plete national recognition in the Norwegian laws concerning illegitimate children, according to a report issued by the Children's Bureau of the U. S. Department of Labor.

These laws make the State instead of the mother responsible for establishing paternity. The State holds both parents equally and continuously responsible for the illegitimate child "The child shall be entitled to bringing upmaintenance, training, and education-from both its father and its mother." The report contains a translation of the several Norwegian laws, with amendments, on illegitimate children and their care. A history of the efforts through which the legislation was secured is given in the intro

duction.

The attitude which looks upon illegitimacy as a child-welfare problem that must be solved for the sake of the child and of the State is exemplified by this Norwegian legislation. In connection with its studies of the bearing of the war upon child welfare the Children's Bureau examined the evidence obtainable but could not find that it justified the statements that have been circulated of widespread increase in illegitimacy since the war. The Bureau believes, however, that the needs of the illegitimate child must. be considered in the Children's Year campaign "to save 100,000 children's lives during the second year of the war and to get a square deal for children." In the Children's Year Working Program attention is called to the necessity of providing opportunity for normal development to the child of unmarried parents.

"The Most Futile Thing
in the World"

Borrowing the well worn expression of one of our famous humorists, "the most futile thing in the world," in our opinion, is for a great city to endeavor to run a health department and manage its hospitals upon a political basis! Kansas City, Missouri, is just now experiencing a travail of this character in its most exaggerated form. The plan is for the mayor to appoint a board of health composed of political lay-men, whose conception of the health problems of the city is usually so circumscribed as to hardly cast a shadow of an idea. This health board then appoints a health director or commissioner who is expected to do the work but to whom no authority is given. Dr. Paul Paquin, a conscientious, scientific man, sacrificed his life as health director of Kansas City in a vain endeavor to raise the standard of the health department under a political handicap. Dr. Coon, an educated, well equipped man from Harvard, very nearly repeated the experience of Dr. Paquin. As it was, Dr. Coon was sent to a political grave because he dared to defy his ward bosses. Just

one instance of the methods employed may be of interest. One day at the General Hospital reports were made of a shortage of sheets, there being only less than an average of one for each cot. The nurses' uniforms were in rags, steril bandages were all gone and old towels were being substituted. being substituted. The superintendent of the hospital made out a requisition for the necessary supplies and the nurses waited, only to be told from headquarters that there were "no available funds." After several days in this deplorable condition, a ward politician chanced to visit the hospital to call on a friend who was ill. This man happened to be the councilman from the 'Steenth ward. Immediately he noticed the condition of affairs and called sharply to the head nurse to know what it meant. He was told in plain words the situation. "I'll fix it," said the councilman, "tell me what you need." He wrote out the requisition, signed his name and "presto" the magic wand served the purpose and the supplies were forthcoming within the hour.

And yet some people ask "what is the matter with Kansas City?"

From the Government Bulletin for May 18, we learn that Kansas has the highest death rate of any city in the United States, showing 26.9 per 1,000. Rather significant as well as humiliating!

Surgeon-General Gorgas

Sixty-three Years Young!

The editor of the Southern Medical Journal pays a glowing tribute to Surgeon-General Gorgas in a recent issue, calling attention to the fact that the General will reach the retiring age of 64 years on October 3, next. The editor of the journal intimates that there might be a possibility of the president's appointing another man in place of Surgeon-General Gorgas at this time, and he expresses his strong opposition to any such possibility. We are quite sure, however, that the editor has no cause to worry. General Gorgas is not only the best fitted man for the place in the United States, but President Wilson knows it and will find a way to keep Dr. Gorgas on the job. The present surgeon-general has his whole heart and soul in his work and is serving his country with a loyalty characteristic of the man. Should the great war end tomorrow, General Gorgas would immediately enter other lines of activity for the good of the health of the people. As an illustration of his loyalty to the health problem we would like to repeat a story which Major Franklin H. Martin tells of meeting General Gorgas in the war office at Washington one morning recently. After a formal greeting Major Martin said "would it not be a grand and glorious feeling to awake some morning and find this great war over and a universal peace established?" "Indeed it would," replied General Gor

gas. "What would be the first thing you would do, General, were you notified tomorrow morning, before getting out of bed, that the war was over?" "Well, Major, I will tell you what I would do," promptly responded the General. "I would reach for the telephone and make immediate reservation for a trip to Ecuador. That is the one place on earth where they still have vellow fever!"

