The Work of the Rockefeller Foundation. Health as an International Bond
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The Empire Club of Canada Addresses (Toronto, Canada), 9 Mar 1920, p. 126-145
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Vincent, George Edgar, Speaker
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A League of Central and South American Nations which has been formed to eliminate yellow fever from the world. A League under a certain type of leadership from the United States, representing a general international co-operative attempt to deal with a disease which has long been a menace not only to Central and South America, but to all countries that have been in immediate trading communication with those centres. The interest in this subject by General Gorgas, former Surgeon General of the U.S. Army. The mosquito theory of Dr. Fantella in Havana, proved correct many years later. General Gorgas' dream to eliminate yellow fever from the world. Places that may be considered endemic centres, the foci of infection. Further scientific studies of yellow fever to see if the yellow fever germ could be isolated. The request of the Rockefeller Foundation of the Rockefeller Institute for Scientific Research to allow their bacteriologist, Dr. Gould and staff, to go down to Ecuador and make a first-hand investigation on the variable causes of yellow fever. Work done in Guyaquil by Dr. Gould. Findings for further studies. Dr. Gould's serum. Dr. Noguchi's work in Mexico. Dr. Conner, who was sent down to Guyaquil to tackle Yellow Fever. Many details of the work that was accomplished. Transferring the success in Guyaquil to other parts of the world. Other The speaker's travels and a report of many medical missions and activities going on in the world. The great purpose of the Rockefeller Foundation.
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9 Mar 1920
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English
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THE WORK OF THE ROCKEFELLER FOUNDATION. HEALTH AS AN INTERNATIONAL BOND.
AN ADDRESS DELIVERED BY GEORGE EDGAR VINCENT, PH.D., LL.D.
Before the Empire Club of Canada, Toronto,
Tuesday, March 9, 1920

VICE-PRESIDENT GILVERSON, in introducing the speaker, said,-Gentlemen, our distinguished guest, Dr. George F. Vincent, comes to us from the United States on a mission of high purpose and great public interest, involving munificence measured in millions. He is known widely as an educationist of brilliant talents and career, but is, perhaps, known best to Canadians as the representative

and .the head of a philanthropic foundation, unprecedented in magnitude, which, established in financial perpetuity, stands as a monument of everlasting honour to its celebrated founder, Mr. John D. Rockefeller. (Applause) Dr. Vincent should also be known to the Club as an honoured son of an illustrious father, Bishop Vincent, of the Methodist Church (applause) an eminent American divine who founded the Chautauqua society of which Dr. Vincent is Chancellor emeritus. Likewise in his connection with and relationship to a prominent local family whose genius for organization in religious, humanitarian and educational work is only equalled by the generous endowment and support they extend to the projects they undertake; I refer to the Massey family and Foundation of Toronto. (Applause) The pleasure with which you will anticipate the treat that is in store for us will carry with it, I know very well, a corresponding jealousy of the time I consume, and I will only say with reference to the subject, if you will allow me, that if ever there was a day when every bond of attachment should be cultivated by every patriot on either side of the line, it is today. (Hear, hear and applause) I will take no further time, therefore, but present Dr, Vincent to you.

DR. GEORGE E. VINCENT.

Mr. President and Gentlemen,-'The announcement of my real topic has filled you with mingled feelings of apprehension and alarm; and anyway, I am going to talk about a League of Nations. (Laughter and applause) Please observe, a League of Nations, not the League of Nations. This League of Nations of which I am to speak is unique. In the first place, no reservations with regard to it have been suggested by anyone. (Laughter) In the second place, no word of criticism has come from either end of Pennsylvannia Avenue. (,Laughter) In the third place, America is a part of this League, (Laughter and applause) In the fourth place, no question of purality of votes has been raised. (Laughter) In the fifth place, actual United States money is being expended. (Laughter) And finally, the League has a definite purpose which it is carrying out by a programme which is producing efficient and satisfactory results.

But that I keep you no longer in suspense, lest I have reached the limit of even your generous cordiality, I am going to talk about a League of Central and South American Nations which has been formed to eliminate yellow fever from the world. (Laughter and applause.) It is a League under a certain type of leadership from the United States, but it represents a general international co-operative attempt to deal with a disease which has long been a menace not only to Central and South America, but to all countries that have been in immediate trading communication with those centres.

