H. EDWIN LEWIS, M. D., Managing Editor

Complete Series, Vol. XXVII, No. 1 New Series, Vol. XVI, No. 1

The League of Nations.-The tercentenary of the landing of the Pilgrims at Plymouth has been celebrated with pageantry and ceremony. The true beginnings of our government may be said to date from this period, despite the settlement at Jamestown in 1607 and the visitation of Hendrick Hudson in 1609. The development of medicine during this period of time has been rapid, particularly during the last fifty years, tho the foundations of its progress antedated the landing of the Pilgrims.

Among the early regulations in this. country there were acts regulating medical practice in the establishment of fee schedules.

These conditions arose from the fact that there was no actual system of medical training beyond that arising from an apprentice and the determination of payment was based upon opinion concerning the competence of those offering themselves as capable of bleeding, cupping, preparing and supplying medicaments.

The seventeenth century was filled with "Devouring, Famine, Plague and War" and the status of physicians in European countries was high, because of their devotion to duty and their conscientiousness in fighting the pests which were decimating the nations.

At this beginning of the year 1921, there is a certain similarity to the conditions of three hundred years ago, despite the ad

IRA S. WILE, Associate Editor

vance in civilization, and regardless of the improvement in social and economic conditions. War, famine and epidemics again. devastate large sections of the universe. The cessation of the world struggle, which cost 10,000,000 lives in battle and 40,000,000 more thru its indirect, vicious effects, has left a long, gloomy trail of tragedy winding in and out of lands where the turbulence of the peasants and the hunger of royalty find a common emotional outlet in their plaintive pleadings for sustenance, relief and re-establishment. It is difficult for thinking people to voice the sentiment, "A Happy New Year," without a consciousness that at best it is but a wish whose fulfilment is doubtful for masses of humanity. struggling for a bare and chilled existence. From the Atlantic to the Pacific the eastern continent is grappling in the toils of pestilence and poverty. The grim spectre of stalking death is within the vision of millions of Americans who have taken their stock and origin from foreign lands.

America, strong in its democratic integrity, possesses countless reflections of European suffering. The United States, in truth, is a federated League of Nations. working out its salvations thru a harmonization of their common interests, and a union of their ideals thru the machinery of a republican form of government. The American idea was born of the fusion of elements whose common bond was an ag

gressive belief in the virtue and benefits of freedom and real liberty.

In would, indeed, be a Happy New Year were it possible to realize a great League of Nations organized on the basis of the common points of mutual interests that are involved in the improvement of their respective peoples. The threatening scourges of cholera, typhus, plague, influenza and syphilis are not to be regarded as diseases of local interest, but of world-wide importance. A national attack upon any of these is inadequate to safeguard the world. For the most effective campaign against such parasitic diseases, an international union is essential. It is imperative that in this League of Nations for protecting the health of the world, the foremost nations of the world shall occupy the positions of paramount leadership. The knowledge, wealth, industry, brains and brawn of the United States possess an obligation to rally to the defense of all other nations, but despite, and because of, the cessation of the war, they find themselves handicapped in aiding and preserving the surviving population.

The diseases incident to malnutrition and dependent upon international poverty are not respectors of nationality, creed, color or previous conditions of servitude. Proletarians, bourgeoisie aristocrats and democrats, monarchists and anarchists, royalists and beggars, queens and maids are, alike, subjects to the inroads of debilitating, if not death-dealing, conditions which exist thruout the world. The wealthy, sanitary and unrationed United States "views with alarm," but takes no action that will effectively check the disaster that impends.

Unless a League of Nations grapples

with these prevailing problems, 1921 will not be a Happy New Year. It will be but a repetition of the selfish nationalistic principles interpreted in terms of commercial aggrandizement, and reflected in sermons, books and articles dealing with the horrors that abound. The fullest measure of happiness, personal or international, must possess an altruistic force which reaches out for the salvation and betterment of others less fortunate. Nations, as men, object to charity when what they seek is justice and opportunity. The non-combatants of the world are forced to suffer from agencies. liberated thru a conflict that cannot be overcome without a large understanding of the brotherhood of man.

In recognizing the problems of immigration in meeting the difficulties besetting our nation by reason of unemployment, the stresses and strains incident to industrial and economic re-adjustments, in estimating the health problems of the western continent, it becomes apparent that due thought and consideration must be given to the sanitary, economic and social status of the transatlantic nations. Our participation in a world war has not made it easy for us to withdraw from participation in the fight for existence of those with whom and against whom we bore arms. If we fought for the democratization of the world and for a peace that would end war, it is incumbent upon us to fulfil the implications of our expressed idealistic attitude. It requires some organization to enable the nations, into whose fortunes we have entered, to ie-establish themselves with security against those foes more powerful and less merciful than the projectors of poison gasses, flames, shells and bullets. As there were leagues of nations in war, so there must be leagues of nations in peace, to fight

the common foes of mankind. A League of Nations for international health is fundamental.

