on any of these subjects, is given advanced standing and is not required to be examined again, on that subject, at his final examination. Where the student fails to make a grade of 75 per cent he is considered failed in that subject and must be examined again before he can be licensed. Now, it is a fact that, out of 60 students who took this examination in May, 1910, 32 failed in chemistry alone, 19 failed in materia medica and many others in one or two of the subjects in which they were examined. In May, 1911, the number of failures was somewhat less but was over 20% of those examined.

One result of this method is that students who have failed make extra efforts to prepare themselves, on the subjects in which they had failed, before their final examination, and as a consequence fewer failures occurred than under the old system of examination. Most candidates for final examination fail on the subjects of the first two years if at all, as the clinical studies usually prove more interesting and being more recent are fresh in the memory.

It is quite apparent to the careful observer that the object of many examining boards is to exclude a certain per cent of the applicants each year, regardless of qualification. The Nebraska board has taken the attitude of admitting any and all who show, on examination, that they can safely be permitted to engage in the practice of medicine.

We publish herewith a statement of the number of applicants examined, the number passed and the number failed during the last two years. If the number of failures in the examination at the end of the second year were included it would show as high a percentage of failures as most other states.

The records of the board are at all times open for inspection and these facts can be verified by anyone who cares to investigate.

The following table shows the number of applicants examined by the Nebraska State Board of Health during the last two years. With very few exceptions the applicants are graduates of Nebraska Medical Colleges, showing that Nebraska examina

tions are not considered an "easy mark" as very few applicants from other schools appear for examination :

A warning against the dangers of dust was issued in a statement made recently by the National Association for the Study and Prevention of Tuberculosis, in which it is shown that the percentage of deaths caused by tuberculosis in dusty trades is more than double that for all employed men in the registration area of the United States.

As a result of the dangers from consumption to those exposed to various forms of dust, and at the request of the National Association, the United States Government has recently appointed a commission to work in co-operation with state authorities in making an investigation into the conditions of the metal mining industries in the United States, with special reference to diseases of the lungs. The work of the commission engaged in this special task will follow lines somewhat similar to those worked out by the Royal Commission of Australia, whose report was recently received in this country.

"Dusts are of three kinds," says the National Association; "factory, street and house dusts." The statement refers to the results obtained through investigations made for the bureau of labor by Frederick L. Hoffman. While among males generally in the registration area of the United States 14.5 per cent of all deaths are from consumption, the mortality among grinders from this disease is 49.2 per cent, and in hardly any of the dusty trades is it below 25 per cent. The percentage of deaths from tuberculosis among all those exposed to metalic dust is 36.9 per cent; to mineral dust, 28.6 per cent; to vegetable fibre dust, 28.8 per cent; to mixed animal and other forms of dust, 32.1 per cent;

to street dust, 25.5 per cent; and to organic, or dust coming from articles being manufactured, 23 per cent.

The statement speaks also of the dangers from house dust, especially in rooms that are not well ventilated. The association warns against dry sweeping and against the use of the feather duster or other devices that scatter, but do not take up the dust.

Since the ordinary dust blown about in the streets is impregnated with disease germs, the National Association urges the adoption of methods that will prevent the further dissemination of such bacilli. It also urges for the coming months of fall and winter more open windows and more fresh air in house, shop and schoolroom.

The Irrepressible Conflict.