This is a subject in which General Gorgas, former Surgeon General of the United States Army, has been for a long time interested. He deserves a large part of the credit which is to be ascribed to those who have been successful so far in the carrying out of this project. You all remember, of course,-one always says that to a lay audience; it is flattering but you won't remember, and therefore I will repeat it (laughter)-you all remember that about forty years ago there was a doctor named Fantella in Havana, who said that he suspected that yellow fever might be communicated from one person to an other by a bite of a mosquito. This was perfectly absurd; not only the layman knew it was absurd-they have a sort of intuitive capacity for judging (laughter) but even the members of the medical profession said it was absurd-and they have considerable capacity for reject

ing new ideas (great laughter); and so nothing happened. Then there came a little unpleasantness, you may remember, a long time ago-some sort of a conflict which was looked upon in a perfectly perfunctory and sports manlike and detached way. It was a kind of a conflict; it was a good deal like smashing an egg with a locomotive. In the course of what we used, courteously, to call the Spanish-American war, it was found necessary to do some sanitation in Havana, and four army surgeons were sent down, and those men carried on all sorts of experiments. They tried all those theories, and it turned out that the mosquito theory was correct, after all; and so by those experiments it became established-and established beyond contradiction, especially in every possible scientific way-that yellow fever can be communicated only by the bite of a stegomyia mosquito; and in this case the female of the species is more deadly than the male, be

cause it is only the female stegomyia that can communicate yellow fever by biting an individual who has not yet contracted the disease. That was established as a scientific fact, and General Gorgas, who was engaged later in the Panama zone on a large scale, with the great est success applied this scientific principle, and reduced the incidence of yellow fever in Havana and Panama zone to such a degree that that great work was able to be carried on with very little loss of life. So that yellow fever, and control of yellow fever as a technique, are perfectly well understood. The Brazilian Government undertook to control yellow fever, and was practically successful in controlling it from Rio.

General Gorgas is one of those men who had a dream and an ideal, and his dream and ideal was actually to eliminate yellow fever from the world and have done with it, to strike it off the list as a menace to mankind. So in 1916, before we were occupied in any other way by trying to explain our inactivity (laughter) we at the Foundation received a suggestion from General Gorgas that he would like, if possible, to get leave from the Government and go ' on a trip to South and Central America to make first-hand investigation looking to a report which might afterwards be made to the Foundation. He was given leave of absence by the Government; he appointed trained colleagues, and certain men who were familiar with the problem went down to South and Central America, and came back and made a report to the Foundation.

The places that may be considered endemic centres, the foci of infection, the seed-beds of yellow fever, were Guyaquil, on the coast of Merida in Yucatan. There is a suspected area in the vicinity of Pernambuco, and on the west coast of Africa there is a little suspected area where a disease like yellow fever had been announced several times. Said General Gorgas, "If we can go to those endemic centres and stamp out yellow fever there at its sources, we shall be able to eliminate yellow fever as a menace to mankind." It was an appealing thing; it took one's imagination; and when at last we went into it, General Gorgas was otherwise occupied. (Laughter) About a year and a half ago he was retired for age. I believe in retiring people for age. Retire a man automatically, so that he can go out and complain that he can do anything that he has ever accomplished. Because this inexorable law applies to all alike, it is a capital thing; it gets rid of dead-wood at the top, and gives young men a sort of show. How can you expect young men to realize their ambitions if old men hold on till the last gasp? (Laughter) If you are going to stimulate any service-governmental, educational, or whatever it may be-have a rule of retiring people forage remorselessly, without exception. Georgas was one of those few people who, when retired, really had the virility of youth in him; and he said, "I am just in the prime of life; I want to tackle this yellow fever job." And the Foundation said, "Come on, we are ready for you." So General Gorgas became the head of a Yellow Fever Control Commission. It is a very simple thing to do.

With these things, occasionally, if you generally have to deal with Governments, you can imagine how for a long time Governments exchange notes, and go on exchanging notes until finally a convention is held to see if something can be done in a preliminary way, looking towards the approach towards the ultimate. (Great laughter) And you can imagine the first gathering of those representatives of various nations for this magnificent co-operation. Possibly you can imagine the banquets that would be held, the courteous and enthusiastic addresses in which people try to conceal their real theories in regard to each others views. You can imagine these going on until finally, a certain stage of repletion having been reached, there would be discussions as to what might be done and what ought to be done, with great differences of opinion, and finally they would break up, after passing benevolent resolutions looking to further benevolent consideration of the subject and larger co-operation in the future. In due time the people get interested and want to go as delegates, and there would be another public uprising for another convention, and there would be large discussions of how the Budget should be distributed-whether a nation should contribute to a common Budget of that kind according to its natural resources, or according to its susceptibility to disease.

