being forced to hand them over to some strange woman or to the cold, bare walls of an institution. This is the corrective work, the "rescue" work, as it is poorly called, the patching up of a bad situation. Much more important is the laying of plans by which mothers in the future will be taught how to care for and feed themselves, so that when the baby comes it will first of all be a healthy baby, and, secondly, that they will know how to care for and feed it, to the end that the sickness which now makes our hospitals and institutions necessary may be prevented; that misery and wretchedness may be eliminated; that the shadow of the hand of death may be withdrawn, and that the home may be kept intact. This is the greatest work. Its requirements are few; they can be furnished by any community, whether it be small or large. Prevention is easy. It can be simply taught by doctors and nurses. If an adequate number of these workers can be provided by municipalities to teach mothers the truth about themselves, about the importance of breast feeding, and the care of their infants; and if they do their work intelligently, with the co-operation of the mothers, infant mortality can be cut in half, perhaps more than half. No city in the country has as yet made. it possible for every mother within its gates to receive this instruction, and for every baby to be protected by medical supervision and nursing oversight. The city that will accomplish this end will stand foremost in humanitarian work among cities throughout the world, for it will be the first city to realize that the organization of the means to save the babies is of equal importance with the maintenance of a fire department to save buildings from fire, and with the maintenance of a police department to save and protect purely the commercial interests of the community. The co-operation of the mothers of the city is essential to such a city programme; so is the organized effort of the physicians, social workers and citizens at large. The Child Welfare Commission, in its work in Milwaukee, has found many mothers who, through ignorance of essential facts, have refused to follow instructions which have been given them, and thus have directly contributed to the illness and death of their little ones. All experts agree that no nursing baby should receive anything but breast milk and water up to five months, except on the advice of a physician or trained nurse who possesses full information as to its physical condition. condition. In spite of this, it is the prac tice among many mothers in this city to feed their babies on a variety of food which an adult stomach would have difficulty to digest. Here is a list of foods. which have gone into the stomachs of babies in Milwaukee under five months of age within the past week: Corned beef, boiled ham, sausage, and other kinds of meats; pickles, overripe bananas, green tomatoes, raw cucumbers (with the peeling on), all kinds of fruits in various states of ripeness and cleanliness, cookies (generally cheap lemon cookies or ginger-snaps), coffee, beer, wine and brandy. It is dangerous to the life of a child. under five months to feed it on any of these articles. Mothers who are feeding their children with these foods must hold themselves liable for the sickness and death of their children, should these deaths occur. If it is a misdemeanor to the health of a community for a man to spit in the street car, and if the health of the community justifies a fine for the committing of this offense, then it is equally a misdemeanor for a woman to feed her nursing baby on any of the foods which I have mentioned. Her infant is the child of the state, and she, its guardian. The state should exercise authority over the guardians of its children. The doctors of the city should rouse themselves to the situation which confronts them; they should inform themselves more clearly about social conditions. They should study more carefully the problem of breast feeding and infant hygiene, and they should be more strict and mandatory in the instructions which they give to nursing mothers. Every baby in Milwaukee during its first year of life should be, in my opinion, under the charge either of its own physician or, in the case of mothers who are too poor to employ a private physician, under the charge of a physician provided by the municipality. Every baby should be visited regularly by a trained nurse, under the direction of such doctors. Systemical instruction in the hygiene and care of babies should be placed within reach of all mothers, so that there will be no excuse if they kill their babies or injure their health. Mothers who refuse it after proper warning, should be held liable; but I cannot believe that any mother wilfully neglects or will neglect her baby; rather, such neglect is the result of false tradition and ignorance, for whose continued existence society is responsible. A prophylactic programme of this sort, combined with an adequate provision for the care of sick babies, will result in a notable reduction of infant mortality not only