morning and evening to counteract the acidity of the stomach, and one-sixtieth grain of nitrate of strychnia hypodermically three times a day for the irregularity of the heart action, and its moral effects on the patient. For the insomnia, he is given peraldehyd, sulfonal, and trional and hot baths. For the diarrhea, astringents are seldom necessary, as this condition subsides in two or three days. The patient is given a general tonic and is detained in bed fourteen days. During that time he is given light, nourishing diet. Usually at the end of ten days his appetite returns and his system cries out for food. It is very seldom a patient will not show a gain of from ten to forty pounds in sixty days. Patients have outdoor work and enforced regularity of living which are useful in eliminating the drug from the system. The physical surroundings are excellent, though the associations are not always helpful, as we have some chronic cases who have no desire to reform and their only pleasure in life is seemingly to use the drug. The patients, leaving the hospital after a detention of from six to eight months are considered "cured." The designation, how ever, does not mean that given the environment and other conditions the patient will not return to his drug. It does mean, by leaving the hospital with the physical functions normal and the craving eliminated. If the supply of drugs were so controlled that when they leave the institution they would not have easy access to any supply, their regeneration would be complete, but owing to the fact that the drug is readily obtainable at the present time fully sixty per cent of the addicts return to the use of drugs after their release. The drug menace is seemingly growing in large centers of population, though this apparently does not apply to cities in Iowa, as the drug addiction is gradually being reduced. The normal consumption of narcotic drugs is three grains per person per year, whereas the consumption in the United States is now thirty-three grains per person per year. I wish that it might be my pleasure to criginate some plan which would not only alleviate the problem of the drug addict, but which would effect his permanent cure. As it is, I am fully conscious of my glaring failure and limited success in dealing with the morphine addict. It is with some sense of satisfaction, however, that we look back upon a certain percentage of cases where good results were obtained in saving men to their families and society. Such experiences partially make up for our prominent failures. The Superintendent Did you ever notice what Blue eyes she has; and that They look so kindly in your own? I know they say she always has a grouch But I was sick one day I fainted dead away She took me to the Nurses Home The Progress of Industrial Hygiene MARY AGNES MEYERS, R. N. Industrial Sanitary Inspector, Department of Health, New York City Down through the ages, Industry has kept pace with the development of mankind. It is as old as the human race. In the course of its progress, it passed through three stages; the first, known as the Domestic Period when production necessary for the home was made from materials furnished by the home itself. It was founded in the early days of slave labor among the Greeks, Egyptians and Romans when little attention was paid to the influence of this form of labor on health, as the lives of slaves were of small importance. The best of these early workshops were perhaps those of the Greeks. Their philosophers and physicians recognized early that the health of the future race depended in no small way on the lives of the workers whose "Arts and Crafts" Hippocrates tells, "caused their pains and plagues." Out of this system grew the Handicraft Period, when free workers, both within and without the home, produced independently their wares, taking them into the towns and villages for sale. During the twelfth century, groups of workers in like crafts began joining together in associations or guilds, thus gaining mutual protection and assuming responsibilities. The monasteries became centers of industrial activity and most of the wood carving, tapestries, pottery sculptures and mental works, we owe to the Guild Systems of the Middle Ages. No sanitation and the general disregard of health prevailed in these small towns. The workers were crowded together and their ranks were frequently diminished by the epidemics and plagues which swept across the countries of Europe from the thirteenth to the seventeenth century. At this time the effects of industry in health attracted the attention of an Italian phy He pubsician, Bernardino Ramazzini. lished his first work on Industrial Hygiene in 1700 and in it he exhorts physicians to inquire into the occupations of their paThis tients when prescribing for them. work which consists of forty chapters touches on numerous industries and their hazards. It has been reprinted and republished in many languages and for nearly two hundred years was an authority on the subject of Industrial Hygiene. Lastly, we come to the factory period, which supplies the needs of large communities by the help of its machinery, water power and electricity. The discovery of America brought on expansion of commerce and trade, and the guild system was no longer able to meet the demands made upon it; then with the advent of capitalism, trade became gradually mediumized and the demand for increase in production was accomplished by the numerous inventions and discoveries of the eighteenth century. This Industrial Revolution made a deep impression upon all branches of human activity as well as the development of industry. A new class of wage earners. grew out of this change, the relations between employer and employee widened and the output of the industry was a thousand fold increased. With the birth of our modern factory system followed the great evil arising from the exploitation of the labor of women and children or a large percent of the growing generations and the mothers of future races were sacrificed on the altars of industrial progress. In England, the children of paupers were bound out into the service of the mill owners and some so badly treated that they ended their tender little lives in suicide. Disease, misery and sin grew in these fac tories and the disclosure of these evils and abuse of the existing factory system led to a demand for improvements and a curbing of the power of the newly made capitalists. As factory legislation is deeply responsible for factory hygiene and sanitation, we will consider its advent as a step toward accomplishing better working conditions, and improvements and protection of the health of industrial employees. The early Cotton Mills were considered a boom to the towns as they employed women and children and so legislation began with the protection of these two classes. As time passed on, legislation regulated the hours of labor, wages, night work, the minimum age for child workers, but the legislative enactments for the prevention and decrease of industrial accidents and diseases, the preservation of the health of the workers, is an obligation more difficult to standardize, hence in one state we find rulings in the labor law and industrial and sanitary codes dealing with building construction, heat, light, ventilation, safeguard for machinery, toilet facilities, drinking water, chairs for workers, etc., general in character but