the teacher, taking the class from six years of age and carrying it along up from one grade to another, impresses upon those little minds the arts of correct living that mean self-preservation, they will learn hygiene without text-books.

DR. THOS. D. WOOD: I am glad Dr. Laine has brought out the point which he has. The trouble is we teach the children something we think they ought to know, instead of knowing what they really need. With reference to athletics, I have been very much amused, as well as interested, in seeing the attitude of some Eastern medical journals within the last two or three years on the subject of hand-ball and athletic sports. It comes within my duty to help patch up the men who are injured in the various athletic sports, at the same time to assist and try to control, in one of our institutions, these games and various phases of athletics. We forget, as physicians, when we see men injured by the excesses in certain forms of sport, certain fundamental, underlying principles and truths. We forget that it is impossible to abolish the causes of disease by statutory law. We forget that it is impossible to civilize or make the human family go through a process of evolution faster than certain forces allow it. For example, take the athletic sports of to-day; the excesses of various kinds have taken the place, in my mind, of something a great deal worse. They have taken the place of the debauches, the revelries, the ungovernable, uncontrollable expression of brute force and strength of a certain age of college students, and in a way this has been a great advance over the habits of public schools of forty or fifty years ago. Nobody deplores the evils of athletics, perhaps, more than I do. I was thoroughly opposed to a good many phases of them five or six or seven years ago, but we cannot make the world perfect in a day. These things must be governed. One of our best teachers has made the distinction between athletics and gymnastics, that gymnastic work is intended to make stronger the organism of the student. Gymnastic work has passed entirely outside of that. Its purpose is to gain a certain objective end in competition, just as much so as the gaining of money is another object. If it were possible to get the students to theoretically and philosophically do their gymnastic work or their work in manual training and derive organic physical benefit from it, we would all like to see them do it, but not until the playing instinct is civilized out of the young man or young woman-and it gets civilized out too fast in a great many cases-can this be done. Athletics must be controlled. They must be improved in a great many ways, but the minute you abolish athletics you will let in something that is a great deal worse, as the Eastern institutions will find out if they try to do it. Manual training is not synonymous with proper gymnastic training. It would be a satisfaction if a child could learn a useful art and at the same time get proper exercise and training for his bodily needs. Unfortunately the manual training work very frequently emphasizes certain tendencies which in the child will shorten his life a great deal, and it has been a mistake to try and make manual training do what it is not possible that it can do by the very nature of its work. The gymnastic training should fit the child fundamentally for usefulness in life, and if the gymnastic training is not more important than the manual training directly or indirectly to his usefulness as an industrial factor, as a healthy human being, it must give way at once to that which is immediately and practically more useful.

DR. S. S. HERRICK: I wish to call your attention to Dr. Potter's remarks in regard to the inutility or inadvisability of communicating to young pupils even a small amount of knowledge of hygiene. I think it is about time that we should realize that poetry and truth are rather antagonistic. The more poetry generally the less truth, and the reason which is applied to hygiene would have just as much force if applied to any other branch of learning; just as much force with reference to mathematics and language as to hygiene.

CALIFORNIA AND TUBERCULOSIS.

By D. A. HODGHEAD, M.D.

It has long been a proverb that westward the course of empire takes its way. A casual glance at the history of nations will demonstrate that in a general way from the dawn of history this has been true. The oldest records and the still older traditions place the origin of empires in the far East, thence the march is westward to India, Persia, and Egypt; northward to Greece, westward again to Rome, extending itself over the remainder of Europe to England, and making its final triumphant rally on this western continent. This advance has represented not only the onward trend of individuals and masses, but it has been coëxistent with progress, with greatness, with intellectual development.

We of California may, with entire naturalness and consistency, be disposed to apply this rule not only to America in general, but to our own State in particular. We have seen this westward drift of civilization, until upon these shores of the Pacific the marching column has taken its last stand. This point completes the circle, and in conformity with what has gone before, we might logically expect that this last triumph should be the greatest. The necessary conditions are here particularly favorable. The climatic influences are of the most invigorating character. Nature has been profuse in her decorations. There are lofty mountains, deep cañons, extensive plains, rolling hills, luxuriant vegetation; in short, everything conducive to the development of man into the highest and most nearly perfect mental, moral, and physical characteristics.