The desolations of war are inherent in its frightfulness. The iniquitous calamities of peace are escapable, providing that the same effort at cooperation that marked the World War is continued and constructively applied to securing conditions favorable to health at the present time. Food distributions are valuable in lessening suffering from hunger. While they may slightly increase the resistance of those sorely undernourished, such relief fails to stem the tide of engulfing disaster or to overcome the shortages of supplies essential for strengthening national health. The efforts of an International Red Cross Movement are promising, but lack the power and direction that would develop from the accumulated resources of a League of Nations determined to handle the problems of the world on the basis of an international friendliness and co-administration.

The greetings of this season should reflect guarantees, sympathy and understanding. From the standpoint of the advance of civilization, in accord with modern medical knowledge, we extend our greetings to the world at large with a deep-felt hope that the ensuing year may be made a happy one thru the restoration of international confidence and international cooperation. Thru the medium of a League of Nations banded together in the interests of human welfare and human advance, may the peoples of the world find strength, comfort and realized promises during 1921.

Daylight Saving.-Now that legislatures are re-assembling, efforts will be made

to inaugurate new legislation and to repeal such enactments as may be deemed undesirable, ineffective or unwarranted. There can be no question that with the mass of legislation that is yearly enacted, much of it is petty, some stupid, some partisan and some purely for political purposes. The great bulk of it, however, is designed to advance the interests of all the citizens.

In states, as a whole, with the admixture of industrial and agricultural populations, it is often impossible to pass bills which will apply with equal comfort to both groups of the population. This is particularly well represented in the Daylight Saving law, whose main opposition arises from rural sections. During the war it came into being in this country as a means of coal saving, as well as an attempt to safeguard the health of industrial workers. After the cessation of active war conditions, the law was repealed in many states and cities, tho it still continued to remain upon the statutes in various sections of the country. An attempt to repeal the Daylight Saving act in New York State failed during 1920, but an attempt is again being made to abolish it during 1921.

There may be certain objections to advancing the clock one hour during the summer period in agricultural sections, but past experience would lead one to believe that these are not serious or insuperable. It is doubtful also whether these objections are not offset by the general advantages accruing to the rural population and which are shared by their co-workers in urban sections.

It would be bromidic for a medical journal to stress the value of sunlight and fresh air as a means of building up bodily resistance to disease. It scarcely appears

necessary to emphasize the advantages which come from increasing recreational opportunities during the hours before twilight. Certainly every opportunity for healthful outdoor life should be seized as a communal advantage, and the Daylight Saving program possesses this attribute to a notable extent. It is to be hoped that the effort to repeal the Daylight Saving bill will be unsuccessful, and that the population of the State of New York will not be denied the valuable health-giving advantages of greater freedom during the hours when sunlight is available to warm the hearts and minds of men.

The National Milk Commission.-The report of the National Commission Milk Standards of the New York Milk Committee, published in Public Health Reports, December 10, 1920, calls attention to the necessity of administering orange juice and tomato juice or other antiscorbutics in the diet of infants, particularly to those artificially fed. The differences in fresh, unheated milk, depending upon the nature of the diet of the mother or the cow, make it imperative to supplement milk in all forms in order to be certain that the infant receives some substances rich in antiscorbutic properties. This procedure becomes more necessary when heated milk is used, because even milk that only has been pasteurized has lost, in part, its protective action against scurvy.

The Commission expresses its conviction of the economic, social and hygienic advantages of a further introduction of dried milk. It demands, however, that sanitary requirements for dried and re-made milk, as far as possible be the same as those de

manded for the liquid milk of light grade. It suggests, therefore, that dried milk be labeled to show the quality of the milk before it was dried, the approximate time and temperature of heating and the fact of the presence or absence of any additional substance. Similarly, it recommends that milk powders should be labeled to indicate whether they represent whole milk, skimmed or partly skimmed. The necessity of these provisions is obvious as the general public is likely to regard all milk powders as essentially the same despite their nutritive differences and sanitary variations. From the standpoint of vitamine content, the preponderance of evidence would indicate that dried milk is in no wise inferior to pasteurized milk and, therefore, if continued for prolonged periods an antiscorbutic food or substance should be employed during its administration.

The tremendous part that milk plays in the dietary of infants and children justifies the annual meetings of the National Commission on Milk Standards and makes its reports and recommendations especially welcome in view of the high scientific achievements of the members constituting it. No service to the community as a whole has been of greater significance in raising the standards of milk production and protection than the numerous reports issued under its sanction. It is equally significant that it has been part of its practice to issue recommendations only when they represent the unanimous opinion of the members of the Commission. Thus, disputed points of view are thoroly threshed out in the light of experience and experiment until there is an agreement upon facts. Progress reports are not issued as conclusions that might mislead the public. Such action, of course, does not necessarily mean finality