reporters, except in the inferential case at Nordhoff recorded by Dr. Perry. During the period covered by this report, three well authenticated cases have been brought to my knowledge by a careful, conservative, medical observer of Los Angeles. If the bacillus tuberculosis be accepted as the proximate cause, and the adoption of insanitary modes of life the remote, there remains no adequate barrier to the wide extension of phthisis here as elsewhere. The mildness of our climate attracts the feeble of all lands, and of these multitudes, cases of phthisis probably preponderate in the proportion of ten to one. As has been demonstrated, the joint occupancy of bed or room by the consumptive and the well, acts unfavorably upon the latter; and in many instances is followed by health failure and early death from phthisis.

Whether a "propter" from this "post" may be argued or not, satisfactorily to all, the oft observed fact remains. One of the most frequent occurrences throughout this region is this insanitary intimacy. Whether believers or not in the bacillus as a potential factor in the propagation of this, the greatest enemy of the human race, medical men everywhere owe it to the well, to protect them, so far as may be, from the almost inevitable evil resulting from such unfortunate association.

If the bacillus theory be true, the great danger to the general public lies in the myriads of these microbes which are daily deposited on every thoroughfare in the sputa of the suffering multitudes. Cultivators assert that the most virulent form of tubercular sputum is the dried and pulverized. Thus, the sunshine and the breeze, health giving and invigorating to the sick, may become the agents of destruction to the well. No needless alarm is proposed by these remarks, but in the interest of preventive medicinethe medicine of the future-the attention of sanitarians is urged with emphasis to this important subject.

The existence of the various cardiac affections is almost unknown except in the case of strangers.

Dr. Bates, Santa Barbara, writes: "Acute diseases of the heart are rare; chronic more common. Many strangers come here suffering from valvular disease."

Santa Maria and San Buenaventura may, to some degree, be considered as exceptions.

Dr. Lucas, representing the former, writes: "It seems to me, for a pastoral and farming community, we have considerable heart trouble here. Of course many cases come in from other places seeking relief.”

Dr. Hill, of San Buenaventura, reports: "Rheumatic pericarditis is the most frequent form of heart trouble encountered with us. Valvular disease is quite common among our pioneers who underwent unusual fatigue and exposure."

Dr. Whaley, of Compton, writes: "Of organic diseases of the heart we have none; functional disturbances occur occasionally."

Dr. W. A. Brown, of Downey, says: "We often meet cases of valvular insufficiency newly arrived from the Western States; have met but two cases originating here."

In regard to hepatic affections, the general report is, "rare, except imported." Some few exceptions are noted.

Dr. Lucas, of Santa Maria, writes: "We have no diseases of the liver, except cirrhosis, due to the use of intoxicants.”

Dr. Curran, of San Buenaventura, reports: "Hepatic congestion frequent; but no more so than is customary in warm climates."

Dr. Hill, of the same place, says: "Diseases of the liver are to be met with, due most frequently to the abuse of food and dram drinking.”

Dr. Weldon, of San Pedro, writes: "Diseases of the liver plenty, from drinking." And in a foot-note adds: "There is a great deal of liquor drank here, and in consequence we have a great many rum stomachs and gin livers to patch up."

Dr. Griffin, of Los Angeles, remarks: "Diseases of the liver are rare, except from alcoholism or other excess.'

Dr. C. W. Brown of Pomona, reports: "Diseases of the liver, I judge, are as common here as in the East. Much is brought from malarious localities."

Dr. Kerr, of Pasadena, writes: "Inactivity of the liver common here." Dr. Crane, of Santa Ana, says: "Functional derangements of the liver not infrequent; organic, rare."

Dr. Fox, of San Bernardino, reports: "Some cases of cirrhosis. Functional disturbance not uncommon. Organic lesion, except from intemperance, rare."

Nephritis idiopathic, another terror of the United States, north and east of the mountains, is not established here as one of the prevailing diseases. We note the comments of those reporting it.

Dr. Bates, Santa Barbara, reports: "A few cases occur each year, usually caused by exposure to rain during the Winter, or to a long ride in a cold wind."

Dr. Lucas, Santa Maria, remarks: "We have a case now and then, generally due to exposure."

Dr. R. W. Hill, San Buenaventura, writes: "Acute nephritis often met with, caused by exposure, over-exertion, mental and physical. Intemperance a frequent cause.'