(Laughter) Then at last you can imagine that, some agreement having been reached meantime, the very difficult and perilous question of appointing medical gentlemen to represent the various governments would arise. Of course some governments would have no difficulty at all, because political influence plays no part whatever in appointments. There would be other governments in which gentlemen who were ambitious, medically and socially, and who had relatives who in one way or another had attached themselves in some capacity of influence with the administration, might lobby for places. You can imagine, after a while, that a nice conspicuous group of mediocrities would be chosen as the government representatives. (Laughter)

Then those gentlemen would gather and there would be all sorts of discussions as to who was to have the leadership, and who would be head of the Commission, and who was to outline the plan; and there would be differences and jealousies and antagonisms, and applications and protests would be made through various diplomatic and consular officials. And so it would go on and on, meanwhile people dying by thousands and tens of thousands from yellow fever.

The other plan is very simple. A group of men meet in lower Broadway; a report is made and considered; then there is the question, "Is there somebody that knows about this?" If there is some relative of a gentleman present who would like to undertake this,--in fact no gentleman who had any relative would long hold his position in that connection. The question would be, "Who is the fittest man in the world in this field? Can he be secured? How much money does he want?" I f you have resources enough, these questions can all be answered. They were finally answered, and General Gorgas was given the commission, and money was put at his disposal in order that he might undertake the work.

Of course, when we are going on to do something of that kind, it is important, even if you think you have a scientific basis, to check it up a little. Scientific men are never satisfied; they always want to check their results, and investigate a little further. So it was suggested that, possibly, it might be well to make further scientific studies of yellow fever to see if the yellow fever germ could be isolated. It has been isolated several times, and turned out not to be the germ. This has happened often in the scientific world; so they thought it would be well to try again; and the Rockefeller Foundation' asked the Rockefeller Institute for Scientific Research if they would allow their bacteriologist, Dr. Gould and staff, to go down to Ecuador and make a first-hand investigation on the variable causes of yellow fever. There is a great advantage in being able to lay your hands on the instrument you want.

It is a deplorable thing-I don't know how it happens, but instead of an implicit faith we found on-the part of our-shall I say amiable-neighbours, that nearly all our neighbours of the South took the most unfortunate view of us. In spite of our desire to benefit all mankind, and the pure and unadultered reputations which we admit ourselves to possess (laughter) our friends in Mexico and our friends in Central America and our friends in South America do not understand it; in fact, they misinterpret our motives, and it is very difficult for us to do anything profitable there because they so misinterpret our motives. Was it not a lucky thing that we were able to send down a Japanese bacteriologist, who was welcomed with open arms? And so we got our Dr. Gould, and we got the guinea-pigs and monkeys, and one or two harmless Americans, and went down there to Guyaquil. (Great laughter and applause)

Why did he go to Guyaquil? To make sure of getting genuine cases of yellow fever. It is very hard, it seems, to diagnose the contagion germ, which looks almost the very same as yellow fever; some of us could not tell it, and some people who have had medical education could not tell. Some work that was done on the west coast of Africa, when further checked up, turned out not to be yellow fever at all. It was very important, then, that there should be no question of the causes of yellow fever for, according to Dr. Gould, you have to deal with them. In Ecuador there were physicians who had had such long experience with yellow fever that they could identify it with certainty; so Dr. Gould went down with his laboratory equipment and assistants, and certain cases that were unquestionably cases of yellow fever were pointed out to him. He took the blood from those people. He infected guinea-pigs, and in due time the guinea-pigs manifested symptoms which seemed closely to resemble the symptoms of yellow fever in human beings. Then from those guinea-pigs that had been so infected and which manifested symptoms, cultures were made and another group of guineapigs were infected, and in due time they began to develop symptoms which closely approximated the symptoms which developed in humans.

