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Periodic Physical Examination of 
 
 Employes: Its Economic 
 
 and Social Value 
 
 Address delivered before 
 
 The National Association of Manufacturers 
 
 May 26, 1915 
 
 By Eugene Lyman Fisk, M. D. 
 
 Director of Hygiene 
 
 LIFE EXTENSION INSTITUTE, Inc. 
 
 25 WEST 45th STREET 
 
 NEW YORK 
 
 Issued by the 
 
 Life Extension Institute 
 
 Incorporated 
 

 To prolong life and mal^e it more livable 
 
 NBW YORK, N. Y. 
 
 2B W. 45TH ST. 
 
 HON. WM. H. TAFT, 
 
 Chairman, Hoard nf Directing 
 
 ELMER E. RITTENHOUSE, 
 
 I'rr^idi'nt 
 
 GEN. W. C. GORGAS, 
 
 Covsiilta nt , Sa ii itat ion 
 
 PROF. IRVING FISHER, 
 
 Chairman, Ilytiicnc Reffrenre Board 
 
 EUGENE L. FISK, M.D., 
 
 Director of Hygiene 
 
 HAROLD A. LEY, 
 
 y ire- President and Treasurer 
 JAMES D. LENNEHAN, 
 
 Srrrilitry 
 
Digitized by the Internet Archive 
 
 in 2010 with funding from 
 
 Open Knowledge Commons 
 
 http://www.archive.org/details/periodicphysicalOOfisk 
 
Periodic Physical Examination of Employes, 
 its Economic and Social Value. 
 
 Address delivered before the National Association of Manufacturers 
 May 26th, 1915, 
 
 Why should a turtle live longer than a man ? What does the 
 turtle contribute to the biological progress of the universe that 
 he should be granted three times the span of human life? 
 
 Is it not a little galling to human pride when we reflect that 
 man, supposedly at the center of the universe, bending most 
 of its mighty forces to his will, is yet unable to distance the 
 tortoise in the race for longevity? 
 
 It is all very well to say that the life of the turtle is flat, 
 stale and unprofitable. After all, he lives long and apparently 
 comfortably and happily — barring such accidents as getting 
 into our soup. Man, on the contrary, lives a brief existence, 
 hampered, nagged and handicapped by countless miseries and 
 disabilities, that not only shorten his existence but embitter it, 
 causing him as a rule to break down prematurely, and })re- 
 venting him from achieving what mind and body are capable 
 of achieving when working in harmony with Nature's laws. 
 
 Man has defied the forces of Nature, and harnessed many 
 of them in his service, but concomitantly he has broken many 
 of the laws of Nature, creating an artificial environment, pro- 
 tective in some respects, menacing in others. 
 
 The Cjuestion that confronts us is tiiis : Is it inevitable that 
 the higher and more complex life of man should be shorter 
 than the lower life of the turtle? 
 
 So far as science can reveal, there seems to be no princi]ile 
 of either life or death. There are many good and bad reasons 
 why men die, but no un(k'rl\ing necessary reason why they 
 must die. The brilliant Carrel, now working in the very jaws 
 of death, has kci)t tissue cells alive outside the body for the 
 
past three years. These cells are multiplying and growing, 
 apparently unchanged by time, to all appearances immortal so 
 long as they are i)eriodically washed of poison and nourished 
 in a proper medium. Wash man of his poisons at intervals, and 
 nourish him. and win- should he not live on so long as there 
 is energy in the universe to supply his needs. 
 
 Notwithstanding what I have said about the turtle, I would 
 not waste one moment of time in pleading for a mere extension 
 of human existence, if there were not sound scientific evidence 
 to prove that such extension can most easily be attained by 
 improving the quality and the total value of existence. There 
 is even something ignoble in hanging on to the coat-tails of 
 Old Father Time just to sneak a few more years of life. 
 Tolstoi is right in advising us not to fear death, which under 
 present conditions like sleej), must come to all. It is, rather, 
 a wasted and deformed life that we should fear and that we 
 should seek to escape, not by leaving it, but by mending and 
 moulding it. 
 
