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to the papers of Foster,1 Heche," and Eddy.3

But as physicians we must also share a portion of the burden. Although it is true that the patient generally comes to us at a time when it is too late for education so far as individual prophylaxis is concerned, yet the conveyance to him of information concerning the nature of the disease, the importance of adequate treatment, the dangers which are apt to occur subsequently both to the individual and, as a result of transmission by him to others, will be of great value.

This applies more particularly to the physician in general practice, who sees the cases in their incipiency, than to the one working in hospitals for the insane, who generally meets with the end results in an individual who no longer constitutes a menace to society because the very disease itself has occasioned the necessity of his sequestration from the community at large. In regard to this one phase of the situation the prophylactic measures to be adopted after infection has occurred, the physician's duty is clear-cut and principally consists in providing adequate treatment for the individual wherever possible, and in affording such information as may enable him to prevent to the greatest possible extent the further dissemination of the disease.

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Government Hospital for the Insane, Washington, D. C.

DEBT, dirt and the devil are three bad things; and while the latter, serpent-like, may wriggle in, the two former may be kept out by hard work, honesty and scrubbing brushes.-SPURGEON.

THE duty of physical health and the duty of spiritual purity and loftiness are not two duties; they are two parts of one duty, which is the living of the completest life which it is possible for a man to live.-PHILLIPS BROOKS.

1 Foster, School Instruction in Matters of Sex. Journal of Educational Psychology, 1911, ii, 440. 2 Heche, A Report on the Teaching and Practice of Hygiene in the Public Normal Schools of the United States. Ibid, page 429.

Eddy, W. H., An Experience in Teaching Sex Hygiene. Ibid, page 451.

DEATHS FROM TYPHOID FEVER IN SOME OF OUR LARGE CITIES. BY HUGH A. BROWN, M.D.,

Washington, D. C.

AN extremely interesting statement has just been given out by the Bureau of the Census, Washington, D. C., regarding the mortality in 1910 from typhoid fever in seventeen of the larger cities of the United States. This statement should be of vital interest, not only to physicians and health officers, but to every person residing in the cities named. It shows the estimated midyear population in 1910 of these cities, the number of deaths in each from typhoid fever, and the death rate per 100,000 inhabitants. Placing the cities in the ascending order of death rates, and adding the rates for 1900, the table may be rearranged as follows:

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Although the total number of deaths in New York City exceeded that in any of the others in this list, the city is to be congratulated on the showing made. Its death rate per 100,000 from typhoid showed a decrease from that of the preceding year, and was only a little more than half the rate for 1900. In 1910 the city stood third in the list, with a rate of 11.6, Cincinnati, with 32 deaths and a rate of only 8.8, holding the place of honor at the head, while Boston comes second with 76 deaths and a rate of 11.3-less than half the rate of 1900. Cincinnati not only showed a decrease from 1909, but a very marked decrease from the rate of ten years ago, when 39 persons per 100,000 died from this disease.

Chicago had an even 300 deaths and a slightly higher death rate than in 1909, while Philadelphia, with 272 deaths, had a rate of 17.5 per 100,000-quite an appreciable decrease from the rate shown in the preceding year, and a marked decrease from the rate for 1900 (37.2). Baltimore DEATHS FROM TYPHOID FEVER,

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There still remains a vast amount of careful study and educational work before we can hope for the complete eradication of this disease, but certainly it is not too much to prophesy that these rates will be materially reduced within the next few years with the increased knowledge we are gaining concerning the modes of transmission of the disease, the probability of immunity from it through the use of a specific serum, and the stringent measures that are being employed in most cities in the way of careful inspection of water supplies, raw fruits and vegetables, milk, and shellfish, and the proper disposal of sewage. Along with these measures must necessarily go further education of the public, particularly as regards cleanliness in the preparation of food as well as personal cleanliness, interest in the source of milk, shellfish, and vegetables, and especially as regards cleanliness in the room of a patient suffering from the disease, and the disinfection and proper disposal of the stools and urine of such a patient.

1910, PER 100,000 POPULATION. 25 30

35

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Cincinnati
Boston

New York

Newark, N.J.
Chicago
St. Louis

Philadelphia
Cleveland

Columbus

Buffalo

Detroit

Washington

Denver

Indianapolis

Louisville

Baltimore Milwaukee

and Milwaukee stand at the bottom of the list, with the highest rates of any of the cities named, Baltimore with 235 deaths and a rate of 42.0, and Milwaukee with 172 deaths and a rate of 45.7, both being increases over the rates for 1909 and 1900.

The significance of these rates is rather strikingly indicated in the accompanying diagram, which shows the relative positions of the seventeen cities in 1910.

