“The next great task of preventive medicine is the inauguration of universal periodic medical examinations as an indispensable means for the control of all diseases, whether arising from injurious personal habits, from congenital or constitutional weakness, or from social and vocational conditions.”  That this declaration by the Commissioner of Health of the city of New York is not the mere expression of an individual opinion, there is abundant evidence.  And no one who has watched the growth of other movements towards such regulation of life as only a few years ago would have seemed wholly outside the domain of practical probability can doubt that the “Life Extension” movement, as thus outlined, will rapidly grow into prominence.  Nor is there much room for doubt that, whether explicitly contemplated at present or not, compulsion as well as universality is tacitly implied in the movement.

I say that the movement is sure to grow into prominence, that it is a thing which must be seriously reckoned with; I do not say that it will march straight on to victory, or even that it is sure to prevail in the end.  It is instructive, in this regard, to hark back to a recent experience in a more special, but yet an extremely important, domain.  Several years ago a report on university efficiency was issued under the auspices—­though, it should be added, without the official endorsement—­of the Carnegie Foundation.  The central feature of this report lay in its advocacy of the application to universities of those principles of system and of standardization which have been successfully applied on a large scale to the promotion of industrial efficiency, and are generally referred to by the catch-word, “scientific management.”  In spite of the merits of the report in certain matters of detail, and of the high standing of the expert who wrote it in his own department of industrial engineering, the report evoked an almost universal chorus of contemptuous rejection not only in university circles, but also from those organs of public opinion which have any claim to be regarded as enlightened judges in questions of education and culture.  The thing seemed to have been laughed out of court.  And yet it turned out that a year or two afterwards a full-fledged scheme for carrying out some of the crudest and most objectionable features of this “efficiency” program was presented to the professors of Harvard University, apparently with the expectation that they would fall in with its requirements without hesitation or protest.  For some days there seemed to be real danger that this would actually happen.  It turned out to be a false alarm; the faculty of the foremost of American universities were guilty of no such supineness.  The project was ignominiously shelved, with some sort of explanation that the springing of it on the professors was due to an error or misunderstanding.  But that the attempt should have been made, and in a manner that argued so total a lack of any sense of its grossness and crudity, is a significant warning of the extent to which the notions underlying it have fastened upon the general mind.