I think we should rely upon our laboratories for investigations and if it is found that we are not accomplishing any more with fumigation than without it, we should do away with it.

Dr. Landis, in closing the discussion, took issue with Mr. Shea in the latter's criticism of Dr. Chapin's figures. He also said with reference to the statement that Marion had stopped an epidemic of smallpox by fumigation that vaccination which was also one of the first steps to be taken in fighting this dease was probably more responsible for the checking of the epidemic than fumigation. He declared that some time ago in Cleveland lives had been lost because the health authorities had tried to substitute fumigation for vaccination against smallpox.

In certain hospitals in the United States and Europe cases of scarlet fever, diphtheria and measles are treated in one ward. During the entire course of the disease concurrent disinfection is carried out. "There is as much difference between concurrent disinfection as there is between day and night," he said. "Where an epidemic occurs in a school room a carrier is generally found and whe nthe carrier is removed the epidemic subsides. We do not mean to cut out disinfection. What we mea nto do is to really disinfect. In such diseases as scarlet fever and poliomyelitis the concurrent disinfection of discharges from the nose and throat should be carefully done; in typhoid fever, disinfection of the urine and feces. Fumigation in these diseases doesn't amount to a tinker's dam.

"When a man knows that a disease is transmitted in a certain way and neglects to block that way, salving his conscience by doing a little fumigating, I don't know of anything that would come nearer to establishing his eligibility for residence in a home for the feebleminded."

PROTECTING THE MOTHERS.

More women 15 to 45 years of age die in the United States from conditions incident to maternity than from any other cause except tuberculosis. And since 1900, while the death rates from tuberculosis, typhoid, diphtheria and croup, and certain other preventable diseases have been greatly reduced, the available figures for the deathregistration area show no decrease in the proportion of mothers whose lives are sacrificed yearly to ignorance and improper care in childbirth.

These facts and their causes, with a detailed study of maternal death rates in the United States and foreign countries, are set forth in a bulletin on Maternal Mortality by Dr. Grace L. Meigs, which has just been issued by the Children's Bureau of the United States Department of Labor.

Dr. Meigs emphasizes the inseparable connection between the life and health of the mother and the life and health of her baby. She points out that the 15,000 maternal deaths which occur annually in the United States are largely preventable; that these 15.000 deaths are

merely a rough index of unmeasured preventable illness among mothers; and that the protection of mothers is essential to the saving of babies' lives.

How can the protection of mothers be accomplished?

Two underlying causes are assigned for the present conditions: First. The hazards have been either ignored or accepted as unavoidable. "Knowledge of the need for good care at childbirth is essential; the lack of such knowledge and of a demand for this care has been, probably, the chief factor in producing the present indifference to this phase of preventive medicine. Communities are still to a great extent indifferent to or ignorant of the number of lives of women lost yearly from childbirth."

"The second fundamental cause-the difficulty of obtaining adequate care is seen to depend to a large extent on the first. As women, their husbands, physicians, and communities realize the absolute need of skilled care, methods for providing it will be developed." The city problem and the rural problem are both discussed. Even in a city well supplied with clinics and hospitals the number of women served by them is small in comparison with the number who bear their children without receiving adequate care. Certain sections of the population depend on ignorant midwives. But the reader is reminded that women of moderate means who cannot pay large fees and who will not visit a clinic sometimes receive the least benefit from improvements in standards of care.

"In rural districts many women bear their children with no attendant other than the husband, a relative, or a neighbor. The nearest physician may be miles away, the nearest hospital much farther."

Dr. Meigs refers to the work for maternal and child welfare which has been developed in New Zealand and in Canada, and suggests a "unit plan" for a rural county in this country to include:

A rural nursing service, centering at the county seat, with nurses especially trained to recognize dangerous symptoms in prospective mothers.

An accessible county center to which mothers could come for information about personal hygiene.

A cottage hospital, or beds in an accessible general hospital. especially for the proper care of abnormal cases.

Skilled attendance obtainable by each mother in the county.

VILLAGES WITHOUT HEALTH PROTECTION.

Another matter brought to the attention of the Board at the February meeting was the fact that eight villages in the state are without either a board of health or health officer. They are Centreville, Oakwood, Norwich, North Randall, Beallsville, Bloomingsburg, Congress and Metamora. The acting secretary was authorized to make an investigation for the purpose of finding a suitable person in each village to be appointed as health officer.

STATE BOARD OF HEALTH ADOPTS RULES GOVERNING PHYSICAL EXAMINATION OF SCHOOL CHIL

DREN.

The secretary, at the February meeting of the State Board of Health, presented the folowing rules governing physical examination of school children, to be jointly adopted by the State Board of Health and the Superintendent of Public Instruction, and stated that these. rules had been approved by F. B. Pearson, superintendent of public instruction.

Rules Governing the Physical Examination of School Children, Teachers and Janitors Adopted Jointly By the Superintendent of Public Instruction and the State Board of Health Under the Provisions of Section 7692-2, General Code.

1. Whenever the board of education of a school district in the State of Ohio shall provide for the physical examination of pupils, teachers, and janitors in the public schools, and whenever two or more boards of education shall unite for the purpose of providing for the physical examination of pupils, teachers, and janitors in the combined school district immediate notice shall be sent to the Superintendent of Public Instruction and the State Board of Health.