showing a marked difference in the detail of their requirements. In 1912, the United States Public Health Service organized its, division of Industrial Hygiene, making a special investigation in various industries and laid out rules for hygiene in the same. Valuable service has been rendered industry by the United States Department of Labor through the exhaustive studies on this subject covering by its departments, occupational diseases and accidents, fatigue, child labor, etc., and as a result they have arrived at a basis for correcting many imperfect conditions existing in modern industry. Twenty-five surgeons engaged in industry in 1916 organized the American Association of Industrial Physicians and Surgeons, aim⚫ing to stimulate scientific study and research in all branches of industrial medicine, and to raise the standards of physicians engaged in industrial practice. At present they number over six hundred and by their combined efforts have accomplished numerous benefits for both employer and employee. The hygiene problem which confronts the Industrial Nurse concerns not only the patient and his immediate family as in private duty-but she must be concerned with the large group associated with her patient, his fellow employees and even his employers. By a constant supervision of the health of workers in the plant where she is engaged, the nurse soon finds it necessary to make a careful study of their working conditions, the hazards which exist, the hours of labor, their wages, home environments, the compensation and benefits received during periods of illness. She must give advice on selections of occupations according to the physical fitness of the individual-aim to restore the disabled to an economic usefulness, and she soon finds her interest and her skill is involved in every human equation which makes up the big problem effecting the health and efficiency of the industrial workmen and all his associates. Authorities on the subject of Industrial Hygiene informs us that the damages from ill health are more far reaching than those from accidents and here the Industrial Nurse can perform a much needed service by obtaining sufficient toilets and wash stands, the latter with hot water, soap and brushes in trades where poisonous substances are handled; proper lighting according to the best standards, to prevent eye strain; sufficient heat and pure air, as temperature and humidity play an important part upon the health and efficiency of the worker; comfortable chairs with backs for women workers, and men, too, engaged sedentary trades, as this goes far toward correcting fatigue and improper posture so common among machine operators; discontinue the use of the common towel and common drinking cup; control of dusts, gases and fumes; relief from tension and undue responsibility. Much industrial fatigue is the result of the monotonous character of the daily work and this can be relieved by short rest periods, in the middle of the morning and afternoon sessions. The introduction of some form of recreational activity during the noon hour or after hours have proven a boom toward monotony and increased the industrial output; adjusting the work to the capacity of the individual generally avoids nerve strain and accidents. The dawn of a new era has spread over industry and banished those dark days when the human machine was worked to its limit and then discarded because of its premature dreakdown. Yet a vast amount of industrial reconstruction awaits us as many still work under intollerable conditions and the existing lack of protection against accident and disease is appalling. A half of dozen of the foremost medical schools are now offering courses which cover the phases of industrial medicine and as many more contemplate teaching this subject in the near future. Thus far the Nursing Training Schools and Public Health Courses covering industrial nursing by lectures, or practice, are conspicuous by their few numbers, but as the demands for Industrial Nurses increases and their duties and opportunities widen the need of some instruction on this subject, will be felt and surely supplied. Endocrinology M. MUSE Instructor of Nurses, Leland Stanford Jr. University What should a nurse know about Endocrinology? Non-scientific discussions in current magazines and Sunday supplements often indicate the trend of scientific investigation. Recently, the frequent occurrence of such startling titles as "Successful Search for Fountain of Youth," or "MonMonkeys Sacrificed to Restore Vigor to Aged," are significant of something more than an abortive attempt at entertaining journalism. If the transplanting of the so-called interstitial glands was the extent of the practice of "Hormone Therapy" it need not concern the nurse. Such operations are best performed in prisons-the one place where it is possible to anticipate the death of a healthy man. But since there is at present no department of Therapeutics attracting so much attention among alert internists, doctors and surgeons in all hospitals, it behooves the nurse to be as intelligent as possible on the subject. Nine out of ten graduate nurses confess that they scarcely know the meaning of the word. The publication, beginning January, 1917, of a new medical journal devoted. entirely to a study of the internal secretions testifies to the interest of the profession in the "Ductless Glands." Since then the reports of observing interns serving upon large clinic wards have constantly inspired the pathologist, embryologist, pharmacist and biological chemist to keener interest and new research. An alert nurse can often greatly assist the intern in making observations; and should at least have an intelligent interest in what is being attempted and accomplished. Many leading scientists expect far reaching results from their present intensive study of the Endocrin secretions. Sajous, President of the "Association for Study of Internal Secretions," goes so far as to predict that it may become possible to "combat the evil trend of heredity and react thereby against Nature's dastardly crime of visiting the iniquity of the fathers upon the children of the third and fourth generation." While the scientific study of internal secretions began in America about fifteen years ago, the empiric use of organic substances to treat disease has prevailed since history began. Often these were of the most revolting character as typified by the ingredients of the witches' brew described by Shakespeare: Eye of newt and toe of frog, Wool of bat and tongue of dog; Lizard's leg and howlet's wing." And now we realize that even the weird "Humoral Theory" of Hippocrates held a grain of truth and possibly foreshadowed— Endocrinology. The bibliography on Endocrin therapy is now so extensive and the contradictory opinions are so confusing that it is necessary to summarize briefly from the most authentic sources in order to glean a practical working knowledge for the nurse. It is now generally recognized that practically all cells of the body contribute some secretion to the blood, and that each gland is probably pluri-secretory and capable of further activities than those already recognized, all being interacting and interdepend ent. In spite of frequent differences of opinion good authorities agree upon the syndromes representing both hypo and hyper secretion of several endocrin glands. Perhaps the most satisfactory way would be to |