of the demand made upon her earning
capacity, and the decline in breast nursing. Wealth is on the whole
more advantageous from the narrow point of view of disease than is
poverty, but if we regard its influence on the race its advantages are
not so evident. Nothing can be worse for a race than that it should
die out, and wealthy families have never reproduced themselves.
Conditions always tending to destruction are a necessary part of the
environment of poverty; wealth voluntarily creates these conditions,
and chiefly by the pernicious influence of its amusements on the
young.

A new and in many respects a nobler conception of medicine has been
developed. Formerly medical practice was almost exclusively a personal
service to the sick individual, and measures looking toward the
general relief of disease and its prevention received scanty
consideration. The idea of a wider service to the city, to the state,
to the nation, to humanity rather than the personal service to the
individual, is becoming dominant in medicine. This is seen in the
establishment of laboratories by boards of health in cities and states
in which knowledge obtained by exact investigations can be made of
direct service to the people; in the medical inspection of schools and
factories; in promulgating laws directed against conditions which
affect health, in the extension of hospitals, and in divers other
ways. The idea of public service and of returning to the people in an
effective way some of the results of their labor also underlies the
large donations which have been given for the creation of special
laboratories and institutes in which, through research, greater
knowledge of disease may be obtained and made available. The
researches which have been made on the nutrition of man and the
nutritive value of different foods are of great importance, and this
knowledge has not yet begun to be applied as it should be.

There seems to be a balance maintained between the restriction of
disease by prevention and the increased influence of social conditions
which are in themselves factors of disease. Preventive medicine seems
to have made possible, by restricting their harmful influence, the
increase in industrialism, in urban life, and in the
intercommunications of peoples. The most important aid in the future
to the influence of preventive medicine must be the education of the
people so that the conditions of disease, the intrinsic and the
extrinsic cause