VOL. 18

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Professor Poncet has reported to the Paris Academy of Medicine the possibility of the transmission of tuberculosis by perspiration. In a careful examination of the perspiration of consumptive patients he claims he has found 42 per cent containing tuberculosis bacilli. Claiming that if a tubercle bacillus can leave by the skin, it may enter in the same manner, he has recommended vigorous skin hygiene. While his results have not yet been corroborated, they are worthy of attention during this hot season of the year when profuse perspiration is so normal. The entire subject of public bathing and common towels is brought forcibly to the front. The sterilization of the water in bathing pools and the abolition of the roller towel in public hotels, bar-rooms and toilets requires consideration.

Of far more importance is the study of the Bacteriologist of the Massachusetts State Board of Health who has recently investigated the bacteria content of roller towels taken from a number of toilet rooms. Twelve towels were studied with a view to ascertaining the presence of any bacteria presumably of fecal origin. Particular attention was given to organisms of the colon type. The bacillus coli com

No. 8

munis was isolated from three of the towels while four others gave marked evidence of fecal contamination. Considering the possibility of infection of towels by typhoid carriers and the consequent infection of the subsequent user of the towel, the possibility of the spread of tuberculosis thru this medium must be borne in mind in the event of Professor Poncet's investigation proving to be correct. The decrease of ophthalmic diseases in institutions became most marked thru the establishment of individual towels. It is important that with the abolition of the common drinking cup the common roller towel should give way to a more rational and hygienic institution. While many cities are giving attention to this phase of public health work, it is well to consider the legislation passed by the Board of Health in Erie, Pa., in May, 1911, and to commend it to the attention of the health authorities. of other American municipalities:

"ERIE, PA.

"The American Murderer" is a very significant title to be given to a very small creature. The general effects, however, of infection by the Necator Americanus well justifies the title. It is impossible to tell how many deaths thruout the Southern States are due to this parasite. Ashford has determined that practically one-third of the deaths in Porto Rico were due to infection by the hookworm. The social importance of this parasitic disease well justifies the establishment of the Sanitary Commis sion for Eradication of Hook-Worm Disease.

The infections by the hook-worm extend to all classes of people in the community, but its real effect is spent principally upon the poorer classes, lacking in nourishment and adequate housing and living under the most unsanitary conditions. Stiles has called attention to the fact that 68 per cent. of the farm houses in North Carolina, South Carolina, Georgia and Alabama, as he had visited them, possessed no toilet facilities of any kind. It is readily understood that the consequent pollution of the soil is a large factor in spreading diseases, among which typhoid fever and hook-worm disease are the most important.

While the hook-worm was probably originally introduced into this country thru the Africans brought to this country to satisfy the demands of the slavery system in vogue, the ne

gro to-day seems to be less susceptible to the ravages of this infection. On the other hand, the negroes continue as a prolific source of contagion inasmuch as they are carriers of the disease while not themselves suffering as greatly there from as do the whites. In our immigration, it is important that those who are infected by the Necator Americanus or its congener, anchylostoma duodenale should be excluded. The importance of this is evident in the fact that 66 per cent. of the Hindoo coolies applying for admission at San Francisco have been found to be suffering from this parasitic infection.

The general social effects of hookworm disease are to be found in the physical retardation of growth and development of children, with the corresponding backwardness in mentality. Many dullards so-called, are in reality suffering from hook-worm disease. It has been estimated that fully 30 per cent. of the efficiency of Southern education is wasted owing to the inability of children infected by this worm to absorb the education provided for them. Many workers, male and female, are incapacitated for industrial life. life. Their ambition is destroyed, their alertness is blunted, and a resultant indisposition to work causes them to be stigmatized as lazy. It is socially important to redeem these many workers at present suffering from anemia due to the necator. It

is essential to free the children from the blighting influence of this bloodsucking parasite.

As a result of the weakening influences of hook-worm infection the industrial classes are having their vital resistance lowered so that they more easily fall a prey to infectious diseases, such as pneumonia and particularly tuberculosis. As a step in the As a step in the direct preventive work of lessening the mortality rate from tuberculosis, it is necessary to wage a campaign against the hook-worm. No type of disease can be presented to municipalities as giving greater promise of hygienic results in preventive measures than the hook-worm disease. The pollution of the soil must be prevented. It means simply the installation of sewerage systems, and the provision of adequate toilet facilities. The "ground itch" can largely be obviated by having children wear shoes

The New

With the development of preventive medicine, the function of the physician is undergoing a marked change. The responsibility is being shifted from the personal care of an individual sick person to the responsibility for the health of the people en masse. Physicians are taking, chameleon like, the color of teachers, sanitarians and social advisors.

Along with this alteration in the conception of medicine there is an evolution of the trained nurse. No longer is she merely a vassal of the hospital, trained as a matter of economy to insure the care of the patients within the hospital. Her field of service has widened until to-day we have three distinct classes of nurses: First, the

or sandals with firm leather soles. Systematic education in the home, on the farm, in the schools, from the pulpits and platform, will serve to educate the people and develop a sense of responsibility that will tend to lessen the likelihood of the spread of the disease. While all these preventive measures are being employed, the general treatment of all ascertainable cases of hook worm disease must be undertaken by the administration of thymol. Thymolizing the worms is the basis of the treatment which is simple, cheap, efficient, and the economic advantage to the community is secured thru more healthful childhood, improved mentality, and greater industrial efficiency. It is a high type of social work to kill the worm and save the man. Prevention of the infection is the essence of the social treatment for the parasitic disease as it relates to whole communities.

Nursing

nurse who is to care for the sick; second, the nursing teacher whose duties are limited to those in health, and third, the visiting nurse who combines the functions of the old fashioned nurse and the teacher. The field of nursing endeavor has grown beyond the confines of the hospital and extends into every walk of civic and social life.

Physicians themselves are utilizing nurses for making routine examinations in blood, urine, stomach contents, and for handling the X-rays. Hospitals are taking advantage of her ability to serve as anaesthetists, social service workers and administrators. Increased variety of public institutions, such as, Sanatoria, Convalescent Homes, Creches, Milk Stations are