HE removal of stains is a necessary feature of the laundering and general care of clothing and other household textiles. Most stains may be removed easily at home, provided reliable methods are known and a few simple precautions are taken. With some stains prompt home treatment is necessary in order to save the article in question from being ruined, and in most cases it is desirable, since all stains are removed more easily when fresh.

Too much emphasis cannot be laid on the importance of at once applying the stain removers, for usually it is much more difficult to remove an old stain. Changes in the character of the stain, brought about by drying, exposure to air, washing, ironing or in other ways, often make it necessary to use chemicals in removing old stains, whereas in many cases much simpler methods are successful if the stains are treated when fresh.

The nature of a stain should be known, if possible, before its removal is attempted, since this determines the treatment to be adopted. Moreover, if an unsuitable stain remover is used, the stain may be "set" so that its removal becomes difficult or even impossible. For example, if hot water, which easily removes most fresh fruit stains, is applied to stains containing protein, such as stains of milk, blood, eggs or meat juice, it coagulates the albumin in the fibers of the cloth and makes it extremely difficult to remove. Similarly, soap, which aids in the removal of grease spots, sets many fruit

stains.

The kind of fabric upon which the stain occurs also should be known. The method of treatment adopted depends as much upon

Abstract from an article published in the Michigan Food and Drug Journal.

the nature, color, weave, finish and weight of the fabric as upon the kind of stain. Cotton and linen are destroyed by strong acids and attacked to some extent even by weaker ones. Concentrated acids, therefore, should never be used in removing stains from these fabrics, and when dilute acids are used they should be neutralized afterwards by a suitable alkali or removed by thorough rinsing; otherwise the acid may become concentrated on drying and destroy the fibres. Generally speaking, alkalis do not attack cotton or linen fabrics to the extent that acids do. However, long continued or repeated exposure to alkalis, especially in hot solution, weakens the fibres. This fact is said to be due to a hydration of the cellulose which constitutes the fibre. The damage to fabrics resulting from the careless use of strongly alkaline soaps, washing powders, washing soda or lye, is well known to the housekeeper.

Wool and silk, being more delicate than cotten and linen, require more careful treatment. The use of very hot water must be avoided, since it turns both wool and silk yellow, shrinks wool and weakens silk and injures its finish. These materials also will not stand much rubbing, as this felts together the wool fibres and results in a shrinkage or thickening of the material, while the silk fabrics, as a rule, are too delicate to stand much rubbing without breaking or separating the fibres. Both wool and silk are dissolved by strong alkalis and are injured even by washing soda or strongly alkaline soaps. The only alkalis which should be used in laundering or removing stains from wool and silk are the milder ones like borax or dilute solutions of ammonia. Acids, with the exception of nitric,

which weakens and turns the fibres yellow, do not attack wool and silk readily.

In general it is more difficult to remove stains from wool and silk than from cotton or linen. In removing stains from materials made from two or more kinds of fibres, such as silk and cotton mixtures, the effects of the stain removers upon all of the fibres should be considered. No chemical should be used which would injure the most delicate of the fibres present.

It is also much more difficult to remove stains from colored than from white materials, for the reason that most of the bleaching agents which must be used to remove persistent stains are likely to destroy the color of the material as well.

The following paragraphs deal with methods and reagents commonly used in the removal of a number of stains.

Ordinary laundering, mentioned frequently as a method for removing stains, should be done as follows: First, soak the stained portion in cold or lukewarm water, rubbing the stain with a neutral soap if necessary. Follow this by thorough rinsing in clean water, after which the article may be laundered as usual. Use this method only for cotton and linen (white or fast colors) and the so-called wash silks and washable woolens. If the materials are delicate, sponge them.

Sponging is applicable to all fabrics, but especially to delicate materials or colors which ordinary laundering might injure. Spread the stained article on a flat surface in a good light, and beneath the stain put a cloth folded into several thicknesses, or clean, white blotting paper, to absorb the superfluous liquid. Change the pad for a fresh one as soon as it becomes soiled. Sponge with a clean, soft, lintless cloth (preferably of the same material as that

stained) and renew it as frequently as may be necessary. Lay the stained material with the wrong side up and apply the water to the back, so that the foreign substances can be washed from the fibres on to the pad without having to pass through the material.

Chemicals should not be used until water or laundering has been tried. There are a few common chemicals which are necessary in removing some stains, and these should be kept in every household. A good plan is to have a small cupboard in the laundry where these chemicals may be kept together with the utensils used in applying them. As some of these chemicals are poisonous, they should not be kept in the family medicine cabinet or pantry. Chemicals most commonly used in removing stains are Javelle water, potassium permanganate (solution), oxalic acid, ammonia water, carbon tetrachlorid, French chalk, and cream of tartar.

With these chemicals should be kept some of the utensils used in applying them; such as a medium sized bowl, a medicine dropper, a glass rod with rounded ends, several pads. of cheese cloth or old muslin, and a small sponge.

