CHILD SAVING, A WAR TIME MEASURE.

DR. FRANCES M. HOLLINGSHEAD.

Director, Division of Child Hygiene, Ohio State Board of Health.

As the enthusiasm grows greater for those activities immediately connected with the war problems and as the immediate necessity becomes more acute, we feel moved to urge more and more strongly the preservation of the work already established in our communities. This is especially true in the smaller communities where the work for social betterment is small in amount and at times of so recent development that its roots have not had time to reach far down into the life of the place. Especially is this new enthusiasm a danger to the work for children. We have known for a long time that work for children is, or should be, all the year round work but that there is often an acute situation during the summer months and the less the regular work which has been going on, the more acute the situation which results.

At present most of the children's work is in the hands of women and much of the newly established Red Cross work is in the same hands. There is a decided emotional appeal in the Red Cross, the work is essential and we have no desire to minimize its importance but we must urge that the work for children shall at the same time be strengthened and increased in amount rather than decreased. Women are, rightly or wrongly, frequently accused of being hysterical and sentimental as well as ready to drop the old interest and rush into any new one. Let us hope that the women of Ohio far from this position will hold steadfastly to their established tasks, realizing that while not showy or spectacular like the actual work at the front, they may represent results of an equal magnitude in the long run. Nor is this only an idle fear. In certain of the places in Ohio during the recent Baby Week campaigns, right in the midst of the week, a number of committee, members withdrew suddenly and left a small group of faithful workers struggling alone with the situation. This is of slight importance if only the Baby Week celebration suffers, but is of intense importance if it is indicative of a permanent lagging of interest. If we all adopted the Canadian slogan "Give until it hurts, and gave in the form of work and energy, the child welfare work could be doubled in amount and the Red Cross still not suffer.

Are we going to sit passively by until nearly all of the women in our localities must need have assistance in the realm of child caring. A most striking illustration of this is the fact that in 1915 in France many thousand mothers were able to give birth to their children without the aid of the "Assistance Publique" (a public fund for such. service), while in 1916 only 1250 of the children born came into the world without this service. Such are the ravages which war has wrought upon the French people for this means in all walks of life. The increase in the infant mortality rate in England in the last year has also been heavy despite the fact that during the first two years of the war it was held very near the normal point. If this is true

despite the almost superhuman efforts which the allies have made to conserve every life by increased government stipends and by the employment of greatly increased numbers of workers and the expenditure of large sums of private capital, what must happen to us if we sit supinely by and make no real effort to control the situation by at least maintaining at its maximum every particle of established work. For we are facing a war issue with our children, fight against it as we may. We are bound to have the broken home with the bread winner away, many women will to into industries, foodstuffs will not be so plentiful, nor so cheap as in other seasons, tuberculosis will soar unless carefully supervised, the mother's anxiety is sure to affect the premature birth rate and the still birth rate. Unless we recognize these facts and square our shoulders to meet the issue, we are bound to reap the results. We must never have Germany's reputed three million illegitimate children, nor numbers of new institutions to care for the babies whose mothers have given them up to go into ammunition factories. Let us begin to avoid these things by doing all in our power to strengthen old agencies already established and to create new ones of a preventive type, but let us begin at once while the problem is small rather than to wait until the crisis arises which causes the necessity of such an overwhelming amount of effort being expended that much of the work cannot be well or thoughtfully done.

TUBERCULOSIS HOSPITAL ACT AGAIN UPHELD.

The Supreme Court of Ohio has again upheld the constitutionality of the District Tuberculosis Hospital act in affirming the decision of the lower courts of Montgomery county in the case of The State of Ohio on relation of William H. Woolery, et al. against Chrales. Brenner and the boards of county commissioners of Montgomery and Preble counties.

The case was decided upon authority of Brissel vs. State ex rel. 87 O. S., 154-155, decided in 1912. It was also decided on March 18, 1913, in a case that came up from Darke county - Coleman et al State ex rel, 88 O. S. 535 and again on September 23, 1913, Dean, Auditor, vs. State ex rel, 88 O. S. 618.

The constitutionality of this act should no longer be a debatable question.