 Man has made some progress in escaping death, and in 
 hammering down the death rate as the following figures show : 
 
 Death Rate 
 Year per 1,000 living 
 
 Geneva 1551-1600 39.7 
 
 Geneva 1891-1900 17.6 
 
 Berlin 1721-1730 40.6 
 
 Berlin -. 1 905-1910 15.5 
 
 London 1 800-1810 29 
 
 London 3905-1910 14 
 
 Paris 1809-1816 30.5 
 
 Paris 1905-1910 17.5 
 
 Sweden 1751-1760 27.4 
 
 Sweden 1912 14.2 
 
 U. S. Reg. Area 1880 19.8 
 
 U. S. Reg. Area 1913 14.1 
 
 While the average duration of human life has been greatly 
 extended during the past century, there has been no material 
 addition to the span of human life. It is true that in certain 
 countries such as Sweden, England and Wales, Prussia and 
 Denmark there has been a gain in vitality at every age period 
 
of life during the past quarter century, but in this country, so 
 far as we can determine from our exceedingly unsatisfactory 
 registration records, there has been not only a failure to 
 lengthen the span of life but a positive loss in vitality at middle 
 life and later, notwithstanding the fall in the general death 
 rate. 
 
 This conquering of death, in the earlier age periods of life 
 is due to man's success in meeting the massive frontal attacks 
 of such enemies as diphtheria, tuberculosis, typhoid fever and 
 diseases of infancy. The elimination of such plagues as "Black 
 Death," yellow fever, smallpox, has also left its impress on 
 the general death rate. But we have been less successful in 
 guarding against influences, agencies and infections which may 
 be compared to submarine attacks, or to sapping and mining 
 operations that reveal no enemy until an explosion occurs. 
 Under this class of agencies we include faulty living habits 
 which tend to disturb the functions of the body and impair the 
 efficiency of our organs, ultimately causing them to break 
 down ; also chronic infections, which pass unnoticed often for 
 years until announced by illness and physical failure. 
 
 HUMAN LIFE A STRUGGLE WITH GERM LIFE. 
 
 Life is one long struggle with micro-organisms. Sanitation, 
 quarantine and the annihilation of pest carriers such as the 
 mosquito and rat, protect us from some of these enemies, but 
 others lodge in our tooth sockets, our tonsils, our middle ears, 
 the nasal cavities, etc., and from such favorable bases of sup- 
 plies stream out and attack our joints, our gall bladders, our 
 appendices, our stomachs, hearts, kidneys and other vulner- 
 able points. 
 
 A sound bodily condition protects against all such menaces, 
 as the normal human body has a war machine that gets quickly 
 and successfully into motion against these minute enemies. 
 
 But few individuals are always in a state of perfect health. 
 Most men have, at least at intervals, their points of least 
 resistance, and few are aware of these weak si)ols until a 
 successful attack reveals their presence. 
 
THE HUMAN MACHINE. 
 
 ]\Ian has often been compared to a macliine. This may not 
 be true of man as a whole, but his body is certainly built on 
 mechanical principles. The motions of his limbs are con- 
 trolled by a perfect system of levers, and he even has shock 
 absorbers. The heart is a pump with valves constructed on 
 ordinary mechanical principles. The blood vessels are elastic 
 tubes that contract or dilate under the control of nerve centers 
 that respond, like push buttons, to certain stimuli. The entire 
 telegraphic and telephonic system of this country is not more 
 complex, and is certainly less efihcient, than the sensory and 
 motor nervous system linking the brain to the body and gov- 
 erning its functions. 
 
 jMillions upon millions of cells — muscle, nerve, brain, kid- 
 ney, liver, heart, are all busily at work, each with a definite 
 function to perform. Few people who buy a manufactured 
 product stop to think of how it is made; how seldom their 
 imaginations are stimulated to go back of the shop in which 
 the article is sold and visualize the army of toilers who bring 
 the article into being. How few have any knowledge what- 
 ever of the marvellous machinery that often seems to be alive 
 and purposeful in the complexity and precision of its move- 
 ments. 
 
 To the manufacturer, the integrity and precision and the 
 smooth working of this machinery is the first rule of preserva- 
 tion in his business. Before a manufacturer can engage in 
 business, he must plan and build his machines and then he 
 must test them. After they are established and in good work- 
 ing order, doe's he then sit back and take their products until 
 they break down? Such a course would be looked upon as 
 insane. No well managed plant but has its system of inspec- 
 tion. 
 
