MEDICINE, SURGERY, SANITATION.
DISCOVERY OF CIRCULATION OF THE BLOOD BY HARVEY--VACCINATION BY
JENNER--USE OF ANÆSTHETICS THE GREAT STEP OF MEDICAL PROGRESS OF THE
CENTURY--MATERIA MEDICA--INSTRUMENTS--SCHOOLS OF MEDICINE--DENTISTRY
--ARTIFICIAL LIMBS--DIGESTION--BACTERIOLOGY, AND DISEASE GERMS--
ANTISEPTIC SURGERY--HOUSE SANITATION.
In the early gropings through the uncertain light of first progress, man
was accustomed to ascribe the ills of his flesh to the anger of the
gods, and in his craven and abject superstition made peace offerings.
Later he learned to locate the cause within himself, and constructed the
theory that the fluids of the body had become disordered. The
characteristic feature of progress in the Nineteenth Century, in this
field, has been in the accurate tracing of the relation of cause and
effect, and with the discovery of true causes has grown efficient means
of treatment. The old expedients of charms, incantations, conjuration
and exorcism gave place first to intelligent medication, and this in
turn is rapidly giving way to the prevention of disease by improved
conditions of sanitation and right living. The ounce of prevention has
been found to be worth more than the pound of cure. With the improved
knowledge of physiology, anatomy, chemistry and biology, which the
century has brought, the intelligent physician was able to make a
logical and for the most part a correct diagnosis, but supplemented with
the microscope, that great revealer of the unseen world of small things,
corporeal existence itself becomes an open book, and from the principles
of organic evolution to the germ theory of disease the mystery of life
and death is being slowly revealed.
When the Eighteenth Century gave birth to the Nineteenth, its great
natal gift in medicine was vaccination. Jenner in 1798 for the first
time announced his discovery of this great boon to the human race. In
1799 Dr. Benjamin Waterhouse, in Boston, obtained virus from Jenner and
vaccinated four of his children, and in 1801 Dr. Valentine Seaman
obtained virus from Dr. Waterhouse and performed the first vaccination
in New York. During the Seventeenth and Eighteenth Centuries the annual
death rate from smallpox in London ranged from 2 to 4 per 1,000 of
population. In 1892 it was only 0.073 per 1,000.
It is also stated on good authority that the mortality from smallpox in
England alone, was 20,000 a year less after the introduction of
vaccination than it was in the preceding century, and that its benefits
to the world at large have been so great that the lancet of Jenner has
saved more lives than were sacrificed by the sword of Napoleon.
Each century in modern history has been marked by some important
discovery in the field of medicine. The Seventeenth Century was notable
for the discovery of the circulation of the blood by Harvey; the
Eighteenth Century brought with it vaccination by Jenner. The Nineteenth
Century’s greatest gift in this field has been anæsthesia, or
insensibility to pain. Nature has wisely endowed man with nerves of
sensation as danger signals for the conservation of life. Accident and
disease, however, are the inseparable concomitants of human existence,
and suffering and pain the ineffaceable legacies of mortality. Sometimes
these nerves of sensation are no longer useful as monitors, and in the
unavoidable emergency of accident, surgical operations, child birth, and
certain diseases, suffering can do no good, and then pain--that Prince
of Terrors--thrusting his presence upon the hapless victim, racks body
and limb, calling forth groans, and shrieks and writhings, till the poor
sufferer, possessed with a dominating agony which displaces all thought
of life, memory of friends, and love of God, breaks down in unutterable
distress, and prays for death and oblivion. To this poor sufferer
insensibility is next to heaven. For the past half century all the
formidable operations of the surgeon have been performed with the aid of
anæsthetics and without suffering to the patient, producing happy
recoveries, and greatly contributing to the success of the result by
relieving the surgeon of the distraction of the patient’s pain, and the
interference of his involuntary movements. Quite a number of anæsthetics
are known and used to-day. Those more generally employed are--naming
them in the order of their first application--nitrous oxide gas, ether,
and chloroform. Nitrous oxide gas is chiefly used for the extraction of
teeth. Sir Humphrey Davy, in 1800, was the first to observe the peculiar
quality of nitrous oxide gas, which gave it the name of “laughing gas,”
from the fact that it caused those inhaling it to act in a manner
exhibiting an abnormal exhilaration. Dr. Horace Wells, a dentist of
Hartford, Conn., in 1844, had the gas administered, experimentally, to
himself during the operation of extracting a tooth, and was the
discoverer of its useful application as an anæsthetic.
