It is believed that two factors are responsible for the marked increase in cases in England and Wales, first the increase in venereal diseases as spread through the laxities of military life; secondly the medical ranks have been so depleted that careful attendance at the birth of a child is much less frequent than in normal times."

Ignorance and Carelessness.
Make Many Blind.

Ignorance and carelessness are the contributing causes of more cases of ophthalmia neonatorum (babies' sore eyes) than anything else. Combating these twin evils is more than half the battle in the campaign for the prevention of blindness among

the new born.

No person would deliberately contribute to the blindness of a helpless little baby. Few doctors or midwives, in attendance at child-birth, will admit carelessness in the treatment of the baby's eyes, but the number of those who plead ignorance as to the gravity of the disease (ophthalmia neontorum), methods of prevention, and the law requiring prompt reporting of all cases of inflammation of the eyes of the new born, is appalling; and this in spite of the fact that copies of the law and literature on the subject are placed in the hands of every physician and midwife. "Didn't know of the law" is the most frequent excuse of the physician when haled into court for a violation of this act.

The "ignorant midwife" is held responsible for many cases of "babies' sore eyes". Many of these midwives cannot read, but "ignorant midwives" do not have a monopoly on ignorance. The educated physician may be just as ignorant of the law, although there is less excuse for it. There is still less excuse for ignorance of this law on the part of those who have to do with its enforcement.

In the prosecution of cases under the Ohio law for the prevention of inflammation of the eyes of the new born, it very frequently becomes necessary to educate the prosecuting attorney, whose duty it is to prosecute all violations of this law. It not infrequently happens that the judge who is to sit in the case, often a justice of the peace, has never heard of the law. Being ignorant himself of the provision of the act and not realizing the gravity of the offense, the magistrate may be disposed to be lenient with the person convicted, but he has no discretion in such a case. The law provides a minimum fine of $50 for the first offense and $100 for the second or subsequent offense, which must be imposed in case of a plea of guilty or conviction. This fine cannot be remitted or suspended. It must be paid into the state treasury.

Obstacles Encountered A case of ophthalmia neonatorum was reIn Enforcing the Law. cently reported to the State Department of Health in which the attending physician through carelessness or ignorance did not use a prophylactic and did not report the inflammation of the baby's eyes which subsequently developed. A representative of the State Department of Health filed information against the physician with the prosecuting attorney of the county. The prosecutor questioned the advisability of proceeding against the physician because of the alleged bad character of the

parents of the infant. The father of the child, he said, was in jail charged with burglary, the mother possibly implicated. Furthermore, he suggested that the State Department of Health would probably be required to put up a deposit to cover costs of prosecution. Being advised that the character of the parents of the child, whose eyes the state was trying to save, was not material in the case against the physician and that if the physician knew of the character of the child's parents, that fact only aggravated the case against him. If, for instance, he had reason to believe the father or mother had a gonorrheal infection, it was all the more necessary that the eyes of the child be treated immediately after birth and that the case should have been reported to the health officer just as soon as possible after the discovery of the condition was made. It was suggested to the prosecutor that this would seem to be a case where the "sins of the father" were visited upon an innocent child rather early in life. much for the prosecutor.

Even the Judge
Did not Know Law.

So

The physician was brought before the justice of the peace and entered a plea of guilty to the charge of violating section 1248 G. C. of Ohio, which requires that physicians, midwives or other persons in attendance at a case of childbirth in a maternity home, hospital, public or charitable institution, shall use a prophylactic against inflammation of the eyes of the new born and that any inflammation of the eyes of the new born shall be reported to the board of health within six hours. The physician pleaded ignorance of this law. He was sentenced to pay the minimum fine of $50 and costs. "However, for good cause shown, I have remitted $40.00 from the above sentence$10.00 fine and costs were paid", the judge wrote upon his docket. Ignorance of the law, the judge reasoned, was a mitigating circum

stance.

Here is where the ignorance of the magistrate displayed itself. He was not aware that he was without authority to remit a fine which the law plainly says shall be paid into the treasury of the state of Ohio. That the prosecuting attorney and the justice might be officially advised on this point an opinion was furnished from the attorney general, which holds that there is no expressed authority conferred by the statutes of this state upon such officers to remit any fines due the state of Ohio.

Question Asked on The question as to whether or not precautions Birth Certificates. were taken against ophthalmia neonatorum will be printed on every birth certificate in Ohio in the future. Dr. J. E. Monger, state registrar, has just had printed 50,000 birth certificate blanks upon which this question is asked: "Was prophylactic against ophthalmia neonatorum used?" with a note stating that the prophylactic and literature are furnished free by the state department of health. This should serve as a valuable aid in the campaign against ophthalmia neonatorum. Birth certificates must be reported to the local registrar within ten days after the birth occurs.

"Your Baby's Eyes- The State Department of Health has just How to Save Them." issued a new pamphlet entitled "Your Baby's Eyes How to Save Them" to take the place of the pamphlet "Babies' Sore Eyes May Cause Blindness.". The pamphlet is for free distribution and may be had by writing the State Department of Health.

Red Cross Seal Sale
A War Time Measure.

This year will mark the first war time campaign for the sale of Red Cross Christmas seals to raise money to fight tuberculosis.

The fact that so many soldiers are returned from the European battlefields suffering from tuberculosis makes this a war time measure, and the campaign this year will be conducted along the lines of other war-time campaigns.

Kill the Winter
Flies Now.

* * *

Now is the time to begin swatting the winter flies. With the arrival of cool weather and firing up of furnaces, flies seek refuge in the home. Only the greatest vigilance will keep them out. Many make the mistake of taking down the screens with the arrival of the first frosty nights. The first freeze will not kill flies. They are not always dead when found lying around on the windows stiff with cold. They may be only playing possum. Do not let your home become a winter haven for flies. Now is the time when swatting may be really effective. The more you swat this fall the less you will have to fight next summer.

