carried over for considerable periods to cover seasons of high price.

2. Το serve any particular need, a cheaper substitute can usually be found in an emergency or even by choice, without its being materially inferior.

In ancient and medieval times, governments regularly prepared for war and against failure of crops by carrying large stocks of grain and other commodities. The same course would be practicable today. To a considerable degree, this would protect the consumer against necessary or speculative increase of price and the producer against the loss from a temporary glut of the market, while the whole country would gain, almost every season, the enormous waste of individual foodstuffs left to rot on the ground because the market-price did not sufficiently pay for the labor of collection. The statement that such a scheme would be practicable is based upon known facts as to the keeping-properties of various foodstuffs, under refrigeration, after desiccation or for grains and cereal flours generally, or merely under ordinary care against the effects of the weather. The necessary methods are, indeed, already in operation (merely as business procedures for securing private profit) on a sufficiently large scale to insure their practicability on a greater scale.

As to Governmental Control or Ownership Popular sentiment has been educated, especially by war-policies, to accept the general proposition that food is as necessary a public utility as are transportation or civil or military protection. Intelligent supervision of production, transportation, and dealing in foods should be continued. The wanton wholesale destruction or waste of foods, for the purpose of maintaining high prices, should be dealt with in accordance with the fact that food represents life. And the same principle should apply to all forms of artificial manipulation of prices wherever it exists.

It is difficult to get rid of the preconceived idea that concentration of industry of any kind and management on a large scale should result in economy and low prices. In some few lines, this idea has worked out in practice, yet, we find almost always that the cost of living rises as cities become larger and the milk industry, other dairy industries, meat industry, and cooperative-farming movements have, as a rule, resulted in increased prices, just as the mod

ern laundry has increased the cost of cleanliness.

How far the explanation rests with the demands of organized executives and trained business men, and of the subsequent and logical demands of organized as opposed to disorganized individual labor, and how far the increase in ultimate cost might be avoided by proper governmental control, is an open question.

It must be conceded that, in general, meat, milk, and other foods handled by large corporations are of better quality than formerly; also, that the prices have been increased by general factors applying to all industries and ultimately resting upon the fact that the real unit of value is labor, and that, if labor is rated higher in dollars and cents, money will have a lower purchasing power, exactly in analogy to the fact that, if gold goes above the par value of currency, the latter will become debased.

Another serious fallacy that applies to foods is the "producer to consumer" theory. In plain words, the fruit-raiser, the marketgardener or the chicken- and egg-raisers has done precisely what the manufacturer has done: kept most of the jobber's and retailer's profit for himself. If anything, the producers of food have gone further than have the manufacturers in expecting the direct purchaser to take the whole burden of transportation and to pay an excessprice, on the ground that the foods are fresh-ignoring that the purchaser is the one who eliminated the necessary or accidental delays of transit-or of superior quality, which may or may not be a fact. The general experience in regard to the expected influence of good roads and automobiles is, that they have increased the cost of foods and have demonstrated the practical necessity of a properly conducted and reasonably simple system of middle

tion and rapidly tends toward an equilibrium. Thus, for example, about twenty years ago, there was a tremendous crop of potatoes, so that the retail price in cities fell to 25 cents a bushel. Most farmers, having received less for their large crop than for a small one, became discouraged. A few, however, planted potatoes for the next year and realized on them a large profit.

On the other hand, a demand in excess of supply, while temporarily increasing prices, tends, if it is steady and reliable, to increase production, so that prices fall. Thus, when oranges were beginning to be sold at prices so low that one was amused at Goethe's having thought it worth while to write a poem to accompany a gift of two oranges, it used to be said, jokingly, that oranges might some day become cheaper than apples. The crossing of the pricecurves of these two fruits has logically occurred, in accordance with the law of supply and demand, although in an exactly opposite way from the usual conception.

