The speech

to go home in the dark." had in it wide courage and a sense of values. One forgives the royal Charles much frivolity for the sake of his dying speech, "Gentlemen, I fear I'm an unconscionable time a-dying," and anyone who has suffered much alone knows all the pathos and the fun in the crippled Heine's complaint that it was too bad of the German philosophers to abolish God-"for who, pray," said he "who am I to groan to at night after my wife has gone to sleep, if there is no God?", In youth, when we are whole and vigorous and trustful of this enveloping life, we may easily prefer tragedy. We indulge a brave desire to understand life and to know it at its worst. No rectified and decorated world, no polite reserves, will assuage our thirst for reality. We are obtuse enough and sound enough to bear the highest pitch of anguish; indeed, it takes a good deal of sensation to rouse our feelings, so thickly are we encased in coursing blood and wholesome flesh. But there comes a time when the luckiest among us bear the scars, if not the open gashes of the battle. The good, strong bones that held us upright and give our eyes a level glance across the field of life, are mashed and broken on the wheel or bent by labor, and then we ask for illusions, for comedy, for diversion, but above all for laughter; sane, courageous laughter. Broken, burdened, helpless as we are, none of us very much to be envied, none scathless, he stands highest who still can laugh. Laughter means that man can still restrain desires, still bear up under torment, still see himself in so large a setting that his personal fate seems small. Anger and contempt and bitterness are all equally silly. They leave use unaware of our relativity. One man's place in the universe is no great matter. The bag of live is deeper than any man's hand has reached. No man of far vision accepts a final despair since beyond the farthest stretch of vision spreads infinite space.

PEDIATRICS AS AN INVESTMENT FOR

THE PRACTITIONER.

Harriet C. Hinds, in the National Eclectic Quarterly, points out that children not only comprise a large proportion of his patients, but, through the parents, influence a still larger number.

When we attempt to consider this question there opens to our vision so many departments of medicine as a profession that we wonder which ones we might slight and yet suffer no loss in consequence. And we argue from the viewpoint that the little ones are grownups not yet developed, and therefore a class not necessarily demanding a separate study. It is true that the fullfledged doctor has been obliged to wade through years of devotion to study in order to fill out the demands of an allround practice with acceptance.

Can we decide to pass over lightly any one study?

We are now considering this one specialty as an investment. Does it pay to slight the diseases of the little ones in our hours of study? If we look at it from the professional side we realize that we cannot certainly afford to lose any help that thorough study may give us in relation to this class of patients.

Little ones are not always born. healthy with strong, vigorous mothers. Therefore, doctors are obliged to supply these deficiencies by their knowledge and skill, if life is to be saved and health restored. In the matter of infant feeding alone we meet with serious difficulty and need all the wisdom and experience. we can gather. So many babies are artificially fed, owing to the inability or unwillingness of the mother to nurse the child. And here must he doctor be able to advise so wisely concerning the food, that it is digestible and nutritious, and goes to building up the little body. Are the proteids too small in quantity? We soon find that our little patient is not gaining in weight and showing other disturbances in nutrition. Does the little one have attacks of colic and a

change in the character of its bowel movements? We think then of reducing the proportion of proteids in its food. In relation to the quantity of fat in the prepared food of the infant, if it takes too large a proportion it will throw off curds between feedings and probably be subject to diarrhoea. Sometimes a baby nursed by the mother may show signs of indigestion through the milk secreted being very rich in fats and poor in proteids. Then the physician must know if the general health of the mother is good, whether her diet is not sufficient or if she has too little exercise. True, we may have all the wisdom of an Æsculapius and yet frequently not be able to correct the faults of nutrition in our little patients. But surely the more we have studied the better we will understand how to assimilate the food to the digestive powers of the baby.

It is difficult to decide when to allow infant foods to be given. They are widely advertised and easily prepared, but not always a suitable food, certainly not for a very young child. They may be substituted for a short time where milk in any modified form seems to disagree. But experience teaches us that they are not adapted to the stomach of a very young infant except rarely as temporary makeshift.

a

Congenital defects in the newborn are occasionally met with, but fortunately are not frequent; yet they need previous knowledge and skillful handling.

The general diseases of children are often studied in connection with those of adults' diseases. But there are many minor points (really major) which are not dealt with in these departments. In fact, there are distinct variations in the mode of attack and in the successive stages of the same disease in children which necessitate a separate study. The disorders of the little ones are not easy to diagnose owing frequently to extreme nervous irritability. They are a class by themselves in many respects, and only he who is familiar with these idio

syncrasies can adapt himself successfully to a wise course of treatment.

