Ribs in Man. J. Atiat. & Physiol, 1897, XXXI, 288-302. ^1 = curved (semilunar); 2 = monoangular or pistol-shaped (nearly straight neck, with nearly straight body); 3 = biangular (distinct angle in body, besides that between neck and body). 'Consult: Anderson (R. J.) — Observations on the diameters of human vertebrae in different regions. J. Anat. & Physiol., London, 1883, XVII, 341-4. Bardeen (Chas. R.) — Numerical Vertebral Variation in the Human Adult and Embryo; Anat. Anz., 1904, XXV, 497-.519. Cunningham (D. J.) — Lumbar Curve in Man and the Apes. Dublin, 1886. Dubreuil-Chambardel (L.) — ^^ariations sexuelles de 1' Atlas. Bull. & Mem. d'Ardhrop., Paris, 1907, VIII, 399^04. Dwight (Thomas)— 164 ALES HRDLICKA Notes: Various measurements and many detailed observations are possible on the spine and its different constituents. As to measure- ments, the most interesting are the relative lengths of the cervical, dorsal and lumbar parts of the spine compared with the total length of the three. The length of these parts is best taken by the small and large sliding compasses, between the mid points anteriorly of the upper and lower border of the body of the first and last vertebra of each segment, with the bones held in a close and natural apposition. The atlas should receive special attention, for it is subject to many independent variations, particularly in respect to blood vessel foramina and canals. The lowest part of the dorsal and the uppermost as well as lower- most parts of the lumbar segment, are also of special interest, the former on account of occasional numerical variation, the latter on account of occasional separation of neural arch, a presence of a sacral element with more or less assimilation, etc. The minor anomalies of the spine and its constituents should be reserved for special study. Tribe . Sacrum, Pelvic Bones, Pelvis . Locality Observer . Sex Age Sacrum : Cat. No. Height Maxim. > Breadth Maxim. Sacral Index2 Number of Segments Curva- ture' Curvature i Special Begins at* | Description of the Human Spines showing numerical variation. Mem. Boston Soc. Nat. Hist., 1901, 237-312, also, Anat. Anz., 1901, XIX, 332, 337-347; and Anat. Am., 1906, XXVIII, 33-40, 96-102. HrdUcka (Ale§)— The atlas of Monte Hermoso. In Bull. 62, Bur. Am. Elhnol., Wash. 1912, 364-9. Papillault (G.)— Variations numeriques des vertfibres lombaires chez I'homme. Bull. Soc. d'Anihrop., Paris, 1898, IX, 198-222. Ranke (J.)— Zur Anthropologie der Halswirbelsaule. Sitz. math. phys. CI. bayer. Akad. Wiss., 1895, XXV, 1-23. Ravenel (M.)— Die Maas- verhaltnisse der Wirbelsaule and des Riickenmarkes beim Menschen. Dwang. Dissert., Leipzig, 1877, 1-27. Regaha (C. E.) — Sulla causa generale delle anomalie numeriche del rachide. Arch. p. Antrop. & Etn., 189.5, XXV, 149-219. Rosenberg (E.) — Ueber die Entwicklung der Wirbelsaule. Gegenbaur's Morphol. Jahrb., Leipzig, 1875, 1, 1-111. Soularue (G. Martial) — Etude des proportions de la colonne vertebrale chez I'homme et chez la femme. Bull. Soc. d'Anihrop. Paris, 1900, S6r. 5, 1, 132-147. Zoja (G.)— Sulle variety, dell'atlante. Bol. sci., 1881, Nos. 1 & 2, repr. 24 pp., Also C. R. R. 1st. Lomb., CI. Sc. mat. & nat., 1881, XIV, 269-296. ANTHROPOMETRY 165 Sacrum, Pelvic Bones, Pelvis (Continued) . Ossa Innominata: Pelvis: Height Maxim. | Breadth Maxim. Mean | Special Index^ Features Breadth Total Superior Maxim.* Index' Strait: Breadth 1 Maxim. Diameter Antero- posterior Maxim. 8 Pelvic Index Re- Right Left Right Left marks Notes: In measuring the height of the sacrum use sliding compass, and apply points of instrument to middle of promontor}^ and middle of anterior-inferior border of the fifth sacral -vertebra. For general comparative purposes measure onlj^ sacra with five segments. In measuring breadth apply stem of compass to the upper surface of the body "of the first sacral vertebra and measure the greatest expanse of the lateral masses of the bone. The height of the ossa innominata is best measured on the osteo- metric board. Apply ischium to the vertical part of the board, hold bone with left hand, apply block to iliac border with right hand and move bone up and down and from side to side until maximum measurement is obtained. The breadth of the ossa innominata is best measured by the sliding compass. It is the distance between the anterior and posterior superior spines. For measuring the pelvis as a whole articulate the bones, hold with both hands, invert, and secure breadth maximum of ilia on the osteo- » Long branch of sliding compass appb'ed ventrally, in median line, to anterior border of lower end and to promontory. * Breadth x 10 . Height 'Slight, moderate, pronounced. * Name segment (from above). ^ Mean breadth x 100 mean height •Pelvis held together with bones in natural position; the bread this the bi-iliac maximum, and can be taken handily on the osteometic board, or by a second person with the large sliding compass. ^ Breadth X^100_ mean height of ossa innominata * From promontory of the sacrum to the nearest point on the ventral border of the pubic bones. 166 ALES HRDLICKA metric board. With the help of a pelviphore (such as that of Emmons) the taking of this measurement and of those of the brim becomes a simple matter. To measure the diameters of the superior strait or brim of the pelvis without a pelviphore, hold pelvis in left hand, and use small sliding com- pass. The antero-posterior diameter is that between the mid point on the promontor}^ of the sacrum and the nearest point on the ventral borders of the pubic articulation. The lateral diameter is the maxi- mum transverse diameter of the brim. A natural slight separation of the pubic bones should be retained during all measurements. Short Bones Patella.^ Tribe Locality . Right Observer . Left Cat. No. Age Height Breadth Maxim.! Maxim. Thickness Maxim. Breadth-Height Index (SX 100) Patellar Mod- ule (H+B+T) Vastus Notch^ Notes: All the measurements to be taken with the small sliding compass. In measuring the height and breadth of the bone, move the latter slightly from side to side between the branches of the compass until the maximum measurement is determined. The height is taken by applying the fixed branch to the anterior surface of the bone and bringing the movable branch posteriorly over its thickest parts. The vastus notch shows interesting variations. 'Consult: Corner (E. M.) — Varieties and structure of the Patella of Man. J. Anal. & Physiol., 1900, XXXIV, XXVIl-XXVlII; also Ten Kate (H.)— Rotule. Rev. Mus. La Plata, 1896, VII, 12-16; and Bull. 62, Bur. Amer. Elhnol., Wash. 1916. 2 — none; si = sUght; m = moderate; 1 = large. ANTHROPOMETRY 167 Calcaxeusi Tribe Localit}' Right Observer . Left Cat. No. Sex Age 5 g S a ' c 2 =* c t g^i Mi; Breadth- i Breadth- Height- Module Articular Length Height Length ' (L + B ->- H) Facets for [ ^ Index Index I Index 5 Astragalus (B X 100) (J5 X IPC) ; (.H X 100) ' H m ' cS F a o rt < Notes: All measurements to be taken with the small sliding compass. The taking of the maximum length will be self-evident. To secure the breadth, the branches of the compass should be applied to the sides of the bone in the region of the minimum thickness of its body. The most practicable height of the calcaneus is obtained by moving the bone from side to side between the branches of the compass, which are applied to what is seen to be the greatest constriction of the body (approximately its middle). As to visual observations on the Os calcis, the greatest interest attaches probably to the number and conformation of the articular facets for the astragalus. These facets may be two in number, an- terior and posterior. But the anterior facet may be divided into two by a ridge; or it may be replaced by two facets, anterior and median, completely separated by a narrow to moderately broad groove or space; or, finally, in place of the single oblong anterior facet there may be a small to rudimentary anterior and a medium-sized median facet, separated by a broad and deep notch. An additional point of some interest is the development of the peroneal spine. > See BvU. 62, Bur. Amer. Ethnol., Wash., 1916. 168 ALES HRDLICKA Astragalus! Tribe Locality . Right Observer . Left Cat. No. Age Length Maxim. Breadth Maxim. Height Maxim. Breadth- Length Index (BX 100) Height- Length Index (i/X ICO ) L Module (L+B + H) Facets for Calcaneus* Notes: For length maximum, apply stem of sliding compass to lowest (most prominent) parts of the medial surface on the bone. The maximum breadth is taken by applying the fixed branch of the sliding compass to the lowest (most prominent) parts on the medial surface of the bone. The maximum height of the astragalus is best taken on the osteo- metric plane, on which the bone is placed so that all the three lowest points of its inferior surface touch the vertical part, while the block is applied to the most prominent part of the bone from the opposite direction. A comparative study of the calcaneus facets on the talus with the corresponding facets on the latter bone, is of considerable interest, and shows some racial variations. Scaphoid' Tribe Locality Observer Right Left Cat. No. Age Breadth Height Maxim. Maxim. Stout- ness Maxim, Height- Breadth Index (//X 100) B Stoutness- Breadth Index (•S'X 100) Facet for Cuboid* Facet Tuber- Addi- for osity* tional Talus, Forms > See Bull. 62, Bur. Am. Ethnol, Wash., 1916. ^ 1 = one facet not divided by any ridge; 2 = one facet divided into two by a ridge; S = two distinct facets, but slightly connected or completely apart. ' See Bull. 62, Bur. Am. Ethnol., Wash., 1916. * Present or absent. " Vf = pyriform; q = quadrilateral; i = intermediary or indefinite. « p = pointed; hi = blunt (markedly); sq = squarish. ANTHROPOMETRY 169 Notes: The maximum breadth of the bone is taken by the small sliding compass and is measured from the extremit}^ of the tuberosity ad maximum. To take the maximum height of the bone use the large sliding com- pass with broad branches; hold instrument vertically, lay bone on movable branch on its talus facet, raise the branch until the bone touches the under surface of the fixed branch and read measurement. To measure the stoutness use same instrument as for height. Lay bone on the movable branch of the compass on its dorsal or superior surface, let it assume a natural position, and raise the branch until the most prominent part of the plantar surface of the bone touches the under surface of the fixed branch. CUBOIDI Tribe Locality . Right Observer . Left Cat No. Age Length Maxim. Breadth Maxim Thick- ness Maxim. Breadth- Length Index (5X100) L Thickness- Length Index (rxioo) Module (L+B+T) for Cunel- lorm- for Talus' Addi- tional Notes: The maximum length of the bone is measured with the small sliding compass, between the most prominent point on the superior and inferior borders of the distal or metatarsal facet of the bone and the point at the inferior medial angle (calcanean process). The maximum breadth is obtained with the cuboid resting on its medial surface in such a position as it naturally assumes. This and the next measurement are best taken by the large sliding compass with broad branches. The maximum thickness is taken with the cuboid resting on its anterior surface in such position as it naturally assumes. 'See Bull. 62, Bur. Am. Elhnol., Wash., 1916. 's = single; r = divided in two by a well marked ridge; 3 = double (connected or not). ' Present or absent. 170 ALES HRDLICKA Internal Cuneiformi Tribe Locality Observer . Right Left Cat. No. Height Maxim. Breadth Minim. Breadth-Height Metatarsal Index (B X 100) H Facet* Note: Measurements taken with sliding compass. Height maxi- mum is secured by applying the fixed branch of the compass to the most prominent parts of the inferior surface of the bone and bringing the other branch into apposition. The minimum breadth, in the middle of the bone, is obtained by applying the fixed branch of the compass so that it rests on both lips of the scaphoid facet, and bringing the other branch into apposition with the bone. It is the only practicable breadth in all specimens. External cuneiform: Note frequency of absence of facet for fourth metatarsal, also for second metatarsal. Middle Cuneiform: Note character of central ligamentous depression and canal running downward from this. Bones of the Hand' Tribe Locality . •. Observer . Right Left Cat. No. Bones of Carpus: Number Obser- I vatlons Metacarpals: Re- marks Length Max. of 1st Meta- carpal Metacarpo- Humeral Index* Phalanges: Number Re- I marks 1 See Bull. 62, Bur. Am. Ethnol, Wash., 1916. 2 Single or double. 3 See Bull. 62, Bur. Am. Ethnol, Wash., 1916. * Max. l ength of 1st metacarpel X 100 . Max. length of humerus ANTHROPOMETRY 171 Tribe . Bones of the Footi Locality Observer . Right Left Cat. No. Sex 1 Age Metatarsals: Number Obser- i i vations i 1st Metatarsal: Length Pollux-Hal- Hallux Fe- I Maxim, lux Index^ mur Index' Re- marks Phlanges: Num- ber Re- marks ESTIMATION OF STATURE FROM PARTS OF THE SKELETON* The International Agreement of Geneva stipulates that: "For the reconstruction of the stature with the aid of the long bones, the maxi- mum length shall be measured in all" cases save in those of the femur which is to be measured in the oblique position, and the tibia which is also be to measured in the oblique position, the spine being excluded." Under these conditions and until something more serviceable may be provided, the student is advised to use Manouvrier's tables, which are here reproduced. These tables apply only to bones of adults; and a proper sexual identification is in each case of the greatest importance. All the long bones present should be measured and the mean length of each pair used for the approximations in the table, the mean of the total of approximations giving the stature. 1 See Bull. 62, Bur, Am. Ethnol, Wash. 1916. * Max. length of 1st metacarpal x 100 Max. length of 1st metatarsal ' Ma x. len gth of 1st metarsal X 100 _ Bicondylar length of femur * Dwight (Thos.) — Methods of estimating the height from parts of the skeleton. Med. Rec, Sept. 8, 1894. (Gives data for estimating stature also from length of sternum and that of the spine.) Manouvrier (L.) — D6termination do la taillc d'apres les OS longs. Rev. Ec. d'Anthrop. Paris, 1892, II, 227. — La determination de la taille d'apros les grands os des membres. Mem. Soc. d'Anthrop., Paris, 1S93, S6r. 2, IV, 347-411. Pearson (K.) — On the reconstruction of the stature of prehistoric races. Philos. Trans. R. Soc, London, 1899 (Mathematical); CXCII, Ser. A, 169-244. RoUet (E.) — La mensuration des os longs des membres. These mM., Lyon, 1899 (Similar to Manouvrier). Topinard (P.) — De la restitutiini de la taille par les os longs. Rev. d'Anthrop., Paris, 1885, VIII, 134. — Proc6d6 des mensuration des os longs dans le but de reconstitues la taille. Bull. Soc. d'Anthrop., Paris, 1885, VIII, 73-83. Also EUments d'Anthropnlogie generate (used maximum lengths throughout). Older data unreliable and lack precision of methods. 172 ALES HRDLICKA The final estimate will be the more reliable the larger the series of subjects involved. In single individuals the error, as Dwight has shown, may be very considerable^ particularly in tall males (1 up to 11.9 cm.).i Percentage of Stature 17.7 18.1 to 18.5 18.6 to 19 19.1 to 19.5 19.6 to 20 20.1 to 20.5 2C.6 to 21 21.1 to Percent of Bones Males Females 1.4 11.7 24.3 12.2 20.7 27.1 31.7 21.6 18.3 9 9.8 3.7 7.3 1.1 Manouvrier's Tables Showing the Correspondence of Bone Lengths among Themselves and with Stature Males Humerus Radius Ulna stature Femur Tibia Fibula cm. cm. cm. cm. cm. cm. cm. 295 213 227 1,530 392 319 318 298 216 231 1,552 398 324 323 302 219 235 1,571 404 330 328 306 222 239 1,590 410 335 333 309 225 243' 1,605 416 340 338 313 229 246 1,625 422 346 344 316 232 249 1,634 428 351 349 320 236 253 1,644 434 357 353 324 239 257 1,654 440 362 358 328 243 260 1,666 446 368 363 332 246 263 1,677 453 373 368 336 249 266 1,686 460 378 373 340 252 270 1,697 467 383 378 344 255 273 1,716 475 389 383 348 258 276 1,730 482 394 388 352 261 280 1,754 490 400 393 356 264 283 1,767 497 405 398 360 267 287 1,785 504 410 403 364 270 290 1,812 512 415 408 368 273 293 1,830 519 420 413 Mean Coefficients for bones shorter than those show 'n in the Ta ble:. 5.25 i 7.11 1 6.66 | | 3.92 4.80 4.82 Mean Coefficients for bones longer than those show n in the Tal )le: 4.93 1 6.70 1 6.26 | | 3.53 4.32 4.37 To determine from this table the stature of the living, add 2 mm. to each length; take the mean of the resulting statures, and subtract 2 mm. from the final height thus obtained. 2 > The author obtained the following correspondences between the humerus and stature in 3.54 male and 82 female dissecting room individuals. Whites, 22-25 years of age, and where both humeri could be measured. « Dwight found that a large proportion of the errors with the Manouvrier tables was due to this subtraction, and advocates that this recommendation be not followed. It should be stated by the author whether it was or was not followed. ANTHROPOMETRY 173 Manoitvrier's Tables Showing the Correspondence of Bone Lengths among Themselves and with Stature — Continued Humerus Radius Ulna stature Femur Tibia Fibula cm. cm. cm. cm. cm. cm. cm. 263 193 203 1,400 363 284 283 266 195 206 1,420 368 289 288 270 197 209 1,440 373 294 293 273 199 212 1,455 378 299 298 276 201 215 1,470 383 304 303 279 203 217 1,488 388 309 307 282 205 219 1,497 393 314 311 285 207 222 1,513 398 319 316 289 209 225 1,528 403 324 320 292 211 228 , 1,543 408 329 325 297 214 231 1,556 415 334 330 302 218 235 1,568 422 340 336 307 222 . 239 1,582 429. 346 341 313 226 243 1,695 • 436 352 346 318 230 247 1,612 443 358 351 324 234 251 1,630 450 .364 356 329 238 254 1,650 457 370 361 334 242 258 1,670 46.4 376 366 339 246 261 1,692 471 382 371 344 250 264 1,715 478 388 376 Mean Coefficients for bones shorter than those shown in the Table: 5.41 I 7.44 I 7.00 | | 3.87 | 4.85 | 4.88 Mean Coefficients for bones longer than those shown in the Table: 4.98 I 7.00 I 6.49 | | 3.58 | 4.42 | 4.52 SPECIAL COMMUNICATIONS AND REPORTS THE MORTALITY STATISTICS OF INSURED WAGE- EARNERS AND THEIR FAMILIES LOUIS I. DUBLIN, Ph.D., Statistician, wdth the collaboration of EDWIN W, KOPF, Assistant Statistician, and GEORGE H. VAN BUREN, Super\'isor, Statistical Bureau L DATA ON THE RACE AND SEX RATIO OF MORTALITY AMONG WAGE-EARNERS Students of anthropology will be interested in the above mentioned work, a recent publication on the mortality statistics of a group of more than ten million wage-earners dispersed over the United States and Canada. From these data, it will be possible to make deeper inquiries than have been possible from data hitherto available, into the influence of urban working-class environment upon mortality at the various divisional periods of life, and comparatively for the sexes; and on the relative mortality of the negro and Caucasian groups of the wage-working population. The authors have throughout the work distinguished the white and colored races, according to sex, in all of the tables, whether relating to the total mortality or to the important diseases. They have also shown comparisons of the data for white wage-earners, by sex, with those of the population of the Registration Area in the United States. It will be recalled that until this volume was issued there had been accessible no such display of detailed public health statistics relating specifically to wage-earners and to members of their families. The published statistics of mortality issued by the municipal, state and federal offices, cover the entire population and give no clue to the mortality situation among the wage-earning masses of the country. The health statistics of the negro, compiled from similar population sources, have been more or less unsatisfactory because of the lack of required detail as to sex, age and diseases causing death. Students of the health of races have long desired mortality statistics of groups comparably situated as regards urban environment and otherwise. In the present work, there is as much detail of tabulation for the white as 175 Amer. Jour. Phys. Anthrop., Vol. Ill, No. 1. 176 SPECIAL COMMUNICATIONS AND REPORTS for the negro groups. Anthropologists may have confidence in these figures of mortality according to race, first, because they are founded upon an accurate knowledge of the number of lives exposed to risk, and second, because the processes of gathering, editing and compiling the facts of mortality were carried on with the utmost concern for accuracy. The report covers the six years from 1911 to 1916. There were more than 635,000 deaths tabulated, of which more than four fifths (82 per cent) were those of white persons, and 18 per cent of negroes. But only 12.5 per cent, of the lives exposed to risk were negroes. The higher mortality rate of negroes becomes apparent at once from this simple comparison of the racial make-up of the exposure and of the deaths. In terms of the actual death rate, the negro group showed an excess life-loss of 56 per cent. Considered according to sex, negro males showed an excess of nearly one half (49 per cent) and negro females an excess of slightly more than three fifths (62 per cent) over the rates for the corresponding sexes among the Caucasian groups. Anthropologists will perhaps be interested in following this ratio between the mortality figures of white and colored persons through the several age-divisions of life. From the published data this can be done not only for the total mortality, but also for any of the important diseases and conditions. The findings on the relative mortality of whites and negroes, and of males and females, in this work may be discussed first, with respect to age, and then for the important diseases and conditions causing death. 2. EXCESS OF MORTALITY AMONG NEGROES (a) Males Considering the excess mortality among negroes over that for white persons, according to age, properly distinguishing sex, we find that whereas the negroes show for all ages one and over^ an excess of 49 per cent among males, this ratio of excess mortality varies con- siderably at the several age divisions of life. Thus, in early childhood, in the period one to four years, there was an excess of 72 per cent. Between 5 and 9 years of age this excess was 49 per cent. There was a sharp increase in this ratio to a maximum of 150 per cent for colored males at 15 to 19 years of age. After age 20 this ratio tends to de- » No infants under 1 are included in this insurance mortality experience. SPECIAL COMMUNICATIONS AND REPORTS 177 crease until in old age there is very little difference shown in these figures between the mortality of insured male white and negro wage- earners. The data are given on page 16 of the book. (6) Females The readers of this journal will be interested in the analj^sis ac- cording to age, of the mortality among colored females in excess of that among white females. Between 15 and 19 years this group of negro females showed an excess of 217 per cent over the mortality of white females. After having risen to this point of maximum excess, the ratio declines, gradually with age, but is higher than the excess for negro males at every age period. The reasons for the unfavorable showing of colored females, especially in the age period of early adoles- cence, 15 to 19 years, are not apparent from superficial examination of the figures at hand. The data suggest detailed inquiiy by students of the comparative health of races. Enough material is given through- out the book for the several diseases and conditions to justify refined analysis of the figures. 3. EXCESS OF MORTALITY AMONG MALES (a) White Persons Among white persons the mortality of males, at all ages one and over, exceeded that of females by 14 per cent and among colored persons by 4 per cent. The mortality rates of the two sexes among white lives tended to approximate each other only in the ages 10 to 19 years, but at all other age periods in this present mortality experi- ence the curves of mortality among white males and females showed a decided excess among males. The maximum excess of mortality among white males is reached in the age period 35 to 44 years, after a series of sharp increments in this ratio at the earlier ages. (6) Colored Persons The group of insured colored lives shows few of the characteristics of the sex-ratio of mortality that are found among the Caucasions. These figures emphasize the caution that inquiries into the sex-ratio of mortality by age must take into account the factor of race. Thus, between 5 and 25 years of age the death rate from all causes among colored males is very much beloiv that of colored females. The age period 25 to 34 years, begins to show an excess of male mortality 178 SPECIAL COMMUNICATIONS AND REPORTS (15 per cent), and this rises to a maximum figure of 19 per cent in the age group 35 to 44 years. In tlie ages between 45 and 75 years of age the excess of mortality among colored males varies but little from a figure of 15 per cent. It will be seen from this brief consideration of the mortality from all causes of death that no general conclusions on the comparative vitality of males and females, of white and colored persons can be drawn without considering the make-up of the mortality according to diseases and conditions. Before passing to such a detailed discussion, however, we would direct the reader's attention to the characteristics of the two sets of curves given on pages 17 and 19 of this book. On the first mentioned page the authors have shown a chart illustrating by age the mortality from all causes of death of white males and colored males, respectively. The curve of .white males is "J" shaped, or concave throughout, but that for colored males shows a convex tendency between central age 12.5 and 30 j^ears of age. The curves on page 19 of the book show the usual "J" shaped curve of mortality for white females, but the colored female group shows a pronounced departure from the "J" conformation between central ages 12.5 and 30 years, more so than for colored males. Among the group of insured colored persons, tuber- culosis seems to be responsible for most of the convex tendency of the mortality curve between central ages 12.5 and 30 years. In addition, among colored females the very high death rate from diseases and conditions connected with child-bearing and the gravid state con- tribute to the hump in the curve for that group at the early adult ages. 4. IMPORTANT ASPECTS OF WAGE-EARNERS MORTALITY ACCORDING TO DISEASES CAUSING DEATH A short abstract table is given below showing the mortality from principal causes of death among this group of insured wage-earners. Death Rates per 100,000 Exposed. Principal Causes of Death among Wage- Earners. By Color and Sex Total White Colored Male Female Male Female All causes of death 1,181 1,182 1,040 1,763 1,689 Tuberculosis— total 205 186 140 212 194 126 147 132 137 430 391 191 385 Tuberculosis of the lungs 349 Organic diseases of the heart 202 SPECIAL COMMUNICATIONS AND REPORTS 179 Death Rates per 100,000 Exposed. Principal Causes of Death among Wage- Earners. By Color and Sex. — Contintied. Total WMte Colored Cause of Death Male Female Male Female Pneumonia — total Bronchopneumonia Pneumonia — lobar and undefined . . Bright's disease External causes of death' 108 30 78 97 94 73 12 7 2 70 68 9 9 6 24 26 19 8 5 17 14 12 4 4 112 30 83 97 147 116 20 5 5 50 60 11 11 5 30 28 i6 11 13 2 2 92 29 63 88 45 36 7 2 88 70 9 9 6 24 25 33 14 9 13 19 10 4 2 179 38 142 139 184 121 10 52 3i 77 5 3 9 10 26 36 10 14 6 18 131 34 97 121 58 Accidents Suicides Homicides .... 39 5 14 War deaths Cancer Cerebral hemorrhage, apoplexy Four communicable diseases of child- hood: ; Measles Scarlet fever Whooping cough ^ Diphtheria and croup Diarrhea and enteritis 88 97 5 2 9 9 28 Puerperal state : 49 Puerperal septicemia 23 Puerperal albuminuria and con- \Tilsions Typhoid fever '. . 12 34 Diabetes 11 Appendicitis 13 Pellagra Malaria 21 22 5. TUBERCULOSIS It can be seen very readily from the foregoing table that tuberculosis is still the chief cause of death among wage-earners. The group of organic diseases of the heart is next in importance in the number of deaths, followed by pneumonia — all forms. In the Registration Area of the United States, 1917, on the other hand, organic diseases of the heart is the first group of causes of death followed by pneumonia — all forms, and then by tuberculosis — all forms. Prior to 1915 tubercu- losis had been the chief cause of death in the general population, but with the continued downward progress of the tuberculosis rate, or- ganic diseases of the heart assumed the place of first importance. Since then, the rate for organic diseases of the heart has been higher than that for tuberculosis — all forms. In 1915 and 1916, organic diseases of the heart, tuberculosis and pneumonia were the three ranking causes of death in the general population, but in 1917 pnoii. ' Includes war deatlis not shown in above table. 180 SPECIAL COMMUNICATIONS AND REPORTS monia displaced tuberculosis as the second cause of death. For the group of insured wage-earners, however, there is still such a gap be- tween the tuberculosis curve and that for organic diseases of the heart that it will be some time before the order of the first three im- portant causes is disturbed, barring years of excessive pneumonia pre- valence such as in 1918. The group of colored males showed the highest rate from tuberculosis (430), with colored females next in order (385) followed by white males (212), then by white females (147). These differences in the tuberculosis death rates of the four chief race and sex groups require much detailed examination before con- clusions can be drawn. There are, first of all, differences in the age distribution of the several groups and in the types of tuberculosis curves when drawn with respect to age. On page 50 of the book, the authors show two sets of curves for tuberculosis of the lungs. Due reflection upon these curves emphasizes the need for extreme caution in comparing the crude tuberculosis death rates of the several color and sex groups or classes when the data are not displayed for age. It will be seen that the curve for white males is of the middle adult age type with its peak at central age 40. That for colored males is, no doubt, a compound of curves ttf an early-adult and a middle- adult age type. There is a sharp rise from childhood to a high rate in the age period 20 to 24 years. This figure is maintained practically until central age 40 after which there is a more or less precipitate drop. The curve for white females covers by far the least area, reaches a maximum at central age 30 but resembles no one type of tuberculosis curve. The outline of the curve for colored females, on the other hand, is frankly that of very early adult, perhaps more properly, late adolescent type, with its maximum point at central age 22.5 years, with very sharp descending limbs on both sides of the maximum. The authors suggest that the figures for the age incidence of tubercu- losis of the lungs may not represent a single disease entity, but that perhaps all of the curves are compounded of constituents, each repre- senting a certain type of the disease in relation to race, economic status, and other causative factors; There may even be a variety of infecting organisms which may help to account for the differences in the two races at the various age groups. In the text the authors have simply stated their findings with respect to the incidence of tuberculosis mortality in the several race groups and by sex and age, but admit that it is extremely difficult to say why tuberculosis mortality of the negro is higher than that of the SPECIAL COMMUNICATIONS AND REPORTS 181 white group, and among males higher than among females. Whether these differences reflect truly the influence of race, or of sex, or whether the explanation lies in environment (sanitation, economic status, occupation, etc.) it is impossible to say. So very much depends upon clinical evidence of the type and characteristics of the disease and upon one's success in evaluating the several factors of inheritance, opportunity for infection, the virulence of the invading and compli- cating organisms and the important facts of environment such as hous- ing, nutrition, medical care during the incipient state and a host of other important facts. Physical anthropology has before it one of its greatest tasks in showing what bodily measurements are associated in tuberculosis with the several race and sex groups, considered by age, which display such widely different types of mortality curves for a single disease. Among white male wage-earners, the authors found a lower rate from tuberculosis of the lungs under age 15, and after that age a higher rate than among males in the general population. This was also true for white females in wage earners' families, with the excep- tion of the ages beyond age 65 years. 6. TENDENCY OF TUBERCULOSIS MORTALITY IN THE WHITE AND COLORED RACES The course of the tuberculosis death rate has been consistently downward during the six years covered by this report and there is no reason to expect any slackening in the tendency toward decline. In 1911, the rate for tuberculosis of the lungs was 203; in 1916, 173 per 100,000 exposed. This represents a decline of 15 per cent. In other words, for every seven deaths from tuberculosis of the lungs in 1911 there was, to correspond, in 1916 only six deaths. This is indeed a satisfactory showing and reflects not only the work of the entire tuber- culosis movement but also every other effort toward the improvement of the public health, especially the advancement of the welfare of children. 7. TUBERCULOSIS IN THE NEGRO Unfortunately, this downward tendency of the tuberculosis death rate of the Industrial Department reflects only the very favorable experience of the group of white lives. Among colored males, there has been a distinct increase in the death rate for tuberculosis of the lungs over the period covered by this report. In 1911 the rate was 182 SPECIAL COMMUNICATIONS AND REPORTS 379 and in 1916, 387 per 100,000. In 1915 a very high rate of 400 per 100,000 was reached for colored males. Although the situation is not so grave among colored females, still, there is no evidence from the statistics of six years that there has been any substantial decline in the rate for tuberculosis of the lungs among this group. It would be conservative to say that the rate for this disease among colored females is practically stationary but that among colored males it has increased at an alarming rate. These sanitary statistics show, for recent years, what has been emphasized by students of negro mortality for the past twenty or more years, namely, that the increasing urbaniza- tion of the negro is, and will be for some time to come, productive of high mortality from tuberculosis of the lungs. It is not possible to say, at the present time, whether there is any prospect of checking the increase in the tuberculosis death rate among colored males be- cause of the elimination of individuals unable to survive under the conditions of urban negro life. Students of the health of the several races of mankind, would do well to observe the trend of the tubercu- losis death rate of negroes in cities, especially in relation to changes in the age or other outstanding characteristics of the disease. 8. ORGANIC DISEASES OF THE HEART So far as we may place confidence at present in any statistics of this group of causes of death, the death rate seems to be very much higher among the negroes than among the insured white group. Organic diseases of the heart, however, showed a higher death rate among females of both race groups than among males. From an inspection of the graphic chart given on page 67 of the book, it will be seen that this higher mortality among females of both race groups occurred under 25 years of age. Among white males, after 25 years of age, the death rates for organic diseases of the heart are greater than for white females. It should be noted that up to 54 years among colored females (with one exception, between 25 and 34 years), the death rate for this group of diseases is higher than among colored males. After 55 years of age, the death rate for colored males is the higher. There seems to be a greater proportionate excess of the death rates of this group of diseases for colored females above white females, than there is for the rates for colored males over those of white males. This will be seen also from the chart given on page 67. By age periods, the mortality from organic diseases of the heart are much higher among wage earners than among the general popu- lation. SPECIAL COMMUNICATIONS AND REPORTS 183 The evidence from table 31 is that there seems to be a stationary death rate from this group of organic diseases of the heart. This may- be contrasted with the apparently increasing death rate in the Regis- tration Area for deaths in the United States. 9. PNEUMONIA Diseases caused by acute infections of the respiratory tract have assumed an increasingly menacing place among the causes of mortality. The public health records of important cities of the United States show that the only bacteria-caused disease in the entire category of such diseases, which had higher death rates in these recent years than 30 or 40 years ago, is the pneumonia-bronchitis-influenza group. The statistics given by the authors in Chapter VI will be a small contribu- tion to the historical study of respiratory infections. It should be borne in mind that pneumonia is the most important, numerically, of the acute infectious diseases. It kills every year more people than die of such communicable diseases as measles, scarlet fever, diphtheria, whooping cough and acute poliomyelitis combined. Somehow or other, until the great outbreak of so-called influenza in the fall of 1918, the general public paid but little attention to respiratory disease mortality. The interest aroused in real preventive measures by the pandemic should be maintained and some solution sought to the riddle of mortality from the group of diseases resulting from respira- tory infections. Reverting to the statistics of insured wage-earners, the death rate from pneumonia, lobar and undefined, was considerably higher among colored persons than among white persons. This applies to both sexes. The most striking differences between the mortality of the two race groups from pneumonia — lobar and undefined, occurred between central age 17.5 and 52.5 years. It is shown on the chart on page 75, that there is a slight convexity in the curve for pneumonia — lobar and undefined between central ages 12.5 and 30 years, for both colored males and colored females. Whether this hump in the curve is due to the inclusion of deaths from tuberculous pneumonitis, is doubtful. The volume also gives a discussion of mortality from bronchopneu- monia. The graph on page 81 shows that the broncho-pneumonia mortality curve according to ages is "U" shaped and not "J" shaped, as for pneumonia — lobar and undefined. If the statistics for the ages under one year were available, a .still higher point would have been shown on the graph for bronchopneumonia, but unfortunately such 184 SPECIAL COMMUNICATIONS AND REPORTS data were not at hand in the insurance records. The data for both forms of pneumonia, taken in conjunction with those for influenza, should afford students of the influenza pandemic a considerable amount of material for study. After 25 years of age, -the pneumonia rate is much higher among wage earners than among the general population. 10. OTHER DISEASES AND CONDITIONS In this abstract a considerable amount of text has been given on the three important groups of causes of death in this experience for wage-earners. In concluding this summary it may be well to comment, briefly, upon the chief facts reported by the authors for the other leading causes of death. (a) BRIGHT's DISEASE The cause of death next in numerical importance was Bright's Disease. As the authors point out on page 87, there is still too much uncertainitj^ in the statistics of Bright's disease, and in fact for the other cardiovascular-renal diseases, that they did not draw any final conclusions on the relative incidence of Bright's disease in the several color, sex and age groups. The statistics, however, are sufficiently good to warrant presentation in detailed tabular form, having in mind always the inherent deficiencies in such statistics of organic diseases. The discussion on page 87, at the beginning of Chapter VII, outlines the reasons why Bright's disease mortality statistics should be viewed with more than ordinary caution. The Bright's disease death rate among both colored males and females, was very much higher than the rates prevailing among white males and white females. These differences are much more pronounced after 35 years of age than earlier in life. The mortality of both groups is, for nearly all age periods, higher among males than among females. (6) EXTERNAL VIOLENCE Mortality from accidental and other external causes of death was high. Accidents, including unspecified violence, showed a death rate of 73 per 100,000, suicides a rate of 12, homicides a rate of 7, and war deaths a rate of 2 per 100,000. These mortality rates were higher at most age groups among the group of white insured wage-earners than in the corresponding sex classes of the United States Registration Area for deaths. The figures of accident mortality in the United SPECIAL COMMUNICATIONS AND REPORTS 185 States compare very unfavorably with those available for the countries in Europe before the War. Thus, in the year 1913, the fatal acci- dent rate of England and Wales for the age period 35 to 44 years among males, was 62 per 100,000. In the Registration Area of the United States, the rate for males at these ages was 140, and among insured white males, 154 per 100,000. It was pointed out, further, that when the fatal accidents for these three areas were classified according to means of injury, i.e., falls, burns, drowning, steam rail- road accidents, etc., the figures for the United States were much above those for England and Wales. The table on page 101 shows that falls were the most frequent of the specified forms of violence, with accidental drowning next in importance and followed by Imrns, steam railroad accidents and injuries and automobile accidents and injuries. The authors indicate that the death rate from automobile accidents and injuries was progressively on the increase throughout the period under observation and showed .that the automobile is a growing menace to the lives of children of the run-about age. Homicide is an important cause among negroes. It is next to tuberculosis and pneumonia, the chief cause of death among colored males at the period 25 to 34 years. (c) CANCER The chapter on cancer statistics is interesting because it presents among other things, a table showing the incidence of the disease in three different economic, strata. The authors show, that age being considered, the cancer death rate is higher among the wage earning groups of the population than among those better situated in an eco- nomic sense. Furthermore, another important fact brought out in the text is that no real increase in the cancer death rate can be de- tected from the statistics of insured wage-earners. Students of the cancer problem will profit from a detailed examination of this chapter. It should be noted that the Journal of Cancer Research for July, 1919, gives the tabular and text material of this chapter in full. (rf) DISEASES OF THE MATERNAL STATE The chapter on diseases and conditions associated with the maternal state will also be interesting, especially those that show the possible effect upon maternal mortality of a comprehensive programme of nursing in the puerperal state. The authors show that there was a 186 SPECIAL COMMUNICATIONS AND REPORTS decline of 10.7 per cent in the death rate from puerperal diseases and conditions among insured white women in the six years as compared with the practicall}^ stationary death rates among women in the Registration Area of the United States. (e) TYPHOID FEVER Typhoid fever, a disease which is practically an index of-the sani- tary intelligence of a community, shows a decline of 43 per cent during the six years covered by this mortality experience for all of the color or sex classes or groups. Rather complete statistics are given for the age and sex incidence of the disease. (/) OTHER DISEASES The statistics for diabetes will be of exceedingly great interest to anthropologists because they show that the death rate is higher among wage-earners than among the general population. It has been thought that diabetes was more frequent, and perhaps caused more mortality, among the better situated classes of the community. The age distribution of deaths from diabetes is also of interest. This is shown by the statistics contained on page 229 of the volume. Stu- dents interested in the mortality from pellagra and malaria, two diseases found at present very largely in the South, will find complete tables according to color, sex and age and single calendar years in Chapter XVI. Enough has been given in the way of an abstract to show that this volume contains a great mass of material instructive to students of public health and of the health problems of races. The Metropolitan Life Insurance Company has made it a policy to distribute this volume to research students, to reference libraries and to members of the medical profession interested in data of this kind. While the supply lasts, the Company will continue to give this work to qualified per- sons who wish to use these data in the furtherance of the study of anthropological, biological and public health problems. SPECIAL COMMUNICATIONS AND REPORTS 187 THE NEWEST DISCOVERY OF ''ANCIENT" MAN IN THE UNITED STATES On July 21, 1919, the Smithsonian Institution received the following letter from a reputable physician : Zaxesville, Ohio, Juty 19, 1919. Smithsoxiax Institution, Washington, D. C. Dear Sirs: I \\Tite you in regard to a highly important anthropological find made six miles from our city at Gilbert Station within the past week by excavators of the Glacial Sand Company of this city in the glacial drift at that point and at a depth of thirty- two feet below the surface and in a gravel strata. The find was a skeleton of prehistoric man and measurement was made at once of the length of the body and it measured six feet. The bones crumbled to dust very promptly excepting the skull, which was brought to this city and which I examined today. The measurements of the skull were from glabella to the spinal foramen, fourteen inches; circumference around the forehead (hat band measure), fourteen inches; from tip of mastoid to tip of mastoid, over top of head, fourteen and one-half inches. This was an adult as shown from type of body and the fact that the sutures of the skull were grown together. The temporal bone was missing on one side and the lower jaw was missing. There was a shallow frontal sinus and ethmoidal sphenoidal cells were present, also mastoid cells. The petrous part of the temporal bone was about the same shape as in modern skull and semi-circular canals were in same posi- tion as in any skull, .showing that the lower jaw could not have been that of an ape. There was a hole in the occipital region which was made delicately and evidently with a chisel, hke the skulls shown in government reports and books of anthropology pubhshed some years ago. Whether tliis hole was made for surgical purposes to extract arrow-head or whether to let out the evil spirit, I do not know. The skull of the body was facing the east. No signs of sjTDhilis on skull. I write you at once so that you can immediately come to Zanesville to examine this skull, should you so desire, before it crumbles to dust, as tliis undoubtedly is a great find. It is in possession of Mr. Henry Buerhaus of the Glacial Sand Company, 17 Richard Block, Zanesville, Ohio. \'ery truly yours, ^ , M.D. P.S. Tliis skull must far antedate Glacial period. I have sent a copy of above to Curator O. Mills, Columbus, Oliio. As the Department of Anthropology of the U. S. National Museum, in cooperation with the Bureau of Ethnology, have made it their aim now for many years to carefully examine into every find of this nature made in the United States that seems to be of some importance, and as the above letter was received from a medical man who evidently had some knowledge of anthropology, a telegram was sent to Professor 188 SPECIAL COMMUNICATIONS AND REPORTS W. C. Mills, of the Ohio Archaeological and Historical Society request- ing him to visit Zanesville, examine the remains, and report at once on the results of this examination. Professor Mills, however, was in the field, and there was no response to the telegram. Efforts were therefore made to have a competent geologist examine the site, which resulted in a visit to the same by Professor Leroy Patton, of the Muskingum College. In addition, the writer sent the following note to our informer at Zanesville: July 26, 1919 Dear Dr. : This letter should reach you on Monday. If so, kindly telegraph at once, Government Business Collect, brief information on the following points: (1) Are the specimens about which you so kindly notified us still available for examination; (2) has any scientific man been there to see them or the site, or is one expected; (3) does the find still appear important enough to you to warrant my coming to Zanesville; (4) has anything else been found besides the skeletal remains you mentioned in your letter? Should the case warrant it, I will reach Zanesville on Tuesday evening. Very truly yours, A. Hrdlicka, Curator, Div. Physical Anthropology Shortly after, the following letter was received from Professor Mills: Flint Ridge Camp, Thursday, July 24, 1919 Prof. W. H. Holmes, U. S. National Museum. Dear Prof. Holmes: I have your telegram wliich was forwarded to me here at Flint Ridge, and in a few moments I started for Zanesville, 20 miles to the east. I found Mr. Buerhaus at his office and he turned over the skull in question and I boxed same and forwarded by express and I hope you will receive the package in due time. Mr. Buerhaus presents same to the Museum and I hope you will acknowledge receipt and give him your opinion concerning the skull. My own opinion is that the skull is adult female (Indian), found in a deposit of river gravel. I did not have time to visit the place but if the skull proves other I will gladly go and inspect the entire region although I have been along the river many times and feel assured in my own mind concerning the location. I have a number of men at work opening the old quarries and felt compelled to return at the earhest time possible. Very truly yours, W. C. Mills The skull came promptly, and after examination the following report on it was sent to the donor: SPECIAL COMMUNICATIONS AND REPORTS 189 July 30, 1919 Mr. a. H. Buerhatjs, Glacial Sand and Gravel Co., Zanesville, Ohio. Dear Sir: According to j-our wish I herewith submit a brief report on the human skull which you had the kindness to send us last week: The skull is that of an adult female subject, probably Indian; but the possibility of it being Wliite cannot be excluded. The specimen is so damaged that very Uttle besides this can be said about it. The hole in the back part is not due to an operation, but evidently to an abrasion. The specimen shows no signs whatever of antiquity. Should any other human remains be found in the work under yoiu- direction, kindly preserve the bones for us. Very truly yours, A. Hrdlicka, Curator, Div. Physical Anthropology Meanwhile, a telegram and several notes wei-e received from our original informer to the effect that the find had upon critical examina- tion by Professoi's Mills and Patton lost much of its importance; and a few days later the following detailed report on the find was received from Prof. Patton: ON THE HUMAN REMAINS IN PLEISTOCENE DEPOSITS AT GILBERT, OHIO On the nineteenth of July of this year announcement was made through the medium of the public press of the finding of a skeleton of a human being near Zanesville, Ohio, in deposits which were said to prove the remains to be of Pleistocene or earlier age. Immediately upon reading the press reports the writer, recognizing the possible importance of the matter, went at once to Gilbert where the skeleton had been discovered and made as thorough an investigation of the circumstances as possible. It was learned that the skeleton had been found in the pit of the Glacial Sand and Gravel Company several weeks previous. After being removed to the office of Mr. Henry Buerhaus, treasurer of the company, at Zanesville, it attracted the attention of some persons interested in geology and anthropology in an amateur way and also other persons interested in news with the result tliat considerable publicity was given to the matter and the find was heralded as proving the existence of man in this region in glacial or pre-glacial times. The skeleton was found by Mr. Cleve Hunter, foreman of company at Gilbert works. Mr. Hunter went over the ground carefully with 190 SPECIAL COMMUNICATIONS AND REPORTS the writer and gave a complete and detailed account of the circum- stances under which the remains were found. The writer desires to state that he found Mr. Hunter an intelligent man, thoroughly honest and straightforward and interested only in giving the facts as he knew them. The Glacial Sand and Gravel Company is obtaining material at this place from a terrace of sand and gravel in the valley of the Muskingum River on the east side of the river one eighth of a mile north of the Pennsylvania R. R. station at Gilbert. The top of this Terrace is 773 feet A.T., the river at this place being 700 feet A.T. The material of the terrace consists of alternating layers of sand and gravel, the sand exhibiting marked cross-bedding practically through- out the whole of the exposui'e. The terrace is a part of the deposits described by Leverett as a valley train, probably of Wisconsin age.