in Milwaukee, but in every city throughout the United States. FRESH PINEAPPLE JUICE IN ANOREXIA. BY SAMUEL FLORESHEIM, M.D., New York. ANOREXIA is a condition that is produced by diseases and disturbances within and without the gastro-intestinal tract. It is an accompanying symptom of acute and chronic nephritis, diseases of the brain, autointoxication, exanthemata, infections and most all other febrile diseases and in the neurasthenias. General constitutional disturbances are usually accompanied by anorexia, while the neurasthenics lay great stress upon this symptom. It is by far better to treat disease upon the basis of a clear understanding of the etiology and the pathology than upon symp toms, but there are cases that are materially benefited by symptomatic treatment. Το these cases this article mainly refers. For the past few years over 150 cases, being treated with pineapple juice, having anorexia as a prominent symptom, were under observation. The number included cases of simple anemia, convalescents from malaria, nephritis, pneumonia, typhoid fever, acute and chronic gastritis, including alcoholic gastritis, and a number of patients in whom there was more or less active pulmonary tuberculosis. In the chronic diseases of the stomach in general, especially the alcoholic type, anorexia being usually of a stubborn type, the administration of the fresh juice benefited the patients to a considerable degree. Two cases of cancer were but temporarily relieved. The administration of the juice is contraindicated in cases of gastric ulcer in high acid content with marked increase of gastric secretion. When duodenal ulcers are present the juice is not well borne. In the acute cases of nephritis, the fresh pineapple juice was not employed. We are all familiar with the long siege of convalescence following the acute attack in which the anorexia is most aggravating and difficult to overcome; yet after the attack has passed off, even though much albumin was present in the urine, improvement was observed after the administration of the fresh juice. In the tubercular the appetite often is the vane (guide) in the establishing of a prognosis. The fear of anorexia coming on during the progress of the disease, or should it be present, is a predicament of no mean calibre. The patient, the physician and the family become much distressed at this stubborn feature. Measures are brought into action, sometimes with success, ofttimes with failure, and I would suggest a trial of the administration of the fresh pineapple juice to overcome this dreaded condition. It has helped wonderfully in those cases I have had the pleasure to observe. In anorexia following attacks of acute hepatitis, hepatic colic and acute gall-blad der inflammation, the fresh pineapple juice materially assisted in improving the appetite and is worthy of further trial. In a number of cases of chronic hepatitis and chronic cholecystitis, where the loss of appetite and concomitant conditions of digestion prevail to the distraction of those. interested after failure of other energetic treatment, the administration benefited these patients considerably. The feces, which were scant, containing much macroscopic undigested food and having a light color, showed material change after a course of treatment under the administration of the pineapple juice. For a short time the administration of the juice was omitted to observe the effects, if any, from its withdrawal. After the second day the digestive disturbing symptoms began to reappear, the feces became changed in color and the macroscopic appearance of the change in the feces was apparent. The reintroduction of the juice soon remedied the conditions considerably. In convalescence from pneumonia, typhoid fever and malaria, the rapidity of increased appetite and thereby the convalescence, was noteworthy. In a number of cases of neurotics, the remedy was tried to find out whether benefit could be derived from this remedy in these cases, which so lamentably cry out their inability to eat. Mention was not made as to the probable effect expected from the remedy. In the majority of the cases improvement was quite apparent, and in two of the cases the improvement was so pronounced that no other medication was required for the general condition of neurasthenia. In two other cases no material benefit was derived. In the latter cases test meal examinations showed states of high acid condition as well as increased gastric secretion. Marked constipation, internal hemorrhoids and an anal fissure were also found. This remedy in the treatment of anorexia is simple, easily obtained and well worthy of further consideration. 