The writer has endeavored to show in chart form public health belief in 1885, as compared with public health belief in 1916. In connection with the 1916 chart it is necessary to explain that the word contact is not restricted to direct personal contact, but is used in the modern public health sense and covers direct personal contact, mouth spray and contact with articles such as public drinking cups recently infected with moist secretions.

Comparison of these charts will indicate clearly why we now believe the high hopes of the health officer of 1885 were inveitably doomed to disappointment. These charts will also make it clear that according to our present day ideas the control of contagious diseases is by no means an easy matter. Sources of infection, such as carriers, mild cases that do not see a doctor, cases not diagnosed and cases not reported are common. Take with this the national daily habit of passing around mouth secretions and you have the conditions to keep contagious diseases fairly prevalent for a good many years at least.

Finally a comparison of these charts will make it clear that the doubt latterly thrown on the efficacy of disinfection as a public health measure is not a fact by itself but is simply part of a general tendency to question and to discard the beliefs of thirty years ago.

Shall We Fumigate?

According to our present day conceptions of the ways in which the contagious diseases are transmitted, the room occupied by a patient recovering from such a disease is not relatively of great importance and consequently whether the room is fumigated or not is not particularly important.

The arguments for and against are somewhat as follows:

The abolitionist will contend that rooms occupied by infectious cases are entirely negligible as compared with other sources of infection. He will point out that such pathogenic bacteria as may be deposited on toilet articles, chairs, bed-steads, door handles, walls, etc., are subject to nature's disinfecting agencies-light, drying, lack of warmth and food supply - and not only do not multiply but die out far more rapidly than they do in the human throat where warmth, moisture, food supply and absence of light are all provided. He will point out that Providence, Boston, and New York and many other cities have discontinued lisinfection after contagious diseases and that return cases from such houses are no greater than they always have been. The scientific evidence that he will cite in support of his points. will be strong.

His conservative opponent will argue something like this: Even if your theory is correct what health officer would willingly allow his own child to occupy the bed or handle the objects in a room in a case of scarlet fever or diphtheria or tuberculosis, without first applying some effective method of purification? It may be that a good deal of the infection dies out in the course of time. Most of it may die out in a very short time. In any case some of it may certainly remain and the room should be disinfected with formaldehyde to dispose of any danger that is there.

The writer frankly admits his inability to decide the controversy. Disinfection will probably do a little good. It will certainly not do much good. The real question is - What is the extent of our public health effort other than fumigation? Disinfection of rooms and objects does not, in the minds of well-informed sanitarians hold the importance that it once did. It is realized that in the sum total of public health effort, the part played by disinfection is small. In towns and cities. where a well organized health department is active, no fault can be found if disinfection continues to be practised. The value of the procedure is not overestimated. The health department does a good many other things than the citizens are aware of and the fact that disinfection is practised does not stand in the way of public education on more important subjects. In a good many cities, towns and rural communities the situation, however, is entirely different. The work of the local health officer is often limited to the placarding and quarantining of such infectious cases as are reported to him together with the disinfection of the premises when the quarantine period is over. These are the visible and spectacular activities upon which the laity forms its opinion of what is good and important in the prevention of disease. No one tells them in any accurate way how diseases really spread, no one speaks to them of the protection of water supplies, of the proper disposal of human wastes, of school inspection, of vaccination, of baby feeding, of the prevention of tuberculosis, of the pasteurization of milk, of any of the many subjects that are of real importance.

In such places disinfection stands as a symbol for stagnation and inaction masquerading as genuine public health effort and that state of affairs is most certainly to be condemned.

THE SUCCESSFUL ADMINISTRATION OF MUNICIPAL HEALTH AFFAIRS DEMANDS THAT THE INTERESTS OF THE PUBLIC SHALL BE THE PRIME CONSIDERATION.

To insure the highest degree of efficiency in administrative sanitation it is necessary to first overcome the apathy with which the public receives the work of its health officials during the quiescent periods of smooth sailing and to be assured of its friendship and help when the uncontrollable spread of epidemics rouses a wrathful storm of vituperative scorn.

Experience discloses the fact that commendatory appreciation of the endeavors of individuals to conform with sanitary requirements, which often are irksome and apparently unnecessary, and detailed explanation of the necessity for fulfilling the requirements of the Health ordinances, will accomplish more than pages of threatening invective or even judicial writs of coercion.-Bulletin Saranac Lake Board of Health, Vol. 1, No. 6.

WAR TIME HEALTH MEASURES PROPOSED AT

WASHINGTON CONFERENCE.

The State of Ohio was officially represented at the fifteenth annual conference of State and Territorial Health Authorities with the United States Public Health Service and the thirty-second annual conference of State and Provincial Boards of Health of North America held at Washington, D. C., April 30th-May 3rd, inclusive, by James E. Bauman, Secretary and Executive officer of the Ohio State Board of Health.

Naturally, the subject of most importance presented at the conference with the Surgeon General had to do with the proposed co-relation of federal, state and local health agencies for service in the present emergency. It was unanimously decided that the Federal Public Health Service, under conditions incident to a state of war, should be the agency of the federal government through which correlation, supervision and direction of the various state and local health agencies should be exercised and it was further decided that aside from the hygenic and medical care of the actual military and naval forces, all sanitary and hygienic activities incident to a state of war which require a national policy, should be corelated, supervised and directed by the U. S. Public Health Service. Suggestion was made in resolutions adopted that a National Sanitary reserve corps be created as an auxiliary to the Federal Public Health Service.