^ Sand and gravel is removed from the terrace by means of a steam shovel which is located at the base of the terrace. Operations have exposed the face of the terrace for a distance of two or three hundred yards and as excavations are made down to water level a vertical face of about seventy-five feet is exposed. Sand and gravel have been taken from this terrace for a number of years, this deposit having been worked by several different firms. The base of the terrace at this place is now considerably further east from the river than formerly as a result of these operations. The material of the terrace stands up in steep faces in some places in the exposure and in others slumps down to the angle of repose. Fourteen feet from the top of the exposure there is a rather persistent layer of sandy clay which stands up better than the rest of the material and forms miniature terraces in many places. The sand and gravel slumping down from above lodge on this shelf and the material piles up at an angle of repose. About five feet above the clay stratum there is a layer of dark carbonaceous material. This is also persistent and is seen throughout the exposure. Mr. Hunter stated that the remains were found above the clay stratum and at an elevation lower than that of the line of carbonaceous material. Asked to point out a situation which resembled as nearly as possible the situation in which the remains were found he unhesitat- ingly indicated one of the miniature terraces described above and said that he first saw the skull protruding from the loose sand and gravel 1 Leverett, Frank, Monograph XLI, U. S. Geol. Sur., "Glacial Formations and Drainage Features of the Erie and Ohio River Basins," p. 157. SPECIAL COMMUNICATIONS AND REPORTS 191 piled up on the ledge. It should be noted here that according to Mr. Hunter's testimony that although he recalls the location of the remains with reference to the cla}^ stratum and the layer of carbonaceous material, that the material above the clay stratum was not in place over the remains when they were found. The skeleton was lying roughh^ parallel to the edge of the ledge when found. Underneath, between it and the clay stratum was perhaps a foot of material. Whether this was the original material deposited on top of the clay stratum or material which had fallen from above could not be deter- mined. It seemed clear, however, from Mr. Hunter's testimony that the material which covered the skeleton was loose material which had fallen from above. This point was made especially clear upon the writer's request to have a geology hammer placed in a deposit of the kind which would show as nearly as possible the conditions under which the skeleton was found. He directed that the hammer be placed in what was unmistakably loose material which had slumped down from above. The writer inquired into the possibility of part of the skeleton being on the ledge with none of the original material being in place over it and part being in the undisturbed stratified material of the face of the exposure. Nothing can be proved as to this, however, as Mr. Hunter cannot state whether it was necessary to dig into any of the undisturbed stratified material as he did not take critical notice of condition. It seems clear, however, from Mr. Hunter's testimonj^ that at least a greater part of the skeleton was found in loose material and there is no evidence to prove that it was not wholly in this kind of material. The position of the skeleton when found in the material above this clay stratum would make its location about thirteen feet below the top of the exposure. Allowing for about two feet of stripping which has taken place the maximum depth from the original surface to the place where the skeleton was found would be not more than fifteen feet. This is an unusual but not a prohibitive depth for interment and there is no evidence here to prove that the remains were not interred in these deposits at this depth. It seems to the writer more probable, however, that the remains were interred at a less depth than this and that together with the material in which they were interred they had slumped down from above and lodged on the ledge on which they were found. The theory of the interment of these remains is further strengthened by several other circumstances. Mrs. Pamelia White, owner of the 192 SPECIAL COMMUNICATIONS AND REPORTS land in question and who has lived here for over forty years, says that when she first came to this place that there were, upon the site where the remains were found, a few stones rudely shaped like tombstones and set in the ground after the manner of placing tombstones. There were some marks on the stones but, either because the characters were nearly obliterated by time or because they were characters the sig- nificance of which was not known, nothing could be learned from them. Nothing was known concerning the history of these stones or whether anyone was buried there. The stones were subsequently removed and their existence all but forgotten. The probability of several people being buried here is further strengthened by the fact that other bones have been found in the pit, although the case under discussion is the only instance of the finding of a nearly complete skeleton. However, irrespective of the suggestion of a possible burying ground at this place, there seems to be no geological evidence in this case that the remains were deposited in the fluvio-glacial at the time this material was laid down since it is not proved that the remains were found in undisturbed material and overlain by undisturbed fluvio- glacial deposits. On the other hand all of the circumstances point to other and more probable solutions. The writer does not base any of his conclusions upon an examination of the remains themselves, having confined his investigations wholly to the geological conditions under which the remains were found. Immediately upon the conclusion of his investigations the writer sent a brief report to the state geologist and also issued a statement to the press to the effect that there is no geological evidence whatever that these remains are of Pleistocene or earlier age. The whole affair is obviously the result of the misguided enthusiasm of some amateur scientific investigators and clever press agent co- operation on the part of over-zealous newspaper writers. Department of Geology, Leroy Patton Muskingum College As a finishing touch to the history of the Zanesville find may be quoted a part of the last letter received from Dr. , which reads thus: "The first article in our local paper (The Signal) was written by a local reporter (you did not see that article) in which it stated the skeleton was found in Glacial drift and was probably 20,000 years old. This was surmise of reporter or owner of sand bank. After the appearance of that article I examined the skull and measured it. It was so small and the report coming from the man who dug the skeleton out SPECIAL COMMUNICATIONS AND REPORTS 193 that the body was 6 feet long made me surmise that the skeleton must have been something unusual \\'ith such a verj' small skull to a six foot body. Also, the first report was that the body was 30 feet below surface." The case represents a fortunate occurrence of the usual initial exaggeration by newspapers and non-experts, with a prompt, sober, scientific examination of conditions. Had some less qualified persons become interested in the find before Professors Patton and Mills could reach the site another item might easily have been added to the already long list of ambiguous examples by which a geological antiquity of man in America is supported. A. H. INFLUENZA AMONG THE AMERICAN INDIANS By the Public Health Service The following tables were compiled by the Public Health Service from data furnished bj' the Commissioner of Indian Affairs. They Cases of Influexza among Indians, Oct. 1, 1918, to June 30, 1919 Population Arizona California Colorado Florida Idaho Iowa Kansas Michigan Minnesota. . . . Mississippi .... Montana Nebra.ska Nevada New Mexico . . . New York North Carolina . North Dakota. Oklahoma Oregon South Dakota. . Utah Washington. . . Wisconsin Wyoming 45,707 16,416 1,222 585 4,208 356 2,275 1,097 12,003 1,253 12,079 2,834 '11,190 22,005 5,982 2,343 9,216 118,227 4,355 23,890 1,704 10,315 9,696 1,696 9,390 2,010 333 20 243 90 625 25 1,311 217 1,111 470 848 5,410 400 409 1,631 6,530 661 4,595 201 824 1,601 1 7,847 2,388 157 46 407 35 235 25 741 432 1,021 391 2,746 5,561 400 372 718 8,697 436 3,964 281 1,197 1,109 15 17,237 4,398 490 66 650 125 860 50 2,052 649 2,132 861 3,594 10,971 800 781 2,349 15,227 1,097 8,559 482 2,021 2,710 16 Cases per 1,000 Pop- ulation 377.1 267.9 401.0 112.8 154.5 351.1 378.0 45.6 171.0 518.0 176:5 303.8 321.2 498.6 133.7 333.3 254.9 128.8 251.9 358.3 282.9 195.9 279.5 9.4 Total I 320,654 ! 38,956 39,221 I 78,177 243.8^ » Includes estimate of 3,000 unenrolled Indians in Nevada and 5,000 in California belonging to the Reno Agency, 194 SPECIAL COMMUNICATIONS AND REPORTS show the number of cases of influenza reported among Indians on reser- vations in the United States, and deaths due to the disease; also morbidit}^, mortality, and case fatality rates. — Publ. Health Rep^s, Oct. 17, 1919. Confirmation of reports that the native Indian population of Bristol Bay, Alaska, virtually was wiped out by an epidemic of influenza has been brought to San Francisco with the return of the United States cruiser Marblehead from a relief expedition to the north. According to Lieut. W. R. Leahy, senior medical oflficer of the ex- pedition, 95 per cent of a population of more than 900 persons had died b}^ the time the expedition reached Bristol Bay. Deaths from influenza among Indians, October 1 1918, to June 30, 1919 Deaths State MlDors Adults Total Deaths per 1,000 Population Fatalities per 100 Cases Arizona 1,027 123 35 3 21 5 13 1 65 18 59 26 52 635 40 25 48 330 45 365 25 89 71 921 133 24 7 54 4 7 1 57 43 80 34 219 610 40 12 72 531 49 390 52 83 87 1 1,948 256 59 10 75 9 20 2 122 61 139 60 271 1,245 80 37 120 861 94 755 77 172 158 1 42.6 15.6 48.2 17.1 17.8 25.3 8.8 1.8 10.2 48.7 11.5 21.2 24.2 56.6 13.4 15.8 13.0 7.3 21.6 31.6 45.1 16.7 16.3 .6 11.3 California 5.8 Colorado 12.0 Florida 15.1 Idaho 11.5 Iowa 7.2 Kansas 2.3 Michigan 4.0 Minnesota 5.9 Mississippi 9.4 Montana 6.5 Nebraska 6.9 Nevada 7.5 New Mexico 11.3 New York 10.0 North Carolina 4.7 North Dakota 5.1 Oklahoma 5.7 Oregon 8.6 South Dakota 8.8 Utah Washington Wisconsin 15.9 8.5 5.8 Wvomine 6.3 Total . . . . : 3,121 3,511 6,632 20.7 8.5 Tuberculosis among the Natives in the West .Indies The death-rate from tuberculosis among the colored population in some of the West Indian islands has in the past been exceedingly high. The persistent efforts of the white residents in Trinidad, Tobago, the Guianas and elsewhere, and especially the organized SPECIAL COMMUNICATIONS AND REPORTS 195 campaign of the Association for Prevention and Treatment of Tuber- culosis, have reduced this mortality by nearly 50 per cent since 1905; nevertheless the death-rate from the disease is still far too high, being in Trinidad little short of 30 per 1000. It has been definitely es- tablished however that the West Indian native, if treated on rational lines in the early stages of the disease, seems to be quite as capable of recovery as is the British patient. — Brit. Med. J., May 31, 1919, 683. Sex Determination In an effort to test the correctness of Dawson's theory that sex is determined by the supplying ovary, males being produced by fertiliza- tion of an ovum from the left ovary, Dr. John J. Murray, Jr., has gone over the records of 17,500 deliveries which occurred in the Obstretric Clinic of the Johns Hopkins Hospital between September, 1896, and March, 1918. (Johns Hopkins Hospital Bulletin, December, 1918, pp. 275-281.) There were 75 cases (70 women, five of them having two pregnancies), in which the location of the corpus luteum was determined by Caesarean section, by laparotomy, or by post mortem, and in which there was no doubt as to the sex of the child. Murray found that "male and female children result in about equal numbers from the fertilization of ova from either ovary" and that consequently Dawson's theory is proved to be incorrect. He con- cludes that "the causation of sex is probably not due to any factor in the unfertilized ovum"; that "the 'chromosome theory' must be considered the only explanation of sex at present acceptable"; and that "the sex of an unborn child cannot be foretold, nor can either sex be produced at will, by any rules known at present." — Eugenical News, June, 1919. It may be recalled in this connection that similar results were in 1911 obtained experimentally by Dean on albino rats: Dean (H, K.) — The effects of semi-spaying and semi-castration on the sex ratio of the albino rat.— J. Exp. Zool, May, 1911, X, 381-392. Heredity in Twins Professor Kristine Bonnevie has published as Contribution No. 2 from the University (of Christiana) Institute for Investigation in Heredity a paper entitled "On Tvillingsfodslers Arvelighet," or "On the Inheritance of Twin Births." A certain rural family shows about three times the normal proportion of twin births in a population of 196 SPECIAL COMMUNICATIONS AND REPORTS about 5,000 individuals. In the special "twin branches," the pro- portion of multiple births rises to 7.7 per cent, or six times the average. The author concludes that among younger mothers, below 30 years, 1- and 2-egg twins are about equally numerous, while the twins borne by older mothers are practically all from 2 eggs. The proportion of 2-egg twins to 1-egg twins in the family is about 4: 1, and it is in double egg twin births that inheritance is most clearly shown. Out of 88 twin-producing mothers, 67 (the best known) are without ex- ception shown to descend from twin families through both parents or through the one parent who is known. "The hereditary nature of the disposition for double-egg twin births is thus proved without doubt. Its types of heredity seem, further, to be that of a recessive character, demanding for its manifestation that the twin mother should receive her disposition in a double dose through both her parents. The twins seem, among their brothers and sisters, not to be predis- posed to twinning." — Eugenical News, Nov., 1919. Mortality of Infants of Different Racial Groups In the New England Medical Gazette, vol. 52, page 366, Dr. F. H. MacCarthy gives the following table of death rates of infants under one j^ear per thousand births from the three principal causes of in- fant mortality grouped according to nationality of mothers. Causes of Death u. s. Canada Ireland Italy Russia and Poland Congenital debilitv 36.37 20.60 13.09 30.00 14.63 15.29 26.08 16.56 12.83 13.00 19.58 29.53 20.00 Gastro-enteritis 15.78 Pneumonia , 19.62 1 CURRENT NOTES The Anthropological Society of St. Louis. — On January 2, there has been organized in St. Louis The Anthropological Societij of St. Louis. The membership of the Societ}^ consists essentially of the local anatom- ists and prominent medical men interested in anthropological research; but its interests will comprise the whole field of anthropology. Pro- fessor R. J. Terry has been elected the first President of the Society. Mr. George G. Heye, director of the Museum of the American Indian, Hej^e Foundation, announces that the department of physical anthropology, which had to be closed during the period of the war, has again resumed active work under the direction of the same staff, namely, Dr. James B. Clemens and Dr. Bruno Oetteking. The department has now separate housing accommodations at 11 St. Nicholas Place, corner of 150th Street, which suits its present needs. Dr. Hrdlicka left Washington early in January for the Far East, in the interests of his studies on the origin of the American Indian, and in those of anthropological work in China and Hawaii. He expects to be back in June. The Journal will meanwhile be in the hands of Dr. Gerrit S. Miller, curator of the Division of Mammals, U. S. National Museum. As the Journal was going to press it became known that the XX International Congress of Americanists, which was to have met at Rio de Janeiro in June of this year, has been indefinitely postponed. The reason given is that the unsettled world conditions prevent European representatives from attending. It has been intimated that the next Congress will meet in 1922. Dr.' A. A. Mendes Correa, formerly assistant of the faculty of science of the University of Oporto where he was teaching anthropology since 1912, has been some time ago proposed by the faculty for the vacant place of ordinary professor. A faculty of letters having been lately founded in the University, Dr. Mendes Correa was named ordinary professor of the new faculty for the group of geographical sciences which include anthropology. From the daily press we learn that Dr. and Mrs. Gustaf Dolinder, the former a leading Swedish scientist, sailed for South America early in January. They expect to remain one year, engaged in general ethnographic and archeological investigations; considerable attention will later be devoted to the Indian tribes of the Magdalen River region. 197 Amer. Jour. Phys. Anthrop., Vol. Ill, No. 1. 198 CURRENT NOTES Dr. Franz Boas late in December tendered his resignation as one of the representatives of the American Anthropological Association on the Committee of Anthropology and Psychology of the National Re- search Council. Ludicig Stieda.'^ — Belated German periodicals bring the an- nouncement of the death of Dr. L. S. Stieda, emeritus professor of anatomy at the Konigsberg University. He died in 1918, in his eighty-second year. Physical anthropology owes a debt to Professor Stieda for his lifelong interest in the science, and for his very useful annual reviews of Russian anthropological literature, published period- ically for many years in the Archiv fitr Anthropologie. Richard Lynch Garner.^ — Professor Garner, who was widely known through his investigations among the anthropoid apes, died suddenly at Chattanooga, Tennessee, on January 23, 1920. He was an indefati- gable worker, and has contributed greatly to our knowledge of the life and habits of the apes. Horatio C. Wood.>^ — Science reports the death, on January 3. of Horatio C. Wood, M. D., LL. D., emeritus professor of materia medica, pharmacy and general therapeutics in the University of Pennsylvania Medical School. Notes from the Far East Dr. J. G. Andersson, of the Chinese Geological Survey, has loaned a number of human skeletons from Chihli Province excavations to the anthropological department of the Peking Union Medical College. Dr. E. H. Tang, president of the Government Special Medical School in Peking, has also loaned his valuable series of Chihli Province crania to the anthropological department of the college. Pere Florent De Preter, of the Belgian Mission at Chin-Chow, who has been decorated by the Chinese government for his ethnological work in Manchuria, has recently visited Peking. Ai-rangements for the despatch of an expedition by the department of anthropology, P. U. M. C, to investigate the cave burials in the vicinity of Chin-Chow have been greatly facilitated by Pere De Preter's cordial cooperation. Mr. Roy C. Andrews, of the American Museum of Natural History, has obtained a number of human crania from the vicinity of Urga. Mr. Andrews experienced the greatest difficulty in collecting and transporting this material owing to the present unsettled condition of that part of Mongolia. BIBLIOGRAPHY OF GEORGE M. KOBER, M.D., LL.D. Dean and Professor of Hygiene, School of Medicine, Georgetown University, Washington, D. C. 1874 Infantile parah'sis. Pacific Med. and Surg. Jour., San Francisco, 1874, xvi, 261-273. Urinologj' and its practical application, etc. In: Richmond and Louisville M. J., Louis^dlle, 1874, xviii, 229-256, 2 pi.; 357-387, pi.; tables; 469-490; 580-609. 1875 Chronic dysentery treated with injections of chlorate of potassa. Am. Med. Weekly, Louisville, 1875, iii, 241-242. Adenitis treated with injections of carbolic acid and glycerine. Am. Med. Weekly, Louis^alle, 1875, in, 241. Muriate of ammonia in neuralgia. Am. Med. Weekly, LouisAalle, 1875, in, 242. Incontinence of urine treated with chloral hydrate and belladonna. A. Med. Weekly, Louisville, 1875, in, 243. Tincture of iron and digitahs in dropsy. Am. Med. Weekly, Louisville, 1875, in, 243. 1876 Report of a case of gunshot wound of the knee joint and right hand treated with antiseptic injections of iodine and carboUc acid. Am. J. M. Sc, Phila., 1876, n.s., Lxxn, 427-431. 1877 Die Kriegs-Chirurgie der letzten 150 Jahre in Preussen. A review of Prof. E. Gurlt's oration. Am. J. M. Sc, Phila., 1877, n.s., lxxiv, 226-227. 1878 Analysis of the Medical and Surgical History of the War of the RebeUion 1861-1865; part 2, volume 2; being the Second Surgical Volume. Washington, D. C, 1876, 4°, 1024, XVI pages. Militararzt, 1878, xxviii, 21-23; xxix, 6-8; 126- 127; 141-145; 150-152; 157-158; 165-166; 173-176. (In this review, the reviewer placed himself on the side of the innovators and vigorously combated the objections of Prof. Ashhurst, Hamilton and others to enterorrhaphy without visceral protrusion.) 1881 Die Gelenk-Resectionen nach Schussverletzungen ; ihre Geschichte, Statistik, End- Resultate, von Prof. E. Gurlt. Berlin, 1879, 1333 pp. Review in: Am. J. M. Sc, Phila., 1881, n.s., lxxxi, 457-i61. 1885 Report on the topography, botany, climatology and diseases of Surprise and Goose Lake Valleys. 31 p. 8°. Repr. from: Report of State Board of Health of 199 Amer. Jonn. Phvb. Anthkop., Vol. Ill, No. 1. 200 BIBLIOGRAPHY^ GEORGE M. KOBER California, Sacramento, 1885, ix. (See editorials: Med. Rec, N. Y., Nov. 11 and Dec. 13, 1886.) 1889 Lectures on hygiene. 48 p. 8°. Repr. from: South. Clinic, Richmond, 1889. 1890 The etiology and prevention of tuberculosis. 8 p. 8°. Sacramento, 1890. Repr. from: Report of State Board of Health of California, Sacramento, 1890, xi. A contribution to the etiology of typhoid fever. 7 p. 8°. Berlin, L. Schumacher, 1891. Repr. from: Verhandl. d. X. Internat. Med. Congr., 1890, Berlin, 1891, V. Referat iiber eine von H. Remondino, San Diego, eingesandte Arbeit: Ueber Meteor- ologie und Khma des sudlichen Cahfornien in Bezug auf Leben und Gesundheit. Deutsche med. Zeitung, Berl., 1890, 724. 1891 SyphiUs and prostitution. Virginia Med. Month., Richmond, 1891, xviii, 85-89. 1892 The etiologj' and prevention of infectious diseases. 18 p. 8°. Richmond, 1892. Repr. from: Virginia Med. Month., Richmond, 1892-1893, xix. 1893 Laparotom}^ for wounds of the peritoneal ca\^tJ^ Med. Rec., N. Y., Jan. 21, 1893. The etiologj', distribution and prevention of land and ship cholera. 6 p. 8°. Repr. from: Proc. State San. Convent., Sacramento, 1893, i. Also: Virginia Med. Month., Richmond, 1893-4, xx, 133-152. 1894 A plea for the prevention of tuberculosis. 12 p. 8°. Repr. from : Proc. State San. Convent., Sacramento, 1894, ii. A study of soil in relation to health and disease. 29 p. 8°. Richmond, 1894. Repr. from: Virginia Med. Month., Richmond, 1894-5, xxi. A study of water in relation to health and disease. 37 p. 8°. Repr, from: Rep. State Bd. Health Calif., Sacramento, 1894, xiii. 1895 Impure milk in relation to infantile mortality. 15 p. 8°. Repr. from: J. Am. M. Ass., Chicago, 1895, xxv. A plea for vaccination. 16 p. 8°. Repr. from: Virginia Med. Month., Richmond, 1895-96, XXII. Max Bartel : Die Medicin der Naturvolker, ethnologische Beitrage zur Urgeschichte der Medicin. Leipzig, 1893. (A review, with a condensation of the subject matter on primitive, minor and major surgery.) Repr. from: Virginia Med. Month., Richmond, 1895-96, xxii. BIBLIOGRAPHY, GEORGE M. KOBER 201 Report of the prevalence of t>T)hoid fever in the District of Columbia. Report of the Health Officer of District of Columbia, 1895, 254-292. Also: Abstracts of Sanitarj- Reports of the Marine Hospital SerA-ice, December, 1895, 1157-1203. Also: Editorials Med. Rec, N. Y., Feb. 22, 1896, 267. Morbific and infectious milk (with S. C. Busey). Report of the Health Officer of District of Columbia, 1895, 299-378. Also: Public HeaUh Reports, Feb. 14, 1896, 118-131. Also: Editorials /. Am. M. Ass., Chicago, March 7, 1896, 487; Med. Rec, X. Y., Apr. 18, 1896, 557; Am. Med.-Surg. Bull, N. Y., May 23, 1896, 694. 1896 A study of milk in relation to health and disease. 51 p. 8°. Sacramento, 1896. Repr. from : The 14th Biennial Report State Board of Health. Opium habit in the District of Columbia. U. S. 54th Congress, 2d Session. Senate Document 174, January 21, 1897. Report of the Editorial Committee of the Medical Society of the District of Columbia. Trans. Med. Soc. Dist. Col., 1896, 3. Trachoma (Discussion). Trans. Med. Soc. Dist. Col., 1896, 11. Milk bacteria (Discussion). Trans. Med. Soc. Dist. Col, 1896, 99. Diphtheria (Discussion). Trans. Med. Soc. Dist. Col., 1896, 111. Skin diseases (Discussion). Trans. Med. Soc. Dist. Col., 1896, 120. 1897 Relations of water supply and sewers to the health of cities with special reference to the City of Washington. PubUc Health Reports, Wash., 1897, xii, 197-200. The place of miUtary medicine and surgery in the medical college curriculum. Repr. from: Proc. Ass. Mil. Surgeons, U. S., CarHsle, Pa., 1897, vii. Predisposition and immunitj'. 7 p. 8°. New York, 1897. Repr. from : Praci. iWed., N. Y., 1897, VIII. * Prevention of puerperal fever. 16 p. 8°. Richmond, 1897. Repr. from: Virginia M. Semi-Month., Richmond, 1897, i. The progress and achievements of hygiene. (Address before the Anthropological Society of Wasliington.) 12 p. 8°. Repr. from: Science, N. Y., 1897, n.s., vi. Sj-philis (Discussion). Trans. Med. Soc. Dist. Col., 1897, 9. Scurvy and rickets in children (Discussion). Trans. Med. Soc. Dist. Col., 1897, 27. Bubonic plague (Discussion). Trans. Med. Soc. Dist. Col., 1897, 56-57. Malarial diseases in the District of Columbia (Discussion). Trans. Med. Soc. Dist. Col, 1897, 73-75. Neurasthenia (Discussion). Trans. Med. Soc. Dist. Col, 1897, 207. 1898 Higher medical education and a plea for better training of the volunteer medical officer. 5 p. 8°. Repr. from: Virginia M. Semi-Month., Richmond, 1893, ixi. Water supply and sewage disposal in the District of Columbia. U. S. 55th Congress, 2d Session. Senate Document 183, February, 1898, 16-25. Pollution of rivers. U. S. 55th Congress. 2d Session. Senate Document 194, March, 1898, 32-40. Arthritis deformans (Discussion). Trans. Med. Soc. Dist. Col, 1898, 14. 202 BIBLIOGRAPHY, GEORGE M. KOBER Typhoid fever (Discussion). Tram. Med. Soc. Dist. Col, 1898, 47-54. Gangrene of eyelids (Discussion). Trans. Med. Soc. Dist. Col., 1898, 109. Hydrophobia (Discussion). Trans. Med. Soc. Dist. Col, 1898, 113. Malarial fever (Discussion). Trans. Med. Soc. Dist. Col., 1898, 117. Expectorants (Discussion). Trans. Med. Soc. Dist. Col., 1898, 120. Ruptured spleen (Discussion). Trans. Med. Soc. Dist. Col., 1898, 163. 1899 Many of the causes of so called school diseases found in the home. U. S. 55th Con- gress, 3d Session. Senate Document 65, February, 1899, 40-43. Sarcoma of the testicles; conclusions based upon one hundred and fourteen cases. 18 p. 8°. Repr. from: Am. J. M. Sc, Phila., May, 1899, cxvii. The effects of modern fire arms in war. (Address before a joint meeting of the Anthropological and Medical Societies of Washington.) 6 p. 8°. Repr. from: Nat. Med. Rev., Wash., October, 1899, ix. Filtration, the pollution of streams and the purification of public water suppUes, U. S. 56th Congress, 1st Session. Senate Document, 1900, 8 p. Protest from the ci\dc center of the District of Columbia against the passage of Senate Bill No. 34, providing for the further prevention of cruelty to animals (Vivisection Hearings). U. S. 56th Congress. Senate Document, 101-111. Report on the housing of the laboring classes in the City of Washington, D. C. Repr. from: Report of the Health Officer of District of Columbia, 1899, 107-121, 1 plate. The fiftieth anniversary of the graduation in medicine of Doctor Samuel Clagett Busey, compiled and edited by George M. Kober, 63 p. ports. 4°. Washing- ton, 1899. ("Dr. Busey, physician, author and teacher," 37-42.) Texas fever (Discussion). Trans. Med. Soc. Dist. Col., 1899, 3. Malaria (Discussion). Trans. Med. Soc. Dist. Col, 1899, 19. Medico-mihtary affairs (Discussion). Trans. Med. Soc. Dist. Col, 1899, 24. Milk laboratories (Discussion). Trans. Med. Soc. Dist. Col, 1899, 36; 145. Report of the Committee on longevity (Discussion). Trans. Med. Soc. Dist. Col, 1899, 103. Uric acid diathesis (Discussion). Trans. Med. Soc. Dist. Col, 1899, 110. Convulsions in typhoid fever (Discussion). Trans. Med. Soc. Dist. Col, 1899, 153. Knee-joint-shot-injuries (Discussion). Trans. Med. Soc. Dist. Col, 1899, 160. Katatonia (Discussion). Trans. Med. Soc. Dist. Col, 1899, 181. 1900 Shall alcohol be considered as a food? 7 p. 8°. Repr. from: Virginia M. Semi- Month., 1900, V. Conclusions based upon 330 outbreaks of infectious diseases spread through the milk supply, 6 p. 8°. Read before Section of Epidemiology and hygiene, 13th Internat. Med. Congress, Paris, August 4, 1900. Repr. from : Am. J. M. Sc, Phila., 1901, cxxi. Army nursing (Discussion). Trans. Med. Soc. Dist. Col, 1900, 18. Tuberculosis (Discussion). Trans. Med. Soc. Dist. Col, 1900, 66; 71. Remarks on science building. Trans. Med. Soc. Dist. Col, 1900, 106. BIBLIOGRAPHY; GEORGE M. KOBER 203 Therapeutic effects of sunlight (Discussion). Trans. Med. Soc. Dist. Col., 1900,173. Paragonimus Westermanni (Discussion). Trans. Med. Soc. Dist. Col., 1900, 179. Tj-phoid fever infection (Discussion). Trans. Med. Soc. Dist. Col., 1900, 182. Smallpox (Discussion). Trans. Med. Soc. Dist. Col, 1900, 189. Gunshot injuries (Discussion). Trans. Med. Soc. Dist. Col., 1900, 214. 1901 The need of addi tional playgrounds, parks and reservations. U. S. Senate Committee on District of Columbia, March 27, 1901. The pollution of streams and the purification of public water suppUes; comparative efficiency of slow sand and mechanical filters. 8 p., 1 table. 8°. Repr. from: J. Am. M. Ass., Chicago, 1901, xxxvi. The progress and tendency of hygiene and sanitary science in the nineteenth century. (Oration on State Medicine delivered before the meeting of the American Medical Association, St. Paul, Minn., 1901.) 31 p. 8°. Repr. from: J.Am.M. Ass., Chicago, 1901, xxxvi. Also: N. Y. M. J., June 8, 1901, 991; Med. Rec, N. Y., June 8, 1901, 898; and also: Lancet, London. Recent books on hygiene (a review). 6 p., roy". 8°. Repr. from: Science, N. Y., 1901, n.s., XIV. Sudden death after gastroenterostomy (Discussion). Trans. Med. Soc. Dist. Col., 1901, 26. Gonorrhea in women (Discussion). Trans. Med. Soc. Dist. Col., 1901, 38. Filtration of the municipal water supply (Discussion). Trans. Med. Soc. Dist. Col., 1901, 55; 68. Tapeworm (Discussion). Trans. Med. Soc. Dist. Col., 1901, 95. Cancer (Discussion). Trans. Med. Soc. Dist. Col., 1901, 105. Obituary on Dr. James W. H. Lovejoy. Trans. Med. Soc. Dist. Col., 1901, 125. Report of the Editing Committee of the Medical Society. Trans. Med. Soc. Dist. Col, 1901, 137. SypliiUs (Discussion). Trans. Med. Soc. Dist. Col, 1901, 159. Report of Prof. Waldcj'er's visit to Washington. Trans. Med. Soc. Dist. Col, 1901, 251. Uncinariasis (Discussion). Trans. Med. Soc. Dist. Col, 1901, 270. Diphtheria (Discussion). Trans. Med. Soc. Dist. Col, 1901, 302. 1902 Butter and butter substitutes and their relation to health and disease. Abnormal milk and mUk-borne diseases. Statement before the Committee on Agriculture, House of Representatives, U. S., Tuesday, January 14, 1902, p. 37-135, Wash- ington, D. C. Milk, butter and butter substitutes (read before the Am. Social Sc. Ass., April 24, 1902). Repr. from: A?n. Med., Philadclpliia, 1902, iii, 1085-1089. The causation of di.sca.se. 63 p. 8°. Repr. from: Wash. Med. Ann., 1902, i. Review of five text-books on hygiene. Science, 1902, 218-227. Report of the Executive Conunittec of the Medical Society of the District of Colum- bia on the proposed consoUdation of the medical work in the District Govern- ment. Wash. Med. A/i«., April 2, 1902. House-sanitation. Rcf. Handb., M. Sc, 2d ed., N. Y., 1902, iv, 750-769- 204 BIBLIOGRAPHY, GEORGE M. KOBER Milk in relation to public health. Milk-borne diseases. Ref. Handh., M. Sc, 2. ed., N. Y., 1902, V, 833-843. See also: Rev. ed., 1914. Milk in relation to pubUc health. The necessity for the enactment of Senate BOl entitled "A bill to regulate the production and sale of milk and cream in and for the District of Columbia." U. S. 59th Congress, 1st Session. Senate Document 441. 235 p., 15 plates. 8°. Wasliington, Govt. Print. Off., 1902. See also: Editorials J. Am. M. Ass., 1902, 1397; Phila. M. J., 1902, 653; Med. Rec, N. Y., 1902, 897. The etiology of intermittent fever (Discussion). Wash. Med. Ann., 1902, 25-26. Causation of disease (Discussion). Wash. Med. Ann., 1902, 62. Obituary on Dr. W. W. Johnston. Wash. Med, Ann., 1902, 171. 1903 The canteen. 22 p. 8°. Repr. from: Am. Med., Phila., 1903, vi. The transmission of bovine tuberculosis by milk, with a tabulation of eighty-six cases. 26 p. 8°. Repr. from: Trans. Ass. Ayn. Physicians, 1903. Obituarj' on Dr. Walter Reed. Wash. Med. Ann., January, 1903. The Uver as a factor in the cause and prevention of disease (Discussion). Wash. Med. Ann.. May, 1903, 99. Drug adulterations (Discussion). Wash. Med. Ann., July, 1903, 226-227. Human and animal tuberculosis (Discussion). Wash. Med. Ann., July, 1903, 246- 247. Chronic bronchitis (Discussion). Wash. Med. Ann., Sept., 1903, 184. 1904 A review of the work of the Medical Society of the District of Columbia during the past eighty-five years. (President's address.) Repr. from: Wash. Med. Ann., 1904, II. A plea for a standard medical curriculum (read before the Association of American Medical Colleges). Repr. from: J. Am. M. Ass., Chicago, August 13, 19'04. Rheumatoid arthritis (Discussion). Wash. Med. Ann., Jan., 1904, 482. Surgical methods among savage races (Discussion). Wash. Med. Ann., March, 1904, 73. Scarlet fever (Discussion). Wash. Med. Ann., Julj', 1904, 205. Obstetrics (Discussion). Wash. Med. Ann., July, 1904, 218. Dehrium tremens (Discussion). Wash. Med. Ann., Nov. 1904, 357. 1905 The physical and physiological effects of child labor. Address delivered at the Meeting of the National Child Labor Committee, Washington. 4 p. 8°. New York, 1905. Suggestions concerning the administrative control of venereal diseases. 7 p. 8°. Repr. from: J. Am. M. Ass., Chicago, March 11, 1905. Report of the committee on national uniformity of curricula of the Association of American Medical Colleges. 6 p. 8°. Repr. from: J. Am. M. Ass., Chicago, 1905. Etiology of appendicitis (Discussion). Wash. Med. Ann., Jan., 1905, 427. BIBLIOGRAPHY, GEORGE M. KOBER 205 Caesarian section (Discussion). Wash. Med. Ann., Mar., 1905, 87. Rational versus empirical therapeutics (Discussion). Wash. Med. Ann., July, 1905, 204. Modern treatment of tuberculosis (Discussion), Wash. Med. Ann., Sept., 1905, 254. Senile cataract (Discussion). Wash. Med. Ann., Nov., 1905, 295. Smallpox (Discussion). Wash. Med. Ann., Nov., 1905, 313. 1906 Our LL.D.'s response to a toast at the banquet of alumni, Georgetown UniversitVj June 4, 1906. In : Georgetown College Journal. The health of the City of Washington. (President's address of the Anthropological Society of Washington.) 14 p. 8°. Repr. from: Charities and Commons, N. Y.,' March 3, 1906. The prevention and treatment of tuberculosis by state methods. Pan-Am. Med. Congr., Panama, 1906, ii, 249-258. Washington Filtration Plant. Discussion on water filtration. Proc. of Soc. Civil Engineers, 1906, xxxii, 959-961. President's address at the meeting of the Association of American Medical Colleges. Proc. Ass. Am. Med. Colleges, 1906. President's address (Discussion). Wash. Med. Ann., Jan., 1906, 336. Gastric ulcer (Discussion). Wash. Med. Ann., Jan., 1906, 359. Diseases among Indians (Discussion). Wash. Med. Ann., Jan., 1906, 386. Appendicitis (Discussion). Wash. Med. Ann., Mar., 1906, 8. Protozoal human parasites (Discussion). Wash. Med. Ann., Mar., 1906, 54. Therapy of pulmonary consumption (Discussion). Wash. Med. Ann., May, 1906, 82. Eye cases (Discussion). Wash. Med. Ann., May, 1906, 86. Obituary on Dr. Louis Mackall (Discussion). Wash. Med. Ann., Sept., 1906, 212. Ophthalmology (Discussion). Wash. Med. An7i., Nov., 1906, 266. 1907 Die Herstellung reiner Milch fiir kleine Kinder in Washington. Repr. from: Ztschr. f. Sduglingsfursorge, Leipz., 1906-7, i, 375-380. Arbeit erwohnungen in Washington. Internat. Kongr. f. Hygiene u. Demographie, Berlin, September 23-29, 1907, XIV. Ber., 1908, iv, 339-345. Unterbringung von schwerkranken Schwindsiichtigen und der Luftkur bediirftigen leichtkranken Tuberkulosen in einem und demselben Krankenhause. Internat. Kongr. f. Hygiene, etc., Berlin, September 23-29, 1907, XIV. Ber., iv,423^33. The history and development of the housing movement in the City of Washington, D. C. 64 p. 8°. 1907. (See editorial J. Am. M. Ass., Feb. 27, 1909.) The combat of scientific medicine with superstition (Discussion). Wash. Med. Ann., Jan., 1907, 335. Report of tuberculosis cases treated at Starmont Sanatorium (Discussion). U'as/i. Med. Ann., Jan., 1907, 345. Obituary on Dr. David Henry Hazen. Wash. Med. Ann., Jan., 1907, 410. Tuberculosis (Remarks). Wash. Med. Ann., Jan., 1907, 422-425. Schott treatment of chronic diseases of the heart (Discussion). Wash. Med. Ann., Mar., 1907, 27. Medical inspection of schools (Discussion). Wash. Med. Ann., Mar., 1907, 45-46. Naval medical service. Wash. Med. Ann., 1907, 282; 290; 380. 206 BIBLIOGRAPHY, GEORGE M. KOBER Sanitary milk production. Report of a Conference appointed bj- the Commissioners of the District of Cohimbia. U. S. Dept. of Agriculture, Circular No. 114, August 20, 1907. 1908 Industrial and personal hygiene. A report as chairman of a Committee on social betterment of the President's Home Commission, Washington, D. C, 1908. 175 p. 8°. (See Editorials: J. Am. M. Ass., Chicago, 1909, 138; Boston M. and S. J., 1908, 448; Bull. Bureau of Labor, No. 75, Wash., 1908.) Hygiene and public health; a review of Prof. Louis C. Parkes' textbook. Science, 1908, n.s., XXVIII, 924-92G. The Tuberculosis Hospital in Washington, D. C. 6 p. 4 i)lates. 4°. Washington, 1908. Conservation of hfe and health by improved water supply. Address deUvered at the Conference on the conservation of natural resources, White House, Washington, May 13-15, 1908. 51 p. 8°. Address deUvered at the complimentary banquet to Surgeon General George M. Sternberg on his 70th birthday, June 8, 1908. 30 p. 8°. The fight against tuberculosis in various countries. Opening discussion. Sixth Internat. Cong, on Tuberculosis, Washington, D. C, September 28 to October 5, 1908, IV, pt. 1, 105-110. Pterygium (Discussion). Wash. Med. Ann., Jan., 1908, 432. Internal medicine (Discussion). Wash. Med. Ann., Jan., 1908, 450. Report of the Committee on Public Health. Wash. Med. Ann., Mar., 1908, 30. The causes of typhoid fever in the District of Columbia. Wash. Med. Ann., Mar., 1908, 98-103. Acid-intoxication (Discussion). Wash. Med. Ann., May, 1908, 147. Principles of aseptic surgery (Discussion). Wash. Med. Ann., May, 1908, 186. Snake-poisoning (Discussion). Wash. Med. Ann., July, 1908, 276. Obituary on Anne H. Wilson. Wash. Med. Ann., July, 1908, 284-286. Appendicitis (Discussion). Wash. Med. Ann., Sept., 1908, 307. Congratulations extended by the Medical Society to Dr. Kober on his Wliite House address. Wash. Med. Ann., Sept., 1908, 315. 1909 Report of the committee on social betterment. President's Home Commission, Washington, D. C. 278 p. 8°. Also: U. S. 60th Congress, 2d Session. Senate Document 644, January 8, 1909. (See Editorials: J. Am. M. Ass., Chicago, 1909, 895; also; April 24, 1909.) Contents oj the report on social betterment: AUmentation and foods. Food and home betterment. The causation and prevention of disease. Infant mortality. The prevention of permanent disabihties in childhood. Sexual and moral prophylaxis. The tobacco habit. The alcohol question. Patent and proprie- tary compounds containing sufficient alcohol to be intoxicants. The drug habit. The nostrum evil in general. Sociological studies of 1,251 famiUes. The scale of wages and the cost of living. Suppression of usury. Review of hygiene and sanitary science (read before the Medical Society of the District of Columbia, April 14, 1909.) Repr. from: Wash. Med. Ann., viii. No. 3. BIBLIOGRAPHY, GEORGE M. KOBER 207 The influence of sewers and general sanitation upon the prevalence of tuberculosis. Repr. from: Johns Hopkins Hosp. Bull., 1909, xx. Civics and health: review of Prof. Allen's book. In: Chanties, N. Y., 1909. The general movement of typhoid fever and tuberculosis in the last thirty years. Tr. Ass. Am. Phys., 1909. Also: Am. J. M. Sc, Philadelpliia, November, 1909. Pture food and drugs. Bull. Vermont State Board of Health, December, 1909, No. 2. Eczema in children (Discussion). Wash. Med. Anv., 1909-10, viii, 428. Gall stones (Discussion). Wash. Med. A7in., 1909-10, viu, 436. Case of acute yellow atrophy of the hver (Discussion). Wash. Med. Ann., 1909-10, VIII, 124. Obituary on Doctor Robert Reyburn, Wash. Med. Ann., 1909-10, viii, 141-142. Re\aew of hygiene and sanitary science. Wctsh. Med. Ann., 1909-10, viii, 167-181. Discussion, 184. A plea for a more hberal diet in tjT^hoid fever (Discussion). Wash. Med. Ann., 1909-10, VIII, 199. Flexible instruments in urethral stricture (Discussion). Wash. Med. Ann., 1909-10, \^II, 210. • Prevention of ear infection in scarlet fever (Discussion). Wash. Med. Ann., 1909-10, vin, 238. 1910 The influence of pure water and air upon the health of communities. Bull. Vermont Slate Board of Health, March, 1910, No. 3. Review of some recent hterature with special reference to anti-typhoid vaccination, the hygiene of medical cases, transmission of disease by insects. Bull. Vermont State Board of Health, June, 1910, No. 3. Statement before Senate Committee on Public Health concerning the creation of a Department of Health. June, 1910. Diseases which menace pubHc health and morals (read at the twelfth annual school for the instruction of health oflBcers.) Repr. from: Bidl. Vermont State Board of Health, 1910, xi. Miliv in relation to public health. Bull. State Board of Health, CaUfornia, 1910. The dissemination of disease by dairy products and methods of prevention. U. S. Dept. Agriculture, Bur. Animal Industry, Circular 153, April 28, 1910. Re- view: Wash. Med. Ann., 1910, 324-327. Dispensary tuberculosis work (Discussion). Wash. Med. Ann., 1909-10, viii, 370- 371. Thymol in uncinariasis (Discussion). Wash. Med. Ann., 1910-11, ix, 41. Measles and mice (Discussion). Wash. Med. Ann., 1910-11, ix, 60. Obituary on Dr. Thomas Taylor. Wash. Med. Ann., 1910-11, ix, 78-80. The written law in reference to the unborn child (Discussion). Wash. Med. Ann., 1910-11, IX, 160. Digestion in fever (Discussion). Wash. Med. Ajin., 1910-11, ix, 401. 1911 The hygiene of schools and the prevention of permanent disabililics in children. Lecture before the thirteenth annual school of instruction for health officers, Burlington, Vt., August 21, 1911. Bull. Vermont Stale Board of Health, xii, No. 1. 208 BIBLIOGRAPHY, GEORGE M. KOBER Pernicious anemia (Discussion). Tr. Ass. Am. Pliysicians, Philadol])liia, 1911, XXVI, 294. Toxicitj'^ of alcoholic beverages (Discussion). Tr. Ass. Am. Physicians, Philadelphia, 1911, xxvr, 66. The prevalence and control of venereal diseases. Tr. Ass. Aiti. Physicians, Phila- delphia, 1911, XXVI, 155-165. Use of vaccines in gonorrheal arthritis restoring the power of locomotion (Discussion). Wash. Med. Ann., 1911-12, x, 11. Use of tincture of iodine as an injection in gvuishot wounds (Discussion). Wash. Med. Ann., 1911-12, x, 165; 179. 1912 The management and control of infectious diseases. Lecture before the fourteenth annual school of instruction for health officers. Bvll. Vermont Stale Board of Health, 1912, xii. No. 4. The venereal peril. Lecture before the fifteenth annual school of instruction for health officers. Bidl. Verviont Stale Board of Health, 1912, xiii, No. 1. The hygiene of occupations (Chairman's address). Tr. XVth Internat. Cong. Hygiene and Demography, Washington, 1912. The management and control of smallpox and other eruptive fevers. Lecture before the fifteenth annual school of instruction for health officers. Bull. Vermont State Board of Health, 1912, xiii, No. 1. Tuberculosis as a disease of the masses. Ibid. Psychopathic w^ork at the Washington Asylum Hospital (Discussion). Wash. Med. Ann., 1911-12, x, 240. Typhoid and venereal prophylaxis in the United States Armj^ (Discussion). Wash. Med. Ann., 1911-12, x, 265-266. Rickets and tuberculosis among Indians (Discussion). Wash. Med. Ann., 1912, xi, 118. Shall the professor be in practice? (Discussion). Wash. Med. Ann., 1912, xi, 166. Busey, Samuel Clagett, 1828-1901. In: Cyclopedia of American Medical Biography . . . from 1610-1910, ed. by Howard A. KeUy, Philadelphia, 1912, i, 140-143. EUot, Johnson, 1815-1888. In: Cyclopedia of American Medical Biography . . . from 1610-1910, ed. by Howard A. KeUy, PhUadelphia, 1912, i, 279-280. 1913 The progress of public health and the need of increased federal health activities in the United States. 