much the same as I do toward the drink habit. Let the stuff alone. Save those who have not abused their bodies by drinking impure water and breathing impure air, and then you will see a great diminution in our death-rate.

I am sure this subject has been presented to us in a way that will enable us to retain many points of value and interest, and when we go home we should all work for pure air and pure water, knowing that we are doing one of the greatest things that we can for the benefit of the communities in which we live.

Mr. H. L. Stillson, Bennington, Vermont.

I simply rise to express my pleasure in listening to the speaker of the evening and to express my approval of the remarks made by the gentleman from Ohio. If I had the time, I should like very much to put into print my opinion. I am a writer and not a speaker, consequently I am not able to make a very good speech off-hand. Sometimes experience does a fellow good and sometimes we profit by the experience of a brother. I live in one of the largest towns of the state, where the death-rate is two in a thousand. If the deaths among the soldiers at the Old Soldiers' Home were omitted from our town list, the percentage would be considerably lower. The water system was put into our town about 1885 or 1886. As the trench was laid diphtheria followed, and we had as many as three hundred cases in a season. There was no antitoxin at the time, and I remember of carrying out entire families of children. Following close on this we had typhoid fever, two deaths out of every three being from typhoid. That has been entirely eliminated as the years have passed by. I know of only four cases of typhoid reported so far this year. Last year there were seven. I know where all but one were contracted, and it was not in the town of Bennington. People working out of town were taken sick and would return to their homes in Bennington. Our water system is watched very closely. In addition to the watershed, we have one of the lakes. Around the banks of this lake were a lot of campers. I heard there were quite a number of invalids camping out there, so I immediately made an inspection and found such to be the case. I explained what the result would be if a case of typhoid fever should occur among any of these campers and I soon got this trouble overcome. As to tuberculosis, we have had as high as 27 deaths in a year among the 9,000 inhabitants. We had a death-rate last year of 11, and I know of only four cases in our town to-day. I speak of the improvement in Bennington, not because I live there and am the health officer of the town, for I suppose St. Albans, North Bennington, Burlington and Bellows Falls, and a score of other towns, are all improving in a like manner. However, I think the local boards of health and the State Board of Health and the health officers throughout the entire state, are probably responsible for

some of this good work. As to pure air, much can be said. We have two graded schools and two parochial schools and nine town schools. One of the parochial schools accommodate 275 children and has all the improvements for ventilating and heating. The larger public school has a registration of a thousand or more. I wish a course of instruction in ventilation and heating might be given and required of every teacher before she takes charge of a school room. My great trouble is in educating the teacher how to take care of the school room. I have passed by schoolhouses to find the windows thrown open and the children walking back and forth. When I call for an explanation of such conduct, I receive an answer that the room became unbearable and the only relief available was to throw open the windows and allow the air to enter. I don't know of any way to remedy this trouble except we begin with the mother. Every mother teaches her daughter there is no way to ventilate except through the windows and doors. I have more trouble in educating a tubercular patient that he must have fresh air day and night, winter and summer, than I do with any other part of the treatment. A young girl of twenty was infected with incipient tuberculosis. Just above us is Camp Comfort, and the doctor having charge of this case advised her to go there for a rest and a change. I provided the essentials. The attending physician took the mother and the daughter up to the camp. The girl was to remain perfectly quiet, sleep all she could and eat all she could and exercise very little. She gained rapidly for a week or two and the doctor suggested calling upon her once a week on Thursday or Friday, instead of every day or every other day. The following week, on Thursday, the doctor started to make his call and upon ascending the hill three and one-half miles, found his patient sitting by the road-side. She had got down there and could not get back to her camping place. Her improvement was so great during her first week at the camp that her mother got impatient and asked her why she did not get out of bed and exercise. After a little talk with the mother she agreed to do better and obey the doctor's orders. A week afterwards the doctor went up there again but found no girl there. The mother was picking berries. The doctor asked where the girl was, and the mother replied she was in the hammock, she supposed. Some of the neighbors had come along past the hammock on their way trout fishing and had said that she looked well enough to go to walk, so she went along with them up to the river. The doctor drove up to where he was informed they had gone fishing, and there, sitting beside the stream, was the girl. Nothing more can be said. The girl died the following November. Who is responsible for that death? Have you any idea? You can't reason with mothers. Those daughters, when they are not sick, are school teachers. I have known trustees to nail down the windows to prevent the teachers from opening them. So you see, I feel as though the first work should be done with the mothers, and also that every teacher should be instructed, and intelli

gently, too, how to govern the ventilation and heating of their respective school rooms.

Dr. C. O. Probst, Columbus, Ohio.

ness.

I don't know as I have anything to add to the subject. Dr. Kober has covered the subject very thoroughly. The city of Cincinnati is situated on the Ohio River and receives its water supply from that stream, and thus receives the filth from Pittsburg. It had a large death rate from typhoid fever before the installation of the filter plant, but since the plant has been in operation there has been very little typhoid fever. One physician told me he thought the filter plant would put at least 150 doctors out of busiIn my home city, Columbus, we have had just about the same result. Our filter plant has been in operation now for about one year, and we have had very little typhoid fever since its installation. Before the installation of our filter plant we had quite a high death-rate, with some severe epidemics. Some years we have had as many as 400 deaths. It seems to me you have the most admirable natural conditions for obtaining a good supply of pure water here. You should preserve your watersheds for your various cities. I don't know how your state and various municipalities could spend their money in any better way than in preserving your natural conditions here for pure water.

