From the earliest ages, according to the records of geology, human beings have congregated in greater or less numbers, and as civilization. has advanced, so have great cities been evolved from a mere aggregation of tents, or a group of leafy huts, until the modern municipality is a seething mass of humanity and a complicated network of mechanical devices. There is nothing more interesting to the average person than suggestions regarding the future state of affairs, and as a sanitarian I shall shortly speak of some of the probable improvements that will be made in the near future in most all large cities of the civilized world. Naturally, however, we first wish to look over the past history of man's development, and see what the formation of a city actually means, and how brought about. Man showed the same general traits that other animals possessed, gathering in numbers for mutual protection and companionship tens of thousands of years ago. We find human bones and implements in surroundings which indicate their existence during the pre-historic quaternary and neolithic periods; and, as we follow the devious pathway of uncertain records down through the mystic ages of the past, we arrive at a period of authentic history. We know of the high state of civilization that existed in ancient Egypt, Assyria, and later in Greece; and we read of the founding of the great city of Babylon, by Nimrod, in the twenty-second century before Christ, soon followed by Thebes, beautiful Nineveh, and others whose ruins are still visible to sight-seers. Since then the progress of civilization and evolution of centers of population are matters of unquestionable record; but the facts regarding sanitary science are very meager up to the last few hundred years, so that sanitation may be regarded as a modern science-the outcome of necessity. As a natural sequence of the change from a limited and primitive settlement, where nature had sufficient power to overcome the deleterious results of the life of man by pure air, water, and abundant soil, to the great cities of to-day, there have arisen most serious questions as to the best methods of overcoming the dangers arising from the waste products of the living. If there were no cities there would be no sanitary science necessary to aid in the maintenance of ordinary health, but the conditions as they are necessitate boards of health and health officers to labor for the suppression of epidemic and endemic diseases, and that also means, as you well know, the expenditure of immense sums of money annually. It is only necessary to look over the statistics of mortality in the great cities of the world to see the decided changes brought about by the enforcement of sanitary measures, the most important being the disposal of sewage and other refuse to protect the city from self-infection, and quarantine, to protect it from dangers from outside sources. Judging from those who have occupied the floor before me, it seems to be the fashion for the speakers to relate their experience as sanitarians, so I will modestly state (to be in the swim) that three years ago, when I was a member of the Board of Health of Stockton, the little city which I have the pleasure of representing, I had an opportunity to see what decided changes are produced even in a small place by enforcing sanitary rules and regulations, and especially by establishing a complete system of sewerage. This brings about greater confidence of the people in their town as a residence place, besides beautifying the town and enhancing property values. The ideal city is a thing of the indefinite future, but it is by no means an impossible creation; still it is doubtful if many towns of to-day will grow into municipal perfection, for, like individual men, they are more or less dependent on circumstances. Location is the prime factor, and the future of a city depends greatly on the foresight of the founder, who, if he has judgment enough, will choose a location where drainage will be natural and climate agreeable, as far as commercial interests will allow. However, it is not usually an individual who founds a city, but it is the result of a natural growth as the resources of the surrounding country become known and used. Cities are no longer formed under the same circumstances that they were during the infant stage of the human race, when mutual protection was the guiding instinct; now the location of a town depends on natural agricultural or commercial advantages, and it is only after the population increases to a considerable extent that the health and general well-being of the people need supervision. San Francisco, in which we have the pleasure of meeting to-day, enjoys wonderful natural advantages of position and climate, and should be an ideal city according to the sanitarian's view, but it has the common afflictions and shortcomings of all large places -as Dr. McNutt just said in his paper-that it is one of the dirtiest cities in the world; however, considering the fact that it is a mere infant, as compared with other municipalities, in age and experience, it is in a promising and quite satisfactory state of growth and improvement. Its numerous hills are most favorable for natural drainage, and its equable climate unfavorable for the decomposition of refuse material. Incoming vessels can be easily quarantined, and cases of infectious diseases isolated without much trouble. The direction of streets is determined by rail or other roads, or waterfront position. The future city will have streets of a nature to produce as little noise as is consistent with traffic, by bituminous or other smooth pavement, and only a few cobblestones will be preserved as relics of a barbarous age. Economy in conveyances