his way home. The new nurse had no difficulty in proving that she was "not much hand to fix up things for sick folks," and the good women of the neighborhood kept the young mother supplied with the little delicacies that she relished. Anon Jim's wardrobe began to show a pitiful deficiency of those useful articles known as "squares," and a midnight search of the cellar revealed to Papa Fox a mound of these conveniences. Mrs. Root promptly confessed that she was the mound builder and explained that these and sundry other soiled articles were awaiting the coming of the "wash-lady" next Monday (a mythical personage, by the way, in the Fox household). Mrs. R. had inadvertently forgot ten to inform the family that as she had "rheumatics quite bad in both wrists" she couldn't bear her hands in water any length of time; that was why she didn't wash the baby "all over," and that may have been why one of the lady counsellors happened along about the middle of the afternoon to wash up the breakfast and dinner dishes from which Mrs. Root and her patient had eaten. Papa Fox's hands were strong and tough, and that night while others slumbered he took two hours off and taught himself the laundry business with the result that the growing mound of soiled linen was, by much toil and perseverance, converted into a line of bedraggled "baby fixin's" which stretched three times across the kitchen.

Being of a quiet nature and little disposed to disturb the peace of others, the worthy Mrs. Root observed her periods of rest with studied regularity, especially in the forenoon, before her dinner and in the afternoon, before her supper. While taking the rest cure, she bore the ordinary disturbances of the household with remarkable fortitude, rarely suffering them to interrupt the serenity of her repose. Others, marvelling at the depth of her abstraction, tried in vain to learn the secret of her wonderful imperturbability. One afternoon the next-door neighbor was doing the dishes in the kitchen, the senior counsellor was straightening up little Jim and putting the bedroom to rights, and the much-enduring Mrs. Root was "restin' up" on the spare bed. All at once the new mother said she guessed she was going to faint, and her attendants went scurrying around for the household restoratives. The decanter of wine which "the boss" sent them for their

first Christmas was produced from the top of the sideboard-empty! The quart of whiskey, so thoughtfully provided by Papa Fox as an insurance against such casualties as the present, was requisitioned all gone! Finally the pint of kimmel, brought by "the German lady" to soothe Jim's colicky stomach was confiscated-nary a DROP!!

The new mother didn't faint. She sat right up in bed! "I feel like swearin'," she testified; and the neighbors vowed that she looked smarter than she had been for a month.

That evening the worthy Root showed her first signs of peevishness. Her hands ached her awfuller than ever and she had

to go to the drug store to fetch some medi

cine for her head before bed time. In her
absence the council once more convened as

by common consent and collusion and, a
quorum being present, went into executive
session. It was a time for action, not for
criticism or censure. "This aint no retreat
for bums," said Papa Root, hotly. "Nor
for spongin' females," added the senior
counsellor, with an outraged air. The de-
cency of the neighborhood had been violated
and there was just one thing to be done to
redeem their good name. A committee of
ways and means was at once organized with
an enthusiasm that guaranteed the comfort
of Jim and his mother for an indefinite
period in advance; another committee of
one kindly volunteered to relieve the man
of the house of a disagreeable function-it
remained for her to break the news to the
worthy Mrs. Root that her services were
no longer required, with the gentle hint
that she "might go and get her booze off of
somebody else." Incidentally it was calcu-
lated by one of the wisest economists pres-
ent that the nurse had actually performed
about seventy-five cents worth of service in
five days. On this basis Mr. Fox calculat-
ed he could save two dollars more than the
ten already saved by paying her off in full
and getting rid of her before she had "et
up her full time."

Here we let the curtain fall, merely remarking that this little story would not be worth the telling, true as it is in every detail, if the selfsame comedy were not running every day and every night in the year, with variations, in all our large communities. While we talk big things among ourselves about "efficiency" and "conservation" and all that sort of stuff we overlook

THE Canadian Nurse says:

It seems to us absolutely and entirely wrong and blameworthy to send out pupil nurses to earn money for the hospital. Is there any possible excuse for such procedure? The nurse gives her services to the hospital that she may in return receive an adequate training, practically and theoretically, that will fit her to care properly for the sick under all conditions, and to cope with any emergency that may arise in this work. Is the hospital fulfilling this obligation-for it is surely an obligation-when the pupil is sent for weeks at a time to care for private patients outside? To make the thing more glaring, the hospital boasts of the money its pupil nurses have earned. Is this right? Is this just to the

pupil nurses? Are they getting the education for which they are paying, not in dollars and cents, it is true, but in service the very best, the value of which cannot be reckoned in dollars and cents?

This is an easy question because the answer is contained in the query. There is a "possible excuse" and a very good one. Necessity is the excuse. Read the question.