In 1858, William H. Seward, senior senator from New York, in describing the approaching struggle between two opposing conceptions of our national government, spoke of it as "the irrepressible conflict." His prophetic eye foresaw the coming storm. He saw, too, how impossible it was to prevent it. This phrase, caught up at once all over the nation, became one of the famous sayings of this strenuous period. The tendency of history to repeat itself has become proverbial. The present "investigation" of Dr. Wiley by the congressional committee affords another instance of a conflict just as important and irrepressible as that of fifty years ago. At the beginning of the hearing, the question at issue was whether or not Dr. Wiley had violated the law in the manner of employing an expert pharmacognosist. But this point has long been lost sight of. The committee and congress are now called on to determine whether the national Food and Drugs Act, won after years of struggle, shall be administered for the benefit of the people, or nullified for the profit of the manufacturers. Wiley and Bigelow and Kebler on the one hand, and Wilson, McCabe and Dunlap on the other, are but the representatives of the opposing interests. The real question is: Which is of greater importance, the health of the American people or the financial prosperity of cer

tain business houses? This is the "irrespressible conflict" of to-day. It must be fought out to a finish and it must be settled aright. Which will triumph, the people or the interests? This is the real issue in the Wiley case. J. A. M. A.

Dr. William H. Welch, retiring president of the A. M. A., recommends carrying out the suggestion made by the Medical and Chirurgical Faculty of Maryland that, in connection with the proposed celebration of the completion of the Panama canal in 1915, there shall be suitable commemoration of the greatest triumph of modern times in the domain of preventive medicine. This celebration will be neither complete nor worthy without the fullest recognition of the contributions of sanitary science to the successful completion of the Isthmian canal. The completion of this stupendous undertaking could not have been possible without large sacrifices of lives had it not been for the scientific discoveries of Reed and Carroll and their colleagues. It is to the glory of American medicine that through the practical application of these discoveries it was possible to build the canal without great sacrifice of human life.

An old South Carolina darkey was sent to the hospital of St. Xavier, in Charleston.

One of the gentle, black robed sisters put a thermometer in his mouth to take his temperature. Presently, when the doctor made his rounds, he said:

"Well, Nathan, how do you feel?”

"I feels right tol'ble, boss."

"Have you had any nourishment?"

"Yassir."

"What did you have?"

"A lady done gimme a piece of glass ter suck, boss."

A series of revival services was being held in a western city and placards giving notice of the services were posted in conspicuous places. One day the following notice was posted, "Hell, Its Location and Absolute Certainty. Thomas Jones, baritone soloist, will sing, 'Tell Mother I'll Be There.'"-Lippincott's.

ORIGINAL ARTICLES.

Preventive Medicine.

*By W. H WILSON, M. D., Lincoln, Neb.

It is not the purpose of this paper to go into this subject deeply or to treat it exhaustively, but rather to call attention to the importance of this branch of the practice of medicine and to urge that it receive more consideration at the hands of the profession, for while it is true that great advancement has been made along the line of the prevention of disease during the past quarter of a century, yet the writer is convinced from observation and some years of experience that systematic efforts in the prevention of sickness and death has not been advanced as it might or should have been. The reason for this, no doubt, has been that the mind of the profession has been almost entirely centered on the one idea, that of means to cure disease, but fortunately of recent years there seems to be an awakening to the great need and the possibilities of preventing disease. We have reached an epoch in civilization in which the public no longer regard sickness and disease with that superstitious awe that for many centuries, and in fact, which, until very recently, held the individual and public mind in its fatalistic grasp, so that sickness and death were regarded as mysterious dispensations of Providence, which were unsearchable and unavertable. Happily for suffering humanity the laity, in common with the profession, are coming more and more to a realization of the fact that in disease as in all else where there is an obvious effect there is a potent cause underneath it. This has given rise to original research and investigation as to the causes of disease and the means of its prevention, which in turn has given birth to hygienic and sanitary measures which have been developed into a scientific system which is producing flattering results and which is capable of inestimable value as it develops and is rightly applied. The most notable instances, perhaps, of which one might mention are the great reduction of infant mortality, the progress of which has been quite gratifying in the past two decades and the cleaning up of yellow fever districts. It has been granted that much has been accomplished in the prevention of disease and the work somewhat systematized, yet when we take into account the statement of an eminent authority, made after extensive investigation, that forty per cent of the

Read before the Nebraska State Medical Association, Omaha, May 2, 3 and 4, 1911.