will be as marked as the salutary effect on the nervous system of the city inhabitant. Good thoroughfares will be the result of a demand from cyclists and other travelers; indeed, there is no one class of people who have brought about a greater improvement of roads than the wheelmen, for still more improvement is a necessity as well as a luxury with them. Any observing person can see the injurious effect of bright sidewalks and paved streets on the eyes of children, and also of adults, and I believe that the glare of reflected light from these pavements is as responsible for so many children wearing glasses as is a poor light in the home or school-room. What is the remedy? It is simple and cheap. A dull coloring and sandy finish will mitigate the evil 75 per cent. Dark brown and chocolate colors reflect but little light; and also blue or yellow, if combined with a rough finish, reflects comparatively little. The overhead trolley system of electric cars will be relegated to the past within ten years, and their place supplied by underground conduits and compressed-air motors. Horses will be abandoned in cities and used only in frontier territory, and their place be filled by the monocycle, bicycle, and electric conveyances, bringing about more rapid and economical transportation with less noise and more safety to the traveler. If any one regrets the inevitable fate of the horse, let him go into the commercial streets, or almost any place in a great city, and see the labor that they undergo and the abject slavery which they represent, and he will then welcome mechanical power, if only to please his humane sentiment. Sewage disposal is perhaps the most serious problem that confronts the modern sanitarian. The mere carrying off of waste products to a dumping-ground, or emptying of the same into river or lake, will be followed sooner or later by pestilence and death. Owing to the unfavorable location of some cities the carrying off of debris necessitates the solution of great engineering problems. The chemical precipitation establishments, portable garbage engines, pumping stations, sewage farms, etc., are all the products of necessity and answer their purpose with partial success. Eventually the disposal of sewage will resolve itself into those methods which can be operated at a profit, the most promising being sewage farming, and all waste products which cannot be utilized for agricultural or commercial purposes will be destroyed by fire. The disposal of the dead will resolve itself into a universal method of cremation, which alone is worthy of modern civilization. The contamination of air, water, and soil, by cemeteries located within the limits of a city, will no more be tolerated one hundred years hence than would a pesthouse to-day. Cremation was the practice of a large portion of the early nations, and we are just now seeing and utilizing a great sanitary truth which was an every-day fact with people who did not boast of our civilization. History repeats itself in civil as well as in political life. As the earth follows its path around the source of light and heat and comes back to its starting point, so we, too, travel along the tedious road of experience until we come back to the very same starting point in many ways and things, even though we do not wish to admit the same. It is dust to dust sooner or later, and it remains with us to assist nature in bringing about the dissolution of man's body in a clean, rapid, and sanitary way, and by so doing we trample on no rational religion, nor crush the tender sentiments of bereaved relatives and friends. Why, you may say, can we expect municipal perfection, when outside of the electrical and a few mechanical features we are but little in advance of such civilizations as Nineveh, Babylon, or Thebes of four thousand years ago. We are a vast improvement in a sanitary way, and sanitation is what we are discussing in this convention; but perfection will never be attained. Before the millennium (so called) is reached, this earth will be a dead world like the moon. For untold ages after the human family ceases to exist, this planet will continue to follow its endless path around the dying sun-a chill, grim monument to the folly of man! Whatever we speak of in this line of thought is only relative. I can prophesy-can give you my ideas, and they are as good as any one's, so far as we can prove. The future is unknown, therefore I can prophesy what I wish, and who can say no? You see, gentlemen, this is a very safe subject to talk about; in fact, any topic dealing with the future renders one secure against criticism that can be proved, and it so occurs with this subject-if I don't happen to know what I am talking about, neither do you-so there you are! We doctors, and especially those interested in sanitation, are a most paradoxical set of men, who labor for our own extinction by the annihilation of disease whereby we make our own daily bread. If man ever reaches the millennium (and he never will) there will be no doctors known. Disease will be annihilated and death be a natural dissolution of old age, or else the result of accident. Sanitary science is the redemption of the physical world-it will cause the selective diseases to die for want of food after consuming the weak, and the fittest will survive and flourish, meteor-like, before they start on the downward path of dissolution, which is the ultimate fate of the human race. IS TUBERCULOSIS OF CATTLE COMMUNICABLE TO MAN? By C. B. ORVIS, D.V.S., of Stockton, Cal. In the subject, "Is Tuberculosis of Cattle Communicable to Man?" it is presumed to be conceded that the contagion of tuberculosis is linked to the bacillus tuberculosis, and without it there can be no tubercle, and