Now read the answer: The nurse gives her services to the hospital that she may in return receive an adequate training, practically, that will fit her to care properly for the sick under home conditions, and the hospital would fail of its ends if it did not

send the pupil for a period of service in the home. Private nurses are sometimes misfits because the hospital that trains them does not take the time or trouble to acquaint them with conditions as they must be met in the average home.

Where learn home nursing better than in the home? What time is better for learning home nursing than that time in which they are pupils? Shall they wait until they are graduated and registered and then pick

up this special form of knowledge by repeated experiences and trials?

As to whether the home pays the hospital or not, we cannot see that it matters to the nurse in training. The real question should be: Does the nurse render efficient serviceproperly supervised-to the home, and is she receiving in return adequate training in home nursing? If not, the arrangement is unfair. Now ask us something hard.

THIS brief quotation is from Miss Janette Miller, a teacher who is associated with a doctor and a trained nurse, his wife, in Mission work at Angola, on the Atlantic coast of Africa. What a field for the resourceful woman.

We quote from the Missionary Herald: Much of my time since Dr. Moffatt left is spent at the dispensary. It takes about two hours every morning, when I am alone. I thought crowds would not come when the Doctor is gone, but the people will get sick

and they are used to my helping the Doctor. One dropsy patient will do well if he lives till the Doctor's return. I know what he needs, but I wish I could keep him till Doctor can be here at the crisis anyway. I tap him every week. Another man has a window in his jaw from not cleaning his teeth, and there is a lot of ankylostomiasis and some "big head," which is a peculiar tropical disease of sores in mouth and nose.

I've been carefully taught, but you can think how glad I am that Mrs. Moffatt is here to share the responsibility. I am glad, too, that she is a trained nurse.

WHAT Next, inquires the American Journal of Nursing as a caption to the following editorial. We think the next thing is for no nurse to attend a case without a frank understanding of the duties expected of her, both possible and impossible. Most of our trouble with other people of the genus homo is due absolutely to lack of mutual understanding. We agree entirely with the Journal:

The point of view of people on the outside, or of the medical profession, is always interesting. We have become accustomed to being told that the nurse should perform all the duties of cook, laundress, chambermaid, housekeeper, etc., but the last criticism which has reached us was from a member of the medical profession who did not want a certain nurse again because "the little fool let the furnace fire go out," and suggests that janitor service should be added to her other duties.

We always claim that there is no household emergency that a nurse should not be

ready to meet when occasion requires that she should do so, and that she should be willing to do in another woman's house what she would be willing to do in her own, under the same conditions. The care of a furnace, under modern conditions, is not specially arduous, it is undertaken by many women in their own homes, and is regularly required of many servants. Rather than let the fire go out, we would say it would not be unreasonable to expect a nurse to put on a few shovelfuls of coal, but that she should be expected to regularly care for the furnace, in addition to her duties in the sick room, and that her ability to care for the sick should be measured by her ability to care for the furnace is, we think, going one step beyond reason.

We have known doctors who could make beds and give baths in an emergency, and we can imagine such a man being glad to attend a furnace rather than allow a patient to suffer, but he would certainly consider it unreasonable in a family to refuse to call him a second time because he failed to perform any one of these duties.

THE GAZETTE for March 1904 contained the following significant comments on certain statements made by Dr. Cyrus Edson:

Dr. Edson speaks of the "honor of having found the antitoxin of diphtheria." Is this "honor," then, well and securely founded? I have before me the July 15, 1900, issue of a medical journal, Pediatrics, of New York City. In it is described a meeting, held April 9, 1900, of the Medical Association of the Greater City of New York, at which a discussion of this antitoxin took place.

Drs.

Winters, Rupp and Herman (who have for years been investigating the antitoxin) came forward with overwhelming proofs of its uselessness and injurious effects. Dr. White said he had "never seen a case of diphtheria cured by antitoxin." The president, Dr. Weir, said, "none of the serums had proved satisfactory." And only one member could be found who would defend it.

To-day the physician who refuses to administer antitoxin in a case of diphtheria is considered little better than a criminal.

WITH the increase of paternalism in connection with the Federal Government, the several Commonwealths, and the first class Municipalities in America we have witnessed the development of practically Governmental Medicine, although not as yet recognized as such. With this has been developed a high class of Social Service Work, which has been entrusted to salaried Trained Nurses presenting satisfactory credentials.

Organized Charity and the Collegiate Instruction in Sociology have made it imperative that an investigating bureau be attached to all philanthropic enterprises. The question of organized charity is open for discussion, but since we have granted the existence of the same, we must all concede that the investigation department, known usually as the Social Service, is absolutely necessary.

Unfortunately philanthropic enterprises, as a rule, feel that it is necessary to maintain complete individual organizations and plants for obtaining information and disbursing charity, or whatever it is they call it, to their dependents. An interchange bureau is in existence in but very few communities.