9 p. 8°. Repr. from: Case and Comment, August, 1913. Occupational diseases, with special reference to the stone cutting industry in Ver- mont. Lecture before the fifteenth annual school of instruction for health officers. Bull. Vermont State Board of Health, xiii, No. 3. A condensed history of the hospitals and medical charities in the District of Columbia. Repr. from: Annual Report of Board of Charities, Washington, 1913. The sense of hearing from a hygienic standpoint (Discussion). Wash. Med. Ann., 1913, XII, 48. Anti-typhoid vaccination in the army (Discussion). Tr. Ass. Am. Physicians, Philadelphia, 1913, xxviii, 466. Syphilis among school children (Discussion). Wash. Med. Ann., 1913, xii, 228-229. Hospital milk (Discussion). Wash. Med. Ann., 1913, xii, 240-241. BIBLIOGRAPHY, GEORGE M. KOBER 209 1914 Sanitation in ancient civilizations (Discussion). Wash. Med. Ann., 1914, xiii, 349- 351. Streptococcus sore throat (Discussion). Tr. Ass. Am. Physicians, Philadelphia, 1914, xxrs, 292. 1915 Tuberculosis with special reference to its prevention. Address of the President at the Annual ^Meeting of the National Association for the Study and Prevention of Tuberculosis, Seattle, Washington. Repr. from: Tr. Nat. Ass. for Study and Prevention of Tuberculosis, 1915. The child and the home. Tr. Nat. Ass. for Study and Prevention of Tuberculosis, 1915. Tuberculosis wath special reference to its epidemiologj', transmissability and preven- tion. Repr. from: Public Health Re-ports, Oct. 29, 1915, No. 339. Chapter "Avoid house dust" in Washington Health Rules, a collection of chapters dealing with the essentials of hygiene published by the Association for the Prevention of Tuberculosis, 1915. A plea for a cancer clinic (Discussion). Wash. Med. Ann., 1915, xiv, 77. 1916 Address at a memorial meeting in honor of George Miller Sternberg. Repr. from: Wash. Med. Ann., 1916, xv, 81-91. Diseases of occupation and vocational hygiene, (edited by Kober and Hanson). 918 p. 8°. Philadelphia, Blakiston Sons & Co., 1916. Dr. Kober WTote the chapter on the effects of diminished atmosphere, with special reference to aviators (p. 211-217), and also the chapters on the etiology and prophylaxis of occupational diseases (p. 417-761). The Army Medical Museum; a history (Discussion). Wash. Med. Ann., 1916, xv, 33-34. Ernest Pendleton Magruder; an appreciation (Discussion). Wash. Med. Ann., 1916, XV, 57. Actinomycosis (Discussion). Wash. Med. Ann., 1916, xv, 61. Responsibility of the physician with respect to the insane patient (Discussion). Wash. Med. Ann., 1916, xv, 117. Infant welfare and infant mortahty (Discussion). Wash. Med. Ann., 1916, xv, 273. Psychoanalysis in its relation to psychiatry (Discussion). Wash. Med. Ann., 1916, XV, 342. Dr. Agramonte's resolution of condolence on the death of General George M. Stern, berg (Remarks). Proc. Second Pan-American Scientific Congress, Wash., Dec. 27, 1915- January 8, 1916, ix, 314. Housing of wage earners, by Dr. Lawrence Veiller (Discussion). Pmc. Second Pan- Anurican Scientific Congress, Wash., Dec. 27, 1915- January 8, 1916, ix, 310-320. International agreements in relation to the suppression of vice, by James B. Reynolds (Discussion). Pmc. Second Pan-American Scictdiftc Congress, Wash., Dec. 27, 1915-January 8, 1916, ix, 504. Discussion of papers relating to soi ial medicine. Proc. Second Pan-American Scien- tific Congnsx, Wash., Dec. 27, 1915-January 8, 1916, ix, 584. The significance of chemistry in water purification, by E. Bartow (Discussion). Proc. Second Pan-American Scientific Congress, Wash., Dec. 27, 1915-January 8, 1916, X, 226-227. 210 BIBLIOGRAPHY, GEORGE M. KOBER Fresh air and ventilation in the hght of modern research, by C.-E. A. Winslow (Discussion). Proc. Second Pan-American Scientific Congress, Wash., Dec. 27, 1915- January 8, 1916, x, 243-244. George M. Sternberg: Historical resume of investigations of yellow fever leading up to the findings of the Reed board (Discussion). Proc. Second Pan-American Scientific Congress, Wash., Dec. 27, 1915-January 8, 1916, x, 650. 1917 Artificial pneimiothorax in the treatment of tuberculosis (Discussion). Wash. Med. Ann., 1917, xvi, 78. American achievements in medicine (Discussion). Wash. Med. Ann., 1917, xvi, 160. Cirrhosis of the hver (Discussion). Tr. Ass. Am. Physicians, Philadelphia, 1917, XXXII, 478. Effects of dust inhalation upon the lungs. Tr. Ass. Am. Physicians, Philadelphia, 1917, xxxii, 106-107. 1918 Sanitation of rural workmen's areas with special reference to housing. Committee on labor. Council of National Defence. Repr. from: Public Health Reports, September 6, 1918, no. 487. Recent developments in infant feeding. Discussion of Mr. Emile BerUner's address read before the Association for the Prevention of Tuberculosis, Wasliington, D. C, November 25, 1918. 1919 The venereal problem in civil life. Address delivered at the first of a series of educational lectures and film exhibitions before medical schools. Bull. U. S. Public Health Service, Feb. 1, 1919. Osier's influence on American medicine (Osier's anniversary volume, 1919). In press. Protest by Dr. Kober, dean of the Medical School, Georgetown University, against the passage of Senate Bill No. 1258: Providing for the prevention of experi- ments on the dog. Vivisection hearing before the U. S. Senate Judiciary Committee, November 1-4, 1919, 101-108. Washington, D. C, Govt. Print. Office, 1919. Occupations in relation to tuberculosis. Address delivered before the College of Physicians, Pliiladelphia, December 17, 1919. In press. Chapters on hygiene for elders. In: Illustrated Health Rhymes for Children, Washington, 1919. Miscellaneous. Description of Frankford Arsenal. Army and Navy Journal, N. Y., August 12, 1871. Auch eine Ansicht i'lber deutsche Schulen. Washington Journal, September, 1873. Amerikanisch-deutsche Klinik. Washington Journal, April, 1874. Das Central-Dispensarium in Washington; eine arztliche Anstalt ftir unbemittelte , Kjanke; das deutsche Element zahlrcich vertreten. Washington Journal, June 29, 1874. Aus dem fernen Westen. Washington Journal, June 26, 1877. Rifle practice for the army and navy. Army and Navy Journal, N. Y. August 10, 1878. BIBLIOGRAPHY, GEORGE M. KOBER 211 The Army Mutual Aid Society. Army and Navy Journal, N. Y., October, 1878. "St. John's Day." Original poem deUvered at Masonic celebration at Fort Bidwell, California, Jime 22, 1883. Lake County Examiner, Oregon, June 30, 1883. "Eternal vigilance is the price of Uberty." Fourth of July oration delivered in Cedarville, Cahfornia, July, 1885. Columbian oration dehvered at Fort Bidwell, Cahfornia, October 21, 1892. Alturas Plain Dealer, October 23, 1892. Comphmentary dinner to Dr. Joseph J. Ivinyoun, Washington, May 20, 1899. Address. Repr. from: Georgetown College Journal, June, 1899. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY Rules Concerning Communications 1. Recognizing the universal character and essential unity of anthropological laws and problems, the Journal lays no geographical restrictions on its activities, and wiU freely receive high-class communications from foreign contributors. 2. At the outset, communications must be restricted to those in the English language; but as soon as pecuniary conditions permit, the Journax. will also be available for articles in Spanish, as the next most important language on the American continent. 3. Articles of merit will not be hmited in length. 4. AU papers submitted for pubhcation will be subjected to careful editorial scrutiny, only those being accepted whicli present contributions of real value to Physical Anthropologj^ and which are in correct form. 5. Until the Journal is on a sound financial basis, illustrations, detailed tabular matter, extended quotations in foreign languages, and extensive use of mathematical formulae, must be restricted, unless their expense is borne by the author or his institution. 6. Only carefully prepared, finished, typewritten manuscripts can be considered for pubhca- tion. To avoid undue delay, but one proof vdU be submitted to author for correction of typo- graphical errors, except in special cases. Changes in the text or additions can not be considered unless the author bears the cost of resetting. 7. All tables, plates, and figures must be provided with full legends and presented in finished form. 8. Reprints will be furnished at cost. 9. While due care will be exercised in accepting articles, discussions and reviews for pubhcation, the responsibility for these must rest wholly with the authors. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY Vol. ni— No. 1 JANUARY-MARCH, 1920 CONTENTS KoBER, De. Geokgk M. ; Biography iii Neavton, Philip: Observations on the Negritos of the Philippine Islands . 1 Keegan, J. J.: The Indian Brain 25 Cameeon, John : A New Craniometric Method, Including a Description of a Specially Designed Indexometer for Estimating it • • • 63 Maccuedy, George Geant : Aspects of the Skull: How shall They be Represented? . . 77 Laufee, Berthold : Multiple Births among the Chinese 83 Thompson, Warren S. : Race Suicide in the United States , 97 Hedlicka, Ales: Anthropometry— E. Osteometry 147 Special Communications: The Morbidity Statistics of Insured Wage-Earners and their Families, Louis I. Dublin, Edwin W. Kopf and George H. Van Buren, 175 ; The Newest Discovery of "Ancient" Man in the United States, Ales Hrdlicka, 187. Notes: Anthropological Society of St. Louis, 197 ; Physical Anthropology at the Museum of the American Indian, 197; Studies in the Far East, 197; Twentieth International Congress of Americanists, 197 ; Dr. A. A. Meodes Correaaud the University of Oporto, 197 ; Swedish Investigations in South America, 197 ; Resignation of Dr. Franz Boas, 198 ; LudwigStieda, 198 ; Richard L. Garner, 198 ; Horatio C. Wood, 198 ; Chihli collections at Peking Union Medical College, 198; Investigations near Chin-Chow, 198; American Museum of Natural History Collections from Mongolia, 198. BiBLIOGEAPHY OF DE. GEOEGE M. KoBEE 199 PRESS OF THE NEW ERA PRINTINQ COMPANY LANCASTER, PA. laan 192a AnntuprHarji ©rtbtil^ tn CUfDrgp iiartin IKnlipr. JH. i.. SIG. i. iln (Kelpbrattan of i|iH rmtj itrii|baa mnvtli 28, 193D 3Fraiiria A. ulonliorf, ^. 3, i Mlaalitnijtnn. S. (H. 192D t % QVICVNQVE . HEIC . LEGATIS GEORGII . MARTINI . KOBER ALMAE . MATRIS . GEORGIOPOLITANAE . DECORIS DICTA . SCRIPTA . FACTA QVA . IPSIVS LVCE . NATIVITATIS . SEPTVAGESIMA ADMIRAMINI . IMITAMINI Scripsit Tondorf. Born, March 28, 1850 LL.D., June 14. 1906, Georgetown University Al.D., March 7, 1873. Ceorficliwn I'nivcrsity Francis A. Tondorf, S.J., Head of the Department of Physiology, Georgetown Medical School. S 2vlUCH knowledge cU>es not constitute wisdom nor a facile memory a philosopher, so mastery of the medical science does not of itself make a great physician. If he be without a heart, the sufferings and countless ills that human flesh is heir to become, to the practitioner so many modes or acci- dents of being, clinical phenomena, to be tabulated, observed, treated and cured, it may be, but there his philosophy of utility exhausts itself. When, on the other hand, to skill and learning is joined the sweet and generous temper of the friend and comforter who knf)ws the precious art of [>enetrating beneath the sore to the seared soul, then has medicine achieved the pattern set by the lirst Great Physician of Humanity. It WMs not by chance that the Anglo-Saxons called the Saviour of the world "Haelend." the healer. The true dignity of knowledge lies in its dedica- tion to the common good. To indicate that the seventy years of the life of Dean Kober measure up faithfully to this standard has made the task of itemizing the following facts (jue of sincerest love. Dr. (ieorge Martin Kober was Ix^rn to Jacob and Dorothea (Behr) Kober at Alsfeld, Iles.sen-Darmstadt. CJcrmany, on March 2(S. 1850. He received his earlier education at the public and grand-ducal "kealschule" of his native town. His father, a revolutionist, had vowed that none of his sons should serve under a German king, prince, or potentate. Accordingly he early prevjiiled upon George to emigrate to the United States, which he did in April, 1867. Upon his arrival, he found that his brother Charles, who had preceded him to the States, had secured for him an assignment to the hospital corps at the Carlisle Barracks, Pennsylvaiu'a. Under the tutelage . Wright, U. S. A., Kober began here what might be fittingly styled his pre-medical course. His application in January. 1870, for an appointment as hospital steward was acted favorably on and 217 ANNIVERSARY TRIBUTE. accordingly we find him reporting for duty on January lo, at the Frankford Arsenal, near Philadelphia. Here he read medicine privately under Dr. Robert Bruce Burns, a graduate of the University of Edinburgh. Ordered to Washington, to the office of the Surgeon-General, in September, 1871, he found it possible to formally enter upon his medical studies in the Medical School of Georgetown University. With the schedule calling for no exer- cises before 5 P. M., Kober was able to attend all the classes and, not satis- fied with this, he tutored privately under Drs. Johnson Eliot and Robert Reyburn. After two winter and summer courses he was graduated in March, 1873. The following winter he figured as the first graduate of a post-grad- uate course, inaugurated by Drs. Thompson, Busey, Ashford, and others, at the Columbia Hospital, Washington, D. C. During the period of his medical studies, Kober considered himself fortunate in being assigned the duty of indexing all the official communications on file in the Surgeon- General's office from 181 2 to the date of his departure m 1874. In these dusty records he found many items of extreme scientific, historical, and epidemiological interest : so the reports of Surgeon William Beaumont, sta- tioned at Fort Mackinac, Michigan, on his "Observations and Experiments in 1825 in the case of Alexis St. Martin,'' who had been treated for a gun- shot wound of the abdomen resulting in a gastric fistula :. so too the report of a perforating gun-shot wound of the chest with recovery in the case of Gen. James Shields, of Mexican War fame. Of equal interest weie the reports on yellow fever during the Seminole Indian and Mexican Wars, as also subsequent reports on yellow fever and cholera up to the year 1874. Kober learned here to respect the old Army doctors, for when referring to ihem afterwards, in his lectures, he ever insisted that "they knew how to use the English language better than men of modern times." Whilst engaged in this indexing, Kober had gained the confidence and good will of Surgeon- (jeneral Barnes and Assistant Surgeon-General Crane, of Drs. Joseph J. Woodward and George A. Otis, editors of the Medical and Surgical History of the Civil War, and Dr. John S. Billings, in charge of the library, and who, with the assistance of but one hospital steward, was layiifg the founda- tion of the Index Catalogue. Billings found Kober of service in supplying correct titles for the articles published' in the German medical periodicals. His fellow clerks fittingly christened him "Index" because of his unselfish devotion to this trying work, and lest the harvester. Time, should rob him of this new birth-right, his close friend, George Dowe, on the occasion of Kober's twenty-fourth birthf'ay, did this title into the following verse: 218 ANNIVERSARY TRIBUTE. Index you are rightly named, Let thy future name be famed. I do not come in grim scholastic mood To fuhiiiuatc some dreary platitude. But only wish, my loved and honored friend, That hope and peace he yours till life shall end. Hope, the sheet anchor of the youthful soul, And peace zchen angry woz'es of trouble roll. And, while you practice well the healing art. Let strength be giz'cn to act the manly part; Good common sense to know the good from ill. And test the powers of plasters, draught or pill. And if, upon some distant honored day. The men and women you have cured for pay Shall add their record to your fair renown. By ivriting some good testimonial down, Be this the message one and all shall send: That ezrry patient was your fervent friend. Search carefully true zcisdom's bounteous stores, That all her waiting treasure may be yours. May she attend, zvhen years run trembling dozi.m. With honors zvreath your zvhitening hairs to crozvn. Appointed acting assistant surgeon. U. S. A., he became post surgeon in July, iedition against hostile Indians nnd in 1877 took active part in the Nez-Perces war. From July to October of this year the field hospital at Kamiah, on the Clearwater. Idalio. was under his charge. In November, 1877. he met for the first time Dr. Gec^-ge M. Sternberg, then post surgeon at Walla Walla, and this acquaintance ripened into a life-long friendship. Dr. Kober never tired of acknowledging his indebted- ness to the General for the many inspirations he had received from him. Having .served as post surgeon successively at a camp near Spokane, W. T. ; at Fort Coeur d'Alene, Idaho; Fort Klamath, Oregon: an*^ Fort Pidwell, Cal- ifornia, he was relieved from this service on the reception of the following orders, highly commendatory of his efficiency : 219 ANNIVERSARY TRIBUTE. Post Orders) Fort Bidwell, California. No. 104 ) Nov. 11th, 1886. * * * In recognition of the long and faithful professional services rendered to the government during the past twelve years in the field, in pursuit of hostile Indians, and at various posts, the commanding officer cannot part with him without some expression of his feelings of regret, as part of this service was rendered under his immediate command. His devotion to his professional duties has been warmly' recognized not only by his commanding officer, but by others, and has stamped him as one of the most skilful surgeons in the U. S. Army. A steadfast friend, a faithful officer, with the many acts of kindness to all, pro- fessional and otherwise, he has endeared himself not only to the officers and enlisted men of the garrison, but to the community at large, which he has helped to build up. * * * He carries with him our best wishes for his future welfare and happiness. By order of Major Gordon. (Signed). L. M. Brett, 2nd Lieut, 2nd Cavalry. Post Adjutant. After severing his connections with the army, Kober remained at this sta- tion caring for his many civih'an patients until June, 1887, at which time he traveled extensively in America and Europe. He returned to Fort Bidwell the following year. In the fall of 1889, we find him in Washington devoting his time to college, hospital, and literary work. Besides acting as professor of Hygiene and .State Medicine in the Georgetown Medical School, he assisted his friend and former classmate, Dr. Carrol E. Morgan, in his specialties, dis- eases of the throat, chest, etc. In the winter of 1889-90, he directed the attention of the District authorities to the sewage pollution of the Potomac water, indicating this as an important factor in the alarming prevalence of lyphoid fever in Washington. In August, 1890, he went to Berlin as a member of the Tenth International Medical Congress and there read a paper entitled: "Etiology of typlioid fever with special reference to water-borne epidemics." His California investments necessitated his return to Fort Bid- well in December, 1890. He resumed his medical practice there and for a year or more was again attending surgeon of the post. His alma mater welcomed him back to the lecture room in the fall of 1893. {-"rom this date on, lieakli prol)lems of the District, its social and industrial betterment were his one concern. At the request of the Health Officer, in [895, he investigated the possible causes of typhoid fever in the city and in his report suggested the agency of flies as a transmitter of the disease. His pul:)lic addresses on various occasions and researches into the relative merits of the various processes of water filtration, very materially influenced Con- gress towards appropriating the necessary funds for the installation of the 220 ANNIVERSARY TRIBUTE. model filtration plant at Brookland, District of Columbia. During the years [895-96, Kober was a volunteer worker in the Hygienic Laboratory of the Public Health Service of the United States. As a member of the board of directors of the Associated Charities the housing problem for the least resourceful people in the national capital appealed to him with special emphasis and accordingly he is recognized as one of the principal promoters of the Washington Sanitary Housing Company, organized in 1897 and 1904. Through these agencies sanitary houses, at reasonable rentals, have been provided for over eight hundred wage-earners and their dependents. The success of this earlier enterprise has lent encouragement to a system on a wider basis not only in the national capital but other larger cities of the States and merited for Kober a gold medal of award at the Paris International Exposition of 1900. Acting as secretary of two housing companies from the day of their organization until November, 19 15, upon the death of General George M. Sternberg, he succeeded to the office of president. In 1897, he was elected an honorary member of the Association of Military Surgeons of the United States, undoubtedly in recognition of his services as civilian physician in the United States Army as likewise because of his able com- munication "The Place of Military Medicine and vSurgery in the Medical College Curriculum." When reviewed in the light of the recent World War this paper and a kindred one entitled: "Higher Medical Education and a Plea for Better Training of the Volunteer Medical Officer," published in [898, have special significance. As a medical educator, Dr. Kober strenu- ously espoused every method of scientific research. Thoroughly convinced tiiat animal exi>erimentation must yield most marvelous results, we find him. as chairman oi the Committee of Public Health of the Civic Center on Feb- ruary 15, 1900, filing a most vigorous protest against the enactment of Sen- cile I'ill. No. 34, whose purport was to restrict the use of animals for experi- mental purposes in mechcine. The brief he submitted on this occasion t:mbo(lies facts and arguments which convinced even the sponsor of the bill, Senator J. H. Gallinger, that the propo.sed legislation was superfluous. It may be pertinent to mention here that Kober very effectually recalled this inci- dent before the Judiciary Comnn'ttec Hearing in November, 1919, when a similar bill by the anli-vivisectionists was under discussion. In 1901. Kober was selected to deliver before the American Medical Association, at St. Paul. Minnesota, the "Oration on State Medicine." His theme was: "The Progress and Tendency of Hygiene and Sanitary Science in the Nineteenth Century." This same year he was invested as dean of the medical scliool of 221 ANNIVERS.VRY TRIBUTE. his altiui mater. Plis plans for a curricnlnni calculated to insure for medical aspirants a more complete and harmonious education was set forth in his "Plea for a Standard Medical Curriculum," read before the Association of American Medical Colleges, in 1904. At this meeting he was appointed chairman of a "Committee on National Uniformity of Curriculum." The report submitted by the committee was approved and it is a pleasing reflec- tion to recall that Dr. William J. Means, in his presidential address, March J, 1919, referred to it in most appreciative terms. June 14, 1906, Kober was the recipient of the honorary degree of Doctor of Law from his alma mater. The citation follows : "It is fitting that universities should show their appreciation of their sons who have done distinguished service in the cause of science and humanity. There are none more worthy than they who lessen human misery and by their genius and devotion ward off disease and suffering amongst men. They are the true philanthropists, inspired with genuine unselfish love for their fellows. Such is the man whom this university gladly and gratefully honors today; a man who besides his duties to the public, acknowledged and rewarded already by distant nations, has labored in season and out of season for the welfare of the medical school of this university and of each individual student until his work has been recognized by the official medical body of the United States in electing him President of the Association of American Schools of Medicine, and in its public declaration that the course of study introduced by him into Georgetown Medical School should be the standard of all medical schools." President Theodore Roosevelt in 1906. designated Kober as a member of the Board of Charities and in May of the following year as a member of the President Homes Commission. As chairman of the Committee on Social Betterment he drew up monographs on "Industrial Hygiene" and "Social Betterment," which were published as Senate document No. 644 in 1908. At the meeting of the first Conference on the Conservation of National Resources, which convened at the White House May 13, 1908, on invitation of the Presi- dent of the United States, he addressed that body on "The Conservation of Life and Health by Improved Water Supply." Dr. Kober has been a member of the National Tuberculosis Association since its organization in 1905. He is also a member of the local Society for the Study and Preventi'Mi of Tuber- culosis. His plans were adopted in the construction of the Tuberculosis Hospital in Wa.shington, formally opened to patients June 28, 1908. and were awarded a medal at the exposition connected with the International Con- 222 1866 1873 1881 1895 1904 1916 ANNIVERSARY TRIBUTE. gress on Tuberculosis held in Washington in the fall of 1908. He may be very fittingly designated a pioneer worker in the crusade against tuberculosis, liaving read as early as 1889 a paper entitled: "Etiology and Prevention of Tuberculosis in the Light of Alodern Research," before the Medical Society of the District of Columbia. This lecture was published by the State Board of Health of California as a special pamphlet in 1890 and was followed by a second in 1893, "A Plea for the Prevention of Tuberculosis," which had been previously read before the State Sanitary Convention of California. Dr. Kober is a Fellow of the American Medical Association, of the Amer- ican Association for the Advancement of Science, likewise a member of the Advisory Council of that same body. Member of the Cosmos Club. Mem- ber of the Association of American Physicians (Secretary from 1909 to 1916, at which time he retired and was elected honorary member). Member of the American Public Health Association ( Vice-President, 1916). Asso- ciation of American Medical Colleges (President in 1906). The National Association for the Study and Prevention of Tuberculosis (President in T915). National Housing Association. Medical and Surgical Society District of Columbia (President 1889, 1917-19). The Medical Association of the District of Columbia (President 1898). Medical Society District of Columbia (President 1903). The Washington Anthropological Society (President 1907, 1918-1919). The Social Hygiene Society of the District of Columbia (President 19 18- 19 19). Chairman of the Committee on Lec- tures, Sixth International Congress on Tuberculosis, Washington, D. C, Sep- tember 28th to October 5th, 1908. Honorary Member of the Medical and Surgical Society of Washington, D. C, 1910. President of Section IV, Industrial and Occupational Hygiene of the 15th International Congress on Hygiene and Demography in Washington, September 23-28, 1912. Chair- man of Sub-Section C, Sociological Medicine of the Pan-American Scientific Congress, held in Washington, D. C, December 27, 191 5 to January 8, 1916. Member of the Washington Academy of Sciences (Vice-President 1919-1920.) In 191 2, Dr. Kober was appointed by the President of the American Medi- cal Association, Chairman of a Committee on Red Cross Medical Work. This Committee was created so as to provide a body of representative physicians of approved qualification to direct or participate in medical work, carried on by the Red Cross in different localities in times of war or emer- gencies and to advise with representatives of that society in handling medical and sanitary problems incident to such an occurrence. The Committee up to May, 1916. organized committees in 588 county medical societies located in 223 ANNIVERSARY TRIBUTE. 47 states. During the recent world war he was a member of the committee on "Conservation and Welfare of Workers" and chairman of the Committee of Rural Workmen's x\reas with Special Reference to Housing; Member of the Council of Defense, District of Columbia; Chairman of the Committee on housing. Dr. Kober is the author of no monographs, chapters in text books, journal articles and reviews on medical, surgical, sanitary and sociological subjects, and over 120 published discussions. His first medical essay was on "Infantile Paralysis" published in the Pacific Medical Journal in November, 1874, in which he presented all the available evidence that the disease was due to some organic lesion of the medulla spinalis. In the same year he published his Urinology and its practical application. In 1875, he published notes in the American Weekly, Vol. Ill, p. 241-243, on chronic dysentery treated with injections of a solution of chlorate of potash, and adenitis (tubercular) treated with injections of carbolic acid and glycerine. In October, 1876, he reported in the American Journal Medical Sciences, a case of gun-shot wound of the knee joint, in which he used probably for the first time an injection of tincture of iodine and carbolic acid. Dr. Edmond Souchon, of New Orleans, in his monograph on "Original Contributions of America to Medical Sciences" credits Dr. Kober as having been the first to publish notes on the three subjects referred to. He also credits him with having been the first to point out that insects, especially flies are doubtless frequently the cause of spreading typhoid fever. Dr. Kober's tabulation of 330 milk-borne epidemics and his monograph on "Milk in Relation to Public Health" and his first book on "Industrial Hygiene," published as Senate documents, and his chapter dealing with the effects of diminished atmosphere upon the health of aviators published in 1916, are regarded as pioneer contributions to American medi- cal literature. Such is the story of a lifetime of sound scholarship and scientific achieve- ments which have made him an ornament to the medical profession and a consolation to his alma mater. No form of human misery has been so low as not to be the object of his solicitude, no need of the University has been so insignificant as not to command complete response. He has done good in the open, he has done good by stealth, but, withal, as one devoid of the spoiling taint of vanity or self-seeking. Of a personal integrity unimpeached and unimpeachable, of unswerving fidelity in adherence to higli ideals of medical education, his is the singular privilege to note his name chiseled high on the pillar of the temple of fame. 224 ^^^e^r^r^^^-^ yj^a-^^-^^^ Hum Mdiili .'S. /.S'.-io. Pciiii Ccoriictown I'liivrrsity Mrdiftil School June. luoi. A N N I V E R S A R Y T R I P. IJ T E . Wilfred AI. Barton. M.D., "92. Professor of Therapeutics, GeorgctoK'u Medical School. June 13th, 1901, was an important day in the history of the Georgetown Medical School for on that date George Martin Kober was elected Dean. Nearly twenty years have since elapsed and preparations are complete for a great testimonial in honor of his 70th birthday and of the high esteem in which he is nniversally held. The election of Dr. Kober to the Deanship was made at a regular meeting of the Medical Faculty on motion of Prof. S. S. Adams; and Prof. Joseph Tabor Johnson, Vice-President, was requested to cast the unanimous ballot of the faculty for him as Dean. Dr. Kober is the seventh Dean which our seventy year old medical school has had. His predecessors were Howard, Eliot, Reyburn, Ashford, Lovejoy and Magruder. In point of years of service only one has equalled him, nariiely, Eliot who served continuously in the same office from 1856 to 1876. At the time of Dr. Kober's election as Dean in 190 1. Rev. Father John D. Whitney was Rector of the University, soon to be followed by Rev. Father Jerome Dougherty. These two distin- guished Jesuit Fathers have intertwined their names into the very tapestry of Georgetown history and it was under their authority that Dr. Kober began !hat work for the Medical School which has moulded its form and nurtured its development and progress for a fifth of a century. The acclamation of his colleagues on his election had scarce died away (in that night of June I3tli when Dr. Kober was called upon to present his report to the {''acuity of the meeting of the Association of American Medical Colleges which he had attended at St. Paul on the 3rd of June. We men- tion this report specifically because it gives a key to the character and an example (;f the sturdy service of the man. He had gone to the meeting at St. Paul as a delegate from Georgetown Medical School, in whose faculty he was pnjfessor of hygiene. It was his duty to attend the meetings of the association, to listen to the pa|)crs. to partake in the discussions and to report U) his colleagues what had been done by those who were interested in luedical education. This he did. and ou that night after his election he gave a succinct but cf)mprehensive report of what he had seen and heard at the meeting in St. Paul, lie t^'M tliein that tlie tcndencv of medical education seemed t<> be along the lines of emphasi/ing practical rather than didactic ANNIVERSARY TRIBUTE. teaching in the medical schools. Always on the lookout to have Georgetown in the advance guard of progressive schools and advocating every true reform in medical teaching, Dr. Kober urged upon his colleagues the necessity of striving for the highest ideals to be maintained by the medical school. On many subsequent occasions Dr. Kober pleaded for his high ideals, not always without opposition from those of a conservative group who believed rather in following closely than in leading. It is needless to say that this char- acteristic of Dr. Kober to stake everything on the altar of his ideals has been a chief factor in enlarging the reputation and prestige of Georgetown Medical among the elite colleges of the country. Unendowed and conse- quently handicapped for funds the Medical School has had a somewhat difficult struggle, and a man of less grit than he might well have been excused for adopting an ultra-conservative policy in the face of the many demands being made for higher ideals in medical education. But such a thing never occurred to him to do. If the proposition was to lengthen the hours of work, to increase the burden of endeavor in any direction, if it meant progress for the school, he favored and adopted it. His untiring devotion and support, his disposition to shift no responsibility or labor and, finally, his unfailing optimism have always been factors in overcoming what appeared at first sight to be almost insurmountable obstacles and difficulties. In October, 1902, Dr. Kober brought before the faculty the schedule of minimum requirements for medical schools adopted by one of the Western States, and because of its progressive character earnestly advocated and secured its adoption. The development of a standard curriculum for all medical schools soon took possession of his mind, and to the perfection of this scheme Dr. Kober for several years devoted a great deal of energy. In 1904 he secured the appointment of a committee by the Association of Med- ical Colleges to investigate this question, and in 1905 the report of this committee, of which he was chairman, was adopted. In 1906, Dr. Kober was elected president of the association. It seems incredible that a single mind could develop such power of concentration upon a single topic and yet find energy and opportunity for the pursuit of a great variety of scientific and civic activities; activities which varied from studies of the epidemiology of typhoid fever to sanitary house construction ; from scientific work in many fields of public health and hygiene to civic labors of multitudinous variety. Nevertheless this was the case, for during the early years of his deanship, when a thousand details of college and hospital administration and con- struction continually harassed him, he found time to keep up his association 226 ANNIVERSARY TRIBUTE. with scientific bodies of many sorts and with civic and social duties which would have overwhelmed the average man. Dr. Kober has always been a great detailist without being small or petty, a particularist without being narrow or prejudiced. Much of his writing, both scientific and secular, he has often done with his own pen, at what must have been prodigious labor, so careful has he always been that any piece of literary, scientific or even clerical work to which his signature was to be affixed should be absolutely accurate and exact. The history of our University Hospital is all bound up with the name oi Kober. At the time of his election to the office of Dean in 1901 all there was of Georgetown Hospital was a small central wing located on a plot of ground next to the corner of 35th and N streets, four stories and a base- ment high, accomihodating twenty-nine beds, which had been built in 1898 at a cost of about thirty thousand dollars in money and an amount of human energy and aspiration too great for adecpiale description. For, this institu- tion small in size at that time, now grown to large proportions, represented the realization of a dream which all loyal medical sons of Georgetown had iiad for many years to build a clinical hospital in connection with the medical school. Dr. Kober had been a leading spirit in this movement long before he became Dean. He had preached the necessity of a hospital to be attached to the medical school, he had aroused enthusiasm in his colleagues and the public, he had begged funds and given money from- his private resources: in short, he had worked with untiring enthusiasm for the realization of his ideal. It is not to be wondered at, therefore, that when he became Dean. Dr. Kober's chief ambition, it may be truly said, was to develop the hospital idea in every possible direction. Anyone who will stand today at 3Sth and X streets and contemplate the extensive hospital buildings occupying half a city block will feel to what a wonderful extent his dreams have come true and how completely his aspirations have been realized. It will be appre- ciated also with ecpial force what energy, wliat indomitable will, what capacity I'or mental and physical work, what hope and trust under trying circum- ^tances, were displayed by the man — Our J)ean — upon whom all these re- ^ponsibilties were piled. Dr. Kober's almost herculean labors in behalf of the University Hospital may perhaps be best appreciated l)y giving a brief account of the develop- ments which have taken i)lace in its growth since he became Dean of the Medical .School, in each one of which he took a prominent part both in il^ 227 ANNIVERSARY TRIBUTE. tjiigin and in its progress. The original small hospital hnilding was completed in August, 1898. In 1903 the first addition was completed. This was a wing on the east side, four stories and basement high, which increased the capacity of the hospital to one hundred beds. In 1904 Dr. Kober per- sonally completed and equipped a new operating amphitheatre in memory of his parents. In 1907 the new nurses' home was built. In 1908 the Eisner Memorial addition to the hospital was erected, which increased the capacity to 155 beds, and other additions and improvements were made. In 1910, Mr. E. Francis Riggs was interested by Dr. Kober in the subject of erecting a maternity building, but the untimely death of Mr. Riggs in that year pre- vented him from carrying 'out this worthy charity. His widow, however, in 191 1 generously created the Francis Riggs building fund for the erection of a building in commemoration of her husband. The Riggs maternity was built in 191 1. In 1912 Dr. Kober personally authorized the erection of a building four stories high, which was completed in the same year, and has since been known as the Kober Building. In 19 14 Dr. Kober installed in this addition a modern x-Ray department. In 19 17 an addition was made to the outdoor department, which provided a much greater space and en- larged its facilities. In 1919 two wards were completed, with a capacity of diirty beds, making the total capacity for the hospital three hundred beds. The number of patients treated in the hospital has increased from 273 house cases and 633 dispensary cases in 1908 to 4,329 house patients and 15,325 outdoor patients in 1919. This short resume of the development of the University Hospital during Dr. Kober's service as Dean will give a slight idea of the enormous labor and responsibility involved in their realization. Dr. Kober will always be remembered as the director and part creator of this great work, which in itself would be a sufficient life labor for any man. To feel that he is the recipient of well-merited praise and admiration from his colleagues and friends and all those who are interested in Georgetown University Hospital must always be a source of gratification to him. In considering the subject of Kober as Dean many interesting facts worth recording leap into memory. Unfortunately, limitations of space forbid us mentioning them. There is one circumstance, however, which should not be forgotten. Dr. Kober, in 1893, re-introduced into the medical cur- riculum a course on military surgery and hygiene, for it was at Georgetown in 1864, during the Civil \\'ar, that the first course of lectures ever given in 228 ANNIVERSARY TRIBUTE. an American medical school upon this subject was delivered by Dr. Thomas Antisell of the United States Army. The office of dean in the modern medical school has lost much if not all of its original ecclesiastic significance, but Dr. Kober in his unselfish and untiring devotion to Georgetown has managed to reflect upon his work some of the spirituality of the ancient Decani. It will remain for the future his- torian of our Alma Mater- — some future Easby-Smith renowned in classical scholarship and love for Georgetown — to write the complete history of the deanship of George Alartin Kober. In the meanwhile it is the wish of all ihat he may be spared for many years to contemplate the fruition of his long labors and see them grow into even greater things. John A. Foote, AI.D., 'o6. Associate Professor of Clinical Medicine, Georgetown Medical School. I do not think that any phase of Dr. Kober's career is better known than that of his paternal attitude toward the student in the medical school. There may have been some students who passed through the modest building on H Street with little or no jjersonal contact with the Dean except in the lecture room, but there are not many such. Few men can live four years in the modern medical school without some sort of worry — scholastic, financial — or what not. To the students in trouble Dr. Kober is best known, not as the exemplar of retributive justice, but rather as "one who was born for the world rather than for himself." The delinquent student may have worried about his class standing more than rhe Dean — but he did not grieve as much as Dr. Kober. The Dean has a soft spot in his heart for those boys whom he has often referred to as "weak vessels." Indeed, he has frequently stood in a painful position- — his affection for the student balanced against his desire to uphold the high standing of the graduates from the institution which he loves so well. Poor indeed in discernment is the man who does not see the friendly interest and feel the kindly urge of Dr. Kober's friendship at all such times, and many a heedless or many a loitering candidate for a degree has l)een spurred to hopeful action by the knowledge that he has a real friend in the Dean's office, who believes in liim and counsels him as a father might counsel a son. A N N 1 V E R S .\ R Y TRIBUTE. 1 don't think anyone will really know how many students have gone to him with their Iniancial proljlems. It is safe to say lliat no individual willing to work has ever ajjplied in \ain to him for aid in eking out tuition at the medical school. Dr. Koher believes that "faith without good works is dead." He is him- self an untiring worker and he has always expected his students to work, it was Dr. John Brown, who said : 'T don't expect my students to know every- thing, but I expect everyone of them to be able to do something." Dr. Kober is tolerant of the man who is not unusually intelligent, provided he atones for it by being consistently industrious. Laziness and wastefulness, especially of time, he always has and always will abhor. I can remember very distinctly how in my student days the Dean invited me to his home to attend a meeting of a local medical society, how on another occasion he talked with me on the necessity of the younger man doing origi- nal work and showed me a splendid Ijrochure on urinalysis which he had written when both himself and this branch of clinical, medicine were com- parativelv young. This was only one of his methods of edtication employed with the hope of making the student think for himself and have confidence in his own judgments and potentialities. Some day Dr. Kober may l)e induced to i)ublish a book of letters from fathers taken from the large collection of these epistles which he has received. Very soon the father of the student discovers the paternal strain in Dr- Kober, and that is why the latter's correspondence is so voluminous. From counseling wavward sons to disbursing monthly stipends — all sorts of offices have been intrusted to him by confiding old gentlemen, and many of these rhe Dean has gravely performed, possibly because of the innate courtesy which so characterizes him, but more probably because he secretly likes these offices f>f \-icarious fatherhood to be thrust upon him. As a teacher in the lecture room it was always observed that the lectures on hygiene were well attended and that excellent notes were taken by the students. Dr. Kober's lectures in hygiene were carefully written and delivered slowlv and with a \ocal di.stinctness that was eminently satisfying. The largest annual attendance — recruits coming often from both upper and lower classes— was always noted at about the time when comuicrcial beverages were being considered, l)ecanse it was at one time the custom to have the classes inspect, not only wholesale bottling establishments and dairies, Imt also a brewery IcK'ated near the Museum of Hygiene. Needless to say the maximum attendance came and the most diligent attention was observed at the 230 ANNIVERSARY TRIBUTE. lectures on fermented beverages. The enthusiasm of the yonng men in testing on themselves the physiological action of the malt beverages — these experi- ments l^eing made possible by the too generous hospitality of the brewers on visits of inspection, obliged the cessation of one very popular feature of the course in hygiene and dietetics. To the thoughtful student, Dr. Kober has always seemed more than a friend, a counselor, or a teacher. The lesson of unselfish devotion to the cause of medical education which he instilled by his long hours spent at the school each day, his efforts to know and properly value the w^ork of each student, his personal gifts to the University Hospital, and his scrupulous attendance at all University functions, have long made him more an institu- tion than a mere individual — one whom we did not judge by the ordinary values with whicH we measure men. but rather as one concerning whom we might quote the lines from Othello : "He hath a daily beauty in his life Which makes me ugly." (gpiirgf ilarttn IKnbpr An Apprecier, 187 1. when he became .'1 student of medicine in my father's office, and as the years rolled by this acquaintance was cemented by a strong bond of friendship. Looking to those, years it has been amazing that we shoukl have been friends, since George Kober was my very antithesis in point of disposition and habits. He was studious, moderate, modest and retiring, while I, on the other hand, did not cultivate these qualities so faithfully. .\s a pupil his intelligence and understanding, his industry and perseverance made him a graduate of whom any instructor could well be proud. While he was a student we were serving as hospital stewards in the army ; and after his graduation Dr. Kober became one of the first matriculants in Dr. J. Harry Thompson's School of Obstetrics and (iynecology, where he passed his e.xaminations without an error, but 2;n ANNIVERSARY TRIBUTE. Dr. Thompson was forl)i(lden l)y the Secretary oi War to award diplomas, inasmuch as his school liad hecn established without oificial authority. We next find Dr. Koher as a contract surgeon in the army at Alcatraz Island, California, serving willi that faithfulness to duty characteristic of the man. and it was here that he added the study of hygiene to his other accomi)lishments. His model reports to the State Board of Health of California were widely circulated, but the first paper published by Dr. Kober himself was a study of Infantile Paralysis, in the early seventies. Then came a Manual on Urinary Analysis, and soon a treatise on "A Case of Gun-shot Wound of the Knee Joint." In this Dr. Kober described the use of tincture of iodine as an antiseptic, and I believe this to be the first published report of such a use for iodine. No attention was then paid to this treatment, but Dr. Kober Loday sees the general adoption of his idea by the profession, although due to his modesty it is only recently that his claim to priority has been mentioned. Since those early days his publications, each one marked by a master's hand, have become legion, and these, with his splendid work at Gein'getown Liniversity Hospital, have brought him honors and official positions at home and abroad. To write more of Dr. Kober would encroach upon the fields of others of liis friends who will wish to pay him tribute, but none would begrudge the space in which I tender my congratulations and my wishes for continued years of health and happiness to a true friend, a genial companion, an earnest student, a diligent worker in the cause of humanity, a charitable and godly man. What else may one say? Srtbutp nf th^ Efu. 31. HawuB Etrl^arbH, ^. 