You cannot replace a man like Gorgas!

Medical Society of the Missouri Valley

The annual meeting of this society will be held in Omaha, Neb., Sept. 19-20, under the presidency of Dr. A. I. McKinnon of Lincoln, Neb. The following committees have been announced by Dr. Tyler, president of the Omaha-Douglas County Medical Society: Committee of arrangements, J. E. Summers, chairman; B. W. Christie, L. B. Bushman, I. S. Cutter. Reception committee, A. F. Jonas, R. W. Bliss, Roy A. Dodge. Ladies' committee, Mrs. J. E. Summers, Mrs. B. W. Christie, Mrs. A. F. Jonas, Mrs. G. A. Young, Mrs. Palmer Findley, Mrs. A. F. Tyler.

On the first evening there will be a patriotic meeting and dinner with speakers of national reputation, followed by moving pictures from the war zone. Members desiring to read papers should apply at once for a place upon the program as the number will necessarily be limited. Headquarters and meeting place, Hotel Fontenelle, room reservations should be made early.

CHARLES WOOD FASSETT, Sec'y. 713 Lathrop Bldg., Kansas City, Missouri.

Stand Behind the Boys

How many doctors have applied this now very expressive phrase to themselves? There is nothing that puts more heart and gives so much confidence to a soldier in the thick of a fight than the thought that if he does suffer a casualty he will receive proper medical care and attention. What are you doing in this respect?

There are many boys, sons of your patients or friends, who have been or will be called into the service, and what a source of consolation it would be to the parents to know that possibly their own doctor might be the one to look after their boy and they will welcome your acceptance of a commission in the Medical Reserve Corps and compliment you for so doing.

The opportunity for you to do the most good in a professional way to the greatest number of people, is to offer your service to your country

through the Medical Reserve Corps. Do not think longer about it, but apply at once to your nearest Medical Examining Board, and if you are not informed of its locality, the editor of this journal will supply the necessary information. Stand by our boys, your boys, their boys. Remember the gallant French in '76. The British who stood by Dewey in 1898. The Garibaldis who were always for LIBERTY.

The rapid expansion of the army calls for a largely expanded Medical Reserve Corps. The Surgeon General has issued a most earnest appeal for doctors. The Department has reached the limit of medical officers available for assign

ment.

"Conserve Food and preserve liberty."

In convulsions-administer chloroform by inhalation, until arrested and under control.

The Medical Society of the Missouri Valley recently purchased a $100 Liberty Bond.

Chromic acid 100 grains to 1 ounce of water. Apply solution to warts every other day. The warts will soon vanish.

Primrose dermatitis is not an instance of anaphylaxis, the toxic agents being a glucoside and an acid, not a protein substance.

Ethereal solution of menthol, 10 to 50 per cent, applied by camel's hair brush, averts boils. carbuncles, and inflammatory gatherings, and cures itching eruptions.

To Delinquents-Next month we will revise our subscription lists, and all delinquent subscriptions (excepting those in U. S. service) will be cut off. If you miss your Herald it is a fairly sure indication that you have not paid your dues or subscription.

To Prevent Undesirable Marriages-Virginia is the first state in the Union to adopt a practical marriage statute, prohibiting the marriage of habitual criminals (three or more felonies), idiots, epileptics, insane, imbeciles, or those afflicted with any contagious venereal diseases. Marriages in violation of this law may be declared void.

New Hygiene Faculty Dr. William H. Welch, Baltimore, announced the following appointments to the Institute of Hygiene and Public Health to be opened in Baltimore next October: Dr. Carroll G. Bull of the Rockefeller Institute, New York, associate professor of immunology and serology, and Dr. Raymond Pearl, of the experiment station, to take charge of the department of biometry and vital statistics.

