much progress in this state along the lines of occupational-disease prevention. The American Association of Labor Legislation has continued its very active programme, and much of the Ohio appropriated $14,000 for the legislation passed by the different state Board of Health to conduct a states during 1913 can be directly attwo years' survey of occupational distributed to its efforts. It seems very eases. This survey is now being conducted by Dr. Hayhurst. A bill to provide for the prevention of occupational diseases in California was passed by the legislature with the backing of the state Board of Health, but was killed by the Governor with the pocket veto. certain that a tremendous advance in the prevention of industrial diseases and accidents will be made in the immediate future. Tuberculosis. In November, 1912, Dr. Friedrich Franz Friedmann of Berlin reported to the Medical Society of that city a method of treatment for tuberculosis, consisting of injections of what he described as living, avirulent tubercle bacilli. He stated that the original source of these bacilli was a tuberculous turtle. In his communication he claimed many cures as a result of his treatment and was corroborated by several other physicians, although the leading members of the profession present expressed scepticism as to the legiti licity followed, particularly in America, and in February, 1913, Dr. Friedmann came to New York to demonstrate his treatment in person. The Maine, Minnesota, New Hampshire, and Ohio passed bills adopting the standard form for reporting occupational diseases as drawn up by the American Association for Labor Legislation. This bill was vetoed by the Governor in Pennsylvania. Bills for the prevention of occupational diseases were passed in Ohio, Pennsylvania and Missouri. These three states, in addition to Illinois, are now requiring the monthly medical ex-macy of the claims. Widespread pubamination of persons employed in certain unhealthy trades and regular reports of the conditions found have to be made to the proper state authorities. (See also XVII, Labor Legisla-U. S. Public Health Service and the tion.) New York City Department of Health While no definite laws providing immediately demanded full informacompensation for occupational diseases tion regarding the preparation of the were passed, the outlook is very fa- new vaccine and the methods of emvorable for such legislation. The in-ploying it before granting permission troduction of the Kern bill in the to use it within their respective jurisUnited States Senate, extending the diction. Dr. Friedmann was finally principle of compensation to include forced to yield to the extent of furOccupational diseases, has attracted nishing his preparation to the aumuch attention. thorities and demonstrating the treatment under the auspices of the Public Health Service. A series of carefully observed cases was treated in New York City and later another series in Rhode Island. Dr. Friedmann subsequently visited Canada and treated a number of patients in that country. In May, Dr. J. F. Anderson of the Public Health Service made a preliminary report on the cases under the care of the Service in New York, stating "that the effects thus far observed do not justify the confidence in the remedy which has been inspired by widespread_publicity." In September Dr. H. L. Barnes reported on 120 cases of pulmonary tuberculosis treated in Rhode Island, stating that none of them had shown the ben The Public Health Service has also commenced to take up the question of industrial hygiene and contemplates a comprehensive study of tuberculosis in relation to industries in a large manufacturing center. As an aid in the enforcement of an Act of April 9, 1912 (A. Y. B., 1912, pp. 335, 413), providing for a tax upon white phosphorous matches, the Service has prepared regulations providing a systematic inspection of match factories, and systematic examinations have also been begun to determine the constituents of matches on the market. It is anticipated that the passage of this Act and its enforcement will cause the disease known as "phossy jaw" to be come a matter of history. efits claimed by Dr. Friedmann and | This latest recruit in the public-health that 17 had shown "an increased activity of the disease which would not have been expected under ordinary sanatorium treatment." The reports from Canada confirm the findings in the United States. Hookworm Disease. The Rocke feller Sanitary Commission for the Eradication of Hookworm has continued its very important work. During 1913 the annual report of the Commission for the previous year was published. The following statistical figures taken from the Journal of the American Medical Association (May 17, 1913) indicate the scope of the work accomplished: In Texas 83 counties have the infection and of the 884 counties in the other 10 states, infection has been found in 796. It is presumable that the remaining 88 counties will also be found in fected when the work is extended to them. In all, 238.755 persons were treated at an expenditure per person treated of 77 cents, as compared with 140,378 treated in 1911 at an average expenditure per person of $1.05, and 14,443 treated in 1910 at an average expenditure per person of $4.66. In the three years, a total of 393.566 persons have been treated for hookworm. The total expenditure of the Commission