that the bacillus of the ox is the same as the bacillus tuberculosis of man. We therefore deem it proper to consider, first, the three most common probable modes of infection, and second the probability of infection from each of them. The modes of infection are chiefly: (1) Through the consumption of milk from tuberculous cows; (2) Through the consumption of tuberculous meat; and, (3) Through the inhalation of dried excretions floating in the air that emanate from the animal body. COMMUNICABILITY OF CONSUMPTION THROUGH THE USE OF MILK. I deem it unnecessary to bring to your minds evidence to prove the existence of the bacillus tuberculosis in the milk of cows suffering from generalized tuberculosis, or tuberculosis of the udder. In the experiments conducted for the Trustees of the Massachusetts Society for the Promotion of Agriculture, from the microscopic examinations of the milk of thirty-six tuberculous cows, the bacilli were found in twelve of them, or 33 per cent. In milk taken from a tuberculous udder, the bacilli are very plentiful. It is granted, then, that milk from a cow with generalized tuberculosis, or tuberculosis of the udder, is infectious. Estimating from the researches of others, it would seem that 15 per cent of all dairy cows are tuberculous. In 33 per cent of tuberculous cows, the bacilli of consumption are found in the milk, without considering those where the udder is implicated. For the sake of argument, we will say that this class (namely, the ones in which the gland is affected) comprises about 13 per cent more, making 35 per cent of diseased cows that transmit the germ to the milk. Now, then, 15 per cent of cows are diseased, and 35 per cent of this number give milk containing the bacillus tuberculosis. This would indicate that 5 per cent of all milch cows transmit the germ of the disease from their own tuberculous bodies. Therefore, one cow in every eighteen is giving poisonous milk, and that poison will certainly reproduce itself and cause its own specific lesions, if deposited in a suitable medium. The ratio of susceptibility between animal and man I have been unable to determine, but that certain persons and animals are more susceptible than others, there is no doubt. The amount of virus entering the body has also much to do with the likelihood of infection. In the experiments for the above-mentioned society, in feeding calves and pigs upon milk from tuberculous cows, the percentage of infection in calves after a period of from four to seven months was 33 per cent, and in pigs 50 per cent, while of rabbits that were killed after being fed upon diseased milk for four weeks, only 2 per cent were found tuberculous. These subjects, it must be remembered, were selected with the greatest care, so that none but strong and vigorous animals would be used. It must also be remembered that they were fed only on tuberculous cow's milk. From the above experiments we should expect a large percentage of infection to children and others who use a considerable quantity of milk. Whether the human family is as susceptible to the disease as the ox, I cannot positively state. Is not the infant as susceptible as a selected healthy pig or calf? From 33 to 50 per cent contract the disease when fed upon tuberculous milk. Would it not be well, then, to be sure that your family cow is free from the disease? The communicability of tuberculosis by the use of milk has been demonstrated by actual experiments, to the entire satisfaction of such German investigators as Klebs, Gerlach, Peters, and others, and of such American investigators as Law, Salmon, Smith, Pearson, and others, and it has been proven, as I have already explained, that milk contains the bacilli in a large per cent of cases, even though the udder may not be the seat of disease. To obtain an opinion from physicians and veterinarians, Harold C. Ernest, M.D., sent out circulars to eighteen hundred practitioners who were thought to have enough experience to make their observations of possible value. The circulars were sent out for the Trustees of the Massachusetts Society for the Promotion of Agriculture, and were as follows: HOWARD MEDICAL SCHOOL, BACTERIOLOGICAL LABORATORY, Į DEAR SIR: It is desired to obtain the following points: Have you ever had a case of tuberculosis which it seems possible to you to trace to the milk supply as a cause? An answer upon the inclosed postal card will greatly oblige, Yours very truly, H. C. ERNEST, M.D. Although in the replies received there was no scientific proof of the transmission of the disease in this way, it is the best in this line obtainable, and I would refer you to their bulletin, entitled "Infectiousness of Milk." In the replies, eight were that positive infection had taken place through the milk from mother to child; eleven from cow's milk to child; sixteen others were reported suspicious; negative disbelief, nine; simply negative, eight hundred and ninety-three; sixty-one others had paid no attention; fifteen were out of practice, and reported negative. There seems to be a decided association of this exceedingly prevalent disease with the dairy cow. It would be impossible for me to give a more concise account of this than was given by Dr. Archibald, in his contribution to this Board a year ago, but on account of limited time, it was not read. He wrote as follows: "After several years of close study of this affection, and consulting all accessible statistics, and the habits of the people where the disease prevails, I have reached the conclusion that the only constant associated factor is found in the bovine species, without any regard to the social position of a community, its geographical habitation, terrestrial or atmospheric condition. There are |