The scientific man is constructed in a most extraordinary way. He gets a certain group of things that look like something, and that are called phenomena, and when he gets those phenomena, he sets out what is called a working hypothesis, which connects these phenomena, and relates them in the order of co-existence. Then the scientific man goes on and discovers more phenomena, which do not fit into this hypothesis. Just at this point the business man's mind and the scientific mind part company, because when a business man gets the phenomena he forces his hypothesis to fit them (laughter) while the scientific mind transforms the hypothesis until it will take care of all the phenomena. The scientific man never asserts anything positive. All you can get him to say is that, "It looks as though there might be some sort of interest; there is in this, I suspect, an unsolved problem."

So you could not get Dr. Gould to say he had discovered the germ of yellow fever. To be sure, he isolated a very small squirming thing, passing between a microbe and a bacterium-a comparison which will give you a, precise idea of what it is like. (Laughter) This little microscopic plant, if you please, was found present, and he thought it would be interesting to carry on investigations. Here the lay mind would have jumped to conclusions; not so-the scientific mind. All you could get Dr. Gould to admit was that this phenomena in monkeys and guineapigs offered interesting subjects for further investigation, and the fact that this little squirming thing, hard to detect with the most powerful microscope, seemed to be mixed up with the business some way, might lead to the suspicion that it had something to do with it. This was as far as we could get Dr. Gould to go. He made another experiment. He got some perfectly healthy guinea-pigs, and also got some that were suffering from this phenomena; and he got these female stegomyia mosquitoes, and got them to bite those guineapigs that were suffering from something like yellow fever, and then got them to bite the healthy guinea-pigs. The lay mind would have jumped to the conclusion that a mistake had been made. All Dr. Gould would say was that it looked like some primary thing (laughter) but after he had done his worst, we brought him home, (laughter) and then with this information, which of course was interesting, people said, "You can identify yellow fever with this germ." To be sure Dr. Gould made some serum, and this serum has been demonstrated on a number of people, and they have all recovered from yellow fever. But there you must not jump to conclusions, because in the third or fourth day people take a turn for the better; you cannot tell whether the serum made them turn for the better or the worse. Dr. Noguchi said he wanted to go down to Marida and Yucatan that he might confirm or review his work, and so not long ago he went down to Yucatan; that is, he touched, part of Mexico. Though under the control of native laws, it is a part of Mexico. He was received heartily there, and down in Mexico City he was given a dinner and had a great reception on the part of the Medical profession, and was received by the President of Mexico, and everywhere this Japanese bacteriologist visits in Mexico he is received with the greatest heartiness. Well, what difference does it make, if he is getting the germs? In due time we obtained for that bacteriologist the support of every kind of political party, every shade of opinion, every sort of race and nationality, so that we are able to prescribe for any international situation, no matter how complicated. (Applause) Thank goodness, the time has not -been reached when we have to be particular what kind of men we send to Canada. (Laughter and applause) So, the scientific foundations having been laid, it was time to begin the actual work, to go down to Guyaquil and see what could be done in the way of eliminating Yellow Fever in Guyaquil, where it had been going on cheerfully for five years, from 1912 to 1917 inclusive. There had been an average of 259 cases a year of Yellow Fever in Guyaquil; and since 1842, since the time the sanitary records began, Guyaquil has been quarantined against the other parts of South and Central America most of the time.

Dr. Connor was sent down-a most delightful Irishman with a most persuasive manner (you are not surprised)-a gentleman able to talk in a beguiling and friendly way. (Laughter) We picked him out for the purpose, and he took along just two subordinates from the United States with him. You see, this was to be an equatorial undertaking; the Americans, so to speak, were just to be interested spectators. When Dr. Connor arrived he was greeted cordially. Noguchi had made a good impression, and it was made quite clear that Dr. Connor had come there in just a quiet way, but, to be sure, it was known that he was going to tackle Yellow Fever. Guyaquil has become a little cynical about Yellow Fever; they have had it eliminated so often that it is getting a little on their nerves; they had so many people go down and profess that the bacteriological millennium was about to dawn, and it had not dawned; if anything, the Yellow Fever has been slightly aggravated by those ministrations, and you cannot blame the equatorians for being a little credulous and cynical. So when Dr. Connor arrived and went around to see the newspaper people -which you have to do in any communitythere are popular newspapers in Guyaquil, and he got them-and I think this is one of the most extraordinary things, it surpassed anything that was accomplished in bacteriology or microbes-he got those four editors agreed on a ban of reticence for sixty days. This is almost incredulous. Those newspapers said they would hold their peace for sixty days while these apparently futile operations were under way.

