to push along to the best of his ability the campaign for equipment. which will make his county an effective fighting unit in the war against tuberculosis now become a phase of the great war for democracy. Any information or advice desired by county officials or by individuals interested in laying this matter before their county officials will willingly be furnished, upon application, by the State Department of Health. Outlines of just how to go about founding a hospital and concise statements of the exact tuberculosis situation in every county are available. Scarlet Fever Danger Emphasis laid in an article in last month's to Children From 2 to 10 Ohio Public Health Journal upon the dangers of whooping cough and measles to child life should not have the "reverse English" effect of causing the importance of scarlet fever to be underestimated. As shown by figures which accompanied the article mentioned, scarlet fever, during the five-year period 1911-15, caused fewer deaths than did either of the three other important childhood epidemics. Nevertheless, a death total of 1,666 in five years is by no means a small one. Furthermore, analysis of the four totals shows that for one period of life scarlet fever stands not fourth but second. From the child's second birthday anniversary to his tenth, scarlet fever is a far more. threatening disease than either measles or whooping cough. The death totals of these three diseases and of diphtheria for this period of life are: Diphtherial Scarlet fever Whooping cough 2.811 1.073 618 475 At ages under two, there is no comparison between the enormous death toll of measles and whooping cough and the small one of scarlet fever. After the tenth birthday, however, scarlet fever continues to be surpassed only by diphtheria, until the twentieth birthday, when measles overtakes it. The figures for this period, while not quite so pertinent to a discussion of childhood diseases as those above, are here given, for the same five-year period: The latter part of winter and the early part of spring bring most of the scarlet fever deaths. The rate falls to its lowest point in late summer. The present, therefore, is in the midst of the scarlet fever season, and is the time when physicians, health officials and parents should be exceedingly watchful for symptoms. Protect the babies against whooping cough and measles, and educate their mothers to consider these diseases seriously. But at the same time be sure to protect their slightly older brothers and sisters against the deadly ravages of scarlet fever. Embalmers Must Register The attention of local boards of health and of embalmers is called to the fact that embalmers' licenses and renewals of such licenses, issued by the state board of embalming examiners, must now be registered with the State Department of Health and not with local boards. Section 1343 of the Ohio General Code, as amended in 1917, says, after prescribing the details of the issuance of embalmers' licenses: The person to whom the license is issued shall register such license with the state board of health either by mail or in person. The same section, after providing for the renewals of licenses, continues as follows: Each license renewal card shall be registered in like manner as the license originally issued. Despite this provision of law, not more than 300 of the 2,700 embalmers in the state have registered the renewal of their licenses for 1918. It seems probable that many of those who are failing to comply with the law are not aware of the change which has been made. To obtain greater publicity for the new mode of procedure, the State Department of Health requests local boards to inform embalmers who may come to them to register their license renewals, that such registration must be with this Department. It also requests them to urge promptness in registering. The "Why" of Smallpox a Graphic Illustration A typical answer to the question of why Ohio is now experiencing an unusual prevalence of smallpox is found in a recent report of a State Department of Health investigator, submitted after he had visited one of the infected localities. Here are two quotations which tell the story, not only for this particular town but for many others as well: "The health officer reported that much of the difficulty regarding the quarantine of these cases developed as a result of a difference of opinion among physicians regarding the diagnosis of these cases. A physician, residing in a nearby village, who had treated several of the milder cases, made a diagnosis of chickenpox, and because he had not recommended quarantine, the cases had been permitted to run at large." "The first case known to have developed in the village was in the person of the local hardware dealer. An effort on the part of this man to avoid quarantine and publicity regarding the disease is supposed to be responsible for the spread of smallpox in the village." * * Wrong diagnosis by physicians, failure of the health officer to cope with the situation, selfishness on the part of infected persons who were unwilling to take necessary measures to protect others—there you have a story which has been repeated with minor variations in many other places. Physicians must have regard for the safety of the community as well as for the feelings of their patients. Health officers must be active and thorough in their work. Victims must accept the situation gracefully and submit to necessary restraints. Only by these means can Ohio rid herself of smallpox. Failure to Vaccinate Another important contributing cause in the Another Frequent Cause spread of smallpox is lack of general protection