2. Whenever by agreement between the board of education of a school district and the board of health, or officers performing the functions of a board of health within the school district, the physical inspection of pupils, teachers, and janitors is transferred to the board of health or officer performing the functions of a board of health, notice shall be sent to the Superintendent of Public Instruction and the State Board of Health.

3. As soon as a school physician, or school nurse, is appointed notice of such appointment, with the name and address of the appointee, shall be sent to the Superintendent of Public Instruction and the State Board of Health.

4. When a school nurse is to be appointed it shall be held that the words "trained nurse," as found in Section 7692 General Code, mean a person who is a graduate of a recognized training school for nurses and who is registered by the State Medical Board as a nurse.

5. It shall be the duty of each principal, teacher, or person in charge of a school building to report to the school physician or nurse in the most expeditious manner possible the absence from school of any pupil, teacher or janitor unless such absence is known not to be due to a communicable disease.

6. It shall be the duty of the school physician, or nurse, to immediately notify the health officer within whose jurisdiction the school building is located of the existence of any case of communicable disease occurring in a pupil, teacher or janitor or in the family of such person. Likewise it shall be the duty of the health officer to notify the superintendent of schools, principal or teacher in charge of a school building of the existence of a case of communicable disease in the family of any pupil, teacher or janitor.

7. In addition to the physical examination of all pupils, teachers and janitors at the beginning of the school year a thorough physical examination shall be made of all pupils, teachers and janitors who may enter or be employed in the schools during the course of the school year.

8. An index record card of the form prescribed by the Superintendent of Public Instruction shall be used for each pupil, teacher and janitor attending or employed in the schools of the school district. When the physical examination is made by a physician other than the school physician such physician shall give all the information required of him. Each record card shall be signed by the physician who makes the examination, shall be made complete and shall be filed in the building which the pupil attends, or in which the teacher or janitor is employed.

9. No pupil, teacher or janitor shall be permitted to attend or return to school after being quarantined by a board of health, or health officer, until a written permit so to do is issued by the board of health, or health officer, and a record of such permit shall be made by the principal or other person in charge of the school building.

10. A report of the work of the school physician and nurse shall be made at the end of each school year. Such report shall be in writing, shall contain such information as the Superintendent of Public Instruction and the State Board of Health may require to be included therein, and a copy shall be sent to the board of education, the superintendent of Public Instruction and the State Board of Health.

On motion of Dr. Miller, seconded by Dr. Brown, the above rules were adopted.

Those voting in the affirmative were Messrs. Miller, Hasencamp, Howell, Brown and McGhee.

In the negative, none.

NEGLIGENT HEALTH OFFICERS TO BE INVESTIGATED.

Health officers who fail or refuse to furnish the reports required by law and by the State Board of Health will have to show cause why approval of their re-appointment should not be withheld by the State Board when their names are presented by their respective city councils and boards of health for re-appointment.

The names of three officers serving in lieu of boards of health were presented for the approval of the State Board at its February meeting. The acting secretary reported that each of the three officers had been remiss in making the required reports. The Board accordingly withheld its approval and ordered the acting secretary to make further investigation as to the fitness of the candidates.

COMPULSORY VACCINATION LAW HELD CONSTITUTIONAL.

The Alabama Supreme Court holds that Code Section 1289. authorizing municipalities, by necessary ordinances, to provide a system of compulsory vaccination, is constitutional as an expression of the police power, even though its effect is to commit to municipal corporations a measure of discretion as to the circumstances under which the power thus delegated shall be made effective. A municipal ordinance forbiding any child to enter a public school of the municipality who had not been vaccinated, enacted under the express authority given by the statute, was held valid, notwithstanding Code Section 1755, providing that every minor over seven years old shall be entitled to admission into any school, etc.; the privileges assured by the latter statute being subject to reasonable regulation. The ordinance was a reasonable exercise of the power conferred by the statute, notwithstanding its effect is alone visited upon children eligible to attend the public schools, since such classification is justified, and the whole matter is by the statute committed to the reasonable discretion of the municipal authorities.-Herbert v. Demopolis School Board of Education, Alabama Supreme Court, 73 So. 321.

ANNUAL MEETING OF THE NATIONAL ASSOCIATION FOR THE STUDY AND PREVENTION OF

TUBERCULOSIS.

The annual meeting of the National Association for the Study and Prevention of Tuberculosis will be held this year in Cincinnati on May 9, 10 and 11. This is the first time the association has ever been entertained by Ohio. The Ohio Society for the Prevention of Tuberculosis will hold its annual meeting at the same time. Also the conference of superintendents of tuberculosis hospitals in Ohio will hold its regular May meeting during the session, at the Cincinnati Municipal Tuberculosis Hospital. The program contains many papers of interest in all phases of public health work. An outline of the program follows, giving the titles of those papers which especially pertain to public health work.

General Order of Sessions.

WEDNESDAY, MAY 9.

2:00 P. M.

Registration opens at conference headquarters, Hotel Sinton.

2:30 P. M.

Meeting Sociological Section, especially for Nurses.

4:00 P. M.

Meeting Executive Committee and Board of Directors of National Association.