Dr. Connor had a little time to work, not all the time needed to organize his staff, but he got 120 equatorians, and began to divide them into groups of five each, and those were mosquito groups; he was going to beat the mosquitoes. Do you go about swatting mosquitoes? Birth control is the only way you can deal with the stegomyia mosquito, and you have to head them off before that time. The stegomyia mosquito is very fond of laying her eggs in water. She will put up with water that is not altogether potable if she cannot find a better quality of water, but water is the thing she must have. She lays the larvae in the water, and ultimately they become mosquitoes and go off on their infecting tasks. The thing was to head off the mosquito. He got a spot map, and had every spot where there had been yellow fever for five years in Guyaquil. There were two spots indicated where Yellow fever was last. What was the surface water condition? The stegomyia is a household pest; it does not wander from household to household; it stays close by its home, and it is essentially a domestic mosquito, and you therefore have to deal with it in the houses. The conditions in Guyaquil were perfect for the stegomyia, for they have an extraordinary water supply in Guyaquil. It comes from about ninety miles up country, and people help themselves to it as it comes down, so it does not leave very much for Ouyaquil. In the old days Guyaquil never knew when it was going to have a water supply; but the distributions have now been systematized so that Guyaquil can have one and a half hours of water supply out of the twenty-four. You might have an intense ablution during the day or you might drink-the equatorians are not any fonder of water than many of you (laughter); but what they do take they prefer to have distributed over twenty-four hours rather than face the horrible task of dealing with it in the one and a half hours.

Therefore they have developed various devices. The well-to-do people have tanks in the upper part of their houses, and the water comes to nearly fill the tanks up in the one and a half hours when it is running. The poor people have barrels and receptacles of various kinds, and get the water from water carriers who go around the streets, and go around to the hydrants during the hydrous hour.

To prevent the stegomyia mosquito from getting into these tanks was a task. They decided that the tank must be screened. You get a vested interest, but the people have invested their money in screens. It did not cost anybody but the householders anything to screen those tanks, and that was the main part of their problem. There were a lot of those water containers that did not have screens; you could not put a cover on; you would have to have an inspector put the cover back when ever anybody took water out.

So Dr. Connor remembered that in dealing with the malaria mosquito, which is another kind of mosquito, tape minnows had been used. You put minnows in those pools of water, and they take care of the larvae as fast as they get deposited. Dr. Connor got a few of those tape minnows and put them in the barrels,, and they ate the larvae with avidity; but the minnows were delicate, were sensitive-They were a sort of Jersey cows among minlows-and, if anything happened, their nervous organizations would go to pieces and they would die. It was very discouraging, when you wanted a thing to co-operate with you, that those fish laid down on the job. (Laughter) There are a great many people that would have been discouraged, but Dr. Connor was not. He sent his people out exploring for fish, a very vigorous fish, but the only trouble was it would jump out of the barrel every time anybody put it in; you could not keep it in the barrel; and by the time the fish had been retrieved several times and put back in the barrel it had lost vitality, it had lost interest in the game, and ultimately quit. So this wouldn't do. But Dr. Connor was not discouraged; he said, "Somewhere in the economy of nature there must be a fish admirably adapted to this particular problem, and we will look for another fish." At last they found an ideal fish that was a glutton for larvae, but of a retiring disposition; and every time a native came with a pitcher for water, it went down to the bottom and stayed there. They said, "How can you be sure that the people would keep the fish going?" A very simple device. Was the fish there? If the fish was there, all was well; if not, turn the barrel upside down and let the water all go. You can see how human nature was utilized, psychologically. (Laughter) The consequence was that the people were running to Dr. Connor's office and saying, "Our fish doesn't seem well; give us another fish;" and as a copious supply of fish was kept at headquarters, things went on. The tanks were all screened, and the fish were waiting, looking for the larvae, and gobbled them up as soon as they were deposited. It was a fine situation.

