weights were compared with standard measurements, so that the ratio of actual weight to average weight for height could be determined for each child. The children represented four school grades. Different conditions were provided for these four classes and an attempt was made to determine to what extent various methods of procedure were successful. These conditions were grouped under the following captions:

(1) Instruction in health habits including proper habits of eating; sufficient mastication; regular meals, the cutting out of stimulants such as tea and coffee.

(2) Removal of physical defects, such as adenoids, enlarged tonsils and defective teeth.

(3) Rest and lunches.

(4) Direct feeding,-to provide for cases of malnutrition, due to inhability to procure the necessary food.

One group of children was given only a midday meal, which was supposed to meet all the demands in the way of quantity and quality of food. Another group was given only instruction in health habits, with recommendations for rest and food and the removal of physical defects. Another group was given the instruction in health habits and provision was made for rest periods and mid-morning lunches, with recommendations for the removal of physical defects. Still another group was given all of the provisions so far mentioned. Comparison of results in these different groups shows that the poorest progress is made where nothing is provided except a sufficient quantity of food. The greatest progress was made by the children who were instructed in health habits, and who were simply advised to have frequent intervals of rest and more frequent meals.

Preventive Value of Industrial Nursing

A new method of attacking the tuberculosis problem is reported from Massachusetts. The plan has to do with the promotion of industrial nursing and is being carried on by the Massachusetts Committee on Health in Industry which is a joint committee of the Boston Association for the Relief and Control of Tuberculosis and the Massachusetts Tuberculosis League. The committee is interested not only in establishing full-time nursing service but in stimulating visiting nurse associations to arrange with local employers for a supervising service in the smaller plants. The secretary of the committee interviews employers to interest them in providing nursing service, helps them with plans for the necessary rooms, submits lists of equipment, supplies public health nurses and continues in an advisory capacity when called upon by employer or nurse. For such service there is no charge. Various measures for the prevention of illness fall within the province of the industrial nurse: The sanitation of the plant, the detection of physical defects in their in

cipiency, the prevention of occupation disease and of the introduction and control of communicable disease, the adaptation of the work to the physical condition of the worker and the education of the worker in methods of keeping well.

The committee is responsible for nursing supervision of the health of approximately 150,000 people in Massachusetts. There are now over 200 industrial nurses in the state,a good proportion of whom were placed through the efforts of this Committee. The Secretary has been instrumental in organizing an industrial nurses club with a membership of over a hundred which meets once a month and discusses problems pertaining to industrial nursing.

A New Medical Specialty

The revolution of conception in regard to tuberculosis constitutes one of the most remarkable and interesting chapters in the history of modern medicine according to Dr. George Thomas Palmer. In a recently published monograph called "Tuberculosis-A Medical Specialty Through Popular Demand," Dr. Palmer emphasizes the change in attitude which has lately developed. Until very recently pulmonary tuberculosis from the standpoint of the majority of the medical profession was of less importance than either typhoid fever or appendicitis. Within the past two decades, however, there has come about a radical change in attitude, through which the diagnosis, treatment and management of the disease have come to constitute a distinct specialty. A medical specialty, according to Dr. Palmer, is a branch of medicine requiring exclusive application on the part of the practitioner to permit him to develop the high degree of technical skill essential to his successfully engaging in it.

"A more practical, if not commercial, definition of a specialty is a field of medicine in which the demand is so general as to warrant or require the full-time service of considerable numbers of physicians to meet the public need. Measured by this definition, tuberculosis stands out throughout the entire Nation, and particularly in Illinois, as a specialty of the first magnitude."

Thirty-three Illinois Counties have voted within the past year to establish sanatoria and now they are confronted with the problem of securing suitably trained physicians for the institutions. Unlike other specialties interest in tuberculosis has developed largely outside the medical profession. "The general public has continued to agitate the tuberculosis problem until it has provided remarkable medical machinery for which it is asking the medical profession to supply expert guiding hands. The public has created a medical specialty for the medical profession to man when the medical profession is prepared to do it." Copies of this pamphlet-Monograph No. 1—may be secured from the Illinois Tuberculosis Association, Springfield, Illinois.

