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Association, recently submitted, a code of regulations for the sanitary control of waterways is suggested. This code contains the following regulations:

“There shall be no active (potentially dangerous) bacterial contamination or gross pollution of properly located and authorized bathing beaches and other bathing places."

In a discussion of this regulation it is pointed out that control is needed, both in the selection and authorization of bathing places and of the discharge of sewage and wastes into the waters in which bathing is authorized.

In summation, the following salient statements appear to be warranted:

1. There has been insufficient investigation of bathing beaches and similar bathing places as factors in the occurrence of typhoid fever and other water-borne diseases.

2. Sufficient data have been obtained to show beyond reasonable doubt that typhoid fever and other water-borne diseases result from bathing in sewage polluted water.

3. Such conditions can be prevented by proper selection of the location of bathing places, protection from future polluting influences and proper maintenance.

4. As expressed by the consensus of opinion of the state health departments thruout the United States, control of bathing beaches and similar bathing places by state and local health departments should exist.

PREDICTS BIG PROFITS FOR CITY IN MANUFACTURE

OF ALCOHOL FROM GREEN GARBAGE. Experiments in the manufacture of denatured alcohol from green garbage at the Columbus municipal garbage reduction plant have proved successful according to a report recently made to the city council by C. P. Hoover, chemist in charge of the Columbus water purification works and Thomas D. Banks, superintendent of the Columbus disposal plant.

Tests were made under the process patented by J. J. Morgan, chemist, of Chicago, who has agreed to give the city free use of his process, if the city will install an addition to the plant for the manufacture of the alcohol and give him the privilege of using it for demonstrating purposes.

The Columbus plant already has a wide reputation for efficiency. It has been a money-maker for the city from the start, seven years ago, and, the latest enterprise is only further evidence of the endless opportunities for a municipality that once becomes awakened and alive to its problems.

Columbus has solved the garbage disposal question and at the same time a troublesome liabliity into a live asset for the city, Taxpayers no longer ask the question "how much did our garbage disposal cost last year?" but instead, "how much money did our garbage plant earn last year?"

The report of operation of the plant for 1916 shows the revenue derived from the operation of the plant in 1916 reached $88,564.07 and the actual cost of operation was $48,423.74. The profit over cost of operation amounted to $40,140.33. This profit was made from the sale of grease, tankage and hides. This, of course, did not take into account the cost of collection, which is operated as a separate division. The cost of collection was $48,937.44. Counting in the net profit made from the operation of the reduction plant this left net cost of collection and disposal, $8,797.11, or four cents per capita.

In their report on the experiments with the alcohol process Messrs. Hoover and Banks estimate that this should return to the city an annual profit of $26,910 or 75 per cent on the investment, based upon present war prices. Based upon average prices prevailing during normal times they estimate the annual return would be $4,340 (12 per cent).

The results of the experiments show, according to the report, that one ton of green garbage yields on an average 4.55 gallons of 95 per cent alcohol, or, based on 90 per cent, the average yield was 4.8 gallon per ton of green garbage. The Columbus plant treats not less than 20,000 tons per year, therefore a yield of 96,000 gallons has been made the basis of the report. A year's supply of garbage, based upon experiments, should produce as much alcohol as 33,600 bushels of shelled corn or 39,529 bushels of wheat or 110,344 bushels of potatoes. Hence it is pointed out that the manufacture of alcohol from garbage would result in a large economic saving and conservation of food supplies.

The war time slogan “starve the garbage can”, according to Mr. Hoover, has had the effect of making the garbage of lower value as regards grease and fertilizer materials, and if the present newspaper propaganda that is being made now in order to conserve our foodstuffs should cause a wave of utmost economy to spread throughout the country, there is no doubt, says Mr. Hoover, that the garbage would no longer be as high in convertible corbohydrates as at present and the yield shown might be somewhat reduced. On the other hand, indications are that with equipment, such as will be provided should a large plant be built, with careful selection of proper yeasts and improved methods of neutralization better efficiencies and larger yields will be obtained than were obtained with the experimental equipment.

HOSPITAL ASSOCIATION ELECTS OFFICERS. The third annual meeting of the Ohio Hospital Association was held in Columbus, May 23 and 24. Officers elected are: President, F. S. Bunn, Youngstown; vice presidents, Rev. C. H. LeBlonde, Cleveland, and Dr. A. R. Warner, Cleveland; secretary-treasurer, Dr. E. R. Crew, Dayton.

THE NEW PUBLIC HEALTH. In a discussion of recent public health reports published in the National Municipal Review for May, A. W. Hedrich, editorial assistant of the American Journal of Public Health presents statistics prepared by Franz Schneider, Jr., of the Russell Sage Foundation which tend to show that control of communicable diseases and infant hygiene work might profitably constitute two-thirds of the activities of the health department.

Schneider analyzes the cause of preventable deaths from the standpoint of damage done, preventability, cost of preventive work, and communicability of the disease to others. With the results of this analysis as a basis a set of vaļues is arrived at which indicate roughly the relative importance of each of the commoner branches of health work. These "final values" are given herewith:

Control of communicable diseases

Tuberculosis
Venereal diseases

All others
Infant hygiene
Privy and well sanitation.
Milk control
Fly and mosquito suppression.
Food sanitation
Inspection of school children,
Vital statistics
Education
Dispensary and clinics.
Laboratory

12.1

6.6 25.3 20.3 3.5 2.7 2.4 0.1 7.0 5.0 5.0 5.0 5.0

Total

100.0

On the last five branches the values are arbitrarily assigned.

