The inaugural meeting of the annual conference of the British Medical Association is a fitting occasion for a public gathering; since of all professions the medical one is the most intimately bound up with public interests, with questions of social advancement and the amelioration of conditions of living, with the welfare and happiness of the individual, and with the maintenance and prolongation of the period of usefulness of each unit of society. The day when disease and its effects were looked upon as a visitation of God or the gods is happily a thing of the past.

To-day the public mind has been aroused to the knowledge that, broadly speaking, disease is the result of unsuitable and unsanitary surroundings; it appreciates that the ravages of typhoid, plague, and other deadly infectious diseases are not best avoided by this or that particular line of treatment when once the disease has broken out, but by proper sanitation, by a scientific system of drainage, and the maintenance of proper air spaces about individual homes and the conservation of suitable large open areas and public recreation grounds, and I have no hesitation in saying that the serious outbreak of typhoid fever which occurred in this town two years ago and which taxed your hospital resources to the utmost, and which cost the community the lives of many useful citizens, including those of several nurses who contracted the disease in the discharge of their duties in nursing the sufferers, was a very grave, reflection on a city like Auckland, which can find money to build bridges and Town Halls whilst yet it has no proper system of drainage and whilst the sanitation of many parts of the city and Suburbs is a disgrace to any civilised community.

The desirability and usefulness of bridge and Town Hall building I in no sense decry, but I do say that desirable as they may be, their public usefulness is not for one moment to be compared with that of a proper system of drainage, and this later ought to be pushed on with, and every effort and all available financial energy directed towards its completion at the earliest possible date. The mental and physical-well-being of the individual members of the community is a matter of very pressing moment to the City and the State, since every departure from such condition becomes either directly or indirectly a charge upon and inconvenience to the community.

Every healthy man or woman is or ought to be an asset of the State, hence the necessity for the preservation of individual health and the prevention and cure of disease by all means in our power. To this end all over the country in all big centres, and also in many ridiculously small ones, we have hospitals established. With the increase of population these have increased in size, and we constantly hear complaints of the expense of these institutions to the ratepayer and taxpayer. This, Ladies and Gentlemen, is frequently a very short-sighted point of view. In thickly-populated centres disease tends to increase in a ratio greater than the actual increase in numbers, hence hospital expenditure may be expected to increase in geometrical rather than in arithmetical progression, and whilst I urge as strongly as anyone the necessity for the economic management of these institutions according to all the most strictly business-like and commercial methods, yet in no case should efficiency be sacrificed to economy, and it is very necessary to bear in mind that a sick man or a dead man belongs to the debit and a healthy one to the credit side of the State balance sheet.

Let us have our large hospitals equipped in every respect with all modern convenience and appliances which have been proved useful in the treatment of disease, the community will save in the end.

I have said that Hospitals are established in some ridiculously small districts, and this is, I think, a unwise and wasteful procedure. No small hospital can be thoroughly well equipped except at extravagant rates, since if equipped for all emergencies large sums will be wasted in appliances which may never be used or used so seldom that when needed they are out of order and those in charge of them have never has opportunity for becoming expert in their use. County hospitals should be receiving stations for the urgently ill and for accident cases so severe that they unfit the sufferers for travelling to a large centre. Other cases of serious disease should be drafted at the expense of the small districts to a hospital in a large centre, only in a large centre can every convenience be economically provided, and only in a large centre can the experience of disease be developed to its full extent and the patient get the advantage of expert skill.

The Mental Hospitals also are becoming an ever-increasing charge on the community, and whilst we are all agreed that the care of the mentally afflicted is as much the duty of the community as the care of the bodily ill, and that such cases should be treated o the most modern and humanitarian lines, yet the increasing ratio of mental disease is becoming so alarming a problem that sooner or later serious steps will have to be taken to check this increase, and for myself I hope the day is not far distant when the State will forbid marriage of individuals who are or have been the subject of disease which is likely to prove hereditary, and will rigidly enforce the permanent segregation of individuals the subjects of chronic or relapsed mental disease, the personal liberty of such tends to increase of criminality and mental disease and must ultimately become a serious menace to the State.

How many people, I wonder, ever contemplate the immense commercial value of the recent advances in the science of medicine. For example, the discovery by Manson and Ross after years of research of the fact that malaria is always carried by a certain species of mosquito, which can easily be exterminated ; later the discovery of the causes of other deadly tropical diseases, for example, Sleeping Sickness. Consider what this means—that huge areas of the globe up to now uninhabitable, areas rich in minerals, vegetation and general productiveness, will be thrown open to civilization, and the immense potential riches made available for mankind.

In conclusion, Ladies and Gentlemen, let me say that the medical profession, though individually inclined rather to Conservatism, is the most Liberal of all. None so ready to take advantage of any and every discovery in any branch of science in which there appears the least chance of benefit in the treatment prevention of disease, and let me remind you that both individually and collectively the medical profession have done and are doing more to enhance the welfare of the individual and to aid the general progress of social advancement that you are sometimes inclined to credit them with.