vaccination. During the past week, Dr. Walsh said that he had been with Dr. Calkins, of Columbia University, who was working on the protozoon, supposed to cause smallpox. This protozoon occurs also in vaccinia. In the case of vaccination, however, the parasites invade only the cell bodies, while in smallpox they invade the nuclei of the cells, grow much more luxuriantly, and after a time invade the whole body, thus producing a generalized septic condition. In recent years we have come to realize as the result of studies in immunity, that babies who are fed on mother's milk are better protected against contagious diseases than are those artificially fed. The principal reason for this is that most mothers have had the ordinary diseases of childhood, and enjoy immunity from them. Immunizing substances occur in their milk, and are transferred to the child during the nursing. This constitutes another reason why mothers should be encouraged to nurse their offspring, and not allowed to neglect this sacred duty unless there is some absolutely necessary reason.

THE FOURTH QUARTERLY MEETING OF THE PROVINCIAL BOARD OF HEALTH.

THE Provincial Board of Health commenced its fourth quarterly meeting, at 2 p.m., on November 18th, 1903, at the Parliament Buildings. Those present were Dr. Kitchen, St. George, Chairman; Dr. P. H. Bryce, Toronto, Secretary; Dr. Cassidy, Toronto; Dr. Oldright, Toronto; Dr. Boucher, Peterboro'; Dr. Thompson, Strathroy; Dr. Douglas, Cobourg.

Dr. Bryce reported that the Province had been remarkably free from common endemic diseases, the deaths numbering only 1,992, or 12.5 per 1,000. The death rate from consumption was lower than usual, but nearly double all the rest. Smallpox was almost wholly absent, but diphtheria, in its distribution rather than its frequency, was ominous of an increase when the schools opened, and the result had been as feared. The returns for October to date from 52 municipalities reporting show 464 cases and 54 deaths, against 240 cases and 30 deaths in 38 municipalities in September, and 122 cases and 24 deaths in 27 municipalities in August. Reports during November indicate its continued appearance. The local health authorities seemed to be more than ever awake to their responsibilities. In Toronto the cases increased from 51 in August to 118 in October, with 14 deaths. Of 770 cases up to October 31st in Toronto, 445 were treated in hospitals, and the death rate was 12.72. The extension of the Isolation Hospital is expected to be completed in three months'

time. A medical inspector of schools has been appointed, whose duty it will be to follow up the suspects from the school-rooms.

In Guelph 9 cases of diphtheria were treated in hospital, without any deaths. In cities and municipalities where isolation hospitals do not exist the opposite story is told, and the increase of fatal cases of diphtheria has been marked.

In London, one of the best cities from the standpoint of site and sanitation, a number of fatal cases occurred in January and February, after which cases occurred, at first mild but almost steadily increasing in virulence. In June there were 23 cases and 1 death; in July 35 cases and 2 deaths; August, 18 cases and 4 deaths; September, 39 cases and 4 deaths; October, 94 cases and 8 deaths.

London had the worst experience in Ontario, but is now getting along better, with an isolation system of tents.

In Chesley a bad outbreak occurred. There were 23 deaths within thirteen days. The disease was spread principally by milk sold from the infected house before the local physician had learned the nature of the disease.

The principal cause of infection in diphtheria, Dr. Bryce said, was undoubtedly the games played by children at school. They played together, and one child with an infected throat, by kissing one other, might cause a large outbreak.

In Ottawa, out of 19 deaths in 319 cases, 9 occurred in January, when only a part were treated in hospital.

Scarlatina had decreased during the late summer months. Local Boards of Health were awakened by last winter's outbreak and were now adopting precautionary methods not formerly used. Typhoid has been remarkable for its absence.

Dr. C. A. Hodgetts, Provincial Medical Health Inspector, submitted a quarterly report upon smallpox. There had been a marked decline for the three months ending September 30th. The monthly returns were: July, 29 cases and 1 death in 11 municipalities; August, 15 cases and 1 death in 4 municipalities; September, 10 cases and no deaths in 2 municipalities. The total was 54 cases and 2 deaths in 17 municipalities. In 7 municipalities there was only 1 case each, showing the efficacy of the steps taken to prevent the spread of the disease. The outbreaks had been due in nearly every instance to mild cases infected at points outside the Province, some in Quebec and some in adjoining States. In every case with which he dealt he found no evidence of vaccination. It was as difficult to enforce vaccination now as it was five years ago. The indifference of the public was lamentable, and the present law was unwieldy. Dr. Hodgetts complained that those in high places often opposed vaccination, and he thought that if there was to be any progress made in stamping

out this disease some measures should be adopted to enforce vaccination in our schools and workshops. The indications for a general outbreak of smallpox this winter, he said, were not strong, though one centre in Frontenac, Lennox, and Addington, and adjoining townships existed in which he thought there had been infection undiscovered since last winter's outbreak.

A motion was carried that the Secretary communicate with the Minister of Education, with a view to securing, if possible, his co-operation in an effort to improve the ventilation and general sanitation of school buildings.

The Board met again at 10 a.m., on November 19th.

The morning was taken up in reading a number of communications from local boards of health. Mr. E. Mallon Davis, C.E., of Berlin, and Dr. Varden, M.H.O., of Galt, presented the plans for a system of sewerage for Galt. The system provides for a septic tank and coke beds, at an estimated cost of $20,000. The system was passed by the Board.

The Board then took up the plans presented by Mr. Speakman, C.E., for a waterworks system for the town of Whitby. The scheme provides for filtration at the lake shore through the sand, and received the Board's approval.