The facility with which businesses may be changed or modified is one reason why fluctuations of supply and demand will not permanently alter prices beyond the limits of willingness of producer to sell or of the purchaser to buy. This applies especially to the supply of milk and its derivatives. It would be very sensible for healthy adults to drop the use of milk as a beverage, and it would appear that the price of the milk for infants, invalids, and the necessary domestic uses would thus be restored to the former normal standard. But, the distributing forces could be easily demobilized, centers of municipal distribution would divert the milk to the manufacture of icecream, buttermilk, butter, butter substitutes that are using part milk or cream; or, if these centers were not willing to pay the original price to the producer, shippingcenters would be converted into creameries or else the dairy farmers would convert milch-cattle into meat or sell the animals into more remote parts of the country where the hilly nature of the ground makes ordinary crop-farming unprofitable, but, where cheese-factories exist or could easily be established. Meanwhile, the original dairy-farms would be available for marketgardening, sanitariums, golf-clubs or suburban real-estate tracts.

It is not the intention to prophesy that exactly this course would be followed or

that exactly the same processes of demobilization would occur about each municipal center, but, merely to indicate that the various steps of milk production, conversion into other dairy products, and delivery are liable to rapid adjustment according to fluctuations in demand for any particular milk product or for milk in general, so that the law of supply and demand would result only temporarily, at most, in a reduction of price.

Practical Application of Economics The law of supply and demand is, to a certain degree, amenable to the interests of the ultimate consumer, if he understands and follows its details practically and promptly, largely with regard to the principle of the use of substitutes. For example, the various mammalian meats are, for practical purposes, interchangeable, analogous cuts having nearly the same nutritive values. One who buys at any period or day whatever meat occurs to him as a choice, without regard to price, especially by telephone, will, in the long run, pay about 50 percent more for the same quality, quantity, and variety than one who selects from day to day whatever meat is cheapest and who avoids, for periods of several weeks, any particular kind that happens to be beneath the normal production. Such a course not only reduces individual expenses, but, automatically tends to secure a general maintenance of a price fair alike to producer and consumer. Approximately owing to differences of composition, and especially of waste, the actual quid pro quo is the same when the price, per pound, of lean mammalian meat equals that of a dozen of eggs, it is double that of poultry per pound, and quadruple that of small fish per pound. In this connection, the fallacy of general strikes against high price for any given foodstuff is easily seen. few years ago, a general meat-strike was called. This gave ample warning all along the line to slow up supplies. Fish were largely used as a meat substitute, at an apparent saving of 50 percent by weight, but, at an actual doubling of the cost of the nutriment furnished. The fisheries profited, retailers were embarrassed only by transient losses and the necessity of slight change in wholesale marketing. Meantime the popular appetite for real meat was whetted and the ultimate demand for meat at the original price prevented

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any loss by the meat-industries, except for the transient slacking of business.

A general, continuous policy of selective buying according to real food values would produce the desired result, up to the point at which the demands of the successive producers and dealers would remain firmnamely, at the average profits or wages demanded for comparable industries in general.

Here may be mentioned another economic principle the neglect of which probably operates to decrease the value of the purchase of food, in proportion to expenditure, more than of any other commodity. Many persons assume that certain articles are inevitably and permanently luxuries, and beyond the means of the average. Thus, in the meat-strikes already mentioned, the great majority of purchasers bought small fish at, say, 10 cents a pound, believing that the larger and better fish at 20 cents were luxuries, even though, with reference to the net nutriment, the latter actually were cheaper. In inland communities, there is quite a general belief that salt-water fish are expensive luxuries, whereas, owing to the greater average size and proportionately less waste, they often, if not usually, are more economic than fish from nearby sweet waters.

