30 pupils, nine positive cases and four suspicious ones were found in November.

In addition to the impetus which was given the epidemic by the original faulty diagnosis, imperfect quarantine regulations aided its spread. Cases were released from quarantine, when apparently cured, without bacteriological examination of throat cultures to establish freedom from infection. As a result, later examinations have proved that a number of patients who were released still had the germs in their throats and acted as dangerous "carriers."

Parents also failed to take their responsibilities seriously, and ig

nored instructions to consult a physician when the school nurse sent their children home with suspicious throats.

Steps have now been taken to correct these laxities, as a result of advice given by Dr. Albaugh at a meeting of health authorities, school officials, physicians and Findlay residents. Findlay's fight, however, has become a much more difficult one than it would have been in the beginning. This situation is due largely to the failure of everybody concerned -physicians, school officials and teachers and parents, as well as health officialsto take the epidemic seriously enough when it started.

It is proposed to spend $150,000 on the structure, which will accommodate 100 patients. The site has not been selected.

The plan under consideration calls for the extension of the initial expenditure over 10 years, with yearly installments of $15,000. Estimates put the cost to the taxpayers at about five cents per $1,000 per year for 10 years. The total tax duplicate of the five counties interested is $361,422,670.

The cost, which is assessed by law among the participating counties in proportion to the relative sizes of their tax duplicates, will fall as follows: Lorain county $52,537, Huron $25,754, Erie $28,374, Sandusky $27,225, Ottawa $16,109.

the five counties of District 3 numbered 198, divided among the counties as follows: Erie 43, Huron 25, Lorain 82, Ottawa 16, Sandusky 32. For preceding years the death totals for the district were as fol

lows: 222 in 1909, 230 in 1910, 215 in 1911, 230 in 1912, 195 in 1913, 182 in 1914, 168 in 1915.

The addition of the new district will raise to 32 the total number of counties which are providing care for their tuberculous citizens. District hospitals already established -located at Dayton, Springfield, Lima, Springfield Lake and Chillicothe provide for 22 counties. There are also three county and two municipal tuberculosis hospitals. Besides the 32 counties thus accommodated, nine counties maintain their patients in a private sanitarium at McConnelsville, under contract. The state sanatorium at Mt. Vernon cares for incipient

cases.

During the five years which ended a year ago, nearly 2,400 Ohio children died of whooping cough. In the same period 1,849 deaths from measles occurred in the state. Of those who died of

whooping cough, nearly four-fifths were babies a year old or younger, and all but a bare handful were under five years old. In the case of the measles victims, threefourths were under five years old.

The figures in the accompanying table show in detail the terrific gamble with death which is undertaken by the thoughtless mother who exposes her baby to either of these diseases it will get them and have it over." The table also shows shows how how measles and whooping cough compare in fatality with diphtheria and scarlet

fever those two generally dreaded diseases of childhood. During the five years in question either measles or whooping cough alone took more lives than did scarlet fever, and the two together practically equalled diphtheria in fatality.

Data for 1916 are not included in the tables herewith, which were compiled before detailed figures by age groups were available for that year. The totals alone, however, for 1916 are as follows: Whooping cough 674, measles 781, diphtheria and croup 621, scarlet fever.

210.

Last year, that is, produced whooping cough and measles death totals larger than any of the preceding five years and diphtheria and scarlet fever totals smaller

Following a survey of public health administrative methods in Springfield, Dr. Carrol Fox of the United States Public Health Service has submitted his report. He

says:

"The city of Springfield may take just pride in the fact that it has the foundation of an excellent health department which, by a little rearrangement and some additions, could be made a highly efficient organization."

In the line of "rearrangements" and "additions," he makes the following recommendations:

That a full-time bacteriologist be employed at not less than $1,000 a year.

That the nursing staff be increased by the addition of two public health nurses, each to receive a salary of not less than $900 a year.

That a telephone clerk be added. to the staff of the health depart

ment.

Employ Food Inspector

That a food inspector be employed at not less thas $900 a year to work under the supervision of the milk and dairy inspector.

That the board of education employ one more nurse and attach its staff of nurses to the health department.

That the anti-tuberculosis league employ a nurse instead of an investigator and attach her to the health department.

That the city be divided into seven districts and a nurse placed in each district to perform within. that district all of the duties re

quired of a public health nurse, including post and prenatal work, welfare work, school nursing, and services required in the control of the communicable diseases.

That a nurse follow up every birth reported to the health department, and that she be provided with a "certificate of registration" to present to the parents, this certificate to be furnished by the health department; and that activities concerned in the conservation of child life be carried on during the entire year.

That provision be made in the new wing of the city hospital for the care of infants.

Isolation Hospital Urged

That an isolation hospital of not less than 30 beds be constructed on the site of the old hospital; that it be used for the isolation of all communicable diseases (including smallpox) except tuberculosis.

That the isolation hospital be under the supervision of the city hospital but that the admission and discharge of patients be placed. under the control of the health officer.

That typhoid fever be made a placardable disease, and that disinfectants be issued free of charge to families in which there is a case of that disease.

That all children be required to be vaccinated against smallpox before entering the public or parochial schools.

That all surface wells and privies be adolished within the city limits.

That the city water supply be treated by chlorination before it is delivered to the consumer.

Test Water Daily

That daily bacteriological examinations be made in the laboratory of the health department of the city water supply.

That all of the milk of the city of Springfield be pasteurized before delivery to the consumer.

That the standard for pasteurized milk shall be as follows: that it be heated rapidly to a temperature of 145° F. and held at that temperature for 30 minutes; that it be cooled immediately to a temperature of 50° F. or lower and promptly bottled; and that it contain not more than 50,000 bacteria per cubic centimeter when delivered to the consumer.

That milk from dairies which do not score 60 or above be excluded.

That milk be transported from producer to distributor in sealed. cans, and that only bottled milk be sold to consumers.

That the board of education appoint the health officer as a memder of its teaching staff to lecture. to the pupils of the high and grammar school on the subject of public health, and that the pupils be required to pass an examination on that subject upon the completion.

Bulletin for School Pupils That the health department issue a weekly bulletin on the subject of the lecture, a copy to be given to each pupil.

That the city install as soon as practicable a modern disposal plant for the treatment of sewage, a chlorine plant for the treatment of the water supply, a municipal abattoir and an incinerator for the disposal of garbage.

That thorough and comprehensive study be made looking toward the development of a satisfactory water supply for the city.

That ordinances be passed requiring the proper disposal of manure and stable refuse and the cutting of weeds.

That the sanitary inspector be authorized to devote his entire time to those matters which have a direct bearing on the spread of communicable diseases, including the abolition of surface wells and surface privies, the proper disposa! of manure, and the requirement that all householders provide themselves with a garbage can.

That the police department lend its co-operation by making it a duty of the patrolmen to abate those nuisances which have no direct bearing on the spread of communicable disease, such as ash piles or other accumulations of rubbish, unsightly matters in general, weeds, chicken yards, slop water, bad odors, etc.

Transfer Plumbing Inspector

That the plumbing inspector be transferred to a building division or the enineering depart

ment.

That the poundmaster be transferred to the service department.

That as soon as practicable the city inaugurate a system of garbage and refuse collection, including manure.

That not less than $17,000 be appropriated to the health department to be spent as outlined in the body of the report.

That in the building code, now being written, ample provision be incorporated to prevent block congestion and overcrowding of houses; to regulate the construction and use of tenement and lodging houses, etc.; to require toilet