Now, on the commercial side of the question (for there is one), do we not gain by a thorough study and close attention to the diseases of children? If we look around we see now many practitioners devoting their time and making a specialty of pediatrics. They gain thus public recognition and a consequent increase of patronage, not always specially deserved, but they get the reward of their devotion and sometimes earn it. It is true that looking at the subject financially is not the highest ideal of a successful practice. The honorable physician of today is not taking a mercenary view of his life work. The saving of life and the building of a strong, healthy body is the greatest reward of his efforts; and he aims to meet on equal grounds the most devoted of students by making a thorough study of every department of medicine his most valued investment.

TAKING NO CHANCES.

One Saturday night, when butchers generally hang hams, etc., outside, a hungry passerby stole one, and to get out of the way ran into the vestibule of a church. He found that confession was being heard, and his conscience compelled him to confess his sins.

The priest asked him: "Where is this ham?"

And the man said: "Under the last pew."

He was given his penance, and when he went to look for the ham it was gone.

For two months he did not go near the church, and during that time fell in love with a girl and married her. When finally he went to confession, he told the priest about it, and was asked: "Where is this girl?"

But the man quickly answered, "Not on your life! I told you where the ham was."

HYGIENE OF THE SLEEPING ROOM.

Between the extremes of "fresh air crank" and "catch cold crank," very sensibly remarks the Charlotte Medical Journal, there is a sensible moderation and in no place, perhaps, is this simple moderation more necessary than in our sleeping rooms. The hygiene of the sleeping room, however, involves more than just the freshness of air in the room. It involves the location of it, the furnishing of it, the airiness of it, whether it be light or dark and the size of it in relation to the number of people who occupy it.

As the proper hygiene of the sleeping room is a part of preventive medicine, it is within our province to discuss it. In fact, a good many naturally healthy human beings have their normal resisting power rendered vulnerable to the invading hosts of disease by sleeping rooms medically unfit for habitation. This statement not only refers to the houses of the poor but to those of the wealthier classes as well. Many diseases really gain their foothold in our bodies while we sleep. Ignorance of the proper hygiene of the sleeping room is one of the causes for poor sleeping rooms and neglect on the part of the doctor to discuss things with his patient and to seek to correct the errors that he sees is another.

In the first place, the sleeping rooms of our houses should be the best rooms; however, as a rule, they are the worst because company don't see them, whereas for the reason that company does see them the best rooms are usually given over to the parlor and sitting room. The sleeping room, if possible, should be large, light and airy, with plenty of windows on every side. This latter arrangement allows of fresh air at all times, without the discomfort of having

everything blowing about, no matter in which direction the wind happens to be blowing.

If the room is to be occupied by more than one, the proper ratio of cubic feet of air space for each occupant of the roem should be looked for. Each occupant should sleep alone and the beds should not be close together. Folding beds are not as desirable as others, for obvious reasons. A tendency to curvature of the spine will be prevented by having a good firm bed spring and over that a fairly firm mattress.

Washable blankets are the only coverings that conform to the rules of hygiene. Comforters, feather or cotton filled, are most glorious germ holders, and are mentioned mostly to be absolutely condemned. Besides the sheet covering the mattress, it is cleanly and, therefore, more healthy if another sheet is used between the night dress and the bed coverings. Iron beds are more healthy than wooden beds because they can be kept cleaner.

The floor covering of the sleeping room should be on the style of a rug, so that it can be taken up frequently and thoroughly cleaned in the open air. The floor should be of such a finish that it can be scrubbed several times a month with some good antiseptic solution and should be wiped up daily with a damp cloth. A damp cloth is used because dirt will cling to it; whereas, with a dry cloth dirt would be merely brushed from one spot to another and into the air of the room. The hangings of the room should be as few as possible, as they are merely ornamental germ gatherers. Such as are used should be of washable materials.

Soiled clothes should never be kept in the room while waiting for wash day to come around. If it is found necessary

to keep portable toilet conveniences in the room at night they should always be of the covered variety and when not in actual use they should be kept covered. Food should never be kept in the sleeping room, nor eaten there except in cases of sickness where the patient is confined to bed. A sleeping room is not necessarily to be considered as well aired because it is cold. Impure air can also be sold. On the other hand, it is not necessary to have everything in the room blowing about as in a gale to properly air the room.

QUIETING THE BABY. Remember, admonishes Dr. Register, in his excellent journal, that the best baby pacifier known is the very simple expedient of making and keeping your baby comfortable. A baby who gets enough to eat, gets enough sleep, and who is kept dry and clean in comfortable clothes with no pins sticking him anywhere, will be so busy crowing in his joy of living that he will have no time for fretting and irritability. It is your unwell or neglected baby that looks for any such artificial, imitation sort of comfort or solace as is given by a pacifier.