The World War News

P. I. LEONARD, M. D.

"Our country; its need is our need, its honor our honor, its responsibility our responsibility. To support it is a duty, to defend it a privilege, to serve it a joy. In its hour of trial we must be steadfast, in its hour of danger we must be strong, in its hour of triumph we must be generous. Though all else depart, and all we own be taken away, there will still remain the foundation of our fortunes, the bulwark of our hopes, a rock on which to build anew-our country, our homeland, America."-From American Medicine, May, 1917 (National Number.)

For the week ending May 10, 1918, the personnel of the Medical Department of the army included: Medical Reserve Corps, 18,833, including 1,281 majors, 4,629 captains and 12,923 lieutenants. On active duty, 16,690, including 1,205 majors, 4,277 captains and 11,208 lieutenants.

The A. M. A Journal of May 18, 1918, contains an interesting article by Major F. R. Green, M. R. C., secretary of the Council of Health and Public Instruction of the A. M. A.

The minimum in his first list of what is essential to start with as an equipment is $64.87, and the maximum $156.25. But in summing up, the expense would be, minimum, $400.34, and maximum, $705.62 equipment to report for training camp, additional articles which are optional and overseas equipment. Living expenses in camp about $50 to $55 a month. It is to be regretted that a medical reserve officer can not buy his entire equipment from the quartermaster and thus save a great deal of money.

Moutier says that in addition to the ulcerations that have been noted in esophagus, stomach and upper bowel from the toxic action of chlorin gas shells, he has witnessed a number of cases in which the appendix evidently shared in the lesions. He describes six cases in detail in which the appendix had been previously supposedly sound, and three in which there had been a previous suggestion of appendix mischief. The "incubation" was five to eight days in the first. group, and twice this or more in those with old lesions. The symptoms did not indicate serious disturbances, and they subsided under local applications. He does not attempt to decide whether the appendicitis is the result of swallowing some of the gas or of a general toxic action.

Beck's experience leads him to advise the use

of your victory?"

Germany: "How many will be left to enjoy the fruits in charge of one of the Red Cross units which for a time worked in a German base hospital, also used this method of injecting suppurative wounds resulting from shrapnel, gunshot and bayonet, and reported most satisfactory results. Beck urges that in those cases in which early sterilization was not obtainable and the wounds persist in suppurating the bismuth paste injection or similar formula should be employed, before another radical operation is resorted to. In the residue of cases in which the bismuth paste treatment is not effective, the sutureless skin sliding operation should be employed, since with this method we are able to clear up nearly all of these apparently hopeless cases.

Thirteen cases of bullets lodged in the heart have been treated in French hospitals during the present war, with ten recoveries. The vast majority of such wounds are, as heretofore, almost immediately fatal, but French surgeons feel that as surgery is pushed to the front, in accordance with the present policy, the results in cases that are not immediately fatal from massive hemorrhage, will be very good, not even of so high a mortality as penetrating abdominal wounds.

A series of 2,203 wounds treated at a hospital in Belgium April-October, 1915, were classified as follows: rifle bullets 497, shrapnel 94, shell fragments, etc., 1,074, accidents not directly due to combat 203, fractures 179, other wounds 108, undetermined or unspecified from imperfections of records 48. Over 75 per cent of this series were returned to the firing line.

The objection to using iodine before suppuration has occurred, is that it coagulates albumin

and lowers the vitality of the wound. Turpentine has been suggested as a substitute but, on the whole, properly prepared Dakin's solution has given the best results.

The aggregate mortality of abdominal wounds is nearly 70 per cent-40 per cent shock, 20 per cent peritonitis, 10 per cent hemorrhage. 64 per cent mortality is the best report thus far made of any considerable series.

Captain W. T. Elam. of St. Joseph, has been

called to the Rockefeller Institute in New York City for instruction.

Major O. C. Gebhart, of St. Joseph, is now "over there."

Lieut. G. F. Patten, M. R. C., New York, has received the croix de guerre.