The article contrasts the old methods with the new in sickness prevention and public health work.

In this connection Dr. Charles V. Chapin, superintendent of health of Providence, R. I., whose labors in the field of public health date back to the early days of the modern era of health administration is quoted as saying in his annual report for 1915:

“When I was elected superintendent of health in 1884 it was considered that most of the energy of the health department should be devoted to the abatement of nuisances and the promotion of general municipal sanitation. This is just what was done in most cities. It was believed that germs bred in dirt and that filth was the chief cause of disease. Bad odors were thought deadly and a whiff of sewer gas fatal. It was the business of the health department to sweep the streets, cart off garbage, clean up cellars, whitewash tenements, bury dead animals, and stop bad odors. The inspector of nuisances was in those days the whole of most health departments. This belief in the efficacy of municipal house cleaning to "stamp out” disease was not even then the teaching of science. There had been before the eighties of the last century few men of science engaged in public health studies and these did not teach the filth theory of disease. This theory and the sanitary practice based upon it were due to propaganda by enthusiastic reformers to whose esthetic sense the campaign for cleanliness appealed. It was not based on painstaking study."

The public health activities which Chapin finds most productive of results are control of communicable diseases, infant hygiene nursing and educational nursing for cases of tuberculosis. After these he places medical school inspection, supervision of milk and, last of all, general sanitation. He recognizes that public comfort and decency require that cities pay attention to backyards, alleys, garbage and the like, “nevertheless, town and city councils have no right to spend money for these things and then claim that there is nothing left with which to save the lives of babies or ferret out incipient tuberculosis, or supervise the milk supply."

Making allowances' for local requirements such as mosquito, hookworm and pellagra propaganda in the South, plague prevention in cities like New Orleans and San Francisco, Hedrich says it is evident that there is an utter lack of proportion in the distribution of funds in many health departments. "In general, food inspection and general sanitation (especially nuisance inspection) are over-inflated at the expense of communicable diseases and infant hygiene work.

"The dominant note in the new public health is that things do not spread disease as much as persons" says Hedrich. Progressive health officers are therefore turning away from ash cans, back yards, garbage, bad odors and the like, and are devoting more attention to the careless consumptive, the diphtheria and typhoid carrier and the ignorant mother who feeds her baby anything from beer to garlic sausage. Thus we find Dr. Terry, late of the health department of Jacksonville, Florida, suggesting in his report that six sanitary inspectors be dropped from the payroll, and public health nurses substituted.

"Another straw in the same current is the abandoning of fumigation after scarlet fever, measles and diphtheria. Providence, New York, Rochester, and other cities have experimented and found that the incidence of these diseases was no higher in districts where fumigation was omitted, than in the rest of the city. As a consequence the money that was formerly spent for smoking up harmless chairs, tables, carpets and walls ranging from $1 to $3 or more per case, is now spent for better supervision and concurrent disinfection, that is, disinfection of infectious discharges during the course of the disease.

Venereal Diseases a New Field. "Of late a number of health departments have begun to attack the venereal disease problem. Among the first if not the first of cities to enter this field was New York. In order to combat the evil influence of quacks, notices are inserted in newspapers and distributed in toilet rooms of saloons, lodging houses, large industrial establishments and other public places. The notices bear the information that the department of health maintains a list of medical practitioners, dispensaries, and hospitals and that the department is prepared to make free diagnosis, but Buffalo, Newark, and the cooperative clinic of the Oranges in New Jersey go so far as to give free treatment.

"The barrier of false modesty is very properly being broken down. While statistics are largely guess-work, it is estimated by high authorities that at least 50 per cent of all adult males are at some time or other infected with gonorrhea and about 10 per cent with syphilis. A tragedy lies in the fact that many cases are innocently contracted, especially among females and young children. Is it not time therefore that we cease considering this problem from the purely moral side and regard it as a public health menace as well, and undertake to protect the nation?

The Trained Health Officer.

“Upon looking over the report of cities under 250,000,” says Hedrich, "one is impressed with the number of non-medical men of special training, who are giving excellent service as health officers. Before me are the excellent reports of Montclair and the Oranges in New Jersey, Palo Alto, Cal., and Dallas, Texas, whose health officers belong to this class. In each case the administration is unusually efficient.

“The chief reason for the present inefficiency of municipal health departments has been the lack of trained, full-time health officers. Usually a practicing physician is appointed who lacks much of the necessary knowledge, and cannot afford to give sufficient time to the office. In this connection, Preeble of the United States Public Health Service says: 'He (the health officer) need not necessarily be a physician, but he should have either thorough experience or previous training, and a good working knowledge of sanitary principles and practice.'

"There is no good reason why surgery, obstetrics and similar studies should be essential to efficient health administration, but on the other hand, such subjects as epidemiology, housing, water supply, and vital statistics are very necessary.”

TUBERCULOSIS DEATH RATE DECREASES.

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The death rate from tuberculosis in 1916 for the entire registration area (about 65 per cent of the population of the United States was only 146.8 for each 100,000 population. In 1906 it was 195. per 100,000 population. This is a decrease of 25 per cent ing of one-fourth of the lives that would have been sacrificed to the Great White Plague according to standards of a decade ago. Analysis of the figures plainly indicate that the decrease is more a question of proper housing, decent working conditions and efficient sanitation rather than a question of place or climate.

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