While sickness insurance for all classes of workers will be a great incentive toward the prevention of occupational diseases of both groups, still the shortage of help and the great necessity of conservation today make the creation of specific regulations for industrial hygiene in all industries very essential. Industrial America must heed such methods in order to compete with the great efficiency and economy of the minutely organized system abroad.

HEALTH BOARD TO DO LIFE EXTENSION WORK. North Carolina State Board of Health Will Inaugurate in Alamance County Unit of Life Etension Work.

To prolong life and make it more useful is the object of the Life Extension Unit, a new feature of health work that is soon to be inaugurated in Alamance County by the State Board of Health of North Carolina. Dr. A. J. Ellington, of Wake Forest College and Columbia University, has been put in charge of the work, which will begin in February or not later than March 1. Doctor Ellington has done service for eighteen months in the New York City Hospital. He has also studied with the New York City Health Department and the Life Extension Institute preparatory to this work in North Carolina.

The plan of this unit of health work, popularly known as periodic medical examinations, uses the county as a basis. At the county's expense, every white person in the county between the ages of 30 and 65 years will be given a physical examination to detect any defects or impairments leading to any serious degenerative disease. No treatment or operative procedure will be undertaken and suitable advice concerning personal hygiene and proper living habits will be given. Wherever subjects are found that demand treatment, they will be referred to a physician, dentist or oculist of their own choosing.

The examination, which will be made in a well-equipped office with modern laboratory facilities, will be, first, to detect minor physical defects which decrease one's capacity for work or pleasure; second, to detect the earliest of disease tendencies and physical impairments which may later lead to serious and fatal diseases; third, by teaching practical personal hygiene. To this end, an examination of the urine, sputum and blood as indicated of the patient will be made.

The degenerative diseases that are to be guarded against, and whose mortality rates in this country are every day climbing, are cancer, tuberculosis, kidney diseases, including Bright's, organic heart diseases, diabetes, apoplexy and arterio sclerosis or hardening of the arteries. Conditions leading to these diseases will be detected and the remedy made known.

Out of 330,179 school children examined in the city of New York in 1914, 194,207, or 58.8%, suffered from defective teeth. This exceeded the sum total of all the other defects noted by nearly 80,000. Defective teeth impair general health and impede school progress. Disorders of the digestive tract, tuberculosis and various other diseases frequently are preceded by diseased conditions in the mouth.

PROHIBITION EMPHASIZES THE NEED OF PUBLIC COMFORT STATIONS.

It looks now as if the saloon, which has for many years and in many communities done duty as a public comfort station, would pass out of existence with the rapid growth of sentiment for prohibition. In some cities which have gone dry the hotels have been over-burdened as a result and their proprietors are adding their voices to the agitation for better facilities in the way of convenience stations.

That the public comfort station should be regarded as a public utility and planned, financed and operated on this basis is the contention of J. J. Cosgrove, Director of the Public Comfort Station Bureau, New York City, in a recent article. He estimates that they can be erected out of local materials and fully equipped at a cost of from six thousand to eight thousand dollars, depending upon the materials used and the cost of labor and materials in the locality where erected.

That these facilities are patronized when provided is shown by the figures given by Mr. Cosgrove and that they could be made self-supporting is the conclusion which he draws in the following paragraphs:

"Could anything be more necessary wherever large numbers of people congregate than toilet conveniences? Unquestionably no, and this is proven by the general use of public comfort stations whereever they are built. For instance, the number of people who visited the underground public comfort stations at Thirteenth street and Pennsylvania avenue, Washington, D. C., during a certain month was 86,500. Of these, 4,600 visited the station during one day that being the greatest number for an open period- and 1,100 was the minimum number of people that visited the station during any one day.

During the same month, the public comfort station at Seventh street and Pennsylvania avenue, in the same city, and only six blocks from the one just mentioned, had an attendance of 88,000 of which 4,300 attended on the maximum day, and 1,600 on the minimum day.