This began on the 28th of November, 1918. For the month of November there were 77 cases of Yellow fever reported in Guyaquil. During the month of December, during which such work was carried on, the number of such cases rose to 86. Then one editor broke loose-I don't blame him-and he wrote an editorial in which he gave his real opinion as far as the censorship would permit-his real opinion of Americans who came butting in, claiming they could do things, and who failed miserably, and who had an altogether exaggerated opinion of their own importance in the Western hemisphere and in the entire cosmos. It was a capital editorial, but was not nearly as wicked as if it was written in English, because no one can be so peppery in the flowing language of Castile as they can be in English. But it alarmed Dr. Connor. He went around and pleaded with this man that they had not had a chance; that they had not got under way; give him another month, and if there was not a substantial modification the ban was to be off, and they might cut loose. So he watched for January with great interest. In January there were 78 cases, showing not much of a reduction, but they were keeping under. Then came the returns for February, 37; March, 13; April, 2; May, 1; June, 1, July, zero. August, zero; September, zero. And when I left New York a week ago, no further cases of Yellow fever had been reported. (Great applause)

THE ROCKEFELLER FOUNDATION 139

There you are; that is characteristic of laymen, going off at halfcock. (Great laughter) That is just the way I felt about it, you know; but the scientific men, like lawyers-I have to associate with them all the timesaid, "Oh, we are not out of the woods yet; probably there may have been cases of Yellow Fever that were not reported during the serious season for Yellow Fever; wait, the season is new; there may be more cases; this is just encouraging; that is all that can be said about it." So that is all I dare say, only it looks to me as though something had been done, and the people in Guyaquil think something has been done, and they have given Dr. Connor a watch, and have made speeches to him, and the legislature has passed resolutions thinking that something has been done; but we know better, of course; we know that something else may happen. But if this thing can be continued, it is going to look awfully encouraging.

So now you can understand that Gen. Gorgas, though he sees the end, is on his way to Toro-there has been a little epidemic in Toro-and then he is going over to London, and the British Government have detailed two of the best men in public health one a specialist in Yellow Fever-and they are going down to that place on the West Coast of Africa with Gen. Gorgas to make a complete diagnosis. They are going to have a man who has been trained by Neguchi, and then to leave the man there to stick by that job until whatever it is-Yellow Fever or whatever it is-has been examined. Another group is in Venezuela, and another is going down to Merida just as soon as proper arrangements can be made, and those seed-beds are going to be kept under surveilance. If we can judge by the success in Guyaquil, we are going to finish Yellow Fever, and Gen. Gorgas is going to write the last chapter of the history of Yellow Fever. (Loud applause)

It is a rather inspiring sort of adventure, this adventure in public health. Why have I described this to you? For two reasons. First, because it is an awfully good story; it seems to me it is a mighty interesting thing. One of our own lawyers came to me after he heard that address and he said, "Is it really true about those fish?" (Laughter) I had to go to Dr. Connor's report and lay it before him and ask him to read it and he said, "I beg your pardon." So far as the facts that I have reported to you are concerned, they are accurate and they make a good story.

But I told you this story for another reason. It seems to me that in these times, when we so easily misunderstand each other, when it is so easy to view with alarm, and take a gloomy view of the future, like those who see nothing but disaster, who see this old world going to pot, who see the British Empire on its last legs, and see even the glorious United States of America on the point of disintegration, isn't it a comfort to fix your attention on a few striking things? Is it not a satisfaction to see men working together confidently with good will, using the resources .of science, and to know that this is a type of communion that is going on all around the world?

What a lot of things are going on! This last year I have been about half way round the world. Last summer I was in Hong Kong, and I went the whole of this magnificent journey around on the great highway of the Canadian Pacific and on those fine boats across the north Pacific and then down to Honk Kong; and I went up on the top of the peak at Hong Kong and in my imagination could see what Hong Kong was in this great circle of the British Empire all around the world; and when I thought of all the fine things that have been done under the British Flag and all the fine things in the future that are going to be done under the British Flag, in the way of bringing order and peace and health and all the benefits of the thing that we still, in spite of cynics, call civilization, and then when I thought of all the other co-operative nations of the world, I could not help feeling this kindling of my imagination and the stirring of my heart, and I said, "There are great days ahead of this old world of ours." (Great applause) If eye will only come to understand each other, (applause) if we can only seek not for the differences but for the things we have in common; if we can only get great constructive tasks upon which we can organize ourselves with splendid courage and a good fellowship, and work together, heart to heart and shoulder to shoulder, in great enterprises to make life all around this world a thing worth living for man women and children,- aye, the old world will be patched together again. (Applause)