The greatest discovery, however, in anæsthetics is the application of
ether for this purpose. Ether as a chemical product has been known for
several centuries, and as early as 1818 Faraday pointed out the
similarity between the effects of ether and nitrous oxide gas. Dr.
Morton, a dentist, of Boston, first applied it as an anæsthetic Oct. 16,
1846, being guided largely in its selection and use by Dr. Jackson, an
eminent chemist of the same city. On Nov. 12, 1846, U. S. Pat. No. 4,848
was issued to them for this invention. In the latter part of December of
the same year Dr. Liston, an eminent English surgeon, performed the
operation of amputating the thigh while the patient was under the
influence of ether.
Chloroform, discovered by Guthrie in 1831, was first applied as an
anæsthetic by Sir James Y. Simpson, of Edinburgh, in 1847. Of the two
leading anæsthetics, ether is more generally used in the United Sates
and chloroform in Europe. Ether is less dangerous, but its
administration is more difficult and disagreeable. It is said on the
highest authority that in the Crimean War chloroform was administered
25,000 times without a single death, and ether is even safer than
chloroform. In the hands of a skillful physician practically no danger
is to be apprehended from the use of either of the two agents. A little
over fifty years ago any severe or prolonged surgical operation involved
such irresistible pain that the patient’s writhings were required to be
restrained by powerful muscular assistants, and by straps which bound
the patient to the table, and when it is remembered that a false cut of
a hundredth part of an inch might be fatal, the haste, the disquieting
influence upon the surgeon, and the interference with the accuracy of
his hand, added greatly to the percentage of unsuccessful operations, as
well as to the prolonged agony of the patient. Contrast this with the
present methods of using anæsthetics, and we find the patient dropping
into a quiet and peaceful sleep before the operation, and awakening
thereafter to find, to his astonishment, that it is all over, and that
recovery is only a question of careful nursing.
_Materia Medica._--Many important contributions have been made to the
pharmacopœia in the century. In 1807 the remedy known as ergot was
brought to the notice of the profession by Dr. Stearns, and named by him
pulvis parturiens. Iodine was first used as a medicine in 1819 by Dr.
Coindet, Sr., of Geneva. Quinine was discovered by Pelletier and
Caventou in 1820, although Peruvian bark had long been used for the same
purpose. Chloral hydrate, discovered by Liebig in 1832, was applied in
medicine in 1869 by Dr. Liebreich, of Berlin. Carbolic acid was
discovered in 1834 by Runge. Artificial seidlitz powders were first put
up under Savory’s British Pat. No. 3,954, of 1815. Veratrum viride,
lobelia, worm seed, and chloroform were all introduced in the first part
of the century. The sulphates of morphia, strychnia, atropia and other
alkaloids are of comparatively recent addition to the pharmacopœia, and
the iodide of potash, tincture of iron, digitalis, bichloride of
mercury, sub-nitrate of bismuth, boracic acid and gallic acid, chlorate
of potash and Dover’s powders have become standard remedies within a
hundred years. In the latter part of the century the new remedies
derived from coal tar have occupied an important place. Of these may be
mentioned antipyrine, by Knorr (pat. Oct. 28, 1884), phenacetin, by
Hinsberg (pat. March 26, 1889), salol, by Von Nencki (pat. Sept. 28,
1886), sulfonal, by Bauman (patented Jan. 22, 1889), antikamnia
(acetanilide), and many others, besides new and valuable antiseptic
compounds, such as salicylic acid and formalin. A characteristic feature
of the modern practice of medicine is in improved forms of its
administration. Sugar-coated pills, gelatine capsules and cod liver oil
emulsions make the remedy much less disagreeable to take, and very
ingenious and effective machines have been devised for putting up
remedies in such forms.
[Illustration: FIG. 174.--THE OPHTHALMOMETER.]
_Instruments._--Laennec’s discovery in 1819 of auscultation, and the
stethoscope, for determining internal conditions by sound, was a great
step in diagnosing diseases. The binaural stethoscope was invented by
Cammann in 1854, and a later improvement is the phonendoscope, by
Bianchi. The opthalmoscope is an instrument for inspecting the interior
of the eye, which was invented by Prof. Helmholtz, and described by him
in 1851. The laryngoscope, for obtaining a view of the larynx, was said
to have been constructed by Mr. John Avery, of London, as early as 1846.