Conceding, then, for the sake of argument, as well as for the many good reasons that may be advanced, that this coast, while being the final point which empire may reach in its march, contains all the conditions necessary for and favorable to the development of the highest type of man the world has yet known, the object of this brief paper plainly becomes apparent and the questions at once arise: What are we doing, and what can and should we do to bring about this state of possible perfection?

We, as physicians, are the conservators of the mental and physical health of the people. Our office is not alone to alleviate suffering and heal disease, but to exercise as well the science of prevention. Most especially in this latter particular does the work devolve upon those composing the convention here assembled. What are we doing to aid the present generation and the future generations of California in ren

dering this final step in the march of empire the greatest and best? I shall tell you what we are not doing. We are not giving the people of this State pure blood. We are not excluding disease. We are not exercising the art of prevention. On the other hand, we are keeping our gates wide open and extending unreserved invitation to the lame, the halt, the diseased in lung, liver, joint, and brain, to come and make one with us. We raise our hands in abject terror at cholera, smallpox, and leprosy, and extend, at the same time, an urgent appeal, a most cordial welcome to the tuberculous of all climes, classes, and stations. We deliberately invite among us those incurably affected with the most relentless, the most unsparing, the most widely distributed, and the most fatal of all diseases. To consumption, which respects neither age, sex, condition, nor locality, which claims annually more victims than any other three diseases, which contaminates the living and transmits itself to succeeding generations, to this direct enemy of the human race we extend an especial greeting. The people of this State are doing this thing, exposing to contagion the living, contaminating the tissues of those yet unborn, in order to sell a few more lots or rent rooms at a sanitarium. To such an extent has this practice been carried that residents in a large section of this State are popularly known as one-lunged.

What means it that the death-rate of San Francisco is almost equal to that of London, or that California should record a mortality as great in comparison as that of England? Would these things be if we had not attempted to make our fair estate one huge hospital for the world in general and for North America in particular? I should prefer to take my chances of living in the lowlands along the Mississippi than in the so-called choicest spots of California, where one third of the population is tuberculous. We are selling our birthright for much less than a mess of potage. If we would respect the inheritance which nature has bestowed, if we would take proper advantage of the opportunities before us, if we would produce here the most magnificent type of mankind the world has yet known, a type in keeping with whatever else nature has here evolved in her most unstinted extravagance, we would not make of California a sanitarium. It cannot be true that the choicest spots on earth, to be found in our State, where blow the gentlest zephyrs, where bloom the sweetest flowers, where shines the balmiest sun, are fit only for the habitation of invalids. I believe we should shun and exclude a diseased lung even more readily and vigorously than a smallpox pustule or a cholera germ.

At first thought it may seem cruel and inhuman to withhold from the sick and afflicted the opportunity for health and life. But if some of the sick are not exempt, why should others be? Besides, for commendation we may rely upon the principle that self-preservation is the first law of nature, and for further justification, both in the face of the present generation and of those yet unborn, we may turn to the fact that excluding contamination brings the greatest good to the greatest number.

It seems to me that California has a peculiar mission to perform. She stands in a position unique and unprecedented. The climax of civilization has here been or is to be attained. In point of territory we can go no farther. It is not within the power of the earth to bestow greater natural advantages. By the short-sighted, narrow-minded, selfish policy now being pursued, we shrivel our bodies, stultify our brains, dwarf our opportunities, make of this fairest land a pesthouse, and bring upon ourselves the curses of posterity.

Discussion of Paper Read by D. A. Hodghead.

DR. H. BERT ELLIS: It was a very interesting paper, and contains much of truth, very much of truth, and yet I think Dr. Hodghead has exaggerated it in order to bring out that point. True, we have a great deal of consumption, tuberculosis, in this State, and we are, by our methods, inviting more of it here. At the same time, we are making plans to prevent other diseases from coming, and it is the one disease from which we have most to fear. It is not the most rapidly fatal, but when we take the grand total into consideration, I think probably it is the most fatal of all diseases. The paper, as the doctor has written it, has suggested a new name for the State. We might call it the " onelung" State, or "the State of one-lungers."

DR. J. R. LAINE: I was in hopes that the writer of the paper would suggest some plan to obviate the "selfish method" that he says is now in vogue. He said that we are pursuing a selfish course in permitting these people to come here as they do. Now, how are we going to avoid it? He has not told us. He practically left off where he began. It is easy to find fault, and I must confess I see that too frequently in bodies of this kind. Carping fault-finding is easy. To tell us we might improve, does not tell us how to improve. What remedy will we have? How are we going to prevent consumptives from coming to the State, or the halt or blind from coming here if they desire to? He does not tell us how we are going to prevent people from contracting the disease, nor how to treat them after they have contracted it. I was in hopes the doctor would indicate in some way what we should do in order to free ourselves from those things that we do not desire.