31. President of Gcorgctozvn Unk'crsity, 1888-1898. J am rejoiced to learn that our dear dean and devoted friend, Dr. Kober, IS about to celebrate his seventieth birthday and to be myself privileged to add my congratulations to those of his many intimate friends. To grow old is not always a pleasant thing and a cause of rejoicing, in spite of the advantages set forth so attractively by Cicero in the treatise De Senectute 'hat is read with such trustfulness by your youthful students. But to grow old and vet remain young — that is an achievement worthy of admiration and joy ! And this is truly Dr. Kober's privilege. 232 ANNIVERSARY TRIBUTE. My first acquaintance with the doctor was at the centennial celebration of the College in February, 1889. He was then in the middle years and had not yet begun those extensive and careful researches in hygienic science or other departments that have since rendered him so well known and distin- guished in his profession. Anyone who may be curious can find his portrait in the centennial group photograph, in the first line of the alumni present, and will be struck by the fact that it differs scarcely a particle from his appear- ance today. Some time afterwards I received a note from him, dated from somewhere in the wilds and mountain fastnesses of Idaho, respectfully drawing my atten- tion to the fact that an omission had occurred in the awarding of honorarv degrees at the academic sessinn of the celebration. He considered that Dr. Fthelbert Carroll Alorgan, then professor of laryngology in our Medical Schocjl, but a hopeless invalid, was eminently worthy of an honorary degree. He set forth strongly the distinguished position held l)y Dr. Morg-an in his specialty and his international reputation, evidenced l)y his incumbencv as president of the American Association of Laryngologists. He added that ])esides his eminent w^orthiness, the shadow of his approaching end would make the conferring of the honor a graceful and consoling tribute. Being then quite fresh in ofiice and not having had the privilege of birth or residence In Maryland, I was not acquainted with the historic family of Morgan, so intimately connected from the earliest times with the Jesuit h'athers, save that I had laitght Dr. Carroll's younger l)rotIicr. j. Dndlev Ab)rgan ( wlio later became a distinguished figure in medical circles in Washington) in the class of physics in his graduating year. But inquiry among those who knew confirmed Dr. Kober's estimate of this professor. The degree was awarded at the next commencement in June, 1889. That incident was characteristic of deorge M. Kober. He never thinks of himself, but is keenly alive to the interests and happiness of his friends and the furtherance of every good and noble cause. When Dr Kober returned from the Wild West, in 189:^. and became |>or- in.anently associated with our faculty as pr(»fessor of hygiene, ni\- ac(|iiaintance with him became more intimate and ripened into warm friendship. I do not think it i)ossil)le for anyone to really know Dr. Kober and not lo\e him. It was in the foundation of the (leorgelown l'ni\ersitv Hospital, toward ilie end of mv term as president, that I was most cIosel\' .associated with \)y. Kober. lie was not the very first to work for the hospil.al. but he was by 2;i3 ANNIVERSARY TRIBUTE. far the most devoted and efficient factor in its inception, as he has been in its growth and expansion. If the history of the hospital is ever written in detail, as it no doubt will be, the name of Kober will shine therein with a lustre beyond all others. At that time the faculty and directors of the College had in view and in desire three great objectives — a gymnasium, a preparatory department sepa- rate in locality from the College itself and a school of physical science and engineering. In remote preparation for the accomplishment of the last of these projects. Dr. Edgar Kid well, now head of the Kidwell Boiler and Engineering Company of Milwaukee, had made a tour of inspection of the leading engineering schools of the East and had handed in estimates of the faculty and ecpiipment needed for a start and of the probable expense. But when Dr. George L. Magruder, then the energetic and devoted dean of the medical department, reported that the. professors had reached the conclusion that a hospital of our own was an absolute and pressing necessity, all other ambitions were laid aside for the time being and all energies were devoted to this object. Dr. Magruder and I called one Sunday morning on Martin F. Morris, the venerable dean emeritus of the law faculty and the chief ad- viser of the College, and, in company with Mr. Morris, went to see Mr. Elisha Francis Riggs, who had shortly before fitted up the Riggs Library of the College. \\'e were most cordially received, and to encourage the movement Mr. Riggs subscribed immediately one thousand dollars. A com- mittee was promptly organized to raise the necessary funds, of which body Dr. Kober was made secretary and treasurer, and soon proved to be the very soul. As the president of the University is ex-officio the beggar-in-chief, I was brought into constant contact with Dr. Kober in our efforts to stimulate the generosity of our friends and the general public. At that time the sys- tematic drives of the present day were unknown. Our methods were com- paratively crude and ineffective. \Ye had secured the cordial approbation of His Eminence, Cardinal Gibbons, who consented gladly to our inviting the Sisters of St. Francis of Glenriddle, Pa., to this portion of his archdiocese. We had the no less hearty co-operation of His Grace, Archbishop Ryan of Philadelphia, whose consent was necessary to the coming of the Sisters. We had the enthusiastic welcome of the people of Georgetown to the plan. But we had no money; and the task of getting it proved anything but easy and agreeable. We received nuich sympathy but little cash. I can never forget the self-devotion and constancy with which Dr. Kober pursued the quest. It was due to his initiative that the first room was founded by Mr. Lisner, ANNIVERSARY TRIBUTE. whose interest, once awakened, continued until it resulted in after years in the erection of a separate wing of the hospital. Finally Dr. Kober and I made a personal canvass of a number of the business houses of Washington. We were always respectfully, frequently cordially, received. But rebuffs were not wanting and the sums subscribed were in general pitifully small, i doubt whether I would have had the courage to persevere had it not been tor the example of my companion's constancy and self-abnegation in the work. His imperturbal:)le good humor and optimism in the face of difficul- ties were a perpetual inspiration. When the first tiny building was finished, with a capacity, if I remember rightly, of onl}- twenty-se\'en beds, and the Sisters had arrived and taken charge, Dr. Koljer's sympathy and assistance were unfailing. The equip- ment of the operating room was his gift, the forerunner of his larger bene- factions in the same line W'hen the greater buiklings were added. He recog- nized in the good Sisters kindred spirits to his own. Their lives of heroic .^elf devotion without hope of earthly reward mirrored his ideal. Their Superior. Sister Pauline, to whom the Hospital owes much of its success and present prosperity, always found in him a faithful friend, a wi.se adviser and a most devoted helper. I leave to others to speak of Dean Kober's eminence in his profession and his chosen specialty, of his researches in the statistics of the drug habit and other fields of Preventive Medicine, of his activity and influence in various ersi.stent labor — that according to my analysis is the constituent formula ot" Dr. Kober's character — and a r.'ire and ])recious combination it is! 1 may even go a step further, and without, 1 hope, trespassing upon precincts that ought to be sacred, may sav that his iirofoundly religious spirit is a worthy example to men of .\atural Science 235 ANNIVERSARY TRIBUTE. and a proof that the most exalted knowledge of natural phenomena and prin- ciples may and ought to dwell with the simplest and most intense faith. His soul is too wide to harbor any narrow bigotry. Sturdy Lutheran as he is in profession, his heart is so truly Catholic that he might easily be mistaken for a Jesuit in disguise! This celebration is in no sense a farewell ! I do not indeed expect to be present at the exercises nn Dr. Kober's ninetieth birthday, but only because long before that happy exent. I shall have passed to a better world, where doctors are unnecessary and death shall be no more ! But I do confidently expect that God will grant me the privilege of seeing from the eternal hills my old friend still hale and he.arlv and radiating light, goodness and happi- ness as he has done in the first sexentv vears of his existence! So ir. 2Cnb?r (On the celebration of his seventieth anniversary.) 7V:» ministcv, to case the restless pain; To bring to fevered spirit courage new; To keep a comrade's silent vigil through The aging hours, as life slips hack again Into Eternity; to head the train Of nezv-born's heralds in the niorning dew Of life's first rosy infant dawn; to viezv With charity mail's boasted strength so vain; All this, and threescore honored years and ten Are yours, each graven with the artist's care, In finest lines of kindness tozvard men To leave on ev'ry heart an impress rare. A greeting? Aye! Let salutations pay All mankind's debt on this, the Doctor's Day! Edward F. Mack, A.B., '20. 236 ANNIVERSARY TRIBUTE. ^hhv^BB Srfor? tit? ^porg^tomn ^Itmral ^omtg James A. Gannon, M.D., '06. Associate Clinical P.rofcssor of Surgery, Georgetoztm Medical School. [t is particularly fitting that the Georgetown Clinical Society, which is composed of his former students, should meet on this occasion to remind Dr. Kober of the love and esteem we have for him. He will receive many honors this month at the hands of his other scientific and civil associates but he will hear no words of congratulation which are more sincere, more heartfelt than those we extend to him tonight. We meet to celebrate his seventieth birthday ; to show him how glad we are that the completion of three score and ten years of useful life finds him in the prime of mental and physical vigor; to remark how lightly the hand of time rests on his shoulders. We sometimes speak of one who has passed seventy years as old, but Dr. Kober is not old. If ripe judgment born of much experience is a sign of age, if vast knowledge caused by much study and industry is another sign; if high esteem and great reputation among his fellow men, the result of devotion to duty and contributions to scientific literature, constitute another sign — then indeed Dr. Kober is not seventy Init one hundred and fifty years old. I met Dr. Kober eighteen years ago when 1 enrolled as a student at the Medical School. When I reached my third year I took his course in Hygiene. At the close of this year we had our first misunderstanding. This is how it came about. I figured that by paying close attention and taking careful notes, it would not be necessary for me to purchase a text book on Hygiene and I did not purchase one. My omission somehow came to Dr. Kober's notice and I was unable to explain that it was due to the clarity of his lectures and to the economic principles with which he sometimes punctuated his remarks. During my more or less stormy career as an interne at Georgetown Hospital, I had occasion more than once to l)e guided by his good advice thereby pre- venting, I am sure, the world having another proof that youth and wisdom are seldom companions. Many times, since I have been in practice 1 have sought his good advice which has always been sound and worth following. His scientific attainments are many, but as 1 see Dr. Kober, he would be great without even these, for lie possesses a virtue which is too rarelv found in this world — charity. Most of the Ten Commandments are written around 237 ANNIVERSARY TRIBUTE. ibis virtue and he who possesses it to the extent Dr. Kober has shown, is ^reat if he has no other attainments to liis credit. His whole hfe has been one of sacrifice and devotion to his fellow man. Since his retirement from the army, his activities have been toward making the world a better place in which to live. His Medical School and Hospital affiliations, his membership on the Board of Charities and on various commissions for the betterment of morality and living conditions of less fortunate men, his numerous contribu- tions to scientific literature and his legacy to posterity in the form of a volume on Industrial Diseases — have all brought work and worry and responsibility and practically no financial reward. It has been a matter of enthusiastic com- ment, especially among his former students, that, although Dr. Kober has Ijeen out of active practice for many years, he has kept up with present day med- ical accomplishment. At medical meetings we have all heard him bring out some point in the discussion which was unknown to the essayist wlio had given much time and thought to the preparation of his paper. Often when his day's work is done and he would be doing more justice to himself by resting at home, he can be found attending smokers and meetings where medical students congregate, instructing them, advising them, inspiring them. He takes great pride in tln)se he calls liis boys and 1 doubt if there is a grad- uate of the Medical School since Dr. Kober has been Dean whose record is not known to him. There are few members of the faculty who caniKJt recall the interest he has had in each meml)er of the graduating class. When final examinations were being held, who cannot remember the moisture in his eye and the emotion in his voice when he discovered the failure of .some stu- dent to attain sufficient credits to allow him to receive his diploma? Dr. Kober, we have all l)een of those medical students to whom you have devoted your life; and as children appreciate their parents more after child- hood is past, so with the passing years we have learned to appreciate you more. We feel that we are better doctors and l)ctter citizens because of vour influence. L'.'iS on hycilneaMj DE^OGPfAPHr "WathiHji^ .y^y. ANNIVERSARY TRIBUTE. In closing I desire to read a short verse by Leigh Hunt, which is famih'ar o most of yon, and which could be written with truth about Dr. Kober. Abou Ben Adhein {may Jiis tribe increase!) A-cVokc one night from a deep dream of pea<:e, And saw within the moonlight in his room, Making it rich, and like a lily in bloom, An angel uriting in a book of gold: — Exceeding peace had made Ben Adhem bold, And to the Presence in the room lie said, "What writest thou?"— The vision raised its head, And, zcith a look made of all S7i'eet accord. Answered, "The names of those who love the Lord." "And is mine one?" said Abou. "Nay, not so," Replied the angel. Abou spoke more low, But eheeril\ still; and said, "I pray thee, then, Write me as one wJio loves his fellow men." ^ The Angel wrote and vanished. The next night It came again with a great wakening light. And showed the names whom Urve of God had blessed. And lo! Ben Ad hem's naine led all the rest. 2:5!) ANNIVERSARY TRIBUTE (Dr. (Jeorge M. Kober. who recently celebrated his 70th birthday, began liis career as a pliysiciau in 1S73. ) Almost a half ccnlury ago He y'lrdcd on his annoiir for the tight Against the ereepimj hordes of F\iiu and JVoe, Almost a half century ago,* The petaled pliiiiis of ease, bedecked and bright, Allured him not, he faced creation's blight And girded on his armour for the tight Almost a half century ago. When the bright torch lie reared aloft is dim Many a lif' 7vill linger o'er his name Breathing a million blessi)igs oi'cr him. Ulien the briglit torch he reared aloft is dim. Not scrii'oied gold, nor the glad cry of Fame Shall ser-ee his humble greatness to proclaim: Manx a lip leill linger o'er his name When the bright torch he raised aloft is dim. John A. Foote, M.D., '06. •240 ANNIVERSARY TRIBUTE A Srtbutp to ir. SCnbFr From a Pre-Medical Student. Three score and ten hath lightly laid its crown Of fruitful toil upon thy thoughtful hrozv. For you Heaven's ''Well Done" comes softly down To approve thy task and us -with hope endozv. You sought to make life a smoother path for all To tread its uncertain zcay zcith steady stride And ever quick to heed Pain's gasping call To ease her ache ami leaz'c "good cheer" beside. So upon this da\ so fraught zcith tender charm IV e semi aloft this prayer for you our friend, "May God e'er keep your love and friendship zvarm For those to zchoni your Jieritage zi'ill descend. Ripe tho u)i plucked! Fearless thy God to faee! When plucked thou art, zee ask. hut to till thy place. Thomas E. Mattingly. 1:41 ANNIVERSARY TRIBUTE Hfrtlf IVcr so wic Du in cincui rcicJicn Lcbcn Des Wissens iind dcs Herzcns ganze Kraft Dem VVohl der Menschhcit vdllig hingegchcn, IVer redlich, uncrmiidlich hat geschaift, IV er in den Dicnst harmhcrc ger Ndchstenliebe Sein Wollen imd sein Konnen hut gestellt: Der sorgte selbst, dass ihm bestdndig bliebe Die Achtiing und die Ehre dieser Welt. Aiis deiitschein Stauini in dieses Land gekunwicn Hast Du, von Deiner Rasse Geist bclebt, Dem hehren Zicl, das Du Dir vorgenoninien, In treuein PflicJitbeiinisstsein ziigestrcbt. Dies -Pflichtbezvitsstsein, Deiner Vdter Brbe, Hat imm€r Dich den rechten Weg gelehrt Und Du hast cs, zi'ar audi der Weg oft hcrbe, Dem neuen Land als treuer Suhn bewcihrt. Ein Lehrer bist Du tausenden gezvesen Und tausendc hat Deine Kiinst geheilt, Not und Gebreste machtest Du gcnesen, Wo imnier Segeu stiftcnd Du geweilt. War je ein Leid, das Dir nicht sprach ::um Her:;en? Je eine Not, zvo Du nicht half est gem? Gabst Du Dein Bestes nicht, rr// lindevn Schmcrzenf Was menschlich ist, stand nic und nie Dir fern. So stehst in Deiner sieb::ig Jahre Kran:;e Du heut geehrt, bewundert und gelicbt, So kront den Ehrentag mit hcUeni Glanze Ein Gli'ick, das lauter ist und ungctriibt: Denn blickest aiif die Summt' Deines Lebens Am heut' gen Tage priifend Du surilck, Dann siehst Du, dass Du lebtest nicht vergebens, Und das zu seh'n ist seltnes Menschengliick. Gewidmet vom Knrt Voelkner am 28. Marz 1920 242 ANNIVERSARY TRIBUTE. iEititnrial Georgetown College Journal, March, 1920. Joseph R. Mickler. Jr., A.B., '20. To few men is it given to live their allotted span of three score and ten years in devotion to dnty and in service to humanity, and finally to find ihemselvcs at the end of those years with their sacrifices appreciated and their services recognized. History is replete with the lives of men whose praises were not chanted until many years after they had been laid to rest in the unbreakable silence of the tomb ; where, we may believe, the sound of chant- ing voices is not heard. But of the men who win acknowledgments of their good works before they pass on. one hears but seldom. It is the way of fame, to place a wreath of laurel on. a piece of dull, cold marble; leaving the living brow uncrowned. So that a man who receives a generous meed of earthly glory from his .contemporaries, and that, too, without any of his own seeking, nuist of neces.'iity have that about him which stamps him as worthy. I do not know (ieorge Martin Kober in jjerson ; I feel that i do not liaxe to. I know his works and 1 know his friends, and I feel that by knowing them 1 ha\e known him as well. They l)oth declare that if e\er lixing man was well worlln- to wear the mantle of highest honors, he is that man. With their testimony ] am gladly content: since his works and his friends are eciualK^ insistent in compelling admiration for the man whose seventv years have been spent in generous service to mankind. Seventy years! Years crowded with episode, warmed with altruism, lighted with courage; gliding years, mo\ing now slowlv. now swiftly, as their burdens were light or heavy, but gdiding always onward to tiie fulfillment of their glorious promise. .\nd now, to the eyes of youth, it seems that at last he. George Martin Kober, must surely have attained the completest ful- fillment. Loved, honored. res])ected. and secure in the consciousness of work well done can he ask more of life than life has alreadv given? To be sure, he must ha\e met with withering disenchanimenls. undergone a \ast amount of mental drubbing during the eventful years. The vigorous liian is destined to a multitude of disapi)ointments while he li\es. Ihu from the pleasant .security nf seventv years must not these appear trivial, nnist not the whole voyage of his life seem to have been taken under rose-colored skies? In :i43 retrospect, life must appear a most joyful thing indeed. Surely Emerson must have erred greatly to sup^wse that "Life only avails, not the having lived." Much more pleasing is the philosophy of Stevenson on the same matter. He says : "To lead an adventurous and honorahle youth, and to settle when the time arrives, into a green and smiling age, is to he a good artist in life, and to deserve well of yourself and your neighhor." This, to me, must always be the goal of human endeavor. How George Martin Kober views it, one cannot say. He has given much to the world in seventy years; more, indeed, than the world can or is likely to repay in seven times seventy years. He has lived in a way that can bring him few regrets, and has well earned repose in this life and in the next. "In tJic dozvnJiill of life, ivluii I find I'm declining, May my fate no less fortnnaie be!" GEORGETOWN UNIVERSITY, School of Medicine. Washington, D. C, March 28th, 1920. Dr. George M. Kober, Worthy Dean : The Students of the Sophomore Class present, most respectfully, their heart- iest greetings upon this, the occasion of the Seventieth Anniversary of your birth. That the unfathomable future may bless you with a liberal share of lifes' rarest treasures; that our Alma Mater may have the good fortune of a mani- fold rq^etition of the years of thy faithful stewardship, is the ardent with of a grateful class. James J. O'Rourke, Walter E. McCawley, Vincent R. Reilly, Frank J. Russell. Committee. 244 ANNIVERSARY TRIBUTE. ilfbtral SnrlPtg of 11)? itatrtrt of OInlumbm Excerpt from the minutes of the Executive Committee of the Medical Society for a meeting held Nov. 3, 1919 : "Dr. \Mlliam Gerry Morgan called attention to the fact that Dr. George M. Kober's 70th birthday will occur March 28, 1920, and suggested that the Society should take cognizance thereof. Ordered : that it be recommended to the Society that a committee be appointed to arrange for a dinner to be held on the occasion of Dr. Kober's 70th birthday as an evidence of the Society's esteem." The foregoing recommendation was adopted by the Society at its meeting held November 5, 1919. H. C. Macatee, Recording Secretary. 1317 Connecticut Avenue, Washington, D. C. Dr. George M. Kober, November 17, 1919. 1819 O Street, N.W., Washington, D. C. Dear Dr. Kober: It having come to the knowledge of the Medical Society, through the report • 'f the E.xecutive Committee, that you are about to attain the seventieth anni- versary of your birth on March 28, 1920. a resolution was offered and unani- mously passed, that a dinner be given in your honor in celebration of this anniversary. It is indeed rare that one reaches the three score and ten mark in life; rare for one to possess such unusual distinction in the science of medicine, sociok)gy and civ-ic virtues. The Medical Society in honoring you wishes to honor itself, and we trust that you will accept our invitation. The committee finds that March 2H, 1920. falls on Sunday, and \vc therefore re(|uest that you designate the date nearest that day that you desire us to celebrate. c- 1 Smcerely, The Committee : Dr. C. \V. Riciiard.so.v, Cliairman. Dr. S. S. Adams.- Dr. W. M. Barton. 245 A N N I V E R S i\ R Y TRIBUTE. 1819 Q Street, Washington, D. C. To: Dr. Charles \V. Richardson November 22, 1919. Dr. Samuel S. Adams Dr. \V. M. Barton, Committee. My dear fricmis: 1 liave the honor to acknowledge the receipt of your letter of the 17th inst. informing me that in accordance with a resolution adopted by the Medical Society of the District of Columbia, a dinner will be given in my honor in celebration of the seventieth anniversary of my birth. In response to your communication, I beg that you will convey to the Society I he assurance of my heart-felt appreciation of the distinguished honor con- ferred upon me, and of the gratification it gives me to know that my conduct has received the approval of my professional friends and colleagues. Since your Committee finds that March 28, 1920, falls on Sunday, I would suggest that either Saturday, March 27, or Monday, March 29, may be desig- nated for the date of the dinner. Very sincerely yours, George M. Kober. Complimentary Dinner to Dr. George M. Kober in Commemoration of His Seventieth Birthday. A Complimentary Dinner will be given to Doctor George M. Kober on his seventieth birthday by the Medical Society of the District of Columbia ;ind other Scientific and Civic organizations, at Rauscher's, on March 27th, 1920, at 7.30 P. M. Dr. Kober is well-known, respected and admired for his untiring interest .in all organizations for the promotion of benevolent projects, and the betterment of social conditions in this community, and undoubtedly a large number will wish to honor him on this occasion. The cost per plate will be five dollars ($5.00). and the Committee respectfully requests that you send your subscriptions as early as possible to its Chairman that plans may be fully completed. Charles W. Richardson, M.D., Chairman, 1317 Connecticut Ave., Wa.shington, D. C. Samuel S. Adams, W. M. Barton, For the Medical Society. L. O. Howard, For the Allied Scientific Societies. ■ 246 » | t< ij*i •m r ^^-«.-^^>, THE INTERNATIONAL CONGRESS ON TVBERCVLOSIS WASHINGTON 1908 AWARDS T4IS ntDAL TO THE TVBERCVLOSIS HOSPITAL OF WASHINGTON DESIGNED BY G.M.KOBER ^ ANNIVERSARY 'I" R I \) I' T \\ . Sinnpr to (gwrg? iMarttit IKnbpr, ii- i., 21 IC. i. 3ln Qlpkbrattatt of Bta rnth ItrtljfiaH Sl|p Hf btral ^omtg nf tli? itatrirl nf (Cnlumbta anil AUtrb ^rtrnttftr ^crtrttrH anJi (Etuir (igatti^atiatta at iSauBrl^pr'H i^aturbau. iHJarrli 2r, 1920. at r.30 p. m.. liaaliittgtou, S. CE. ANNIVERSARY TRIBUTE AbbrrfiBffl of (Eongratulatton L)K. FKANCIS K. HACNKR President .Medical Society, D. C. 1)K. JOHN A. FOOTE Toastmaster I)u. W1I>L1AM ('. WOODWARD Kei)reseiitlii,ir the Medical .Society, D. C. Mk. WILLIAM H. HOLMES Representing the Anthropological Society Mk. henry B. F. MACFARLAND Representing the Civic Organizations Mu. ROBERT S. WOODWARD Representing the Washington Academy of Sciences Dr. HARVEY W. WILEY Rei)resenting the (.'osmos Club Dk. CHARLES W. RICHARDSON I'resentatiou Db. GEORGE M. KOBER Response 248 ANNIVERSARY TRIBUTE It the dinner giirn by the Mcdieal Society of the District of Coluiiibiti and .■lllied Scioititic Societies a)id Cii'ic Organi-zations. Acker. Dr. (ieorge N. Adams. Dr. Roy D. Adams, Dr. Samuel S. Adams. Mrs. Aimette A. Ailes. Milton E. Arnold. Dr. J. S. Arthur. Col. Wm. H., Med. Corps. Atkinson, Dr. Wade H. r>aid\vin, William H. Ilailoeh, Dr. E. A. r.arker, Dr. L. F. Barton. Dr. Wilfred M. Dauer. Dr. Louis A. Hell rend. Dr. Edwin B. Hell. Alexander Graham H.ell. Charles J. Her liner. Mr. and Mrs. Emile Hernton. Dr. Harry S. H.orden. Dr. W. C. Hoswell, Dr. A. W. I'.owen, Dr. W. Sinclair Hranson, Bruce S. Hrett. Col. Lloyd M, H.rickenstein, J. H. H.rownlow, Commissioner Louis H.ryan. Dr. J. H. Hryan, W. B. Hi-yant, Mr and Mrs. Arthur L. Hutler, Dr. W. K. Call. Arthur D. Casteel. Dr. F. A. Clark. Allen C. Clark. Api)leton, P., Jr. Coale. Dr. Edith S. Cole. Dr. .John T. CoiLstas. Dr. John Cook. Dr. (I. Wythe Cnpelii'id, Dr. Edfjar P. Coville, F. V. Creeden. Rev. John B., S.J. Crossoii. Dr. Henry J. Davidson, Dr. E. Y. Dclacey, Judge William H. Digges. Dr. J. H. Duehring. Dr. Frank E. Duffey, Dr. H. Clarence Dugan. Dr. C. L. Easton. Dr. Charles D. ImIsou. Mr. and Mrs. .John Joy Einhorn. Dr. Max Eliot, Dr. Johnson Eliot. Dr. Llewellyn I-niis, Dr. (Jeorge R. Eynon. W. J. Fadeley. C. E. Farrand. Dr. Livingston Fenning, Frederick A. ^Fletcher. Alice E. Foley. Dr. Thomas .M. Folkmar, Dr. Elnora C. Foote, Dr. .John A. Foster, Dr. liomulus A. Fowler. Dr. H. A. Fowler, Dr. W. C. I'ox, Albert F. P'oye, Dr. A. Francis B'rench, Dr. William G. Friedenwald. Dr. Julius (Jannon. Dr. James A. Gans, Isaac (larrison. Dr. Fielding IL. V. S. A. Gasch, Herman E. Glose, Rev. Joseph, S.J. Goodman. Dr. William 1{. Gordon, General David Stuart, T'. S. .\. Gore, James H. Griffith, Dr. Charles I. Grosvenor, Gilbert H. Gude, William F. Gwynn. Dr. William C. Hagner, Dr. Francis R. Hall, Dr. A. J. Hamilton, (teorge E. Hamilton, Dr. Ralph A. Hammett, Dr. Charles M. IL'itlield, Dr. Charles J. 249 ANNIVERSARY TRIBUTE. Hazeu, Dr. Henry H. Homier, Dr. Wm. F. Herbst, Mrs. and Mrs. William P. Herbst, ]Miss Herrmann, Mr. and Mrs. J. Phillip Heurit'h, Chris. Hickling. Dr. D. P. Hilkemeier, Charles Hird, Dr. John D. Holden, Dr. R. C. Holm. Dr. H. C. Holmes, Professor W. H. Hough, Dr. Walter Hough, Dr. William H. Howard, Dr. L. O. Hurtt, Dr. Harry Ireland, Surg.-Gen. Merritt W., U, S. A. Jackson, Dr. V. B. Johnson, Dr. Joseph Taber Johnson, Dr. Loren B. T. Johnson, Dr. Louis A. Johnson, Dr. Paul B. Jones-Taylor, Dr. Louise Judd, Neil M. Kelley, Dr. J. T. Knopf, Dr. S. A. Kober, Miss Gretohen Koons. John A. Krechting Dr. Wilhelm E. H. Lamb, Dr. D. S. liamb. Dr. Isabel LaFlesehe, Francis Langworthy. Dr. Charles F. Leclere, Mrs. Lizzie LeComte, Dr. Ralph M. Lee, Dr. Thomas S. Leech, Dr. D. Olin Leech, Dr. Frank Lind. Dr. John E, Link. Mrs. Henry L(»\ve. Dr. Thomas F. McCarthy, Dr. Joseph J. ^[cCaw, (Jeneral Wra. D.. U. S. A. M. C. McLaughlin, Dr. T. N. :Macatee, Dr. H. C. Machcn. Dr. Francis S. Macfarland. Hon. Henry B. F. Mack. Edward F. Mackall, Dr. Louis Manning. Dr. W. J. Marbury, Dr. Charles C. Meltzer, Dr. S. J. Merritt, H. B. Michelson. Dr. Truman Miekler, Joseph R., Jr. INIitchell, Dr. Claude N. Moran, Dr. John F. Morgan, Dr. Edward L. Morgan, Dr. William Gerry Moore, Charles Morrison, Dr. Edward L. Moser, Dr. James M. Moulden, Dr. W. R. Murphy, Jerome Muncaster, Dr. S. B. Munson, Col. Edward L. U. S. A. M. C. Neill, Dr. Charles P. Newsholme, Sir Arthur Neumann, Felix Neuman, Dr. Lester Nevills, Rev. Coleman, S.J. Nicholay, Miss Helen Nichols, Dr. H. J. Nichols, Dr. J. B. Nichols, Col. A. J., U. S. A. M. C. Noble, Gen. Robt. E., U. S. A. M. C. Ong, Dr. Harry A. O'Donoghue, Dr. John A. O'Donnell, Dr. William F. O'Malley, Dr. Mary Owen, Col. W. O., U. S. A. M. C. Owens, Dr. S. Logan Parker, Dr. Henry P. I'attisou, Terrell Peterson. Dr. George Pezold, Mathilda Pfender, Dr. Charles A. Pratt, W. S. Raker, Hon. and Mrs. John E. Ray. A. M. Reeside, Frank P. Reeves, Di-. W. P. Reichelderfer, Dr. L. H. Rench, Dr. V. B. Rudolph. Mr. and Mrs. Cuno H. Richardson. Dr. Charles W. Safford, Lieut. W. E., U. S. N. Sage, C. R. 250 ANNIVERSARY TRIBUTE Schreiber, Dr. Heury R. Seibert, Dr. E. K. Sexton, Dr. R. L. Shaiulelle, Rev. Henry J., S.J. Shugrue, Dr. J. J. Shute, Dr. D. K. Silve.ster. Dr. Richard L. Skinner, Dr. J. O. Sowers. Dr. William F. Si)igel. Dr. Harry Spofford. Florence P. Stafford, Justice W. P. Stanton. Dr. W, J. Sternberg, Mrs. George M. Stone, Dr. I. S. Streeter. Dr. Edward C. Stuart. Dr. Daniel D. V. Sullivan, Dr. Robert Y. Sutton, Dr. Richard N, Taylor. Dr. Bruce L. Taylor, Dr. L. H. Tewksbury, Dr. W. D. Thomas, Dr. Ada R. Thomas. Dr. John D. Thompson, Dr. J. Lawn Tindall, Dr. William Tondorf, Rev. Francis A., S.J. Townsend, Dr. J. G., U. S. P. H. Turpin. Perry B. Ufford. Mr. and Mrs. Walter S. \ auiihan. Dr. (ieorge Tully Van Schaick, Dr. John, Jr. \eil)rycke, Dr. .J. Russell Walker, Dr. Reginald B. Wak-ott. Dr. Charles D. Wall. Dr. Joseph S. Walsh. Rev. Edmund, S.J. Welch. Dr. William H. Wells. Dr. Walter A. West. Dr. and Mrs. R. Thomas White. Dr. Charles S. White, Dr. William A. ^Vhitmore. (\)1. Eugene. U. S. A. M. C. Wiley, Dr. Harvey W. Wilmer. Dr. William H. Wilson. George S. Willson, Dr. Prentiss Wolf, Hon. and Mrs Simon WoUenberg. Dr. and Mrs. U. A. Woodward. Dr. Robert S. Woodward. Dr. William C. AVynkoop, Dr. J. C. Yarrow, Dr. H. C. Zehuer, Harry 251 ANNIVERSARY TRIBUTE. Rev. John B. Creeden, S.J. President of Gcorgclo7ini Lhik'crsiiy. Bless us. O Lord, and these lliy gifts which of Thy hounty we are to par- take. May the useful life of him in whose honor we are gathered be prolonged through other decades in health and happiness. ^lay his example inspire in all of us an effective desire to imitate him in his de\'otedness to science and to philanthropy. 3ntro5urtorg S>pn(\} Francis R. Hagner, M.D. Pi'csidoit Medical Society, District of Coluiiibia. As president of the Medical Society of the District of Columbia, it becomes mv pleasant duty after the gastronomic treat we have just had, to open that part of our gathering which will consist in the enjoyment of a feast of a .different sort. It is a great pleasure to us to have present tonight representatives of the other scientific and civic societies to which our honored guest belongs. As everyone present is aware we have met here tonight to do honor to our colleague, Dr. George M. Kober, wdio has reached his seventieth milestone today, and I only hope if I survive the vicissitudes of life until I shall reach his age, I may wear the years as gracefully as he, and count upon the affec- tionate regard of so great a number of my confreres. The committee of arrangements has provided a regular program for your entertainment and therefore my part will be ended when I introduce to you the genial toastmaster of the evening, Dr. John Foote; I take great pleasure in intrfxlucing I^r. Foote. ©p? ntng AiiJirp00 of tl|p (Fcaatmafitpr Dr. John A. Foote. Mr. President, Ladies and Gentleinoi: Shortly after the American forces went to France we began to hear tales of stupendous task performed with incredible celerity by the American Engineers, so that after awhile it was said that the motto of this corps became : "It can't be done but there it is." 252 ANNIVERSARY TRIBUTE. We have assembled here tonight to celebrate the seventieth anniversarv of the birth of a man who has spent the greater part of a useful and busy life in our midst, and to testify by our presence here the pride which we feel in his career as a medical scientist, our admiration for his civic virtues and the love which we havq for him as a man. I have not said that we have come here to honor Dr. Kober, for there is no individual, no matter how distin- guished he may be in any field of knowledge, who can add anything to that honor which George ]\I. Kober has earned for himself. We have come here gladly to a rich and pleasant task and we have no desire to leave this duty to posterity. We feel indeed like the man who said : "What do I owe to posteriy? \Miat has posterity ever done for me?" Dr. Kober has done far more for posterity than posterity ever will be able to do for him, no matter how it may praise him. And, while it is true, to para- phrase the words of a favorite poet, that : ''Great men grozv greater by the lapse of time, JVe knozi.' those least zchoifi zve have seen the latest; And they 'niongst all zchosc )iaines haz'e grozini snblinie, Who icorked for human Jiappiness z\.'as greatest." Yet we can conceive nothing more appropriate than the ceremony in which we have so joyfully engaged this evening. Let no one think that this is a meeting in which we will say "Hail!" and then "Farewell !" \\'e have revised our estimate of "old" men in the lessons taught us by the great \\'orld War, and we know that to men like Dr. Kober the spirit of "76 means the years 76 and not the year '76. We know that he has the spirit of that great European statesman who said on his eighty-first birthday that while he had always understood that the first eighty years of a man's life were the most pleasant, he had now come to realize that a great many good things had been reserved for the second eighty vears. There are many here tonight who have l)een the associates of George M. Kober in his notable life work, some who are his peers in other branches of science. One of these left us alx)ut two years ago to accept the highest post in the health councils of a great northern city. We had long known him when he was with us for his crisp rhetoric, his certain logic and his swift gift of oratory, and after a year's l)urnishing attrition with the keenest nn'nds of that city whose own sons have on occasion admitted that she is the center of western culture, we may expect of him even greater accompli.shment tiiis 253 ANNIVERSARY TRIBUTE. evening. It has been well said. "Von can tell a man from Ijoston, but you cannot tell him very much." I take pleasure in introducing an old friend in the person of Dr. William C. W'oodward, Health Commissioner of the City of Boston. ir. iimtam (U. fflnabuiarb Health Coinniissioncr of Boston, Mass. Representing the Medical Society, District of Columbia. Mr. President, Our Honored Guest, Ladies and Gentlemen: My introduction by our genial toastmaster has been most embarrassing !o me, but it has relieved me of a large part of the sense of responsibility that previously I had felt. The rules of the evening provide, the toastmaster tells us, that for any failure in the program of the evening, he, and he alone, is resposible. For my shortcomings, therefore, you will please blame the toastmaster. In so far as shortcomings may be absent, I must beg of you to attribute that fact to the inspiration that must come to even the dullest head and the coldest heart, if human at all, on an occasion such as this. Sitting here among my many friends and associates, 1 can hardly realize why 1 should have been introduced as a gentleman from Boston. It is so natural and homelike to be here with you. But then it comes over me that I am no longer physically and bodily one of you, however much I may still be so in spirit, and I feel more deeply indebted even than before for the honor you of the Medical Society of the District of Columbia conferred upon me when you asked me to be your spokesman on this occasion. I am sure the honor comes through no merit of my own, unless it be a merit to esteem and love the society with which I have been so long identified, and to esteem and love our guest, Dr. Kober. Dr. George Martin Kober was born at y\lsfcld. (icrmany, in 1850, on March 28. In 1867, soon after the close of our Civil War and when he was a mere lad of seventeen, Kober came to the United States, and shortly thereafter entered the army and was assigned to the hospital corps. It was thus that he was put into the way of achieving a boyhood ambition to become a doctor of medicine. His first post of duty was at Carlisle Barracks, Pennsylvania, and there he kept the records of the hospital, acted as pharmacist, assisted in minor dressings, and discharged many of the duties of a clinical clerk. His youth and then .slight .stature. Dr. Kober says, exempted him from most of the 254 ANNIVERSARY TRIBUTE. usual duties of an orderly, but I surmise that his mental and moral strength, rather than any physical weakness, procured for him the superior opportunities that came with the duties assigned to him, to advance his knowledge of medicine. At any rate, the unusual qualities of the quiet, sincere, studious German lad attracted the attention of the medical officer at the post. Dr. |. J. B. Wright, and of Mrs. Wright, who thereafter lost no opportunity to help him toward his goal. Kober remained at Carlisle Barracks until January loth, 1870, when he received the appointment of Hospital Steward and was then sent to Frankford Arsenal. Either a knowledge of the esteem in which the lad was held at Carlisle Barracks had preceded him to Frankford Arsenal, or else the medical officer at the Arsenal, Dr. Robert Bruce Burns, was as discerning as Dr. W'right, at Carlisle Barracks, had been ; for every facility was extended to Kober here as at his former station to enlarge his knowledge of medicine. Frankford Arsenal was near enough Philadelphia to enable him to attend some of the lectures at the medical school of the University of Pennsylvania, then as now one of the leading medical schools in the United States, and by copying the notes taken by a student at the Arsenal who was able to attend regularly, a son of Dr. Burns, Kober was enabled to make substantial progress. Dr. Kober today, with modesty that is quite characteristic, is profuse in his acknowl- edgment of his obligation to Dr. and Mrs. Wright, and to Dr. Burns, and refers to his good fortune in coming under their guidance, but it is hardly likely that the good fortune came undeserved. It seldom does. The next step in Kober's advancement toward a medical career, came as an assignment to duty in the Surgeon General's office in Washington, in 1871. So far as the record shows this transfer was merely one of the ordinary changes of post that any man in the army must expect to befall him from time to time. Beneath the surface, however, we must recognize the hand of Providence '.hrough the discernment, wisdom, and great-heartedness of Dr. Wright, Dr. Bums, and the other friends in the army who had by that time taken a fancv to tlie very likable and friendly young Kober, now at the threshold of man- hood, and somewhat matured by four years of army life. The medical schools of Washington at that time gave their instruction in the evening, so that an ambitious young man might work during the daylight hours in a g(^vernment department or elsewhere to earn his livelihood, and devote his evening hours, liis holidays, and possibly his Sundays, to study and to clinical instruction. It was hard w<>rk. as those of us who jiave been throuoli it can tcstifv; hut ANNIVERSARY TRIBUTE. Kober was not afraid of hard work, and so he ijroniptly matriculated at the medical school of Georgetown University, where he came under the preceptor- ship of Dr. Johnson Eliot, one of the most distinguished physicians and sur- geons in Washington at that time. He was graduated as a doctor of medicine in the spring of 1873. Time will not permit any extended account of Kober's career in the medical school. One event of outstanding importance must be mentioned, however, for it marked an epoch in Kober's career, and has much to do with our present relations with him. For it was while Kober was .-till an undergraduate that his preceptor. Dr. Eliot, invited him to attend a meeting of the Medical vSociety. Kober gladly accepted the invitation, and from that time until he left Washington in July, 1874, he was present at every meeting. Promptly after graduation, Kober sought membership in the Medi- cal Society, but before his application was acted upon he had been appointed an acting assistant surgeon in the United States Army and had reported for duty as post surgeon at Alcatraz Island, California. The fact that he was iwentv-five hundred miles away for an indefinite period did not lessen his interest, however, and upon election, October 6, 1874, he accepted member- ship, and that membership he maintained continuously during his army life in the far West, upwards of twenty years, and has maintained ever since. Dr. Kober returned to Washington in 1889. The esteem in which he was then held by the medical profession, notwithstanding his prolonged absence, was well shown by his election in the very year of his return, as president of the Medical and Surgical Society of the District of Columbia. In 1898, he was elected president of the Medical Association of the District of Columbia. In 1903, he was elected president of the Medical Society of the District of Columbia, the highest honor within the gift of the local medical profession. In 191 5 he was president of the National Association for the Study and Pre- vention of Tuberculosis, now the National Tuberculosis Association. He has been dean of the Medical Department of Georgetown University since 1901. I might go on for the entire evening telling you of Dr. Kober's work, but to most of you his life of service is already an open book, and all of you, I know, are eager to hear the speakers who are to follow. And so with these remarks, a few words in appreciation of Dr. Kober's services, and a few words of congratulation to him on the attainment of this his seventieth birth- day, I might complete the very pleasant duty with which I have been honored bv the Medical Society — if Dr. Kober were just an average man. For the life and work of most of us, of the average man, can well be summed up in such a fashion as that wdiich I have thus far followed. A few 256 ANNIVERSARY TRIBUTE. dates, a few incidents of little or no lasting importance in the life of our profession or of the community, a few scjuare feet of earth, a mass of granite — and the life story of the average man has been told. But were I to attempt so to recount the work of Dr. Kober, in order that we might do honor to ins life of service, I should certainly fall far short of my obligation as the message-bearer of the Society on this occasion. Dr. Kober is not an average man, or else we would not be here this evening; for to his chosen profession, to the Medical Society, and the community he so diligently serves Dr. Kober has come to be something more than a mere flesh and blood man, something- more than a mere series of dates and incidents. He must be studied and appraised rather as an influence — a moral or spiritual influence, if you will — lending constantly, toward the enlarging and uplifting of the lives of those with whom he comes into contact : an influence that will continue to stimulate and direct the activities of the Medical Society long after Dr. Kober has been called from the field of his earthly labors — which, pray God, may be an event long delayed. If you were to ask me to name the secret of Dr. Kober's influence, I would answer first, loyalty, loyalty to an ideal. To the Medical Society — and it is for the Medical Society that I speak — he has been loyal first, loyal last, loyal at all times and above all things. Picture, if you please, the young Kober, iust turned twenty-one years, with all the temptations to idleness and pleasure incident to that age, with the burden of daily toil for his livelihood and evening and nightly toil for an education, and yet after his first introduction into tiie Medical Society, as a guest, never missing a meeting so long as he remained in Washington. Eollow him through nearly twenty years of absence, maintain- ing membership in the Society, without any incentive whatsoever beyond his bare loyalty to it. Then recall him, returning, his place in the medical pro- fession assured and with no intention of practicing medicine, and yet imme- diately resuming his position in the councils of the Society. How many of us would have done likewise? None, I venture to assert, and not more than a !-()rry few. I am sure. The record is. I believe, unique in the history of the Society. And after his return, trace his course througli the years that fol- lowed — always in his place in the deliberations of the Society, and excelled by no one in interest and zeal in its scientific program and professional and public activities, even right up to the present moment as he rounds out his seventieth year. Do you wonder at the esteem and affection of the Medical Society for Dr. Kober? 