It may seem a hopeless task to break down the barriers of years of ignorance, but the results of the past ten years show conclusively that these barriers are far from insurmountable, and that it is only a question of time when typhoid fever will be classed with diseases like yellow fever and smallpox, which seem destined to a quick and sure extinction.

306 Fourth Street, S. E.

PROTECTION OF WELLS.

By C. C. YOUNG,

Chemist, State Board of Health, Water Laboratory,
Lawrence, Kan.

THE necessity of protecting wells absolutely against any chance of pollution from surface drainage or infiltration of water just below the surface of the ground is a well-known principle of sanitary science. However, the hazy ideas that are prevalent as to ways and means of effecting this protection have led the writer to make the following notes on construction of wells:

The curb of the well should be twelve to fourteen inches above the surface of the ground. At the surface of the ground there should be a platform of concrete or stone, sloping away from the walls of the well. The edge of this platform should be at least four feet from the wall. The walls themselves should be so constructed that no water can pass through them without having percolated through at least eight to twelve feet of soil, depending upon the character of the soil. The top of the well should be covered with a water-tight cover of wood, concrete, or stone. If wood is used, nothing should be considered but shiplap or tongue-and-groove lumber.

The two generally approved methods for constructing the walls of the well are as follows:

First. The wall may be of bell and spigot vitrified clay pipe two or three feet in diameter. The three or four sections of pipe at the bottom should be perforated, and the remainder of ordinary pipe with joints carefully closed with cement. The second method allows considerable variation of material, depending on local conditions, brick, stone, or concrete being used. The wall should be laid dry to within ten or twelve feet of the top of the well, but from this point to where the well is finished off for the cover the brick or stone

should be in cement mortar. Then this upper section of the wall should be incased by a concrete retaining wall, or by a carefully prepared clay puddle. The well should then be finished off with a platform as described above, being sure that the platform makes a water-tight joint with the wall of the well.

Bored, drilled, or driven wells usually have a shallow pit to protect the pumping apparatus from the frost. These all should be constructed and protected with as much care as the dug well. Drainage entering this pit, either by the direct route of falling through the cover or percolating through a few inches of soil, is cumulative and will follow the path of least resistance down the casing and in time grossly pollute the water below.

Old wells can be remodelled by raising the curb and digging out the dirt on the outside of the wells, and then plastering the walls with cement plaster-two parts sand and one part of cement. The well should then be encased with clay puddle or concrete. The final step would be a platform on the surface of the ground sloping away from the well.

By carefully following these directions and locating the well at least 100 feet from a privy or cesspool, there need be little danger of having a contaminated well unless the ground water itself is polluted by larger sources than privy or cesspool. Or again, the privy or cesspool may be in the same water level that furnishes the well with water. In this case the well should be abandoned at once.

ERRATA.

IN DR. BRAM's paper, "Morphine Inebriety," published in the December GAZETTE, the figures in regard to the use of opium in Formosa should read, respectively, .64 per cent.; .18 per cent.; .20 per cent.; 75 per cent.; instead of 64 per cent.; 18 per cent.; 20 per cent.; 75 per cent.

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THE LEISURE HOUR

HISTORY, PHILOSOPHY, FICTION, HUMOR, SATIRE, POETRY.

LEISURE Hour was fouNDED IN THE BELIEF THAT THE PHYSICIAN IS REALLY HUMAN; THAT HE LOVES THE BEAUTIFUL IN THOUGHT AND SENTIMENT AS EXPRESSED IN LITERATURE, AND THAT HE IS AT TIMES SURFEITED WITH TECHNICAL MATTER. SHORT, CRISP CONTRIBUTIONS ON ANY OF THE SUBJECTS NAMED IN THE SUB-HEADING ARE INVITED TO THIS DEPARTMENT

MEDICAL MEN AS STATESMEN AND POLITICIANS.

As a rule, medical men have been undistinguished in politics, national or municipal. The roll of political fame in all the countries of the world is inscribed with few names of members of the medical profession. Perhaps deep science and modern politics are incompatible. Science is a jealous mistress and in order to achieve eminence therein one must devote oneself entirely to its study. Moreover, the scientific man despises the game of politics as played nowadays, and could not bring himself down to the trickery and chicanery which seems to command success in this sphere of life. There have been one or two notable exceptions. Virchow, in Germany, for instance, was prominent in medical science, and he likewise shone in politics. He cannot, however, be said to have gained material success. He was a leader in Germany of the then forlorn hope, socialism, and while he made himself a name as an eloquent, able and energetic debater, of course he was never in power. The man of blood and iron, Bismarck, is said to have respected Virchow more than any of his opponents, for the courageous little professor at Berlin University never failed to denounce the policy of the maker of modern Germany in the most unmeasured terms. Virchow also took part in municipal politics. In France and in Austria well known men of science have occasionally interested themselves in affairs of state and in municipal matters, but have never reached quite the front rank. In Great Britain a very few conspicuous men of science have been in parliament, of whom