The conference of executive officials of the health departments of the various states and territories unanimously adopted a report of a special committee of which Dr. Herman M. Biggs of New York was chairman in which is set forth the various activities and functions that should be exercised by these officials during a state of war. They are as follows:

First. The sanitation of military and naval camps and camp sites.

Second. The exercise of police powers in relation to the sanitation of the environment of military and naval camps.

Third. The provision, when required, of public health laboratory facilities for the diagnosis and sanitary surveillance of infectious diseases occurring among the troops.

Fourth. The provision as far as possible, when required, of hospital accommodations for the care of cases of communicable disease occurring among the troops.

Fifth. The protection of military and naval camps from the introduction of communicable disease (including tuberculosis and venereal diseases) from the civilian population.

Sixth. The sanitation of intrastate transportation facilities.

Seventh. The investigation and exclusion from military and naval camps of disease carriers.

Eighth. The immediate reporting to the Public Health Service of epidemic foci or various infectious diseases (especially poliomyelitis, epidemic cerebro-spinal meningitis, smallpox, typhus, typhoid, and paratyphoid fevers and bacillary dysentery) developing in any of the states or territories. Ninth. The sanitary supervision of refugees and interned aliens.

Tenth. The sanitary supervision of the sources of the water, milk and food supplies of the combatant forces.

Eleventh. The sanitary supervision of soldiers suffering from pulmonary tuberculosis, or those rejected from the army and naval forces.

Twelfth. The sanitary supervision of migratory laborers and of industrial

camps."

The proposal to create a reserve for duty in the Public Health Service in time of national emergency was presented in the form of a joint resolution which was to be introduced in Congress as soon as approved by the National Council for Defense.

REGISTRATION OF BIRTHS AND DEATHS.

Why Register Births?

That the birth, date of birth, parentage and other essential information for governmental and identification purposes may be made a matter of official record.

That the ages of school children may be definitely known, making the proper enforcement of school laws possible.

That the lares affecting child labor may be effective, and the children of the poor thereby protected.

That litigation in matters of inheritance and settlement of estates may be simplified by the definite knowledge of the ages of all persons concerned.

That the American-born children of foreign-born parents may have indisputable evidence of American birth which will protect them from enforced military service when visiting the mother country of the parents.

That blindness may be prevented by prompt medical attention to the infected eyes of the new born.

That infection and mortality among women may be prevented and that young babies may be saved by immediate attention by existing agencies for the relief of the poor.

Why Register Deaths?

That there may be available complete and accurate information as to deaths of all human beings, with dates of death and causes of death, to the end that preventable causes of death may be eliminated and human lives lengthened.

That the various public health agencies-national, state and municipal-may determine what part of our mortality is preventable and when and where preventable deaths occur.

That pestilential and epidemic diseases may be detected promptly. That we may apply our remarkable scientific knowledge of disease prevention at the time and in the place where such application is most needed.

That home-seekers and immigrants may be guided in the selection. of safe and healthful homes by accurate information rather than by misstatement of interested persons.

That the settlement of estates and matters of inheritance, pensions, etc., may be definitely settled by official record of death instead of on the memory of interested witnesses.

Death registration without birth registration is like an accurate accounting of expenditures without consideration of income.-Bulletin Kansas State Board of Health.

"HELP MAKE OHIO A 'REGISTRATION STATE.'

JOHN EMERSON MONGER, M. D.,

State Registrar, Vital Statistics.

To the Health Officials and Local Registrars of Ohio:

Just as rapidly as possible we are making an effort to make the personal acquaintance of every health official in the state. So far, our experience in this line has been very pleasant, and I wish now to extend my thanks to those who have been so courteous to our inspecting force and to myself. I also want to assure you of our hearty and entire co-operation, for by this means I believe we can make our work mutually helpful.

The value of statistics to the sanitarian are incalculable, and it will be our effort to render the results of our work available for your use. This Bureau will have published monthly reports for each county (and the 37 larger cities) in THE OHIO PUBLIC HEALTH JOURNAL, and also in the Journal of the Ohio State Medical Association.

Statistics are valuable in the exact ratio to the use made of them. Filed away in the archives of the State they do little, if any, good, but if put in the hands of the men who are administering the Health Laws we feel they will be of real value and help. Should you at any time wish data on your community, the mortality of a particular disease or group of diseases, the information will be promptly furnished upon request.

One of the interesting things in the work of this Bureau is the growing rivalry among cities and communities as to their death rates. in certain preventable diseases. "Well, we cleaned up on

last year. They were all puffed up on their rates for '15, but we surely "showed them up" in '16", was the expression of one of the ablest health men in the state when he came in recently and got the advance "dope" on his city. Some of them are as proud of their low rates as a star ball-player is of his batting average.

This rivalry is one of the finest things in Health Administration. The New York Bureau has as its slogan, "Public Health is Purchasable. Within Natural Limitations Any Community Can Determine Its Own Death Rate." There is a wonderful amount of truth in this. slogan.

The tremendous strides made in one line of endeavor tuberculosis is an example. Cleveland, Cincinnati and Columbus, in the period of 1906 to 1910, had a joint rate of 183.4 per one hundred thousand. In 1911 to 1915, 160.8, and in 1916, 154.5 per one hundred thousand. Typhoid, Diphtheria, and especially Diseases of Children "under two" show an even better gain.

Our registration of deaths is fairly well taken care of, our main difficulty being with delays where necessary and to send back for "Additional Information". In 1916 we were compelled to ask for "Additional Information" for 7 percent of the births, and 11 percent