257 ANNIVERSARY TRIBUTE. But loyalty is not a thing that springs up without cause, when and where it will, and it may be well to inquire into the cause for Dr. Kober's loyalty to the Medical Society. We have already seen that his devotion could not have been due to any personal benefit that he might hope to derive, and we may well ask ourselves whether it may not have been due to some distinguish- ing merit in the Society itself or to the attributes of its members. Although uur pride may suffer by the admission, we must admit, it seems to me, that such was not the case ; it was Kober, not the Medical Society and not ourselves personally, that developed that spirit of loyalty that has marked his career. If you doubt it, search the long list of physicans admitted to membership since Kober became a member. How many of them have been bound to the Society or to ourselves by any such ties of devotion as has Kober, and yet all have had at least an equal opportunity, and many have had better. Merit there is in the Society and in its members, unmistakable merit, merit of a high order; else the Society would have long since perished. But it takes the exceptional man to find that merit, to analyze and appraise it, to avail of it, and build it up and strengthen it so that others may share in it the better; and Kober was one of those exceptional men. Early in life he came under the influence of an ideal — duty, duty, duty — and he has lived steadfastly up to it ; duty to his patients, duty to his fellow physicians, duty to the organized medical profession ; duty to his fellow man. The Medical Society was an agency that would fit him to discharge that duty, and it became, therefore, from his student days onw^ard, an object of untiring devotion. He owed it to his profession and to his fellow man, he thought, to keep himself abreast of the advances in the science and art of medicine, and the Medical Society was to him a ix)st-graduate school that enabled him to discharge that obligation. But the purely scientific and professional advantages to be gained by attend- ance on the meetings of the Medical Society and by participation in its activ- ities would hardly have bound Kober to the organization as he was bound. There was a human element in the atmosphere of the Society, however, that attracted him, for Kober has always been pre-eminently a lover of his fellow man. Whether that man was the Indian on the plains or in the mountains of the West, a dark-skinned brother in the alleys of Washington, a medical student struggling against odds like those that Kober had met and overcome, or a struggling member of the medical profession, it mattered not. Kober was his friend and brother. The Medical Society afforded a meeting place 258 ANNIVERSARY TRIBUTE. where he could come into contact with his fellow physicians, take part in their discussions, share in their joys and successes, sympathize w^ith them in their griefs -and failures, and promote the welfare of his chosen profession in the Capital City: and so he threw himself whole-heartedly into its work, admin- istrative, professional, and public. His investigation of typhoid fever in the {district in 1889 and again in 1895 ; his intense and prolonged labor in bringing ab(jut the proper filtration of the water supply of Washington; his activity for ihc improvement of the milk supply ; his energy and effort that led ultimately to the establishment of the tuberculosis hospital ; his early recognition of gonorrhea and syphilis as presenting grave social problems ; his fight in company with Gen- eral Sternberg, for the improvement of housing conditions ; his untiring, self- sacrificing labors as dean of the ^ledical School of Georgetown University in the interest of medical education in the District of Columbia and throughout the country; his labors in the interest of industrial medicine and sanitation; these mark some of the high points in Kober's professional career. And these, and his indefatigable energy in recording the results of his studies and observations so that others might reap the benefit of them, serve as a measure (;f a life that has brought honor and distinction on Kober as a physician, a sanitarian, and a philanthropist, and that has added to the credit of the .Medical Society, the scene of so much of his labors. But it is to the human side that we must always recur if we would see the true Kober — always simple, straightforward, honest, friendly, self-forgetting. One of his associates said to me only this afternoon: "I always liked Dr. Kober: lie always tells the truth." It is a sad c(Mnmentary on our ])resent nifjral standards that a man should be chosen for a friend because he always lells the truth, yet how many of us do. But the observation concerning Dr. Kober was true: he always tells the truth. Who here has ever even so much as suspected him of prevaricating for the sake of policy or expediency, or even of evading or beating about the bush when truth was called for. As must already have become apparent from the picture I have drawn. Dr. Kober is withal a man of profound religious convictions — not in the sense of one who adheres to form or creed but as one in wlmm the .si)irit of religion in its \ery essence lives and breathes and directs and controls his daily life: a man with no religion to talk of and wear on his coat sleeve, but with a religion to live by. In one of our more intimate mcmonts. Dr. Kober told me of a conversation he once had with one of the venerable elders of one of the Indian tribes with whom he came into contact during his life in the Great West — a conversation about the Great Father and his divine control over the affairs 259 ANNIVERSARY TRIBUTE. of this life, and about the hfe to come — and often since then I have had pass before me as I thought of Kober, the young army surgeon and the venerable old Indian, before the camp fire, out under the canopy of the heavens, dis- cussing the eternal truths as we poor mortals, white man and Indian alike, reach out to grasp them. It has been, I believe, his recognition and acknowl- edgment in his daily life of all mankind as brothers, and of a Divine Provi- dence in the affairs of men, that have made Kober what he is to us today. Truly, the Medical Society of the District of Columbia has occasion to be proud of George Martin Kober. Truly, it is indebted to him for the work he has done and the influence he has exerted over it. Throughout his pro- fessional career he has stood for the best there is in medicine; with Busey, Eliot, and Johnston, wMth P'ord Thompson, and Morgan, and Toner, and a host of others too numerous to mention, in Washington and elsewhere, whose lives have been devoted to the alleviation of the sufferings of mankind and the uplift of the human race. Truly, the Medical Society is but doing itself an honor in acknowledging as it does this evening its indebtedness to Dr. Kober and its esteem and affection for him. Dr. Kober, I pray that you accept from me, therefore, on behalf of the Medical Society, its congratulations on the attainment of this your seventieth birthday. I have been instructed by the Society to acknowledge its indebtedness to you for the work you have done and the influence you have exerted over it. The Society is proud to number you among the very foremost of its members who have brought honor and distinction to it, at home and throughout the land. And it is the prayer of the Society that you may long be spared in your life of service to your fellow men to enjoy the fruits of your labors and to live in the understanding and appreciation of the great esteem and love that we of the Medical Society bear toward you. The Toastmaster — Introducing Professor William H. Holmes. One of Dr. Kober's attributes is thoroughness. This is true of his scholar- ship as well as of his work. We have long known him as a philanthropist, but he is equally well known as an anthropologist. Dr. Kober loves his fellow'-man so well that he is even interested in his natural history. He has been a member of the Anthropological Society of Washington for many years and is a former president of that body. Many members of the Anthropo- logical Society are here tonight and they haxe chosen to speak for them a former president of the local society who is internationally known as a scientist. He has been president of the Washington Academy of Sciences, 260 ANNIVERSARY TRIBUTE. of the Cosmos Club and is the directing force of the National Academy of \rt and the Anthropological Section of the National Museum. It gives me pleasure to introduce Mr. William H. Holmes. ProffBBor MtUtam % Holntpa. Head Curator Department of Aiithropoloyy, U. S. Xational Miiseiim. Representing the Anthropological Society. I am greatly honored and greatly pleased to be accorded the privilege of saying a word on the occasion of the seventieth anniversary of the appearance of Dr. George M. Kober upon the world stage and to be asked to represent the Anthropological Society of Washington in doing homage to its president 3n the thirty-third anniversary of its organization. Dr. Kober's career has been a long, an arduous and a most honorable one, and at 70 he is still in the foremost rank of the advancing columns of science, education and humanization ; while about him are a multitude of the voungfer generation who have grown up under his influence and who are, in turn, press- ing forward into new fields, profiting always by his experience and inspired by his example. There are those present who have a much more intimate knowledge of the Doctor's professional career than I claim and they will doubtless be heard from, and I am thus tempted, at the risk of introducing myself unduly into the story, to recall certain coincidental linkings of his career and mine during the nearly half century of our association with the national service. In 1871, two young fellows reached Washington and began their life work; the one from the valley of the Rhine, the other from the American Rhine — the Ohio. Both at once found employment ; the one in Georgetown University and the other in the Smithsonian Institute. I-'ive years later, while the one was acting as surgeon with the military expedition against hostile Indians in southeastern Nevada, the other, in charge of the San [uan division of Survey of the Territories, was just across the border in Arizona having serious trouble with the treacherous Piutes. Whilst the one. durino- his service in Nevada, turned his attention toward the physical characteristics of the tribes and to the study and collection of their skeletal remains, the other, as a result of his work among the cliff dwellings of the Mesa Verde country, turned his attention from the field of geology to that of archeology and finally to that of anthropology. 261 ANNIVERSARY 1^ R I B U T E . It happened further that the great collection of skeletal remains of the Indian trihcs, to which the one contrihuted while on duty as surgeon in the field, which later was assenihled in the Army Medical Museum, was, through thf .'.gencv of the other, transferred to the United vStates National Museum, leading thus ip the estahlishment of the Division of Physical Anthropology and to the selection of Dr. Ales Hrdlicka as Curator. This was in due course followed hv the founding of the Journal of Physical Anthropology of which Dr. Koher is an associate editor; and the two lives have thus come again in louch, for while the one as President of the Anthropological Society of Washington is here on his seventieth anniversary to receive the commendation of a multitude of friends, the other is here to hand him as a token of their esteem a special copy of the Journal which lioth, under the direct instru- mentalitv of Dr. Hrdlicka, were instrumental in founding. To you, sir, on behalf of the Anthropological Society of Washington — a .'society to which you have belonged for many years and which you have hon- ored by becoming its president, I have to say that we are especially gratified [o have this opportunity of further manifesting our appreciation of your services to the society, to the country, and to the nation, and especially of expressing our admiration for the qualities of mind and heart which have so endeared you to all. The Toastmaster — Introducing the Hon. Henry B. F. Macfarland. Xo one has had a more keen interest in the health of this community than Dr. Kober. Manv of his sanitary investigations were begun primarily to help local conditions. It is only fitting that the ci\ic and economic associa- tions of tlie city should ha\'e representation at this meeting and have voice as well as presence at this gathering. 1die gentleman who will next address you is so identified witli affairs of the District of Columbia that he has Ijecome almost a godfather to this or|)han community. Speaking for the District of Columbia is nrj new experience for him. In 1900, he delivered the official address at the White House of the Xational Capital Centennial. .\t the P)uffalo I'Lxposition, the St. Louis Exposition and the Jamestown lvx])osition he was the chosen orator for the District Day I^xercises. h'or ten years he was chairman of the lioard of Commissioners of the District of Columbia, and his interest in kjcal affairs has never lessened. 1 take great pleasure in mtroducing the Hon. Henry B. F. Macfarland. 2{i2 ANNIVERSARY TRIBUTE. Mm, limt^ 1. iF. Marfarknb Formerly President of the Board of Commissioners of the District of Columbia Representing the Civic Organizations, District of Columbia. Aristotle said that a city was a place where men work together for noble ends. That would be an ideal city. But in every city there are men who are working together for noble ends, men who are willing to make sacrifices that they may give service. Washington is rich in such men and equally rich in women of the same spirit and devotion. No other city surpasses It in this respect. The charge so frequently made that there is lack of public spirit here and tlierefore lack of self-sacrificing service of the public is absolutely false. One value of such an occasion as this is that it enables us to give the lie to such a charge. So we are honoring our city by honor- ing our guest, for he is typical of the civic patriots who make the most of opportunity in the service of the national capital. They have the satisfaction of knowing, as in this case, that what they do here is seen all over the country by those who are looking for examples of civic service and that they benefit not only Washington, but the United States. Sometimes this is said to be a thankless task. It is often so. But we ought to give thanks not only as reward, but as encouragement. "Our praises are our wages" and men are working for them as for no other wages. Therefore tonight we heartily thank Dr. Kober for his service to our community and to our country through its capital. For thirty years, Dr. Kober has been identified with practically every movement for social welfare of the national capital. He has been an exam- ple to those who, retired from active life, come here to live. He recognized at once his obligation to the community. With his sense of duty, he could not be a parasite. Ever since he came to Washington, he has been active in public service. He became a member of the Board of Managers of the .\ssociated Charities in 1895, one of his first public efforts here and has been ever since faithful to the duties of that office as a member of the F.xecutive and other standing committees and in the line of all his efforts to promote thrift particularly active through the agency of the Committee on Provident Plans. In 1906, he was a])pointed l)y I^resident Roosevelt a member of the P)oard (jf Charities. He has served continuously as a member of the Committee on Medical Charities. He designed the Tuberculosis Hospital which was opened ANNIVERSARY TRIBUTE. in 1908 on the Georgia Avenue tract which the Conunissioners had acquired for a municipal hospital. The Sixth International Congress on Tuberculosis iield in Washington in 1908 awarded him a medal for the design of this hos- pital. He was a pioneer in the campaign against tuberculosis, one of the founders and always a leader in the local Association for the Prevention of Tuberculosis and a leader also in the National Association of which he was president in 1915. President Roosevelt in 1907, appointed him a member of the Presidents' Homes Commission. He was chairman of the Committee on Social Better- ment and as such prepared monographs on Industrial Hygiene and Social Betterment, published in 1908 as Senate Document No. 644. One of the founders of the Washington Sanitary Improvement Company, organized in 1897, and also of the Washington Sanitary Housing Company, organized in 1904, he served for years as secretary and latterly for a number of years as president of both companies. . He has been a member and active worker in the Monday Evening Club, the Civic Center, Social Hygiene Association and Playground Association. He has endowed scholarships for excellence in Domestic Economy in the Public Schools. But then I fail to enumerate all about this model citizen of the National Capital; and after all it is the spirit in which these services have been rendered, rather than the quality and cpiantity of the service that was given, of which Vve think first and most tonight. There are men in Washington who get discouraged because they have no political opportunity in the District of Columbia.. They say we are not citizens of the District of Columbia, we have none of the political duties of the District of Columbia ; why should we care? Why should we take any interest in the affairs of our city? The time will come, I believe, when we shall have national representation in the Senate, the House, and Electoral College, and we shall have full scope for our political talent and activity when it will be no longer possible for our friend from Britain to smile as a reminder that we fought the Revolutionary War for the principle that "Taxation without Representation is Tyranny." But until that time comes, and it may be distant, we shall have constantly before us the common task of the common citizen of any community. And if we have the spirit of Doctor Kober we shall do that ta.sk with the zest, the enthusiasm, the thoroughness, and therefore with the success, whicli has brought us all here tonight in affection and admiration. 264 A N N I \^ E R S A R Y TRIBUTE. The Toastmaster — Introducing Dr. Robert S. Woodward. Several vears before Dr. Kober was born, a Scotch immigrant lad began to work in a mill near Alleghany Pennsylvania, at a salary of $1.20 a week. Last year this boy died after having given away to varicnis philanthrcjpies over $300,000,000. One of the most important of these l)enefactions. the Carnegie Institution of \\'ashington. was founded in 1903. Great difficult) w.'is experienced in finding a suitable head for this new type of research insti- tution, until the governing body discovered their ideal in a fannuis research worker who was at that time head of the Department of Pure Science of Columbia Universitv. Under the care and direction of this eminent scientist the notable achievements of the Carnegie Institute of Washington have been ;iccomplished. X6 one could be better qualified to speak for the scientific societies of Washington — included in the Washington Academy of Sciences than Dr. Woodward. Writing his acceptance of the committee's invitation, he said: "You can count on me to help sound the praises of our colleague and to abuse liim appropriately for his delay in joining the septuagenarians." I take pleasure in introducing Dr. Robert S. Woodward, President of the Carnegie Institution oi Washington, President of the Carnegie Institntiun of Ji'asliiiu/ton. Representing the Jl'asliington Academy of Sciences. It is a rare and a happy privilege accorded us tonight to celebrate the attainment tothe ranks of the septuagenarians of our friend and colleague and coadjutor in all good works, Dr. Kober. It is a special personal privilege, since, having preceded him by many months, nearly a whole year, indeed, in arri\- ing at the ])ro\'erbial threc-score-and-tcn e])och, I am tliercln- i)ernu'tted to patronize him a little and to tell you in his presence of the high esteem in which we all hold him. It is a si>ecial source of relief also at this time lo turn from the turmoil of the affairs of a sadly shattered, if not wrecked, world to a consideration of the altruistic labors and achievements of our versatile, unpretentious, indefatigable and always effective associate. Dr. Kober. The value of a man to society is measiu^cd by the work he accomplishes. 'I'bis ma\- be cither of immediate or of futiUT benefit to our race. The work 265 ANNIVERSARY TRIBUTE. uf Dr. Kober is conspicuous in both these respects ; he has not only sought to remedy existing- ills but to prevent their recurrence and to forestall the development of new ills. His vision comprehends at once the past, the present, :ind the future. He has proved himself to possess both the insight and the foresight uf a prophet in the best sense of the word. His activities in the j^iromotion of sound sanitation, from its foundation up, and his preaching and practice in right living make him one of the leaders of progressive |)athology. But I presume the best service he has given to society is that rendered as Dean of the Medical Faculty of Georgetown University. Having had some experience in the business of a deanship and allied occupations, I am disposed lo bow in admiration to any man who can serve a faculty for twenty years in such a capacity. A dean has a difficult and often thankless task. It is his duty to stand between the conservative body of trustees, or governors, on the one hand, and the commonly impetuous members of the faculty on the other hand. It is his duty to recognize facts and to secure the working- relations of reciprocity between these two groups. His capacity and reputa- tion are always under strain and often in peril. Only men with sound diges- tion and a lively sense of humor and proportion can survive. In Dr. Kober's case, however, the indispensable relation of reciprocity just referred to have been furnished in high degree I mistake not, by the university and by the faculty he serves. I am an outsider, as you are well aware, and may not pretend to know much about Georgetown University. Nevertheless, I began making observatifMis on this academic establishment more than thirty vears ago, when I had the good fortune to become acquainted with Father Ilagen. then in charge of the University Observatory and now (and for years past) in charge of the Vatican Observatory in Rome. It was plain that a fine, high spirit and practice prevailed at the 'University then and it lias become plainer and more impressive as the years have passed. Naturally, in recent years I have heard more of the medical college and of the Georgetown Hospital than of other branches of the University. As a man grows older and more and more in need of repairs, precaution requires him to contemplate the beneficent provision now made in our leading hospitals for bodily derangements. It has been my privilege also to know intimately of the skillful and the merciful treatment accorded at the Hospital to a numlier of close friends, friends ranging through all walks of life. We have not met on this occasion to moralize. It is an occasion rather for felicitation and for good fellowship. I may be pardoned, however, for 266 A N N I \^ E R S A R Y TRIBUTE. recalling your attention to the principles for which colleges, universities and other altruistic establishments stand. They are the principles which have survived throughout the ages. They have flourished even amid the ruins of empires. They are espoused, upheld and effectively applied by only a rela- tively small number of representatives of our race. There is much evidence in contemporary events to indicate that such representatives are now needed as never before. All hail, therefore, to Dr. Kober and men of his kind! Let us welcome him as a sage of seventy but indulge the hope that he will long remain young. The Toastmaster — Introducing Dr. Harvey W. Wiley. A much traveled visitor to Washington during the war period, wlio was :i guest at the Cosmos Club, said that he had never before seen so many dis- linguished men regularlv assembled under one roof. Modesty is a \irtue which no toastmaster should possess, so I will have to find some other reason for not telling vou of the high standard of membership in this club — l)esides there are manv members of the club here tonight who might perhaps blush. It will be no exaggeration, however, to say that to have been president of ihis famous organization implies a greater degree of scholarship and achieve- ment than is represented liy the highest academic honor in the gift of an)- .'f the universities. It is fitting that a former president of the club should sjjeak of Dr. Kober's connection with it. This gentleman in writing his acceptance said: "I shall be glad to speak after the dinner and tell him what a bov will) was six vears old when he was born thinks of this callow \outh." \'ou will recognize the writer when I tell you that he is "The foremost authority *on the chemistry of foods." and the only table he has ncn madt- absolutely safe is the peace table. Dr. Harvey Wiley really needs no introduction. Sr. ^nrvH} W, fflilru Director uf Hurcmi of Foods, Saiiitadoii and Health. Representing ilic Cosmos Club. Mr. Symposiarch: In your letter whicli I received in regard to this celebration. 1 was told "that I was to represent the Cosmos Club. Xow. fortunately, the day has passed when I can represent the Cosmos Clul) and I doubt if there is any living t^or.son who could represent that remarkal)le aggregation of intelligence, ANNIVERSARY TRIBUTE. learning, philosophy, pathology and patriotism. 1 shall not attempt to speak for the club, but what I s^y shall be from my own heart. I nave known Dr. Kober for nearly a third of a century. I am inclined to bestow upon him the appellation "right man." I have had some oppor- tunity to ascertain Dr. Kober's attitude on many great problems affecting human welfare and 1 have ne\er known him to be on the wrong side. You may be interested in knowing how I reached this decision. It is a perfectly simple method which any of you can adopt. In every one of these questions lo which I refer Dr. Kober has been on my side. I have not sounded him vet on Albert Einstein's theory respecting the mental delinquency of Isaac Newton, but I have no doubt when he does make up his mind on that point he will be right, much as Mr. Newton might protest. I am free to confess also that I do not know his attitude on the League of Nations, but I have great faith in my belief that when he does chance to express himself you will find him again occupying the same old position. I will urge him, however, if he desires to be recorded in the matter before the funeral takes place, that he might do well to tell his patient just where he stands now. Almost every- body feels like saying a good word for a corpse. What I recall with most delight and pleasure in my association with the guest of the evening is the great fight that we put up for the Pure Food and J^rug Law. Dr. Kober was always to be had on demand. In the 25 years in which this legislation was considered before the Committees of Congress, Dr. Kober was always an interested and helpful attendant. No kind of sophistry on the part of those members of the Committee who wanted to be "shown," ever in the least disturbed his self-poise, his suavity, or' his ability U> answer the puzzling questions. When he was urged to consider the fact that the mea^ires which he espoused would "ruin business," he did not respond as he might well have done, "business be damned," but he proceeded to impress upon the Committee that the welfare of humanity, the health of the people and their proper nourishment were a great deal more important problems than the accumulation of wealth by a few trading in adulterated and misbranded products. So calm was he in his consideration of the sub- ject, so forceful in his attitude and so truthful in his replies that he always came ofif victor in these encounters with the Committee. I have had the honor and pleasure of being associated with Dr. Kober in his lifetime devotion to the conquering oi tuberculosis. I do not recall ever having been present at a meeting of the Directors of the Anti-Tuberculosis 26.S ANNIVERSARY TRIBUTE. Society in the District of Columbia at which he was not present. I regret that owing to many circumstances over which I had no control, he has had many opportunities to note my own absence from these meetings. Dr. Kober early perceived that prophylactic medicine was a greater factor in human welfare than therapeutic medicine. He has, therefore, given all his time, his ability and his means largely in this direction. His monumental work on "Occupational Diseases and Their Control" is an evidence of his zeal, his mastery of the theme, and his helpful instructive work. Those who are able to drive a motor car have often noticed that in one make, quite com- mon, there seems to be an innate faculty of self reparation. For instance, if in driving a Ford one of the cylinders misses fire, you need not get out with a monkey wrench and a screw driver and repair the trouble. All you have to do is to keep on going and presently all will go well. This is a practice which leads one to follow that school of medicine which very properly regards the human body as a Ford motor car, capable of restoring of itself any dis- located parts. All you have to do is just to let "natur caper," and one great function of preventive medicine is to see that nature has a chance to "caper" properly. We have long since learned that drugs do not cure. They may sometimes aid nature, but they never can function when nature gives up the job. He has realized throughout his later life at least, that sanitation, diet, exercise, sleep, play and favorable environment, condition the true vis mcdi- catrix naturae. In doing this Dr. Kober has not become an osteopath to crack jokes on spinal columns and thus relieve human ills. He has main- tained his view of a true physiologist who sees in the human body the most wonderful complex yet discovered, but nevertheless governed by an unalter- able law. He would not send his ailing watch to a blacksmith for repairs, nor his ailing body to an osteopath. Dr. Kober has fortunately iDeen so situated as to give the greater part of his time to help humanity. If everyone were animated by the same spirit which he has always shown, then the greatest blessing that could come to a man would be to be born with an income so that he might give all his work to philanthnjpy. In that case, however, Hamlet would soon be minus a job as there would be no one needing help. The man who closes his eye? to the "will o' the wisp" of fortune-making, and sees only the work he can do for human l)etterment deserves all the praise. We have come to look upon the acquisition of wealth as the only measure of success. We have al.so seen some illustrations of the men who acquire wealth who have given most gen- erously to human improvement. In the last few years we have seen legisla- 260 ANNIVERSARY TRIBUTE. tive efforts which tend to rehe\'e the wealthy of a hirge part of their means, in some instances up to 65% of their tcHal income. How mucli better it would be if we had in this country the same public spirit which ruled Athens in the glorious days of (ireek civilization. .Mthoug'h there was no law to that effect, yet public opinion was so strong in that center of culture as to j)revent a man from accumulating wealth for his own use. He gave his wealth freely to the state and lived himself in a humble home such as the ordinary citizen of Athens inhabited. Dr. Kober has always been actuated by the noble spirit of the civic life of Athens. Usually when one reaches the dignity of septuagenarian it is expected that ihe younger members of the community shall do him honor. I feel, there- fore, that I am particularly favored in having been selected as one of those who came to do him honor and still look upon him as a boy. I love to encourage youth. I remember Gladstone's great work entitled "J'-i^'^'''ti-is Mundi," written when he had reached his eightieth year and as Gladstone looked down on that sea of youth to which he ascribed the hope and salvation of the w^orld, so do I look down on this youth whom we honor here tonight and trust that now at the threshold of his great career he may keep that strength and courage, that hope and ambition which he has manifested in his boyish days and that now as he steps into the full light and activity of adolescent maturity he may keep his gaze, as he has already done, on the high mark which he has set, that he may fail not in his aspirations for the betterment of the community, and when, as an octogenarian, he looks back on the most fruitful decennial period of his life, he may feel that he has hitched bis chariot to a star and the hitcliing strap has never been broken. The Toastmaster — Introducing Dr. Charles W. Richardson. One of the first and most important tasks which confronted the Medical Society in arranging for this evening's event was the selection of a chairman. It was conceded that the one who was to hold this tried position must be an old and tried member of the Medical Society and must ha\e an unusual capacity for organization. The chairman who was selected has already testi- fied to his capacity for organization by the success of this event. He is a man distinguished in the surgical specialty which has been his life work, called to many posts of honor in the associations of those devoted to rhinology and otology, and distinguished and honored for his work in the office of the Sur- geon General and elsewhere during the great World War. He has something Presented to George ::.:•.:.. ....;. .!../.. i.L.D., Soldier, Seieiitist, Pliysieiaii Philanthropist, by the Medical Society of the District of Columbia and Allied Scientifie and Civic So(i((ie^^ on his Seventieth Birthday, March 28, 1920. i/'((/ ANNIVERSARY TRIBUTE. very important to say both to Dr. Kober and to the guests at this dinner this evening and I will waste no further words in introducing Dr. Charles W. Richardson, Chairman of the Committee on Arrangements for this evening's function. President American Otological Society: President American Laryngological Rhinological and Otological Society; At present Trustee Ainerican- Medical Association. Dr. George Martin Kober — This day, the anniversary of your seventieth birthday, the Medical Society of the District of Columbia and allied scientific and civic organizations honor themselves in bearing tribute to you. We are proud of the fact that each of the contributing organizations here assembled claim you as their own ; but we of the medical profession are prouder of the fact that we have had you in our fellowship longer. This is manifest fur- ther from the evidences you bear of our training, for without this training and the broad humanitarian principles developed in you out of your medical experi- ence, it is possible, but not probable that your mind would have been directed along the various social, civic and philanthropic efforts, to which you have directed your attention during the latter days of your eventful career. You are a living demonstration of what a man of vision, capacity, scientific tiaining, with indomitable courage and persistence may accomplish within three score and ten years. You., sir. epitomize the honor of labor. In whatever field of labor you entered, you gave to it your uttermost efforts. What an example you offer to the youth of the present age! Distinguished in medicine, hygiene, anthropology, general science, soci- .logy, philanthropy, you stand today in your seventieth year as one whom this as.semblage and the community at large take pride in honoring. And as a special mark of affectionate esteem for you the pleasant task has been accorded me of placing in your hands this emblem of our pride, confidence and admiration. When this evening with its addresses and delightful sur- '•oundings is all but a memory you may turn to this emblem as the material evidences of the well wishes of your friends for the remaining happy years that are to come to you, "Your health toiight Take from this board of friendly hearts The memory of a proud delight." 271 ANNIVERSARY TRIBUTE. Deem of the Georgetown Medical ScJwol. Response. Mr. President, Friends and Colleagues: I thank you from the depths of my heart for this evidence of good will and esteem. Your kindness and the heautiful words spoken are overwhelming and I find it difficult to give adequate expression of my gratitude. When =,T, years ago I landed in New York Harljor, I was indeed a vouth without a country. My father, a German revolutionist of 1848, had vowed that none of his sons should serve under a German prince, king or potentate, and upon arriving at military age one after the other renounced allegiance to the Grand Duke of Hesse, and sought refuge in this hospitable country, the home of the free and the brave. If, in the course of years, I have become a useful citizen of my adopted country, I owe it not only to the inspiration of my dear father, who shared the ideals of men like Carl Schurz, but also in large part to my good American friends who always acted upon the Golden Rule. After four years service in the Army I met Senator Schurz in Washington, in 1 87 1, and became a ready convert to his doctrines on the Americanization of the German element in this country. There were at that time between five and six thousand German born citizens in this city- — all engaged in useful occupations and many of their descendants occupy prominent positions in business and the skilled trades today. It is true they had a German news- paper founded in 1854 by a former townsman of mine — they also had their singing societies, sporting, athletic and dramatic clubs and churches in which the services were conducted in German, because they were in the transition stage and had to acquire a new language. But at heart they were all true Americans, and during the Civil War, the editor of the German Journal organized a battalion of Germans, left his printing office and fought for the preservation of the Union. His son, Edward Koch, has been connected with ihe United States Census Bureau for many years and is Chief of the Division of Population of the present census. These German gatherings were not infrequently graced by the presence of members of the Cabinet and other men prominent in public life. Senator Schurz and our fellow citizen, the Honorable Simon Wolf, never lost an opportunity on such occasions to impress upon the Germans the ijnportance 272 A N N 1 V E R S .\ R Y TRIBUTE. oi speedy Americanization. My own contribution to the movement con- sisted in my opposition, in 1874, to the organization of a German Dispensary. but I did aid in the reorganization of the Central Dispensary and the appoint- ment of a few (lerman speaking physicians on the dispensary staff. In this I was ably supported by my friend, the publisher of the German Joiinml. I could accomplish my aim all the more readily, as my prospective appointment in the army and removal to the Pacific Coast precluded all suspicion of sel- fish motives. 1 look upon my early life in Washington, from September, 187 1, to fulv. 1874. as arduous but extremely profitable. In addition to my duties in the Surgeon-General's Office I attended the evening courses at Georgetown Med- ical College, and have sincerely grateful recollections of my professors and my earnest fellow students. As pointed out by Dr. William C. \\'oodward, I enjoyed the privilege of attending the meetings of the Medical Society of the District of Columbia as a Senior medical student, but had little suspicion then that I would at some future time be tendered a complimentarv dinner bv the members thereof and receive enconium for my activities in this Society. I fear my former chief has deviated from his usual judicious temper and. like many others befitting an occasion of this kind, has become an over-indulgent critic. He has failed to tell you that 1 have only partially discharged my obligations to the Society and this community and that without your co-oper- ation my feeble efforts would have been in vain. I must own here that whatever success I may have attained in my professional career is largely due to the teachings and example of men of the type of Busey, Elic^, Johnston- Mackall, Ashford, Morgan. Ford Thompson and a host of others who espe- cially impressed me by their steadfast purpose to keep abreast with the pro- gress of medical science. I sincerely hope that every physician, young and o\(\ alike, will enroll in the ranks of builders of our Medical Temple, where study, honesty and truth serve as watchwords. I still am convinced that a medical society is a graduate school in which the members teach each other. This form nf education cannot fail to prove of value not only to the members. but also to the public at large. Indeed the progress of sanitation of the Xational capital is intimately connected with the history of our old and lionorable institution. 1 extend my heartiest thanks to I'residcnt llagncr to Toaslmaslcr l'"oole and to two of my oldest yet ye as fruitful in friends and achievements as the last have been. W. W. Keen. ( Philadelphia.) Dear Doctor Richardson: The annoiuicement of the dinner to be gi\en to Dr. Kober has just been leceived. 1 should be only too delighted if it were possible for me to attenil, but I am sure that this is out of the (juestion. Will yon not express to Dr. Kober my sincere regrets and mv great adnn'ration iny his untiring interest :;7i) A N N I V E R S .V R Y TRIBUTE. in and devotion to all activities and measures designed to promote the advance- men of medicine and public health. \\'ith many regrets that 1 cannot attend the dinner. I am Very sincerely yours, Herman ]M. Biggs. Dear Dr. Richardson: I have been hoping to be able to attend the complimentary dinner to be given to Dr. George M. Kober on his seventieth birthday by the Medical Society of the District of Columbia and other scientific and civic organizations on March 27th. but find that owing to circumstances over which I have no control, it will be impossible for me to be present. It has been my good fortune to be in a position to number Dr. Kober among mv valued friends. I have long felt that he belongs to a small group of lofty idealists — men who have a vision and consistently and persistently pur- sue that vision. Such men who we dare to call our professional brethren deserve our gratitude for the inspiration experienced through their example. It is not so much perhaps the result of their intellectual power as their elevat- ing and stimulating influence, which gives us a higher and in every way, superior perspective of life. How cheerfully I should sIkjw my appreciation of Dr. Kober's long and useful life by indicating my presence at the ban(|uet, if this were possible. Please pardon the liberty I have taken to express my feeble tribute to a real hero and ornament of our noble profession. J. M. A'nders. (Philadelphia.) My dear Rr. Richardson : Dr. George M. Kober has done so much to advance medicine and the intei- ests of the medical profession in this country that I should be most happy to join in a complimentary dinner to him on the occasion of his seventieth birthday. Unfortunately, it will not be possible for me to leave Philadelphia on March 27th. I trust you will be good enough to extend to Dr. Kober my best wishes for many more years of health and happiness. As long as the world is interested in industrial medicine and occupational diseases, Dr. Kober's work in that field will keep his name alive. David Riesman. (Philadelphia.) 2ii0 ANNIVERSARY TRIBUTE. My dear Dr. Richardson: I am very sorry that I shall not be able to participate in the dinner to be given to Dr. Kober on the seventieth anniversary of his birthday. I have known him and esteemed him highly for a long time. We were together on the Counsel of the Association of American Physicians for a good many years, — he as Secretary and I as Treasurer. My congratulations go with this, even though I cannot be present. L. P. Crozier Griffith. (Riiladelphia.) My dear Dr. Richardson: Your invitation to the complimentary dinner to be tendered to Dr. George M. Kober in commemoration of his seventieth birthday, on March 2"/, 1920, was received during my absence and was handed to me on my return to the city a day or so ago. I am very sorry indeed that it will not l>e possible for me to be with vou on what should be a very memorable evening. Dr. Kober's services to indus- trial hygiene and the advancement of public health in the United States cover- ing many years of tremendous activities have left lasting results which are almost incalculable in value. It is a delight to us who have known him many years to realize that he is still in the enjoyment of the best of health, and that we may have a continuation of his admirable services for many years to come. I hope on an early occasion to have the opportunity of extending my con- gratulations to Dr. Kober in person. Should this however not occur prior to the time of the dinner, may I ask you to extend to him for me the good wishes of all his colleagues who really have no fitting way of expressing their admiration for him and for the splendid services which he has rendered. Lee K. Frankel. (Metropolitan Life Insurance Co.) Dear Dr. Richardson: I am exceedingly sorry but I shall not be able to get to Washington for the (Hnner to be given in honor of Dr. Kober. I would be glad to give proof of my personal friendship for Dr. Koj)er and my admiration of his unselfish devotion and intelligent work for the good of humanity. L'nfortunatelv. I cannot get away from Xew York at that time. Please expres.s my deep regret to Dr. Kober as well as to your committee. Sincerely yours, J. M. Glenn, Russel) Sage Foundation, New York. ANNIVERSARY TRIBUTE. Dear Doctor Kobcr: ' It is with sincere regret that 1 find (owing- to a coriza cold) thai 1 sliall not be able to l)e present at the banquet given in your honor this evening. Through all the years that I have known and been associated w'ith you in various scientific activities in Washington. I have always had the greatest regard for vour continuity i)f purpose, sincerity, and self-al)negation if only the result desired could be secured. J trust that the inspiration of the banquet will act as a compelling force to sustain you in your good work for a decade to come, and thai ten years from now your friends may ]ia\-e the opportunity of again paying their tribute of friendship, respect and admiration. Sincerely yours, Charles D. Walcott, Secretarv Smithsonian Institution. Army Medical School. Washington, D. C, April 12th, 1920. Rev. Francis A. Tondorf. S.J., Editor Koljer Anniversary Tribute, (ieorgetown University, Washington, D. C. My Dear Sir: Answering your note of April loth, I may say that Dr. Kober is one of my old friends for whom I have a great admiration. I am glad' that in his youth, when he came to the United States, the Medical Department of the Army knew a good man when they saw one and therefore were of assistance in starting Dr. Kober on his long and honorable career. I was associated in 1911 and 1912 with Dr. Kober in the organization of the Congress of Hygiene and Demography which met in this city — rather an historic occasion as it was the last of many of these important international congresses, and it seems very unlikely, in view of the world disturbance, that others of the same nature will be held for many years. Dr. Kober w'as the President of one of the most important sections of that Congress and performed his important functions with distinguished credit to himself and American medical science. Sincerely yours, Walter D. McCaw. Brigadier-General. A.sst. Surgeon General, U. S. Army. 282 ANNIVERSARY TRIBUTE lEBER Onkcl'.—Hochcrfrcut, Gvatulicrcn i^'ir Dir hciit, Jl'ir siiid hicr im Gcisfc nah Bci Dir in Aincrika Und dcr trautc Muttcrlaiit Griisst Dick licitt als siissc Brant. Wo ZL'ir Dciner Jngcnd dcnkcn Und das Deutsche Here Dir sclienken. Wo dein Wieyenfest erschienen Wollcn zcir Dick froli hcdicncn. , Weil Du schon von Jngcnd an ■ Vielen Menschcn wohlyetan. Dnrcli Dein'n Gcist und ticfcs ll'isscn Legcn zcir zn Dcincn Fiisscn In dcni schlichtcn Doktorklcide Unsern Ehrcnkranz niit Frcndc. Heutc dankcn — fansemi Briider Allc freudig. — hoch und nicdcr Doss in Ndchstodieh bcdissoi Du sie hast dcni Tod cntrissen Feind vom Streit und I'dllcrei, I 'on der Menschheit Tyrannei Hast Du edles Blut geschaifen Dnrch des Geistes Sieg und Waff en. Denn gar bald zcird es anf Erden Einigkeit und Frieden werden, — Alle miissen i>^ir bekennen Dass sie Dich als Heifer nennen, Der so z-iele hat frei ge mac lit Von der Sii)uie, East und Schinach. Heutc bist Dn siebcig Jahr Hoch gcchrt als Jubilar, Alt gczvordcn niit I'ergiiiigoi, Denn Gesundheit muss doch siegen Die der Herr Dir hut beschieden. Leb dariDn >ioch king in Frieden Wie seithcr fiir Mcnschcnieohl Inimcr gut uiul liebcvoll. H EL WIG KOBKR. 283 A VINDICATION OF VIVISECTION A COURSE OF LECTURES ON ANIMAL EXPERIMENTATION BY MEN OF THE HIGHEST AUTHORITY IN THE MEDICAL AND OTHER PROFESSIONS GIVEN UNDER THE AUSPICES OF THE GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE IN GASTON HALL OF GEORGETOWN UNIVERSITY. MARCH 28 TO MAY 16, 1920 FRANCIS A. TONDORF. S. J.. PH. D. WASHINGTON. D C. 1920 PREFACE. To see life steadily and to see it whole is the serious duty of every true philosopher. And,*after all, what is philosophy save unadulterated common sense amplified and systematized. Hence your real sensible man will approach the subject of animal experimentation dispassion- ately and weig:h it in its ])roper relation to the good of the human race. Let hiiu disregard these prime postulates of sound reason and he is headed straight for unbalanced sentimentality and irrational hvsteria. The stereotyped arguments advanced against the practice of animal experimentation are two, to wit, brutality and total lack- of demonstrable and tangible results as might warrant the physical pain occasioned following the most clever scientifically regulated methods of vivisection. It is the modest purpose of this brochure to make available for the general jniblic a discussion of such accusations and the pertinent resj^onses made by experienced research workers in a series of public lectures given under the auspices of the Georgetown University School of Medicine in Gaston Hall of the Georgetown University from March 28 to ^lay IBth of the year nineteen hundred and twenty. To profit by the content of these pages the reader nuist divest himself of every prejudice or partisanship and focus his attention not on feeling but on the issue. He must recall that our cynophile friends are persistently dogmatizing that this is a moral question and then evaluate our ethical arguments against theirs. He must learn that their ])ervertecl commentary of the text which tells of the findings of medical researches envolving animal experimentation belies the original. He must read into this text the salus populi, the lex su]:)rema. Then may we look for a fair judgment. Fr.xncis a. ToNDOkF, S. J., Ph. D., Editor, Head of the Department of Physiology. Cieargetoicn L'nizri\';ity School of Medicine. |une ;!()th, l!>-.M). 