tice that in river valleys where anopheles are relatively scarce, anopheles often become excessively numerous as the river waters are impounded. In the construction of our roads and railroads, culverts are often so placed as to prevent effective drainage of the lands above the culverts. Borrow pits and wide bottom ditches are so constructed as to be permanent sources of anopheles. In the irrigation regions, malaria increases with the extension of the territory irrigated. This is due largely to improper design of the water canal borrow pits. And, in recent years, we are building many lakes for recreational and fishing purposes. Camps are being established close to these artificial lakes. The travel to such places has enormously increased with automobile transportation. Also for conservation of wild life and with the establishment of State park lakes, without residential restrictions, we are creating dangerous conditions. It seems probable that we may soon have many more malaria carriers in the suburbs of our towns, and it is essential that we build the malaria mosquito out of existence in these residential zones. It is not difficult to visualize a decidedly large increase in size of what we term our malaria belt. Indeed, it looks as though the malaria belt of the near future may include the hill country as well as the river valleys. EXTENSION COURSE IN PUBLIC HEALTH The New York State Department of Public Health again held its annual extension course in connection with the Conference of Health Officers and Public Health Nurses at Saratoga Springs during the week of June 21. The program of the extension course included the following addresses: The Local Health Officer's Part in the Maternity and Infant Health Program--Dr. Changes in the Public Health Law and the Sanitary Code Affecting the Work of Lo- - Dr. Edward S. Rogers, Di Importance of the Health Officer in Pneumonia Control Community Organization for Tuberculosis Work--Mrs. Bessie Paige Hansen, Executive How the Public Health Officer May Capitalize Mental Hygiene Values as an Integral Some Studies of Recent Outbreaks of Communicable Disease--Dr. Hollis Ingraham, Public Health Problems Involving Local and District Health Officers--Dr. Burke S. The Physician's Opportunities in the Statewide Orthopedic Service--Dr. Walter J. Chemical Composition and Characteristics of the Saratoga Spring Waters--Herbert Therapeutic Uses of the Saratoga Spring Waters--Dr. Walter S. McClellan, Medical HOW WOULD YOU ANSWER THIS ONE? A LETTER FROM THE FILES OF THE UNITED STATES PUBLIC HEALTH SERVICE United States Public Health Service Dear Sir: Last November a Doctor here gave me a series of injections without expressed reason except that I had a headache. They completely destroyed all coordination and balance in bodily control. In fact my resistance was so completely gone I could gain no strength and continued to have pain in chest, back, abdomen, eyes and head. In February I consulted a City Doctor who discovered I have tuberculosis in both lungs. I could hardly believe it for I was said to show no signs of tuberculosis when dismissed from hospital in December 1936. He also said that the injections I had taken were to prevent me from having children. Some of the shots (four) were Theelin. What could the others have been? Is there any hope that sterilization may not have been complete or that I could ever be well again? Do you need details of my reactions to answer that? How could one identify other preparations with same purpose? Is an oilly substance to be rubbed into a child's skin one of them? We were told to rub one drop of oil on the child every second night. Or is it true that there is such a substance that will prevent tuberculosis? If there is such a substance why would the Doctor be unwilling to tell me its name or anything else about it? Please give me this information and your source or authority. Even should this not come under the regular duties of your department, will you not help me because of my suffering and so great need? Thank you very much. Yours truly, P. S. I have three children. Here is one of those letters which are, according to Bauer and Hull in their recently published manual on "Health Education of the Public" (W. B. Saunders Co., 1937). "an exceedingly valuable index to the state of the public mind with respect to health." If we accept the above communication as such an index (and there are too many like it to regard it as exceptional), the state of the public mind is a fog on many fundamental as well as controversial facts. While her physicians may have deemed the correspondent incapable of intelligent comprehension, it would seem that considerable mental anxiety in this case could have been eliminated by frank and thorough information from those familiar with the patient. That she found it necessary to turn to an outside source for the information she needed to set her mind at rest, is unfortunate since it is extremely difficult, and sometimes hazardous to answer such questions without seeing and examining a patient. Yet, such a letter deserves a frank and comprehensive answer in so far as is possible. This letter runs the gamut of ignorance from such fundamental matters as the causation and prevention of tuberculosis to such a controversial, but in no way mysterious subject as glandular therapy. Perhaps a few minutes of sympathetic explanation of the nature and probable effects of the injections given would have prevented that distrust in medical science which so often breeds confidence in quackery. Such misconceptions as the following, found in the above communication, are current in the public mind, more prevalent than the professions might expect, and may frequently be brought to the public health official for clarification: 1. The patient believes that mysterious injections of biologic products 2. The patient believes that theelin, which has been experimentally used How would you answer this one? BOOK REVIEWS PSYCHOLOGY AND THE SOCIAL ORDER. J. F. BROWN. MCGRAW-HILL Book Co., INC., NEW YORK. 1936. 