แ

"Dr. S. W. Welch also makes helpful suggestions. In his words, 'Applied knowledge (regarding health and disease) is valued in the degree that it leads to social satisfactions, which include wealth, power, beauty, health, joy, and service.'

"Questions 9 and 10 asked for principles or laws which may be used in 'putting across' information regarding disease and health and in influencing behavior in such a way that conduct detrimental to public health will be avoided.

"Dr. R. S. Woodworth suggests that we should remember in this connection that 'a large share of adults are on a par in intelligence with children 10 or 13,' and nevertheless the adult does not like to be talked down to like a child.' He also proposes as useful a 'law of "projection"-the tendency to attribute objectionable behavior to others rather than to the self. It is easier to get people to object to others sneezing into the air than to get the individual to have much conscience about doing so. Thus social pressure may be created.'

"Dr. Joseph Peterson also believes in the effectiveness of social pressure. He cites the principle that individual purposive conduct is affected largely by approval or disapproval, or imagined approval or disapproval.' 'Get people to feel or imagine,' he says, 'the disapproval of society in connection with wrong conduct.' Doctor Peterson also suggests that we must remember that a large per cent of people have low intelligence.

"Dr. Aaron J. Rosanoff suggests that the gregarious instinct (loyalty to herd appeal) may be used effectively in influencing behavior. "Dr. Henry T. Moore believes that the repetition of stimulus (such as catch phrases) and habitual attitude' has value for the same purpose.

"Mr. D. Edgar Rice says that principles or laws for use in 'putting across' information regarding disease and health can be determined only by investigation. A priori opinions by those who have not made a special study of the problems are of little value.'

"Doctor Watson, Doctor Seashore, and others believe that fear must be appealed to in our efforts to influence behavior.

"Of the sanitarians, Doctor Armstrong and Doctor Welch make definite suggestions. The former says that in attempting to influence behavior conducive to health 'it is important to appeal to certain fundamental interests and instinct, such as personal welfare, love of family, pride in community, individual desire for superiority, etc.' "The next question was:

"What are the chief limitations of psychology in its application to public-health education?

"Dr. R. S. Woodworth believes that besides scientific principles, common sense and imagination are needed to apply those principles to concrete problems.

"Dr. L. M. Terman says: 'We don't know enough about the psychology of normal development.'

"There are no limitations of psychology in its application to public-health education, except money to carry out the work and the right kind of men,' says Dr. John B. Watson.

"Dr. S. W. Welch says that psychology is a comparatively new science, still in the experimental stage. To continue in his own words: A popular demand for knowledge in the field of applied psychology has led to its exploitation by numerous half-baked pseudoscientists whose public utterances have tended to discredit it among thinking people.""

"Questions 12 and 13 refer to the usefulness of Doctor Watson's study of venereal disease educational materials and to the desirability of similar studies. Many of those replying were not familiar with this study, and therefore could not answer these questions. Dr. Knight Dunlap states that the study was useful as a ground breaker, to develop methods and show the lack of precise information available.'

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"Dr. Adelbert Ford says that the study was 'very useful.' 'We need more of it,' he continues, but more carefully worked out.'

"Dr. Henry T. Moore believes that we need a study of the effectiveness of religious sanctions in relation to personal hygiene'; also 'studies of the relation of athletic interest to personal hygiene.' "Dr. L. M. Terman says in regard to Doctor Watson's study: 'I think it gave an interesting cross-section view of opinion * We do not need similar studies. We need facts, not opinions. Must have carefully controlled researches if we are to get anywhere.' (Doctor Terman may refer to Watson and Lashley's 'Consensus of medical opinion upon questions related to sex education and venereal disease campaigns,' published in Mental Hygiene, October, 1920, instead of to the study of venereal disease educational material.)

"Dr. Z. C. Dickinson suggests that we should select communities where reliable health statistics are kept, conduct campaigns in public-health education in one community and not in the other, and compare results with the aid of statistics.

"In conclusion, the question was asked:

"What kind of scientists should be recruited to develop in a more systematic manner the work of public-health education?

"The question suggested three kinds: Psychologists,' advertising psychologist,' 'educational psychologist.' and a line was left for naming any other kind of scientist."

"In the replies of the 10 sanitarians, the educational psychologist is mentioned six times, the general psychologist three times, and the

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advertising psychologist twice. Dr. S. W. Welch believes that we need the educational psychologist for this work. But the advisory service of these scientists,' he says, 'should be recruited from among the recognized leaders of education within the State and Nation rather than by setting up a competitive leadership in educational psychology within the State board of health.'

"It is significant that each of the sanitarians believes that some kind of a psychologist is needed to develop in a more systematic manner the work of public-health education. Only one in the group (Mr. Courtenay Dinwiddie) cites the need for any other kind of a scientist. As previously stated, he suggests the importance of the biologist and the sociologist.

"In examining the replies of the 21 psychologists to this question we find the general psychologist recommended thirteen times, the advertising psychologist eight times, the educational psychologist eleven times, the psychiatrist twice, a sanitarian of some kind seven times, the sociologist once. Mr. D. Edgar Rice seems to think that other kinds of scientists are not now so necessary as is the psychologist. The scientific facts are sufficiently determined,' he says. 'The problem is one of " putting across " propaganda.'

