Both the Public Health Association and the American Medical Association point to the cruel dangers inherent in the publication of misinformation. The former termed the article "vicious in that it will cause fear in the minds of many readers who are unaware of the craving for sensationalism that apparently was the only motive for this particular diatribe." The latter says: "There is evidence that the article has already produced fear in the minds of some readers." Because both these Associations have the weight of authority and scientific standing, and are respected by the layman, it is too bad that their professional journals cannot carry these editorials directly to the public. Therefore it is gratifying to learn that at least one other popular magazine, Health and Hygiene, has taken sure aim at Coronet's little fairy story. Quoting Dr. Francis Carter Wood, Director of the Institute of Cancer Research at Columbia University, Health and Hygiene in its April issue takes the article apart with a humorous approach that reaches the American mind so quickly. The title of this refutation is "Milk Is Not Cancer's Ally." Readers Digest, father of pocket-size magazines, has published many splendid articles on safety, syphilis control, mental hygiene, education, and other public problems. The editors of Readers Digest cooperate closely with the professions, and with their members who have a right to speak. So do most reputable magazines. Our larger daily newspapers and all syndicated news services assign special writers to scientific subjects, men and women especially skilled in interpreting the findings of science to the public. A comparison of the care with which so many popular articles are prepared, with Coronet's contribution, reveals the necessity for the professions to maintain continuous and active relations with the various media of public information. The United States Public Health Service joins with the American Medical Association and the American Public Health Association in condemning Coronet's type of gross misinformation on matters vital to the public health. Let those concerned with public health education, in particular, be alert to the use of dangerous, inaccurate and sensational materials having no foundation whatsoever in scientific fact. 'Crude statistics have been the undoing of many good things, and de- THE APRIL CONFERENCES OF HEALTH OFFICIALS IN WASHINGTON Four days of conferences on State, national, and international public health problems began April 5th at Washington in the Public Health Service Auditorium. Many important recommendations developed as State and Federal health officials discussed the new problems of public health administration and the rapidly widening fields of public health work. 1. CONFERENCE OF STATE AND PROVINCIAL HEALTH At the initial session of the Conference of State and Provincial Health Authorities of North America, two distinguished members of the British medical profession gave a firsthand story of England's experience in venereal disease control. Dr. Thomas Anwyl-Davies, one of England's leading syphilologists, and Director of the Venereal Diseases Department and Lecturer at St. Thomas' lospital, London, discussed venereal disease from the statistical standpoint. He pointed out that the control of venereal diseases in Great Britain has been in a large measure successful because of the operation of a definite plan during the past seventeen years. Apart from a striking fall in adult infections, the magnificent investment for the future of the venereal diseases program is revealed by the wonderful drop in congenital infections. In five years, congenital syphilitics decreased from 2439 to 2031 per annum. Dr. Anwyl-Davies then went on to exhibit graphs showing the total number of new venereal cases in London since he became associated with the program in 1917, when it was initiated. These graphs demonstrated the small percentage of women who attend clinics in comparison with men, and the astonishingly high proportion of syphilitic females compared with those attending with gonorrhea, approximately three times as prevalent. The problem of the diseased female, who more often than not is ignorant of her dangerous infectivity to the community, indicates a sad weakness in the campaign. "The greatest cause of the spread of syphilis is the cervical chancre, painless and hidden", said Dr. Anwyl-Davies. "Its presence is unsuspected by both sexes." The beneficial effects of readjusting a clinic and reorganizing it to the patients' requirements were demonstrated by his experience as Director of the Whitechapel Clinic in the East End of London from 1930 to 1936. In Dr. Anwyl-Davies' opinion, the declining incidence of venereal disease in Great Britain has been achieved by a combination of psychological, medical, and administrative machinery. Education of the public by radio and newspapers is almost impossible in England, due to the taboo now rapidly disappearing in the United States. Another great difficulty, now being gradually overcome in England, is that of obtaining adequately trained staff of medical officers and nurses. In England, all-day and every-day clinics, at which any one is treated free of charge are provided. Transportation for patients living at a distance from the treatment center is paid for by municipal authorities. Contacts and recalcitrant