289 A VIXDICATIOX OF AXLMAL EXPERIMEXTATIOX. Based upon the 7cork of the Rockefeller Institute for Medical Research in Neiv York. By Si.Mox Flexxer, Director, 'SI. D., Sc. D.. LL. D. Xote of the Editor. — The favor and enthusiasm with which the lectures of this symposium were generally received by our audiences have prompted us to extend them to a larger public. The introductory dissertation by Dr. Simon Flexner, head of the Rockefeller Institute for Medical Research of Xew York City, was not delivered from manuscript, and, unfortunately, no complete steno- graphic report was made. The Doctor left unexpectedly for Europe as American delegate to the International Convention of the Red Cross, and so even his notes were not available. This digest was assembled from notes as jotted down for their own use by University students in attendance upon the lecture, sup- plemented by references to Dr. Flexner's publications, and it is hoped repre- sents the more noteworthy items. It is offered with every apology to Dr. Flexner. The Lecturer after thanking the Rector of the University for his ccmpHnientary reference to the work in Preventive ^ledicine of the Rockefeller Institute for Medical Research, expressed satisfaction that the creation of an institution for the study of medical ])roblenis by a great and liberal philanthroj^ist had placed him with his co-workers in a favorable position to accom])lish something for the benefit of mankind. The lecturer traced the development of medical science from its earliest ince])tion, giving an account of the methods used by medical men to gain knowledge of diseases and graphically described the tran- sition from an empirical to a rational basis. The result depending ])rincii)ally on our present-day knowledge of physics, biology and chemistry. He declared that at the present time the medical profession is better eqtii])])ed to discharge its duties to mankind than ever before, a condition largely to be accredited to improved methods of attacking medical problems. The major portion of advances in scientihc medi- cine having been acconii)lished within the i:)ast fifty years. Dr. Flexner exjjlained why the public should be informed as to the work and methods of scientific men in tlie medical profession, and explained the reasons for using animals to study disease. He con- trasted the methods of clinical observation at the bedside of the jiatient with the present method of study by isolation of the causative organ- ism, reproduction of the disease in animals and study of it there. He lold of the relative ])rogress of medicine in the last fifty years as com- ])arcd with all preceding history. He declared that man's employment of his inalienable right to use the material things of the world was re3))onsible for the rai)i(l strides in medicine, and ])ointed out that in the solution vif a number of difficult ])roblcms the scientific medical 290 invcstii,'ation in the LmuIccI States had made important and mo>t creditable rontributions. Dr. Flexner expressed keen regret that an effort sliould be made in the Congress of the United States to prohibit experiments upon living dogs in th District of Columbia or the Territorial or insular pos- sessions of the United States as contemplated by S. 1"2.")8, which bill, if enacted into a law, would be a serious blow to the progress of scien- tific medicine, as much of our physiological knowledge and the action of drugs is based upon experiments on dogs, and for some experiments no other animals can be substituted. Dr. Flexner deprecated every effort to restrict this line of re- search work, in view of the fact that any reputable investigator takes special pains to j^revent unnecessary suffering by the administration of anesthetics or opiates, and the prevention of cruelty in animals is especially well safeguarded by laws now in force in the District of Columbia. He referred to diabetes, a disease of considerable fre- ((uency, as illustrating the value of experiments on dogs in promoting knowledge of this important disease of man, and also in contributing to its better therapeutic control or treatment. He stated until the crucial experiments by two German physicians on dogs some years ago the cause of diabetes was unknown The Ger- man scientists extirpated the pancreas on dogs and the animals so oj^erated on developed rapidly fatal diabetes. The ]iractical use of this knowledge was employed by Dr. Allen who by modifying the operative ])rocedure ascertained the manner in which to induce grades of diabetes closely simulating those of luan. With these animals he was able to work out a treatment which has brightened the outlook of the diabetic and has ])rolonged the life of these individuals enabling many of the sufferers to attend their duties and vocations over long periods of time. These exj^eriments so useful to man have been made on dogs, and no other animal suffices for the purpose. This work was begun at the Harvard iVledical School and completed at the Rockefeller Institute for Medical Research. Dr. Flexner stated that he had given a single concrete instance, but the instances could easily be multijilied, through which the benefi- cent use of the results of experiments on animals could be shown. He declared that by animal experimentation we have not only benefited man, but investigation into the disease of animals has led to the eradi- cation of many of the diseases of animals with incalculable economic returns. C)ur knowledge of yellow fever would probably have been delayed for many years if the work of the Bureau of Animal Industry of the United States on Texas fever had not been done. The Lecturer em])hasized the im])ortant work done b\- tlie Federal Government for animal industry, all of which involved animal experi- mentation, and called attention to the Department of Animal Pathology 291 of the Rockefeller Institute, established a few years ago on a farm of -too or oOO acres, near Princeton, N. J., with laboratories, stables and other appurtenances, and a highly skilled scientific staft installed for the intensive study of diseases of animals themselves. Could the eco- nomic wastage caused by disorders of cattle, poultry, etc., be con- trolled or reduced, the cost of living, now such a matter of serious con- cern, would be materially diminished. In addition to diseases of eco- nomic animals we have, he said, a real interest in diseases of domestic animal pets, which are themselves the victims of many severe and fatal diseases, such as distemper among dogs. The study of this disease by the experimental method is not only indicated, but it is fair to say that if we learn to control distemper, we should throw new light on the pneumonia ])roblem ; and he was tempted to add that had the lower animals the power of voice, they might well ask to be saved from those who appear to be their friends. Contrasting the ancient use of drugs with the manner in which they are employed at the present time he showed how their specific action has been determined by the employment of animals for experi- mental study. Beginning with a tribute to the pioneer work of Pasteur, Koch and other pioneer-research workers, the lecturer traced the various steps in the development of the great branch of bacteriology that em- braces all that we know of the cause, the prevention and treatment of all infectious diseases, including serums and vaccines, and ends at the present time with the researches by Noguchi on the organism of yellow fever As an instance of the curative powers of antitoxins he cited the vast reduction in mortality following the employment of di])htheria antitoxin, which is now less than one quarter of the death rate before the introduction of the antitoxin. Cerebro-Spinal Meningitis. Dr. Flexner said he had been asked to say a few words about the benefits of animal experimentation in relation to epidemic cerebro- sjjinal meningitis. This disease, also known as cerebro-spinal fever and spotted fever, was described as early as 1X0.") and has a])]ieared in epi- demic form at various intervals in Europe, in the United States and other ])arts of the globe. Hirsch distributes the epidemic occurrence of this disease through four ])eriods, namely, IHOa-lSlJO, l.SOT-lSoO. 1854-187.*), ]8T() to date. In the first period it appeared in isolated ei)idcmics in Europe and to a much greater extent in the United States. After its ])rimary appearance in Massachusetts in 18()G, according to some e])idemologists, it continued throughout New England in various localities for the next ten years. During the second period widespread 292 ejiidemics occurred in France, Italy, Algeria, Denmark and the United States; during the third period it prevailed in Europe, Asia, Africa, South America and the United States. During the last period it has been specially marked in Germany, Italy and the United States. The disease prevailed in an epidemic form in 1!)()4 and continued to be more or less active until 1!)10; since then, although less active, it has not entirely disapi)eared and became again active during the recent war. The organism causing this disease, thanks to animal experimenta- tion, had been isolated and described by Weischselbaum in 188T under the name of diplococcus intracclliilaris inciiiiigitidis, and although per- fectly familiar with the cause and nature of the disease, the medical l)rofession was heljdess in the way of treating this acute infectious dis- ease quite fatal in its tendency. Dr. Flexner in li)()4 during the e]Mdemic along the Atlantic sea- board and from there inland, studied the disease at the Rockefeller Institute and ])roved by inoculation experiments that it was communi- cable to animals. This was an enormous step forward, for it gave him a basis for the hope of being able to treat the disease successfully by means of immunized serum. The work was done on monkeys, and subsequent experimentation proved that not only could the disease be reproduced in these animals, but also successfully treated with immune serum. Later this treatment was and is now being used in the treat- ment of cerebro-s])inal meningitis in man. Dr. Flexner said that 25 monkeys had been used in this work. (It has been estimated by Professor Welsh and other competent critics that before this method of serum treatment was employed, out of every one hundred patients seventy-five died, while under the serum treatment the mortality has been reduced from seventy-five to twenty-five per cent. It is not gen- erally known that this demonstration based upon animal experimenta- tion is regarded as one of the most important contributions ever made to scientific medicine and has secured for Dr. Flexner, the Rockefeller Institute and American medicine a place of honor in the medical world. —Editor.) Poliomyelitis. Dr. Flexner recalled the work of the Rockefeller Institute with reference to the etiology and pathology of poliomyelitis, popularly known as infantile paralysis, and explained how they had been able to transmit the disease from monkey to monkey through the secretions of the nasal-pharyngeal mucous membrane and thus secured important information as to the mode of transmitting the disease He said in part : In the United States we are becoming increasingly familiar with epidemics of poliomyelitis. Prior to 1907 infantile ])aralysis was a rare disease in this country ; since then it has prevailed fitfully every 293 summer and autumn, and in one notable instance at least also in the •svinter season, claiming victims by the score or hundred, until in 1916 an outbreak of unprecedented severity, with its center of violence in New York State, swept over a considerable number of States. Our knowledge of poliomyelitis has grown since Wickman's epochal clinical studies published in 190T. Thanks to animal experimentation we are in possession of precise information covering essential data with regard to the nature of the inciting microorganism, notwithstanding its very minute size, and also concerning the manner in which it leaves the infected or contaminated body within the secretions of the nasopharynx chiefly, and gains access to another human being by means of the corre- sponding mucous membranes and apparently in no other way. More- over, the inciting virus, so called, up to the present time and notwith- standing many and assiduous efforts, has not been detected apart from the infected or merely contaminated human being, and there is there- fore no foundation in ascertained fact for an assumption that the virus is conveyed to persons otherwise than by other persons who harbor it. Control of Yellow Fever Epidemics. As an example of the manner in which an epidemic disease may be eradicated he briefly related the history of the conquest of yellow fever and expressed his satisfaction that the causal organism had been discovered before the complete disappearance of the scourge. If so, it will be the first disease to so disappear since recorded history. We no longer fear yellow fever in New York, Philadelphia and other Northern districts of the United States in which formerly it was a serious pest, claiming victims by the thousands. We are now sufficiently informed of the conditions of its origin and spread to main- tain effective safeguards. The everthreatening hotbeds of yellow fever at Havana and in Brazil are now under control, and can be kept so if we do not relax our vigilance. Prior to the beginning of the present century yellow fever was a peril because no oiie knew the exact conditions favoring its spread. In 1900 a commission of officers from the United States Army, headed by Dr. Walter Reed, with Drs. James Carroll, Jesse W^ Lazear and Aristides .\gramonte went to Havana where the fever flourished, and made a series of studies and catue to the conclusion that there must be a living organism in the blood of yellow-fever j^atients in the early days of the disease. They found that a nios(|uilo could act as inter- mediary in conveying the disease. They did not spare themselves, and following the bite of a ])ur])osely infected mosf|uito, Carroll became ill of yellow fever, while Lazear died after a short illness. Reed died in lIM)-i, and his memory li\es in the great Walter Reed Hospital at Washington. From this knowledge of the mosquito as a carrier of yellow fever it became clear that the way to i:)revent the s])rea(l of the disease was either by kee])ing the mosquito from patients in the early stages of their illness through proper screening of windows and doors, or by killing and destroying their breeding places. All these measures were applied in Havana by General Gorgas. They have since been practiced in New Orleans, Vera Cruz and Rio de Janeiro. In the Southern States, how^ever, while the old, aimless and largely futile struggles against the disease when once it had gained a foothold can never come again, there is always the liability of costly and increas- ing local outbreaks so long as permanent nests of the disease exist in countries with which direct social or economic intercourse is main- tained. The everthreatening hotbeds of yellow fever at Havana and m Brazil are now in control and can be kept so at the price of intelligent and unremitting vigilance. But here and there in ]\Iexico and South America and on the west coast of Africa it still lurks unguarded. It is the aim of the International Health Board of the Rockefeller Founda- tion to discover and clean up the remaining lurking places for germs of this disease, along the lines already inaugurated in the fight against hookworm and the eradication of malaria in different parts of the globe. At the request about a year and a half ago from Ecuador for counsel and assistance in solving the problems of yellow fever at Guayaquil, the Rockefeller Foundation and the Rockefeller Institute cheerfully sent General Gorgas and his associates of the International Health Board to study conditions in that country. The Commission was accompanied by Dr. Hideyo Noguchi, the accomplished Japanese bacteriologist, on the stalT of the Rockefeller Institute for ]\Iedical Research Dr. No- guchi apart from his command of cultural technique and great patience was also well acquainted with a disease called infectious jaundice, which resembles yellow fever. It is one of the diseases whose origin has only recently been traced. The inciting germ, called Leptospira, is a spiral motile organism, parasitic in rats and other animals. In insanitary places frequented by these animals it may gain access to the bodies of humans and incite serious and fatal disease. Noguchi suc- ceeded in inducing in guinea pigs by transference of a small quantity of the blood of yellow-fever patients, symptoms comparable with yel- low fever in the human race. The blood of these experimental ani- mals, when conveyed to other guinea pigs, produced the same disease, and in this infected guinea pig blood, a minute organism resembling the Leptospira of infectious jaundice was detected. Young dogs and monkeys were also found to be susceptible to inoculation with yellow fever blood. Noguchi also succeeded in cultivating from the ])lood at first of his artificially infected pigs and then of man a living organism which he carried through many successive generations in his culture tubes, and from which by inoculation he could induce the identical fatal dis- 29o ease in the guinea pig. Xoguchi called this germ "Leptospira ictc- roides." \\'ork is now being carried on by animal experimentation for the solution of unsolved problems, including the perfection of a suitable serum for this disease. It is hoped this work will be entirely successful and prove a blessing to mankind. Control and Management of Other Epidemic Diseases. On this important topic Dr. Flexner reviewed our knowledge of epidemic diseases and the practical hygienic measures, based on this knowledge, which have heretofore been applied, or which in the ordi- nary course of events may be applied with a reasonable hope of pre- venting the spread of these epidemics. The Lecturer expressed the hope that by a carefvil review of what has been accomplisliecl in the past we may form a judgment of the efficiency of such measures and arrive possibly at new points of view from which to launch a more decisive attack. ( Dr. Flexner is evidently a stanch advocate of the doctrine that disease germs have their origin somewhere, and scientific medicine demands that all epideniics must be traced backward to their starting ])oint, and when found the original seedbeds must be stam])ed out. In supjjort of this doctrine, which is now practically applied by the International Health Board of the Rockefeller Foundation, he spoke in part as follows: — Editor.) Regarding epidemic diseases in general we assume the introduc- tion from without, and usually from a distant locality of a special kind of organism which is held directly resj^onsible for the e])idemic ensuing. In the case of influenza wide divergences of oi:)inion re- garding the nature of the inciting microorganisms and the manner of infection still ])revail. The reason for these difYerences are several, but the most imjjortant perhaps relates to the common observation of the manner of s])read or attack of the disease. While other epidemics proceed from bad to worse, with at least progressive increases of in- tensity, influenza seems to overwhelm communities over even wide stretches of territory as by a single stupendous blow. While in the one case the gradually accelerating rate of speed of extension may be taken to indicate personal conveyance of the provoking microrgan- ism ; in the other case, the sudden wide onset ajipears to be the very negation of personal comnnmication. Hence the invoking of mysterious influences, the revival of tlv notion of miasm and similar agencies, to account for this phenomenon, indeed, the pul)lic mind in general lends itself readily to such formless conce])ts, for the reason that there still resides in the mass of the people a large uneradicated residue of superstition regarding disease. One does not need to look far or to dig deej) to uncover the source of this superstition. We have only recently emerged from n jiast in which 296 knowledge of the origin of disease was scant, and such views as were commonly held and exploited were mostly fallacious. It is, indeed, very recently, if the transformation can be said to be perfect even now, that the medical profession as a whole has been completely emancipated. All this is very far from being a matter of remote importance only, since in the end the successful imposition of sanitary regulations involves wide cooperation, and until the majority of indi- viduals composing a community is brought to a fair level of under- standing of. and belief in the measures j)roposed, serious and sustained endeavor to enforce them is scarcely to be expected. Influenza. No better instance of a communicable disease could perhaps be invoked than influenza to exorcise the false idea of the mysterious origin of epidemics. To dwell solely on the sudden and overwhelming stroke of the disease is to wholly overlook the 'significant incidents that precede the mass infection, because they are of such ordinary nature and lack the dramatic quality. Accurate observers noted long ago that influenza in its epidemic form did not constitute an exception to the common rule regarding epidemic diseases, which are obviously associated with persons and their migrations. What the early stu- dents made out by tracing the epidemic backward to its point of de- parture more modern observers have confirmed by carefully kept rec- ords, often geographically compiled, as in the excellent instance of the Munich records covering the epidemic of 1880-92, which can now be supplemented by a number of similarly constructed records of the epidemic just j^assed. These records show convincingly a period of invasion during which there is a gradual rise in the number of cases to culminate, within a period variously estimated at from one to three weeks, in a widespread, so-called '"explosive" outbreak of the disease. It happens that the early cases of influenza tend not to be severe, chiefly because they are rarely attended by pneumonia and hence are frequently mistaken, and the confusion in diagnosis is resolved only when the full intensity of the epidemic is realized. In the meantime rich opportunity has been afl:'orded for the free and unrestricted com- mingling of the sick and well, of doubtless healthy carriers of the inciting agent and others, until so high a degree of dissemination of the provoking microorganism has been secured as to expose the entire susceptible element of the population, which happens to be large, to •an almost simultaneous response to the eftects of the infecting microbe. Deductions of like import can be drawn from the geographical movements of an influenza e]:)idemic. In Eastern Russia and Turke- stan influenza si)reads with the pace of a caravan, in Europe and America with the speed of an express train, in the world at large with 29: the rapidity of an ocean liner ; if one project forward the outcome of the means of intercommunication of the near future, we may pre- dict that the next jjandemic, should one arise, will extend with the velocity of an airship. It is desirable, in the interest of clear thinking, to carry this con- sideration of the characteristics of epidemic influenza a step farther. A feature of the epidemic disease of particular significance is the tendency to recur ; that is, to return to a stricken region after an inter- val, usually of months, of relative quiescence Thus the beginnings of the last pandemic in \\'estern Europe and the United States have been traced to sporadic cases appearing in April, ]\Iay and June, pos- sibly even earlier in certain places, while the destructive epidemic raged during September, October and November of 1918. The dis- ease also prevailed, more or less, in the United States during 1919 and again during the present year. The epidemic of 1918-19 cost more in a few months in human lives than were killed during the five years duration of the great war. The statistics from India alone show something like 6,000,000 deaths. In this country the estimates so far have varied from 600,000 to 800,000, and you can carry that pro- portion around the world. There are very good reasons for believing that influenza is not in itself a serious disease, but that its sinister character is given by the remarkable frequency with which it is followed in particular instances by a concomitant or secondary pneumonic infection, to which the severe effects and high mortality are traceable. Now, it is this high incidence of pneumonia, the product of invasion of the respiratory organs with bacteria commonly present on the upper respiratory mucous membranes — streptococci, pneumococci, staphylococci. PfeitTer's ba- cilli, and even meningococci — that stamp the recurrent waves of the epidemic with its bad name. If we compare the pneumonic complications of influenza with those that arose in the cantonments in 19n-18, first as attendants of measles and later as an independent infection, we note immediately that in both instances the severe effects and high fatalities arose, not from bacteria brought or imposed from without, but from their repre- sentatives which are commonly resident uj^on the membranes of the nose and throat in health. Whatever we may have to learn of the microorganisms inducing measles, still undiscovered, and of influenza, still under dispute, and their mode of invasion in the body, no one would question that the bacteria inducing ])neumonia are ])ersonallv boine. Streptococcus Pneumonia. ]n discussi'ig this subject the lecturer pointed out that du'-;ng the winter of IMIT-IH there occurred in several localities withii- the Um'ted States, and also, but in a less degree, in I-'rance, at least a great increase •298 ill the incidence of a fy])e of pneumonia which previously had heen very infrequent. It appears also that the greatest number of cases and of fatalities arose in the United States in the military cantonments ; that the disease first prevailed, as already stated, as a secondary pneumonia following measles ; but before long the severity of the infection was such that cases of primary streptococcus pneumonia began to arise. ^loreover, at this juncture the disease spread from the military to the civil populations. The nature of the microorganism inducing this form of epidemic pneumonia is indicated in the name which the disease has come to bear. The difificulty in this instance has not been in finding out the inciting microbe, but, rather, in differentiating the streptococci responsible for the epidemic disease from streptococci possessing the ordinary pathogenic properties, or even from those of saprophytic nature so commonly present on the upper respiratory mucous mem- branes without provoking widespread disease. However, numerous studies of the bacteriology of this epidemic of i)neumonia, at distinct and often widely remote cantonments, involving much animal experi- mentation, showed that the microbic incitant w^as in almost every in- stance streptococcus heiuolyticiis. Moreover, because of the wide oc- currence of the ejiidemic pneumonia, this type of streptococcus could l)e found in normal throats and as a secondary invading microorganism in the lungs in cases of ordinary lobar pneumonia. Thus far very little progress has been made in the classification of streptococci, which form a class apparently even more heterogeneous than the pneumococci and will involve much arduous experimental laboratory work. With these various considerations before us we may now discuss the question of the efihciency of our public-health measure in diminishing the incidence of epidemic diseases. It is evident that in diseases in which the inciting microorganism enters the body by way of the air ])assages, although not necessarily, as in poliomyelitis, directly injuring those parts, protection is not to be secured by api)lying sanitary meas- ures on a wide scale to an extraneous and inanimate source of the which the inciting microorganism enters the body by way of the air dejecta of typhoid i)atients, or even to inferior animal species such as the mosquito or the rat, which act as intermediaries in conveying the germs of yellow fever or of infectious jaundice; but it is alone to be attained by methods of personal hygiene, applied on the individual scale of safeguarding one person from another, the most difficult of all hygienic regulations to enforce. As a result of animal experimentation in epidemic poliomyelitis we may fairly claim that we are in possession of the essential facts which, if widely applicable, should enable us to control the spread of that disease. Epidemic diseases in the commonly acce])ted sense have fixed lo- cations — the so-called epidemic homes of the diseases. In those homes they survive without usually attracting s])ecial attention often over 299 long periods of time. But from time to time, and for reasons not entirely clear, these dormant foci of the epidemics take on an un- wonted activity, the evidence of which is the more frequent api:)ear- ance of cases of the particular disease among the native population, and sooner or later an extension of the disease beyond its endemic con- fines. Thus there are excellent reasons for believing that an endemic focus of ])oliomyelitis has been established in Northwestern Europe from which the recent epidemic waves have emanated. Similarly there are excellent reasons for regarding the endemic home of influenza to be Eastern Europe, and in ])articular the border region between Russia and Turkestan. Many recorded epidemics have been shown more or less clearly to emanate from that area, while the epidemics of recent history have been traced there with a high degree of conclusiveness. From this eastern home, at intervals of two or three decades, a migrating epidemic influenza begins, moving east- ward and westward, with the greater velocity in the latter direction. Now, since the combatting of these two epidemic diseases, when they become widely and severely pandemical, is attended with such very great difficulty and is of such dubious success, and this notwith- standing the prodigious public-health contests which are waged against them in which the advantages are all in favor of the invading nu'cro- organismal hosts, it would seem as if an eft'ort of central rather than peripheral control might be worth discussion. According to this proposal, an effort at control amounting even to eventual eradication of the diseases in the regions of their endemic survival should be under- taken, an effort, indeed, not occasional and intensively spasmodic, as during the pandemical excursions, but continuous over relatively long periods, in the hope that the seed beds, as it were, of the diseases might be destroyed. That such an effort at the eradication of a serious epidemic dis- ease may be carried through successfully the experience with yellow fever abundantly i)roves. In attacking the disease the combat was not put off until its epidemic s])read had begun and until new territory, such as New Orleans, Jacksonville, Memphis, etc., had been invaded ; but the attack was made on its sources at Havana, Panama, and now Guayaquil, to which endemic points the extension into new and neu- tral territory had been traced. Such a ])lan is now in process of elaboration by the Rockefeller Institute. Encepii.xlitis Leth.vrgica. Another disease that demands animal experimentation and inten- sive study is lethargic encephalitis. ap])arently only recently introduced in, and already widely distributed through, tiiis country. It is highly desirable that the main facts known should be given ])ublicity ; and it 300 may be well that the experience, gained with poliomyelitis, may serve lis in dealing more effectively with the ence])halitis peril. It appears that the first cases of that disease recognized in the United States occurred in the winter of U) 18-19. In contradistinction to epidemic poliomyelitis, there is no reason to suppose that this epi- demic affection of the central nervous system ever before existed in America. The point is an important one. At ])resent the disease seems to be widely distributed, as cases have been reported from many States. It is ])ossible to trace the cases of lethargic, or epidemic encephal- itis, now arising in this country, to an outbreak which occurred in Vienna and neighboring parts of Austria in the winter of 1916. Be- cause of war conditions, knowledge of this unusual disease did not at once reach Western Europe and the United States ; but nevertheless cases of ' the disease occurred in England and France in the early months of 1918, and in America about One year later. Both in Austria and in England, in which countries the first cases were observed, res]iectively, in eastern and western Europe the disease was first mis- takenly attributed to food intoxications. In Austria the early cases were ascribed to sausage poisoning; in England to botulism arising from various foods. This error is not perhaps as remarkable as might at first appear. In the first place, both countries were laboring imder unprecedented conditions of food shortage, preserved foods were employed on a scale never before equaled, and, of course, waste and refuse were reduced to a minimum. Furthermore, an early symptom of this encephalitis is third- nerve paralysis — giving rise to diplopia, ptosis, etc. — which happens also to be an early symptom in certain forms of food poisoning and notable in botulism. Ultimately, in both countries the notion of food origin became untenable, and the disease was recognized as arising independently of diet and other usual con- ditions of life, and come to be viewed as probably of microbic origin and of communicable nature. It is now sufficiently obvious why the popular name of "sleeping sickness" has been applied to this malady. The disease is, of course, wholly distinct from African sleeping sickness, which is a trypanosomal infection carried from person to person by means of an insect vector — the tsetse fly. When an apparently new disease arises, it is always important to inquire whether the particular set of symptoms that are taken to characterize it has been observed and recorded before. In the present instance there are significant records which may easily refer to a similar and possibly identical disease. The first one dates from 1712 and refers to an outbreak of so-called sleeping sick- ness centering about Tubingen in Germany. The second record dates from 1890 and deals with a puzzling malady called nona, which is described rather in the lay than the medical literature of the time and seems to have prevailed in the territory bounded by Austria, Italy and Switzerland. In respect to neither instance, however, do the records 301 contain the minuter data which would admit of a certain identification of the disease described with the encephahc malady we are consider- ing. One circumstance is, however, significantly suggestive. The location of the 1800 affection "nona," which was characterized by somnolence, stupor and coma, coincides roughly at least with that of the first cases reported in the present epidemic. The question may, therefore, well be raised whether the endemic home of this epidemic variety of encephalitis may not be that corner of southeastern Europe overlapping the three countries mentioned. If this should prove to be probable, the next question to arise would relate to the circumstances under which the disease slumbered on in ordinary times, and to the conditions that favored a greater activity and a wider spread about the year 1916. To deal with the first one will require particular and intensive studies carried out with the especial object in view to disclose hidden cases in the region originally afifected. An answer can in the mean- time be hazarded to the second question. The depressing effects of war, acting by way of hunger, cold, migrations of populations and general insanitation, might initiate the conditions through which a low endemic might well be converted into a higher epidemic incidence of the disease. It is now a matter of great importance to determine the precise nature or etiology of lethargic encephalitis. i\Iany unsuccessful at- tem])ts have been made to communicate the disease to monkeys and other animals through the inoculation of nervous tissues showing the particular lesions in the manner so readily and successfully employed in monkeys for poliomyelitis. This circumstance alone would serve to distinguish this epidemic encephalitis from epidemic jioliomvelitis. Rut in two or three instances, what are stated to be successful trans- missions of the disease to animals have been re])orted. It is still too soon to say whether or not we are now at the thresh- old of clearing up, by way of animal ex])erimentation, the etiology and mode of transmission of this menacing disease, as was accom- ])lished so recently, and also by animal experimentation in the case of j)oliomyelitis. But at this moment, and while waiting for the ultimate and convincing experimental results, one need entertain no doubt of the infectious and communicable nature of lethargic encephalitis. In conclusion Dr. Flexner remarked that time would not permit him to discuss many of the problems now awaiting solution or to ref.-^r to the work carried on by the staff of the Rockefeller Institute for Medical Research in all of its departments, but expressed the fervent hope that in the interests of the human race and the animals themselves, the progress of scientific medicine would not be impeded ny unneces- sary legislation. 302 THE LEGAL ASPECTS OF VIVISECTION. By William Creighton Woodward, jM. D., LL. M. Health Commissioner of Boston, Mass. Professor of Medical Jurisprudence Georgetozvn University. After the ex])osition that has just been made of the inestimable benefits in the interest of human heahh and hajipiness that have been achieved through animal experimentation, and that would have been impossible without it, no one of you can fail to see the danger inherent in any attempt to restrict that field of research or to hamper operations within it. Certainly any needless restriction and hindrance would be hardly short of criminal, and the burden of showing the necessity for any such restriction or hindrance as may be ])roposed rests clearly ujwn the proponents. In the absence of clear evidence of a wrong, to be righted, no legis- lation to restrict and hinder animal experimentation is justifiable ; and if wrong be shown, then such remedial legislation as may be proposed should have some direct and demonstrable relation to the end to be accomplished and should go no further than is necessary to accom- plish that end. Let us see what the facts are with respect to the legis- lation now pending in Congress to prohibit absolutely and forever, in the District of Columbia and in the Territorial and insular possessions of the United States, all experiments upon living dogs, luiless the ex- periment has for its sole purfjose the healing or curing of some physical ailment of the very dog experimented upon.a The alleged motive of the proposed legislation is set forth in the preamble of the bill ; the enactment of such legislation is, "an act of right and justice to the dog," because "the dog has made a wonderful war record," and "because he has been decorated for bravery, serving his country, following its flag, and dying for its cause." But some doubt seems to be thrown, I am sorry to say, on the sincerity of this preamble by a statement made by one of the leading proponents of the bill, to the effect that "We are so modest that we are beginning with the thin edge of the wedge. We want to save dogs, and later on we will probably try to save other animals."/; If dogkind is now to be honored a A bill to ])rohibit ex])eriments upon living dogs in the District of Columbia or in any of the Territorial or insular po.ssessions of the United States, and jjroviding a i)enalty for violation thereof. S. 1258, 66th Congress, 1st session. b Hearing before the subcommittee of the Committee on the Judi- ciary, United States Senate, 66th Congress, 1st session, on S. 1258, page 25. 303 in the manner proposed in this bill, becatise of the distinguished serv- ices rendered by dogs during the war, it is not quite clear" why similar honor should be bestowed upon other species that did not render such service; such a course would certainly cheapen the honor bestowed on the dog! And if other species did render such distinguished war service, it would seem as though they, equally with the dog, should be honored now in the pending legislation rather than asked to wait for their honors. The horse and the mule, that di-1 such noble v.'ork in transportation ; the carrier pigeon, that did such remarkable messenger service; the steer, the sheep, the hog, the chicken, and even the tlsh. that gave up their lives that the army and the people might live ; mavbe even the cat, who did her bit in the protection of food supplies f i om rodent depredations ; and most assuredly, the modest guinea pig, that endured so much in testing and standardization of medical supplies — certainly the righteous claims of all of these cannot justly be ignored and lightly brushed aside if the real purpose of this bill is to grant in peqjetuity as a reward for war service freedom from all experimep- tation. Waving, however, possible question as to the motive of this bill and i^roceeding to a study of its text and of the hearing on it, we fail to discover any evidence of ''the wonderful war record" of the dog notwithstanding the fact that that record would s.^em from the p;-eaml)le to form the very heart of the demand that al! dogkind be relieved for all time of its obligation to repay to man in some small degree the affection, care, and effort that man has bestowed upon him, and of the demand implied in it, to transfer to other species the burden that the dog might equitably be expected to share with iheni, of submitting to exi)erimentaticn in the interest of mankind and of animals generally. That some dogs manifested faithfulness and courage during the war (to the extent that such virtues can be translated from mankind to the brute creation), no one will deny; but that all dogs tried out in A\-ar service distinguished themselves by such conduct has never, so far as I am informed, been asserted, nor even that faithfulness and courage were distinguishing characteristics of most of them. And yet this bill proposes to do, homage to all dogs alike ; not merely to the faithful, but also to the traitor; not merely to the coura- geous, but also to the cowardly ; not merely to the dog that saw war service, but also to the i)ampered pet in the fashionable, steam-heated a])artment house or palace, that lived on the fat of the land, and occu- j)ied the time of his mistress and maybe a nurse maid or two, that had better been devoted to the welfare! of the men in the trenches; and that the honors may be entirely even, they extend even to the sheep- killing mongrel that did his best to keep down the meat supply and the wool su])ply of the country during war time. Finally, as if the present generation of dogs were not numerous enough, and big enough, and strong enough to carr\ the honors that the proponents of this bill 304 would heap upon the species, it is proposed that such honors he spread over generations of dogs as yet unborn, from now on henceforth for- evermore. Certainly, if the attribute of courage can riglitly be attrib- uted to dogkind, no self-respecting dog that did its bit during the war would ask for his offspring forever that it be exempted from all lia- bility to one of the most important services it can render mankind — and brutekind, too, for that matter ; for experiments on dogs con- tribute to the well being not only of human beings but of domestic animals as well, including dogs themselves. Even if we were to agree with the proponents of the legislation now under consideration, that for the reasons stated in the ])reamble honor should be conferred upon dogkind, there would still lie before us a wide field for discussion and debate as to just what honor and how much honor should be conferred. Discussion and debate of this kind would, however, take us so far afield as to render impossible any profit- able result within the time at our command, and the proponents of this legislation, by naming in it a single and very definite form of honor have virtually limited discussion to that form. After the enactment of the ])ro])osed legislation it is to be unlawful in the District of Colum- bia or in any of the Territorial or insular possessions of the United States "for any person to experiment or operate in any manner what- soever, upon any living dog, for any purpose other than the healing or curing of said dog of physical ailments" ; and the bill is entitled "A bill to prohibit experiments upon living dogs in the District of Columbia or in any of the Territorial or insular possessions of the United States, and providing a penalty for violation thereof." To he sure of our ground, it may be well to make certain just what an "experiment" is, and the Standard Dictionary is probably a safe guide upon this point. To experiment is, according to the Standard Dictionary, to make an experiment, test, or trial ; to submit a thing or person to any i)rocess or ordeal, as for purpose of investigation or discovery. And an experi- ment is an act or operation to discover, test, or illustrate some truth, principle, or effect. Manifestly, then, the enactment of the proposed legislation would make unlawful any test or trial upon any living dog for any ]nirpose whatsoever, other than the healing or curing of said dog of some physical ailment. A dog without a |)hysical ailment could not be sub- jected to any experiment, test, or trial, of any kind. A dog suffering from a physical ailment could be subjected only to an experiment, test, or trial that was designed to remove that particular ailment from that particular dog. Whether the experiment, test, or trial was calculated to add to the dog's comfort, to give it pain, or to give it pleasure would be utterly immaterial for the purpose of determining whether the ex- periment was or was not ]nmishable under the law. Probably, how- ever, we can for present jjurposes ignore the proposed prohibition of comfort-giving and pleasurable experiments, tests, and trials, which 305 maybe the proponents of this bill did not really intend to prohibit — although it would have been much better for them to have expressed their ideas more clearly if that is the case ; and we can limit our con- sideration of the matter to the general class of experiments that cause varying amounts of inconvenience and possibly even some pain to the dog experimented upon, varying from the prick of a hypodermic needle to the pain that may be suffered after recovering from the anesthetic administered during some more or less serious and important experi- ment, made in the interest of humanity or of animal kind generally. Is there, or is there not, need for any legislation to prevent the infliction of such pain and inconvenience upon dogs in the District of Columbia and in the Territorial and insular possessions of the United States? Within the time at my command, I have not had the opportunity of examining the laws in force in the various Territorial and insular ])OSsessions of the United States relating to the infliction of pain and discomfort on animals. If such laws are adequate there is no need for further legislation ; and the burden of proving inadecjuacy rests upon the proponents of the legislation now before us. If the legislative bodies of those several jurisdictions have fallen short of their duty, evidence of that fact should be produced before Congress is asked to assert its jurisdiction in the j)remises. And I may add incidentally, the record shows no demand for this proposed legislation from the people of the Territories and the insular possessions — nor from the people of the District of Columbia either, for that matter. The pres- sure for its enactment seems to come largely from persons residing in jurisdictions that cannot be affected by it, and in these jurisdictions they have not succeeded, and i)Ossibly have not even tried, in procuring the enactment of such legislation as they now suggest be imposed on communities to which they are in large part strangers. That so far as the District of Columbia is concerned there are laws for the punishment of persons guilty of cruelty to animals is too well known to need comment. Prosecutions are being brought con- tinually under such laws. There is, however, in the law, as in common speech, a distinction between cruelty and the mere imposition of dis- comfort or pain. The imposition of discomfort or i)ain constitutes cruelty and is punishable only when it is not inflicted for a justifiable end. The determination of the matter now before us, in so far as the adequacy of existing law in the District of Columbia is concerned hinges, then, on the question whether the ends sought by ex])erimenta- tion on dogs are justifiable ends, and whether in connection with such experiments, if the ends sought are justifiable, such ])ain as is inflicted is or is not a necessary element of the experiment. If, all things con- sidered, the ends sought by such experiments are justifiable, then clearly the experiments should not be prohibited; and if pain is a necessary element in such experiments, then to prohibit pain is to pro- hibit the experiments. .\ brief exann'nation of the law in force in 30G the District shows that all of these considerations have passed in care- ful review before the legislative authorities of the District of Columbia and that they have been wisely acted upon. Public morals have been duly safeguarded, the humane treatment of animals definitely insisted upon, the rights and opportvniities of investigators reasonably safe- guarded, and extraordinary ])rovisions made for the enforcement of the law. The law governing experimentation upon animals in the District of Columbia was enacted by the Legislative Assembly in LSIl and is set out at length in Abert's Statutes in Force in the District of Colum- bia, pages 540 ct scq.a. It makes it unlawful to inflict umiecessary cruelty upon any animal or to authorize or i)ermit any unnecessary torture, suffering, or cruelty of any kind. And if there were any doubt as to whether the provisions of this law were or were not ai)|)li- cable to cases in which pain might be inflicted in connection with ani- mal experimentation, it would be very definitely dispelled by the fol- lowing provision : "Section 15. Nothing in this act contained shall be construed to l)rohibit or interfere with any properly conducted scientific experi- ments or investigations, which experiments shall be performed only under the authority of the faculty of some regularly incorporated medi- cal college, university or scientific society." Stated in other words, no infliction of pain is to be tolerated unless the experiment is of a scientific nature and properly conducted ; and in order that there may be some assurance that such experiments as are ])erformed are presumptively of this character, they may lawfully be performed onlv under the authority of some com])etent, responsible organization, which in effect stands back of the experiment either by authorizing the particular experiment that is to be made or else by vouching, as it were, for the judgment and cpialifications of the ex- ])erimentor to engage generally in that field of work. But in order to guard against the possible incompetence or care- lessness of experimentors, medical colleges, universities, and scientific societies with respect to this matter, it is made the ex])ress duty of all police ofificers and of any member of the Washington Humane Society to prosecute all violations of the act that come to their notice or knowl- edge. And if any member of the Washington Humane Society be- lieves and has reasonable cause to believe that the laws in relation to cruelty to animals have been or are being violated in any particular building or ])lace, he is u])on oath or affirmation to that eff'ect, and due application, entitled to a search warrant. .