thropy even contributes largely to extend the evil of physical degeneration. "In the primitive phases of civilization those of weak and defective blood were more liable to be swept into an early grave than to-day; now all such are skillfully nursed up to the fertile period, to the multiplication and perpetuation of their kind. The profound study, the active sympathy and systematic charity bestowed upon the wrecks of our race for their cure and preservation, when compared with the prevailing indifference as to the means of preventing the steady increase of such unfortunates, is far from flattering to our foresight in economy and beneficent work." Vast infirmaries, hospitals and asylums are built and sustained at enormous expense to shelter and keep alive the constantly increasing number of those hopelessly bankrupt in vital condition, and thus aiding in their increase and perpetuation. The problem of how to exercise our benevolent instincts without helping to bring about so deplorable a result is an important one. I have already stated-and the fact is well established-that acquired conditions are hereditary, and because of this our form of civilization and our social habits are doing much to develop new lines of race deterioration. But time will not permit me to direct your attention to more than one single matter in this connection, and that relates to defects in our system of education that entail serious disease on many children. We have in Indiana over 13,000 teachers, and more than 700,000 school children. It is apparent, therefore, that all questions in relation to the influence of school-life on the health of children are of importance. A faulty construction of seats and desks causes many cases of spinal curvature, with distortion of the chest, that favors the development of consumption; the air of school-rooms is usually bad, and it is an established fact that bad air tends to develop this fatal disease. Professor Richardson says: "The large proportion of the consumptive population have been brought up in close schoolrooms during school hours far too prolonged." Dr. Bowditch, of Boston, tells us it is very common for the consulting physician to see a child who has been, at school, much interested in his studies, and constantly stimulated by his teachers and parents, without regard to his physical health, to study that he might stand high in his classes, having his emulation excited by prizes, who has been "The crushed by the pressure thus brought to bear upon him. prize gained, or the examination concluded, being the signal for entire decay of the physical powers," and the development of consumption. Dr. Clark has clearly pointed out* how females are liable to suffer in health from attendance on school, and that the methods pursued in our schools are largely responsible for the neuralgia, hysteria, and other nervous derangements, that do so much to produce the chronic invalidism of many American women. The force, which should have been used up in the production of "blood, muscle and nerve, being expended in the brain work of the school-room," there is produced a woman, beautiful but fragile, illy fitted to transmit healthy life to her children. During the school life of the girl there is often laid a foundation of disease, important to her as an individual, because of the mental and physical pain resulting, but of very much more consequence because of its effect on her children. Another evil of great magnitude, for which our system of education is mainly responsible, is injury to eye-sight. An examination of many thousands of school children has shown that most of the defects of sight originate in school life, that a large percentage of scholars is affected, the percentage increasing with the stage of advancement in study, and that these defects "are progressive in degree, according to the length of school experience." Defects of sight are hereditary, and as a consequence, all scholarly races show a large number of persons with defective vision. Very serious tendencies to disease of the nervous system are developed in the school-room. "Temporary active hyperemia is the condition of brain action," and it is easy to understand how the young brain, subjected to severe and long continued mental strain, may be vitally injured. Our present system is practically a "machine system of education." The individual peculiarities of the child are lost sight of in the effort to make everything conform to rule and system, that are as inflexible as the bed of Procrustes; the bright child must be cut down, and the dull one stretched up. In both cases the excitement of the brain following study is increased by the emotions excited: in one case there is crushed hope, in the *Sex in Education. †Effects of Study on Eye-sight. Ward McLean, Popular Science Monthly, November, 1877. other gratified vanity; the brain is unduly stimulated, and the rest of the body suffers. It is a law among living things that rapid growth and development are followed by early decline and death, and the brain of a child offers no exception to the rule. Cerebral stimulation tends to produce insanity. Dr. Ray recognizes that "hard study at school lays the foundation of many attacks of insanity later in life," and similar statements are made by many other