The Iowa Trudeau Society

On the call of Dr. John H. Peck, President of the lowa Tuberculosis Association, twelve physicians from almost as many different Iowa cities met in Des Moines on May 9th and organized the Iowa Trudeau Society as a clinical branch of the State Association. Or. Ethan A. Gray, of the Fresh Air Hospital, Chicago, outlined the advantages of such an organization as they have been demonstrated in the Robert Koch Society of that city. Frankly acknowledging the responsibility for the early recognition and diagnosis of tuberculosis as a load that can be carried by the medical profession alone, the men talked to the text which was aptly offered by one of the first speakers, "The Tuberculosis Problem is the Doctor." Ways were pointed out to indicate how, by joining together, the medical men interested in tuberculosis could help each other and at the same time interest other medical men over the state in this important problem. Clinics and papers at County Medical Society meetings, a periodical bulletin, the use of a loan library maintained at the headquarters of the State Association, are among the means which the Society contemplates using to secure its ends. Every physician qualified to practice in the State of Iowa will be entitled to membership on request or declaration of interest. No dues are to be charged. The incidental expenses of the Trudeau Society will be carried by the Iowa Tuberculosis Association and the Executive Secretary of the latter organization is to serve as the Society's secretary. Dr. Peck was elected the first president and Dr. H. V. Scarborough, Superintendent of the State Tuberculosis Sanatorium at Oakdale was named as vice-president.

The Cost of Measles and Mumps During the spring of 1918 the city of Riverside, California, in common with other cities of the State was visited by an epidemic of mumps, measles and German measles. Unlike many towns, Riverside was alive to the seriousness of these epidemics and a survey was made of the contagious disease situation in the elementary schools of the city with a view to bringing the problem to the attention of the Board of Education, the physicians, and the people of the town. A census covering the greater part of the school year was taken of cases of contagious diseases. The results of the census, covering the number of cases, total days lost, etc., are reported in a recent Bulletin of the California State Board of Health. It is impossible to obtain any figures on the most important phase of the matter,the sum of the lasting effects which these diseases had on the children affected, or on the retarded school program resulting from illness or absence, but on the purely financial side there are some interesting figures. The average cost of education per pupil per day in Riverside was 30 cents. If a child is absent the expense is the same but the money is wasted; this amounted to $1,381.50. In addi

tion, the State and county appropriation for the following year is based on the average daily attendance for this year; and because of some 4,000 days lost the Riverside School district will lose over $800 as a result of contagious disease. In consequent of the findings certain recommendations were made to the Board of Education. As the initial step in combatting contagion open open air schools are advocated. Among the other measures proposed are instruction of the children in the practical fundamentals of hygiene; the instruction of teachers in regard to early symptoms; close cooperation between the health officer and the school authorities and the employment of a school physician.

Memorial to Dr. Sachs

A memorial tablet in honor of the late Dr. Theodore B. Sachs was dedicated on Sunday, June 1st, at his grave on the grounds of the Edward Sanatorium at Naperville, Illinois. Quite in harmony with Dr. Sachs' life and work is the memorial,-a large glacial boulder on which is fixed a bronze tablet. The monument was erected by the Directors of the Chicago Tuberculosis Institute, the patients of the Edward Sanatorium and the Jewish Consumptives' Relief Society of Chi

cago.