Dr. J. C. Kerr, Pasadena: "A case now and then, caused by drinking." The ordinary contagious affections are almost as infrequent as the noncontagious. But one especially noteworthy feature has been mentioned by reporters, viz., the general mildness of the attacks, and the absence of serious sequelæ.

Under the caption "miscellaneous," tænia alone is even occasional. From my own observation I am able to report its presence as by no means infrequent; but I am very sure it is far from being as common as the charlatans would have their patients believe. Indeed it has been reported that not a few specimens, said to have been removed from willing victims, proved to be celluloid.

From the foregoing it may be correctly inferred, that whatever may be the commercial importance of Southern California, or its future as the center of the great industries which are even now developing in our midst, its . excellence as a health resort cannot be exaggerated.

"Within a circle of one hundred and fifty miles, one may find spots below the sea-level, or with an elevation ten thousand feet above it; spots that have nightly a heavy fog, and spots that never know the presence of a fog; places swept by an almost constant breeze, and others sheltered from all wind; the odors and gases from asphaltum and petroleum springs, or the air of the mountain pineries; the scent of the orange blossom, or the balsamic odor of the plants of the desert. Differences of elevation which elsewhere one travels a thousand miles to find, here are found in a radius of fifty miles."

No epidemic has ever visited this part of the State, and contagious diseases which have been brought here have never obtained a foothold. It is moreover a region of easy access by rail and steamer. Food of every variety is abundant, and all of the delicacies and comforts required by invalids are readily found.

IRRIGATION.

By H. C. CROWDER, M.D., Member State Board of Health.

The question of the effect of irrigation in California is one that deeply interests every inhabitant of the Pacific Slope, and, in some localities, is the all-absorbing question of the day. Beautiful California, with her mild and invigorating climate, properly irrigated, would bloom like a rose.

The hot and arid plains of Colusa County, where one can travel half a day on a ranch belonging to one man, and where in 1884 were cast two thousand eight hundred and ninety-nine votes, could, with proper irrigation-which would cause a division of the land-support as many thousand voters as there are now hundreds, and then it is doubtful if the products could be taken care of without importing help.

It has been demonstrated beyond a doubt that oranges, lemons, and all the citrus fruits will grow and mature in Colusa County as well as in Los Angeles County. In the latter, land is worth from $50 to $500 per acre, while in the former it sells from $20 to $60. So much for irrigation.

The application of water used in irrigation varies greatly in manner, but may be described by two different methods, viz., first, by flooding the whole surface of the land by means of ditches, and the second, by sub-irrigation, where the water is conveyed through pipes beneath the surface of the ground. The latter method, being of recent date, will not be considered, owing to its being but very little used. In the application of water through open ditches, where the land is flooded, there has been various reports made by impartial judges, which are in some instances conflicting. In that portion of the country where the soil is sandy or gravelly loam of unknown depth, the water sinks, or if there is much slope, drains off very rapidly.

In Southern California, where irrigation has been carried on for more than a hundred years, there is but very little, if any, evidence that malarial diseases predominate; hence, we come to the conclusion, where irrigation is used scientifically, there will be an increase of malarial diseases only as there is increased population in the country. It is said that "all the M.D.'s in the State are in favor of irrigation; that it would increase their business one hundred per cent," etc. It would undoubtedly increase the population more than one hundred per cent, and in that way produce more business for all.

Along the bottom lands of rivers, where the drainage is not good, and where the soil is continually saturated or moist, the case is different. There can be found more or less intermittent and remittent fevers; and, in fact, all miasmatic and zymotic diseases prevail to a greater extent. Professor Loomis, of New York, includes those acute infectious diseases which depend upon poisons developed outside the body of the affected person:

These poisons possess two distinct characteristics: First, each poison is specific and distinct from every other in its action, and hence, inferentially in its nature, so that the pathological process which it incites is always identical in kind and associated with that one etiological element, and with no other. These processes thus become the means of differentiating this class of poisons. Second, all of these poisons possess the power of indefinite reproduction when placed under favorable circumstances, and their resulting

diseases are, therefore, generally endemic. When the poison affects large numbers at the same time rather than sporadic, such a poison is termed a virus, and has its origin either in the bodies of diseased living beings or in decomposing organic matter. Every virus is more or less diffusible, and may be conveyed by air, fluids, or solids; while in some diseases it becomes so localized that it can be transmitted by inoculation. These morbific agents give rise to distinctive diseases, either by changes which they produce in the blood or by their direct action upon the cellular elements of the different organs and tissues. When a virus originates and attains its full development only in a living animal, and is excreted in an active state, it is called a contagion, and the disease which it produces is contagious. When the morbific agent is solely the product of decomposing organic matter, it is termed a miasm, and the affection it develops is a miasmatic or malarial disease. Contagions may be transmitted mediately or immediately, and are reproduced with each infection. Miasms are conveyed only by diffusion generally through air or water, and their activity is limited to a single infection.