Of the people visiting both these stations about 12 per cent were women. In other words, during that month 10,380 women visited the Thirteenth street station, and 10,560 women visited the Seventh street station.

In Brooklyn, N. Y., we have an even better showing. That city. has a total of six stations, a number hopelessly inadequate for a city of its size, but nevertheless showing a proportionately larger number than most American cities. During the year 1905 these six stations were visited by 12,115,117 people, averaging over two million at each station for the entire year. Of the total, 1,336.930 were women. Could anything speak more eloquently of the need of these convenience in every city.

The liberal patronage of public comfort stations wherever erected shows their need in all parts of a city, and this has led to the treatment of the subject as suggested by this bureau, as public utilities.

That is, plan them as such, not one, two or three at a time, but as a system for the city, then finance them by bonding, and make them self-supporting.

Chicago has already taken the lead in this respect, a thorough survey having been made by Louise Osborne Rowe, Commissioner of the Department of Public Welfare, and reported in a bulletin which was so valuable that unfortunately the edition is exhausted. Chicago will vote at the spring election on bonding the city to raise $500,000 to build sixty-eight stations, sites for which have even been selected. Omaha, too, is asking for enabling legislation to permit it to treat the problem in the same way, while several cities have issued bonds to build from three to six stations at a time.

Whenever debt is incurred, there ought to be some plan in mind for meeting not only the interest on that debt, but paying off the principal within a reasonable period of time. This has been taken care of under our American plan, by providing a building which is more than a toilet station, which has a waiting room like a railway station, with booth privileges, parcel checking racks, pay telephones and pay toilet compartments. It is believed that when a chain of these stations exist, news companies will pay a good rental for the stand privileges. Why not, what is it makes a stand valuable? Why, the number of people which are brought there, whatever the object of their coming. A large tobacco concern before opening a retail store anywhere, stations a man to count the number of people who pass that store during a day. If enough people pass, they figure they can attract them by their offerings. Where, then, can be found six small inconspicuous stores which attract 12,115,317 people within their walls annually? Yet that is just what the six stations in Brooklyn do year after year.

The attendance at the Brooklyn public comfort stations has rather changed the writer's ideas about the conducting of these stations. Originally, the thought was that at least half of the toilet fixtures should be free, the rest pay. Even now he believes there should be one free toilet in both the men's and women's compartments. Outside of that, why should they be free? We charge for water, we charge for gas, electricity and transportation, then why not for the use of this new public utility? Not a big fee, understand, not one that would be burdensome, but the very smallest fee we can exact, and yet one which will make theh stations more than self-supporting.

Suppose a fee of one cent were charged in Brooklyn. That is, one cent or six tickets for five cents for what are now the free accommodations, and five cents for the usual pay compartments. A charge of one cent would not be felt by anyone, yet, see what it would do for this new untility? Twelve million pennies equals $120,ooo income a year from these conveniences alone, not to mention what would be taken in annually from the stand privileges. The income in one year would pay all expenses and pay for the cost of the building and equipment. Thereafter the income could be applied to erecting stations in various parts of the city where while they would not be such good revenue producers, would at least pay their way. and prove a boon to the community."

COMMUNICABLE DISEASE-PREVALENCE

DURING DECEMBER.

The following is a brief summary of the findings resulting from investigations made by members of the Division of Communicable Diseases during December:

The sanitary conditions in a work camp of the Big Four Railroad, on the outskirts of Cincinnati, were investigated December 5, in compliance with the request of the health officer of Cincinnati. It had been reported that conditions maintained in this camp were such as to menace the health of the surrounding populace. Thorough investigation showed that sanitary conditions were rather better than usual. A few recommendations of a minor nature were made and immediately complied with by those in charge of the camp.

The reported prevalence of typhoid fever at Milford was investigated on December 5. No cases were found and the health officer and physicians stated that none had occurred for some time. It was found that three cases of the disease in a colored family living in a township adjoining Milford, had been erroneously ascribed to that village. These three cases had been taken to a hospital in Cincinnati, and arrangements made to prevent the further spread of the disease.

