The garden is big and bewildering and marred by many unsightly patches where work is sadly needed. The workers give too much attention to the more showy human plants which exist mainly to be looked at, and they neglect the plain-looking varieties which often possess more commercial value. This is a reproach to human husbandry which we are striving to remove. We shall have to give attention to everything that grows in this garden, and not to a few special crops in which we happen to be interested.

Does this view of your work seem too figurative too much like a parable? Then stop, and recall some of the flowers of humanity that you have had the privilege

of enjoying flowers that perhaps you have by your own toil and skill prevented from fading and withering before their time. The picture becomes very real again. You are actually a worker in this garden, taking a very vital interest in the health of your plants, sacrificing your own affairs, if need be, or else waiting for the bell to ring and relieve you at the end of another day's grind.

If you are sometimes tempted to think your work is too laborious and not worth while, remember the words of Dr. Clement Dukes: "I have no hesitation in saying, from a wide experience, that a due amount of care has never yet been bestowed upon the young human being."

In

We think of the sun as the source not only of light but of life on this earth. The fierce heat of summer often reminds us of the other fact that the sun may strike us down if we are not prepared to withstand the power of his rays. Many deaths are directly attributed to the sun's rays. fact, as Professor Aron, of the University of the Philippines, has observed, man is able to live in the Tropics only by avoiding such injurious factors as direct sunshine or learning to protect himself when exposed. Aron proves his assertion by a number of very interesting observations on tropical monkeys. These animals quickly succumb to the direct rays of the sun unless their bodies are constantly cooled by a breeze or by artificial currents of air. It is quite evident that the monkey would be unable to endure the tropical heat if it were not for his habit of living constantly in the shade

of the trees.

This lesson ought to have been learned by the human race before this age, but there are still to be found people who will risk themselves in the fiercest sunshine with no protection, until they collapse and have to be cooled off by their excited friends, or, more often by the internes of the nearest hospital. People should not be averse to carrying an umbrella in the sunshine if they cannot enjoy any better shade. Better an umbrella than the hospital bath tub.

Professor Aron has made another observation which he reports with the facts quoted above in the Berliner Klinische Wochenschrift. He finds that prolonged sweating with profuse evaporation of water from the skin is liable to cause fatal collapse, similar to that in cholera.

Hard work or exercise in sunlight therefore has a double peril for one who is careless of ordinary precautions-depletion of body fluids and direct heating action of the sun's rays.

DRY cleaning seems to be the order of the day, even to the "dry shampoo" of the hair. For some time there was a suspicion that this kind of treatment was not perfectly harmless because the barbers in France had noted that their customers were often uneasy and sometimes decidedly ill while receiving their shampoo. The Journal of the American Medical Association has reported

several fatal cases of poisoning from this treatment. The following case is worth repeating here for the sake of the details given. The scene is in France:

A woman aged 30, on returning home after a trip, wished to clean her hair by the so-called dry method. She went into her dressing-room, which was rather small and was heated by a radiator which raised the

war according to any of the above methods of extermination without first suffering in battle. If there is any way of protecting our bodies from the invasion of fleas, it is worth knowing. We get the following suggestion from a writer in The Lancet:

During residence in a work-house infirmary, which involved frequent visits to the receiving ward, I kept drops of eucalyptus oil on (a) ankles, (b) wrists, and (c) neck, with successful results. I also carried a

chloroform drop-bottle for emergencies. At another time, being resident in a hospital, and my bed being infested with pulices, I emptied one ounce of eucalyptus oil on the

mattress.

We can imagine the sensation up and down that hospital when the human inmates, to say nothing of pulices, scented the smoke of the good doctor's battle. The hospital is the last place on earth where any of our insect pests ought to find comfort.

There is no more difficult situation than that of the graduate nurse at the present time. She is cut off apparently from service to the great mass of people of moderate means, and confined largely to the service either of the well-to-do or to the service of the very poor through endowment or charity. She is subject also to increasing competition from the ex-pupils of rapidly multiplying institutions giving short courses, or correspondence courses.

