"The first requisite for longevity must clearly be an inherent or inborn quality of endurance, of steady, persistent nutritive force, which includes reparative force and resistance to disturbing agencies, and a good proportion or balance between the several organs. Each organ must be sound in itself, and its strength must have a due relation to the strength of the other organs. If the heart and the digestive system be disproportionately strong, they will overload and oppress the other organs, one of which will soon give way; and, as the strength of the human body, like that of a chain, is to be measured by its weaker link, one disproportionately feeble organ endangers or destroys the whole. The second requisite is freedom from exposure to the various casualties, indiscretions, and other causes of disease to which illness and early death are so much due." In following out our study of diseases, we have been too closely narrowed down by the old symptomatic story of disease; we have too much treated surface symptoms, and neglected to study the man and his surroundings as a whole; we have overlooked the fact that there exists a geographical fatalism in a physical sense as well as the existence of the influence of that climatic fatalism so well described by Alfred Haviland, and the presence of a fatalism of individual constitution as well, which is either inherited or acquired. The idea that Charcot elaborates, that, as the year passes successively through the hot and the cold, through the dry and the wet season, with advancing age the human body undergoes like changes, and diseases assume certain characteristics, are also points that are overlooked; and nowhere is this latter view seen to be more neglected than in the relations the prepuce bears to infancy, prime and old age, as will be more fully explained in the chapters in this book which treat of cancer and gangrene. Admitting that Haviland has exaggerated the influence of climate as an etiological factor in its specific influence in producing certain diseases; or that M. Taine claims more than he should for his "Theorie des Milieux," or influence of surroundings; or that Hutchinson has drawn the hereditary and pedigreeal fatherhood of disease too finely; it must also be admitted that the solid, tangible truths upon which these authors have founded their premises are plainly visible to the most skeptical; the architectural details of the superstructure may be defective, but the foundation is permanent.