The opthalmometer, Fig. 174, is a comparatively recent invention. It is
designed to ascertain variations in corneal curvature for the correction
of corneal astigmatism. Electric lights with reflectors are arranged on
each side of the patient’s head, while the operator looks into the eye
with a telescope. The sphygmograph, a little instrument to be strapped
on to the wrist to record the action of the pulse, was first reduced to
a practically useful form by Marey in 1860. A later development of these
devices, by Verdin, known as the sphygmometrograph, is shown in Fig.
175. The endoscope, for looking into the urethra, and the cystoscope,
for looking into the bladder, are other useful instruments of the modern
practitioner. Greater than them all, however, is the modern X-ray
apparatus, for locating foreign substances in the body and making
visible the bones through the flesh, for which see special chapter. The
use of the thermometer in recording the progress of fevers is also a
valuable modern application, and the list of instruments and small tools
is beyond enumeration. There are series of obstetrical appliances,
instruments relating to bone surgery, to the taking up of arteries,
cupping instruments, trepanning instruments, speculums, hypodermic
syringes, electric cauteries, fracture appliances, instruments for
lithotrity, bandages for varicose veins, atomizers, breast pumps,
inhalers, nasal douches, trusses, pessaries, catheters, abdominal
supporters, and an endless variety of proprietary articles, such as
electric baths and belts, plasters, chest protectors, liver pads, and so
forth, all of which are practically the products of the Nineteenth
Century. The surgeon of to-day can straighten the eyes of a cross-eyed
man, or take the bow out of his bandy legs, can make him a new nose of
his own flesh, patch his skull with a silver plate, remove the stone
from his bladder, supply him with a wind-pipe, wash out his stomach, and
perform many other operations even more difficult. Among such more
important operations may be mentioned ovariotomy, which was first
performed by Dr. Ephraim McDowell, of Danville, Kentucky, in 1809, and
the tying of the great arteries. The operation of lithotrity, for
removing stone from the bladder by crushing the stone, was introduced by
Civiale, 1817-1824, who devised successful instruments and modes of
using them. In 1836 to 1840 Richard Bright, an English physician, made
important researches and discoveries in relation to the functions and
diseases of the kidneys, and established the nature of the so-called
“Bright’s disease.”
[Illustration: FIG. 175.--VERDIN’S SPHYGMOMETROGRAPH, FOR RECORDING THE
ACTION OF THE PULSE.]
_Schools of Medicine._--While the regular school of medicine (called by
some “Allopathy”) has held the leading place in medicine, various other
schools have sprung up in the Nineteenth Century, all of which represent
advances in a knowledge of the laws of health, and the modes of
preventing and curing diseases. Hahnemann, in his “_Organon der
Rationellen Heilkunde_,” in 1810, gave homœopathy its name, and reduced
it to a system. The doctrine of _similia similibus curantur_ (like cures
like), has gained great popularity in the latter part of the century.
Hydropathy, as a school, also made its appearance in the early part of
the Nineteenth Century. Priessnitz was its first disciple, and the
_Grafenberg cure_, established in 1826, was a noted institution for many
years. The useful application of water in the form of baths and cold
packs, has been known for centuries, and will always be used as a
valuable agency in sickness and in health. The “Thompsonian” system of
treating diseases was covered by patents in 1813, 1823 and 1836, and
attained considerable notoriety in the early half of the century.
Sweating by hot bricks and hot tea made of “Composition Powders,”
vomiting with lobelia to produce relaxation, and a fiery liquid for
cramps, called “No. 6,” were the chief remedies, and very few boys who
had once taken the treatment were ever willing afterwards to admit that
they were sick. In the latter part of the Nineteenth Century
_electro-therapeutics_ has received a large share of attention, many
forms of medical batteries have been devised, and probably no more
promising field of study and research exists in the whole domain of
medicine.