And that baby needs attention of another kind other than that false temporary quieting down induced by sticking. a dirty bit of rubber into its mouth for it to suck on. Oh! yes, many babies who have had pacifiers survived and grew up seemingly as strong and healthy as babies whose doctors were wise and sensible enough not to hazard the lives of their little charges. But what about those who didn't? Ask the sorrowing parents who mourn the loss of their little "sunshines of the household." What about the doctors who did and still allow their patients to stick these "infant destroyers" into the mouths of their helpless babies? We are rather ashamed to admit that in this age of scientific medicine and knowledge of bacteriology that still such medical (?) men can be found, but it is our not vain hope that

pretty soon they will be as scarce as the proverbial "hen's teeth." Should you be one of these won't you please give this subject the serious thought it deserves? If you do you will not only stop the use of them in your practice but will wonder why you ever allowed yourself to be guilty of using them.

POISONING FROM PAINTED BED

STEAD.

Hirsch, in Berliner Klinische Wochenschrift, reports a case of lead poisoning in a two-year-old child. The child was brought to him with the history of continued vomiting and colic for six weeks. On the strength of this it had been treated at some clinic for whooping cough. The child vomited all food and was constipated. There was great pallor and emaciation and a scaphoid abdomen very painful to palpation. He elicited the history that for weeks the child had been gnawing and sucking at its bedstead, which had been painted by the child's father, who was employed in a dye and paint works. Inspection of the bed showed that the paint had been sucked off an area about 4 by 8 inches. Scrapings of the paint and a small portion of the child's feces both showed a

large percentage of lead by chemical analysis. The child developed a weak, irregular pulse, and fatty renal epithelium and casts with traces of lead, were found in the urine. Pneumonia developed an terminated fatally. No blue line was found on the gums. Autopsy and microscopic findings showed fatty degeneration of the myocardium, the liver, and especially the renal epithelium, with the presence of pneumonia. Hirsch points. out the danger from bedsteads painted with any preparation containing lead or zinc, since children often have the habit of gnawing and sucking at their bedsteads. He advocates laws forbidding the employment of paints containing lead or zinc for such purposes.

THE UNTRAINED NURSE. The Medical Times holds that in not a few instances the physician is relieved of a disagreeable responsibility by the availability of a near relative of the patient, as a nurse. Perhaps, in the future, it will be a common custom for families of moderate means to send one of their girls to a training school, with no thought of professional career, but simply to provide for emergencies. Still, there are general objections to such a course, as for medicine, law and other professions. Constant practice is necessary for the best efficiency. Moreover, the average girl will, whatever her original intentions, be very apt to contract domestic ties of her own, and while such a one may be extraordinarily prepared for wifely duties, there will obviously be times when she herself will require care by another nurse. We recollect a superior girl who married soon after leaving the training school. She lived in a farming community and was constantly called to act as nurse as a matter of charity, until it became evident to her husband and herself, that, however much she was needed in this way, she was neglecting the place where charity is said to begin.

As we have previously declared, there is a field for the untrained or partially trained nurse, not as an ideal fulfillment of a want, but as a practical compromise with necessity. But there must also be some practical provision for highly skilled nursing in the families of independent, but small means. All things considered, we are inclined to think that this demand must be met, as are other emergent, accidental demands far beyond the probable immediate resources of the average family, by some form of insurance. As counter-insurance against the temptation to demand nursing for trivial conditions, we are inclined to think that the insurance should not be in full, but simply for the delivery of services at a reduced rate, say $5 a week and board. Just how such insurance

should be conducted is, in itself, a complicated problem. Off hand, we should say that it should not be conducted as a business interest, but that it should be connected with hospitals or guilds, to which the beneficiaries contribute, and that the services of the nurses should be available for general philanthropic purposes when not needed by the members.

THE FARM BABY.

Its Advantages and Disadvantages. Of all the products of the modern farm, the baby crop is by far the most valuable, and calls for the greatest exercise of care in the raising. There are certain reasons why the farm baby starts out in life with an advantage over his city cousin; and, because we are often prone to overlook our own advantages, and so to miss availing ourselves of them, it may not be out of the way to point out some of the respects in which the baby born and reared on the farm has the better of the offspring of the city.

To begin at the beginning, the farm baby usually not always, but usuallyhas the benefit of good, healthy stock. The rugged, simple life of the farm generally insures in the parents a sturdy strain which is an inestimable physical capital to the child of such parentage. And the value of this kind of a foundation is seen in the fact that the men who weather the strenuous, nerve-racking life of the city best, and last the longest under it, are always the men whose boyhood was spent upon the farm. So, even before it is born, the farm baby has the goods on the city baby.

Then the farm baby has all the advantages of pure air, fresh milk, and later, good farm food, all of which, intelligently utilized, reinforce the healthy stock inherited by the child, and make a strong, healthy man or woman out of it. It is not alone that these advantages are obtainable in the country, which are so hard to get in the city, but they are within the reach of every farmer, no