for the year was $184,671.60, in addition to which the sum of $22.482.44 was spent by counties and $19.972.52 by states for fighting the hookworm, mak ing a grand total of $227,126.56. microscopic examinations made in 1912 numbered 326.951, as against 90,724 in 1911, and 14,789 in 1910. The International Health Commission. During the year the Rockefeller Foundation established an International Health Commission, its objects being the prevention and cure of disease with the world as its field. Dr. Wickliffe Rose was appointed director, and the Commission is now engaged in work of relief and control of hookworm disease in infected countries. The Commission on taking up the work in any country will seek to coöperate in organizing agencies and directing them as follows: (1) to study the geographic distribution and the extent of the infection; (2) to cure all carriers of infection; and (3) to bring about sanitary conditions which will prevent soil pollution and consequent infection with hookworms. Cancer. Still another scourge has called forth a movement to combat it. field is the American Society for the Control of Cancer. The new association is unique in that it is attacking a disease the cause of which is unknown and regarding which the ignorance is profound. Its specific task is the education of the public to the recognition of the significance of certain symptoms and the necessity for early diagnosis and operation. As in the case of many of its sister societies, the initiative has been taken by leading members of the medical profession in America, who have called to their side interested laymen to ensure the efficiency and success of the movement. It is understood that the pathology of cancer will not be regarded as falling within the field of the new society, but in addition to public education, careful studies will be made of the incidence and distribution of the disease as well as of the results of operative procedure. Ignorance of causation naturally renders the cancer problem more baffling than that of tuberculosis or the other preventable diseases which the civilized world is now engaged in fighting. For that reason there is, perhaps, the greater need of initial steps, and we welcome the new organization to the group whose activities give vigor to the great public-health movement of the day. (See also XXX, Medicine and Surgery.) Infantile Paralysis.-Dr. Milton T. Rosenau reported in 1912 experiments which proved that monkeys could be infected with anterior poliomyelitis (infantile paralysis) through the bite of the stable fly (Stomoxys calcitrans), and this discovery was confirmed by Drs. J. F. Anderson and W. H. Frost of the U. S. Public Health Service (A. Y. B., 1912, pp. 705-7, 717). Anderson and Frost in a further series of experiments were unable to duplicate their earlier work. The reason for failure to repeat the earlier experiments has not been explained. Anderson and Frost in discussing the subject (Public Health Reports, May 2, 1913) express the be lief that it is doubtful if infection through the bites of this fly is the important factor in the spread of the disease and that epidemiological studies of poliomyelitis appear to them to indicate that the disease is The cases of tetanus and blank-carmore likely transmitted largely tridge injuries for the past 11 years through passive human virus carriers. are given below: Drs. Simon Flexner and Hideyo Noguchi of the Rockefeller Institute report the successful cultivation of the virus of poliomyelitis (Jour. of Exper. Medicine, XVIII, 461). The 1913. organism was grown on a specially 1912 prepared medium, and after various 1911. cultures the growth of the organism 1909. is visible to the naked eye. The injection of these cultures into monkeys has caused the typical disease. XXX, Pathology and Bacteriology, 1904. and Medicine.) 1910 1908. 1907 1906. (See 1905. were Trachoma.-A special study of trachoma (an important communicable disease of the eyes) among American Indians was conducted during the year by Dr. J. W. Schereschewsky of the U. S. Public Health Service; 39,231 Indians were examined, and of these 8,940 (22.7 per cent) found to be infected with this disease. The wide dissemination of this important disease amongst the Indians is accounted for by bad housing conditions and lack of personal hygiene. Dr. Schereschewsky considers the present widespread diffusion of trachoma among the Indians a serious menace to future white populations of Indian reservations (Jour. Am. Med. Assoc., Sept. 27, 1913, p. 1113). Other important studies on trachoma have been conducted in Minnesota and Kentucky and reveal the existence of a great deal of this disease. Fourth of July Injuries.-The wonderful results obtained through the advocacy and establishment of a safe and sane Fourth of July are well shown in the 1913 records. The results have been compiled by the Journal of the American Medical Association (Aug. 30, 1913, p. 679). The total deaths due to accidents of various kinds (exclusive of tetanus) since 1905 are given in the following table: YEAR 1905. 1906.. 1907 1908. 1909 1910. 1911. 1912. 1913. 95 83 102 90 1903. The greatest praise for the remarkable showing must be bestowed on the Journal of the American Medical A8sociation, which has so vigorously fought for a safer celebration which would bring forward true patriotism and not leave in its wake an army of dead and maimed. International Congress on School Hygiene.