Objections to Compulsory Health

Insurance

it

"To establish compulsory health insurance would be one of the most serious mistakes that any commonwealth could possibly make." This statement was made by Dr. Edward O. Ochsner of Chicago in a recent pamphlet entitled, "Further Objections to Compulsory Health Insurance." Dr. Ochsner supports his conclusion with the following reasons: would be bound to lower the quality of medical services rendered to its citizens, it would increase loss of working time for sickness; it would throw an enormous financial burden upon the taxpayer, the employer and the employee, it would greatly reduce the incentive to thrift and industry and put a premium on deception, sloth and shiftlessness, and compel the industrious, hard-working, clean-living, workman to pay tribute to the untruthful, lazy, shiftless and immoral, and finally, it would have a tendency to take from independence and self-reliance its proper pride and from dependency its salutary shame. Copies of the pamphlet, Bulletin No. 10, may be secured from the Insurance Economics Society of America, Majestic Building, Detroit. Ex-Patients in War Service

On the honor roll of the Nopeming Sanatorium (Minnesota) are the names of nine former tuberculosis patients, headed by Dr. W. M. Hart, first superintendent of the Sanatorium and now lieutenant-colonel in the British Army. Before coming to Duluth, Dr. Hart was at one time a patient at Trudeau Sanatorium. At the outbreak of the war he enlisted in the Canadian Army, was sent overseas and at the

battle of Ypres was captured by the Germans. After a sojourn in a prison camp he was exchanged and saw fighting in later battles, and is now in charge of the army hospital in Kent, England. Besides Dr. Hart there are at least four others who have taken the cure at Nopeming, have seen service overseas, and have kept their health in spite of wartime hardships.

Tuberculosis in Switzerland

From Switzerland it is reported that tuberculosis increased steadily during the war. The cases and deaths in the Swiss army increased during mobilization from 107 cases and 25 deaths, in 1914, to 1,244 cases and 105 deaths in 1917. It is stated that during four years, about $1,000,000 has been spent by the military insurance department in caring for the tuberculous and in paying indemnities to families of those whose deaths were due to the disease.

Missouri Public Health Conference Conducted under the auspices of the Springfield Chamber of Commerce cooperating with the Missouri Tuberculosis Association, the Missouri Public Health Conference was held from May 29th to June 1st. The object of the conference was to bring together national and state leaders in health work, health legislation, and education for a conference on the state-wide public health educational program which has been instituted by the Missouri Tuberculosis and its affiliated societies. On the program were a number of prominent educators and specialists in public health work, as well as representatives of the United States Children's Bureau, the Surgeon General's office, the American Red Cross and the National Tuberculosis Association.

Personals

Sir Arthur Newsholme who has come to the United States, following the Red Cross conference at Cannes, France, has accepted the chair of hygiene in the new School of Public Health of the Johns Hopkins Medical School.

Miss Etta M. Dobbin has succeded Mrs. M. E. Hefferon as secretary of the Wyoming Public Health Association.

Dr. J. S. Lock has accepted the position of executive secretary of the Kentucky AntiTuberculosis Association.

Miss Margaret S. Purvis has been appointed field nurse of the Red Cross Seal Commission of South Dakota.

John W. Jacobs has been appointed executive secretary of the Utah Public Health Association, succeeding Frank W. Le Clere.

A public memorial meeting in tribute to Dr. John H. Lowman was held on June 1st in the Memorial Chapel of Western Reserve University, Cleveland. Addresses were made by Dr. William T. Corlett and Dr. Samuel Ball

Platrer.

NATIONAL ASSOCIATION

RESOLUTIONS

The National Tuberculosis Association at its recent meeting in Atlantic City went on record through resolutions adopted as favoring a number of important movements including the daylight-saving law, a plan for universal military training, the movement for physical education in the public schools, and the bill now before Congress creating a division of tuberculosis in the United States Public Health Service. The resolutions as adopted follow:

Daylight Saving

"WHEREAS, The National Tuberculosis Association has always advocated a maximum amount of sunlight and fresh air as a means of prevention and cure of tuberculosis, and

"WHEREAS, The said Association considers the present daylight-saving law an aid in preserving the general health of the country and, particular, a help in the prevention of tuberculosis, be it

"RESOLVED, That the National Tuberculosis Association views with concern the present effort to abrogate the daylight-saving law, and hereby protests against any effort that shall tend to stop the operation of that law."