_Dentistry._--George Washington had false teeth, and it is said that the
teeth of some of the mummies of Egypt had gold fillings, but it
remained for the Nineteenth Century to establish dentistry as an art,
and its influence in securing better mastication and digestion of food,
more sanitary mouths and shapely faces, cannot be estimated. Few people
can be found to-day who have not either filled teeth, bridge work, gold
caps, or artificial sets of teeth. The most important advance in the art
was in the invention of the rubber plate for holding the porcelain
teeth. This was the invention of J. A. Cummings, and was covered by him
in his patent No. 43,009, June 7, 1864. In more recent years
“bridge-work” represents the most important advance. In this practice
one or more artificial teeth are firmly held in the place of missing
teeth by a strong bridge-piece of metal, which at its ends is anchored
to the adjacent natural teeth. This was first done by Bing (British Pat.
No. 167, of 1871), and was afterwards patented in somewhat different
form in the United States by J. E. Lowe, No. 238,940, March 15, 1881,
No. 313,434, March 3, 1885, and Richmond, May 22, 1883, No. 277,933.
Porcelain and gold crowns and dental pluggers run by electricity
represent other important advances in this art. It is said that there
are 20,425 dentists in the United States, and that in 1899 they employed
in their practice 20,499,000 false teeth.
_Artificial Limbs._--With the successful work of the surgeon came the
effort to repair, as far as possible, the loss of the limb. Until about
the middle of the Nineteenth Century the survivor of an operation was an
unsymmetrical, unique, and pitiful object. The peg-leg of Peter
Stuyvesant lives in history, and the arm-hook of Capt. Cuttle is
familiar to every reader. The first United States patent for an
artificial leg was granted to B. F. Palmer, Nov. 4, 1846, No. 4,834.
Wooden legs with a restricted back and forward ankle motion and a
spring, were constructed by A. A. Marks from 1853 to 1863. On Dec. 1,
1863, a patent, No. 40,763, was granted to Mr. Marks for the use of
sponge rubber for constructing artificial feet and hands that dispensed
with the articulated joints, and made a great improvement. In patent No.
366,494, July 12, 1887, to G. E. Marks, the foot and leg portion of a
wooden leg are made from wood which grows with a crook, as at the root
of a tree, where the strength and lightness of a continuous natural
grain is obtained at the instep. About 300 patents have been granted for
artificial legs and arms. Modern improvements have extended to every
detail of construction, and so perfect to-day is the average wooden leg
that it is hardly to be detected. Men with wooden legs ride horseback,
are expert users of the bicycle, and have even performed feats on the
tight rope. The inventor’s genius has not stopped at repairing limbs,
however, for artificial eyes, artificial ear drums, the audiphone, foot
extensions for short legs, crutches, braces, abdominal supporters, and
various other applications to supplement the defects of the body have
been devised.
_Digestion._--The physiology of digestion had, perhaps, the first real
light shed upon it by Beaumont’s observations from 1825 to 1832. A
Canadian boatman, Alexis San Martin, was wounded in the abdomen from a
charge of buckshot, and the wound healed, leaving a permanent opening in
the stomach, through which the operation of digestion could be observed.
This furnished visible evidence of the relative digestibility of
different kinds of foods, and the general functions of the stomach. The
peculiar and different conditions governing the digestion of the starch
foods, the albumenoids (such as meat and fish), and the sugars and fats,
have been clearly ascertained, and “what is one man’s food is another
man’s poison” is now susceptible of intelligent diagnosis and effective
adjustment. Of late years the stomach has been greatly aided in its
functions by prepared or predigested foods. The action of diastase, in
converting starch into grape sugar, has been taken advantage of, and
cereals treated with diatase, malted milk, lactated and peptonized
foods, have proven a boon to the enfeebled digestion, while the
intelligent study of dietetics has done much to relieve the physician
and promote the health of the individual by right living.