808 Lexington Avenue. DRY FIRE EXTINGUISHERS. BY C. C. YOUNG, Chemist Kansas State Water Survey. So much is being said about the immense national fire loss that a word about one of the fraudulent forms of protection against fire which prey upon this common knowledge may not be amiss. It is a very common thing in buildings, especially in small towns and rural districts, to see a long tube, filled with dry powder, hung on the wall, labeled in lurid colors, "fire extinguisher," no thought being held as to its efficiency as a means of protection against fire. The word "extinguisher" certainly promotes a false idea of security which should be expelled. It has been the fortune of the writer to examine the contents of some of these contrivances, and in every case which has come to his notice the basis of the powder has been baking soda or soda ash. Experiments have shown that the dry fire extinguishers (the only protection against fire in many buildings) are of no more value for putting out fire than a small coal shovel full of ashes. A New York chemist was very much impressed with a demonstration in which the salesman for the extinguisher company poured a thin stream of benzine on the floor, ignited it and then put the fire out with the dry powder. The chemist went home somewhat perplexed, but found that with a little practice he could do the same trick with a quart cup full of sand, salt or fine dirt, dexterity being the secret of the salesman's success. The chemical composition of a typical fire extinguisher is as follows: doubtedly it will naturally occur to anyone reading these figures that they can save $2.95 by purchasing a package of saleratus at the "corner grocery," for the 10 per cent. of yellow ocher is absolutely inert. Fire extinguishers of a very similar composition were in use at the Iroquois Theatre, in Chicago, at the time of the disastrous fire, and an employee attempted unsuccessfully to extinguish the first small blaze with one of them. It is a matter of record that the United State government placed hand grenades on battle ships at a price of 50 cents a quart for the solution contained therein. This solution was found, on examination, to be nothing more than salt and water. The only virtue this solution possessed over pure water was that its freezing point was lower. The type of extinguisher that will insure protection in a measure is the soda-water extinguisher. This consists of a copper cylinder filled with a solution of soda in water. A bottle of acid is so arranged that, upon turning the apparatus upside down, the contents of the bottle is spilled into the soda solution, and a strong pressure, due to the liberation of carbon dioxide, is obtained, thus forcing the water out of a short hose that is connected to the bottom of the cylinder. By this means a small stream of water can be directed very nicely upon the fire. We recommend to anyone depending upon a dry fire extinguisher for protection that they throw it in the rubbish heap and install the soda-water type or pails of water. SIMPLE DIET In an encyclopedia published in 1835, there is an article on temperance, in which article it is stated that in India some British officers were captured, imprisoned and kept on cold water and rice solely. Many of the officers went into the dungeon with diseased livers and other complaints; when they were released, after several years' confinement, they were in perfect health, and on returning to the army found themselves high in rank through the death of the officers who had been their superiors, but who had meanwhile lived freely and drank wine and spirits. SOAP AND NATIONAL CLEANLI NESS. BY HUGH A. BROWN, M.D., Washington, D. C. ARE we a cleaner nation to-day than we were a few years ago? Are the lowly scrubbing brush and the well-soaped wash cloth performing more valiantly than in the past? Does the small boy have the corners of his anatomy more violently inspected on Saturday nights? Can we say with Colonel Goethels that we are “making the dirt fly" faster than it used to? No less an institution that the Bureau of the Census, where liars are not allowed to figure, and whose figures, consequently, never lie, is authority for the statement that, whereas in 1904 there were produced 1,389,622,000 pounds of hard soap and 43,935,000 pounds of soft soap (not, however, the kind your wife uses on you when she wants a new hat) or a total of 1,433,557,000 pounds, the production of hard soap had risen in 1909 to 1,784,889,000 pounds and that of the soft variety to 59,337,000 pounds, a total of 1,844,226,000 pounds-an amount of concentrated cleanliness amply sufficient, if cut into onepound blocks six inches long and placed end to end, to encircle the globe seven times and have enough left over to stretch from New York to San Francisco and back again; enough to give each and every inhabitant of this old earth, from Hottentot to Eskimo, from Paris boulevardier to Chicago street urchin, a pound of the suds producer. In five years the production of soap has increased over 28 per cent., whereas during the same period the population of the United States increased only about 10 per cent. Thus in 1904, after deducting the relatively small amount exported, the number of pounds of soap per capita in the United States was about 17, while in 1909 it had risen to nearly 20, or at the rate of an extra pound for each man, woman and child every year and eight months. Fast as this increase has been, To there is hope for the small boy in the