\nd as though to insure beyond the peradventure of a doubt that the ]M-ovisions of the law would be carried out, it is ])rovided that fines and forfeitures collected upon or resulting from the complaint or information of any member of the Washington Humane Society shall inure to and be paid over to that society. a For the pertijient parts of this Statute see Appendix. 307 On the face of things, the law as set forth above certainly seems ample to prevent cruelty to animals, including within the meaning of the word cruelty all such pain as may be inflicted in connection with unnecessary experimentation and all such as may be needlessly in- flicted in connection with experimentation that is in itself necessary and proper. Dogs and all other animals seem to be amply protected. And when it is remembered that this law has been in effect for almost half a century it seems certain that if there has been any unnecessary inflic- tion of pain in connection with experimentation on animals there must be within that half century some record of prosecutions which, if the law be effective, must have resulted in convictions and punishments and, if the law be ineffective, must have left upon the records of the courts of the District erf Columbia evidence of that fact. I had occasion in the year 1000 to look carefully into this matter, the law having- been then in force for more than a quarter of a century, and I was then unable to find any evidence of a single prosecution having been brought, either upon the initiative of any private citizen, or of any police officer, or of any member of the Washington Humane Society. No record could be found of a single search warrant having been applied for under the act or of any effort ever having been made to institute any prosecutions under it. It follows, of course, that there was no record of any court ever having construed this law as inappli- cable to cases involving the infliction of unnecessary cruelty in connec- tion with animal experimentation. All of these facts were made pub- lic at the time, and certainly should have served to stimulate the issue of search warrants and to stimulate prosecutions, if reasonable suspi- cion or concrete evidence of violations of the law were at hand. Ever since this situation was made public, the year 1000, I have been inti- mately in touch with thq situation, and during all that time I have known of no effort to obtain a search warrant under the law, of no attempted prosecution under it, and, of course, of no court decision indicating the ineffectiveness of the law to accomjilish its manifest ])ur- pose. It seems safe to say, therefore, that there is in the District of Columbia no experimentation U]:)on dogs or other animals that is not regulated by existing law, duly safeguarded by the watchful and spe- cial authority of the Washington Humane Society itself. The conclusion just set forth seems too definite and too clearly supported to need reinforcement. If, however, reinforcement be deemed necessary, it may be found by reference to the records of the numerous hearings that have been held from time to time since 1800, before Congressional committees, in connection with bills that have been introduced for the purpose of regulating or preventing experi- mentation upon animals in the District of Columbia. Certainly, if any such bill could ever have found sui)port in the least degree upon evi- dence of any specific instance or itistances of cruel experimentation on animals in the District, that evidence would have been forthcoming. 308 for there could be no other evidence of so much weight, and yet 1 can recall no single instance in whicli any such evidence has been adduced. It might be argued, however, that even though there be no wrong to be righted by the proi)osed legislation, yet that its enactment would do no harm and that it would be a very inexpensive way of ])aying a sui)])osed debt to all dogkind. At best it would be a paying of a sup- posed indebtedness to dogkind by saddling upon other animals the service now rendered by dogs, which would be a most unjust thing to do, since many other species have rendered to mankind in the war and at all other times service far beyond that rendered by the dog. As a matter of fact, however, those who are best qualified to speak with respect to the subject will tell you that certain experiments in the interests of mankind and of animals generally »cannot be as well ])er- formed upon other animals as they can be upon dogs. Moreover, one of the witnesses adduced by the pro])onents of the measure frankly announces that this bill is but the small end of the wedge with which it may be possible to stop all animal experimentation. Under the cir- cumstances, and in view of the lucid statement made by the preceding speaker as to the "wonderful benefits that have accrued from animal experimentation, the i)assage of this bill could never be condoned on the ground that it was at least harmless — for it is not. The bare fact, however, that the enactment of this bill is unneces- sary, and even the fact that its passage would work harm, is not suffi- cient to prevent the bill from becoming a law. There are persons of wealth, of social standing, and of intellectual standing who believe in it and who have w^orked and will work actively for its passage. Sen- ators and representatives who will be called upon to consider it are men busy with large afifairs of national and international importance, who have but little time for personal research into the merits of measures such as this, and who may be misled by the plausible arguments of the ])ro]:)onents of the bill unless there be an intelligent and energetic cam- paign to place before these senators and representatives the facts of the situation. It is in such a campaign that Georgetown University is now assiuning a position of leadership, and under its banner I ask all of you to enlist and to fight for the cause. 309 Appendix. Extract from section one of an Act of the Legislative Assembly OF THE District of Columbia, entitled : "An act for the more effectual prevention of cruelty to animals in the Territory of the District of Columbia," approved August 23, 18T1. "Whoever, having the charge or custody of any animal, either as owner or otherwise, inflicts unnecessary cruelty upon the same * * * shall for every such offense be punished by imprisonment in jail not exceeding one year, or by fine not exceeding two hundred and fifty dollars, or by both such fine and imprisonment. "Every owner, possessor, or person having the charge or custody of any animal, who * * * knowingly and wilfully authorizes or permits the same to be subject to unnecessary torture, sufifering, or cruelty of any kind, shall be punished for every such ofifense in the manner provided in Section 1. "Whenever complaint is made by any member of the Association for the Prevention of Cruelty to Animals (Washington Humane So- ciety) on oath or affirmation, to any magistrate authorized to issue warrants in criminal cases, that the complainant believes, and has reasonable cause to believe, that the laws in relation to cruelty to ani- mals have been or are being violated in any particular building or place, such magistrate, if satisfied that there is reasonable cause for such belief, shall issue a search w^arrant, authorizing any marshal, deputy marshal, constable, police officer, or any member of the Association for the Prevention of Cruelty to Animals (Washington Humane So- ciety), to search such building or place. "It shall be the duty of all marshals, deputy marshals, constables, police officers, or any member of the Association for the Prevention of Cruelty to vVnynals (Washington Humane Society), to prosecute all violations of the provisions of this Act which shall come to their notice or knowledge, and fines and forfeitures collected upon or re- sulting from the comjilaint or information of any member of the Asso- ciation for the Prevention of Cruelty to Animals ( Washington Humane .Society) under this Act shall inure to and be ])aid over to said associa- tion, in aid of the benevolent objects for which it was incorpo- rated. * * * "Nothing in this Act contained shall be construed to ])rohibit or interfere with any properly conducted scientific experiments or inves- tigations, which experiments shall be performed only under the au- thority of the faculty of some regularly incori)orated medical college, university or scientific society." 310 SO^IE OF THE ETHICAL ASPECTS OF ANIMAL I;X1M':KT- MENTATION. By W.M. H. Arthur, ]\I. D., F. A. C. S., Colonel, U. S. Army, Retired. Medical Director Gcorgetoivn University Hospital. Lale Couunandant Army Medical School. In a world full of sickness and suffering", in which are daily occurring many thousand premature and unnecessary deaths ; with a constant struggle going on in the effort to accumulate money, which is to-day the generally accepted measure of success, ihere are some unselfish men who, giving up all prospect of pecuniary rewards, or of reputation outside the limits of their own profession, are devoting their lives to reducing the sum total of human and animal disease, alleviating pain and prolonging life. The work in this field has achieved already magnificent results but much yet remains to be accomplished. \'ery few people l^egin to realize what humanity already owes to these investigators, past and present, and will owe to those to come unless irresponsible interference from outside ends their efforts. Yet while the names of great military commanders or men who have accumulated enormous wealth are familiar to everyone, these great benefactors of their kind are known by name only to the medical profession. Let me illustrate. How many non-medical men or women know who Leishman was or Loffler or Pasteur or Lister or Walter Reed? These men (and there are many others) who have conferred the greatest possible benefits on the race, are little known to the world generally. Yet the first named, Leishman, de\'ised a method of con- trolling the most common, dreaded and fatal of camp diseases, typhoid fever, which saved at least 290.000 of our troops in the great war, ten divisions, from three or four months invalidism, with 30,000 deaths. The morbidit}^ and mortality from this disease that would certainly have occurred in the great army assembled for this war but for preventive inoculation are calculated on what actually did take place during the Spanish war, before this method of preventing typhoid fever was discovered and introduced. Loffler paved the way for an anti-toxin which annually saves hundreds of thousands of child- ren from deatli or crip])ling from diphtheria. The combined work of Pasteur and Lister has made modern surgery with all its magni- ficent triumphs possible ; and the last, Walter Reed rescued our South Atlantic and Gulf Coasts from the annual terror of yellow fever, which had ever since the colonization of the country become epidemic at frequent intervals, killed thousands of people, and demoralized commerce every year by the enforcement of the April to November cpiarantine. All of these great benefits to humanity would have been impossible but for animal experimentation. 311 The word 'vivisection' is unfortunate, misleading and inapplicable to what it is intended to describe. It means simply cutting Hving tissue. l-2very surgical operation, involving the making of an in- cision, is a vivisection, but it is done under an anesthetic, local or general, and the same is true of the research laboratory, but the word to the sympathetic, emotional misinformed man or women brings up a vivid and distressing mental picture of a helpless animal tied down, struggling and groaning, while a brutal doctor tortures it, with no other object (for it is claimed, that no useful purpose is accomplished ) than the gratification of a morbid, insane pleasure in inflicting and witnessing suffering. This is true only of criminal degenerates and is a very false conception of what actually takes place in these laboratories. Instead of "vivisection" the term 'animal experimentation" might be used, but exen that does not entirely cover the ground, for animals must be used in laboratory diagnosis and in the preparation and testing of certain anti-toxins, sera and vaccines, that have long ago passed the experimental stage, and now ])rovide the sanitarian and the practising physician with their most powerful means of preventing and curing certain very fa al infectious diseases. Many thousand deaths, now easily avoidable, would result if the supply of this material should be cut off, as it would be if the use of animals in scientific work should be pro- hibited by law. The suffering inflicted in the type of laljoratorv under discussicjn is grossly exaggerated. A \-ery large majority of the so-called 'vivisections' consist of a j^rick with a hy])odermic needle and an in- jection of the material to be tested or the supj^lying to or the with- holding from animals of certain food elements. Anesthetics are always used in ]:)rocedures that would otherwise inflict pain. I am not myself and never have been a laboratory investigator, but I have had under m}- inspection and control a number of laboratories of this kind in this country and in the Philippines, and have seen a great deal of the work of my subordinates, and I have never witnessed the harrowing scenes so graphically described by the antivivisectionists, most of whom have never entered a labora- tory. The men engaged in this kind of work are normal men, not at all lacking in the ordinary feeling of liumanity, quite as merciful as the average non-medical man of the educated class immeasurably more merciful than the sjjortsman. who hunts for his own amuse- ment, or the tra])per who catches animals to secure furs for personal adornment. How often have you heard a big game hunter boast, that though he failed to bring in a deer, he is sure his shot took effect, for the animal limjied badly as it escajK'd and there was blood on the trail? That deer ])robably. with a shattered hip or shoulder or some even more serious injury, lingered for days in intolerable suffering, finally dying of starvation or exhaustion. .\t the cost of 312 what untold sufferiiii^- were secured llie furs of the fox. beaver, marten or otlier animal, that even the most tender hearted anti- vivisectionist does not hesitate to buy or wear? Yet what is done for sport or vanity seems io be considered perfecLly pro])er and natural, while great indignation is expressed at the relatively negli- gible suffering inflicted in the laboratory, with the highest possible moti\e, the search for means for reducing the sum total of human misery, and also the suffering of other animals, for animal ex- l)erimentation saves in cattle, swine, sheep, poultry and dogs, in- finitel}- more suffering than is inflicted on guinea pigs, rabl)its etc in the laboratory. The bureau of animal industry, the farmer, the stock raiser or poultry man are dependent on animal experimenta- tion for the study of animal diseases. Any scientific veterinarian will bear me out in this statement. It is a very safe assertion that the suffering inflicted on animals in the laboratory is infinitesimal as compared with the stift'ering other animals are saved as a result of this kind of research. The protestants against the use of the lower animals in scientific research, as well as in diagnosis and in the prei)aration and testing of material of thoroughly j^roven and enormous value, base their attack on two assertions, both false" First: That intolerable crueltv is wantonl}' practised in the laboratory. Second : That no useful purpose has ever been secured by this method of research. As said before, I venture to assert that more animal stift'ering results from one day's sport or from a trapper's successful catch, than is inflicted in years in the busiest research laboratory. Yet no one. so far as I know, opposes big or little game htuiting, or refuses to wear furs, because they have been secured at the cost of so much suffering ; for imagine a fox, beaver or other animal caught in a spring trap, in cold weather, with a shattered leg, slowly freezing to death, unless as often happens the unfortunate animal, to the trapper's disa]")- ])ointment, secures his freedom by gnawing oft his shattered leg. Nothing comparable with that ever ha])pens in a laboratory, but it is a common occiu'rence in trapping fur-bearing animals. The second statement that nothing of im]:)ortance has ever been d.eveloped by animal experimentation can be believed only by ])eo])le incapable of understanding facts or being convinced) by absolute i)roof, or actual demonstration. Idie whole science oi phvsiology. the stndv of the working of the animal mechanism, is built up on animal experimenta.ion. liut for it we shoidd kncnv nothing of tlie circulation of the blood, the functions of the viscera, or the brain, spinal cord and nervous system generally. We should be no further adx'anced in knowledge of this subject than were Paracelsus or .\vicenna, or than is now the old fashi(jned Chinese doctor, who teaches his students that the intellect resides in the spleen, and the soul in the left kidney. No new drug used by the ]^hysician could 313 be safely employed in treating sick human beings, till its effects were tried out on lower animals. Anesthesia, one of the greatest of benefits to mankind ever devised, wotild never have been intro- duced and used as it is to-day, with incalculable saving of suft'ering (animal as well as human) but for the use of animals in testing its safety and its g'eneral eft'ect. The whole of bacteriology and modern surgery have been slowly workefl uj) to their present position among the sciences bv animal experimentation. Xo surgeon would dare to remove a kidney or suture the intestine, no matter how badly damaged, unless it had been shown it could be done in anesthetized animals with perfect safety, and without suft'ering. Remember, in passing, that even if all in- vestigators in this field were entirely devoid of the ordinarv human instincts, which of course is nonsense (what logicians call a "violent supposition") it would be impossible to do a delicate dissection on an unanesthetized struggling animal. Aseptic surgery, one of the greatest triumphs of modern times, would be impossible without animal experiments. 1 am old enough and young enough to be able to contrast the surgical conditions of forty years ago with the magnificent surgical successes of to-day, impossible without animal experimentation The study of the ultimate cause of diseases, which is the first stej) in finding means to prevent and cure them, has made enormous progress but much still remains to be done. An intensive study is going on all over the world to find the cause, prevention and cure of cancer. There is still much to be learned of small-pox. The ultmiate cause of scarlatina, measles and mum])s arc unknown, that of influenza not definitely determined. There are many other problems of this kind to be solved. Put a stop to animal cx])eri- mentation and the search must be abandoned. Incaculable dis- aster to the human race and to the lower animals would result, many epidemics now controllable would spread unchecked. The result- ing misery and death no man can begin to calculate, and medical progress would be completely arrested. It is undeniablv true that medicine and surgery owe the bulk of what they have accomplished in the last fifty years to animal ex])erimentation. Let me state from my own observation and ex])erience what was accomi)lished in the eradication of disease in the niili])pines in nine years, most of it the result of aniiual experiments, and methods developed and worked out in the lalxjratories of difi'erent countries, largely by animal exjjerimentation. When I left Manilla, after two years stay there, in 1erations, if possible, take the first boat for America? It is because they feel that they can get better surgical treatment in this country than an\ where else in the world. The wonderful advances in 324 American surgery have in no small measure been due to the careful and painstaking animal experiments carried on in the United States. The people of the world owe a tremendous debt to Louis Pasteur, to Joseph Lister and to the results of animal experimentation. Myri- ads of useful men and women, now alive and well, would have long since passed to their eternal resting place had it not been for the funda- mental discoveries of Pasteur and Lister, and for the new and better methods revealed to us by experiments on dogs. The citizens of the United States, when ill, rely absolutely on the judgment of their surgeon and place themselves and their families under the care of these surgeons, knowing full well that they will receive the best possible surgical care. Such being the case, the public can with confidence rely on the surgeon to be careful, conscientious and humane in his experimentation on dogs, which is absolutely essen- tial to the continued advancement of this important branch and to ^Medicine as a whole. ACPIIEVEMENTS OF ANIMAL EXPERIMENTATION IN GENERAL SURGERY. By George Tullv Vaughan, M. D., LL. D., E. A. C. S. Professor of Surgery, Geor(jeto%<.'n University. Man in the beginning was given control of all inferior animals for use, but not for abuse, and this right to use extends to confining the animals in captivity, making them work for him, and even taking their lives for any good and sufficient reason. Man gives his own life and often sustains great hardship and suf- fering in supi^ort of a worthy cause, or for the benefit of his kind ; then why should he hesitate to use the lower animals, who have been given into his keeping, for any worthy purpose ? I am as much ojiposed to cruelty in the true meaning of that word as the most violent and senseless antivivisectionist, but the use of ani- mals and their sacrifice at times even with suflfering, when done for the benefit of the human race, is not cruelty. I have read a number of attacks on all who believe in the ])rin- ciples I have just stated, and especially on the members of the medical profession, but the most remarkable and amusing of them all is a book by Stephen Coleridge. Stephen Coleridge, in his book entitled "Vivisection — A Heartless Science," 19 1(5, feels it his duty to attack vivisection as he is a repre- sentative in the fourth generation from the one who wrote the "An- 325 cient ^Mariner," and modestly continues, "I may claim with some par- donable pride to have acquired my convictions from three generations of ancestors, whose title to distinction in the fields of law and letters cannot be gainsaid." After reading his book one is com]:)elled to believe that however much he may know of "law and letters," his knowledge of physiologv is woefully deficient. To select one from the numerous examples of erroneous deduction, ignorantly or wilfully made, read his criticism of certain experiments made on animals by keeping them continually under the influence of alcohol, as showing his idea of cruelty : "Surely it is time that all decent men and women in England raised their voices in solemn protest against these dreadful claims of physi- ology, claims that revolt the heart and shock the conscience." Coming from a man of such pride in his logic, education, and hereditary convictions, this hysterical outburst is surprising over a condition in which the animal is blissfully unconscious of worry and certainly free from all pain. The issue, he writes, is "whether vivisection as practiced is right, not whether it is useful to science." What sophistry — the killing of a man in the abstract is not right, yet it is universally conceded that circumstances often make it right. He attacks the support or aid of medical schools by hospitals, criticiz- ing Lord Lister's approval, and pays his respects especially to the affairs of St. Bartholomew's Hospital, conclusive evidence that he fails to see the benefit which the schools with their students and physicians bring to the hospital, and showing his prejudiced and distorted opinion of the medical profession. The deductions from Sir Victor Horsley's answers to questions by the Royal Commission on Vivisection are unfair and unwarranted ; the insinuation that men like Brunton, Powers, Schaefer, ^lorris, Swazey, Bruce, Osier and others obtained their honors by practicing or sup])orting what he regards as an infamous practice, is slanderous; but the tribute to the leading lights of science in America, in the sug- gestion that asses' ears be grafted on the heads of the o])erators, is anuising, as the idea instantly occurs to the reader that the head of the author would be much more approj^riate for adornment with these emblems of unreasonable obstinacy and stupidity. To read the author's own account of how he has ])unctured the inflated arguments of his o])])oncnts with his irresistible logic, marks him as a regular Boanerges in control of the lightning and thunder, and to oppose his judgment or opinion is to invite destruction. The charge of mcgalocephaly ( bigheadedness) made against Sir Tulward Schaefer is another instance of transferring one's own ])ecu- liaritics to the shoulders of another. The entire tone of the book forces the conclusion that the author is a man whose .self-conceit is colossal, whose skill in distorting language from its honest meaning to suit his 326 purpose is phenomenal, but whose faith in the integrity of those who differ with him is pitiable, and whose logic is ridiculous. Let us hear now some of truth and soberness: After the Roval Commission on \'ivisection had concluded its sessions and the examina- tion of numerous advocates and opponents of vivisection, the Earl of Cromer, who might be regarded as an unprejudiced party, thus ex- presses his opinions : "I felt strongly that the vivisectionists and not their o]:)])onents were the true humanitarians. * * * The argument that the re- searches of the vivisectionists have been barren of results ought to be finally discarded by all save those who are not open to conviction. * * * The case of the antivivisectionists, when submitted to the test of cross-examination, broke down helplessly." A word now regarding some of the benefits we enjoy from animal ex])erimentation. Seventy-five years ago little was known as to the exact relations between the anatomy and the functions of the brain, spinal cord and nerves. Watson in 1845 (Head) said: "The structure of the nervous system has no perceptible or understood subservience to its functions," and he believed that the brain was the seat of a sort of generalized function with no special centers. Now we know, thanks to the experi- ments of Ferrier, Hitzig, Sherrington, Greenbaum and others, on the brains of monkeys that every motion and sensation in the body has its center or little group of cells in the brain which control it, so that any stimulation or injury to that center in the brain is shown by a certain sensation or movement of the muscles of the part so controlled. It is an ordinary event now, in injury or disease of the brain for the surgeon by observing, for example, movements or paralysis of the- muscles of the foot, hand, eye, mouth, etc., to know exactly in what part of the brain to look for the blood clot, tumor or whatever may be causing the trouble. This was illustrated in the case of a prominent presidential candi- date, when twitchings or paralysis began in one of his feet, the surgeon knew just where to look for the cause in the brain, namely, the center controlling that foot, so he opened the skull and found and removed a tumor. It was Charles Bell's experiments on a donkey about ISll that established the difference in function between the fifth and seventh cranial nerves and thus enabled us to oix-rate successfully on thousands of cases of neuralgia of the face. The surgery of the thyroid gland and the intelligent treatment of goitre was worked out by animal experimentation ; even great anato- mists like Luschka having no appreciation of the functions of the thyroid or jjarathyroid glands and their im])ortant relation to life and health. In the first operations sometimes all of the thyroid and i)ara- thyroid glands were removed, when the patient either died in convul- 327 sions or lived a short, crippled life with bloated features, cold and thickened skin, intellectual stupidity, ending in imbecility. By investiga- tion on animals it was found that when all of the parathyroids were removed, the animal dies of tetany, so that now in surgical operations for goitre we are always careful to leave at least one parathyroid gland. Before removing the larynx for cancer in man, Czerny experi- mented on dogs and found that they survived the operation and con- tinued in good health and now it is an established life-saving opera- tion for man. Likewise Simon in 1869, before removing a kidney from man, established the fact that dogs survived the loss of one kidney without any detriment to their health, and that is now a very common opera- tion for malignant tumors, tuberculosis, abscess, stone, etc.. and the man lives and enjoys life seemingly as well ofif with one kidney as with two. In 18()7 (Oilier proved by experiments on animals that bone or periosteum would live and grow and make new bone if transplanted from one ])art to another of the same animal, or if transplanted from one animal to another animal. From the knowledge obtained in this manner have come the numerous and wonderful operations on bones. In olfler times surgeons could make a new nose (for one whose nose had been destroyed) by turriing a flap down from his forehead or getting a flaj) from his arm. but it was a soft, mushy nose. Now, when this is necessary, we trans])Iant a ])iece of bone to stiffen the soft ])arts, obtained from the outer table of the skull, from the end of a finger or from one of the ribs. Parts of the skull are sometimes destroyed by wounds leaving the brain covered only by the soft parts which may cause fits or lead too easily to injury to the brain. These defects in the skull are filled in now, not by silver or celluloid plates, as was formerly done, but by bone obtained by splitting off a piece of tlie outside table of the skull near the defect or by cartilage obtained from the ends of the patient's ribs. .\ long bone partially destroyed may have the gap filled in by transplanting a fragment from some bone large enough to spare it — placing and fixing the fragment between the ends of the two fragments and holding it in place until union occurs. Where the thumb has been lost or all the fingers, a substitute for the thumb for the fingers to press against, or a substitute for the fingers for the thumb to press against, has been made by transplant- ing a suitable bone or fragment and fixing it in its new position. For the treatment of tuberculosis of the spine, which leads to hunciiback, a fragment taken from the larger bone in the leg is trans])lanted into the part of the s])ine which is diseased in order to hold the parts at rest until cure takes ])lace and jircvent the deformity of hunchback. l-'ven entire joints, as the knee, have been transplanted success- fullv — the (h'seascd joint is cut out and a healthy joint of proper size from a recently amputated liml) is {]\i.H\ in its place until union occurs. 328 APetchnikoff in 1!)03 inoculated apes with syphilis, and in 1905 Schaudin and Hoffmann discovered the germ of the disease. A few years later, in 1910, Ehrlich discovered his famous (JOG, or salvarsan, after 605 other remedies had been tried unsuccessfully. In 18 T6 Gussenbauer and Winiwarter experimented on dogs' stomachs and were surprised and pleased to tind after cutting out pieces and sewing them together that the jxirts united and grew together as kindly as do wounds of the skin, instead of being digested or destroyed by the gastric juice as was the common belief. In 1861 Billroth did the first successful pylorectoiuy (excision of a portion of the stomach) on the human being. In 1881: few surgeons were bold enough to open the abdomen even for the treatment of gun- shot wounds. Then it was that Parkes, at Chicago, exjDerimented on thirty-seven dogs by shooting them through the bowels while etherized, then operating on the wounds and proved that opening the abdomen and sewing up the bullet holes was the best method of treatment. This has led to the saving of thousands of lives, and the surgeon of today who fails to operate in such cases would be negligent of his dutv. Not only do we operate for wounds of the stomach and bowels, but for many diseases, such as cancer and ulcer. A portion of the stomach containing the cancer is cut out and the ends sewed together, or the ends may be closed by stitches and a new opening made between the stomach and the bowel. When the disease is so far advanced that removal is impossible, the stomach or the bowel above, and the bowel below the disease, which causes obstruction are united, "short circuited" as it is called, so that the obstruction is relieved and the patient's life prolonged and made more comfortable. It was also found that the entire stomach could be removed and the patient live. Schlatter at Zurich, Switzerland, did the first successful complete removal of the stomach in 189T, and the ])atient lived about one year, dying of a return of the disease (cancer) in some other form. Since then the operation has been done many times with good results. Forty years ago no one had dared to operate on a human heart. If it was penetrated by a knife or bullet, the patient was permitted to die without any interference on the part of the surgeon. Even with this method of no treatment some patients recovered, and in 186T Fischer published a list of 456 wounds of the heart with an estimated recovery of 5 to 10 per cent ; but as no operation was done, it is prob- able that most of the recoveries were in those in whom the heart had not been wounded, and it would be nearer correct to assume that recov- eries from penetrating wounds of the heart treated by the "watchful waiting" plan would not exceed 5 per cent. In 1895 Rosenthal and Del Vacchio made a number of experiments on dogs and found that they could be cured when the heart was wounded by opening the chest and sewing up the wound in the heart. The next year Farina, of Rome, sewed up a wound in the heart of a 329 man. and the man lived six days and died of pneumonia. During the same year Rehn performed the first completely successful operation of sewing up a wound in the heart. Twelve years ago (1908) I col- lected 150 cases in which wounds of the heart had been sewed up and 35 per cent {o2) of the patients recovered — a gain of about 30 per cent over the do-nothing method. Since that time many other patients with wounds of the heart have been saved by operation. All of us hope to see the time when diseases of the heart can be operated on and cured in the same way. In diseases of the heart, the valves often become too small, or the natural openings by which one chamber opens into another or into the great blood vessels, become too large or too small, so a leak occurs. Carrel and his co-laborers at the Rockefeller Institute have demon- strated the fact that in dogs the valves in the heart and the natural openings can be sewed up, enlarged, or reduced in size without killing the animal. In the same way large blood vessels which have been wounded have been preserved by sewing up the wounds, or where they have been divided by sewing the ends together, or where much of the vessel has been destroyed, by transferring a piece of another ves- sel which can be spared to take the 'place of the portion which has been destroyed. In several cases one lobe (that is nearly half) of one lung has been successfully removed, and in one case Lilienthal removed almost the entire lung with recovery of the patient. I cannot do better in closing than to quote the words of Dr. W. W. Keen, the Nestor of American surgery, in comparing the achievements of the friends of experimentation with the achievements of its oppo- nents. UxDER Experimi:nt.\tiox. "1. They have discovered and developed the antiseptic method, and so have made possible all the wonderful results of modern surgery. "2. They have made possible practically all modern abdominal surgery, including operations on the stomach, intestines, appendix, liver, gallbladder, pancreas, spleen, kidneys, etc. "3. They have made possible all the modern surgery of the brain. "4. They have recently made possible a new surgery of the chest. including the surgery of the heart, lungs, aorta, oesophagus, etc. "5. They have almost entirely abolished lockjaw, after operations, and even after accidents. "G. They have reduced the deathrate after compound fractures from two out of three ; i. e., <)() in a hundred to less than 1 in a hundred. "T. They have reduced the deathrate of ovariotomy from 2 out of 3 or ()fi in a hundred to 2 or 3 out of a hundred. "S. They have made the deathrate after ojjcrations like hernia, amputation of the breast, and of most tumors a negligible factor. :VM) "!». They have aboHshed yellow fever — a wonderful triumph. "10. They have enormously diminished the ravages of the deadly malaria, and its abolition is only a matter of time. "11. They have reduced the deathrate of hydroj)hobia from 1"^ to 14 j)er cent of persons bitten to 0.77 per cent. "12. They have devised a method of direct transfusion of blood which has already saved many lives. "13. They have cut down the deathrate in diphtheria all over the civilized world. In ]i) luiropean and American cities it has fallen from 7!).l) per hundred thousand of population in 1894, when the anti- toxin treatment was begun, to 19 deaths i)er hundred thousand in 1 !)().") — less than one-quarter of the deathrate before the introduction of the antitoxin. "14. They have reduced the mortality of the eiiidemic form of cerebro-spinal meningitis from W) or even '.)0-odd per cent to '^0 per cent and less. "lo. They have made operating for goitre almost perfectly safe. "Ki. They have assisted in cutting down the death rate of tuber- culosis by from ^O to 50 percent, for Koch's discovery of the tubercle bacillus is the cornerstoiie of all our modern sanitary achievements. "IT. In the British Army and Navy they have abolished Malta fever, which, in 190"), before their researches, attacked nearly 1,;}()0 soldiers and sailors. In 190T there were in the army only 11 cases; in 190.S, ,-) cases; in 190i), 1 case. "18. They have ahnost abolished childbed fever, the chief former peril of maternity, and have reduced its mortality from ."J or 10 up even to oT in every hundred mothers to 1 in L'^^O mothers. "19. They have very recently discovered a remedy which bids fair to ])rotect innocent wives and unborn children, besides many others in the community at large, from the horrible curse of syphilis. "•^0. They have discovered a vaccine against tyjihoid fever, which among soldiers in cam])s has totally abolished typhoid fever, as Presi- dent Taft has so recently and so convincingly stated. The imjiroved sanitation which has helj^ed to do this is itself largely the result of bacteriologic experimentation. "21. They are gradually nearing the discovery of the cause, and then we hope of the- cure, of those dreadful scourges of humanity, cancer, infantile paralysis and other children's diseases. Who that loves his fellow creatures would dare to stay the hands of the men who may lift the curse of infantile paralysis, scarlet fever, and measles from our children and of cancer from the whole race? If there be such cruel creatures, enemies of our children and of hutuanity, let them stand up and be counted. "22. As Sir Frederick Treves has stated, it has been by ex])eri- ments on animals that our knowledge of the pathology, methods of 331 transmission, and the means of treatment of the fatal 'sleeping sick- ness' has been obtained and is being increased. "23. They have enormously benefited animals by discovering the causes and, in many cases, the means of preventing tuberculosis, rin- derpest, anthrax, glanders, hog cholera, chicken cholera, lumpy jaw, and other diseases of animals, some of which also attack man. If suf- fering dumb creatures could but speak, they, too, would pray that this good work should still continue unhindered." On the other hand, what have the foes of experimentation achieved ? "1. Xot a single human life has been saved by their efforts. "2. Not a single beneficent discovery has been made by them. "3. Not a single disease has been abated or abolished by them, either in animals or man. "4. All that they have done is to resist progress — to spend S500,- ()()() in 30 years in Great Britain alone, and very large amounts of money in the United States — and to conduct a campaign of abuse and gross misrepresentation. "5. They apparently care little or nothing for the continued suf- fering and death of human beings. ^he grief and not seldom the ensuing poverty of their families, provided that 2G out of every l.doo dogs and cats, monkeys and guinea pigs, mice and' frogs experimented on shall escape some physical suffering. "6. They insist, therefore, that all experimental research on ani- mals shall sto]), and — astounding cruelty — that thousands of hiuiian beings shall continue year after year to suffer and to die." achie\:emexts of the medical corps of the army LN preventive MEDICINE. A \TXD1CATI0N of ANIMAL EXPERIMENTATION. By ■ George B. Foster. Jr., M. D.. Dr. V. H. Major, Medical Corps, U. S. Army. I have been asked to discuss animal cx])crimentation in it- relation to the advances that have been made in i)revontivc medicine through the work of- militarv surgeons. It is not my intention to apj^roach this subject in a controversial way, as I feel that the scientific achievements of the Medical Corps of the Army offer, in themselves, an argument that is incontroverlible. I shall endeavor to outline briefly two of the more important ])roblems that have been solved, leaving entirely to your judgment the (|uestion as to whether they have contributed to the safety, happiness, and pros- ])erity of mankind. 33-^ In considering the relation that animal experimentation — and lab- oratory methods in general — bears to great sanitary trium])hs, one must remember that no great achievement has been the work of one man or of one institution. To Marshal Foch has been attributed the remark that "battles are won with scraps." This a])plies equally in the field of ])reventive medicine. ]\Iagendie, the great French physiologist, likened himself to a chiffonier — a rag-picker — wandering through the realms of science, picking up fragments of knowledge, piecing them together and applying them to his own problems as he went along. ]\Iany times the observations of clinicians at the bedside or of epi- demiologists in the field furnish the clue that leads to some epoch- making discovery in the laboratory ; while, au contraire, in innumerable instances the truths elucidated in laboratories, applied practically by sanitarians and clinicians, have resulted in the conquest of disease. Now let us see what has been accomplished. Typhoid Fever. The great scourge of armies during the nineteenth century was typhoid fever. At the beginning of the F'ranco-Prussian War, the infection existed in every coq^s of the German Army and was epidemic in at least one division. After mobilization the disease spread like wild-fire, especially among the troops besieging Metz and Paris. Within two months after mobilization typhoid had spread so rapidly among some of the German troops that one man out of every six was sick of this disease. The total cases of typhoid in the German Armv during that war was 73.390, or nearly 10 ])er cent of the average strength. In the Afghan War of 187 8-80 typhoid fever developed at nearly every station occujMed by British troops, although some of these re- gions were practically uninhabited. During the Oran campaign, in 1885, the French troops camped in desert stations never before occupied, and yet typhoid fever not only occurred, but the outbreaks assumed the proportions of alarming epidemics. Many similar instances might be cited where troops were furnished drinking water of unimpeachable quality and occui)ied ideal cam]) sites that could not ])ossibly have been typhoid i)ollutc^sion of yellow fever by the mosr|uito. Yellow fever, ])eculiarly a disease of the .\merican continent, is one of the most fatal to which the human race is subject. The earlv colonists suflfered severely from this disease, and it had an important 336 bearing upon colonization in the Western Hemisphere. Its ravages in tro])ical America made this section a veritable plague spot for white men, resulting in the settlement and development of the temj^erate regions rather than the tropics. Untold agricultural and mineral wealth was diverted from the world's markets for 150 years by this grim reaper of human lives. As Vaughan so graphically states, "A certain dread and romance attaches to its history." Formerly the disease existed perpetually in Havana, and from there it made frequent devastating incursions into the United States. Outbreaks occurred along the eastern seaboard as far north as Boston. It wrought its greatest havoc, however, in the Southern cities, where, during the great epidemic of 1878 — only 43 years ago — 16,000 persons died, and the economic loss was estimated at $100,000,000. This catastrophe focused public attention for a time and resulted in the birth of a National Board of Health to protect the United States from another invasion. As most of the epidemics that had visited the United States were imported from Havana, it was evident to sanitarians that great pro- tection would be afforded the United States were it possible to eradi- cate yellow fever at its source. The opportunity so long desired arrived when Havana came into our possession in 1898. At this time nothing was definitely known as to the cause of yellow fever, or the means of its transmission. Sanarelli, an Italian doctor, had just announced the discovery of an organism which he called Bacillus icteroides, and he claimed it as the specific cause of this disease. Immediately keen interest was evinced in this discovery, and General George ]\I. Sternberg, Surgeon General of the Army, him- self a pioneer investigator in yellow fever, who had paved the way for subsequent workers, appointed an Army Board, consisting of Maj. Walter Reed and Dr. James Carroll, to investigate and report upon the relation of bacillus icteroides to yellow fever. This was in 1897. Reed and Carroll, through numerous experiments on swine and other animals, proved conclusively that Sanarelli's bacillus is a variety of the common hog cholera bacillus and has nothing to do with yellow fever. In 1899, when yellow fever appeared among the American troops stationed in Havana, Reed and Carroll again, with Drs. J. W. Lazear and Aristides Agramonte, constituted a commission sent to Cuba to investigate its cause and transmission. Shortly after arrival Reed was afiforded an opportunity to study an epidemic of yellow fever among our troops at Pinar del Rio, and he became convinced, through his observations there, that the theory then governing all preventive measures, that transmission occurred through infected utensils, clothing, bedding, etc., was efroneous. He determined to give up, for the time being, further search for the spe- cific cause of the disease and to devote all his efforts to the immediate 337 pressing need of the elucidation of the means of transmission in order that effectual preventive measures might be instituted. The belief that the disease was transmitted by mosquitoes, ex- pressed by Dr. Carlos Finlay, of Havana, nearly twenty years before, appealed to Reed as the most logical theory to investigate. The only way of proving or disproving this theory was to permit infected mos- quitoes to bite susceptible persons as laboratory animals were thought to be immune. After weighing the terrible responsibility of carrying out such experiments on human beings, the commission decided that if they succeeded in transmitting the disease experimentally through mosquitoes, the benefit to humanity would justify the hazard. They agreed, however, that in justice and fairness they themselves should be included among the volunteers. Female mosquitoes of the variety known as stegomyia fasciata were obtained from Dr. Finlay, infected by feeding on patients acutely ill with yellow fever, and then applied to the volunteers. The first experiments were carried out by Lazear as Reed had been recalled temporarily to the United States. Lazear's first attempt to infect himself was unsuccessful. Later he was bitten by a mosquito while collecting blood from a patient in a yellow fever ward, and he purposely permitted the mosquito to take his fill. Several days later he became ill of yellow fever and died. In the meantime Lazear had applied infected mosquitoes to Carroll, and this resulted in the first successful experimental inoculation. It can best be described in the words of Carroll himself : "The insect, which had been hatched and reared in the laboratory, liad been caused to feed upon four cases of yellow fever, two of them severe and two mild. The first patient, a severe case, was bitten twelve days before, the second, third and fourth patients had been bitten six, four and two days previously, and their attacks were mild, severe and mild, respectively. In writing to Dr. Reed on the night after the incident, I remarked jokingly that if there were anything in the mos- quito theory I should have a good dose; and so it happened. After having slight ])remonitory symptoms for two days, I was taken sick on August 31, and on September 1, I was carried to the yellow fever camp. My life was in the balance for three days, and my chart shows that on the fifth, sixth and seventh days my urine contained eight-tenths and nine-tenths of moist albumin. On the day that I was taken sick. August 31, 1000, Dr. Lazear a])plied the same mos(|uito, with three others, to another individual who suffered a comparatively mild attack, and was well before I left my l)ed. Thus it ha])])encd that I was the first ])erson to whom the mos(|uito was ])roved to convey the disease. On the eighteenth day of Se])tcmber, five days after I was permitted to leave my bed. Dr. Lazear was stricken and died in convulsions just one week later, after several days of delirium with black vonnt. .'