melting snows—a treasure which we carelessly allow to escape down the Sacramento and San Joaquin Rivers into the ocean, while we continue to drink contaminated water filled with bacteria. Is this our boasted intelligence? This city could be supplied with pure water at less cost than we now pay for the impure, and at the same time confer a similar boon on all the coming generation. It is left for you, gentlemen, to express a strong opinion on this subject.

The members of the Board of Health of a large city hold a post of great responsibility. Good sewerage, pure water, pure milk, and pure food come under their care, and for the good health of the citizens they are mainly responsible.

In the multitude of counsel there is wisdom, and I welcome the tendency of the age to hold congresses, where ideas are enlarged, new thoughts developed, and where a fraternity is established amongst men of the same calling.

Again, gentlemen, let me welcome you here in San Francisco.

THE CHAIRMAN: We have listened attentively and with pleasure to the words of welcome that have been uttered by the representative of this great city by the sea, this great metropolis of the Pacific Coast, and I thank you, sir, in the name of the State Board of Health, and of the Third Sanitary Convention here assembled, for those kind words of welcome and the spirit which dictated them. We, as medical men, of course, are engaged in the healing art. Our province is to cure disease, which is a high, holy, and noble calling. But we also, as sanitarians, are engaged in a calling equally as high, equally as holy, equally as noble-that of the prevention of disease. And now, sir, in the name of the gentlemen here assembled, I again thank you for the words of welcome that you have uttered.

ELECTION OF OFFICERS.

THE CHAIRMAN: The next business in order now, gentlemen, will be the election of officers for the ensuing year.

The first will be the elec

tion of the President. Will you please nominate?

DR. BARD: It gives me great pleasure to place in nomination the name of Dr. C. W. Nutting, of Siskiyou County.

WINSLOW ANDERSON: Mr. President, I desire to second the nomination of my old friend, Dr. Nutting, as a gentleman who has served long and faithfully on the State Board of Health; a gentleman who is most eminently fitted for the position of President of the Sanitary Convention. I second the nomination of Dr. Nutting.

(Nominations closed, and the Secretary was instructed to cast the ballot of the convention in favor of Dr. Nutting.)

THE CHAIRMAN: The next thing in order is the nomination of VicePresident.

DR. J. R. LAINE: I desire to place in nomination a gentleman from the opposite direction. We have now elected for President a gentleman from the northern portion of the State. I want to nominate for VicePresident a gentleman from the southern, or near the southern, portion of the State; a gentleman well known to you all, who thinks it of enough

importance to come here and contribute annually. The gentleman I wish to nominate is Dr. C. L. Bard, of Ventura.

(Nominations closed, and the Secretary requested to cast the ballot of the convention in favor of Dr. C. L. Bard.)

THE CHAIRMAN: Nominations for Second Vice-President are now in order.

DR. J. H. CAROTHERS: One gentleman has seen fit to say that one of the officers is from the far north and the other is from the sunny south. I wish to place in nomination a gentleman from the central portion of the State. I therefore nominate Dr. J. C. McLean, of Alameda.

(Nominations closed, and the Secretary was instructed to cast the ballot of the convention in favor of Dr. J. C. McLean.)

(Dr. Winslow Anderson was placed in nomination for Secretary, and unanimously elected.)

(The retiring President, Dr. C. A. Ruggles, read the following address :)

ADDRESS OF DR. C. A. RUGGLES, RETIRING PRESIDENT.

Ladies and Gentlemen of the Sanitary Convention: It has become an established custom for the retiring President to address the convention upon his leaving the chair. In accordance with that custom I wish to call your attention to a few remarks of a retrospective nature: In the name of the State Board of Health I wish to congratulate you upon the almost complete exemption of our State from the invasion of any infectious and contagious disease during the year past. Much cause for anxiety has pervaded the minds of our sanitary brethren in the East on account of the prevalence of smallpox. But with the exception of a few cases in Modoc County, which were easily controlled and speedily stamped out by the local health authorities, we have been fortunately exempt.

La grippe has been quite prevalent and very fatal among elderly persons during the past year.