_Bacteriology._--Although Leeuwenhoeck discovered the bacterium in
1668-1675, up to 100 years ago disease and death were largely regarded
as dispensations of Providence, and with fatuous resignation were
accepted as inevitable. The microscope and the study of bacteriology,
however, have revealed to us the presence of minute living organisms or
germs, which are everywhere around us, infesting the air, the earth, the
water, our food, our bodies, and all organic matter in countless
millions. These infinitely small beings multiply with a rapidity and
fecundity that bewilders the imagination. Their method of multiplication
is by fissiparism--that is to say, each splits into two independent
beings that separate and afterwards lead independent lives. It is said
that there is one species in which not more than six or seven minutes
are required for the division to take place. A single individual might
consequently produce more than a thousand offspring in an hour, more
than a million in two hours, and in three hours more than the number of
inhabitants on the globe. They are known as micro-organisms, of which
the bacteria are the most important. The bacteria are further divided
into species, and names are given them to distinguish the different
forms. The little rod-shaped ones are called _bacilli_: the spheroidal
ones _micrococci_ or _cocci_. If they cling together in chains they are
called _streptococci_; if of a spiral or corkscrew form they are called
_spirallae_. The curved bacilli are called “_comma_” _bacilli_, from
their resemblance to the punctuation mark of that name. The presence of
peculiar forms of these bacteria in diseases has so suggested the
relation of cause and effect as to have given rise to the so-called
“germ theory” of disease. Now we know with reasonable certainty that
cholera, diphtheria, typhoid fever, whooping cough, mumps,
cerebro-spinal meningitis, pneumonia, tuberculosis, hydrophobia, and
many other diseases have each its specific cause in the form of a
microbe.
[Illustration: FIG. 176.
BACILLUS OF TUBERCULOSIS IN SPUTUM. BACILLUS OF DIPHTHERIA
(KLEBS-LOEFFLER).
BACILLUS OF TYPHOID FEVER.
(Photo-Micrographs, 1,000 diam., by William M. Gray, M. D.)]
[Illustration: TERTIAN FORM. AESTIVO-AUTUMNAL FORM.
FIG. 177.--BLOOD OF MAN. SHOWING PARASITE OF MALARIA (LAVERAN).
(Photo-Micrographs, 1,000 diam., by William M. Gray, M. D.)]
Henle, a German physiologist, as early as 1840, maintained the doctrine
of _contagium vivum_, or contagion by the transmission of living germs.
Certain classes of diseases have also long been known as zymotic, or
ferment diseases. Louis Pasteur’s work, however, marks the first
definite and important results in the study of bacteriology, and he is
the father of the “germ theory” of disease. He exploded the previously
held theories of scientists concerning the spontaneous generation of
living things, and clearly established and promulgated the knowledge of
disease germs. Commencing his great work about 1865 with the
investigation of the silk worm plague in France, he discovered it to be
due to parasites, and checked it. He also gave great attention to the
subject of fermentation, proving it to be caused by micro-organisms.
Taking up the diseases of men and animals, he gave practical value to
the truths of his theory in the treatment of hydrophobia, diphtheria,
and other diseases, using the principle of vaccination to destroy or
render innocuous the toxins or disease-producing poisons derived from
living germs. Working along the same lines must be mentioned Dr. Koch,
whose success in detecting the microbes which cause consumption and
cholera has made him famous the world over. Of the great variety of
these little microbes which have been separately identified, many are
innocuous, and, in fact, subserve many important and useful purposes in
nature, while others are to be as much dreaded as the deadly cobra or
the rattlesnake. A few typical examples of the latter are given in Figs.
176 and 177, multiplied 1,000 diameters. The illustrations represented
in Fig. 177 show the parasites that cause malaria, or fever and ague.
The dark bean-shaped cells are the normal blood corpuscles, and the few
speckled cells are those infested with the malarial parasites. It is now
believed that the mosquito is the active factor in the dissemination of
malaria, and it is, therefore, to be remembered that this pestiferous
little insect not only inflicts a painful and disagreeable sensation
with his puncture, but innoculates the system with poisonous malarial
germs at the same time.
[Illustration: FIG. 178.
TUBE CONTAINING CULTURE OF BACILLI OF TUBERCULOSIS.
TUBE CONTAINING CULTURE OF COMMA BACILLI OF CHOLERA.]
For the study of bacteria they are propagated artificially in a test
tube--_i. e._, a substance called a “culture” is prepared from some
organic material which, like the substances of the human body, is
favorable to their propagation. Such culture media are found in beef
blood, gelatine, beef extracts, meat broth, milk, etc. An ordinary
test-tube is supplied with some of the culture medium, and is then
sterilized over the fire to destroy all interfering germs. Material
infected with the microbe is then placed in the test-tube by a
sterilized platinum wire and the tube closed by raw cotton. It is then
placed in an incubator oven and is subjected to a gentle heat. In a
little while the microbes begin to develop and increase, forming
colonies, in which they swarm by the million, and present the clotted
appearance seen in Fig. 178. The separation of different bacteria
existing in the same material, so as to isolate each species and get
what is called a “pure culture,” has been greatly promoted by Prof.