501 PP. $3.50. Social psychology investigates the behavior and reaction of the individual with regard to his fellow men whether as individuals or as groups. It is concerned with the effect of the group on the behavior of the individual and that of the individual on the behavior of the group. Hence, the reviewer feels that this book by Professor Brown of the University of Kansas should be read by all physicians, especially public health physicians. Perhaps, it would be even better if the subject matter here covered were a pre-medical requirement although there is some reason to believe that Dr. Brown's point of view can be better appreciated after one has finished medical school. In his treatment of social psychology the author has taken an entirely new approach. He has, for the first time, applied to social psychology the mathematical conception applied by Lewin* to problems of individual psychology. To put the thesis as briefly as possible, Brown believes that human behavior is subject to the law of cause and effect and that behavior is predictable within certain limits, provided we know the underlying structure of the social fields in which the individual has "membership-character." In time of war, for example, there is usually a complete "restructurization" of the entire social field with consequent predictable changes in mental attitudes and behavior patterns. All psychological and social behavior may be ordered to psychological and social fields which can be represented, according to Brown, as mathematical spatial constructs. This is, we believe, a rather startling point of view to a surprisingly large number of scientists and physicians who cling to the belief that there will always be something incommensurable in human behavior and human nature. H. G. Wells said that because of the complexity of human behavior, sociology could never become a science. Karl Pearson said that sociology awaits the obstetrical genius of a man of the calibre of Pasteur before sociology can be born and take its place among the sciences. No one should attempt to absorb the contents of "Psychology and the Social Order" by reading a few pages each night before going to sleep. The first section, especially, on Methodology is difficult reading and is appreciated most after the rest of the book has been finished. In the Psychology section personality is defined as "Neither the gift of God nor the possession of the individual by the devil. It is but little determined through individual heredity.......Personality is not a constant thing but changes radically with changes in social field structure.....It is determined primarily in the way in which individuals meet blockages in their psychological field." Genius is defined paradoxically as "simply insanity which has a practical value. Several contemporary geniuses would be in asylums were it not for the fact that their delusions have a sale value." In the section on Political Science the author admits an anti-facist bias, "because it is daily more obvious that facism is antiscientific." Whether one agrees with the political implications of the author's study or not there is much valuable material here for physicians who wish to keep abreast of modern social trends. All who are engaged in the practice of either preventive or curative medicine now recognize that man is a socio-psycho-somatic organism and they are just as much interested in the behavior, normal and abnormal, of the individual as a whole as in the behavior of the various organs or parts of the body. —R. R. SPENCER. *Lewin, K., Psychol. Forch. 1926. Vol. 7, 294-329. "PREPARATION FOR MARRIAGE". ERNEST R. GROVES, GREENBERG PUBLISHERS, PRICE $1.50. 1936. PP.124. It has been facetiously remarked that the re are three kinds of marriages, those in which the man dominates the woman, those in which the woman dominates the man, and those in which the fight is still going on. There is as much truth as humor in this statement for successful marriage is not a gift; it is an achievement. It requires a fight and a struggle just as all other worthwhile things in life. We do not get married to get tested; nevertheless marriage is a proving ground which will bring out the best and the worst in the average individual. Children who have been pampered and raised in a sheltered environment do not easily relinquish their infantile tendencies, and no one with infantile tendencies should consider marriage as a career. At bottom, biological ignorance or ignorance of life is the chief cause of most marital difficulties. Successful marriage requires much knowledge, and modern educators are beginning to supply that knowledge, which is good evidence that they doubt the old doctrine that marriages are made in heaven. Dr. Ernest Groves, the author of "Preparation For Marriage," pioneered in education for marriage and family life, and was the first to start in this country (at the University of North Carolina) a college course preparing young graduates for successful marriage. "Preparation for Marriage" is the first of a series of books, the author states, designed to meet the needs of those who wish knowledge in the field of marriage, the family or mental hygiene. We can heartily recommend this book to physicians and health officers who wish to pass this knowledge on to those who are seeking such information. On the cover of the book we find the statement that "It is neither sentimental preachment nor obscure, theoretic analysis, but a frank, helpful discussion of health, heredity, confessions, parenthood, birth control--including the natural method--pre-marital examination of both man and woman, legal qualifications, income, budget-making, housekeeping and domestic policy as these are related to a modern, scientific preparation for marriage." R. R. SPENCER PROSTITUTION: AN INVESTIGATION OF ITS CAUSES, ESPECIALLY WITH REGARD TO HEREDITARY FACTORS. BY TAGE KEMP. ENGLISH TRANSLATION BY ELSIE-MARIE WERNER KORNERUP, B.A. Co PENHAGEN: LEVIN & MUNKSGAARD, EJNER MUNKSGAARD, 1936. PRICE 