EDITORIAL SECTION

OUR LAST LINE OF DEFENSE.

The enemy has arrived and is threatening our last line of defense. Before another month has passed the "invading army" will have increased its numbers by millions. It's too late now to kill off the advanced guard to swat the first fly-but it is not too late to protect baby from his worst enemy the fly-by screening the house, or the porch, or baby's crib, and protecting his food from the poisons the enemy carries.

Children mean more to America and the world today than ever before. Patriotism demands that we protect them, particularly the helpless babies. Approximately one in ten of all babies born in the United States die before completing 12 months of life. Thus it can be seen how the strength of the nation is being impaired by conditions that make babies sicken and die.

With the approach of summer baby's health becomes a more difficult matter to protect. Medical authorities have warned us that with the arrival of the fly season, infantile paralysis will again scourge this country as it did last summer. Philadelphia has inaugurated a fly campaign with the avowed purpose of preventing a recurrence of the disease this summer.

Many communities of Ohio have observed "Baby Week" and "Clean up Week" and they have undoubtedly accomplished much in the way of calling attention to the importance of protecting the health and eliminating filth and breeding places of flies and disease, but this is only the beginning. Let the good work go on. As the country is guarding against the alien enemy so every parent and every community should guard the common enemies of health.

THE HEALTH PROBLEM AND THE ARMY.

The Federal government is preparing to spend millions of dollars this year on crop promotion and food production. The State of Ohio will probably spend a quarter of a million or more through the recently organized Council of National Defense in promoting crops and securing labor.

The average citizen, falling in line in this great movement, and doing his or her "bit" in the backyard garden or on the farm may not

realize how important a part he or she is playing in the making of an army for Uncle Sam.

The United States enters this greatest of wars with all the valuable lessons learned by the British and French armies in their three years' experience. One of the first lessons it has learned is that its soldiers must be healthy, and, that to be healthy, they must be well fed.

Sir Alfred Keough, Surgeon General of the British army in an interview with a representative of The Associated Press recently, revealed for the first time, the close co-operation between the medical branches of the American and British armies, maintained since the early days of the war.

That the American soldier ought to be the healthiest soldier in the world, because he starts out backed by a medical organization that has been given all the valuable lessons learned by the big British army in its three years' experience in this greatest of wars was the observation of Sir Alfred, the man responsible for the health of five millions of British soldiers scattered over the various theatres of war.

"Of course, the United States has always had a very highly efficient medical service," continued Sir Alfred. "The only question is whether it is fully prepared for the expansion necessary to raising a large army. I say this because I doubt whether those outside the organization understand its importance.

"The layman usually thinks only of the killing efficiency of an army, not realizing that to be able to kill the enemy an army's health must be right up to scratch, all the time.

"The first essential for an efficient army is that it be well fed. A well-fed army is an army in which disease prevention has its greatest chance of success. We cannot protect health which is undermined by inadequate feeding. The next essential to an efficient army is the immediate investigation of epidemics. Both of these problems have been solved by us.

"The British army is well fed and free of epidemics. Since the outbreak of the war we have had but three epidemics in the British forces and in each case they have been stamped out almost instantly. We did this by concentrating our best medical effort at the source.

"We learned our lesson in sanitation from the South African war just as the American army has benefitted by its experience with disease in the Spanish-American war and later in the big camps on the southern border of the United States. We first tried enteric innoculation in the Boer war and have perfected it since with the result that this disease. has been practically stamped out. In our whole army we now have but four or five cases of enteric fever in one month.

"The United States army medical authorities know all about our experience. They know what the problem at the outbreak of the present war was. Has modern medical science enabled us to prevent epidemics in modern warfare? They know that the answer is "yes." The American authorities, fully alive as they are to the necessity for efficiency in their army as in all other things, have learned from us that it is up to the medical branch of the service to acquaint themselves in time of peace with what they must ultimately learn in time of war.

"Rural sanitation is another subject that America is alive to. This is evidenced by the fact that they have sent to us one of the most learned professors of Johns Hopkins University at Baltimore to make a special study of rural sanitation in the towns in France which we take charge of as soon as our enemies enter them."

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REPORTS SHOW IMPROVEMENT.

While reports for March, of cases of notifiable sickness reported show a decided improvement over any previous month for the past four years, there is still room for much improvement. Nor is the negligence in the matter of reporting cases of notifiable disesase confined to the smaller cities and rural communities. Public Health Reports of April 27, issued by the United States Public Health Service, giving statistics of reported prevalence of notifiable disease shows that in many Ohio cities there is a failure to secure anything like complete reports. That a number of cities in Ohio show high mortality rates from various diseases is undoubtedly due to incomplete reporting of

cases.

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PRACTICAL PATRIOTISM.

One highly practical form of patriotism is the conservation of childhood. No people can prosper long if it be careless of its babies. It is a subject of more than usual timeliness this year. No American can afford to assume an air of indifference toward a subject of such vital national concern.

This is baby week in Cleveland. "Better babies better Cleveland" is the slogan. The people of the Sixth City are appealed to by the health authorities and others to give heed to the importance of baby culture.

