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 largest ward, and from that position to point out every patient therein who had been taking stimulants for three or four days at least, and I succeeded. To me the pale worn aspect of the patient is unmistakable.

With this I end my paper. It is not for me to go into statistics on the point, such as may be found, I dare say, in books or hospital reports. I know that such statistics are scant, for the question has not yet become a matter of calm scientific investigation. It is still one of the "fads" of the day, which the practical physician has not time to trouble about. Nevertheless, the reform is irresistibly advancing. No one can overlook the unmistakable diminution of the consumption of alcoholic liquors in hospitals. This is probably due in great measure to the greater temperance of the general community—a change of fashion rather than a reform of practice. It has been said long ago that the evils wrought by a theory have never in history discredited the theory; and certainly this would seem to be true in the practice of medicine. The melancholy history of the use of calomel and of opium in India is a saddening illustration. A few men here and there question the theory, and gain adherents chiefly among the young. The older men are not so much converted. They die out, and by and by the world awakes and exclaims how foolish the last generation was.



N one of my latest conversations with Darwin he expressed himself very gloomily on the future of humanity, on the ground that in our modern civilization natural selection had no play, and the fittest did not survive. Those who succeed in the race for wealth are by no means the best or the most intelligent, and it is notorious that our population is more largely renewed in each generation from the lower than from the middle and upper classes. As a recent American writer well puts it, "We behold the melancholy spectacle of the renewal of the great mass of society from the lowest classes, the highest classes to a great extent either not marrying or not having children. The floating population is always the scum, and yet the stream of life is largely renewed from this source. Such a state of affairs, sufficiently dangerous in any society, is simply suicidal in the democratic civilization of our day."

That the check to progress here indicated is a real one few will