Dr. C. F. Dalton, Burlington, Vt.

Just about so often some one will telephone me that sewer gas is escaping from the sink or man-hole and they very much fear they will contract diphtheria if the trouble isn't stopped. My idea of the contagiousness of diphtheria is that it is carried by coming in contact with some infected individual or infected clothing, and I was not of the opinion that it could be carried by sewer gas. I would like to know if sewer gas is effective as a carrier of diphtheria, and just how much of a factor it is.

E. A. Graves, Sunderland, Vt.

I wish to ask if bovine tuberculosis is on the increase.

Prof. Geo. M. Kober.

Taking up the subject of the possible relation of sewer air and diphtheria, I believe it is not at all likely that diphtheria is carried by sewer air. I believe the impure air has rendered the person more susceptible; has weakened his vitality, and thus leaves him in a condition where he will readily contract the disease if exposed. We know, of course, that K.L.B. is present in the mouths of perfectly healthy individuals; that is also true of the pneumococcus. It requires something more than the

organism to produce infection. There must be the lowered vitality. Animals subjected to impure gases, more particularly sewer air, and then subjected to infection, are more susceptible than the control, animals.

As regards the prevalence of bovine tuberculosis, I am not aware that bovine tuberculosis is on the increase. The same factors are responsible for the prevalence of tuberculosis among cattle as among men; and among the predisposing causes none are more potent than bad housing conditions. I am interested in some cattle out west where there is no housing at all. They never have tuberculosis. The reason you have more tuberculosis among dairy cattle is because they are housed, but without sufficient regard to light and air. Personally I do not think bovine tuberculosis is more prevalent to-day than it was ten years ago. The best way to improve the condition of your cattle is by improving the housing of your cattle. We all know that tuberculosis is less common among sailors, shepherds and farmers than among those in any other walks of life. This because they enjoy the benefits of fresh air.

Dr. A. O. Morton, St. Albans, Vt.

Substituting typhoid bacilli; is it possible for the excrement to become dry and the germs be carried up where the faucet is dry and defective?

Prof. Geo. M. Kober.

There has been a great deal of experimental work done in that direction. Recent experiments at Gibraltar indicate that it is possible for typhoid germs to be wafted in the manner suggested.

OBSERVATIONS FROM THE DAILY WORK OF A MILK
INSPECTOR.

J. O. JORDAN, PH. G., MILK INSPECTOR, BOSTON, MASS.

Courage is required to approach the milk problem in these times of multiplicity of papers dealing with this subject, and in treating the question. in a broad sense, the element of newness is likely to be lacking. That this is a condition and not a theory can easily be determined by those who undertake to delve into what has been written concerning this topic; one which should appeal to every consumer and producer.

Despite this condition, however, the subject is not quite threadbare, other efforts will follow, and not infrequently as in this attempt, an occasional fact will be unearthed to support a theory.

There has been a deluge of ideas for remedying the real and imaginary conditions governing the milk subject and for a time it seemed that these

wordy assaults fell upon unfertile soil; but indications now point to a healthy change of sentiment, and so it must be assumed that the varying treatments accorded this topic have served to a degree the purpose for which they were intended; namely, that of arousing public interest in this vital question. In addition to the individual awakenings there has also been fostered a spirit of organization, which has manifested itself in various commissions, leagues and societies, which are proving factors of tremendous importance in moulding public opinion. The past indifference and inertia has been great and difficult to swerve, and this change has been accomplished only after repeated and determined attempts. The contest has not yet been won, but there is a gradual awakening with the creation of corresponding healthy public sentiment. This attitude is readily discernible to observers who have devoted years to the work, and has shown itself in personal inquiries, letters and telephonic communications, so that within the past year it can be easily demonstrated that there have been many more requests for information as to sources of clean milk supplies, reports as to undesirable conditions of places where milk is produced or sold, with accompanying requests for inspections, than were ever noted before within a similar period.

This is an encouraging indication, and despite the fact that increased labor is involved, it means that the efforts of years are beginning to be crowned with success. But there is another lesson to be learned from this change; namely, that the time is not far distant when this spirit of discrimination will entail more care in the production, handling, and sale of milk, i.e. the commercial success of the milk business will require education and the employment of correct principles. Otherwise the consumption of this food will sink to a lower level.

This assertion is founded on fact and not purely theoretical, and is based upon an actual decrease of milk in a large community. In Boston since 1905 there has been a gradual lessening in the use of milk, despite⚫ the annual increase of population.

In 1906 Bostonians consumed daily about 249,196 quarts of milk; in 1908, about 236,521 quarts. The figures for 1908 denote a daily decrease of about 12,675 quarts, which for one year would approximate 4,626,375 quarts, or 1,156,594 gallons.

That this decrease may be attributed to several causes cannot be denied, but I believe that investigation would show that chief among the reasons would be the agitation against stale, dirty and diseased milk.

What are the conditions which have produced this alertness on the part of the public, and engendered this silent protest; and is there ample foundation for the position assumed by consumers? Investigation would more than support the contention of the rebellious members of our population. Furthermore, if the facts concerning the production and handling of milk were known, there would be more recruits for the constantly increasing number of non-milk users.