"In the preliminary statement regarding the questionnaire, attention was invited to the present confusion in the minds of sanitarians and educators regarding the meaning of the term 'public health education.' It was suggested that the term has been used at various times to refer to at least five different types of work which were described. Dr. C. E. Turner proposes that these five types of work be differentiated by the use of the following terms:

"(1) Health training' or 'health instruction' to refer to teaching children in school health habits and giving them health information.

"(2) 'Public health training' to refer to teaching men and women to become health officers and nurses.

"(3) Health education' to refer to teaching present and prospective school-teachers how to teach health habits and how to give health information.

"(4) Publicity work' to refer to 'selling public health to the people' so that they will give moral and financial support to public health agencies and public health work.

"(5) Popular health education' to refer to the giving to the general nonschool-attending public information regarding disease and hygiene, and influencing their behavior so that they will avoid disease and not expose other persons to infections."

HEALTH OF THE NAVY.

Although the time is approaching when the annual increase in sickness from infectious diseases of the respiratory type must be expected, the vital statistics of the Navy for the month of October indicate a continuance of very satisfactory health conditions. The figures show merely a 5 per cent increase in admission rates from respiratory diseases, including acute tonsillitis and acute bronchitis, for the past month as compared with September.

Indeed, there was a decrease in admissions for influenza during October, the admission rate for the entire Navy falling from 14.2 to 11.7 per 1,000 per annum. This rate is only about half the experienced median October rate for recent years. The weekly health index compiled by the United States Bureau of the Census from telegraphic returns from 71 representative cities for the week ended November 3 shows that the combined weekly death rate curve is following the curves for 1922 and 1921 very closely. There are no indications at present that influenza will become widely epidemic. However, a greater prevalence must be expected than in years immediately preceding the recent pandemic. The decrease in admissions for influenza in October was due to a 50 per cent decrease among the forces ashore. The admission rate for personnel afloat was practically the same as for the previous month. From the entire Navy reports of 114 cases were received. Twenty cases were reported by the battle fleet and 31 by the scouting fleet.

Pneumonia as well as influenza caused fewer admissions during October, only 21 cases being reported for the whole Navy as compared with 28 during September. The admission rate for the month was about 30 per cent less than the median rate for the corresponding month during the past five years.

Mumps was somewhat less prevalent in October than during the previous month. The admission rate for the United States fleet. was about nine times as great as the rate for all forces ashore. With regard to actual cases, 152 were reported from the fleets, 132 from the battle fleet, and 6 from the scouting fleet, while but 10 cases were reported from all shore stations. No case was reported by any shore station in the United States. It would therefore appear that the cases now occurring on board ship are not dependent upon infection introduced by the transfer of men from naval training stations. It remains for ships that are now dealing with mumps cases to trace their sources of infection. During September and October the U. S. S. Texas has reported 138 cases, the U. S. S. Oklahoma 39, and the U. S. S. Maryland 27 cases.

German measles, which was quite prevalent two months ago, has ceased to figure in morbidity reports, only 7 cases having been reported by the entire Navy during October.

Ten cases of scarlet fever were reported from the naval training station, Great Lakes, Ill., during October. It has not yet been reported whether all these cases occurred among incoming recruits. Since then the diagnosis has been changed in four cases to tonsillitis or other title. With this exception scarlet fever is not prevalent at this time.

Dengue continues prevalent among marines in Haiti and Santo Domingo, 80 cases having been reported as occurring among approximately 4,000 marines. One hundred and four cases developed among these forces in September and 79 in August. Twenty cases. were reported from other naval units in October, five from the Asiatic Fleet. Dengue continues to be more prevalent than in recent years.

The Navy has been comparatively free from malaria this autumn. It is gratifying to note that a steady decrease in the incidence has taken place during the worst part of the malaria season, the cases notified for the entire service decreasing from 159 in August to 93 in September and 74 in October. Approximately half of the cases occurred among marines in Haiti and Santo Domingo.

Diseases of the digestive system caused fewer admissions in October than in September. The total admission rate for disease, 412.9 per 1,000 per annum was low for the month of October, the median rate for the last three years being 576. Noninfectious diseases, as well as infections, caused fewer admissions to the sick list.

The rate for venereal diseases was also low for the month of October-99.25 as compared with the unusually high rate of 147.88 per 1,000 per annum in September. This rate (for the whole Navy) fluctuates a great deal as a result of the lack of regularity with which morbidity reports are received. The rate for forces afloat which is compiled from monthly reports of venereal disease (Form A), was 138.56 for all ships, month of September, as compared with 150.35 in August. The rate for shore stations in the United States dropped from 69 in September to 55.5 in October.

The rate for accidental injuries continues higher than three-year median rates for corresponding months. The admission rate, entire Navy, for all injuries and poisonings was 73.6 per 1,000 per annum in October as compared with 76.8 in September. The three-year October median rate is 66.2. Injuries which resulted from the grounding of destroyers at Pedernales Point, Calif., contributed to keep the rate high, because many of the Form F cards were not received until October.

The following table contains the rates per 1,000 per annum for the principal communicable diseases, October, 1923. For com