In all of this work the newer devices that have been developed and the research that has come from the laboratories of physiology, pathology, and bacteriology throughout the world, have been of inestimable value. The endowments that continue to grow for furthering such investigation are going to make safer and happier men, women, and children in the future.

Diseases of the Lungs. The lungs, which are subject to many disorders, are now investigated not only by the old method, wherein the physician thumps and listens, but also by laboratory tests of the secretions from the lungs, by the use of the X-ray, by the insertion of a needle, and by the injection of substances which make the lungs particularly visible under the X-ray. Whereas the lung complaints most commonly considered in the past were bronchitis, pneumonia, and, most frequently of all, tuberculosis, to-day it is known that the lungs may be infected by many other bacterial organisms, that chronic diseases may produce permanent changes in the lungs which interfere with breathing, that the lungs may be subject to cavity, to consolidation, to the growth of tumors, to the inhaling of foreign bodies, and to many other conditions. When the diagnosis is properly made, treatment applied to the specific cause of the disturbance frequently results in the cure of cases which formerly passed inevitably to death.

The Stomach and the Intestines. The contents of the stomach may be pumped out and examined to determine whether or not food is being digested properly by the normal secretions. The shape of the stomach may be determined by injecting substances which make the stomach visible to the X-ray. A defect in the lining of the stomach shows on the X-ray and gives the physician an indication as to whether he must look for some abnormality in the shape of the stomach, for the presence of ulcers or of a cancer. Each of these conditions produces changes in the secretions of the organ itself. A certain amount of time is required for the stomach to mix the food thoroughly and to subject it to the various secretions, after which the food is passed on into the intestines. Any delay or undue haste in the emptying of the stomach manifests itself by symptoms which are exceedingly disagreeable.

By the use of the fluoroscope and by the use of serial X-ray pictures, it is possible to determine exactly how long the stomach requires for its work. By the use of the esophagoscope or gastroscope it is actually possible to look into the esophagus and the stomach. It is even possible, by means of a newly invented camera, to take pictures of the lining of the stomach without opening up the patient. In the vast majority of cases of indigestion, though, it is not necessary to make all these studies, for the simple reason that it is possible to tell from easily determined symptoms just about what is wrong and, by the giving of suitable advice concerning diet and digestion, to free the patient from his disagreeable symptoms.

On the other hand, in many cases called indigestion, it is difficult to make certain whether or not the patient is suffering from a disease of the stomach, a disease of the gall bladder, an inflammation of the appendix, or a nervous disorder without manifest changes in the stomach itself. There are people who find it impossible to eat or to swallow their food, owing to nervous manifestations which produce no definite visible change in the esophagus or in the stomach.

There are still many unexplained conditions involving the stomach which demand further research for their solution. There are instances in which the stomach fails to supply the proper secretions, and the reasons for this failure are unknown. Apparently the tissues of the stomach may be made to yield extracts essential to health and to life, such as the extract that controls pernicious anemia. Here is a new field for intensive research.

The procedures that apply to the study of the stomach apply also to the study of the intestines. Only recently has it become possible to pass a tube through the stomach and into the intestines in order to withdraw their secretions for investigation. Only recently have methods been devised for determining the rate at which food moves along the intestines, for studying the bacteria that live there normally and abnormally, and for observing the obstructions, paralyses, and many other disturbances which manifest themselves by serious symptoms.

There are forms of constipation which are due to interference with the digestion in the intestine, other forms which are due to disturbance of the motility in the intestine, and some forms which are merely the results of bad habits. There are situations in which it is exceedingly dangerous to eat food with too high an amount of roughage, and situations in which an increase in roughage provides the conditions necessary for a successful cure.

Within the past twenty-five years methods have been developed for changing the nature of the intestinal flora. Metchnikoffs original idea that the Bacillus bulgaricus was the normal inhabitant and that its presence was synonymous with long life has been changed to emphasis on another germ called the B. acidophilus. Attempts to implant the acidophilus organism in the intestine brought out the information that certain types of food were necessary to secure successful implants.

At the lower end of the intestine the development of varicose veins, commonly called hemorrhoids, represents an extremely disturbing condition. Fifty years ago only quacks attempted to treat this condition by injection methods. Their methods were found to be dangerous and not infrequently fatal. Yet continued study over a period of twenty-five years has developed several methods of injection, and particularly safe methods of prompt operation. The hemorrhoids are now removed under local anesthetics with prompt healing and with the loss of only a few days from work. They can, moreover, be removed by electrical desiccation as well as by injection methods.