-The fourth International Congress on School Hygiene convened in Buffalo, Aug. 25-30, 1913. The total membership of the Congress was 2,181, the registration total in Buffalo 1,442, and the total attendance estimated at 3,000. The Congress was divided into the following sections: Section 1, Hygiene of School BuildSection 2, ings, Equipment, etc.; Hygiene of School Administraton, Curriculum, and Schedule; Section 3, Supervision in Schools, Medical Hygiene, Sanitation. Edward T. Brown in discussing the Congress in the Survey (Oct. 11, 1913) sums up the subjects covered by the various papers as follows: а Papers on the hygiene of buildings discussed the location, plan, construction, equipment, and maintenance of schools. School architecture, in its æsthetic and practical aspects; decoration, with maximum of beauty and minimum of eyestrain; illumination, ventilation and plumbing, were considered, as well as school furniture, water supplies, lunch room problems, school grounds and similar topics. A second group of papers, those on the hygiene of administration, studied the forces which make for health in 108 country, village and city schools: people coming into contact with the school teachers, business officers, janitors, children; the schedule, its adaptedness to age and growth of the normal child, its provision for backward, delinquent, or 29 crippled children, its hours and their 64 47 35 relation to school efficiency and school fatigue, its recesses and its vacations; its home-work requirements, its provision for athletics. Special plans were laid for the teaching of hygiene, when, what, how for training teachers of hygiene on the preventive, educational, community, sex and other phases of the subject. Problems of heredity, first aid, and the relation of school to home were also included in these sessions. A third group of papers discussed supervision, medical, sanitary, hygienic, not only in public schools but also in colleges, universities and professional schools. From every standpoint known to the science of school hygiene such questions were viewed as the relation of boards of health to educational authorities, the control of medical inspection by school or health authorities; training, equipment and hours of school physicians and school nurses, and their compensation; school clinics, their administration, scope, location; relation of inspection to the home, follow up for medical inspection treatment of physical defects; and finally, the standardization of medical examinations and records, and statistical treatment of results. The president of the Congress was Charles W. Eliot, President Emeritus of Harvard University, and the Secretary-General, Dr. Thomas A. Storey, Professor of Hygiene, College of the City of New York. The Congress was eminently successful and undoubtedly will go far toward improving the status of school hygiene in this country. The important papers are to be published, and when brought together will form a most valuable series for all interested in the subject. Among the more important resolutions passed were the following: Resolved, That it is the sense of the Fourth International Congress on School Hygiene that in each one of the United States such legislation should be made. effective as would permit the establishment of systems of medical inspection and examination of school children, so that each school child in the United States would come under the hands of such health supervision. dis and children afflicted with pulmonary tuberculosis or children suffering with tuberculous joint or bone diseases; and Whereas, It has been demonstrated in New York and other cities that carded vessels lend themselves admirably to transformation into all-year-around hospitals and sanatoria for consumptive adults, sanatoria for children afflicted with joint and other types of tuberculosis, and into open air schools for tuberculous, anemic and nervous children; be it Resolved, That the Fourth International Congress on School Hygiene petitions the United States Government to place at the disposal of the various states of the Union as many of the discarded battle ships and cruisers as possible to be anchored according to their size in rivers or at the seashore and to be utilized by the respective communities for open-air schools, sanatorium schools for children, or hospital sanatoria for adults. Commission on Milk Standards.The second report of the Commission on Milk Standards appointed by the New York Milk Committee (A. Y. B., 1912, p. 636) was published in Public Health Reports for Aug. 22, 1913. The Commission divides milk into three grades, according to its sanitary status. An appendix to the report contains standard rules for the protection, handling and distribution of milk. New York Public Health Commission.