At the time when we were preparing for an expected invasion of Asiatic cholera the State Board of Health advised all local boards to cause much diligence to be exercised in having their several respective localities made clean. Fortunately we were spared from such a call from so unwelcome a visitor. But all sanitary reports to the State Board showed a very positive and well-marked decrease in the number and the mortality of diphtheria cases, encouraging us to continue in advising as perfect a system of cleanliness as is possible. In this connection, while I have no desire or intention to speak as to the curative properties of any remedy, I am constrained to remark that the literature of the day justifies the statement that in diphtheritic anti-toxine we have a prophylatic agent that is well worthy your serious consideration.

I am glad to notice a very great advancement in public sentiment as to sanitation. The people are beginning to inquire as to the prevention of disease, as well as to its cure. Much interest is being manifested in the subject of sewerage. Cities and large towns are studying the best methods of protecting their water supply from the percolation of pathogenic germs, and are fast arriving at the conclusion that altogether too intimate relations are existing between the well and the cesspool

and the privy vault, and from us they should receive all possible encouragement to continue in their good work. The efforts of sanitarians in general, and our local health officers in particular, have been happily rewarded in their endeavors to instruct the public mind, producing a more perfect understanding as to the communicability of disease and the necessity of certain preventive and restrictive measures, causing a pleasant and graceful submission to quarantine, isolation, and other sanitary methods, readily acceding to temporary personal inconvenience for the good of the public. At the commencement of my remarks I stated that I should confine myself to thoughts entirely of a retrospective nature, but I trust I may be excused for my deviation from what had been to what ought to be, done.

The great importance of the subject will justify my action. I allude to the milk question, one of such moment as to demand our most serious attention. Sanitary statistics show us that 60 per cent of hand-fed babies in our cities and large towns perish before they are five years old. That the mortality from nutritional diseases, directly or indirectly, during the first year comprises nearly 90 per cent of the whole. My firm impression and belief is that this premature, and in many instances unjustifiable, weaning of babies, is too fashionable and cannot be too harshly condemned, as it exposes the little innocents to all the dangers of contaminated milk, or to many of the not less dangerous artificial foods. There is no doubt that the logical sequence to be deduced from these premises is that a very large part of the mortality in cities and large towns is traceable to cow's milk as a cause. The number of diseases known to be transmissible by milk have multiplied with our increasing knowledge of pathology. The formerly much used terms, intestinal catarrh, summer complaint, cholera infantum, marasmus, teething diarrhoea, and a host of other vague designations may now be spoken of as acute or sub-acute milk infection, referring by these terms to the effects of the numerous poisonous products of the bacteria found in milk. Taking into serious consideration the great importance of the question, the State Board of Health, as an advisory body, has concluded to recommend to all local health boards to procure the formation of city | or town ordinances which will cause all cows producing milk sold in I said cities and towns to be inspected as to their health and to their proper sanitary surroundings, an order of things now in use in Alameda.

Scarlet fever, which in former years has been so great a terror both on account of its fatality and its sequelæ, has been unusually light, and our local health officers are entitled to much credit for their thorough manner of isolation and restriction, rightly believing that though it was light and scarcely worthy of so much notice, they were obliged to adopt the same quarantine regulations, as a mild case was accompanied by the capability of producing a very severe one. At the Sanitary Convention at San José last year the subject tuberculosis monopolized most of the time. Much was said, and was well said, as is evidenced by the fact that the printed proceedings of that meeting have been in great demand by our Eastern co-laborers. While there was some difference of opinion as to some of the restrictive measures advocated, there was great unanimity as to the necessity of the public being better instructed as to the communicability of the disease and its prevention. But with all that has been said, and the awful object-lesson daily presented, it is something past understanding why the state of general apathy and

apparent indifference that seems to pervade the minds of those who should strive to instruct the people in those important matters; with all the facts staring us in the face; the full knowledge that one in every six or seven of all deaths is from this disease; the bacteriological certainty of its communicability-all these facts are naught in staying the progress of this great white plague; "this pestilence that walketh in darkness and the destruction that wasteth at noonday." On it marches unobstructed and unimpeded, taking the fairest and best of the land as its victims, and we the custodians of the public health are doing so little. During the last year our worthy Secretary informs us that there were two hundred fewer deaths from this disease than during the previous year, but we as health officers cannot take any credit for that decrease in mortality, but rather ascribe it to the stringency in the money market, which compelled our Eastern friends to deny their sick the privilege of dying in California, the too much boasted and too highly lauded sanitarium for all tubercular patients. I do not wish to be considered a scold or a fault-finder, but if the public are not instructed in these matters by those who well know about it, whose fault is it? who are to be blamed?

