plant was visited on August 11th; the farm was visited during milking time. The notes show that the cows were fairly clean, the barn was defective, showing hay protruding from the ceiling. and covered with cobwebs and dirt. Windows dirty. The barn had a southern exposure, so that the sun increased the heat. The manure gutter was not clean; the bedding of shavings had not been removed. Various articles were stored in the barn, such as feed, farming utensils, and the clothing of the men. The cows were getting full rations of hay; the animals were hot and restless, and covered with flies, which necessitated a constant moving of the tail. No means were supplied for keeping the cow quiet during milking. The milk was strained in the barn with a wire strainer, which was bent and rusty. The dairy-room was hot an! sunny, showing dust and flies. The milk was passed over an aerator, in which the temperature of the water was found to be 60° F.; the receiving vat and stationary vats were not covered. so that flies and dirt got in. The bottles were standing in icewater at 50° F. A fair sample of milk produced under these conditions and tested at once show a bacterial count of 455,000. Suggestions just described were offered, and four days later a second visit was made. As the result of specific directions, in the barn the walls were whitewashed, windows cleaned, and green shades had been placed at the windows having a southern exposure. The floor was cleaned, and the bedding had been removed; the manure gutter was also clean, and land plaster had been sprinkled on the floor and manure gutter. All storage of feed and utensils had been removed. The cows were getting scant grain rations, so that there was not a large pile of hay before the animal that would fill the air with dust and induce movements of the body. The cows were well cleaned. The barn was cooler, and hence the animals were not so restless. The milk was not strained in the barn, but removed at once to the dairy. The dairyroom was clean, dark and cool, with receiving and stationary vats covered with cheese-cloth. The temperature of the water in the aerator was 40° F. The bottles were standing in ice-water at 38° F. A fair sample of milk thus produced showed a count of only 3,600 to the cubic centimeter. This is not an exceptional condition, as a similar experience was repeated at four different times and places. This shows that an elaborate and expensive plant is not necessary to put out a clean milk. What is needed is intelligent attention to detail. A small as well as a large producer can furnish clean milk. The following example will illustrate an experience with a small dealer, the visit being made September 5th. The cows, barn and man fairly clean. Utensils fair. No aerator and no steam. Ice was being used sparingly. Milk drawn under these conditions was placed in water at 70° F., then taken to the creamery for bottling and sent to the city. An examination here showed a count of 89,000. Various suggestions were offered, and the second visit was made in eight days. Result, cows and barn well cleaned, the milk strained through absorbent cotton and cheese-cloth attached by clothes-pins to a forty-quart can, which was kept standing in a box surrounded by ice. This can had previously been steamed for twenty minutes at the creamery. The can was then taken to the creamery and placed in a vat of ice-water at a temperature of 40° F. In three hours the temperature of the milk stood at 44° F. It was then bottled and sent to the city. A sample of this milk showed a count of 5,400, as the result of the few simple changes suggested. Even a creamery is not necessary for a small dealer to put out milk up to the standard of the Commission. As an example, milk was sent from a small farmer, where cooling to 40° F. was practised within fifteen minutes after milking. This milk was sent to the city in 40-quart cans, surrounded by jackets. Samples taken on the platform in New York at 3 a. m. showed a count of only 3,000. All the visits made to these farms were educational. The whole family, including wife and children, became interested and cooperated in the work. The attention of neighbors was also attracted to the improvements, which were often imitated, and formed the subject of evening discussions at the village grocery store. The Commission has no special method to advise, but asks a hearty co-operation from every one concerned in handling the milk. The methods must vary with each plant. In general, it may be said that the following three heads include the essential conditions: (1) Strict cleanliness, which includes the barns, yards, cows, milkers and all utensils. Bacteria which get into the milk by means of dirt are thus thoroughly excluded; (2) rapid and sufficient cooling of the milk (the few bacteria that do get in are thus prevented from growing); (3) thorough icing around the milk until it reaches the consumer. The production of toxins. from the growth of bacteria is thus retarded. In every case the dealer has been able to reach the standard of the Commission without expensive apparatus, by following the indicated details. The one thing always necessary is plenty of ice. At the same time, great labor has been done by farmers and dairymen as the result of suggestions by the Commission. New plumbing has been put in, new dairy-rooms have been built, floors have been cemented, ceilings made tight, and time and endeavor have not been spared. One dealer was so impressed with the subject of right conditions that a special new barn was put up in order to meet them. Two others are planning new barns that will insure hygienic conditions. Even where the milk has not reached the standard for certifying, great advances have been made, and the general output improved. Eight dealers are now putting out some of their milk up to the standard of the Commission. They are as follows: Slawson Bros., Briar Cliff Farm, T. W. Decker & Sons, Mrs. Van Zandt, Sheffield Farms, Mr. Tuthill, Harlem, Century Co., Locust Farms and Mr. Keller. Many others are making changes and applying for a certification who will doubtless pass the test of the Commission. In spite of the summer having been