12 KR. ($3.999 PP. 253. This book deals with prostitution and its causes, with special reference to hereditary factors. It is the result of a series of investigations made in Copenhagen between 1931 and 1935, during which time 530 prostitutes were given a medico-psychiatric examination with special attention paid to inherited traits. The book contains 50 case records in full. The author approaches his subject from a purely objective standpoint, regarding prostitution as a biological phenomenon without harboring moral or political prejudices. He points out, however, that it is impracticable to avoid entering into the social conditions and legal interpretations which form an ever-present background for this problem. The investigation was begun at the request of Police Superintendent Schepelern-Larse, who for 30 years has been Chief of the Health and Morality Police in Copenhagen. The psychiatric work was done under the general direction of Professor August Wimmer, Director of the Psychiatric Clinic of the University of Copenhagen, assisted by Doctor G. E. Schroder and Doctor Max Schmidt. Assistance was rendered in the genetical problems by Professor Oluf Thomsen, the Director of the University Institute of General Pathology in Copenhagen. The book deals with a brief historical account of prostitution; details of the method and extent of investigation; the causal significance of hereditary factors in prostitution; relationship of environmental influences in childhood and adolescence. The mental quali ties and abnormalities of prostitutes is discussed with reference to bodily illness and with special reference to venereal disease. Conditions affecting adult situations such as poverty, unsatisfactory working conditions, family and social problems are briefly reviewed. The application of correctional procedures and measures is also touched upon. The last chapter of the book is devoted fairly complete bibliography. to a summary and conclusion, followed by a The author points out that only 29.4 per cent of the cases examined were mentally nor mal or without defective intelligence. Of those examined 22.5 per cent were pronounced psychopaths; 0.8 per cent were imbeciles; 6.8 per cent were morons; 19.1 per cent were regarded as dullards; and 23.2 per cent were below the average or retarded, whereas 36 per cent had committed actual criminal offenses. The study indicates that the majority of prostitutes are below normal mentally, but this abnormality was insufficient for a court to declare such individuals incapable of managing their affairs. It was thought from the study that they belong to a "borderline" group of psychopathic characters and that many of the same type were found among the collaterals of their family. All seemed to lack the ability properly to adjust themselves socially or they were actually anti-social in their adaptations. The case records cited illustrate the way in which society deals with these borderline groups, often highly unsuited for the purpose, and that legislation and administration of the subject has frequently proven unsatisfactory. The author comments that "if we reflect to where and how widely eugenic sterilization could have been advantageously undertaken in these families, we come to the conclusion that the possibility of carrying out rational, effectual sterilization on a firm scientific basis, on a certain social group such as is represented here is in reality slight." The ways and means suggested by the author to improve the existing conditions would include an educational program for parents, guardians, school authorities, homes, reformatories, police authorities and courts with reference to psychopathic abnormalities of the borderline type; with the necessity for obtaining psychiatric assistance and guidance for the disposition and treatment of such persons; and with such regulations as may be necessary for the extensive use of psychiatric examinations in connection with the legal disposition of prostitutes. The author also calls attention to the necessity for permanent community supervision of the "slightly mentally defective person" not requiring institutional care, by such agencies as boards of guardians that may exercise supervision over adolescents and the general supervision of persons discharged from homes, reformatories, mental hospitals, and those released from prisons and workhouses. The recommendation again appears to the effect that efforts should be made to detect the difficult and mentally defective children already in school, and to arrange for the special training of those who cannot profit by the usual course of study, keeping such persons under constant guidance during the compulsory education period. The book recommends, for mentally abnormal prostitutes who are not defective enough to be placed in mental hospitals or institutions for the feebleminded, that they not be subjected to police control, fines and imprisonment, but be placed under some type of provident care and control, or perhaps in an institution especially suited to their needs. The need for "mor ality police," cooperating with public welfare institutions more extensively than has been the custom, is recommended, and that the practice of imprisoning and fining prostitutes such as is now the case is neither suitable nor necessary for the solution of the problem. The author recommends the general reduction of social inequality and especially the improvement of working conditions for female servants.--WALTER L. TREADWAY, ASSISTANT SURGEON GENERAL, MENTAL HYGIENE DIVISION, U.S.P.H.S. RURAL HEALTH PRACTICE. HARRY S. MUSTARD, M.D. THE COMMONWEALTH FUND, LONDON, 1936. 603 PP. PRICE, $4.00. Doctor Mustard who was Associate Professor of Public Health Administration in the school of Hygiene and Public Health of Johns Hopkins University from 1930 to 1937, will this fall assume new duties in New York University School of Medicine. The value of his book is further guaranteed by the fact that he has also had extensive practical experience in the |