In the afternoon the Board took up the consideration of a bill for the appointment of county medical health officers. It is the intention of the Board to send out a report to the various municipalities for their consideration, recommending the idea of -county officers. In this connection it is the intention of the University of Toronto to establish a course leading to a diploma in public health.

Dr. Cassidy, Chairman of the Committee of Epidemics, introduced a report containing a number of resolutions to provide for the regulation of barber shops. Regulations of this kind had been passed by the Board at the fourth quarterly meeting of 1902. After they were published, however, objections had been made by the Barbers' Protective Association of Toronto to some of the regulations, especially to those providing for the disinfection of razors, cliprers, shaving brushes, etc. The committee had endeavored to obtain further information as to the most expeditious and trustworthy methods of disinfecting the various tools, instruments, etc., used in the barber's trade. To assist the committee in their investigations, experiments for the disinfection of razors and brushes had been made on several occasions by Dr. Amyot, bacteriologist of the Board. The amended regulations for barbers' shops are as follows:

(1) A barber should be clean and neat in his person and dress, should use the bath regularly, and be particular in maintaining a healthful condition of the mouth and hands.

(2) No person suffering from any disease of the skin, scalp, or hair should act as a barber, nor should anyone suffering from consumption, or any disease commonly known as contagious, serve in this capacity.

(4) If diphtheria, scarlet fever, smallpox, measles or any other contagious disease should occur in the family of a barber, or among his friends or acquaintances, he should not nurse or visit the patients, nor in any way come in contact with them, and if any such disease should appear in his own dwelling or boarding house, he should temporarily change his residence.

(4) Persons suffering from any disease of the skin, scalp, or hair, or from consumption, or persons who have recently recovered from diphtheria, smallpox, scarlet fever, or other contagious disease, should not visit any barber shop or parlor, but should be attended by the barber or hair-dresser at their own homes. All instruments used on such patients should be carefully disinfected after such use.

(5) The floor of a barber shop should be made of hardwood, or, if not so made, should be covered with sound oilcloth or other impermeable floor covering. The floor of the shop should be frequently washed with hot water and soap. As a matter of ordinary routine, it should be mopped every morning with a damp woollen cloth. If the floor is to be swept, it should first be sprinkled with dampened sawdust or wet tea leaves, or oiled and then swept, in order that as little dust as possible may be raised.

(6) The shop or parlor should be well aired before the day's work is begun, and it should also be ventilated during the day. The shop must never be used as a dormitory. Every barber shopshould be provided with running hot and cold water.

(7) The shop should be kept very clean, as should also all thechairs, razors, clippers, brushes, towels and all other articles or instruments used in the business. Towels should be carefully washed and boiled and then rinsed to remove the odor of soap.

(8) Customers should be encouraged to use, or have used on them, their own instruments (razors, soap, brushes, etc.), and in the case of persons suffering from diseases of the skin, scalp or hair, this practice should be compulsory. For operations on the dead body, a barber should have instruments used only for that purpose.

(9) (a) Razors, clippers and scissors may be disinfected by being boiled for ten minutes in soapy water or in water containing a little carbonate of potassium. For this purpose the instruments should be laid in an enamelled or galvanized metal dish, and be completely covered by the water. After boiling they should be quickly cooled in cold water and carefully dried. Steel

instruments boiled in the carbonate of potassium solution are not liable to rust.

(b) Razors may be disinfected by being held in a stream of boiling water for thirty seconds. They should then be put into cold water for a short time and carefully dried.

(c) Razors, clippers (disarticulated) and scissors may be disinfected by being exposed in a dish for fifteen minutes to the action of Hebra's spirit of soap, spiritus saponatus kalinus. They should then be rubbed dry.

(d) Razors, clippers (disarticulated) and scissors may be disinfected by being exposed in a dish to the action of 95 per cent. alcohol for forty-five minutes. They should then be rubbed dry.

(10) Hair brushes, shaving brushes, combs and straps may be disinfected by being first washed in a strong solution of sodium carbonate and soap, and afterwards placed in a small air-tight closet or case, in which is kept a saucer constantly filled with formalin, about one ounce of formalin to each cubic foot of space. It is recommended that all instruments be laid on racks or trays in this closet. This disinfection should be carried on every night.

(11) Shaving brushes may be entirely dispensed with, and a puff of cotton used instead, which can be destroyed after one using. A shaving brush may be disinfected by being placed in boiling water for ten minutes before using.

(12) Before passing from one customer to another, the barber or hairdresser should thoroughly wash his hands.

(13) The powder puff should be replaced by the powder blower, fresh ball of absorbent cotton or clean towel.

(14) A stick of alum should never be used to stop the flow of blood. A small piece of alum, after being used on a customer, should be thrown away. Astringent pencil may be used if after use it is disinfected in hot water.

(15) Sponges should not be used in a barber's work, because they cannot be cleaned as a towel may be. In place of sponges towels or balls of absorbent cotton should be used.

(16) Toilet wax should not be used indiscriminately; each customer should have his own toilet wax, which should be kept in a tube.

(17) The hairdresser should remove vaseline from the vessel containing it with a spatula or spoon. Preferably vaseline put up in collapsible tubes should be used by hairdressers.

(18) Only strictly clean linen-towels, wrappers, etc., should be used for each customer. If a freshly-laundered wrapper cannot be supplied to each customer, a clean towel should be used in place of the wrapper.

The report was adopted. This completed the quarterly meeting.