In the Montgomery county case, William H. Woolery, a farmer, sought to enjoin the district board, representing Montgomery and Preble counties from issuing bonds to erect a District Tuberculosis hospital and prevent the condemnation of a part of his farm necessary for a right of way to and from the proposed hospital. Among other things he alleged the unconstitutionality of the district tuberculosis hospital act. All of the courts decided that he had no right

of action.

LAWS PASSED BY THE 1917 LEGISLATURE PERTAINING TO PUBLIC HEALTH.

Plumbing Inspection.

EDITOR'S NOTE-Recognizing the importance, from a health standpoint of proper construction, installation and inspection of plumbing and drainage, the Legislature in 1910 created the office of state inspector of plumbing and in 1911 conferred upon the State Board of Health the duty of enforcing, through the plumbing inspector, part four of the Ohio Building Code, relating to sanitation. As is the history of most new legislation, imperfections developed and changes were found necessary. The Eighty-first General Assembly provided for two inspectors to enforce the provisions of the law, but the wording of the law was not changed to confer the same powers on the deputy inspectors as was conferred upon the chief inspector. This has been corrected in the recent amendments to the law. Another amendment substitutes a graduated fee system for the flat rate system provided in the old law. The old law required that a fee of $5 be charged regardless of the size of the building, the number of fixtures installed or the number of visits required. The graded system prevails in many municipal codes in Ohio. Another important amendment requires the submission of plans and specifications to the State Board of Health for approval. The jurisdiction of the State Board of Health in the matter of plumbing does not extend to those municipalities where ordinances have been adopted and are being enforced but only where no municipal inspection is provided, or the laws are not being enforced. The operation of the law is confined to public and semi-public buildings and does not include private residences. The law is designed to protect public and private institutions, sanitariums, hospitals, schools, prisons, factories, workshops and places where men, women or children are or might be employed. Improper plumbing or drainage in a building may nullify all the advantages of a perfect sewage system or a 100 per cent pure water supply. For this reason plumbing in building is not strictly a requirement affecting the safety of the structure nor has it to do with the thickness of the walls, carrying weight or fire hazard, but it does directly affect the comfort, convenience and health of the occupants and for this reason the installation and supervision should be from a health and not a building construction standpoint. Without governmental regulation and inspection the smaller communities and rural districts, become the dumping ground for insanitary and defective plumbing, creating conditions which are favorable to the origin and development of disease. Inspection of plans before installation is a preventive measure which should result not only in better sanitary conditions but is expected to prove a great economy. The lack of sanitary engineering knowledge of many architects who design buildings, is responsible in many instances for additional and unnecessary labor, pipe and fittings, which if checked before the building is started, would mean a more efficient system at a lower cost. Following is a copy of the plumbing inspection act as amended and effective after July, 1917.- ED.

SECTION 1261-1. There shall be, and is hereby, established and created in this state the office of state inspector of plumbing, under the direction and supervision of the state board of health.

SEC. 1261-2. It shall be the duty of the state board of health, within ninety days after passage and approval of this act, to appoint an elector of this state to fill the office of state inspector of plumbing, who shall hold office until such time as his successor may be appointed and ualified. The person so appointed must be a plumber with at least ten years' experience. The state board of health may appoint such number of deputy inspectors as the necessities of the work shall

require and the appropriations for such inspections will permit. Such deputy inspectors shall be practical plumbers with at least seven. years' experience, and skilled and well trained in matters pertaining to sanitary regulations concerning plumbing work. The state board of health shall have the power to make and enforce rules and regulations governing plumbing and register those persons engaged in or at the plumbing business to carry out the provisions of this act. Plans and specifications for all sanitary equipment or drainage to be installed in or for buildings coming within the provisions of this. act shall be submitted to and approved by the state board of health before the contract for installation of the sanitary equipment or drainage shall be let.

SEC. 1261-3. It shall be the duty of said inspector of plumbing, as often as instructed by the state board of health, to inspect any and all public or private institutions, sanitariums, hospitals, schools, prisons, factories, workshops, or places where men, women or children are or might be employed, and to condemn any and all unsanitary or defective plumbing that may be found in connection therewith, and to order such changes in the method of construction of the drainage and ventilation, as well as the arrangement of the plumbing appliances, as may be necessary to insure the safety of the public health.