The idea of many housewives as to the expensiveness of olive-oil is so firmly es

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tablished that they often fail to realize that "a pint is a pound" and that olive-oil often is less costly than butter. This idea is closely associated with the implicit belief that everyday foodstuffs are hearty and nutritious and that more or less modern, fancy preparations are the reverse. vegetables that are not seeds or starchy accumulations in tubers and roots are weak in nutritives, while almost any culinary preparation containing sugar or oil is highly nutritious. Aside from meat, eggs, and other animal products, which are, probably, inevitably of relatively high cost, and which need be used only to secure about 25 Grams of animal proteid a day; and bread, which, on the other hand, is, one of the cheapest and most nourishing foods, especially in regard to proteid, it is generally true that the socalled plain, hearty foods are far more expensive, in proportion to nutrients, than are fancy courses, including most dessert-dishes.

Some of the economic principles of dietetics are as self-evident as they are popularly misconceived. Thus, no one will dispute the fact that the mass of similar solids varies as the cube of similar diameters. But, suppose it comes to the choice of 2-inch oranges at 20 cents a dozen and 4-inch oranges a 60, how many realize that if the former price is reasonable, the larger ones represent a saving of one dollar?

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HE title selected for this strike the reader as a little bizarre, still, it seems to me to be particularly appropriate to the subject about which I purpose to write. It is not new for the men drafted into military service to induce or to simulate some disease (before or after being called), in hope of securing exemption. Since the beginning of the present war, we have seen multiplied the number of those who have feigned illness of every description, as well as many that have mutilated themselves in order to escape military serv

ice. It is these fraudulent conditions that will be discussed more in detail.

In the venereal and dermatological clinics, a great majority of these camouflage patients were suffering from picric icterus, petroleum abscess or other provoked eruptions, while many had induced blenorrhagia. However, it is only just to say that, although the number of those thus trying to avoid doing their duty is large, it is insignificant when compared with the number actually at the front, and they are composed chiefly of the class called the submerged

tenth and who are devoid both of courage and of honor.

In the army itself, there are two opposite causes that give rise to induced disorders. First, in the tranquil sections of the front line, where there is no fighting or excitement, the soldier provokes an eruption so as to escape the deadly monotony of trenchlife. Second, in the section that has not been free from fighting night or day for many days, and where the determination of both sides to win causes death to stalk up and down the line without a moment of repose.

Milian' relates the case of a lieutenant, twice wounded, twice decorated, many times

Fig. 1. Pustulous Dermatitis produced by Thapsia (Milian).

cited in regimental orders for bravery and dash; No. 1, in his battalion for promotion, who arrived at the base hospital with a provoked eruption. It was at the time when the Huns were battling for the Vaux fort in front of Verdun. The lieutenant's battalion was to take the chief line of defense the next day. "It was almost certain death and I was afraid," he said. And this same man when once in action was a stranger to fear. The apprehension of certain danger is more terrible to support than the danger

Milan Press Médicale, May 5, 1917.

itself. Thus, we must take into consideration for this man and for all like him the extenuating circumstances that are active at the moment.

There are numerous kinds of eruptions that can be artificially provoked, the leading ones being as follows, their frequence being in the order of their enumeration: Pustulous dermatitis, bullous or phlyctenular eruptions, eczematiform dermatitis, edemas, false leg-ulcers, false mucous plaques, provoked blenorrhagia.

Pustulous Dermatitis

This is one of the most frequent skin troubles presented and one of the most characteristic. The elementary lesion in this form of provoked dermatitis is a pustule, that is to say, a little dermic elevation of the size of a pinhead and containing pus.

This pustule, if examined attentively, will be found to be reposing upon healthy tissue; and, this characteristic is important. There may be a border of inflammation surrounding it. These pustules are, as a rule, in close juxtaposition and abundant. The next important point to be observed is, that they are in the form of isolated plaques, usually two or three in number and, as a rule, all in the same neighborhood; but, even if located at different spots on the body, there always is the marked characteristic of localization. There is no diffusion nor any sign of a general character significant of constitutional disturbance.

