Morning journal and courier., 1889-03-28
The Prevention of Disease.
From Andrew H. Smith, MD, in Harpsr's Maga-
 zine for April

l From Andrew H. Smith, MD, in Harper's Maga- zine for April.I
 The family physician should have constant opportunity to know just what is the physi- cal condition of each member of the family
 in the absence of any manifest evidence of disease. To this end periodical examina- tions should be made of such character as to reveal any lurking morbid tendency with out waiting for its development into actual disease. There should be no such thing as discoverable affection remaining undiscover- ed. Death from unsuspected heart or kidney disease, for example should cease to be possible. There should be no more histor- ies like the following, now so frequently re- peated:
 person supposed to be in good health is hastening along the street, perhaps hurrying to catch the train. All at once he is seen to stagger and fall. Passers-by rush to his as. sistance, but he gasps few times, and before any aid can be rendered he is dead. An au- topsy reveals that he had fatty degeneration of the heRrt, and the extra demand made up- on the heart by the unusual exertion was more than its enfeebled walls could respond to. He was not aware of the existanee of this condition, but if his doctor had merely laid his finger on the pulse his suspicion would have been aroused, and listening to the heart would immediately have confirmed it. By proper treatment, and the avoidance of severe exertion, the catastrophe might have been averted for many years, and the usual limit of life might perhaps have been attained.
 Or again, 8 gentleman who has thought himself quite well goes as usual in the morn ing to his place of business. A few hours later he is brought home in state of uncon- eoio Tn cr,ifo o& xI,a, judicious treatment he does not recover from his coma. On the contrary, convulsiens set in, and in the course of few hours he dies. Unknown to him or his family, he has been suffering from Bright's disease, the symtoms being latent up to the last moment. Yet @ very simple examination would have revealed to his doctor the actual condition of affairs. and by proper care and proper treatment the fatal termination might have beeen almost indeGnately deferred.
 The records of examinations by the physi~ clans of life-insurance companies show nu- merous instances in which very serious dis ease exists without being suspected by the patient or his friends. This fact In addition to the frequency of cases such as thoss dis scribed above, is enough to show the extreme importance of system by which the actual condition of persons not consciously i'll should be periodically investigated.
 In view of this it should be a part of the duty of the family physician to make tho- rough physical examination of every member of the family at least twice year, and in the case of feeble or delicate person at much shorter intervals. The results of these exs- minations should be fully recorded, and the record kept in possession of the doctor, to be transmitted to his successor. A record of this kind would possess immense value, but also for their posuerity. It is by knowing the vital history of the parents that we know what to expect in the children. Heredity is an influence which it is difficult to estimate, for the reason that the absence of records prevents our tracing it backward in the fam lily history. Yet we know that this influence may shape the physical destiny of genera tions to come. Dr. Holmes has said that the proper time to begin the treatment of some diseases is hundred years before the birth of the patient. He might have added that the treatment sometimes needs to be con- tinued for a hundred years after his death.
 But the opportunity afforded to the family physician to ward off injurious influences from those under his care might be extended much further. It should be in his province to indicate what occupations were suitable to a'given youth, and what, in the interests of his health, should be avoided. He should be able to paevent feeble, ll-nourished, narrow chested lad being put behind desk in counting room, where the tendency to pull monary disease already existed would cer. tainly be developed. He should have such voice in the selection of boarding schools as would prevent the children being sent to in stitutions in unhealthful localities. or in which there was danger from defective ssni-