through vaccination. How serious this lack is in some localities is shown by results of recent examinations of children in country schools of Ross County by Dr. D. E. Robinson and other United States Public Health Service officers who are in charge of sanitation in the Camp Sherman zone. Of 258 children examined in 13 schools, 238 had never been vaccinated. Think of the epidemic which would be caused by the accidental introduction into such a group as this of one case of smallpox! With conditions such as now exist in Ohio, every board of education ought to require vaccination of the pupils under its jurisdiction. The history of epidemic after after epidemic shows that vaccination is, either permanently or for a long period of years, a practically perfect safeguard against smallpox. Where the need for vaccination is disregarded, the health of the child is being neglected. An Object Lesson in * Aside from the vaccination figures uncovered in the Ross County examination, the inspection by the federal authorities is demonstrating the great amount of good which could be accomplished by the installation of physical and medical supervision in all the schools of the state. One result, for example, has been the disclosure of four cases of trachoma. Under ordinary circumstances, these children's condition would have grown steadily worse, with the nature of the disease probably unknown until serious impairment of vision-perhaps blindnesshad resulted. The installation of adequate public health machinery may mean the saving of their sight. What the installation of adequate public health machinery might mean in other rural districts of the state one can only guess. New Epidemiologist Takes Up Duties * * Trained in public health work through long experience as city health officer at Salem, Ohio, Dr. E. J. Schwartz on January I assumed the position of director and epidemiologist in the division of communicable diseases of the State Department of Health. The place was made vacant by the departure of Dr. F. G. Boudreau for military service. Boudreau is on a leave of absence for the term of his army service. Dr. Schwartz served Salem as health officer for fifteen years and was a practicing physician there for nineteen years. Dr. His coming will measurably increase the efficiency of the department in extending epidemiological aid to local health authorities of the state. This work has for several months rested entirely upon the shoulders of Dr. W. E. Obetz, assistant epidemiologist, and since the development of the smallpox situation the demand for aid had been greater than the department's available supply. Sew Another Star * An eighth star can be added to the seven which twinkled in the State Department of Health's service flag constellation last month. Russell D. Scott, assistant bacteriologist in the division of laboratories, has been commissioned a first lieutenant in the army sanitary corps and is now in service. Scott is the fourth man to leave the laboratories for service under Uncle Sam. The laboratories staff before any left numbered nine. The division of public health education and tuberculosis has made two contributions to the service, and the divisions of sanitary engineer ing and communicable diseases one each. The department's complete honor roll now includes: Major John R. McDowell, First Lieutenant Frank G. Boudreau, First Lieutenant J. F. Granger, First Lieutenant Russell D. Scott, Second Lieutenant John S. McCune, Private J. R. Russell, Miss Amy L. Mercer, nurse, Canadian army, Higher Milk Prices * Recent investigations in Cleveland developed the fact that an increase in the infant death rate paralleled an increase in the price of milk. The explanation was that many mothers cut down their milk purchases when the price went up, with consequent injury to the health of their babies. The trend of milk prices in Cleveland is probably typical of the thend throughout the state- at least in the larger cities. What the cause of the steady rise may be whether all or any of the increases are justifiable these are questions for other authorities than those who are dealing with public health. What the health authority must consider is the effect of the rise on public health. It is evident that this effect is a damaging one. The remedy one naturally thinks of, of course, is to force the price back down. This may not, however, in all cases be possible or advisable. In that event, the health worker must seek other remedies. The only one which presents itself other than free distribution of milk to those who are absolutely unable to pay the higher price — is the education of mothers in the great danger of lessening their babies' milk consumption. If milk prices have risen recently in your city, an investigation of its results on milk consumption would be advisable. Mothers who are found to be buying less than before should be warned that no other food can be substituted for milk without injury to the child. It is imperative to the health of babies and young children that they have plenty of good, pure milk, however great a sacrifice be necessary to provide it. Health Officer Ought to Confide in Public It is gratifying to note the increasingly large number of health officers and organizations interested in promoting the public health that are availing themselves of the general willingness of the newspapers to publish news and educational matter pertaining to public health work. "Health columns," conducted by health officers, are appearing in a number of Ohio papers. Reports of these officers, reports of public health nurses and similar articles are seen frequently. Often where |