prospect that, with the awakening of China and the probable necessity for the export of a larger share of our soap products, this per capita amount may not show any material increase during the next few years. those of us, however, to whom soap is not merely a Saturday night dragon, the prospect of increasing national cleanliness is a cheering one. Therefore we say: "All honor to the soap factories. Let their good work go on." 306 Fourth Street, S. E. METABOLISM AND CATABOLISM. BY JAMES BURKE, M.D. THE lesson we may properly learn from the reversion of our food proteid into very simple component parts, before the synthesis of these animo-acids into homologous protein can take place, is a valuable one; it teaches us that in order to appropriate foreign proteid substances, as eggs, meat, beans, etc., the healthy person's digestive processes literally decompose the food proteid into simple units of its complex composition, called animo-acids; there are several varieties of animo-acids, any one of which might result from the digestive processes. Normal quality and quantity of ferments accompanied by the other natural necessities, converts the proteid into protein that can become human tissue; changed or opposite conditions of the ferments -as instanced in the habitual user of alcoholic beverages, habitual users of drugs, dissipators of the energies of life, result in a like changed condition of the consistence of digestive protein products, with a consequent change in the structure and function of all the tissues of the individual-an artificial metabolism, and a corresponding catabolism is established. Most of the protein is absorbed into the general circulation; the blood and tissues are surcharged with the improperly worked-up protein, the nutritive value of which is nil, and the elimination of which, under the emergencies of sickness, is only accomplished by the presentation to it of the simpler component parts of a cognate substance; a vegetable alkaloid or other proteid activity, and through their chemical affinity a harmless excretory product is formed, which forms a natural stimulus for the proper excretory organ and is promptly eliminated from the body. This foreign protein, while stored up in the tissues, is always potential for evil, as any accident, physical, chemical or medical, may resolve it out of the tissues back into the blood and fluids, where, if it meets and combines with a psuedo or other incomplete affinity, a leucomain is formed, the toxicity of which depends on its chemical construction and environmental conditions. During infections these catabolic poisons determine to a great extent the virulence of the infection; bacterial infections through destruction of some proteid of the host's tissues create leucomains and other proteid poisons, the neutralization of which can best be accomplished by the proper use of the vegetable alkaloids. Primarily, the treatment of all acute and chronic diseases should be the unloading of the bowel, of its fermenting contents, and immediately followed with the administration of the sulphocarbolates or some other good intestinal antiseptic, to prove further fermentation of the bowel contents and the consequent gaseous distension and thereby allow the bowels to assume their normal caliber and facilitate the normal flow of blood and fluids to and from the ferment other glands of the intestinal walls. Before attacking the systemic leucomains and toxins, those of the walls of the intestines should be systematically neutralized by the indicated use of podophyllin, juglandin, chionanthin, emetine, sanguinarine, colocynthin, or any other one of this class. Many times this procedure, alone, will suffice to enable the blood and other tissues to dispose of the few leucomains remaining in the system. But emergencies will arise and strychnine must be given, to neutralize the asthmatic leucomain, calchicine and salicylic acid to neutralize the rheumatic leucomain, veratrine to neutralize the eclamptic toxin, dioseorein and boldine to assist in the neutralization of the leucomains usually stored up in the liver, helemin to round out certain toxins usually stored up in irritated lung tissue. These vegetable, proteid principles are best given in minimal, frequently repeated doses; thus presenting to toxins in solution in the blood the advantages constantly accruing in the blood stream, of chemically uniting with the medical proteid principle to form by the union a benevolent excretory product. Care should be taken to ascertain the character of the dominant disturbing toxins, in every case, and then give the affinitive cognates to full saturation of the affinities of both; and short of the so-called physiologic action of the medicine. In administering these principles, the therapeutic and the poisonous action are alone to be considered. The former action is the chemical saturation referred to; while a surplus of medicine beyond that is the poisonous action of the drug-the effort of the principle, in excess, to cotalyze some proteid, component part of living structure, from which |