tures given to Y. M. C. A.'s, clubs, educational institutions, etc., and the state is also intending to spread broadcast pamphlets intended for the instruction of young boys and girls. The newspapers and magazines will also be a valuable aid in this campaign. An example of this municipal work is provided by a brief outline of what is being done in Cleveland:

Placards are being distributed through the saloons of the entire city, and it is intended to distribute them later in manufacturing plants, Y. M. C. A.'s, etc. Through these placards the patients are instructed to visit certain dispensaries, which are the tuberculosis dispensaries, and here they are advised to visit our regular venereal clinics, which run both daily and several evenings a week. If the patient is in a condition dangerous to the community, he is so advised and sent to the Cleveland City Hospital for a certain period of time, where he received at least three doses of salvarsan and adequate mercury to clear up his lesions. He is then referred back to the venereal clinic where he is kept under close supervision and told to come back for treatment as is necessary. In case the patient misses his visit, record of which is kept on a card index system by the social worker, he receives a postal card notifying

him when he shall make another visit. If he neglects to do this the social worker calls on him. If he still neglects, the Board of Health steps in and by force insists on his carrying out the proper measures.

By this method, in a city with a large floating population, it has been found possible to keep sixtyfive per cent under close supervision. What is being done in Cleveland, I trust we shall be able to do in other parts of the State.

The State of Ohio already has at hand 10,000 framed placards of information regarding venereal diseases. Any health officer or physician desiring some of these placards may get them by applying to the State Department of Health. The Bureau of Venereal Diseases has also sent out recently in connection with the United States Public Health Service a circular letter and report cards for reporting cases. There were also enclosed five circulars of information on syphilis and gonorrhea which are to be handed to the patients and in case translations of these circulars in Roumanian, Armenian, Finnish, French, Greek, Hungarian, Italian, Lithuanian, Polish, German, Swedish, Syrian or Yiddish are desired, the same can be procured by addressing the Department of Health. The careful cooperation of all physicians is urgently requested in this work. It means much, both to the state and to the nation.

FIRST OHIO CASE WHERE RECENT VACCINATION DID NOT PREVENT SMALLPOX

The first case to come to the notice of the State Department of Health in which a person recently successfully vaccinated contracted Findlay. Epidemiological investismallpox, has come to light in gation by the Department verified. these details: The patient, a woman, was successfully vaccinated February 15. She developed symptoms of smallpox June 22, but the physician withheld his diagnosis on account of the vaccination, though reporting his suspicions to the health officer. The epidemiologist of the State Department of Health was called. and confirmed the smallpox diagnosis June 28.

I

N the short space of a few months the cities and com

munities of Ohio have responded nobly in the Government campaign against venereal disease. One of the principal parts of this campaign consists in the establishing of day and night clinics for the treatment of these cases and the opening up of sufficient hospital beds to hold such patients as are very sick or are dangerous to the public health-this refers especially to prostitutes. Let us give a few examples:

The city of Toledo has already appropriated a large sum of money, opened a day and night clinic for the treatment of these cases and will very soon have sufficient hospital beds in an old building for the care of such venereals as are found in her limits.

Cincinnati, which already had a day clinic and a sufficient number of beds for males has opened a night clinic twice a week and set aside some thirty to thirty-five extra beds for female cases. Moreover, the Social Hygiene Society is preparing to run a day and night clinic of its own.

The Council of the city of Columbus recently appropriated $10,000 for the establishment of a clinic and the opening of a sufficient number of hospital beds.

Youngstown already has a night clinic and a small number of beds for these cases, and in addition is planning to start a day clinic and has voted funds for more beds in the hospital.

The city of Cleveland heretofore has had two carefully regulated

day and night clinics for venereal cases but they lack sufficient hospital space, there being only twentyfour beds available. However, the people voted a bond issue of $100,000 for this purpose. It has recently been approved by the Capital Issues Committee and within the next two months 150 more beds will be opened up solely for the care of these cases.

Even some of the smaller towns are responding very well. For example, Salem has a well organized day and night clinic to take care of these cases and there are sufficient beds available for all patients that should be hospitalized.

Akron is about ready to start her venereal disease program and the B. F. Goodrich Rubber Company has a venereal clinic of its own.

The commissioners of Ross County have turned over to the health authorities of Chillicothe and the sanitary district surrounding Camp Sherman, sufficient. space and equipment at the county infirmary to care for all cases found in the county.

Dayton likewise is opening a day and night clinic and already has a goodly number of hospital beds.

On the whole the cities of the State of Ohio are doing very well in the campaign to protect the soldiers and the communities against venereal disease. In the next six months we hope to see even greater strides. In the following paragraphs are given a few sketches of municipal venereal disease activities, furnished by the health departments of the cities in question:

CLEVELAND

Like all large cities Cleveland. has been hampered in the past by lack of funds, with the result that thus far we have only had some twenty-four beds available in the City Hospital for the treatment of venereal diseases. Nearly a year ago a bond issue of $100,000 was voted by the city of Cleveland to fit up the old nurses' home in the City Hospital for the care of these cases. This fund has not been made available until within the past few weeks when it was passed by the Capital Issues Committee. However, in the next few days some of these beds will be opened and within two months we can take care of 150 cases.

At present our plan of procedure is somewhat as follows: We have two carefully regulated day and night clinics at the Mt. Sinai and Lakeside Hospitals. These clinics. are in charge of competent men with social service nurses in connection. Careful records are kept. of all cases. All acute cases dangerous to the community are sent to the City Hospital until partially freed at least, from their disease, free salvarsan being furnished when necessary. Thus, in the last year the city of Cleveland gave some $2,000 worth of free salvarsan at the City Hospital. They are then referred back to these clinics and kept under careful supervision until cured.