the hottest in thirty-one years, all those who have been certified have kept up to the standard under most trying conditions. The thanks of the Commission and of the community at large are due to these dealers, who have shown great interest in this work, and have not spared labor or sacrifice in keeping up to the standard. The milk of each dealer has been examined about twice a month during the summer, and labels given that can be placed in the mouth of the bottle as a proof of certification. The bottle for examination is collected from the dealer in the morning, placed in a bag surrounded by ice, and at once taken to the laboratory. If the milk shows a test close to the limit established by the Commission, a second examination is made in a few days. In the meantime, an effort is made to find out the source of trouble, in order that it may be corrected. The Commission feel gratified at the interest excited in this movement on the part of the farmers, milk-dealers, the daily press, and the dairy journals. It is hoped by this movement to inaugurate a general improvement in the production and handling of milk destined for large cities. HENRY DWIGHT CHAPIN, M. D. ABRAHAM JACOBI, M. D. JOSEPH E. WINTERS, M. D. Commission. Too little account, it is thought, is taken by physiologists of the functions of appetite. As these functions belong in one sense to the domain of psychology, the physiologists are apt to devote themselves wholly to the nutritive value of foods, leaving out matters of the taste entirely. That the latter are of first-rate importance is the opinion of Prof. J. P. Pawlow, of St. Petersburg, whose lectures on "The Work of the Digestive Glands" has just been translated from Russian into French (Paris, 1891), and is reviewed in the "Revue Scientifique" (September 7). From this review we learn that the eminent Russian scientist gives the fullest recognition to the part played by the appetite, not only in ordinary digestive processes, but in bringing on or curing diseased conditions of the digestive organs. Everybody knows, says the writer, that the normally profitable food is that which is taken with appetite, with sensation and pleasure. So, to restore the appetite is one of the most frequent requests made to the physician. He continues: "Unfortunately, medical science has strayed from this legitimate tradition, which corresponds to real conditions of digestive function. If we read contemporary treatises on the troubles of the digestive organs, we shall be struck with how little attention is paid to the appetite, either as a cause or as a cure. On the contrary, we may read in certain works the advice that no special heed be given to a poor appetite, which is a subjective symptom of slight importance. Such views can be regarded only as gross errors. "When we advise the patient that he should eat a little at a time and not to satiety, when he is put on a special diet, when we remove him from his habitual surroundings and send him to a place where his whole life is regulated in accordance with his physiologic needs in all these cases the physician is trying simply to awaken the appetite and thus takes account of it as a therapeutic factor. In the first case, when food is prescribed in small quantities, besides the avoidance of repletion in an enfeebled stomach, the frequent excitation of the saliva is of great importance, because of the richness of this secretion and its digestive power." The author cites cases in which an abnormally small secretion of gastric juice in the stomach made it doubly necessary to insure proper digestion by the saliva. As to change of scene, its bearing on the digestion is not so clear at first, but the writer tells us that it acts as follows: "Suppose the case of a man whose mind is greatly occupied. It often happens that he can not even for an instant get away from thoughts of his work; he eats, and while eating occupies himself with his plans. This happens with special frequency in the case of persons who live in the whirl of great cities. Systematic inattention in the taking of nourishment naturally brings on digestive troubles with all their consequences. The saliva no longer is secreted or the secretion takes place slowly; the food remains too long in the digestive canal; it begins to putrefy because of lack of the digestive fluids; it thus irritates the mucous lining of the digestive conduit and produces illness. For such an invalid, who remains in the same conditions of life, no medical prescription can be of any real assistance, because the fundamental cause of disease still acts. There is but one remedy-to remove the sufferer from his environment, to relieve him of his professional work, to interrupt the train of thought that possesses him, and to bring it about that for a certain time his sole object in life shall be to care for his health. This result is attained by sending the patient on a voyage or to a different climate. "It is the duty of the physician not only to regulate the lives of certain individual patients according to these principles, but also to endeavor to extend and to explain widely a knowledge of the importance of the act of eating. The author remarks that this is particularly the duty of the Russian physician. In intelligent Russian circles, where there is generally no sufficiently clear idea of how to live properly, we may find a quite anti-physiologic indifference to the act of eating. In more cultivated nations, the English for example, eating has been raised to a kind of cult. It may smack of animality to give oneself up so exclusively to the joys of the table, but surely it is an ignorant thing to entertain for eating a feeling of contempt. Here the truth lies in a golden mean. "If we consider the influence of the psychic factor in digestion, the question of condiments appears in a new light. Justification is found for the statement which has long been made on empirical grounds-that it is not sufficient to provide nutritious food at meals; it must also be agreeable to the taste. Consequently the physician, who is often called upon to regulate the diet of isolated individuals or of groups of individuals, must think constantly of |