are veritable open sewers and sources of pure domestic water supplies are exceedingly scarce. To such an extent has this fashion prevailed that we are involved in a seemingly hopeless attempt if we seek to prevent river-pollution. The protection of our great inter-state water-ways has been the subject of memorials to Congress. It has engaged the serious attention of State Boards of Health. But the practical accomplishment of the end has nowhere been attained, nor a feasible remedy been suggested. The only solution of this vexed question seems now to lie in the purification for domestic use of the polluted water, its protection being rarely attempted.

The attempt is being made to supply pure water to cities dependent on these sewage-contaminated streams, of which Hamburg and London furnish two notable examples. Here filtration of river water through artificial filter-beds has met with apparent success. This is especially true of the city of Hamburg, where the filtration of the water of the Elbe as suggested by Koch, has apparently relieved the city of all anxiety on account of a threatened recurrence of cholera. In this country experiments of the same kind have been tried, notably at Lawrence, Mass. To procure pure and abundant water-supplies, free from any suspicion of disease germs, is now a vital question with many flourishing communities. This State with its myriad brooks and springs is by no means free from perplexities of the sort mentioned. Pure water-supplies are not so plenty as formerly. More populous villages are every year polluting the neighboring streams with their sewerage, and some are unquestionably now using diluted sewage from such streams. The questions that are being asked and an

swered elsewhere have a very practical interest for us, and that interest must every year increase.

There was recently held in New York city an important meeting of representative bacteriologists from all parts of America, called by the committee on water supply of the American Public Health Association. This gathering was called as stated in the invitations, "to establish some common ground-plan for systematic work in bacteriology in general and in the bacteriology of water supplies in particular." It is to be hoped that the results of this gathering will mark the beginning of a new era in exact knowledge of pathogenic bacteria, especially as related to watersupplies.

The recent death of M. Louis Pasteur, the most conspicuous figure in the world of medical science, calls for passing notice. Pasteur's scientific career began as a chemist; later he became a professor of physics and of geology; fermentation engaged his attention, and finally bacteriology. It is in the role of bacteriologist that his name became a household word, and on his discoveries in this field will his fame in our profession chiefly rest. His early work was full of discouragements and in the face of severe criticism. He rescued the chief industry of his country from ruin by teaching silk-growers how to eliminate diseased worms. He discovered the anthrax bacillus, and in late years his name has been universally associated with the protective inoculations against rabies. He is very properly termed the father of bacteriology. pioneers in science, Pasteur lived to see his theories generally accepted; he lived to receive unstinted credit from former critics, and the homage of a grateful world.

Unlike many

He belonged peculiarly to our profession. and to him it is probably under deeper obligation than to any other man. His untiring labors have done more than those of any other to popularize Preventive Medicine as well as to give it a place among the sciences. It is fitting then that we, in common with the whole world, pay reverent tribute to the memory of this modest Frenchman.

These are some of the prominent features of the recent history of State Medicine. Volumes might be written of the happenings in this department in one short year. Scientific research with ever increasing accuracy is fast formulating rules; the practical sanitarian with equal vigor seeks their application. Here we have the student with laboratory equipment and logical mind; there the sanitarian who must understand the latest results of laboratory work and keep in touch with existing social conditions. The study of disease and disease-producing conditions and the application of the results to modern life are, as I stated at the start, the component factors in State Medicine.

The safeguards that science suggests and the State applies to human life are daily becoming more complex as its enemies and their methods of approach are better known. The remarkable development of recent years augurs well for the future. Medicine and surgery are sciences of prevention as well as of cure. Popular enthusiasm grows apace. The doctor's field lies not only in controlling disease actually present, but also in educating his clientele in its cause and prevention. Doctor and laymen are fast becoming common allies against these insidious foes of the race. The coming year and years to come promise startling results. The full realization of our hopes, the extermination of preventable disease, is perhaps distant. Yet pessimism is not a domi

nant factor of the time. The highest type of civilization in these closing years of the nineteenth century is characterized par excellence by an ever increasing faith in scientific medicine, notably scientific Preventive Medicine.

The perfect control of preventable disease-the triumph of State Medicine-of which we already get hints, will be the crowning blessing of the highest civilization of the fu

ture.

The Medical and Surgical Treatment of Appendicitis.

By S. C. Gordon, M. D., Portland, Me.

In announcing the title of my paper, I seem to hear the ringing of the chestnut bell, and, in an undertone, a chorus of "roasted chestnuts," so much has this subject been paraded in local, state, national and international societies and in medical journals throughout the world; and yet I venture to add another to the long list, for I find on much inquiry, that the profession is still divided on what is the best method of managing this disease, which has excited so much attention within the past five or six

years.

The profession has been ridiculed, caricatured and made the butt of innumerable jokes on what the penny-aliner has considered a "fad,'' while all have been considered "cranks" for believing that the disease has even existed at all. Nevertheless, I am sure that every honest man in the profession knows very well that there has been a much larger percentage of these cases within the time named than existed before in the same number of years; while the laity are asking, if this be true, why is it?

I believe it to be true that the cases have largely increased in the past few years, and my reply to all such