I think of all those things that are going on; I think of the medical and public health work under British auspices-I suppose you know that the British Public Health administration has set the model for the whole world. So far as scientific discoveries go, a great deal has been done in France, and a deal was done in Germany, and a little has been done on the other side of the line here; but when it comes to administration, to the socializing of medicine, to making health a great undertaking, fundamental to community, nation, and empire, there is a glorious record of this British Empire of yours. (Loud applause)

When I think of all the different peoples joining in work for the great common cause when I think of medical missions in China, when I remember the British and Canadian centres, and other Canadian centres that I visited over there, when I remember this splendid enterprise in which the physicians of Toronto are loyalty organizing themselves for establishing in the far Western Province of China a modern medical centre, a centre for public health education and for the public education of the people in regard to those things, I feel a new courage; I am not ready to give up, by any means, and I, with you, congratulate ourselves upon having this chance to work together.

If I may mention, in closing, the object of the visit which brings Dr. Pierce my colleague, and myself to Canada, it seems to me beautifully to symbolize this thing of which I have been talking. The founder of the Rockefeller Foundation, in that Christmas gift of his, properly paid personal tribute to the splendid record of Canada in the great war, and expressed the hope-you will remember how he did it in the letter of instruction under which the money that is given to the Rockefeller foundation is given to the Trustees of the Foundation to use as they deem best within the great purpose of the Foundation, which is the welfare of mankind throughout the world (applause) in that letter of transmittal you will remember that he said that, if it should seem best to the Trustees of the Rockefeller foundation to make some contribution toward the aid of medical education in Canada, he would feel personally gratified. One does not need instructions, one does not need any exhortation, to come on an errand like that; and so, at a meeting of the Foundation Trustees the other day in New York they set aside for this Canadian work the sum of $5,000,000. (Applause) and Dr. Pierce and I have come to make a very little trip to get acquainted with you.

Saturday we spent in Winnipeg: here we are for two or three days; we go on to Montreal, Quebec and Halifax; and then Dr. Pierce is coming back to all those places, and is going to spend a long time, and enter as intelligently and sympathetically as he can into the problems of the various communities. We come with no patented American scheme-you will be surprised at that. (Laughter) You know that working in. all the nations of the world makes you modest. Working in all the nations of the world makes you feel that no nation has a monopoly of wisdom. The great thing is to get all the wisdom you can from each source, remembering that each group has its trouble, that each community has its own set of circumstances, and that therefore no made idea can be imposed on people, even if you have an idea to do that.

So we had our meeting this morning with representatives of the medical. faculty in the University, and they have prepared a most statesmanlike and most interesting and most carefully thought out plan to develop the medical school of the University of Toronto, extending over a period of years. It is a gratifying thing, gentlemen, and I congratulate you heartily on having in your medical school a group of men with the scientific training, with the imagination, with the capacity to plan, with the statesmanlike vision. Those are the things, after all, that make for the most important institutional development. Money is important, but money is wholly subordinate to personality. It is only when you have highly trained men, men of ability, men of vision; men of imagination, that you can build up institutions in permanent form for the welfare of any community. (Applause)

And so I want you to know that we come in no spirit of selfsatisfied and self-complacent omniscience. We come to learn. We come to enter sympathetically into the plans of this group, and we hope that we may have some little part with you-it is too early to say more than that -in the development of your medical school, which, with the splendid history already behind this institution, will enable it in the years to come to be one of the great centres for medical education and research not only in the Dominion but throughout the British Empire and in all the world. (Loud and continued applause, the audience rising and giving three cheers)

TM VICE-PRESIDENT: Gentlemen, I have now very great pleasure in asking Dr. Bruce Taylor, President of Queen's University, to tender to the speaker the thanks we feel for this delightful and thrilling address.

DR. BRUCE TAYLOR.

Mr. Chhirman and Gentlemen,-I am positively certain that we never in our lives listened to anything more delightful than this. (Applause) I have seen many men called upon to move votes of thanks who did not know when they got up what they were going to say, or how on earth they were going to steer around awkward corners. But I have no such difficulty whatever. I do not think I was .ever moved to such admiration as by this rapidity of thought and utterance, and the co-ordination of those two things. Now, you have not had half the fun out of this that I have had. I have been watching three men. I have been watching the official reporter. (Laughter) I can say about him that not only is he a very first-class stenographer possessing a great stenographic facility, but he has an unusual disposition. I have been watching also two of my friends here, Sir Robert Falconer and Canon Cody. (Laughter) Those are men who are no slackers when it comes to linking thoughts with words, and I have noticed them, and I have seen in the back of their minds this question, put with greater familiarity perhaps in one case than the other, but I can imagine my friend Sir Robert Falconer saying, "How the dickens does he do it?" and Canon Cody saying, "Well, that is a very wonderful piece of co-ordination." (Great laughter)

