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As there are many

if necessary have two grades of nurses. nurses who could not give time to so complete a course of study, so there are patients who are not ill enough to require, or who lack the means to employ the highest priced nursing. Let there be two distinct grades then, those able to pursue the longer and more elaborate course of study, getting, as they should, to compensate for the larger outlay, a larger wage. But the long course should, so far as is possible, be in every school the same, and the short course uniform as well.

Now the only way in which this seems to me to be even approximately possible is through a plan which has occurred to me, which appeals strongly to my imagination and which would make possible such splendid advantages that it would surely seem worth the effort it would cost to try it. The idea is one which underlies all present day progress, one which is fundamental in all great business enterprises is, indeed, in everything the spirit of the times, the watch word of the future-coöperation.

The fact that what is impossible to one may be easily attained by a dozen is being proved, if proof were needed, at this moment, in all quarters of the globe, in almost every department of human activity. Why not prove it again in solving the difficult problem of how to establish a uniform and high standard in our training schools, a problem which we find so hopelessly "too much" for any one to grapple with? I would like to see established at various centers throughout the state what might be termed the

UNIVERSITY TRAINING SCHOOL.

Let the various hospitals appoint a member from each of their respective faculties to confer with members of the state universities, and decide upon a uniform course of instruction which could be carried on in the different hospitals throughout the state. Any course or courses requiring paraphenalia not usual in a hospital, or for any reason not possible to give in the majority of the hospitals, might be arranged for at the universities; part of the work being thus concentrated could be better given, at less expense under pedagogical methods, while much of it could be done, as it now is, in each hospital, to its own nurses, but this work being planned by a committee from each hospital staff joining the faculty of the university would be uniform and connected. This would, among other advantages too obvious to need pointing out, give a young woman from any one of these institutions holding the university diploma, a distinct standing known and acknowledged throughout the state.

Fuller courses in anatomy and physiology could be given in the universities than are usually possible in most of our training

schools, and courses in sanitation, hygiene, and domestic economy established by the various universities might not be limited to the training schools' pupils, since a sufficient number of students to make the venture pay for itself would probably be glad to take advantage of the opportunity offered if thrown open to the public.

I cannot, however, take your time tonight to enter into any further details. The advantages and disadvantages of the plan would have to be discussed by the faculties of the hospitals and members of the staffs of the different hospitals with the training school committees. It seems to me that the advantages are beyond computation and the disadvantages certainly not greater than lie in the path of all progress. If it is worth while to raise your profession to a higher level, to bring order and power out of the inevitable chaos of its comparative incipiency, it is worth some effort and some sacrifice to bring this about. It was through the effort of graduate nurses that a beginning has been made toward lifting your profession to the place it should holdsecond to none that any woman may occupy. It remains for you and those who work with you to further and fulfil this ideal.

454 FRANKLIN STREET.

Pernicious Effects of Alternating Current of High Voltage.'

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By FREDERICK H. MILLENER, M. D., Buffalo, N. Y.

HE Niagara frontier has become the great center of mechanical electrical development, and is destined to be at the head in that regard for many years to come, so, naturally, one would expect in this field, that is pregnant with all the possibilities of electricity, there would first be observed such phenomena as result from the immense quantities of this vital force produced here. Just as in the mining regions one looks for conditions arising from the occupation of mining.

In this brief paper I wish to present one phase of the great subject of electricity and its relation to mankind, having reference specially to its pathological effect upon the health and lives of men engaged directly in the manufacture, transforming or transmission of this mysterious field. The Röntgen ray was a chance discovery, and so are many of the discoveries which are afterwards taken up by our medical profession and utilised for the benefit of humanity.

1. Read at the eighty-fourth semiannual meeting of the Medical Society of the County of Erie, June 13, 1905.

Some of the members of this society could bear witness to the fact that I have probably wasted much time dabbling in the various manifestations of electricity; but I wish to add that one result of the vast amount of time I have given to this subject has been the formation of a habit of watching and investigating everything pertaining to electricity that has come to my attention, and the pernicious influence of alternating currents of high voltage has engaged my earnest consideration.

I have made a careful investigation of eighteen cases during the past few months, and the phenomena observed have been so remarkable, and at the same time so uniform and unvarying, that I felt it to be my duty to present the results of my research to this society, as a problem, in the hope that in a multitude of councilors, there might be found the wisdom which would work out the remedy. In the cases which I shall present to your consideration, I have, for personal and prudential reasons any professional man will readily understand, omitted the names of the persons who have detailed to me the symptoms and the conditions which have developed in their several individual cases. It would do no good to give their names to the public, and it might interfere in some way with the tenure of their employment, as great corporations, like the great power companies, do not usually relish having their employes publish conditions attending their employment which might deter others from engaging in the same work.