Sir Michael Foster, the physiologist, was the best known of the rank and file of the medical profession; or even of the best known of those who have been distinguished by their medical and clinical knowledge rather than by their especially scientific attributes, few or none have reached the higher rungs of the ladder of politics. On the other hand, there is a healthy movement on the part of medical men to engage in municipal politics in this country and in Great Britain. In the latter country there are now a large number of medical men who are taking part in municipal and local affairs. In America the same tendency is being exhibited. The lord mayor of London, for the first time in the history of that great city, is a member of the medical profession, and he has also the distinction of being the oldest man (81) ever elected to the office. Great Britain once had a prime minister who chanced to be a physician. Unfortunately he added no lustre to the profession; he was a mediocrity and a time-server and owed his elevation chiefly to the fact that he was in good odor with the Hanoverian king who reigned, who, dull himself, did not wish for a brilliant first minister. Lord Rosebery, in his "Life of Pitt," says of this man that "Addington carried into politics the indefinable air of a village apothecary inspecting the tongue of the state."

The few members of the British House of Commons who are also medical men are strictly party politicians, and would probably rather vote for their party than for legislation in support of public health.

This may be slandering the worthy gentlemen, but it is the general impression in England. In this country the most marked figure in national politics who is likewise a physician is Senator Gallinger of New Hampshire. Dr. Gallinger is a Canadian, but he is believed to have so sunk his nationality and his profession in American politics that, to all intents and purposes outside hidebound reactionary republicanism, he is a negligible quantity. In Canada two members of the new Cabinet belong to the medical profession-Dr. John D. Reid, Minister of Customs, and Dr. W. I. Roche. Indeed, there are several medical men in politics in Canada. In the Ontario Legislature there are some and in Sir Wilfrid Laurier's Cabinet two of the bestknown members had qualified in the healing art. In Canada alas, as here, and, to a lesser extent, in Great Britain, when medical men take up politics they are lost to the profession and do not use their abilities to the promotion of good health and social reform, but to the promotion of their party and, incidentally, of course, to the advance of their personal prosperity.

In England some years ago there was one conspicuous exception to this rule. The late Coroner Wakley, founder of the Lancet, is the one referred to. Coroner Wakley was among the greatest social reformers who ever lived. He founded his paper, in the first instance, for this purpose, and he entered parliament and there balloted valiantly with the same high aim in view. It perhaps would be no exaggeration to say that Coroner Wakley did more toward uplifting the medical profession and benefiting the cause of public health in England than any modern Englishman. Why is it, then, that there are not more of the type of Wakley? So far as great scientific men are concerned, it may be easily understood why they are so averse to entering the stormy and sordid arena. of politics. By temperament and nature. they are not fitted for it. To succeed as a politician a man must be brazen and somewhat unscrupulous, pretending ofttimes

to knowledge that he does not possess, with a glib tongue and strong constitution. Carlyle, in his bitter way, referred to the English House of Commons as the talking shop. The scientific man is usually the antithesis of the above description of the successful politician. Science, if it teaches anything, teaches the sacredness of truth. The use of scientific knowledge is to teach the student how little he knows, and how can such a man, as most politicians and some so-called statesmen do, stand up and arrogate to himself almost universal knowledge? It is the atmosphere of unreality and untruth which repels the true scientific man from politics. The ordinary medical practitioner truly enough says that he cannot spare the time for politics-that is, for national politics-and thus in most of the countries of the world the medical profession has little to say with regard to big questions of public health, which are left largely in the hands of tinkering, although sometimes well-meaning, amateurs. Still, there is a wide field for the medical man in municipal politics and in influencing and training public opinion with respect to health matters. It is as a teacher rather than as lawmaker in which the rôle of the medical man would seem to lie.

Now and then a person may detect in his own face in the looking-glass a momentary flash of expression of the sort which he will find formal in the portrait of an ancestor or perhaps of some living relative, near or remote. In the same way silent memories of strange feeling shall startle and move him. Beneath every face are latent faces of ancestors, beneath every character their characters.-MAUDSLEY.

SPARKLING champagne was unknown before 1695. It was invented in that year by Dom Pérignon, cellarer of the Abbey of Hautvillers, to whom is due also the introduction of the use of cork as stopper for bottles. Hemp soaked in oil had previously been used for that purpose

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