DEATH RATE BY COUNTIES FOR MARCH - APRIL, 1917.

Statistics furnished by J. E. Monger, M. D., State Registrar.

The following table shows the number of deaths and the monthly death rate per one thousand (1000) population, in each county of Ohio, for the months of March and April, 1917.

The following table shows the number of deaths and the monthly dath rate per one thousand (1000) population, in each of the thirtyseven largest cities in the state of Ohio, for the months of Marcn and April, 1917.

PREMATURE OLD AGE FROM THE TRENCHES.

A section in the second report of the British Association Committee for the study of fatigue from the economic standpoint is written by Dr. T. G. Maitland on Agricultural Fatigue in Warfare. This is based on experience with soldiers at the front, where there was no motive that would leave the officers or medical men to exaggerate the effects of overstrain on the men; what they found was forced on them by observation of men who had passed the breaking point.

The most important group of these is composed of men who do not collapse in the field but who, when relieved, are found to have a degree of fatigue that has gone slightly beyond the point of normal physiologic recuperation. They are like rubber that has been stretched too far and cannot recover its former elasticity. The quality of the soldier's work is distinctly impaired, his aim is less sure, his decision less prompt, he shows a faiblesse irritable in the restless movements of hands and feet.

To reduce the number of such cases, which are only an encumbrance to the fighting force, the hours in the fighting line have had to be shortened. The final result of such overstrain when long continued has been observed by Dr. Maitland in Serbian soldiers who have lived through six years of nearly continuous war in the Balkans. They show marked hardening of the arteries, which means premature old age.

Steel foundry-men who work under great strain for twelve hours out of the twenty-four and seven days in the week do not have the physicians anxiously watching the effects upon them of this excessive work, but there is good reason to believe that here, too, the limits of normal fatigue are overpassed and that premature ageing results. Survey.

WHAT OHIO TUBERCULOSIS HOSPITALS ARE DOING.

Representing an investment estimated at $150,000, the new district tuberculosis hospital, maintained by the joint board of commissioners of Montgomery and Preble counties, is rapidly nearing completion. Present plans of the hospital trustees and the joint board of commissioners call for the completion of the building for the transfer of patients and dedication exercises about September first.

The new hospital is located about six and one-half miles north of Dayton, on the Covington pike. It was formerly known as the O. E. Swadner farm and contains fifty-six acres.

With the exception of the equipment the main buildings of the hospital are completed and ready for occupancy. The power building, housing the heating and lighting plant and the laundry department, are still under course of construction.

The service building will contain the dining room and kitchen. It also has been arranged to use this building for lecture purposes and entertainments which may be provided for the patients. The infirmary and ambulatory building are alike in construction. Each building will provide beds for twenty patients, in addition to having two sun parlors, offices and quarters for the physician and nurses and other rooms necessary in the operation of a modern tuberculosis hospital.

The O. E. Swadner residence will be used as the administration building for the hospital, and will provide housing quarters for the nurses and other hospital attaches and the main business offices of the institution.

At a meeting of the board of trustees of the Springfield District Tuberculosis Hospital, Dr. Henry Baldwin was reelected superintendent for a term of one year. Dr. R. H. Grube, Xenia, was elected president of the board, and W. E. Tuttle, Springfield, was elected treasurer.

The Ohio Board of Administration early in June advertised for bids for the construction of a hospital building at the Ohio State Sanatorium for Tuberculosis at Mt. Vernon. The bids were opened June 26th and were all too high. The board has decided to erect the building with prison labor.

The eighth annual report of the Dayton District Tuberculosis. Hospital was filed with the county commissioners by the board of trustees on June 11th. A total of 102 patients were treated during the year; 83 being admitted in that period. The average per capita. cost was $1.53. The total expense of the hospital was $13.500.

The county medical societies of Marion, Morrow, Delaware, Union, Logan and Hardin counties, at a meeting held in Marion on June 22nd, discussed plans for the establishment of a district tuberculosis hospital. Committees from each county medical society have. been appointed to carry out the plans.

At a meeting of the Steubenville chamber of commerce held June 12, Dr. J. C. M. Floyd discussed the proposed establishment of a district tuberculosis hospital to embrace Jefferson, Carroll, Columbiana

and Belmont counties. The county medical societies are also interested in the plans and are aiding to carry them out.

The State Board of Health at a meeting June 22 endorsed the appeal of the Ohio State Medical Association urging tuberculosis hospitals to enlarge their facilities to care for tuberculosis patients in anticipation of an increase in the disease during the war.

CONSCRIPTING TUBERCULOSIS BEDS.

Governor Whitman has written to the boards of supervisors in nineteen counties of New York state calling their attention to the bill passed during the recent legislature providing that every county of more than 35,000 population not already having a hospital for its residents suffering from tuberculosis shall erect such an institution and have it ready for occupation not later than July 1, 1918.

That the state is determined to care properly for its tuberculous patients is evident from the mandatory character of this new law. Writes Governor Whitman:

"In order to insure prompt action in this matter and to meet the demands which will probably be imposed within a year for the care of tuberculous soldiers the law provides that if the board of supervisors of any such county shall have failed to secure the site for a county tuberculous hospital, and to have awarded contracts for the erection of suitable buildings thereon by the 1st of January, 1918, it shall be the duty of the state commissioner of health to forthiwth proceed to locate, construct and place in operation a tuberculosis hospital in and for such county, and all expenditures incurred by the said commissioner of health in this connection shall be a charge upon the county, and provision shall be made for the payment thereof by the board of supervisors of such county in the same manner as in the case of other charges against the county."

The immediate urgency of this measure is the likelihood that American soldiers and sailors may becom infected with tuberculosis. as those of other armies have, through the peculiar conditions of the present war and the serious exposures to which the men are subjected in trenches and dug-outs. But the gain in tuberculosis work in the state of thus having adequate provision for tuberculosis patients will extend beyond the necessities of wartime, and make possible a strong program of control and prevention in the future.

Such a program will doubtless provide some means of consolidating into hospital districts the remaining fourteen counties, each of less than 35,000 population and hence not affected by the present law, even though they have no provision for tuberculosis hospitals. The total population of these fourteen counties is 340,364, according to the state census of 1915. The State Charities Aid Association estimates that 275 beds are needed for this population. Of this number, fifty-six have been authorized by local authorities. — The Survey.