Briefly, however, I may state that all of the facts stated to me have been voluntary, and not the result of questioning, and I am sure that you will agree with me that the similarity of the symptoms points to but one conclusion (and that the one reached by me) that continuous employment in the immediate presence of electric generators or transformers, where one is continuously in an atmosphere heavily charged with electricity, or ozone, or some light or ray as yet undiscovered, results in such disturbed conditions of the digestive fluids or of the secretions of the stomach and its cognate glands and organs, as to greatly impair the digestive function; and that persons so employed lose their appetite, and become of an almost chalky complexion, and experience pain and distress after partaking food, and often have to obtain short periods of vacation in order to recover their ability to eat and digest their foods in a normal manner. Everybody has observed the exhilaration felt, not only by human beings, but by birds and animals and even by insects, just before an electrical storm. Children run and jump and ramble on the lawn or in the field, and feel almost as though they could fly; the young of animals frisk and sport about, birds dart

through the air, and the insect is specially conspicuous in his tantalising capers. But when the storm has at last broken, and the lightening flashed, and the air smells of ozone and of other electric fluids, there is a feeling of depression, and everything alive seeks to find some restful place where it can keep very quiet. And when the storm had passed away, normal conditions return, and the air is said to have been cleared again.

This is the most common experience. Another common experience is to find, immediately after a thunder storm, that all the sweet milk in the house has turned sour in an incredibly short time. Here we can plainly see a chemical force has been at work. What is that force? It has been explained in a variety of ways. Take your choice of the explanations. I have my ideas.

I have visited the largest, in fact practically all, of the power houses and transforming plants in this entire Niagara frontier, notably those in Buffalo, Niagara Falls, Lockport, Niagara Falls, Ontario, and many of the smaller plants; but it is particularly of the larger plants I wish to speak, where the manufacture of electricity or its transformation is the sole business of the plant.

On Saturday night last, I visited one of the power plants and one of the men in charge told me that after working for some time in the plant he found that his tea and coffee did not agree with him. He drank no liquors of any kind. Then he began bringing a bottle of milk with him for his lunch, but he said that did not work, because the milk always turned sour before noon, although it was delivered fresh the same morning. To test this, I personally went to a nearby barn and milked a quart from an obliging cow, and brought it to the plant and placed it where it would have the direct influence of the waste electricity from one of the large transformers, and in less than 90 minutes the milk was sour, the chemical effect of the high voltage alternating current. The man himself had been at work there for 6 months, and he said that when he came to the plant he was hearty, red faced, full blooded, had a good appetite, good digestion, and was a perfectly well man. Now his face and hands were almost as white as chalk, he had no appetite, and when he ate his lunch, he nearly always felt distress from it in a short time, if he remained in the plant. Whereas, if he went home to lunch and stayed away during the afternoon, he had no such distressing feelings. The same was true of breakfast or dinner. If he ate his lunch at home, and returned to the plant, he would feel the distress, just the same as if he had eaten it in the plant.

This condition was not due in any degree to a sedentary life,

for his work kept him very active, and he got all the exercise a man ought to have to keep well and healthy. Neither was it due in any degree to bad ventilation, as in these power plants there is always the very best ventilation, windows and doors are open, and to test the currents of air in one of them, I carried a lighted candle about, and I found a uniform current of air from the outside inward towards the machines. These power plants are kept scrupulously clean; drainage, lighting, heating, and the like, are perfect. In fact no stoves or heating apparatus is ever employed, as the waste energy in the form of heat which comes from the machines is always found sufficient to keep the buildings warm enough winter or summer. One would say that a power house was an ideal place in which to work, so far as all conditions of hygiene or sanitation are concerned, and so it is; but there is that mysterious fluid flowing all around about you, above, below, and on every side. Is it ozone? Is it the x-ray? Is it the violet, or the ultra-violet ray? Or is it some ray or light which science has not yet observed? What is it that throws the digestive apparatus into such disorder?

CASE I.—Mr. P., age 29; married; was employed around transformers, transforming current of 23,000 volts, 11,000 volts, and 2,300 volts per year. After having been near the machines for six or seven months he began to experience abdominal pains, became constipated, lost color and became irritable. This man went to several physicians, who, after examining him, would prescribe a physic and tell him that there was nothing particular the matter with him. He found that the only relief he could get from his trouble was to take a vacation. He has had to seek other employment.

CASE II.-J. E. B., age 27; worked around transformers two years, suffered from indigestion, constipation, and pallor, lack of energy and irritableness, with a desire to go to stool, the results of which are negative, and when he has a passage they are illsmelling but normal in color. As soon as he leaves the station for a couple of days he feels better.

CASE III.-B. W. H.; married; age 30; good habits; has worked around transformers for five years, has been in three different stations. Four months after first going to work he began to have pains across his abdomen, loss of appetite and extreme pallor. He was obliged to "lay off" from his work frequently. Physicians were inclined to believe he was coming down with tuberculosis.

I have a record of fifteen more cases, all of whose symptoms are similar, therefore, I will not read them, but any of the medi

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