A third form of virus originates solely in diseased animal organisms, but is excreted in a passive condition, and becomes active only in the presence of decomposing organic matter. The disease in whose development such a poison is the etiological factor, are termed miasmatic contagions. The theory of organisms, or the germ theory, maintains that the infectious poisons are living organisms which, being received into the blood, reproduce themselves indefinitely, and excite morbid processes which are characteristic of certain types of disease.

This theory at the present time is quite extensively adopted, as it so readily explains very many remarkable facts connected with the development and reproduction of this class of diseases. It is readily understood, and there are so many animal poisons which appear to act in this manner, that to one whose opinions are not based upon clinical experience and actual contact with disease, the arguments in its favor seem conclusive. According to this theory, all of the different forms of diseases included under the head of infectious may be reduced to two classes: first, infectious diseases which depend for their development upon a living animal organism; second, those which depend for their reproduction upon a living vegetable organism.

We all admit that these miasms and organisms are reproduced more rapidly under certain circumstances, but we have no proof showing that irrigation is the means of bringing about these favorable circumstances; on the contrary, it has been conclusively demonstrated that imperfect drainage more than irrigation tends to develop and produce these conditions. From my own experience and observation, I can only state that malarial and low types of fever have been more prevalent during the Summer months following a comparatively dry Winter than immediately after a very rainy season, and that too where there was considerable drainage.

THE DRINKING HABIT IN CALIFORNIA.

By W. H. MAYS, M.D., Superintendent of Stockton State Insane Asylum.

Intemperance is assigned as the cause of insanity in about thirteen per cent of those sent to the asylums of this State. This falls far short of the truth. There is a disposition on the part of the relatives to hide the fact of drunkenness, and hence the exciting cause is set down to sunstroke, business reverses, trouble, blow on the head, etc. Lord Shaftesbury, an authority of the utmost weight, states as his opinion that more than fifty per cent of the cases of mental disease to be found in asylums are due to the drinking habit. My predecessor, Dr. G. A. Shurtleff states, as a result of his long experience, that intemperance produces more insanity on the Pacific Coast than any other influence. Nor, with what opportunities for observation I have had, do I hesitate to add my testimony that no factor is more potent and active in the causation of insanity.

If only the evil done by the inebriate could be limited to himself! Nothing exerts more deteriorating an influence on the race of man, sapping the mental and physical health of our people. Dr. Howe, of Boston, in his report on idiocy, makes the statement that of the three hundred idiots under his care, one hundred and forty-five had drunken parents. In one instance, he continues, where both parents were drunkards, seven idiotic children were born to them. I receive patients daily at the Bicetre,' says Dr. Moreau, "in whom I can trace back the origin of their malady to nothing else but the habitual intoxication of their parents." The following direct instances where the sins of the father were visited on the children occurred in the writer's experience during general medical practice:

66

"

1. The father, a respectable business man, met with reverses and took to drink." Although the parent of two healthy children before this, the next child born to him was a puny, malformed creature, which died before reaching its fifth month.

2. A stout, bright girl, married a man addicted to periodical drinking bouts. Their child was born disfigured with a spina bifida, and died in a few weeks of meningitis.

3. A man, well to do, in a small country town, had for years indulged every few months in an occasional drinking spree of a week or so's duration. His son, when only thirteen years old, was seen reeling along the street in a bestial state of intoxication, and at eighteen was a bloated and besotted drunkard. Instances are not rare, in the experience of physicians, of this direct transmission of the drinking tendency from father to son.

If only the evil done by the inebriate were limited to himself! There are eight thousand inebriates in California to-day, at an impartial estimate. By inebriates, I mean persons who indulge in the excessive use of alcoholics, who cannot resist the craving. Of these, suppose one half are married and have families; for your drunkard is no disciple of Malthus; grant them only one child apiece; think what a terrible inheritance is being handed down, what a ghastly gift to our young State, four thousand children with an inborn tendency to vice and disease. Four thousand children who