 But what about the men who guide and supervise these 
 machines, who sell their products and who keep the wheels 
 of business moving? Is there some good kind fairy that 
 watches for the first signs of faulty heart pump, of an impaired 
 poison separator (the kidneys), of poles and wires down in 
 the telegraph and telephone system (nerves), of hardening in. 
 
those normally elastic tubes (arteries), and countless other 
 indications of over-stoking, rust and clinkers in this marvel- 
 lously complex human machine ? 
 
 In most estabhshments this task is certainly left to the 
 fairies, for there is no human agency that covers it. Wel- 
 fare work and emergency medical relief for employes is pro- 
 vided in most of the important industrial establishments, and 
 many of them require a physical examination before employ- 
 ment. A regular, systematic periodic physical examination 
 of the entire body, such as is applied to ordinary machinery, 
 is, however, practically non-existent, except in the establish- 
 ments taking the service of the Life Extension Institute. * 
 
 PREVENTION vs. CURE. 
 
 Immediate relief for injury or illness is a matter of com- 
 mon humanity, but the prevention of illness and accident is a 
 matter of business economy, as well as humanity. This is well 
 recognized in regard to accidents by the widespread use of 
 safety devices. But the almost infinite capacity of the human 
 machine for going wrong seems not to be recognized, and the 
 remedy is usually applied only after physical deterioration 
 and impairment has resulted in frank illness, or in accident 
 that is essentially caused by illness. Long before the heart 
 breaks down, or the kidneys lose their function, or the arteries 
 become seriously affected, there is a period of slow change 
 which often affects the efficiency of the individual and increases 
 the liability to accident. These early signs of trouble are 
 readily revealed by thorough health examinations, affording 
 the o])portunity not only to prevent disease, and accident due 
 to an improperly working body, but to improve the general 
 
 * I am informed by Mr. Royal S. Meeker, United States Commissioner 
 of Labor Statistics, that it is contemplated to establish a central 
 agency in that Department for the systematic collection of informa- 
 tion regarding welfare work among employes, to supply the demands 
 upon the Department of Lal)or for information of this character. 
 It would seem desirable for employers, who are making provision 
 for the physical examination or care of their employes, to submit 
 a precise statement to the Department in order that those who are 
 interested may have a reliable source of information on this subject. 
 The Institute will he pleased at all times to receive information of this 
 character. 
 
average condition of the individual, raise him to a higher level 
 of physical fitness, and increase his capacity for living hap- 
 pily, contentedly and efficiently. 
 
 All these factors have an economic as well as a social and 
 humanitarian value. An employee who is sound and healthy, 
 who is doing work to which he is physically adapted, is less 
 irrital:>le, suspicious and intractable than an employee who is 
 physically below par and easily stimulated into unreasoning 
 discontent. 
 
 The value of the system of periodic examination is no longer 
 a matter of theory. In one life insurance company (Postal 
 Life), a trial of this system over a period of five years resulted 
 in a reduction in mortality of about 50 per cent, among those 
 taking the examination, and a saving of $13 for every dollar 
 expended. 
 
 The experience of such corporations as the National Har- 
 vester Co., Sears, Roebuck and Co., the National Cash Reg- 
 ister Co. and the Chicago and Northwestern R. R. Co. and 
 others, where examinations of applicants for employment are 
 carried on, show the need of inspecting the human body that 
 is called upon to do work. The Chicago and Northwestern 
 report that 12 per cent, of the men examined were found 
 unfit for the form of employment sought. 
 
 In Sears, Roelnick, through their system of entrance exami- 
 nation and medical inspection and examination of special 
 groups, the death rate among those sufifering from tuberculosis 
 was reduced from 11 to 1 per cent., and the percentage of 
 tuberculous employes from 4.G per cent, to .8 of 1 per cent. 
 
 TITE TOTAL VALUE OF THE HEALTH SURVEY. 
 
 In all establishments of which I have knowledge, the effort 
 seems to be to give the employee work adapted to his physical 
 capacities. The mere weeding out of tuberculous employes or 
 others who are a menace to their fellows, by reason of com- 
 municable disease, is a minor feature of the work. It is, 
 of course, greatly in the interests of the tuberculous employee 
 that he be located and aft'orded an opportunity for seeking 
 treatment, rather than that he continue at work until his 
 malady has perha])s Ijccome incuraljlc. 
 
