The facts I have given establish the disproportionate increase in one great city of those diseases which are largely produced by the strain on the nervous system resulting from the toils and competitions of a community growing rapidly and stimulated to its utmost capacity.  Probably the same rule would be found to apply to other large towns, but I have not had time to study the statistics of any of them fully; and, for reasons already given, Chicago may be taken as a typical illustration.

It were interesting to-day to question the later statistics of this great business-centre; to see if the answers would weaken or reinforce the conclusions drawn in 1871.  I have seen it anew of late with its population of 700,000 souls.  It is a place to-day to excite wonder, and pity, and fear.  All the tides of its life move with bustling swiftness.  Nowhere else are the streets more full, and nowhere else are the faces so expressive of preoccupation, of anxiety, of excitement.  It is making money fast and accumulating a physiological debt of which that bitter creditor, the future, will one day demand payment.

If I have made myself understood, we are now prepared to apply some of our knowledge to the solution of certain awkward questions which force themselves daily upon the attention of every thoughtful and observant physician, and have thus opened a way to the discussion of the causes which, as I believe, are deeply affecting the mental and physical health of working Americans.  Some of these are due to the climatic conditions under which all work must be done in this country, some are out-growths of our modes of labor, and some go back to social habitudes and defective methods of early educational training.

In studying this subject, it will not answer to look only at the causes of sickness and weakness which affect the male sex.  If the mothers of a people are sickly and weak, the sad inheritance falls upon their offspring, and this is why I must deal first, however briefly, with the health of our girls, because it is here, as the doctor well knows, that the trouble begins.  Ask any physician of your acquaintance to sum up thoughtfully the young girls he knows, and to tell you how many in each score are fit to be healthy wives and mothers, or in fact to be wives and mothers at all.  I have been asked this question myself very often, and I have heard it asked of others.  The answers I am not going to give, chiefly because I should not be believed—­a disagreeable position, in which I shall not deliberately place myself.  Perhaps I ought to add that the replies I have heard given by others were appalling.