* *

Deaths from Burns Last year in Ohio 148 babies and little children For 1916. under five years of age burned to death according to statistics recently compiled by Dr. J. E. Monger, state registrar of the bureau of vital statistics. These deaths were all accidental.

The total number of persons burned to death was 458, of which 83 suffered death in conflagrations. Statistics show that the greatest number of deaths from burns occurred in the months of November and December.

In the face of these facts and figures parents should take extra precautions at this time to protect little children from danger of fires. A baby pen can be easily made which will not only protect the baby from fire and other injuries but will keep it off the floor. In case of an open fire place which is dangerous both on account of the fire popping out and the child falling in, a wire netting should be purchased or made to fit the fire place. The same applies to open gas stoves and grates.

Automobile as an
Instrument of Death.

*

An upward trend in the mortality from automobile accidents is, possibly, to be expected. in view of the steadily increasing use of these vehicles. In the registration area in 1915, 3,978 persons were killed by automobiles. In 1914, only 2,826 suffered death in this manner.

The death rate for the registration area rose from 4.3 per hundred thousand population to 5.9, an increase of 37 per cent.

To get closer home, we have figured from the Ohio bureau of vital statistics which show that 404 lives were sacrificed in automobile accidents in 1916 as compared with 304 for 1915, giving a rate for 1916 of 8.3 per 100,000 as compared to a rate of 5.9 for 1915.

Unventilated Garages
Health Menace.

Attention should be called at this season of the year to the poorly ventilated garage as a health menace. They are veritable death-traps, as dangerous as the gas-infested trenches of the European battlefields. Carbon monoxide in engine gas exhaust is odorless, colorless and tasteless and may kill you without warning, or may undermine your health. There are no statistics available as to the number of persons killed or injured by this cause for the reason that it is not among the classified causes of death and it has only become a real health menace since the advent of the automobile and the garage. There were, however, numerous items printed in the newspapers last winter with such headings as "Found Dead in His Garage" and "Overcome by Gas Fumes.' Heart failure is usually given as the cause of death in such cases. Carbon monoxide poison presents a health problem worthy of more than passing notice. The State Department of Health has just published a health warning to all motorists and garage workers, warning them of the dangers of poison gas and telling how to avoid it.

*

Impaired Memory That an overdose or heavy attack of the Result of Gas Poison. poisonous gas discharged from automobile exhausts may result in serious and perhaps permanent impairment of health is illustrated in a case recently reported to the State Department of Health. The patient was a chemical engineer, 32 years of age. He was being treated for a disability due to impaired memory. Symptoms resembled paresis. He dated his illness from an incident which occurred last February when he collapsed in his garage while changing the batteries on his engine. His wife found him collapsed on the garage floor near the exhaust, as if he might have started to open the door when he fell, the engine meantime burning a "rich" mixture. He was entirely unconscious and remained in this state until evening. In the week following he was very weak, knew every one of his friends, but would, for instance, forget that a friend had been there if he chanced to leave the room. He gradually improved, pulse became normal about six weeks after the accident. Since then, however, he became lax in his personal appearance, could drive his car in accustomed places but does not dare go where there is much traffic. Has been able to work a little in his garden. Is improving mentally but lacks initiative and does things at his wife's suggestion. His wife says he is not as friendly as he used to be, is inclined to be despondent, pessimistic and easily forgetful.

Early in August when the physician last heard from him the patient was able to answer a business letter without assistance other than being told the date. He was reported as depressed and had cried several times. The impairment, the physician reported, was largely in the line of memory and emotion.

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Woman Appointed on City Board of Health.

Miss Jennie L. Tuttle, president of the Ohio Association of Graduate Nurses and superintendent of the Instructive District Nursing Association of Columbus, has the distinction of being the first woman appointed as a member of a city board of health in Ohio.

Miss Tuttle's appointment on the Columbus Board of Health to succeed Dr. O. H. Sellennings who resigned to enter Red Cross war service, was made possible by reason of the extension of suffrage, to women in municipal affairs in the city of Columbus. Women have been serving as members of boards of education in Ohio for several years, but under a state law which requires other public officials to be electors, they have been barred from sitting as members of the board of health. The appointment of Miss Tuttle is therefore one of the first fruits of the suffrage victory in Columbus.

However, the appointment of Miss Tuttle was not a recognition of the entrance of women into the field of politics. Miss Tuttle has not been active in the suffrage cause. She has been too busy directing the work of the public health nursing service in Columbus which position makes her especially fitted for the place on the health board. Columbus has for the past five years boasted an infant mortality rate lower than the state rate. The local health officials, without reservation, give a large measure of the credit for this record to the work of the visiting nurses. The appointment of Miss Tuttle is therefore a well-deserved recognition of the nursing service for the part it has played in saving the babies of Columbus.

While the local nursing service is not under the direction of the health department, there has been harmony and co-operation between the two and the appointment of the head of the nursing service on the board of health should insure more complete co-operation and more efficient public health work.

OLD AGE. DEPENDENCY.

It is estimated that one and one quarter million persons in the United States who have reached the age of 65 are in want and are supported by charity, public and private. This means that 28 per cent, or, in other words, more than one out of every four are dependent upon public and private charity. In Massachusetts, where an excellent census was recently completed (1915), it was found that close to 35,000 persons out of a total of 190,000 were the recipients of public or private relief. This constitutes 18.2 per cent of the total population 65 years and over, but does not include a very large number who received assistance or maintenance from relatives and other unregistered sources.-Louis I. Dublin, The Vital Statistics of Old Age.