The chief vakie of the system of complete health surveys, 
 supplemented by education in personal hygiene lies in its total 
 effect on the force, and in its power to raise the general level 
 of fitness, well-being and efficiency. 
 
 These are the broad general purposes that actuate such men 
 as Ex-President Taft, Surgeon General Gorgas, Professor 
 Irving Fisher, Dr. Alexander Graham Bell and other eminent 
 scientific men and publicists who have joined in the work of 
 the Life Extension Institute without compensation or other 
 reward than the satisfaction of seeing these benefits extended 
 to the largest possible number of people. 
 
 The privilege of periodic physical inspection has already 
 been extended to a vast body of insurance policyholders through 
 arrangements made by certain life insurance companies with 
 the Institute. 
 
 The latest company to take this service, the Germania Life 
 of New York, tried this experiment first in New York City, 
 and the opportunities for improving the condition of policy- 
 holders was so manifest that the system was quickly extended 
 to their policyholders throughout the country. 
 
 No life insurance company has any relation with the Insti- 
 tute other than that of patron. The interest of the life insur- 
 ance company is similar to that of the employer. By reducing 
 the number of death claims, the company is reimbursed for 
 its expenditure for the Institute's service. The employer bene- 
 fits by a reduced sickness rate and accident rate among his 
 employes, and an increase in their mental and physical effi- 
 ciency. 
 
 GOOD WORK AND GOOD BUSINESS. 
 
 To measure these benefits to the employer accurately will 
 take years of experience, but it must be evident that an influ- 
 ence that will produce a 50 per cent, saving in mortality and 
 return $13 for every $1 expended in life insurance will at 
 least produce a 10 per cent, improvement in the physical and 
 mental efficiency of empl()}'es. 
 
 There arc oilier c\i)cricnlial data that sujijiort those views, 
 such as the known inllucntx' of alcoht)! in impairing mental 
 
and muscular efficiency, the power to memorize, the power to 
 perform a simple act such as typewriting, typesetting, etc., 
 conditions that are paralleled by functional disturbances and 
 diseased conditions revealed by the examinations. 
 
 Assuming the tigure to be conservative, it follows that the 
 application of the system to a group of employes earning 
 $100,000,000 per annum would increase their productivity 10 
 per cent., and result in a gain in earning capacity of $10,000,000 
 per annum, provided the occupation were one in which the 
 physical and mental efficiency could affect the quality and the 
 quantity of the work turned out. This does not take into 
 account the reduced amount of illness, death and accident, all 
 of which have a tremendous economic and business value. 
 Prolonged illness or death of experienced and valued employes 
 may mean many thousands of dollars to a concern. 
 
 Government has already placed a certain responsibility on 
 the employer for the care and protection of his employes. 
 Workmen's compensation acts are being passed by State after 
 State, and common business prudence dictates that the em- 
 ployer shall take every reasonable means to limit his liability. 
 
 That the liability to accident among a group of employes 
 who are examined once a year is less than the average cannot 
 be questioned by any reasonable person. 
 
 Various considerations of policy and politics have as yet 
 prevented any official and statutory recognition of this fact, 
 but the fact remains. Even where a compensation law calls 
 for compulsory insurance the employer need not shrug his 
 shoulders and say, "I am now protected by my insurance pre- 
 miums, and there is nothing further to be done." With a 
 reduction in the accident rate, from whatever cause, there 
 must ultimately come about a reduction in the cost of insur- 
 ance. Where the employer carries the risk himself, the strong- 
 est possible reason exists for periodic physical examination, 
 from which the two-fold benefit of increased efficiency and 
 reduced accident loss will result. 
 
 Here is a recent instance that came to my notice. The 
 other day, in a large wood pulp plant in Canada, a man was 
 
 10 
 
lightly hit on the head while at work, and instantly killed. 
 It was found that he had suffered from heart disease, and that 
 -a light shock, that would not have put a football player out 
 •of a game, had sufficed to kill. A large indemnity was paid 
 to the widow. How much better it would have been for the 
 man, widow and plant, if the man had been examined and 
 kept out of work that exposed him to accident and injury. 
 