I do not pretend that this form of office offers a solution for all her difficulties, but it does offer a wider field of service and a larger use for her abilities; it offers not only additional chances for supervising nurses, but the inevitable result of such an office is to bring to notice those cases, in all classes of life, of sickness in the home that can be handled properly only by the graduate nurse. This work brings the family into practical, helpful contact with the graduate nurse so that her true value and the need of her in certain cases can be known and appreciated. I can say this that in spite of the amount of work done by other classes of workers for the sick, there is no more widespread and intelligent use of the graduate nurse than in this community I have described, where such general service has been established.

There is another line in which this development promises better things for the graduate nurse.

When there is a civic organization whose business it is to serve the home, that organ

ization can bring about such benefit insurance as will put the service of the graduate nurse within the reach of every home that needs her. That is the only adequate solution. Widespread associations in England have accomplished this with the cottage and visiting nurses by very simple and effective methods, and we can do it here for graduate nurses as well, where graduate service is needed, as it so often is. The great mass of independent people of moderate means cannot be fully served in sickness by endowment, because they are too numerous; nor can they be served by ordinary charity, because they will have none of it. They carry the country, no one can carry them, and they need only the help of organization to carry their own burdens. The only endowment that should be needed is that required to put such organizations on their feet and ensure a good standard of efficiency; the balance of the work for the independent classes should carry itself. The graduate nurse can be brought within the reach of all independent families by means of benefit insurance, as soon as there is established a good, all around system of service for which to insure.

Another point of view from which to look at this work, is that of the non-graduate nurse, who once constituted all the service available. The whole difficulty in the situation has arisen from the newness of the graduate nurse in the field, and the fact that for many things she had to displace the practical nurse. This at first brought

about an attitude of mind on both sides where co-operation was most difficult between the two kinds of nurses, but that stage of development is rapidly passing and we can now look for better things.

There are many women not young enough to enter a training school but well adapted for this work, especially women who have lost their husbands, and women whose children are grown up while they still have abundant strength, energy, and good household experience. From time immemorial, these women have gone into nursing and have constituted the back bone. of the nursing occupation, but now they have been told that they are too old to take a hospital course, and that they should not take the responsibility of nursing without such training. As a result their places in the field are largely vacant, and much of their work is not done. Here is an opportunity for these women,-where they can do good work with no reproach of being irresponsible, for it is the business of the office to determine what they can or cannot do, and to supply any deficiency through the supervisor. The distinctive feature of this work is that the less trained woman works under the supervising nurse and gets the benefit of her help and instruction, a much safer way of determining her qualifications than any grading that may be attempted by means of diplomas. There is no question in the minds of those who know the quality of women of this kind available, that they are an element absolutely indispensable in the nursing field.

There is another most important question; namely, the question arising where this work touches on the field of charity and the great and valuable work that organized nursing is now doing in that field. When organized nursing employing visiting nurses began its work on this side of the Atlantic, it found an enormous task before it, and it did the work that came to its hand in seeking to alleviate in a degree, the enormous mass of distress that comes from the poverty collected in our great cities.

This was good for the poverty, but it was bad for organized nursing, for in the public mind organized nursing has too often become inextricably associated with dependence, and finds this association a most formidable obstacle in extending its useful ness to other classes. A recent address to the public service nurses in convention, by Dr. Frankel of the Metropolitan Insurance

Company, who spends hundreds of thousands annually for visiting nurse work, and has a very practical knowledge of the question, fully sets forth this difficulty.

Now this office of ours is expected to deal primarily with the independent classes, composed mostly of people who value their independence and are accustomed to be dealt. with in a business way. In order to do our work properly, we have found it desirable to make an entire separation between nursing service and charity administration. This means that while work paid for by charity shall be done by the office, the charity shall not be dispensed by those who do the nursing, and the nursing office shall be opened to the public for nursing and household service, on a basis of entire equality for all.

As this question is a very important one, and its proper solution is vital to the success of any attempt to serve the independent classes, I will give the reasons in full for taking this course.

There are the following objections to stating in the office announcement that the work will be taken at this office for "what people be done for certain kinds of persons for can pay," or that certain kinds of work will cally equivalent, for less than cost. less than regular prices, or, what is practiThis makes the office an agency for relief of a certain kind, as well as an agency for nursing.