Universal Service

"BE IT RESOLVED, That the National Tuberculosis Association through its executive officers take immediate steps to secure the co-operation of all other great health organizations, especially the American Medical Association and state and territorial health officers in placing before the American people a united demand for the adoption of universal military service as a public health measure."

Physical Education

"WHEREAS, The introduction of physical education into the schools, including instruction in health principles, direction in physical activities, and periodic physical examinations, is of vital importance in the prevention and combatting of tuberculosis, and

"WHEREAS, The National Physical Education Service has been established for the purpose of unifying the efforts of all interested organizations for the promotion of physical education in the elementary and secondary schools, therefore

"BE IT RESOLVED, That the National Tuberculosis Association will co-operate in every practicable way with the National Physical Education Service in the promotion of physical education in the schools."

Division of Tuberculosis

"WHEREAS, It has become increasingly apparent that a Division of Tuberculosis of the U. S. Public Health Service is necessary and that the creation of such a division will be the greatest step forward in the struggle

living and dead tuberculosis cases in each block in the two districts.

New National Association Officers

At the recent annual meeting of the National Tuberculosis Association, the following officers and members of the Executive Committee were elected:

President-Dr. Victor C. Vaughn.

Honorary Vice-Presidents-Sir William Osler and Col. George E. Bushnell.

Vice-Presidents-Dr. Gerald B. Webb and Mr. John M. Glenn.

Secretary-Dr. Henry Barton Jacobs.
Treasurer-Mr. Henry B. Platt.

The following were elected to serve on the executive committee: Dr. E. R. Baldwin, Dr. George T. Palmer, Dr. William Charles White, Dr. Vincent Y. Bowditch, Dr. George M. Kober, Dr. Hoyt E. Dearholt, and Mr. William H. Baldwin.

In addition the following directors were also elected:

Dr. Z. T. Scott, Austin, Texas.

Mr. Henry B. Platt, New York, N. Y. Dr. Henry W. Hoagland, Colorado Springs, Colo.

Dr. Walter R. Steiner, Hartford, Conn. Dr. Gordon K. Dickinson, Jersey City, N. J. Dr. W. L. Dunn, Asheville, N. C. Dr. Paul A. Lewis, Philadelphia, Pa. Dr. John S. Billings, New York, N. Y. Dr. Harry T. Marshall, University, Va. Dr. Henry H. Peck, Des Moines, Iowa. Dr. Charles V. Chapin, Providence, R. I. Mr. James H. Pershing, Denver, Colo. Mr. Fred M. Stein, New York, N. Y. Dr. Lee K. Frankel, New York, N. Y. Dr. Josephine Milligan, Jacksonville, Ill. The following list of officers and members of the Executive Committee and Board of Directors of the National Tuberculosis Association were elected at the Atlantic City meeting:

President-Dr. Victor C. Vaughan, Ann Arbor, Mich.

Honorary Vice-Presidents-Sir William Osler and Col. George E. Bushnell.

Vice-Presidents-Dr. Gerald B. Webb and John M. Glenn.

Secretary-Dr. Henry Barton Jacobs.
Treasurer-Henry B. Platt.
Executive Committee:

Dr. E. R. Baldwin, Saranac Lake, N. Y.
Dr. George T. Palmer, Springfield, Ill.
Dr. William Charles White, Pittsburgh, Pa.
Dr. Vincent Y. Bowditch, Boston, Mass.
Dr. George M. Kober, Washington, D. C.
Dr. Hoyt E. Dearholt, Milwaukee, Wis.
Mr. William H. Baldwin, Washington, D. C.
Directors:

Dr. Z. T. Scott, Austin, Texas.

Mr. Henry B. Platt, New York, N. Y.
Dr. Henry W. Hoagland, Colorado Springs,
Colo.

Dr. Walter R. Steiner, Hartford, Conn.
Dr. Gordon K. Dickinson, Jersey City, N. J.
Dr. W. L. Dunn, Asheville, N. C.
Dr. Paul A. Lewis, Philadelphia, Pa.