Capt. W. T. Elam is in New York City for instruction in treatment of infected wounds at Rockefeller Institute. On completion he has been assigned to duty at the base hospital, Camp Wadsworth, Spartansburg, S. C.

The Surgeon-General wishes the announcement made that ther is still urgent need for ophthalmologists in the Medical Reserve Corps. Delmas remarks that as soon as the soldier enters the hospital, he steps out from under military discipline, and yet the hospital authorities have no jurisdiction over him. He can accept or refuse needed operations, injections of drugs, etc., at his own will. But almost invariably the wounded or sick soldier trusts absolutely to his surgeon or physician, so long as no foreign element modifies this grateful confidence. There can be only two reasons for refusal to consent to needed measures, fear or ignoble motivesfear of pain, of the anesthetic or of a fatal outcome, and fear of recovery and being sent back to the firing line. Delmas does not hesitate to call the man in the latter case a deserter. The physician or the surgeon should appeal to the man's regimental commander. The man should be sent back to his regiment with a report of his refusal, unless there are grave reasons against his being moved. The presence in the hospital of one such refuser saps the confidence of the other patients. The matter is thus placed in the hands of the military commander who can apply disciplinary measures. The regulations specify that no operation, properly so-called, especially if general anesthesia is required for it, can be done without the assent of the patient. He must be warned that his refusal will be duly considered in determining the amount of his pension. In any event, it behooves the surgeon and physician to write out a detailed report of the incident, under all circumstances. This will fix the respective responsibilities of the surgeon, the wounded and the pension treasury.

A medical officer wrote to the surgeon general that his salary was too large for the work he was doing and requesting that it be reduced.

The officer has heretofore always been considered "of sound mind" and capable of conducting ordinary affairs of human life. The inquest on the lieutenant who opened the letter will be held later.

Rendu describes the lesions induced in the upper air passages by the new gaz vesicants used by the Germans. They are all practically alike, resembling a burn of the second degree, and leaving white eschars. The latter are most frequent on the anterior two-thirds of the free margin of the vocal cords.

Lieut. T. S. Blakesley, of Kansas City, has been called to the Signal Corps Aviation school at Mineola, Long Island, N. Y.

Lieut. E. A. Miller, of St. Joseph, is at Lakeside Hospital, Cleveland, Ohio, for instruction in anesthesia.

The searchlight of war has brought out many interesting facts, and one of these is that the vaunted German efficiency will not always stand. the test of comparison with American efficiency.

The Germans boasted of being the greatest farmers on earth. Investigation shows that in efficiency in agriculture, measured by the produce per acre, America being graded 100, Belgium leads the world at 205; Great Britain comes second at 164, and Germany third, at 155; America comes fourth.

But the better test is the man test rather than the acre test, and here America leads the world by over 2 to 1. Again, grading America at 100 per farm worker, Great Britain produces 43 and Germany 41. The American farmer cultivates 27 acres, the German farmer but 7. With the aid of vast quantities of fertilizer the German produces more per acre, but he produces at a much greater cost per bushel and he produces much less than half as much per man.

Eight per cent of the wounds of the Civil Wa involved the thorax, the mortality being 27.8 per cent. In the Spanish-American war, the mortality of wounds in the thorax was about 9.5 per cent; and slightly less in the Boer War. This was due not only to the introduction of principles of antisepsis but to the smaller calibre and higher velocity of bullets. In the present war, the mortality has risen to 14.5 per cent partly because the fighting has been on highly polluted soil, partly because the stationary nature of the fighting has enabled many very serious cases to be included among the wounded treated which, previously, would have died before collection was possible. The mortality of chest wounds differs widely if we distinguish between penetrating and non-penetrating. Over 50 per cent of the flesh wounds of the Civil War were located in the chest, and the mortality was only 1 per cent, whereas the mortality of penetrating wounds of the chest was 62.5 per cent and, in the Crimean War, it was 91.5 per cent.

Concerning the Doctor

Dr. G. F. Faussett has removed from Kansas City, Kansas, to St. Joseph.