Now this announcement that people need not pay regular prices if not able, instead of bringing in more money to be used for the relief of this form of distress, among exactly the opposite effect from that intendthe people with whom we wish to deal, has

ed. When the average citizen has trouble about paying his bills, he generally gets some relative or friend to help him out. This announcement that people need not pay if they are hard up, relieves from responsibility those who would otherwise come to the aid of the relative or neighbor who is in difficulty, and makes him think that somebody else has undertaken it. On the other hand, there is nothing in the maintenance on a business basis, or on a basis of equal treatment for all, of the nursing office to prevent the raising from outside sources, the money actually needed for charitable relief of this kind and its use in obtaining service from this office. may be that the words "business basis" convey a too mercenary idea, and another word may be better. Let us put it this

It

Our organized nursing needs to be civic nursing not charity nursing.

The advantage of this course can be shown by the fact that the Brattleboro of fice took the following stand, and got the following result:

The report of February 1st, 1910 says: "There is one thing that we are not try ing to do: We do not intend to deprive our churches and other charitable and benevolent organizations of their own peculiar fields for doing good.

"We are a machine for giving service in sickness to all at the least possible cost, but our business is not to provide that cost. Whether the money used through us be a merchant's surplus, a workman's savings, or the allowance of a fraternal order, a church committee's offering, or the funds of a town officer, we are going to try to make the money do better service than ever before, but it is not our business to provide that money. We are merely a machine for doing the work, and those who have the work done will furnish the fuel to run the machine.

"We are a machine, that is, so far as money goes, but not a mere machine in another sense. If we cannot make our work a human expression for ourselves and others of the spirit that underlies true neighborliness, our mere working machinery will be worse than useless."

What has been the result of this policy when once understood?

Nursing expenses for those who cannot pay full prices are paid by town officers, tuberculosis association, charitable funds, churches, fraternal orders, friends, relatives, benevolent individuals, and everybody else except by this office.

The office has never committed the iniquity of making money, but it is able to do more work and better work with the money at its command than would be the case if the office said it would remit to those who cannot pay, for by saying this it would really remit, not to those who cannot pay, but to those who ought to help.

Every place has sources that can be drawn upon for the purpose of relief, that will not be reached if this kind of office attempts to undertake the whole thing, instead of simply attempting to furnish the service.

The applicant himself is often among those who can help if he is given a chance; sometimes he fails because of his own fault, but more often because not supplied

with the right means of insuring against emergencies. There are sufficient instances of this form of insurance in successful operation. In some regions, hospitals and nursing systems are largely supported by insurance or benefit payments, and any attempt to enable people to pay in this way should not be discouraged by a system of remissions from the nursing office.

Another objection to giving financial relief in any form from the same office where service is arranged for, is that it requires two different kinds of mind, and two different kinds of training, to do these two different things well, and you frequently find a very good nurse with her mind so full of nursing, that she is not adapted for the relief part. Moreover it often embarrasses her nursing work, as it brings in financial disappointments and controversy from which she should be free, if she is to handle the family effectively as a nurse.

The lack of ability of nursing organizations to co-ordinate their relief work with other relief work is sufficiently well known, and the waste resulting therefrom is sufficiently notorious not to need enlarging upon. The latest claim of an enterprising agent of relief in Boston is that she has found as many as nine nursing organizations infesting a single family.

But the last and most important reason, why financial relief should not be mixed with nursing is that it imperils the whole scheme as to its ability to get the work done that should be done. By bringing in this charity element, we give the impression to the class of persons that we want most to reach, that we are in a charitable line. The persons, not considering themselves objects of charity, will fail to take us seriously as an agency for supplying their own wants. You cannot deal with them in that way.

Their

If the office is to cover the field intended, five-sixths of the people who use it would be ordinary citizens accustomed to pay market prices for what they get, and accustomed not to have their financial affairs inquired into except for credit. usual attitude toward the office should be like that of the people who deal with the savings institutions and ioan associations, where they expect fair rules and require no special favors.

To put it briefly, the work of handling sickness in the homes of the independent people of moderate means, who make up the bulk of the population is a civic work and not work of charitable relief, and it