Physiology, too, in some of its most important applications, may be regarded as also in its infancy. True, it may be said, that the functions of all, or nearly all, the organs in the body are correctly understood; but then they have been studied chiefly with reference to distinct diseases, and their treatment in individual cases. But the principles of this science have a far wider range, in their application to the laws of life and health as developed in the community at large. The cure of disease has hitherto been considered as almost the sole object of medicine; but when the principles of Physiology and Hygiene become generally understood, the means for the prevention of disease will be sought and demanded as well as those for its cure. The call will not, perhaps, come from individual cases, so much as where the health and lives of multitudes are involved. Here is a momentous work to be performed, in which the members of the medical profession must take a leading part. From their education and daily avocations they are presumed to understand these laws, and are the proper guardians of the public health. But these principles include other things besides mere health and disease. They extend to every department of society, and enter more or less into every subject which affects the physical or mental welfare of man. It is proposed here to notice some of the relations which these sciences sustain to the public. They embrace, it will be seen, many of the living questions of the dayproblems yet to be solved. First in order is

STATE MEDICINE.

This phrase refers to the employment of measures for the promotion of public health and the prevention of disease by means of legislation. It is only about thirty years since any decided steps were taken in this direction, either in Europe or in this country. It is true that for a much longer period there had been legislation with reference to quarantine and the establishment of Boards of Health, but no decided and active legislative measures had been taken directly for the good of the people at large. In Great Britain much progress has already been made in sanitary reform. The reports of the Registrar General, of Royal Commissions, of local Boards of Health, papers read before scientific associations, together with discussions in Parliament, in Journals and books, have attracted very general attention to this subject. Parliament has scarcely held a session for twenty years without having had some discussion, or passed some act referring to health. The principal topics upon which legislation there - has taken place are drainage, sewerage, water supplies, removal of nuisances, construction of lodging houses, hours of labor, public baths, epidemic and contagious diseases. In 1872, several of these laws were remodelled, making them more practical; and new acts were passed, providing for the appointment of health officers to see that these laws were more efficiently executed in all parts of

the kingdom. So general has been the interest created upon this subject, it was predicted by the present Prime Minister that the next great political agitation in England would be on Sanitary Reform.

In this country our own commonwealth has taken the lead in legislation. In 1841, acts were passed establishing throughout the State a uniform registration of births, marriages and deaths, which has been continued for over thirty years. These reports embody the most valuable documents upon vital statistics that can be found in the country. In 1849 an act was passed providing for a sanitary survey of the State, which brought together many valuable facts and statistics relating to health, especially in several of the leading cities of the commonwealth. In 1869 a State Board of Health was created by our legislature. In each step of this legislation it should be stated, that the project was first started in the Massachusetts Medical Society, memorializing the legislature upon the subject. To the credit of this Society it should also be stated, that for thirty years or more it has made repeatedly special efforts for the promotion of public health, either at its business meetings, or by addresses and papers published in its name. But a great work yet remains for the Society to do in this same direction. We should not omit to state that in 1850 two very important acts were passed by the legislature, requiring that physiology and hygiene should be taught in all the public schools of the commonwealth, and that

teachers should be examined in the elementary principles of these sciences; but as the enforcement of those acts was left discretionary with School Committees, the results have not been altogether satisfactory.

But the act creating a State Board of Health is the most important step taken in legislation. This Board has now published five reports, which are an honor to the profession and a credit to the commonwealth. It has a very difficult work to accomplish, and should be sustained by every member of this Society. New questions in sanitary science are coming up for consideration, which will require some positive legislation. The pecuniary interests of individuals and of the public are found to be in open conflict with the lives and health of the people. For instance-have individuals or companies a right to poison the air or the water, which may destroy the health or the lives of multitudes? Shall poisoned or adulterated food be offered in our markets and shops for sale? How long shall it be permitted to construct and rent tenement houses in such a manner as to breed disease and pestilence? Legislation has

always placed great powers in Boards of Health; but either for the want of sufficient intelligence, or from some political motives, they are frequently very dilatory in enforcing the law. Within a few years we have had several marked illustrations of this character. In 1871 and 72 the small-pox prevailed as an epidemic in Lowell and Boston, which might easily have been checked

in its first stages. The Boards of Health in both cities shamefully neglected their duty; and, while they for months were contending about minor points, and shuffling for place and power, the epidemic raged with great violence. Public opinion finally compelled the formation of new Boards of Health, which, by introducing efficient measures, arrested at once the progress of the epidemics. But by this delay more than a thousand lives were sacrificed, a great amount of sickness was caused, and an immense bill of expense incurred. These two cases show the vast importance of having competent and efficient Boards of Health. Human life and public safety and interests should never be thus jeopardized. As extraordinary powers are conferred by legislation upon such Boards, placing in their hands the health and lives of the community, it becomes a matter of the highest moment that they be composed of men thoroughly qualified for the duties of the place. The medical profession should always be here represented by its best men, who, by advice and influence, should take the lead in all measures for preventing or arresting the progress of disease. The voice and influence of the profession, too, should be felt in the halls of legislation, and in the management of our public institutions. Medical knowledge should be brought into requisition in these high places of power and influence to a far greater extent than it has been hitherto. The chief cause of our defective and dependent classes may be found in the violation