As a rule, these pustules are found upon the face and in the beard; sometimes the ears are invaded, either the pavillon or the cranioauricular angle. Often the thighs are the seat of eruption, usually at the side and to the front, where they are most readily reached by the right hand. For the same reason, often the fore part of the left arm may be involved anywhere from the shoulder to the wrist. One of the most important points in the diagnosis is, to observe that the pustules are all of the same age, that is to say, they all present about the same degree of evolution. If the patient presents himself in the early stage, it will be seen that the pustules all develop together and coordinately; if later, they all are in the same stage of desiccation. This characteristic of the eruption, so useful in point of diagnosis, is easily explained. When the patient applied the irritating substance, he waited to see the effect, without renewing it, doubting in some measure whether it would be effective: surprised, often, at the number and marked effect of the application in producing a violent eruption, he makes no further application in the same place and presents himself before the examining surgeon.

The difference is marked between this form of eruption and that of the ordinary local infection-the pyodermatic or follicular. With these, each day, there appear one or more new pustules at points distant from each other, as, on the cheek and chin, to the right and to the left, and while one subsides another appears. It is by this manner of appearing that we recognize the etiological causative agent (Fig. 1.)

If a second eruption breaks out at the close or during the treatment of an existing collection, it appears suddenly, usually in the morning and in a new location. However, it is aways sudden, simultaneous, circumscribed, not showing a progressive evolution of successive pustules as they appear in spontaneous disease.

Two substances are in vogue for producing these skin eruptions-croton-oil and thapsia. The croton-oil causes a pustulous eruption that is more infiltrated and exhibits a more severe inflammatory base than does thapsia. The soldier soaks a tampon of cloth or cotton with the fluid, and with it rubs the oil into the creases of the face or pavillon of the ear. Thapsia ordinarily being found as a plaster or salve, it does not so readily lend itself to introduction into the cracks and crevices, so that the results of its employment are more noticeable upon the cheek-bones and prominent points of the surface affected.

The diagnosis of a provoked pustulous dermatitis generally is easy, if one remembers these marked characteristics: patches of pustules, clean and sharply localized; situated, as a rule, in regions accessible to the right hand; identical age of the pustules and the appearance of new pustules always sudden, simultaneous, and in distinct patches.

As compared with these, the pyodermatitis, the nontrichophytic sycosis, and the impetigo are easily differentiated.

Bullous or Phlyctenular Eruptions The vesicular eruptions are not so frequent, and they are more difficult to account for and more readily recognized. The patient rarely presents himself during the period of vesication; he waits for the blis

ter to dry and then aggravates the condition by various forms of irritation until an ulcer is formed. When he appears early, he presents a phlyctena, rounded or rectangular in shape, that has the appearance of a burn of the second degree; but, he denies having been burned, as that is difficult to prove, and he says, usually, that it came all of a sudden and that he is ignorant of the cause.

The Bullous Dermatitis

These cases also are rarely seen in the early stage of vesication. One patient came into the hospital, having about forty welldefined bullæ of the size of a pea or bean, and all confined to one leg. (Fig. 2.) They resembled pemphigus, but, were found upon healthy skin and without any characteristic peripheral inflammatory zones. They could not be true pemphigus, for the reason that one does not find the evidence of this disease confined to a well-localized part of the

Fig. 2. Bullous Dermatitis provoked by a Vesicant (Milian).

body; moreover, fever or any constitutional symptoms were absent, and the vesicles were all of the same age. These signs must arouse the surgeon's suspicion and enquiry; all doubt usually being dissipated by

the fact that under an occlusive humid dressing these lesions are rapidly cured in three or four days.

These vesicular eruptions are most commonly caused by the application of cantharides in some form, whereupon the subject irritates the base of the vesicle by renewed application, and thus provokes a morbid ulcerous condition. Here, the diagnosis is more difficult.

The bullous dermatitis of streptococcic origin may be confounded with the provoked eruptions; but, there is present an element that at once marks the difference between the two. In the provoked vesicular