enjoy the charm of a forbidden pleasure or to stand well with some dissipated companions! How large a proportion of lifelong female debility is due to an early habit of tight lacing, springing only from the silliest vanity! How many lives have been sacrificed through the careless recklessness which refused to take the trouble of changing wet clothes! How many have been shattered and shortened by excess in things which in moderation are harmless, useful, or praiseworthy,—by the broken blood-vessel, due to excess in some healthy athletic exercise or game; by the ruined brain overstrained in order to win some paltry prize! It is melancholy to observe how many lives have been broken down, ruined or corrupted in attempts to realise some supreme and unattainable desire; through the impulse of overmastering passion, of powerful and perhaps irresistible temptation. It is still sadder to observe how large a proportion of the failures of life may be ultimately traced to the most insignificant causes and might have been avoided without any serious effort either of intellect or will.

The success with which medicine and sanitary science have laboured to prolong life, to extirpate or diminish different forms of disease and to alleviate their consequences is abundantly proved. In all civilised countries the average of life has been raised, and there is good reason to believe that not only old age but also active, useful, enjoyable old age has become much more frequent. It is true that the gain to human happiness is not quite as great as might at first sight be imagined. Death is least sad when it comes in infancy or in extreme old age, and the increased average of life is largely due to the great diminution in infant mortality, which is in truth a very doubtful blessing. If extreme old age is a thing to be desired, it is perhaps chiefly because it usually implies a constitution which gives many earlier years of robust and healthy life. But with all deductions the triumphs of sanitary reform as well as of medical science are perhaps the brightest page in the history of our century. Some of the measures which have proved most useful can only be effected at some sacrifice of individual freedom and by widespread coercive sanitary regulations, and are thus more akin to despotism than to free government. How different would have been the condition of the world, and how far greater would have been the popularity of strong monarchy if at the time when such a form of government generally prevailed rulers had had the intelligence to put before them the improvement of the health and the prolongation of the lives of their subjects as the main object of their policy rather than military glory or the acquisition of territory or mere ostentatious and selfish display!

There is, however, some reason to believe that the diminution of disease and the prolongation of average human life are not necessarily or even generally accompanied by a corresponding improvement in general health. 'Acute diseases,' says an excellent judge, 'which are eminently fatal, prevail, on the contrary, in a population where the standard of health is high.... Thus a high rate of mortality may often be observed in a community where the number of persons affected with disease is small, and on the other hand general physical depression may concur with the prevalence of chronic maladies and yet be unattended with a great proportion of deaths.'[4] An anæmic population, free from severe illness, but living habitually at a low level of health and with the depressed spirits and feeble capacity of enjoyment which such a condition produces, is far from an ideal state, and there is much reason to fear that this type is an increasing one. Many things in modern life, among which ill-judged philanthropy and ill-judged legislation have no small part, contribute to produce it, but two causes probably dominate over all others. The one is to be found in sanitary science itself, which enables great numbers of constitutionally weak children who in other days would have died in infancy to grow up and marry and propagate a feeble offspring. The other is the steady movement of population from the country to the towns, which is one of the most conspicuous features of modern civilisation. These two influences inevitably and powerfully tend to depress the vitality of a nation, and by doing so to lower the level of animal spirits which is one of the most essential elements of happiness. Whether our improved standards of living and our much greater knowledge of sanitary conditions altogether counteract them is very doubtful.

In this as in most questions affecting life there are opposite dangers to be avoided, and wisdom lies mainly in a just sense of proportion and degree. That sanitary reform, promoted by governments, has on the whole been a great blessing seems to me scarcely open to reasonable question, but many of the best judges are of opinion that it may easily be pushed to dangerous extremes. Pew things are more curious than to observe how rapidly during the past generation the love of individual liberty has declined; how contentedly the English race are submitting great departments of their lives to a web of regulations restricting and encircling them. Each individual case must be considered on its merits, and few persons will now deny that the right of adult men and women to regulate the conditions of their own work and to determine the risks that they will assume may be wisely infringed in more cases than the Manchester School would have admitted. At the same time the marked tendency of this generation to extend the stringency and area of coercive legislation in the fields of industry and sanitary reform is one that should be carefully watched. Its exaggerations may in more ways than one greatly injure the very classes it is intended to benefit.

A somewhat corresponding statement may be made about individual sanitary education. It is, as I have said, a matter of the most vital importance that we should acquire in youth the knowledge and the habits that lead to a healthy life. The main articles of the sanitary creed are few and simple. Moderation and self-restraint in all things—an abundance of exercise, of fresh air, and of cold water—a sufficiency of steady work not carried to excess—occasional change of habits and abstinence from a few things which are manifestly injurious to health, are the cardinal rules to be observed. In the great lottery of life, men who have observed them all may be doomed to illness, weak vitality, and early death, but they at least add enormously to the chances of a strong and full life. The parent will need further knowledge for the care of his children, but for self-guidance little more is required, and with early habits an observance of the rules of health becomes almost instinctive and unconscious. But while no kind of education is more transcendently important than this, it is not unfrequently carried to an extreme which defeats its own purpose. The habit that so often grows upon men with slight chronic maladies, or feeble temperament, or idle lives, of making their own health and their own ailments the constant subject of their thoughts soon becomes a disease very fatal to happiness and positively injurious to health. It is well known how in an epidemic the panic-stricken are most liable to the contagion, and the life of the habitual valetudinarian tends promptly to depress the nerve energy which provides the true stamina of health. In the words of an eminent physician, 'It is not by being anxious in an inordinate or unduly fussy fashion that men can hope to live