Such inspector shall not exercise any authority in municipalities or other political subdivisions wherein ordinances or resolutions have been adopted and are being enforced by the proper authorities regulating plumbing or prescribing the character thereof.

SEC. 1261-4. He shall hold himself in readiness at any and all times to go to any part of the state if so directed by the executive officer of the state board of health, for the purpose of making a sanitary inspection of any building or other place that he has reason to believe is in such a condition as to be a menace to the public health.

SEC. 1261-5. When any building is found to be in a sanitary condition or when changes which are ordered in the plumbing, drainage or ventilation have been made, and after a thorough inspection on approval by said inspector of plumbing, he shall issue a certificate signed by himself and countersigned by the executive officer of the state board of health, which must be posted in a conspicuous place for the benefit of the public at large. Upon notification by said inspector, said certificate shall be revoked for any violation of this act.

SEC. 1261-6. No plumbing work shall be done in this state in any building or place coming within the jurisdiction of the state inspector of plumbing, except in cases of repair or leaks in existing plumbing, until a permit has been issued by the state inspector of plumbing and the executive officer of the state board of health. Before granting such permit, an application shall be made by the owner of the property or by the person, firm or corporation who is to do the work. Such application shall be made on blanks prepared for the purpose, and each application shall be accompanied by a fee of one (1) dollar, and an additional fee of fifty (50) cents for each trap or vented fixture up to and including ten fixtures, and for each trap

or vented fixtures over ten a fee of twenty-five (25) cents. The fees so collected shall be paid into the state treasury and credited to the general revenue fund. Whenever a re-inspection is made necessary by the failure of the plumbing contractor to have the work ready for inspection when so reported, or by reason of faulty or improper installation, he shall pay a fee of ten (10) dollars for each such inspection.

SEC. 1261-7. Within ten days after his appointment the said inspector shall give a bond, payable to the state of Ohio, for the faithful performance of his duties in the sum of five thousand dollars. Said bond, when approved by the attorney general shall be deposited with the auditor of state.

SEC. 1261-8. No inspector so appointed shall, during his term of office, be engaged or interested in the plumbing business or the sale of any plumbing supplies, nor shall he act as agent, directly or indirectly, for any person or persons so engaged.

SEC. 1261-9. The state inspector of plumbing and the deputy state inspectors shall receive such salaries as are fixed by the state board of health. The necessary traveling and other expenses of inspectors while in the performance of their official duties, shall be paid from the fund provided for that purpose.

SEC. 1261-10. State inspectors of plumbing shall have the power between sunrise and sunset to enter any building where there is good and sufficient reason to believe that the sanitary condition of such premises is such as to endanger the public health, for the purpose of making such inspection as may be necessary to ascertain the condition of the same.

SEC. 1261-II. The state inspector of plumbing shall report promptly to the state board of health the condition of all premises inspected by him or by his deputies; also the number of inspections and changes ordered, as well as any other information concerning his office that they may require.

SEC. 1261-12. The state inspector of plumbing shall be provided with a suitable office in the city of Columbus, as well as with all necessary apparatus for making tests, and such furniture, stationery and supplies as the business of his office may require.

SEC. 1261-13. It shall be the duty of any owner, agent or manager, of any building where an inspection is made by said inspector of plumbing, to cause or have the entire, system of drainage and ventilation repaired, as he may direct. After due notice to repair such work, it shall be the duty of said owner, agent or manager to notify said inspector of plumbing that such work is ready for his inspection. Failing to have the work ready for inspection at the time specified in such notice, he shall be subject to such penalty as hereinafter provided.

SEC. 1261-14. Any person or persons, owner, agent or manager refusing, failing or neglecting to comply with any of the provisions of this act, shall be deemed guilty of a misdemeanor, and upon conviction shall be subject to a fine of not less than ten nor more than one hundred dollars, or imprisoned for not less than ten nor more