Koch’s method of _plate culture_. In this the propagation of bacteria is
effected upon a sterilized glass plate under a bell jar in such a thin
layer as to facilitate the segregation of species, enabling them to be
counted under the microscope and picked out and sown in another culture
to get an unmixed crop of a definite species. Such a culture so
multiplies the same microbe, to the exclusion of others, as to permit it
to be easily identified and studied.
According to the practice in modern municipal health regulations, the
test as to when a child recovering from diphtheria is incapable of
disseminating the disease is by test culture. A swab of cotton is rubbed
against the interior walls of the child’s throat to secure the germs (if
present), and the swab is then placed in a “culture” in a test-tube and
the tube put in an incubator. If, after the period of incubation, no
colonies of the germs develop, it is accepted as evidence that the
diphtheria germs are no longer present in the throat, and the child is
released from quarantine.
It is the presence of these specific microbes in the fluids or solids of
the system which constitutes the disease, and for the cure of the same
the intelligent physician of to-day looks less to medication, and more
for some agent that will destroy the germ, neutralize its effect, or
render the body tolerant thereto. Out of the knowledge of disease germs
has grown the great era of antiseptic surgery, inaugurated by Sir Joseph
Lister, about 1865. Carbolic acid, the bichloride of mercury, and
formalin are the most efficient weapons against the dreaded microbe.
To-day every surgeon in the civilized world sterilizes his knife, and
conducts the treatment of wounds and all operations by antiseptic
methods, in accordance with a knowledge of the deadly influence of the
ubiquitous microbe, and the result has been to so reduce the risk to
life that even capital operations are no longer coupled with the
apprehensions of death. Every hospital, board of health, and organized
medical and sanitary body predicates its laws and modes of treatment
upon the principles of bacteriology.
_House Sanitation._--The permanent home of the microbe is the sewer, and
sanitary plumbing, designed to exclude from the house the germ-laden and
disease-breeding gases from the sewer, constitutes one of the great
advances of the century. About 3,500 patents have been granted for water
closets and bath appliances, and about 900 patents on sewerage alone,
the most of which are directed to improved conditions of sanitation.
[Illustration: FIG. 179A.--STREET CONNECTIONS, MODERN SANITARY HOUSE
PLUMBING.]
[Illustration: FIG. 179.--MODERN SANITARY HOUSE PLUMBING.]
An illustration of the plumbing and sewer connections of a modern house
is given in Figs. 179 and 179A. The sewer pipes are shown in solid
black, the unshaded pipes (in outline only) are air ventilation pipes,
the single black lines are cold water pipes, and the dotted lines hot
water pipes. The important sanitary feature in modern plumbing is to
keep all sewer gas and disease germs out of the house. For this purpose
traps have long been used under the wash basins, closet hoppers, and
sinks; but the back pressure of sewer gas would sometimes bubble through
the trap into the house, and besides the water in passing out from a
basin would sometimes, by a siphon effect, pass entirely out of the
trap, leaving it unsealed. Both these results are prevented by the air
ventilation pipes which connect with the discharge side of every trap in
the house and lead to a stack extending out through the roof. This
prevents pressure of sewer gas on the water seal of the trap, destroys
the siphon action of the trap and allows a circulation of air to be
taken in from the sidewalk on the house side of the running trap and
through the sewer pipe of the house, and thence through the air vent
pipes to the roof.
The great science of bacteriology, dealing with these smallest of living
things, only came into existence with the microscope, and it was a field
which was not only wholly unknown and unexplored a few years ago, but
there was no suggestion visible to the eye to direct attention to it,
until the lens began to reveal the secrets of microcosm. What
development the future may bring no one can predict, but to the
biologist and the physician no more promising field exists. Certain it
is that the knowledge already gained is of incalculable benefit, and
constitutes one of the greatest eras of progress the world has known,
for with the noble army of patient, devoted, and self-sacrificing
physicians, the discoveries of the scientist, our boards of health, our
hospitals and asylums for the insane, our quarantine laws, our modern
plumbing and improved sanitation in the home and public departments,
there is no reason why the life of man should not be extended far beyond
the three-score and ten years, and the 50 per cent. of population dying
in childhood saved for useful lives and citizenship.