INENTOA EDCLCNR~S hygienie-work in Cuba, in Panama, in the Pllilippines, and in Costa Rica, and for the efforts which they are organizing for a world-wide crusade against ankylostomla disease. Clhemical pathology lhas w%idened our knowledge and our resources, and tlle miystery of immilunity lhas been to some extenit illuminated. Tlle detailed exarmlination of the morphlological elements and the clhemical cllaracters of the blood and of other body fluids has eventuated in tlle rewriting of some

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... f our phiysiology, and tile pathological extension of the knowledge thus gained lias imiproved the diaginosis anid the treatment of several diseases. Thlirty years ago Ord dem-ionstrated to the Congress of that timile examnples of the disease whichihe liad defined as miyxoedema, but wlhic,i witlh surer instinct, Gull had described as a cretinoid state in adults. The gradual evolution of the doctrine of thyroid insufficiency and of its therapeuties is a model of induction; and this important discovery has given a great impetus to the wlhole study of internal secretions, as well as to the employment of organic extracts, of wllich the lust and most interesting is that of the pituitary body. Tlle empirical aind then tlle experimental study of small variations in the ordinary diets of adults and clhildren and infants in different social strata and in different countries has been fruitful in many unexpected ways. The great milk problem is still with us, but we have learnt the blunders of our early generalizations. Cleanliness in the milk supply from start to finish has a far more exhaustive meaning than in days gone by. The curious disease beri-beri, which some of us have long thought had parallelisms with scurvy, has been shown, at all events amongst rice-eating people, to depend on the loss of the nutritive material just internal to the pericarp, which the ordinary process of milling removes. The patient study of chronic alcoholism has opened up a new chapter in nervous diseases. Tlhe routine traditional employment of alcohol in disease has happily been lai-gely discredited. The open-air treatment of all forms of tuberculous lesions has had a wide indirect influence, not only on the treatment of other chronic ailments, but on the daily life of the people. The recognition and radical treatment of oral sepsis due to damage to the gums in consequence of various disorders of the teeth has been followed by remarkable benefit. A strong case has been made out for intestinal stasis as a cause of various forms of malnutrition and for operative measures in dealing with slight mechanical obstructions; on this subject we lhope for furtlher evidence. The additions to diagnosis yielded by x-ray exploration are like the creation of a sixth sense, and its curative applications and those of radium are the opening of a new clhapter of therapeutics. I ventured to hint that medicine had niow and then led to the rewriting of some chapters of physiology, and I may add that recent researches on diseases of the lheart have led to the re-editing of neglected knowledge of the minute structure of heart muscle, and of orderly and disorderly mechanism of its movements. Of the magnificent triumplhs of the surgery of this generation it is beyond my poWver adequately to speak, but I can refer to the wide fields opened up tllrough the beneficent protection of Listerism. We are staggered by the reasoned and calculated audacitv of our brethren when sinuses of the skull are drained, cerebral abscesses evacuated, cerebral tumours removed, the pituitary body even being investigated, when pleuro-pericardial adl-lesions are freed, to the great relief of the heart, when different parts of the alimentary canal are slhort-circuited and when one or other damiiaged viscus is removed eitlher entirely or in part. The active co-operation of surgeons and pllysicians has gained for us some knowledge of wlhat Moynilhan and otlhers have happily described as "'living pathology," and we gratefully acknowledge the invaluable information of correlated sympboms, signs, and morbid conditions, and the statistics of comparative frequency wlicll surgical experience has brought to the common store. The supreme gain, after all, is that many more useful lives are saved than in the last generation, that the realm of grave and hithlerto incurable disease is invaded on every side, and that thle danger of operation qua operation is retreating to a vanishling point. It is impossible even to enumnerate thle varied wrays in whlichl medicine has co-operated with economics, social legislation and philanthropy, wlhich we sum up briedy as public health. The school house and the scholars, the home of the poor, the colliery, and the factory, tho dangerous occupations, the sunless life of the mentally deficient, have benefited, and will benefit still more, by its friendly invasion. And I venture to foretell that, not many years hence, every departm-ent of life and worlk shall be strengthened and purified and brightened by its genial and penetrating influelnce. Surely I have said* more than enough to justify m-ly contention that we have come into a goodly heritage, and that that heritage is like a lofty and miaguificenib tableland of knowledge and efficiency. Tlle gaps are being filled; we are no longer isolated, but are working side by side on adjacent areas which -are inseparably connected. Every day we gain fresh help from the auxiliary sciences, and we realize more and more the unity and tlle universality of medicine. Brethren from foreign lands, we thank you for the treasures, new and old, of observation and experiment, and of a ripe experience, whicll you have brought to this Congress for the common weal. I venture to affirm that the output of work of the Congress week in its twenty-three goodly volumes will astonishi civilized countries by its amount and its solid worth. I welcome you to our dear country, this ancient home of freedom, and I speak not only for the medical men of the British Isles but for our brethren of the Overseas Dominions, who join with us in our cordial greeting. May this Congress add to the common store of fruitful and useful knowledge; may it increase our good fellowship, our mutual understanding and co-operation, and may it help to break down the barriers of race and country in the onward beneficent march of world medicine.