^uch is yellow fever." 338 This ex])eriment on Dr. Carroll was followed by eleven others, nine of which were negative and two ])ositive, and, upon this evidence Reed felt justified in pronouncing, without hesitatiton, that "the mos- quito acts as the intermediate host for the parasite of yellow fever." The experiments did not stop here, however. The idea of mos- quito transmission was contrary to what a great many men believed, and it aroused a storm of adverse comment and criticism. Reed and his colleagues decided, therefore, to repeat and simplify the experiments imder conditions that would leave no doubt as to their conclusiveness. They established an experimental station, a mile removed from the nearest habitations, and surrounded it with an armed guard. No intercourse was permitted with the town except through an immvme ambulance driver and an imnirne hos])ital steward who transported su])]dies from Camp Columbia. The ])ersonnel and such susceptible individuals as were admitted for experimentation were sheltered in tents placed twenty feet aj^art. This station was named Camp Lazear. A small frame building was built, 14 x 20 feet, so screened with wire netting that mosquitoes could not get in or out. The interior of the building was divided into two compartments by a partition made of wire netting running down the center. Two susceptible persons were put in this building — one in each compartment. Breathing the same air and subjected in every way to the same conditions ; bnt entirely separated by the wire netting, they lived and slept in these compart- ments for several days to show that there was no yellow fever infection in the building. Reed then put fifteen infected mosquitoes in one of the comi)artments. left a man in the compartment for thirty minutes., and announced that this comi)artment was now infected. He took the man out of this infected compartment, but left two men in the compart- ment on the other side of the wire netting. The man from the infected compartment returned for twenty minutes in the afternoon of the same days, and again, for fifteen minutes on the following day. During these three visits he was bitten by moscjuitoes fifteen times. At the end of the fourth day the man from the infected compartment was down with yellow fever and the two men who had remained in the other compartment separated only by the wire netting and breathing the same air. were ])erfectly well. Reed then announced that he would disinfect the infected com- partment simply by catching and removing the fifteen mosquitoes. Following the removal of the infected mosquitoes a nonimmune soldier w-as again placed in each com])artment. left there several days and they remained ])erfectly well. Although the experiment created a j^rofound impression and the skeiJtics now admitted that the disease could be transmitted by the mosquito, they still maintained that it could be, and generally was transmitted in other ways, such as by soiled clothing, bedding, and by contact with persons sick with the disease, etc. 339 Reed then had constructed another small building that was almost air-tight — practically devoid of ventilation. In this building he placed material from the yellow fever hospital at Las Animas — mattresses on which yellow fever patients had died, sheets, pillows and pillow cases liberally smeared wath black vomit, excreta and discharges ; and even the pajamas worn by yellow fever patients throughout their illnesses. This material was opened up and spread out in this close room, and Reed asked for volunteers to sleep in the room. Dr. R. P. Cook, of the Army, and several soldiers responded. These men wore the paja- mas mentioned and slept on the bedding for twenty consecutive nights. All the men remained well — not a single case of yellow fever developed from this exposure. This demonstrated, once and for all, the fallacy of the filth or fomites theory of the transmission of yellow fever. The experiments were generally accepted as proving beyond question that yellow fever is conveyed from man to man by the mosquito alone and in no other way. The Board conducted further experiments demonstrating that the virus of yellow fever exists in the patient's blood only during the first three days of the disease ; that the virus is ultramicroscopic, being capable of passing through a porcelain filter that holds back ordinarv bacteria, and that it is killed by a temperature of 55° C. in ten minutes. They also showed that the female mosquito, only, can convey the dis- ease ; that after biting an infected person a period of twelve to twenty days must ela{)se before the mosquito is capable of transmitting it to another ; and that following the bite another period of from three to six days ela])ses before the patient develops the disease. These experiments are the foundation upon which all sanitary campaigns against yellow fever are now based. Let us now consider what they have done for hvmanity. For nearly two years prior to the conclusion of Reed's exj^eri- ments the Army had been in entire control of sanitary afifairs in Ha- vana. Our' cleverest sanitarians, among them Victor C. Vaughan, of the University of Michigan, probably the foremost American epidemi- ologist, had failed dismally in controlling yellow fever by means of methods based on the filth theory of disease. Following Reed's demonstration that the disease is transmitted solely by the mosquito, the sanitarians paid no more attention to fomites, but j)roceeded to apply practically Reed's experimental evi- dence in the following ways : ( L) A strict (|uarantine was established to keep infected persons from entering the city. (2) A daily inspec- tion of all nonimmune persons was made in order to detect new cases during the first three days of the disease — the only jieriod, you will remember, during which the virus is in the blood. (3) .All persons sick of yellow fever were immediately screened and isolated so that mosquitoes could not bite them. (4) A vigorous antinios(|uito cam- paign was instituted aiming at the destruction of all mos(|uitot's — kill- 340 ing the insects in habitations by wholesale fumigation and energeti- cally searching out and doing away with their breeding places. Considerable effort, anxiety and experimentation were extended in perfecting the methods, but on September 26, 1901, seven months after the institution of these methods, the last .case of yellow fever occurred, and Havana w^as free from this disease for the first time in 140 years. During that 140 years not a single month had passed with- out a death from yellow fever, nor had there passed a day in which there had not been some person sick of yellow fever within the city. Conquest of Yellow Fever ix Panama, Soon after the conquest of yellow fever in Havana, our Govern- ment began outlining plans for one of the greatest, if not the greatest engineering project in history — namely, the construction of the Pana- ma Canal. Early in 1902, while still stationed in Havana, where he had di- rected the sanitary work that had rid the city of yellow fever, ]\Iajor (now ]Major General, retired and recently Surgeon General) William C. Gorgas, of the Medical Corps, invited General Sternberg's attention to the enormous loss of life from tropical diseases that had occurred among the French while working at Panama ; emphasized the fact that these fatalities had resulted for the most part from yellow fever and malaria ; and suggested that the methods that had been so effective in Havana, if carried out in Panama, would greatly reduce the mortality that might be anticipated among American workers on the Isthmus. General Sternberg concurred in this opinion and recommended that Major Gorgas, on account of his previous experience in Havana, be placed in charge of the sanitary work in Panama. The contemjilated route of the Panama Canal lay through a low, swampy, densely vegetated country, alternating with rugged moun- tainous regions, where the rainfall was excessive and yellow fever and malaria prevailed to an alarming extent. The French attempt, in the eighties, to unite the waters of the Atlantic and Pacific by this isthmian route, although directed by one of the greatest engineering geniuses of all time — Ferdinand de Les- seps — had to be given up because of the enormous price paid in human lives. The French lost 22,189 laborers by death and sunk millions of dollars. It is said that the price paid in building the old Panama rail- road was a human life for each tie laid. One of the towns on this railroad was named Matachin, from the Spanish words meaning "dead chinaman," because a thousand imported Chinese laborers and a thousand African negroes laid down their lives at this point in six months. Colon at one end of the canal was a veritable white man's graveyard ; while the town of Panama at the other end bore the un- savory reputation of being the plague spot of the universe. There 341 was poverty, there was vice, there was every noisome thing that crawls and creeps. There were pestilences, and the greatest of these were yellow fever and malaria — another mosquito-borne disease. Then came Gorgas with his trained corps of sanitarians — fresh from their victory in Havana. The story of the sanitation of Panama under the administrative direction of Gorgas is a long one, and I shall not bore you with details. Suffice is to state that by instituting sani- tary measures similar to those used in Havana — destroying mosquitoes, rhaking habitations and hospitals mosquito-proof by screening, isolat- ing all suspected cases of yellow fever and malaria, removing under- brush, filling and obliterating stagnant pools and swamps, paving and guttering streets, and installing sanitary water supplies and sewerage systems, Gorgas entirely eradicated yellow fever within a year, and there has not been a single case of this disease in the Canal Zone since ^lay, 1906. Coincidentally with the disappearance of yellow fever there was a drop in the incidence of malaria. At the beginning of this great sanitary campaign 800 cases of malaria occurred annually in each thousand workers. By 1913 the rate had been reduced to T6 per thou- sand. The general annual death rate in the Canal Zone from all dis- eases at the present time is about 20 per thousand — a figure comparing very favorably with that of Xew York or Washington. The work of Gorgas alone made possible the building of the Panama Canal. But this is not the greatest benefit derived from that tremendous task, so spectacularly and effectively accomplished. By salvaging the Isthmus of Panama through sanitation the great lesson learned is that the tropics can be made as habitable for white men as the temperate zone. How different would have been the history of the Americas had it been learned 300 years earlier. In contemplating this — the greatest achievement of modern times — let us not forget Walter Reed — and experimentation. The triumphs over typhoid and yellow fevers have not been the only scientific achievements of the ^Medical Corps of the Army. Did the time allotted to me i^ermit I would tell you of the work of Stern- berg, the first American bacteriologist, discoverer of the diplococcus of pneumonia, ]iioneer worker in yellow fever, author of important treatises on infection, immunity and disinfection, founder of the Army Medical School, and a ff»rmcr surgeon general of the Army ; of the demonstration Ijy Ashliurn and Craig that dengue fever is due to a filterable virus and that it is transnn'tted by the mostjuito and aimenable to prevention by the methods successfully used in malaria and yellow fever ; and of the work of Chamberlain and Vedder, who, by experi- ments on fowls, disarmed the tropical disease beri-beri — tearing from it its mysticism, robbing it of its terrors and placing it in the category of curable as well as ])reventablc diseases. The conquest of hook-worm disease in Porto Rico, work based largely on the demonstration by experiments on animals that the para- 342 site enters the body through the skin, is the work of Bailey K. Ashford, a medical officer of the Army and a graduate of your own university — Georgetown. Many other instances might be enumerated of scientific endeavor redounding to the benefit of humanity. Those cited, however, should be sufficient to show that all advances in preventive medicine have their basis in experimentation — on animals as a rule, but on men when necessary and justifiable. Without animal experimentation we must inevitably stagnate, and many pressing questions as to the cause and prevention of devastating epidemics of transmissible diseases — influenza is one of these — must remain unanswered. I submit to you — shall animal experimentation be prohibited or no ? THE LABORATORY WORK OF THE UNITED STATES PUBLIC HEALTH SERVICE. By A. M. Stimson, Surgeon, U. S. P. H. S. Assista)it Director, Hygienic Laboratory, lVasJii)ujton, D. C. In an attem])t to familiarize you with some of the laboratory re- searches of the U. S. Public Health Service, I find it necessary to select certain illustrative examples from an almost endless list. The Public Health Service did not launch into existence on any definite date, save in name. Its development was gradual. From time to time as the emergency arose, Congress assigned it new duties and granted it fur- ther power. The purpose of the Service in general may be stated to be the ])romotion of ])ublic welfare by conserving and improving the health of the inhabitants of the country. In order to carry out intel- ligently and efficiently the duties laid upon it by law, the Service has had to engage in a great deal of laboratory work. In the course of this work it has been absolutely essential to use the lower animals. Before taking up in detail a discussion of the particular functions of the Service, it is necessary to make clear what is meant by "the experimental method." If we review the works of the ancients, we find that there was no lack of intellectual acumen among them ; in literature and in the arts they give abundant evidence of high mental' powers. Why was it, then, that in matters of science they made very little; progress, and that for centuries medical science especially was in a state of almost com])lete stagnation? The difference, I believe, is readily traceable to the lack of proper methods. Just as in mathe- 343 matics the lack of the calculus prevented the solution of a certain math- ematical problem, so in the physical sciences the lack of the experi- mental method effectually barred the door to progress. We can easily imagine that primitive man was satisfied with the explanation of a thunderstorm that it was due to a combat between devils fighting above the clouds. His explanation of disease was akin to this with the one exception that the conflict was limited to his own interior. In ancient India the Brahmins have accumulated some very interesting anatomical information ; for example, they stated that in the human body there are 100, OOO vessels, each divided into seven tubes, which carry ten different kinds of gases to all portions of the body. Moreover, the origin of the pulse they located in the abdomen ; it was said to be two hands high and three hands wide, and from it little tubes radiate to all parts of the body. When Greece was in her prime her philosophers had elab- orated a most intricate system of medical doctrine ; indeed, their theo- ries curried favor far down into the period following the Rennaissance. Disease was due to the conflict of various humors and spirits which cir- culated throughout the body. It will be noted that all of the philos- ophers up to this time had approached disease from a purely theoreti- cal standpoint. Investigation on the body by dissection and experi- ment had been resorted to very rarely and very superficially, and the practical knowledge of the prevention and cure of disease was, to all purposes, negligible. Let us contrast this mode of introspective philosophy with the method used by William Harvey, discover of the circulation of the blood. This great scientist, who was one of the earliest to use the experimental method in its perfection, actually dissected the body of man and of the lower animals ; he conducted experiments on the living bodies of animals, and only after he had carried on his investigations for more than ten years did he venture to make public the results. These findings were so at variance with the accepted doctrines which had been handed down from the Greeks that Harvey was derided and maligned, but it is gratifying to note that within his own lifetime his views were acce])ted and his practices emulated. The remarkable ])rogress of recent years in the medical sciences is directly traceable to the methods of exjjerimental investigation introduced by William Har- vey and other men of courage who were unwilling to sponsor unsup- ported tradition and who had to see with their own eyes before they tabulated conclusions. The U. S. Public Health Service has, of course, found much of its information concerning disease ready made. Other data it has established by ex])eriniental methods, and it is imjiortant to see that not only in beginning work related to public health is it necessary to use information gleaned from experimental methods involving the use of animals, but that in the actual continuation of the work after routine fashion, it is imperative to rely upon the same. 344 Bubonic Plague. I have selected as the first illustration of the laboratory work of the Service its operations in connection with a disease which probably has solicited the attention of but very few persons in this audience. Bubonic plague, to the average person, is looked upon as a distant, tropi- cal, exotic disease little to be worried about, and my reason for select- ing it is the fact that were it not for the employment of methods which were learned from experimentation this plague might very well be in om- midst today. Daniel Defoe has handed us a pen picture of a plague ei)idemic in London ; that this was not overdrawn has subse- quently been j^roven by many historic recurrences. Fancy a city dis- tracted, the inhabitants rushing about in a frantic effort to escape the pestilence, only to be met at the borders of the city by armed guards stationed to prevent their exit; unburied bodies line the streets and abandoned children are left to starve ; traffic and commerce is dis- organized, famine follows close upon pestilence. Such occurred in the days before science pointed out the cause of the plague and of its spread and suggested a rational, effectual mode of combating the disease. At the present time there is an infection of this plague in one of our larger American cities, yet no panic reigns, tourists visit the city in large numbers, and all is apparently ])rosperous. This because there is constantly being carried on in that city a quiet, eft"ective campaign to meet the emergency. The experimental investigations have shown that plague is essentially a disease of rats ; that it is conveyed from rat to rat, and may be communicated from rat to man through the flea. With this known it is found to be practicable to prevent the spread of plague by systematic examinations of rats captured in all portions of the city. When a plague rat is trapped intensive antirat operations are carried on at the place where this rat was apprehended, and thus an incipient focus of ])lague infection is wi]:)ed out before gaining head- way. The claim that general methods of sanitation will effectually prevent plague epidemics is unsubstantiated ; they merely limit rat infestation. DlPIITIIKRTA. Turning now to a disease more familiar to us I shall review the work of the Service on diphtheria. Diphtheria continues to be preva- lent, chiefly because the germ which causes it may be carried about in the noses and throats of perfectly healthy persons. Since it is im- possible to examine an entire population in order to discover who these so-called "carriers" are, and since it would be impossible to quarantine them all when apprehended, the efforts of health officials have been only in nart successful toward eliminating the disease, but by method.= 345 which were devised by animal experimentation it is possible to reduce the death rate from this disease to a very favorable hgure. For ex- ample, the method of making an early diagnosis by laboratory methods has enabled us to treat cases earlier and more effectually and to pre- vent infection of those who associate with these cases. Diphtheria antitoxin also is one of the most remarkably efficient remedies known to man. But suppose no supervision were exercised over the manu- facture of this antitoxin, and that inert and worthless samples of the product were freely marketed, we can readily estimate how many lives would in consequence be sacrificed. The Public Health Service controls the manufacture of antitoxin, making sure, by methods of animal experimentation, that this i)roduct as it is sold in the drug store is potent and reliable. Furthermore, by animal experimentation a method has been devised for examining the bacteria which cling to the throats of patients followiijg their convalescense to determine w^iether they are dangerous to others or not. Serums and Vaccines. The Service supervises in like' manner the commercial production of many other serums and vaccines which are used for the treatment of various diseases. I may mention in this connection the serum for tetanus, or lockjaw, through wdiich many a soldier in the trenches was saved to the nation. Typhoid vaccine, a product of great efficiency, is standardized by methods in w^hich animals are used ; rabies vaccine more familiarly known as the Pasteur treatment for Hydrophobia, is jjrepared by the Service, and its preparation necessitated the use of animals. This list might be prolonged indefinitely, but it is safe to say that there is scarcely any useful j^roduct of this general class which has not necessitated the experimental use of animals,. either in its dis- covery, in its ])reparation, or in its standardization. At the present time there is being conducted throughout the United States an energetic crusade against venereal diseases. While these diseases involve a moral ]:)roblem for all, to the sanitarian they present also a ]nirely medical j^roblem. Hence it is essential that every person known to be infected from syphilis should be treated to prevent his being a menace to those with whom he may come in contact. To eft'ect this arsphenamine is preeminently efficient. The preparation of this substance is difficult, and, unless the greatest care is taken, a product may be issued for distribution which is unduly poisonous and would, if administered to ])atients, beget most disastrous results. The Public Health Service is charged with the duty of examining each batch of this substance offered for sale. To do this the lower animals must be used. From time to time reports reach the P>ureau of the l\ S. I'ublic Health Service of the occurrence, in this or that part of the coimtry. of 346 a new or rare disease. This calls for an immediate investigation to ascertain whether this condition is likely to spread and become serious, or possibly to end in a nation-wide menace. Such have been pellagra, Rocky Mountain spotted fever, the so-called "deer-fly disease," and a disease called after its discoverer, Dr. Brill. In nearly all of these instances it was imperative to make extensive inoculations of animals in order to determine the nature and cause of the disease, to find out what animals beside man might be afflicted with it, and, in some in- stances, to devise a remedial agent. During the war a considerable number of cases of anthrax, or malignant pustule, occurred among soldiers, and an investigation, in which the use of animals became necessary, showed that these cases were due to a natural infection of shaving brushes through the hair from which they were made. Regu- lations were immediately issued to inhibit the use of harmful material in the manufacture of these articles. Tuberculosis. We have with us at all times a disease which is so common that we perhaps do not fully appreciate what a tax it entails on the economy, the health and the happiness of the populace ; tuberculosis occurs ac- tively in perhaps 1 per cent of the population and occasions at least one out of every ten deaths. If this occurred in an isolated epidemic we should be appalled. Great as have been our advances in the knowl- edge of this condition, there remains much to be investigated and learned. We have been obliged to experiment upon animals in' ob- taining our present information and this practice will necessarily con- tinue, if we are to find out more. The Service is at present engaged in an experimental investigation of tuberculosis with the view to dis- covering some method which will aid in the fight against this insidious malady. Every now and then a new and wonderful cure for tuber- culosis is ushered in with much sound of trumpets and flaring head- lines in the newspapers. Some of these so-called "remedies" are little less than unadulterated, heartless fakes ; others are somewise bolstered by scientific i)lausibility ; unless the public be informed by a reliable authority as to the true merits of these "cures" a most pitiable state of afifairs is likely to transpire. Suft'erers from all parts of the country, many of them in the last stages of the disease, many having spent their last cent for railroad fare, flock to the center where this new remedy is obtainable, only to share disappointment, and frequently to die from exhaustion. It is felt that the Service in investigating and furnishing the public with reliable information on the subject of certain of these reputed "cures" has rendered a valuable service to the country. In such investigations it is necessary to use experimental animals, as it is, indeed, in arriving at a diagnosis in many susi)ected cases of tubercu- losis. 347 Other Problems. Probably no drug is more freely prescribed in diseases of the heart than is digitalis. Yet unless this remedy is of a standard qual- ity, it is apt to be harmful rather than beneficial. Accordingly, with the aid of animal experimentation, the Service has formulated a test which unquestionably establishes the strength and purity of the drug. It has been recently estimated that there are i)erhaps a million persons in the United States who are addicted in some degree to the use of habit-forming drugs. The pernicious effect of these drugs on the individual himself and on the civilization of which he is a unit are well known ; and yet there is a real need for the alleviation of pain and other symptoms of drugs which have an action similar to the habit-forming drug, but free from this distressing feature. Some progress has already been made in devising suitable substitutes, and in this work an indispensable factor has been the use of animals. Those oi)posed to vivisection and, indeed, to animal experimenta- tion generally, are accustomed to characterize many of the investiga- tions carried out by scientific men as being due to idle curiosity. It is true that investigations are made into various phases of the disease problem without there being at the time any apparent way in which the information gained can be practically applied. Nevertheless, such information sooner or later is almost certain to merit its place in devis- ing something of value to humanity. One instance, as an example of this, is anaphylaxis. If horse serum be injected into a guinea pig, even in large amount, it ordinarily provokes no appreciable effect, but an investigator noticed that if, after an interval of ten days or more, another injection of horse serum be given the same animal, it acts as an acute poison, often killing the animal within a few minutes. This finding invited the closest research. No immediate practical 1)enefit to mankind was at first anticii)ated, but, as a matter of fact, the infor- mation thus gained has been of great value in diagnosing hitherto obscure disease conditions in man and in suggesting preventions and cures. Another example : During the examination of the Ixidies of rats for plague infection, a disease of quite different origin, but closely simulating plague in the lesions caused, was unex]:)ectedly brought to light. Through animal experimentation the bacterium causing this disease was cultivated. No immediate bearing of this fact on human health or happiness could be foreseen, yet within a very few years it was discovered that many could suffer a distressing infection clue to this same organism. Problems regarding measles, infantile ])aralysis, hookworm and the like placed before this .Service for solution might very i)r<)fital)ly be called to your attention, but time forbids. In concluding 1 beg leave to advise you that the benefits which have accrued to man con- sequent to animal ex])erimentati()n have touched not only physical 348 but aslo his moral well being. It is true that vice predisposes to disease, but it is no less true that disease, innocently contracted, brands as a criminal one who otherwise would have been a useful citizen. There so appears here a vicious circle between disease and crimi- nality ; there are those that would break the continuity of this circle in the reformation of all criminals, and we wish them well, but surely it is not a step toward the wrong if, with the means at our disposal, w^e, too, interrupt this closed line, ridding the community of the dis- eases, which, directly or indirectly, are responsible for a great part of it. THE ECONOMIC ADVANTAGES DERIVED FROM ANIMAL EXPERIMENTATION By Ernest Charles Schroeder, ^I. D., D. V. ^M. Sitpcrintcndcnt, Expcriuicnt Station, U. S. Bureau of Animal Industry, Bcthesda, Aid. The economic advantages derived from animal expermientation are so abundant and diverse that it is impossible in the time I am privileged to discuss them to do more than indicate their far-reaching importance. To verify this statement I need ask only a few questions like the following: Is it an economic advantage to have the Panama Canal? Is the defeat of Pan-Germanism an economic advantage? Is it an economic advantage to have food and clothing in sufficient cfuantities to insure health ? The Standard Dictionary defines economics as "the science that treats of the develoimient of material resources, or the production, preservation and distribution of wealth, or the means of living w^ell for the state, the family and the individual." If we accept this definition we may conclude that anything, not an actual, inse])arable i)art of ourselves, that contributes to the better develojiment of the human race and tends to make life more desirable, is an economic advantage ; hence, the rational answers to the several questions must be affirmative. The Panama Canal woidd not have been built if animal ex])erimen- tation had not revealed the etiology of yellow fever. The French failed to build it, not because they lacked intelligence, courage or perse- verance, but because they did not know how to combat yellow^ fever. Under the same conditions the Americans would have failed. If the Canal had been constructed with no better knowledge about yellow fever than was avadable at the time the French abandoned the gigantic project, after they had sacrificed more than twenty-thousand lives. 349 success would have cost so many valuable lives that the very thought of it is horror inspiring, and the established short-cut between the Atlantic and Pacific Oceans probably would have proved so perniciously unwholesome and destructive to those who used it that it soon would have earned a name for itself something like, "The water-lane of the yellow death." What the Canal has done and promises to do in tlie conservation of man-power, time, shipping, fuel, etc., and how much it will facilitate the development of the world and particularly the countries on the western -coast of the two Americans, I leave to your imagination. If animal experimentation had not provided vaccines, bacterins and antitoxic sera ; if it had not aided in the development of jiew methods of surgery and the discovery of reliable means to diagnose infectious diseases, and had not taught us how to use war gases and how to defend our soldiers against them, the recent war would have cost many additional thousands of lives and would have produced many additional thousands of cripples ; it would almost certainly have been prolonged and it is seriously questionable whether Pan-Germanism, with its numerous, villainovis atrocities, could have been defeated. The economic significance of its prolongation, leaving morbidity and mortality out of consideration, may be judged from the estimate that the war cost the human race three hundred billion dollars, and about the economic meaning of defeat we should suspend judgment until we have tried to visualize the world under the domination of a victory- elated despot, whose megalomania, fostered by an exultant, reaction- ary, Prussian aristocracy, would have prompted him to assume the rank of a divinity. If animal experimentation had not taught us how to cure many diseases of the lower animals and how to suppress appallingly de- structive animal plagues, the hunger and starvation now prevalent in many parts of the world would be practically universal. I might say, however, if animal experimentation had not provided the means to control human diseases like small-pox, Asiatic cholera, bubonic plague, typhus fever, yellow fever, etc., it is not at all likely that the population of the world would have become great enough to make the spread of food-destroying diseases like rinderpest, foot and mouth disease, anthrax, Texas fever, hog cholera, surra, swine erysipelas, contagious pleuro-pneumonia of cattle, sheep scab, etc., econonn'cally very im-> portant, as food has no value for those who are dead and those who fail to be born. Vegetarians, who do not recognize the need for abundant supplies of meats, animal fats, wool and hides, and persons who hold extreme views on animal rights, may mistake this statement as an exaggeration. Their attention should be called to the fact that it is questionable whether sufficient food for the present population of the world could be producerl withftut the use of animals to convert coarse, vegetable 350 substances, unfit for human stomachs, into easily digested, nutritious food, and to the fact that, in adchtion to serving as indispensable sources of food, clothing, power and pleasure, domestic animals are so importantly, related to the production of vegetable foods and textile fibers that practical agriculturists are convinced that the cultivation of the soil without animals is economically impossible. The spiritual and intellectual nature of man requires that we should look upon him as a unique and unparalleled being, but materially, that is physically and chemically, he is not fundamentally unlike the higher mammals ; consequently, most knowledge valuable for ihe protection of man's health and the treatment of his diseases is similarly valuable for the lower animals, and discoveries, like the circulation of the blood ; the capillary circulation; the vasomotor mechanism; the functions of the nervous system generally ; the flow of the chyle in the lacteals and its passage through the lymph ducts into the venous circulation ; the nature of the digestive fluids and the chemical transformation of food through their action ; the functions of the liver, lungs, kidneys and other organs, the reaction of the cells to various kinds of stimuli ; the significance of the endocrin glands ; the nature of inflammation and other j^athological processes, and practically every other discovery in physiology, pathology and biochemistry, are as serviceable in the work of the animal husbandman and veterinarian as in that of the hygienist and physician, and in this sense have great, material, economic value. The discoveries referred to, and many others, too numerous to mention, were all made through animal experimentation, and could have been made in no other way that has ever been defined. Veterinarians and i)hysicians use drugs, and if the pharmacopoeia contains valuable drugs about which our knowledge has not been enriched through animal experimentation, I must confess that I do not know what they are. A superficial and insufficient knowledge of the actions of some drugs was admittedly obtained through accidental or unintentional, unguarded and undesirable occurrences among per- sons and animals, but the precise knowledge we have of the therapeutic, l)hysiologic an.d toxic actions of the innumerable substances from which our useful drugs have been selected, is all the product of care- fully planned, intelligent animal experimentation. If wc did not know through animal experimentation how the drugs now in use act, on the body as a whole, on si)ecial ])arts of the body, directly or indirectly through the nervous system, and whether their action is immediate or cu.mulative, the death rate among persons and animals would be griev- ously multiplied, and the greater losses among the latter would prove a factor of serious, economic disadvantage. Before ex])erimental methods were used to study living organisms in health and disease, the i)ractice of medicine was little better than a i)resumptive art, based on disconnected and largely misinterpreted observations, and sick persons and animals were tortured as often, if 351 not oftener, than they were helped by the measures taken to restore their health. Since then, fortunately for all sentient beings, medicine has become a true science, and those who practice it make real, un- mistakable contributions to recovery from sickness, the preservation of health and the prevention of suffering. In animal industry this means fewer losses and greater productivity, or, in other words, better and less expensive food and apparel. I wish to emphasize that nearly every discovery that has thrown light on the nature of the human body and its relation to its environ- ment has also thrown light on the nature of the bodies of the lower animals and their relation to their environment, as this fact enables us to recognize that even that portion of animal experimentation, primarily undertaken to secure knowledge for the prevention and better treatment of human diseases, rarely fails to confer benefits on the lower animals-; hence, if the proportion between the pain animal experi- mentation has caused and prevented among animals alone was taken as the major factor in determining whether animal experimentation is or is not morally sound, we would not be left in doubt a single moment, as the pain that has been caused is insignificant in comparison to that which has been and is being prevented. The men who treat diseases among animals probably relieve more pain every dav than animal experimentation causes in a score of years, and they do this through the agency of the knowledge animal experimentatk)n has supplied. Diseases of animals like those of persons may be divided into two kinds, the infectious and the non-infectious, or those caused by para- sites and those due to other causes. The economic advantages derived from animal experimentation, through the light it has thrown on the infectious diseases of domestic animals, are of astounding value, and this can be shown in no better way than by discussing several of them separately. I will begin with Texas fever of cattle, which has the distinction of being the first disease ])roved to attack its victims exclusively through the agency of intermediate host or carrier of its causative germ or micro])arasite. It is a member of a large group of exceedingly de- structive, infectious but not contagious, diseases; oth.r iiicmbsrs ol the group are malaria, yellow fever, typhus fever. Rocky mountain spotted fever, African sleeping sickness, spirillosis of fowls, nagana. African coast fever of cattle, piroplasmosis of horses and sheep and dogs, etc. The intermediate host of Texas fever is the Southern cattle tick. a blood-sucking parasite which absorbs the germs of the disease with its food when it lives on liie bodies of infected cattle. The female ticks, after they reach maturity, drop to the ground, produce two thousand or more eggs, the eggs hatch and the young ticks inoculate the susceptible cattle to which they attach themselves. It is i)erfectly safe to permit liealthy cattle to association with those that are affected 353 with Texas fever, provided no cattle ticks are present, and cattle ticks do not convey or cause the disease unless they are the progeny of ticks that matured on the bodies of infected cattle. Infected cattle, when we deal with Texas fever, means all cattle that are either actively affected with the disease or that have a])parently recoverd from it, as the Texas fever microparasite, once it has entered the blood of cattle, evidently remains as a permanent contamination. In one of the lectures of the present series Dr. Simon Flexner of the Rock feller Institute for ^Medical Research ex])ressed the opinion that our knowledge of yellow fever would in all likelihood have been delayed if the work of the Bureau of Animal Industry oi the U. S. Department of Agriculture on Texas fever had not been done. I have already pointed out that the Panama Canal would not have been constructed without the knowledge animal experimentation gave us on the etiology of yellow fever. Think of the modest investigator whose i)atient study of a mysterious cattle disease proved a great pioneer work in the field of medical research, and incidentally opened the door to knowledge required for the junction of two oceans at a point thousands of miles removed from where nature permitted their waters to mingle. Draw a mental I)icture of the man and his work ; it will give you an inspiring view of intellect successfully combatting evil. But it is unnecessary in speaking about Texas |ever to dwell longer on the role of animal experimentation in the accomplishment of a great engineering feat, as there are other impressive and exceedingly important things to talk about in connection with this disease that must also be credited to animal experimentation. Less than fifteen years ago the prevalence of Texas fever and cattle ticks in our Southern States necessitated the maintenance of a cattle quarantine which included an area larger than three quarters of al million square miles, known as the permanently mfected area. In this area, more than three and one-half times as large as the French Rejniblic and nearly three and one-half times as large as the former German Empire, the losses caused by Texas fever and its carriers were enormous, to say nothing about the frequent, troublesome spread of the disease northward. Most of the cattle raised were undersized, large-boned, unthrifty mongrels and inferior producers of milk, meat and hides. Much of the food they consumed was worse than wasted, as it was diverted from sharing in their growth and development, after their bodies had been taxed with digesting and converting it into blood, to feed the ticks which irritated the surfaces of their bodies and the microparasites which lived beneath the surface. A fairly reliable idea may be formed of the losses caused by ticks alone w^hen we know that female cattle ticks multiply their size and weight by about ten-thousand during the approximately four weeks they remain attached to the skin and feed on the blood of their hosts ; 353 that the adult female tick is about as large as the terminal joint of a woman's little finger, and that ticks of all ages and sizes, often in unbelievable numbers, are present on the bodies of the cattle in the infected territory during the greater part of the year. A light infestation with ticks has been proved to reduce the milk yield of dairy cow^s 18%, and a heavy infestation reduces it more than 40%. Think of the loss, to which must be added the loss in beef pro- duction, the lower value of roughened and scarred hides and the deaths due to Texas fever, which latter, averaged for eleven states, amounted to 13%', or a half per cent more than one-eighth of the total cattle. The reason cattle could be raised at all in the infected and infested territory is that Texas fever in calves rarely is the severe, acute, highly fatal disease it commonly is in susceptible adult cattle. It attacks the calves, has a mild, chronic course, plants its microparasites permanently in their blood and gives them a high degree of immunity against severe attacks later on. Agriculture may be compared to a complex machine ; there are many parts to it, and if one part gets out of order all the others are afifected. The cattle industry is as necessary to American agriculture as tires are to an automobile, and to practice agriculture with cattle ticks, Texas fevef and a cattle quarantine, resembles driving an automobile over a rough road, littered with cutting and puncturing objects and under- going constant repairs that require long detours. Hence, it is not surprising that agriculture in many parts of the quarantined area was unprosperous and that the farmers and breeders were discouraged and depressed. In the year 1906, the methods for eradicating Texas fever and cattle ticks, revealed through animal experimentation, were put into practice by the U. S. Bureau of Animal Industry, and since then, over half a million square miles, a territory one-hundred thousand square miles larger than the combined areas of the French Republic and the former German Empire, have been cleaned of the disease and its carriers and released from quarantine, and in only a few years more the two related plagues will have been wi]:)ed entirely out of our Country. Fully to appreciate what this means, and to measure its economic value, we must know that the formerly infected and infested, quaran- tined territory includes some of the best agricultural and cattle lands in the world, and that it has begun to produce cattle that compete successfully, and on terms of equality, with the finest that enter our stockyards, and that recently it has produced cattle that ca])tured blue ribbons at National livestock shows. The farmers and breeders have taken heart and are working with renewed courage, and increased prosperity and contentment are widely evident. The choice, well- bred, healthy, heavy and j)rofital)lc cattle are being produced at no greater expenditure of labor and forage than the undersized, sufi'ering 354 runts required, as cattle raising and feeding has ceased to mean raising and feeding a combination of cattle,, cattle ticks and Texas fever parasites. It is now safe to send cattle from the North into the rich ])asture lands of the South, where, a little while ago, it was unsafe, notwithstanding difficult j^recautions, to send thoroughbred animals for breeding purposes. Think of the economic advantage. Think of the increased ])roduc- tion of food, think of it with the fact in mind that well-informed men assert that the morbidity and mortality in the world directly due to undernourished are so great in many ]:»laces that they over-shadow the horrors of the war. Those who are not informed about the evils incident to under-nourishment and long continued dependence on food that lacks essential nutritive elements, and how serious the food shortage in the world is today, may find it difficult to believe that millions of human beings in this so-called civilized age, beings and feelings, affections and souls like our own, are being stunted spiritually and jjhysically and are being hurried prematurely out of life because they cannot get enough to eat or enough of the right kind of food, and yet this evidently is the truth. In the United States the ])0]iulation has increased faster than the number of domestic animals, and this probably is one of the causes for the high price of food. In Iuiro]:)e the war has reduced the number of domestic animals so nuich that a replenishment from Countries, ours included, in which the animal industry was less severely injured, is urgently needed. Let us take a look at another diseiase, about which much unfruitful guessing was done until the truth was learned through animal ex])eri- mentation ; the commonest and most widely disseminated of all diseases. namely, tuberculosis. Animal' experimentation proved that the manifestations of tubercu- losis in different portions of the body and in the bodies of different species of animals all have one, essential cause ; it proved that the disease is contagious ; it showed how and why it is contagious ; it led to the discovery of the tubercle bacillus ; it ])roved that the tuliercle bacillus in nature is an obligatory parasite ; it proved that the bacillus is quic1