Now, it is a wonderful story, this that we have been listening to, (hear, hear) and we are apt to forget just how wonderful it is, in all the humour and the flash and the good nature with which it has been put before us. I do not know whether you, gentlemen, ever go back to the things of your childhood, but it was just this week that I had been reading my old friend, "Tom Cringle's Log," and many of you may remember the epidemic of Yellow Fever in Jamaica when he went out there as a youngster, and, when you heard today that old story, you listened to hear about those old water fevers, malarias, and typhoid and how they had been overcome by the progress of science, and you feel that it is a most amazing story. It was a wonderful thing that, amid all the dirt and muck of the war, men should have lived as wholesomely as they did, and that the actual percentage of sickness among the men groping about up to their middles in all kinds of filth, was less than it is in civilized life; that on the evidence of scientific men the percentage of typhoid was less than in all previous wars.

We have listened today to a man whom we have so often heard about, and it is a great thing to feel that there is no let-down. So often you hear about people, and then you meet them and you think, "Well, after all, that is pretty plain Jane." There is no plain Jane about Dr. Vincent. (Laughter and applause) I' have heard of Phillips Brooks, and of his rapidity, and of his power of sweeping people off their feet. Well, in this other sphere of life, in the sphere of administration, we are getting some evidence. It is a wonderful thing that investigators are apparently given full swing, and that out of this effort of men to make money for themselves we should have society reaching a point where money no longer can mean anything to the individual and where the only possible use of it is for society as a whole. That we get in the Carne,-ie foundation; I remember in my student days how the work of that Foundation entirely altered all the scientific and medical teaching in schools, where large libraries had hitherto been lacking but were formed for the purpose of scientific research. Now we are finding this Foundation, which already has done so much, not merely in the medical sphere but in social life of a City like New York, where the report of the Rockefeller Foundation reveals conditions that have improved that old city, as far as the stranger can see it, until it has been made one of the cleanest of cities that it has ever been my good fortune to visit. That was subsequent to the report of the Rockefeller foundation. And now we are getting that same work offered to Canada, as Dr. Vincent has said, not in any spirit of carping investigation but simply with the broad idea of doing the best, first of all, for medical training and research in this Dominion, and through the Dominion the British Empire and the other places where our men may go. For after all, certainly in this northern continent of America, as far as medical education is concerned, there is neither Canada nor the United States; it is a unity. ' (Hear, hear) We cannot draw any line between those two great bodies of mankind, were we inclined. What the Rockefeller Foundation proposes to do will be found in the years to come to have been perhaps the most important thing that ever happened to scientific education in this Dominion. I am sure we extend to Dr. Vincent the very heartiest thanks for what will be to all of us a most memorable address. (Applause and cheers)

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The Work of the Rockefeller Foundation. Health as an International Bond


A League of Central and South American Nations which has been formed to eliminate yellow fever from the world. A League under a certain type of leadership from the United States, representing a general international co-operative attempt to deal with a disease which has long been a menace not only to Central and South America, but to all countries that have been in immediate trading communication with those centres. The interest in this subject by General Gorgas, former Surgeon General of the U.S. Army. The mosquito theory of Dr. Fantella in Havana, proved correct many years later. General Gorgas' dream to eliminate yellow fever from the world. Places that may be considered endemic centres, the foci of infection. Further scientific studies of yellow fever to see if the yellow fever germ could be isolated. The request of the Rockefeller Foundation of the Rockefeller Institute for Scientific Research to allow their bacteriologist, Dr. Gould and staff, to go down to Ecuador and make a first-hand investigation on the variable causes of yellow fever. Work done in Guyaquil by Dr. Gould. Findings for further studies. Dr. Gould's serum. Dr. Noguchi's work in Mexico. Dr. Conner, who was sent down to Guyaquil to tackle Yellow Fever. Many details of the work that was accomplished. Transferring the success in Guyaquil to other parts of the world. Other The speaker's travels and a report of many medical missions and activities going on in the world. The great purpose of the Rockefeller Foundation.