observers. That the influence of the excitement of school life in the causation of insanity is not generally recognized, is because the evil does not come at once. The children grow up with excitable, nervous systems, that often can not bear the fret and strain that come in active life, and insanity—a state worse than death--follows. Even when they do not pass the invisible line separating sanity from insanity, they are irritable, feeble-minded, and of little use in the world. These bad qualities they transmit to their children, and thus the evil is perpetuated and extended. A system of education producing such fruit surely offers many serious questions to the physician who is interested in the prevention of disease, the perpetuation and the advancement of the race. The logical sequence of the broad statements I have made would reduce the questions in relation to heredity to a very simple formula, (when it is a very complex one). My design has been to direct attention to the general law of heredity, by which similar qualities are transmitted from parent to child. It would show an incorrect conception of the law of heredity to look for a return of identical phenomena in each new generation. It does not follow that the children of an insane or criminal father must of necessity be lunatics or criminals; the very diseases of the parent, with the same symptoms, are not always transmitted, only the organic dispositions, and these do not always show themselves, in direct succession; that is to say, the child born of defective parents may present no evidence of physical, mental or moral disease, and conversely the offspring of parents, apparently physically perfect, may be born with the most serious defects. The environment greatly modifies transmitted qualities, either good or bad. The individual having a hereditary tendency to tuberculosus may, by right management, be prevented from dying of consumption, and the child who inherits a vicious disposition may, by careful education and moral training, be prevented from developing into a criminal, and further, the tendency to transmit these original defects may be to a great extent, if not entirely, lost. There being a reciprocal relation between heritage and environment, it follows that to attain the highest state of physical, mental, or moral perfection, men must not only be born right, but afterward subjected to right influences, neither alone being sufficient. In conclusion, gentlemen, now that my task is done, I regret that I have been unable to present these questions in the forcible and impressive manner demanded by their importance. They are worthy of the most profound consideration, and of the grandest eloquence. Every day the demand for their solution becomes more urgent, for everywhere about us the wrecks of humanity are stranded, and all along the stream of life thousands are drifting to a like fate. Every wind is freighted with appeals for help. We can not listen to them unmoved. We must go to their aid, bearing a salvation for the bodies of men. Our prayers will not stay the Nemesis that brings retribution to those who violate the laws of life. Work, persevering, intelligent work, only can, and this must be performed by the physician, and in it can surely be gratified the highest ambition. The world honors Phidias who, in sculpture, and Raphael who, in painting, present us with rare examples of human beauty. Their masterpieces, however, are but carved stone and colored canvas. How much more then should it honor the physician, whose art is to save and develop men, women, and children, that they may exhibit in their own living bodies all the perfection of a divine humanity. THE ICTERIC FORM OF PERNICIOUS FEVER. WILLIAM R. M'MAHAN, M. D., HUNTINGBURGH, IND. Among the various diseases that physicians are called to treat in the routine of their professional lives, there are none in which acuteness of observation, correctness of judgment and promptness of action are demanded more than in the various forms of pernicious fever. The observations of the medical profession have established the fact that it is akin in origin to the common malarial fevers that infest the major part of the earth. It is evident, then, that we will find it, as a general rule, in proportion to the intensity of malarial miasma in any given locality. As this disease is sudden in its onset, rapid in its action and deadly in its effects, it is absolutely necessary to success and the discharge of duty that we, as physicians, should have clear and concise conceptions in regard to each and every form that the disease is known to assume―e. g., the comatose, choleraic and algid. These are the usual forms in this section of the country. But there are other forms equally, if not more, malignant, but less common, and, as a result, the gravity of the disease may not be fully realized until the opportune moment, which is early in the disease, has passed. Among these we find the icteric form of pernicious fever, and to this I wish to direct attention. First, on account of the icteric mask under which it moves. Second, on account of the great mortality that attends it, and third, the scarcity of medical literature on this subject. This form of pernicious fever is confined principally to the intensely malarial regions |