Dr. E. L. Enochs has removed from Santa Ana, Cal., to San Antonio, Texas.

Dr. Foster Thompson has removed from the Corby-Forsee building to 2202 Goff avenue, St. Joseph.

Dr. Richard L. Sutton, of Kansas City, has been honored by election to the presidency of the City Club.

Dr. E. H. Bullock, formerly superintendent of State Hospital No. 2, St. Joseph, has been appointed Health Director of Kansas City, Mo.

Dr. George R. Thompson, former superintendent of State Hospital No. 2, has resumed charge of the Thompson Sanitarium and Rest Home at 2202 Goff Avenue, St. Joseph, Mo.

Dr. M. P. Overholser, of Harrisonville, was elected president of the Missouri State Medical Society at its recent meeting in Jefferson City. Excelsior Springs was selected as the next place of meeting.

Dr. Emmett P. North, of St. Louis, has been appointed a member of the state board of health, vice Dr. M. R. Hughes of St. Louis, who has been appointed to a captaincy in the United States Army Medical Corps.

Dr. James Y. Simpson wishes to announce that the Southwest Sanatorium, Kansas City, is now prepared to accept patients addicted to the use of alcohol and drugs. A separate department has been established for their care and a special treatment formulated for their relief.

Dr. John L. Moorhead, of Neodesha, Kansas, is entitled to the credit of procuring a hospital for Wilson county, the first free hospital to be erected in the state. The hospital is a complete, modern, three-story building, erected at a cost of $40,000. It has every appliance, equipment and facility for hospital work, and maintains six regular nurses. Since it has been in operation it has cared for 340 patients.

Dr. Alexis Carrel, of New York, was made a commander of the Legion of Honor on May 17, the ceremonies taking place in the presence of a number of noted personages. Among them were former Minister of Public Instruction Painleve, former War Minister Mourrier, Dr. Finney of the American army, James Hazen Hyde, and others. M. Mourrier, in an address, recalled the

excellent work accomplished by Dr. Carrel in the biological field and in construction of sutures as well as in blood transfusion.

Dr. J. Julien, battalion physician-in-chief, pays a tribute to Carrel in last issue of "Mecure de France." "To a French surgeon now in America, Alexis Carrel, redounds the honor of being the first to conceive and execute the immediate restoration of wounds, directly upon their disinfection. The seriously wounded had been regarded as lost or doomed to serious mutilation. It was a daring conception, a stroke of genius. Carrel's idea that the wound should be closed at once after being cleansed. Thanks to him and his followers, the order of procedure of modern war surgery may be summed up thus: For a given wound, at Charleroi it was death, avoided at times by a hasty operation; in the Champagne it was "excision" and permanent disability, after a year of nursing; today it is aseptization for fifteen days, followed by grafting and sutures, a healing, and return of the wounded man to the front in three or four months. These are the days of surgery at its best. And the lessons learned will be of permanent benefit. In the great revived industries will not accidents incident to labor be the first to take advantage of the lessons of war surgery? Nothing that has been learned is useless. One might say: "There is no war surgery, there is only surgery pure simple."

and

watha, Kansas, May 21st. Dr. Alexander was Dr. B. J. Alexander died at his home in Hiaone of the most widely known medical men in the state and one of the few doctors in public life who was able to raise above politics and exert his influence to the betterment of the com

munity in which he lived. Dr. Alexander's service on the state board of health for eighteen years was over a period which marked the development of that board from a political organization to one lic health service. The Kansas board of health of great efficiency and of high standard in pubnation, and Doctor Alexander was one of the now ranks well among the medical boards of the members of the board to bring it to its present standard. One of the last services rendered the state by Doctor Alexander was the revelation made concerning the conditions in the Orphans' Home at Atchison. He was one of the committee which made the investigation and found the deplorable conditions, and made the recommendations for correcting the situation. In Hiawatha, Doctor Alexander always was on the side of good citizenship. His influence never was given to any measure or man or organization for exploiting the municipality or creating a situation to the detriment of the city. Last fall Brown County was awarded the governor's trophy as