tumor inevitably proves fatal in the long run if it is not removed.  In a certain percentage of cases it is malignant and will kill whether it is removed or not, but the general result of ovariotomy has been the saving of thousands of women from untimely death.  Bell, of Edinburgh, had imagined the operation and had mentioned it in his lectures, but none the less to McDowell is due the credit of demonstrating its feasibility.

Medicine bore quite its full share in the mitigation of the horrors and hardships of war that marked the Nineteenth Century.  Its work was shown in the great reduction of pestilential disease incident to camp life, in prompt aid to the wounded, in the establishment of salubrious field and general hospitals, and in improved methods of transportation of the sick and wounded.  Certainly the soldier on the sick list never before had such a fair prospect of rejoining his comrades safe and sound as he has now.

In the care of the insane, too—­care not only in the sense of humane treatment, but in the systematic employment of measures for their restoration to mental soundness—­the century has been marked by notable progress.  This has been chiefly in the direction of preventing insanity, and although mental disease is said to be on the increase, it may undoubtedly be said with entire truth that its growing prevalence is not in proportion to the heightened frequency of “the strenuous life.”  We may confidently expect that a more pronounced mastery over diseases of the mind will come when physicians in general are taught psychiatry clinically, so that the beginnings of mental alienation may be intelligently met by the family practitioner.

The supreme achievement of the medicine of the Nineteenth Century undoubtedly has been the development of its preventive feature.  When we recall the fact that but a few years ago an attack of infectious disease was interpreted as a visitation of Providence, by a perversity that even the triumphs of vaccination did not serve to do away with; when we contemplate the well-ordered and well-understood measures that are now resorted to in an ever-increasing number of communities (and resorted to not solely on the outbreak of an epidemic, but at all times), to purify the air we breathe, the food we eat, and the water we drink; and when we reflect upon the greatly reduced morbidity as well as mortality of most infectious diseases—­we must realize the immense service that has been rendered by preventive medicine.  No doubt we must all die some time, and the day is yet far remote when the only causes of death will be old age and injury; but a decided prolongation of the average lifetime, such as the life-insurance companies recognize, is an unquestionable gain to the human race.