patients are followed up, and hostels for infected girls are provided. As far as the control of syphilis is concerned, Dr. Anwyl-Davies said, it is only a question of the efficient administration of modern methods of treatment by experienced practitioners, and the supervision of the patient until treatment is concluded. Dr. Anwyl-Davies reported that he has obtained encouraging results with a new gonococcus antitoxin, developed by Dr. Ferry of the Park, Davis Company. All types of cases, complicated and uncomplicated responded equally well. The evidence indicates that the antitoxin is specific in effect, and it would seem that at last a remedy for the treatment of gonorrhea has been evolved which offers considerable promise. CONTROL OF GONORRHEA Dr. Ambrose King, also an outstanding venerologist from Great Britain, presented an interesting paper on the "Control of Gonorrhea." He stated that the future solution of the problem is dependent upon improved facilities for research work and for treatment, and upon the attraction of selected general practitioners into the work. Propaganda designed to break down the barrier of public fastidiousness, Dr. King asserted, must not implant unfounded fears in the minds of patients, who, uninfected but conscience-stricken, seek unnecessary treatment and sometimes sustain lasting mental trauma. No one who has studied fever therapy in the treatment of gonorrhea can fail to have been impressed by the reported results, Dr. King told the Conference. Practical difficulties which hamper the widespread application of this valuable therapeutic procedure do not alter the fact that the ultimate solution will result from close study of the effect of heat upon the gonococcus and upon the immunity processes of the patient. Dr. King said that if we could accept philosophically the present inability to solve the problem of gonorrhea, even in countries where social control has been brought to a fine art, and be content to wait, possibly in the future some inconspicuous and unsupported genius might hit upon a simple solution. The matter, however, is too serious for delay since the years of neglect have produced a state of affairs which is a menace to the safety of the community. Dr. R. A. Vonderlehr, in discussing the papers presented by the British guests of the Conference, said that steps were being taken to try out the gonococcus antitoxin used by Dr. Anwyl-Davies, in New York City. He further recommended that wherever possible, venereal disease clinics should have some type of fever therapy equipment for the treatment of the complications of gonorrhea. PNEUMONIA CONTROL Dr. Rufus Cole of the Rockefeller Foundation Hospital, New York City, in outlining the possibilities for pneumonia control, stated that the experience of the last twenty years strongly indicates that the medical profession alone, unaided by public health organizations and unsupported by public opinion can never make an important impression on the prevalence of, or the mortality from pneumonia, colds, and influenza. Public health authorities were given the bases of proper organization of this work by Dr. Cole, who said that it first requires men well fitted and trained to coordinate laboratory and clinical work. Steps in such a program include instruction of the public in regard to isolation; stimulation of early diagnosis and treatment of pneumonia; the collection and tabulation of records; epidemiological studies; and aid to physicians in the form of diagnostic and consultative services. The public health agency could play an importabt role in lowering the death toll from pneumonia by aiding and supporting the use of specific therapy. This requires, first, ex,pert "typing" since each type of pneumococcus is highly specific in its immunological prop erties. Here, the training of laboratory technicians for this work and the provision of such diagnostic services are functions of the health department, the exercise of which would answer a great need. Dr. Cole pointed out that when health department laboratories cannot produce serums for the treatment of pneumonia, they should at least be prepared to determine the protective value of such serums as they purchase. During the past year, Dr. Cole's associates, Goodner and Hlors fall developed a rabbit serum to be used instead of horse serum for the treatment of pneumonia. This serum, Dr . Cole said, has certain theoretical advantages and can be produced at much lower cost than horse serum. One of the chief duties of health authorities is to impress the necessity of early diagnosis of the type of pneumonia on both the laity and the medical profession. "Most persons threatened with pneumonia have pneumonia", said Dr. Cole. For this reason, doctors must be encouraged to obtain laboratory diagnosis of pneumonia at the earliest possible moment, since several vital days, so far as treatment is concerned, may be lost if the doctor awaits physical signs of consolidation before liagnosis of pneumonia is male. ACCIDENT PREVENTION Following the reading of a paper on "Accident Prevention", prepared by Mr. 4. V. Rohweder, Vice President of the National Safety Council, a report to the Conference was made by the Committee on Accidents. It was recommended that State health departments assume an increasing responsibility in the promotion of accident prevention programs. Health departments