 The value of such an influence, in reducing accident lia- 
 bility, is plainly implied in the New York Law, which allows 
 under safety and welfare credits a reduction of from 1 to 10 
 per cent, for such vague conditions as "competency of man- 
 agement," "attitude toward employes," "attitude toward acci- 
 dent prevention," "general conditions tending to establish more 
 cordial relations between employer and employes," etc. If such 
 ill-defined factors can properly be given a percentage value, 
 the direct, systematic controlling influence of periodic physical 
 inspection, for the purpose of detecting physical weaknesses 
 and impairments, many of which predispose to accident, can 
 hardly be denied an equal value. 
 
 When we read that 12 per cent, of applicants for employ- 
 ment have been found defective, or that 1 to 4 per cent, of 
 employes have been found tuberculous, it must not be thought 
 that these even remotely express the value of the periodic 
 -examination, and that there is no influence on the balance of 
 the force. 
 
 WHAT THESE EXAMINATIONS REVEAL. 
 
 A consideration of the following analysis of the examination 
 of employes made by the Life Extension Institute shows that 
 practically all those examined ofl'ered some opixtrluuity for 
 betterment. On the other hand, the number that arc found 
 positively unfitted for any form of cniployiiiciit is very small. 
 Yet, business prudence, as well as common humanity, renders 
 it a(lvisal)le to locate this small percentage and to take the 
 ])roper stejis for the protection of all concerned. 
 
 11 
 
RESULTS OF THE EXAMINATION OF EMPLOYES OF 
 
 COMMERCIAL HOUSES, BANKS, ETC. 
 
 BY THE LIFE EXTENSION INSTITUTE, INC. 
 
 Normal Ol^^o 
 
 Imperfect — Advice needed regarding physical condi- 
 tion or living habits .99% 
 
 Not aware of impairment .81% 
 
 Referred to physician for treatment .Q7% 
 
 CLASSIFICATION OF IMPAIRMENTS. 
 
 Moderate to Serious. 
 
 Organic heart disease 6.14% 
 
 Arteriosclerosis— thickened arteries 13.94% 
 
 High or low blood pressure 26.81% 
 
 Urinary — Albumin, sugar, casts 43.27% 
 
 Individuals showing combined disturbance of circu- 
 lation and kidneys 17.82% 
 
 Nervous 1.44% 
 
 Lungs — possible tuberculosis .49% 
 
 Venereal .41% 
 
 Minor to Moderate. 
 
 Functional, Circulatory — Rapid, slow or intermittent 
 
 pulse 10.51% 
 
 Urinary (high and low specific gravity, crystals, in- 
 
 dican, etc. ) 20.58% 
 
 Digestive Organs 9.73% 
 
 Constipation 20.29% 
 
 Nose and throat 30.56% 
 
 Ears 15.38% 
 
 Decayed teeth and infected gums 26.93% 
 
 Anemia 3.50% 
 
 Skin 7.96% 
 
 Errors in diet (pronounced) 28.54% 
 
 Errors in personal hygiene 56.22% 
 
 12 
 
Physical Defects. 
 
 Faulty vision (uncorrected) 22.89^ 
 
 Flat foot 3.09fo 
 
 Faulty Posture 8.62fo 
 
 Rupture, no truss 1.23% 
 
 Overweight, important 6.10% 
 
 Underweight, important 18.44% 
 
 Unclassified 13.94% 
 
 The above table shows the percentages that the various 
 impairments are of the whole number of employes examined. 
 Many employes, of course, showed several combined impair- 
 ments. Average age 30. 
 
 The life insurance experience is along similar lines, but 
 modified by several conditions : a higher average age, the 
 purely voluntary self selection of each individual examined, 
 and the fact that many of these examinations were made in 
 remote sections by less highly trained examiners. 
 
 Many of the impairments above listed constitute serious 
 physical and mental handicaps. They interfere with an alert, 
 snappy, wideawake attention to business. They favor indif- 
 ference, lassitude, and inaccuracy and increase the liability to 
 accidents. Leaving out such serious matters as diseases of 
 the heart, kidney, blood vessels, lungs, ranging from the incipi- 
 ent to well-defined stages, there is faulty vision, mouth infec- 
 tion, nose and throat affections, constipation, flat foot, and 
 other so-called minor defects, all interfering with the proper 
 working of the human machine. 
 
 More than 90 per cent, of those sufificieiUly impaired lo be 
 referred to physicians for medical ircatnient were not aware 
 of any impairment, and were taking no slejis to correct their 
 condition. 
 