With all due respect to my professional brethren, I say it reluctantly, that the fault lies with us. Much good has been accomplished by the efforts of sanitarians in bringing up the public mind to the point of demanding pure water by a better system of sewerage, of lessened mortality from diphtheria by establishing a more thorough plan of cleanliness, much diminished fatality in scarlet fever by rigidly quarantining even very slight cases. If these things can be and are done, why is it that in the very localities where all these flattering results have been accomplished tuberculosis has not only not decreased, but has actually increased in percentage of mortality? Who is responsible? My earnest desire is that this convention will express itself in no uncertain manner as to the duty of sanitarians in this matter.

Thanking you for your kind attention, I now, with much pleasure, will introduce to you your newly elected President, Dr. C. W. Nutting.

(Dr. Ruggles then introduced the newly elected President, C. W. Nutting, who spoke as follows:)

ADDRESS OF DR. C. W. NUTTING, PRESIDENT-ELECT.

Ladies and Gentlemen of the Third Sanitary Convention: The first thing that I desire to do is to thank you for the honor you have conferred upon me in selecting me to preside over this, the Third Sanitary Convention. We who are medical men and women know that it is not customary for the President of a Medical Association, or for the man who presides over medical deliberations, to make much of a speech on his installation into office. My friend, Dr. Ruggles, has just shown you that the time at which the President of a Sanitary Convention or the President of a Medical Convention is expected to address the body over which he presides, is at the end of his term of office. You will therefore excuse me to-day, and when my term of office has expired I will follow the precedent so ably set by my friend Dr. Ruggles.

I again thank you for the honor, and we will proceed with the business of the convention.

(It was moved and seconded that a Committee of three on Publication be appointed. On motion of Dr. J. R. Laine, the appointment of the Committee on Publication was deferred until the evening session.)

A PLEA FOR THE HOSPITAL AT HOME.

By SAMUEL O. L. POTTER, M.D., M.R.C.P.L., of San Francisco, Cal.

Nowadays we see many princely homes, in process of construction or already built, in which the designers have remembered every one who may cross the threshold in every and any capacity. The visitor finds therein his "guest-room," the caller her drawing-room and retiringroom; there are rooms set apart for smoking, billiards, cards, and music. The studiously-inclined finds a library for his use, however few may be the books therein. The lady of the house has her boudoir; the master, his "den"; the children, their nursery and play-room. The butler has his wine-room; the cook, her kitchen and pantry; the maid, her scullery; and the wash-lady, her laundry. The horse has his stable; the dog, his kennel; and the cat, her cushion. But if we ask for the sick-roomthe place provided for members of the family stricken with severe or contagious, perhaps fatal, disease-we will find that no architect has yet thought of designing in the palatial home a place for the illness which comes to almost every one at some time during existence, or for the final scene so certain to be the end of life for all.

While ordinary, middle-class folk are content, even glad, to go into one of our fine, modern hospitals, when ill, the very wealthy find that, with all their luxurious surroundings, they cannot in illness secure isolation at home from the disturbances of the family life, or from the racking noise of the city in which they dwell. It is obvious that, however perfect a house may be in other respects, it cannot be considered a complete home so long as it contains no special provision for the sickness which may come at any moment to even the healthiest of its inmates. Too often the so-called "spare-room," or "guest-chamber," is the only apartment available for use in sickness, which is neither hospitable to one's visitors, nor kind to our sick.

Every family physician, and householder of experience, knows well the discomfort of the ordinary family routine when disease enters the family circle. The bells are muffled, and the servants scolded for every slamming of a door; the older children wander around the house speaking with bated breath, in the all but vain effort to suppress the exuberant animal spirits of the younger ones. Playmates are forbidden the premises; guests take their departure; a trained nurse comes upon the scene to dominate the household and drive the servants to the verge of rebellion. The home, in fact, becomes the most uncomfortable place to all its healthy inmates, as a consequence of the sickness of some one therein. And then, if a contagious disease be prevalent, and suspected to have come into the family, how great the anxiety upon all, the depression on some, the terror on others-physical and mental conditions sufficient in themselves to so lower the vital resistance as to