DR. W. LEMOYNE WILLS: As it seems to be the function of conventions of this kind to meet to resolve, I think a very good and practical thing to do would be to take some action in regard to the transportation of tuberculous sick people in sleeping-cars and in ordinary railway cars. I had an experience about seven or eight years ago. As soon as the man was dead, I was put off the car with his body in the desert in Arizona. The man alive was more dangerous than the man dead, but just as soon as the railroad company knows a man is dead, he will be put off, no matter where you are, in the desert or any place else, and he ceases to be a source of trouble. But alive he is a thousand times more dangerous, and we take our lives in our hands if tuberculosis is as contagious as we believe it to be, and yet consumptives are alongside of us, or over us, or with us, and we can do nothing. It seems to me sanitation ought to have some effect on travel, particularly in California, if we are going to be called the State of "one-lung."

THE CHAIRMAN: If there are any resolutions, they will come up for action at this evening's session.

DR. J. H. DAVISSON: It has been generally thought that tuberculosis kills about one seventh of the entire population of our country, and when we take this into consideration it is surely the most important subject with which we as sanitarians can deal. But many of us are on record already on this subject, and while it is not the proper thing for us to put unreasonable restrictions upon the unfortunate subject who is born without that immunity that makes him susceptible to the disease whenever he runs across it, either in the air that he breathes, or in the food that he eats, or in whatever way he may get it, the proper thing to do

is rather to teach the community and the people at large, that the proper way to deal with tuberculosis in a climatic way is in its incipiency. Teach them not to send their patients to California in the second or third stage, nor to send those cases that are delicate and born without innate immunity, to our State. Teach those sanitarians that the proper thing to do is not to send people when the disease is far advanced, and teach them, as we should, that such patients die wherever they go. It is an every-day experience with all of us, especially physicians who live in the so-called health district that I do-living in the southern citrus belt, where these cases congregate-to find these patients coming from all over the face of the earth. I had a sad experience before I left home, with a patient who came from New England. He had been in Europe, and to all the resorts East, and came to Los Angeles to die there, in the third stage of tuberculosis. Such patients should be taught to stay at home. Their advisers should keep them there. The physicians East are responsible, in a large measure, for the large mortality from tuberculosis in California, as well as elsewhere, and until the profession at large is taught and understands that tuberculosis is fatal in the third stage, wherever the afflicted may go, this thing will probably continue. The patient is not so much to blame for coming. The patient should not be restricted by unreasonable restrictions. Every sanitary convention and every board of health should have this subject discussed, and should pass appropriate resolutions in regard to it; and there should be legislation favoring restriction, and that restriction should be placed upon people who deal with these patients, rather than upon the patients themselves; upon corporations, such as railroads and steamships, and thoroughfares. Restrictions could be placed upon them, as well as upon keepers of lodging-houses and hotels, and upon owners of private houses, if they fill their houses with consumptives. Certain restrictions should be placed that are rigid in that regard, and looked after by the local health boards everywhere. And we are taught also, by the very best authority on modern sanitation, that you can live in the closest relation to a tubercular patient in the third stage, if you will only follow out strict sanitation.

DR. C. L. BARD: There is one point in connection with this subject that I would like to speak about, and it is that the reputation of California as a health resort is world-wide. Desperate consumptives in the Eastern States or elsewhere often express the wish to come to California. If they could only reach California they would get well. A subscription is taken up for that consumptive; he is shipped to California, and dumped out here. In the course of a few weeks he is in a destitute condition, and attracts the attention of his immediate neighbors, and they start out with a petition, which is easily filled, because no one hesitates to sign a petition for anything, no matter what its object may be. A petition with the best names of the citizens of the town or county is presented to the Board of Supervisors. They have no other recourse. The Board allows that consumptive, who has been dumped here, enough to sustain him. He becomes an object of charity, and he becomes our charge. I think it is entirely wrong; I think it ought to be discouraged. I think it is a matter that should receive some recognition from a convention like this.

DR. W. F. WIARD: One year ago I read a paper on this subject before the convention at San José, because I was led to believe it was one of