 All of which goes to show that tlie average individual is 
 usually far below his attainable condition of health and well- 
 being. 
 
 About onc-lialf of these people showed some serious error 
 in diet or personal hygiene, the correction of which would 
 undonl)te(ll\- improxe their condition. 
 
 13 
 
PLANS AND METHODS. 
 
 The method of carrying on this work has been carefully 
 studied by the Institute, and is standardized along certain lines. 
 An examining room is equipped by the Institute in the estab- 
 lishment, and a sufficient number of trained physicians detailed 
 to rapidly examine the force, each doctor working a half 
 day only in order to keep the work up to a high grade of 
 accuracy and precision. 
 
 This work as designed by the Institute is done very thor- 
 oughly, and involves a complete health survey — eyes, ears, 
 nose, throat, lungs, heart, blood vessels, blood pressure, urine, 
 nervous system, physique, posture, possible deformities, rup- 
 ture, flat-foot, consideration of family history and living habits. 
 All these data — derived from the personal statement of the 
 employee, the examiner's report, and the laboratory report — 
 are considered by trained diagnosticians, and if no impairment 
 is found, the employee is notified. If a slight impairment 
 or error in personal hygiene — eating, drinking, working, play- 
 ing, smoking, exercise, etc., — is found, he is directly advised, 
 and also instructed by means of "Keep-Well" leaflets appro- 
 priate to his case. Education in the care of the health is pro- 
 vided Ijy monthly "Health Letters." If some impairment 
 requiring medical attention is found, the report is sent to 
 the family physician or to some physician designated by the 
 employee, and he is advised and urged by the Institute and 
 his employer to seek the necessary treatment, unless the con- 
 dition is one that can be handled by the company's physician, 
 if such there be. 
 
 Every effort is made to protect the employee from undue 
 alarm, if impairment is found. In all cases showing any 
 impairment, the chief local examiner receives the report from 
 the Home Office, and delivers them to the employes, with such 
 suggestions as may properly be gi\en in regard to errors in 
 hygiene, physical defects, or the necessary form of medical 
 treatment to seek. This method guards against misunder- 
 standing of the report, or undue alarm or indifference and 
 neglect on the part of the employee ! A report is, of course, 
 rendered to the employer of each case examined, and an analy- 
 
 14 
 
sis is made of the general results, with such suggestions in 
 regard to the sanitary conditions or the condition of the force 
 as may be derived from the survey of the plant and the force. 
 
 Every three months certain cases, which seem to require it, 
 are checked up in regard to special conditions, such as blood 
 pressure, urine, heart, lungs, etc., in order that the full benefit 
 of the system may be exerted and the progress of such cases 
 watched. 
 
 The Institute is willing to arrange for one of the staff to 
 visit the plant regularly as an emergency physician, but for 
 this special work the employer must make private arrange- 
 ment with the physician, as the Institute does not undertake 
 private medical treatment. Nevertheless, such a physician 
 would be under its general guidance and supervision with 
 regard to the periodic examinations, and would cooperate 
 effectively in giving them their maximum value. 
 
 Where a medical department already exists, it is entirely 
 possible for the Institute to cooperate, specializing as it does, 
 with the assistance of the Hygiene Reference Board, in the 
 work of the Health Survey and the application of the prin- 
 ciples of personal hygiene. No one concern can group the 
 forces and the scientific resources that are available to the 
 Institute, because of its underlying altruistic purposes. If the 
 Metropolitan Life Insurance Company, with assets of $386,- 
 000,000 and a splendidly equipped medical department, labora- 
 tory and an extensive list of examiners, saw fit to pass this 
 work over to the Institute, it must be apparent that the aver- 
 age business concern could profitably do likewise, rather than 
 attempt the work in an individual way. The independent, 
 non-partisan character of the Institute enables it to command 
 the confidence of the policyholder and the employee, and guar- 
 antee the genuineness of the welfare service rendered, a matter 
 of no mean importance — er>pecially to the employer— in mak- 
 ing this work effective. 
 
 The Institute does not advise that these examinations be 
 made compulsory. Usually the cooperation of a majority 
 of the employes can be obtained, if the matter is properly 
 
 15 
 
put before them. It should be made clear that the examina- 
 tions are part of the business policy of the concern, but that 
 they are likewise for the material benefit of the employes ; 
 that any well grounded or serious objection will be consid- 
 ered, but that the total welfare of the force and of the business 
 requires that mere prejudice should not interfere with the car- 
 rying on of the work. 
 