The city of Cleveland has distributed in the toilets of saloons, barber shops, hotels, Y. M. C. A.'s. etc., framed placards in different languages, telling people of the dangers of venereal disease and thus far many lectures have been given in schools, churches, Y. M. C. A.'s, etc.

For Cincinnati, Dr. J. H. Landis, health officer, reports:

"Cincinnati has no vice district and has suppressed street walking. Theoretically, this should reduce. the venereal disease problem to a minimum. No statistics however, on which to base an opinion on this point, are available.

"Hotels, rooming and boarding. houses are under close surveillance by the police department and the indications are that never before in the history of the city has prostitution been as hazardous an occupation as at the present time.

"Women taken in raids are sent to the hospital for diagnostic purposes. If venereal disease is found they are sent via the police court to the Workhouse Hospital for treatment until longer infectious, before being turned over to the Federal government.

no

"Many professional prostitutes have left the city. Many clandestines have secured employment and have given up the old method of securing a living. 'Sitting rooms' are being broken up through the activities of the purity squad headed by Detective Ellenreider, who has had charge of this work for several years.

"Two night clinics. per week (Monday and Thursday from 7:30 to 9 P. M.) will be started June 24th at the General Hospital. These will be made self-supporting and it is expected to hold them. every night when the attendance increases.

"The State Department of Health framed placard (500 of them) has been distributed in public places throughout the city.

"Attempts are being made to secure free Salvarsan for use in selected cases. All in all we feel

that a real step towards neutralizing the venereal peril has been taken."

COLUMBUS

"The Columbus city council has appropriated $10,000 to the board of health as a fund for the control of venereal diseases," says Louis Kahn, M. D., health officer. "It is the intention of the board to equip a part of the city workhouse as a hospital for the treatment of venereal diseases, and to put it in charge of a physician a specialist if necessary and nurses. There cases of venereal disease will be treated and held until cured. We expect to start this work just as soon as the workhouse can be arranged and the necessary facilities. provided to conduct the work."

An ordinance which has been introduced in the Columbus council provides penalties for venereally diseased persons who expose other persons to the disease or who fail to seek medical treatment and to continue such treatment until danger of infection is past. It requires quarantine and compulsory treatment of venereally diseased persons who fail to seek and continue treatment by a physician. The proposed ordinance provides fines for persons other than licensed physicians who furnish prescriptions or medicines for the treatment of venereal diseases. Physicians under the proposed measure would have to report venereal cases to the local health authorities.

Dr. J. G. Marthens, a specialist in this work. At the present time the Miami Valley Hospital has twentyone beds set aside for the treatment of patients afflicted with venereal disease. The police department is already co-operating with us in the apprehension of street walkers who may be thus afflicted, so that we already have our machinery in motion for attempting to handle this question.

"Since July 1, when the new regulations of the State Department of Health went into effect, we have been able fully to cooperate with the rest of the state in carrying out plans. We had planned to conduct this work in a different manner, but now that the state has made a uniform regulation for the control of venereal discases, we have modified our plans accordingly.

"The police department brings to us women that are suspected of being diseased. These women are examined by our clinic physician and, if found to be diseased, are sent to the hospital for detention and treatment. The clinic is conducted three days a week from 4 to 6 P. M. When the work grows to greater proportions we shall cpen an evening clinic.'

YOUNGSTOWN

"The Youngstown board of health promises to co-operate in carrying out present regulations and any other rules which the State Department of Health may promulgate for the control of venereal diseases," says Dr. H. E. Webb, health officer. "Dr. Cole, director of the Bureau of Venereal Diseases, was with us a few weeks ago and met with the county medical society. He was assured of the co-operation of the

The high percentage of positives in April is explained by the fact that the work was being started and a large number of clinically positive cases was examined in order properly to check the reagents used.

The Wassermann test is performed free for Ohio physicians. Outfits provided by the Department must be used in sending in specimens for examination. These outfits are obtainable upon application to the Department, but can not be obtained at the laboratory distributing stations of the Department in various parts of the state. Such specimens can not be sent in the mails except in approved containers such as the Department furnishes.

PREVIOUS VENEREAL

DISEASE ARTICLES

For the convenience of readers the following list of articles dealing with venereal disease prevention, which have appeared in previous issues of the OHIO PUBLIC HEALTH JOURNAL this year, is given:

"All States Asked to Work Together to Control Venereal Diseases" (United States Public Health Service program for state and Federal co-operation), January, p. 26.

"War Increases Ophthalmia Neonatorum" (in British Isles), March, p. 115.

"Army Reports Progress in Venereal Disease Battle" (editorial), April, p. 138.

"Why Not Call a Spade a Spade, Mr. Editor?" (editorial), April, p. 138.

"How the

Venereal Disease

Problem Is Being Met in Ohio, April, p. 170.

"Investigating Arsphenamine," April, p. 182.

"War's Greatest Credit Item; You Can Help Increase It" (editorial), June, p. 234.

"Regulations for the Prevention of Venereal Diseases,' June, p. 258.

"Venereal Quarantine Approved" (California cases), June, p. 277.

Articles in previous years' volumes can be found by consulting the indexes to those volumes.

At Gaucher's clinic in the St. Louis Hospital in Paris, before the war ten percent of the patients were syphilitic. After the first sixteen months of the war 16.6 percent were syphilitic and in the eight months immediately prior to December 16, 1917, twenty-five percent had the disease.