The Social Service is made up of trained workers, so the reports always read, but from comparatively close contact with the workers in the field we find the instruction is about as valuable as the geography we were taught in the lower grades of the Grammar school. While the work is fraught with interest to the young

never

college college girl, the lay mind is prepared to meet many of the contingencies that arise nor to make proper allowances. The social worker works to the best advantage if she be a trained nurse, or a physician, or a medical student.

This can best be understood by a short recital of the work of the nurses employed by the City of Philadelphia in connection with the Public Schools in the downtown section. Until a comparatively recent time this city had no pronounced foreign problem. Like other American cities, it had a fairly large proportion of newly-arrived immigrants but the native Philadelphians rapidly assimilated them and turned them into Americans.

Within an incredibly short space of time, foreign colonies have developed in our midst with all that implies. The habits, traits, manners, views, and language have persisted in these colonies to the total exclusion of things American. Children have been born and raised according to the standards of these people, many without standards of any kind whatever. A certain amount of food and water and air provided, the children grow up, just as does any other biological product.

Far-seeing students of Sociology have appreciated the ultimate bad results of such conditions and by persistent howling through the Press and elsewhere have awakened a certain part of the Public to its obligations. The great middle class, however, regard the entire movement with great skepticism and suspicion, and point

with pride to how they managed to grow up and live comfortably without all this newfangled interference. The problem, itself, is hard enough to handle without the additional discouragement of this smug, selfsatisfied complacency.

The reason for this is probably to be found in the employment of the lay social worker. These young women do admirable work. Of this there is no question. But it is possible to obtain much greater service and better results by the employment of salaried trained nurses. The lay worker never has a real satisfactory reason for intruding herself upon the privacy of any home or family, no matter how unfortunate the family may be, and it is certain to be resented, unless the family belongs to the "Dead Beat" class. A slight verbal duel will frequently defeat the purpose of the worker. A trained nurse can always state the nature of her calling, and find an excuse for investigating, and by her previous training is at ease under all conditions.

The City nurses in Philadelphia are instructed to see that the school children receive the medical attention that the school physicians think it desirable that they should have. This is all they have to do! But in the proper performance of this duty, considerable ingenuity must be developed. Willie Blashefsky, for instance, has ringworm in his head and can't see the blackboard, two independent conditions. He must get rid of the ringworm and he must be examined for glasses. Willie must be bodily carted off to a dispensary (a private doctor being out of question) and treated for the ringworm. This requires two or three months during which time, Willie enjoys a modified quarantine. He is allowed to play with the other children at recess and on the street, but must not attempt to go to school and learn anything.

The health boards throughout the country have determined in some occult manner that all contagious diseases are contagious only during school hours and only during the school term, and make rules which result merely in depriving the children of education, as the children have every means and encouragement for acquiring disease afterwards. Some day special convalescent classes will be provided where children, when able to be about after an illness, may be educated in groups so that the contagious particles, whatever they are, may be kept isolated, and not disseminated as they now The children who have had the dis

are.

eases deserve some consideration as well as those who have not, and in this way their education will not be suspended.

Willie's ringworms may be treated by the X-ray if the doctor has the time and inclination, but if not he is provided with a salve and instructions to use it two or three times a day. This seems very simple but were it not for the attention of the City's nurse Willie wouldn't get even this. Not so much that the parents openly antagonize the treatment but because of ignorance they see no necessity of it.

In the case of Willie's eyes, the making of a Secretary of State may be entirely nullified by neglect of this part of the individual. Poor people are illy fed. Poor people's children are likewise illy fed. Willie may have had ulcers on the cornea from poor nutrition before he was of school age; now he has scars on the cornea; the strain of attempting to overcome the refraction of these scars leads to myopia or nearsightedness, and nearsightedness is a distinct ocular disease, and not merely a condition of altered refraction. His life may be restricted to the field of endeavor open to the myope, or, the distress or difficulty with school work may lead him to "chuck" it, so to speak, and we have truancy, juvenile court, etc., etc.

Now in the proper handling of this young man, he must be taken to the hospital or City Hall for a preliminary examination. Then he must have some mydriatic instilled in his eyes to paralyze accommodation and thus render the examination satisfactory. Despite the arguments and protests of the opticians who prescribe glasses, those physicians who see the most of eyes in their several kinds of disorders, are unanimous in the use of "drops" for purposes of examination. Those who do not use them in adults below 45 or in children are largely influenced by the fact that they have no State Medical license to justify them. Were it not for the trained nurse in charge, this part of the procedure would be far from satisfactory. Insufficient mydriasis or cycloplegia requires that Willie return home again and present himself at the hospital twenty-four to forty-eight hours later. Often under such circumstances, becoming tired of going to the hospital, he will return to school and report that the "doctor said he didn't need glasses"!

Even as it is, experience has shown those of us engaged daily in the work that these children frequently need several examinations in order to satisfactorily prescribe for