 POSSIBLE INFLUENCE ON NATIONAL VITALITY. 
 
 It is indeed regrettable that we have not yet reached the 
 millennium. Almost daily we have some evidence of our 
 remoteness from that happy state. As practical men, we must 
 take conditions as we find them, and do the best we can to 
 improve them. The time has not yet come when an individual, 
 a business institution or a Nation can disregard the matter 
 of physical soundness and efficiency. 
 
 I have referred to the fact that our mortality statistics indi- 
 cate a loss in vitality and an increasing death rate at the middle 
 age periods of life, when man should really be at his best. 
 There has, in fact, been an increase of 40 per cent, during 
 the past 23 years in the death rate per 10,000 in the United 
 States Registration Area from the chronic degenerative dis- 
 eases of middle life and old age and there are signs of the 
 encroachment of these maladies on the earlier periods of life. 
 
 This information is perhaps displeasing to a certain type of 
 optimist, the kind of an optimist who is irritated and aggrieved 
 when his bank notifies him that his account is overdrawn. The 
 other type of optimist, however, the only type that is of any 
 real value in society, the type that receives unpleasant news 
 with a firm countenance and immediately resolves to cheer- 
 fully anfl hopefully apply a remedy, will, I am sure, receive 
 this particular jjiece of unpleasant news in the right spirit. 
 
 The conditions, whatever they may be, that are causing this 
 encroachment of degenerative maladies are not to be remedied 
 by blunt-eyed optimism, but by open-eyed courage and deter- 
 mined action. 
 
 16 
 
It is true that I have presented this subject of health con- 
 servation among employers as a matter primarily of i)ure 
 business economy, as a measure that will contribute to busi- 
 ness success. Every man wiio succeeds by energy, intelli- 
 gence and square dealing in a business that carries "no menace 
 to the people is a public benefactor. There is no need to apolo- 
 gize for this work because it is '"good business." On the other 
 hand, I am confident that there is no member of this associa- 
 tion who would not derive a deep and wholesome satisfaction 
 from the consciousness that the methods by which he carries 
 on his business are exerting a powerful influence in raising 
 the physical standard of our race. 
 
 It is well to avoid the mistake that Sparta made in concen- 
 trating on mere physical excellence, but there is no real rea- 
 son why physical soundness and well-being should not go hand 
 in hand v\ith moral, intellectual and spiritual growth. 
 
 We hear much in these days of our lack of preparedness 
 for military defense, of the need for armament, ships, a 
 trained soldiery. We take it for granted that we have the 
 raw material and that it is of the right quality. There is 
 danger, however, in taking too much for granted when the 
 destiny of 100 millions of people and a splendid civiliza- 
 tion and industrial development are at stake. If there are 
 forces in our country that make for physical decay, it 
 is well that they should be sought for and neutralized. No 
 Nation can carry forward the l)anner of progress, enlight- 
 ment and human freedom, whether in war or peace, unless 
 those who march behind it are of sound and virile stock. 
 
 17 
 
LIFE EXTENSION INSTITUTE, Inc. 
 
 Jl Work of Human Salvage 
 
 ESTABLISHED by well-known leaders in the 
 field of Race Betterment who desire to 
 assist in reducing life-waste and to see the 
 science of disease prevention put on as large, solid 
 and enduring basis as curative medicine. The 
 Institute's mission is 
 
 1. To teach you how to a'cot'c/ disease. 
 
 2. To advocate periodic health examinations that 
 disease may be detected in time to give your 
 doctor a chance to check or cure it. 
 
 3. To provide such examinations for you at low 
 cost to assist in establishing this life-saving 
 practice amongst all our people. 
 
 DIRECTORS 
 
 Hon. Wm. H. Taft, Chairman 
 
 Henry H. Bowman 
 
 Francis R. Cooley 
 
 Robert W. deForest 
 Prof. Irving Fisher 
 
 Eugene Lyman Fisk 
 
 E. R. L. Gould 
 Harold A. Ley 
 
 Elmer E. Rittenhouse 
 
 Charles H. Sabin 
 Frank A. VanderHp 
 
COLUMBIA UNIVERSITY LIBRARIES 
 
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