should not only check the completeness of fatal accident death reports, but also apply epidemiological principles to accident prevention. It was suggested that State and Provincial Health Departments undertake special stulies of accidental deaths during the current year, with special reference to home accidents. Cooperation with the Federal Division of Vital Statistics in its efforts to extend the study of fatal accidents was recommended. The Report of the Committee, headed by Dr. Earle G. Brown, chairman, included a partial study of the reporting of fatal accidents in States and Provinces. Special studies and campaigns in New York, Rhode Island, and Kansas were described. Appended to the report is a Summary of Accidental Death by Type of Accident and Age Groups 1931-1936 from the Kansas records. MILK CONTROL Federal and State courts in this country have consistently upheld all reasonable regulation of market milk by public health authorities, stated Dr. James A. Tobey in his paper on "Court Decisions on Milk Since 1934." Dr. Tobey, who is also consultant with Mr. L. C. Frank of the United States Public Health Service, to the Committee on Milk of the Conference, outlined seventeen important decisions on milk sanitation. Pasteurization requirements by State and city authorities have been sustained by courts in ten States. A recent California decision upheld a municipal ordinance prohibiting the sale of pasteurized milk unless pasteurized within the city. Not all courts, Dr. Tobey declared, have been willing to hold valid the requirement that milk must be pasteurized only in the city where it is sold. He advised State health officers not to concern themselves with the economic control of the dairy industry but to devote their attention to public health measures only. The Committee on Milk, of which Dr. I. C. Riggin is chairman, recommended that the State aspects of public health control of milk supplies, including such dairy products as ice cream, butter and cheese, be made the function of the State health department. It was further recommended that all laws and regulations for the public health supervision of milk supplies should include uniform requirements, at least equivalent to those contained in the Public Health Service Standard Milk Ordinance. A comprehensive milk sanitation program undertaken by all State health departments with the assistance of Social Security funds was recommended. Further recommendations for the control of undulant fever through testing of herds supplying raw milk for consumption in the raw state, the control of goats milk supplies, and for dispensing regulations were made. The regional milk sanitation courses for State and local milk sanitation personnel, inaugurated in certain States last year by the Public Health Service, were approved, and it was recommended that these courses be extended all through the country. NON-RESIDENT DEATH RATES AND LOCAL HEALTH Asserting that the development and increasing use of hospitals, as well as the growing migratory habits of the American people are having an important effect on the evaluation of health conditions in any locality, Dr. Halbert L. Dunn, Chief Statistician of the Division of Vital Statistics, told the Conference that many State departments of health are now making special studies of the non-resident problem. Such studies Dr. Dunn recommenled should be continued and extended. The Division of Vital Statistics, he said, has recognized the importance of this subject since 1900, and has published tables showing nonresident death rates since 1914. A POLIOMYELITIS EPIDEMIC IN MANITOBA A unique system of control in the 1936 epidemic of poliomyelitis in Manitoba was reported by Dr. F. W. Jackson, Deputy Minister of Health of that Province. Because people delayed consulting a physician early in the course of the disease, many cases were brought in for attention only after paralysis had supervened. Hence, "a Province-wide system of what might be called 'State Medicine' was set up", said Dr. Jackson. Local authorities provided that anyone suspecting symptoms of poliomyelitis in any individual within his charge might summon a physician at the expense of the locality. If the diagnosis proved to be poliomyelitis, the doctor continued the service and billed the local authorities. He was entitled, of course, to fees for all cases brought in for diagnosis, whether the cases proved to be poliomyelitis or not. The medical profession cooperated by agreeing to a special schedule of fees for these services, amounting to about two-thirds of the regular schedule. Once this system was put into effect, Dr. Jackson said, "we had an immediate improvement in the end results of cases." A complete survey of all cases was made, subsequent to the epidemic. Those with residual paralysis were located, and the Department of Health engaged a competent orthopedic surgeon to visit the local areas. In consultation with local physicians, he prescribed the necessary remedial treatment. Local authorities or voluntary agencies assumed the responsibility for the after-care of the indigent patients. As a result, said Dr. Jackson, "it looks as if there will not be more than six or seven totally and permanently disabled persons following the epidemic." GEOGRAPHY OF DISEASE Dr. William B. Brierly, geographer of the Carnegie Institution of Washington, presented |