The measures used to control scarlet fever in Whitehouse were investigated December 5. It was found that many mild cases had occurred, which were not reported to physicians or by physicians to the health officer. The latter had not taken steps to locate such cases. The disease was also present in Berlin township, and the centralized school building was closed as a result. The local boards of health were called together and plans discussed. The health officer was ordered to investigate all suspicious cases of sickness and to maintain quarantine for at minimum period of thirty days in all cases. Physicians who had been negligent in reporting cases were interviewed and letters of warning. were sent to health officers of adjoining health districts.

On December 6th, the prevalence of scarlet fever in Caesar's Creek and Jasper townships, Greene county, was investigated. A mild form. of the disease has been prevailing in the former township, and the continued spread has been due to the lack of co-operation of the people. In Jasper township a more severe form of the disease exists. At least a hundred cases of scarlet fever have occurred in the two townships during November and December. A number of children showing marked desquamation were removed from a school. A warning to parents and physicians was placed in the newspaper of largest circulation in the county. The board of health and health officer were instructed as to other measures for the prevention of scarlet fever.

On December 7th, two suspected cases of smallpox at Piqua were examined. The diagnosis was confirmed in both instances. These cases had resided in the same family where another individual had had a skin eruption a few weeks previously. This case was traced to Greenville where the disease exists. Measures for the prevention of further cases were discussed with the health officer.

On December 7, 11, 12, 13, 14, 15 and 16th, a survey was made of the sanitary conditions at the Ohio Soldiers' and Sailors' Orphans' Home at Xenia, with a view to determining the causes for the continued prevalence of diphtheria. There have been several previous outbreaks. The present situation developed on September 27th. Since that time there have been over fifty cases and one death. Unsanitary conditions were found in cottages, hospitals, schools, industrial buildings and dairy. Common drinking cups, towels used in common and other grave faults in personal hygiene were found. There was a lack of system in the physical supervision of inmates. Recommendations for the prevention of diphtheria were made and carried out on the ground, and when the survey was completed, the outbreak was well under control, no cases having developed since December 7th. A number of general recommendations governing sanitary conditions at the institution, were also made.

Cases of suspected smallpox at Chillicothe were examined on December 12th. These cases were found to be chickenpox, but the health officer was instructed to maintain a modified quarantine to prevent unnecessary spread of the disease.

On December 12th, the prevalence of smallpox in Bedford township, Cuyahoga county, was investigated. The disease had masked as chickenpox for some time but was finally discovered by a medical inspector of Cleveland, who was called in as a consultant. The local authorities refused to proceed unless instructed by a representative of the State Board of Health. A number of cases of genuine smallpox were found. A meeting of the board of health was called and instructions given as to quarantine, vaccination, disinfection and other measures of prevention.

The diphtheria situation at Clarington was investigated on December 13th. One of the local physicians has had several cases of diphtheria in his practice. Another physician had treated several cases of sore throat, which he had not reported to the local health officer. On investigation it was found that swabs had been taken from these cases of tonsilitis and submitted to the Division of Laboratories. Reports from the laboratories showed that all cases were negative for diphtheria. Instructions were given to isolate all such cases until reports on swabs had been received and to dismiss all cases of diphtheria by the cultural method. The local board of health, health officer and physicians were acquainted with the method of securing antitoxin at board of health prices.

The prevalence of scarlet fever in Berlin township, Delaware county, was investigated December 18th. The mildness of the disease, the fact that physicians were not called, and that parents had not reported the cases, were found to be the causes of the continued spread of the disease. All school children from this and a neighboring township attend a centralized school building, which was closed December 8th, because of the outbreak. Only those cases reported by physicians have been quarantined. At a meeting of the health authorities instructions were given to locate all cases by enquiring for absentees from school and sending a physician to investigate suspected cases of illness.