ered on regular salt baths, regular diet, careful exercise, change of pursuit, not stoppage of work, and as medicine a minute dose of phosphorus. Where tobacco was in use, it was stopped or rigorously limited.

Almost parallel symptoms are more and more frequently developed in laboring women, over-burdened housekeepers, or "overbearing" mothers (if I may use the expression.) Repeatedly, same treatment has succeeded, but not so surely or quickly, because such women cannot easily change work or let it go.

The upshot of the matter, of which these cases are illustrations, is that much of the effects of overwork, even when exhibited in marked nervous symptoms can be promptly and (apparently) entirely removed, by a treatment which is but slightly aided by drugs. The serious part of the matter, to my mind, is that these marked cases. are striking examples of injuries to nervous power which in less marked exhibitions, are so general as to demand the attention of physician and patients alike to the necessity for prevention rather than cure, and that a wide field of usefulness is open to those physicians who by tongue and pen will endeavor to bring their clients to a "realizing sense," of the relation of this injury of nervous power, to their many other ailments, little suspected of association with it. This done, that they be further made to understand that relief, by change of work or rest from all work, and attention to the restoration and preservation of bodily health, by the use of the simple means at their disposal. Exercise in the open and sun-lighted air, baths, friction, regular food, regular sleep, and hearty enjoyment of all of them, are the very best means we can suggest, and that they will prevent most of the "dreaded effects of our civilization," of which we hear so much, and the very fear of which has done much to cause mental distress and anxiety to this very class.

C. N. HEWITT.

Report of Committee on Epidemics, Hygiene, Etc.

J. C. ROSSER, CHAIRMAN.

Mr. President, Ladies and Gentlemen of the Minnesota State Medical Society:

There is an idea regarding the nature of epidemic contagious diseases which modern investigators have sought, and are still seeking to raise into clearness: the idea, namely, of origin and growth.

These affections are not things of yesterday, nor do we imagine that the slightest controversial tinge is imported into this report when we say that they are not of 6,000 years ago. But, however obscure their origin may be, they are not to be denied; and in order to obtain a full expression on this subject we forwarded our circular to 150 members of this Society, in compliance with the good old legend which admonished us to "Cast our bread on the waters," and lo! it has returned; and we bring it before you.

RED WING, Minn., April 6th, 1883.

DR. J. C. ROSSER, Chairman Committee on Epidemics, Hygiene, etc., State Medical Society:

Dear Doctor: Your circular and letter enclosing same just at hand. In reply you expect me to give you such suggestions as grow out of my long official service in State medicine. I will not therefore discuss the "germ" or any other "theory" of disease cause; but will give you a few of the facts as to the extent of the preventable disease mortality in our State.

One of the two most disgraceful records is that of diphtheria. It began to figure as a death cause in 1872, and

the annual record of deaths since is as follows:

12.12 per cent. of total deaths-double that of any death cause except consumption, which was 10.34 per cent. of total. Over 54 per cent. of deaths from diphtheria were under five years of age; over 92 under fifteen. Over 62 per cent of deaths from diphtheria were of foreign parentage.

The State Board of Health have for the last eight years earnestly striven to persuade medical men to unite with the Board in impressing upon the people that this disease is very infectious, and that it can be best controlled by strict seclusion of the sick and careful disinfection.

We succeeded, with the aid of a few earnest local health officers, in securing the endorsement of the State Medical Society at the Albert Lea meeting three years ago, and the popular opinion is constantly growing in this direction.

The profession are very negligent in their duty, and careless exposure and public funerals are still the rule. I beg your committee to report in the strongest terms on this subject and urge medical men to earnest and united action. Seclusion of the sick, prompt notification of the disease, and very careful disinfection offer the best protection we can at present have against this veritable plague.

Under the new sanitary code the power of local boards of health and of health officers is abundant and they and

the physicians who will help them may rely upon the prompt and constant co-operation of the State Board of Health.

The next record to which I wish to call earnest attention is the following:

In 1881, 1,273 children died of still birth, premature birth and infantile debility, which fact means that 4.4 per cent. of all born are born prematurely or die soon after birth.

Over 11.00 per cent. of all deaths in Minnesota are of this class.

In Massachusetts in five years, 5.53 per cent. of total deaths are of this class, just half our rate.

Now take typhoid fever, to which your circular specially refers. The record by years is as follows:

In 1881, therefore, this disease caused 617 per cent. of total death, of whom more than 51 per cent were between the ages of 15 and 30 years; more than 61 per cent. were between the ages of 15 and 50, and only 24 per cent. under 15 years of age. More than 64 per cent. had both parents foreign, and more than 25 per cent. had both

parents American.

Compared with the other records-they kill the children; this takes its victims from the "self-supporting class.

There is more of this class of facts behind, but this exhibit is enough for my present purpose. Remember that these causes of death are of the preventable class: that

they can be reduced far below their present position on the list of death causes, by means already known and whose use is provided for, in the knowledge and power of physicians, Boards of Healths and intelligent parents, and what excuse have we to offer for the neglect to use and enforce the use of those means by every instrumentality in our power?*

As to the first classes causing death in infancy and early childhood, I wish to call the attention of medical men to the demonstration which these and other statistics give.

Ist, of a very powerful evil influence to be found in ante-natal conditions.

2d, (and next in importance probably) causes to be found in the care of mother and child during the first weeks after confinement.

3d, that the most important, because most effective, death causes are to be found in the conditions of the house, which is the home, and in the modes of life and work and worry of the mother, mental and physical, during pregnancy and in child bed.

There is no necessity for the "refined methods" of modern scientific research, but rather for a clear, calm study of easily discovered facts, most of which are at hand, others to be gotten by careful inquiry and scientific sifting of so-called facts. The microscope and the physical and chemical laboratory are of use, and often essential, but they come in long after practical and immediately available means of staying the slaughter have been discovered, or demonstrated anew, for that is a very common result of such investigation, thanks to faithful work done before.

A perfectly practicable plan would be the study of limited areas of territory by several physicians working in concert. Let one study drainage, ventilation and food supply. Anothsr, the influences bearing upon the mental and physical condition of the mother during and after pregnancy.