And when one stops to consider the facts, the wisdom of the appeal becomes apparent at once. Cleveland is everywhere recognized as an unusually healthful community, yet in 1916 2,034 infants under one year of age died here, half of whom might have been saved had the proper care been given them. Forty per cent. of these babies died during their first month.

Here is a heavy drain on the resources of the city. Multiply the loss by thousands of communities and one gets an idea of the annual sacrifice of infant life which the nation suffers annually. It is certainly worth while to study causes and to get a new grip on the fact that this tremendous cutting off of young life undermines American efficiency.

One particular point the child health bureau of Cleveland is emphasizing this week is the high importance of natural feeding of infants. Of all babies who die 85 per cent. are bottle-fed. No better service is likely to be performed by any mother than to nourish her baby as nature intended she should.

It is a good time in this annual baby week for the people of Cleveland to take an accounting of themselves upon this issue of infant conservation. Let everyone recognize his obligation to family and state

in the matter and resolve henceforth to do his individual best to promote the health and comfort of every little stranger born into the circle of Cleveland's population - Cleveland Plain Dealer.

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THE BLUE ENVELOPE.

Ten per cent. of all the deaths in Toledo are due to tuberculosis. The condition in Toledo is much the same as in other cities. As the city increases in size, the danger grows, because of more insanitary conditions of living. The rich are no more immune than the poor, for while conditions of poverty encourage the disease, it is contagious, and no one in the city will be safe while there is one turberculous patient spreading the contagion.

That is the one big, selfish reason for everyone in Toledo contributing to the District Nurses' fund on Wednesday. Those 27 district nurses are a big part of the fight against tuberculosis and for the safety of all of us. They locate the cases of tuberculosis.

They educate unceasingly on the methods of preventing and curing the disease. They FIGHT the white plague in the interest of the community. Moreover they carry on the child welfare work that the city administration for lack of funds for that kind of activity — had to discontinue.

The District Nurses' organization has but one source of incomethe free gifts of the people of those in whose behalf the fight is made. One day each year is set apart for this contribution. year it is Wednesday, May 2.

This

The contribution last year was $24,000. But the cost for nurses and nourishment for the patients was $30,000. The funds are drained. Toledo News-Bee.

"WHERE THERE IS NO VISION THE PEOPLE PERISH."

Writing under the above caption in the May number of "The American City," George A. Johnson, consulting sanitary engineer of New York, presents a very forceful argument for medical and sanitary preparedness, upon entering the Great War.

"The Public Health is the nation's greatest asset," Mr. Johnson says, "yet in the United States quite 650,000 people die annually from preventable causes. The courts have ruled that the average value of a human life is $5,000. Taking this figure as a basis, the nation's most important asset is thus depreciated in the total sum of $3,250,000,000 annually. "Were the great war to end today, the battling nations would be saddled with a debt bearing interest in the sum of $2,000,000,000 per year. The United States when at peace squandered nearly two-thirds as much more money in preventable deaths."

The writer points out that "public ignorance" is responsible for "this stupendous annual wastage which is about equal to the total amount of money in circulation," and says: "When the public becomes intelligently cognizant of the causes of disease and of the measures whereby they can be prevented, there will be a great upheaval

in health department administration" and "that instead of appropriating cents per capita annually for such work, dollars would be devoted to it."

"To economize in health work is to invite disaster," says the editor of "The American City" in a note prefacing Mr. Johnson's article. The editor points out the health dangers attending the gathering together of great masses of men into training and concentration camps which, he says, "are likely to prove breeding places for disease unless the activities in sanitation are continued with unabated zeal."

In conclusion he says: "Let us as a nation permit no dulling of our vision, let public health activities and sanitation progress thru the months or even years in which we may be engaged in war, with no lessening but rather with an increase of the energies employed in this essential activity."

CONTROL OF VENEREAL DISEASES.

It is indeed gratifying to note that some progress is being made the matter of educating the public to what The Cincinnati Enquirer in its issue of May 12, refers to as "The Scourge of War" and 'A peril of war Greater than that of Battle."

The control of venereal diseases is becoming recognized as one of the nation's greatest problems, and in times like the present when the call is for men physically fit and when the danger of the spread of these diseases is increased by the establishment of great military camps, a definite plan of action is needed.

It is only through education, intensive publicity, the pulpit and public rostrum that there has been brought about, organized effort to check the spread of, and stamp out the great white plague-tuberculosis. Some such concentration of effort is needed to control the social disease plague.

At the recent conference in Washington, D. C., of executive health officials of the various states and territories, this subject was ably presented by Dr. William F. Snow, of New York, executive secretary of the American School of Hygiene Association. Dr. Snow is temporarily attached to the executive staff of the Medical Advisory Board and the government at this time is preparaing against the undue occurrence of venereal diseases in the military and naval forces.

Dr. Snow in discussing the subject referred to the work done with a regiment of New York troops on the Mexican border in which the percentage of occurrence of venereal disease was remarkably low. This was brought about by educating the soldier. Not only was stress laid upon the result of physical incapacity due to contracting venereal diseases, but the soldier was told that exposure to the disease really means disloyalty to the country because it makes the soldier unfit for duty. The soldier was also told of the dangers, not only to the man himself but to the person with whom he comes in contact, especially in the event of marriage. The commanding officer did not rely entirely upon education. He exercised police authority