-On Jan. 10 Governor Sulzer of New York appointed a special commission consisting of Herman M. Biggs, M.D., Homer Folks, John A. Kingsbury, E. R. Baldwin, M.D., W. E. Milbank, M.D., Mary A. Nutting, John C. Otis, M.D., and Ansley Wilcox, to collect facts, receive suggestions and make recommendations as to changes in public-health laws and their administration in New York State. As a result of the report of this committee the Governor sent a which resulted in the passage of an special message to the legislature act which reorganizes the state Department of Health, and provides for a Public Health Council, consisting Whereas, The Congress is convinced of a Commissioner of Health and six that the open-air school is one of the appointive members. This council has most powerful agents in the prevention the power to establish a sanitary code and cure of tuberculosis in childhood, and it has been furthermore demon- which is to supersede all local ordistrated that nearly all climatic condi- nances, thus tending to standardize tions, providing the air is dust-free, lend themselves to the prevention of tuber-public-health practice throughout the culosis in the predisposed and the cure state. of the afflicted and Whereas, Nearly a million tuberculous children, or children strongly predisposed to tuberculosis, are attending our public schools, and there is hardly accommodation for 1,500 to receive instruction in the open air and Whereas, Statistics show that there are not nearly enough hospital and sanatorium accommodations for adults Among other provisions is the division of the state into sanitary districts, each under a supervisor respon sible to the Commissioner of Health. These sanitary supervisors are to aid the local health officers and promote in every way efficient health service. The act is of importance also in that it recognizes the necessity of publichealth nurses. The law ensures tenure of office for health officers and also fixes the minimum salary which is to be paid. An additional law was also passed in relation to vital statistics which will greatly improve the .records of the state. been made for coöperation in work already under way at the Massachusetts Institute of Technology in Boston, at the International Y. M. C. A. College in Springfield, Mass., and at the University of Minnesota. (See also XXVI, Sanitary Chemistry.) Coöperation among Public-Health Organizations. An important movement designed to bring about a closer coöperation among the various publichealth organizations in the country has been inaugurated through the acNew York State Commission on tivities of the Council on Health and Ventilation. At the suggestion of the Public Instruction of the American New York Association for Improving Medical Association. A meeting of the Condition of the Poor, a state the executive secretaries of the most Commission on Ventilation has been important organizations interested in appointed "to examine and investi-public-health work, representatives of gate the subject of ventilating systems the U. S. Public Health Service, the in the public schools and other buildings of the state, and the proper installation of the same to the end that a thorough and effective system, which will assure an adequate supply of fresh air, under the best conditions, will be maintained." The work of the Commission is supported by a fund of $50,000, which is a part of a gift made by Mrs. Elizabeth Mil bank Anderson to the New York Association for Improving the Condition of the Poor. The Commission as ap-organizations might be of value. The pointed by Governor Sulzer on June 25 includes: Prof. C. E. A. Winslow of the College of the City of New York, chairman; D. D. Kimball; Prof. F. S. Lee of Columbia University; Dr. James Alexander Miller; Prof. Earle B. Phelps of the United States Public Health Service; and Prof. E. L. Thorndike of Columbia University. Division of Vital Statistics and other Government bureaus, was held in New York on April 12. A committee of 15 was subsequently appointed to take up a consideration of the activities of all the more important public-health organizations, to determine whether or not serious duplication of effort was taking place, whether or not some fields of public-health work were neglected and just how a closer cooperation between the various health subsequent reports of this committee will be awaited with interest. A American Public Health Association. -The annual meeting of the American Public Health Association was held in Colorado Springs on Sept. 9 to 13, and was well attended. large number of interesting and important papers presented will be published in the American Journal of Public Health (289 Fourth Avenue, New York). Dr. William C. Woodward, Health Officer of the District of Columbia, was elected president. The 1914 meeting is to be held in Jacksonville, Fla., Nov. 24 to 28. The Commission has equipped at the College of the City of New York experimental rooms in which detailed studies are to be made during the winter of 1913-14 of the effect of various atmospheric conditions upon bodily efficiency as measured by delicate physiological and psychological New York Association for Improvtests. These investigations will be ing the Condition of the Poor.-A extended and amplified during the new Department of Social Welfare of season of 1914-15 in specially equipped this Association was established in school rooms for which provision has April as the result of the munificence generously been made by the Board of Mrs. Elizabeth Milbank Anderson of Education of the city of New York to foster preventive and constructive in one of the new buildings to be con- social measures for the welfare of the structed during 1914. In addition to poor of the city of New York as disthese studies to be carried out di- tinguished from relief measures afrectly by the Commission, plans have fecting particular individuals and |