Work rapidly when using chemicals to remove stains, so as to give them as little time as possible to act on the textile fibres. Many brief applications of the chemicals, with rinsing or neutralization after each application, are preferable to the practice of allowing them to remain on the stain for a long time. Stretch the stained portion of the garment over a bowl of clean water and apply the chemical with a medicine dropper. The chemicals may be rinsed out quickly by dipping in the clean water. Another method is to place the stained portion over a pad of folded cloth and apply the chemical with a glass rod. The rinsing or neutralizing always must be thorough.

Measles and Preventive Medicine Dr. Louis I. Harris, Director, Bureau of Preventable Diseases, New York City, considers measles the great stumbling block in the progress of preventive medicine. In a most admirable article in the Monthly Bulletin of the Department of Health for March, Dr. Harris makes the following observations:

With all our proud record of accomplishment in the prevention of disease during the past several decades, it is strange to note the fatalistic and hopeless attitude of public health officers with respect to measles. While public health officers preach with zeal and ardor that infectious diseases can be prevented, and that a community within certain reasonable limitations can determine its death rate, it is surprising to note how with unvarying uniformity health officers throw up their hands in helplessness and proclaim measles the exception to the rule. To deny that the prevention of measles presents a more difficult problem than perhaps any other infectious disease, would be foolhardy. But, if there be any merit in the strong claims everywhere made for the effectiveness of public health education and for the supervision of infectious diseases by public health visiting nurses, then measles need not necessarily continue to be the stumbling block which it has constituted to public health officers everywhere. Because its control is bound up with innumerable difficulties that are real and large, is no excuse for a policy of laissez-faire.

infectious disease. The number of cases has shown marked fluctuations from year to year. For instance, there were 38,653 cases reported to the Health Department in 1908; in 1910 we had 35,374 cases; in 1912, 39,018; again in 1915, 38,186; in 1918 we had 28,675.. It is therefore apparent that year after year an enormous number of cases of measles, relatively speaking, are reported to the Health Department. This presents an opportunity and a legitimate reason for the visit of a representative of the Health Department to a very large number of homes in the city, in addition to the visits made to the homes of other infectious disease cases.

It would be foolish to build great hopes on the ability of the nurse to check the spread of measles through home visits, when one considers that by the time the Health Department has received the report of a case through the mails, a sufficient period has elapsed to have permitted the exposure of all susceptible individuals in the family. We are fully cognizant that in a large number of cases, the nurse's visit is made too late to have any effect in checking the spread of measles. The chief argument in favor of the visit of the nurse to the homes of patients reported to be suffering from measles is that then, if ever, the parent or guardian of the patient is in a receptive mood, and likely to be impressed by counsel and instruction which has for its object to point out that many of the infectious diseases may be transmitted through discharges from the respiratory passages of persons who seem to have only very mild symptoms of a catarrhal character or who are suffering from a variety of diseases whose mode of

transmission is by the respiratory discharges. The visit of the nurse is not so much for the purpose of controlling the spread of measles as to take occasion to deliver as emphatic and helpful a message as possible, at a psychological moment, with a view to opening the eyes of people to the great importance of the common cold." and discharges from the respiratory passages of persons suffering from influenza and pneumonia and many other conditions in which the cause of fever or other signs of illness may be obscure. In other words, if we can create in people a profound respect and an attitude of caution which will lend them to avoid at least some of the numberless modes of contact which now prevail in the home, school, factory, restaurant, and social environment, we will have made considerable progress in educating such families in methods to prevent the occurrence of infectious diseases. To put the matter differently, the public health officer should be most solicitous to have the home visit made by the public health nurse for purposes of education, whether the disease be measles, pneumonia, acute, anterior poliomyelitis, or any other disease in which the modes of transmission of infection are to a large degree similar, so that the lesson that is driven home is one which has value in helping educate such families to prevent all other infectious diseases with which they may come in contact directly or indirectly, and in which the mode of infection may be of the same general character.

Assuming that public health nurses are properly educated, and that they possess the personal qualifications requisite to deliver a message impressively and intelligently and if they are not, we must properly train them-it must be apparent that if all cases of acute infectious disease which are transmitted through respiratory discharges are reported to the Health Department and are visited at once, we will in

which will have substantial value in educating the public as to the methods by which epidemics of one or another of these acute infectious diseases may to an appreciable degree be controlled. According to current practice, educational activities of a direct and personal character such as are here advocated, are brought into play only when one of the acute infectious diseases threatens to assume epidemic form. The plea for this type of intensive educational work does not overlook the fact that its effectiveness is necessarily limited in varions ways, but taken together with other protective measures, it is bound in time to enhance the usefulness of our service to the community and to constitute an addition to our defensive measures which is clearly in line with the trend in the direction of more intensive education in public health matters."

New Jersey's Child Welfare Program

If New Jersey's Child Hygiene work could have been organized and doing its effective work for the past decade, their figures of conservation for 1919 would have saved 19,955 babies and mothers. The State appropriation of $125,000 for its Child Conservation work does not seem to have been money ill spent as a few of the facts will show:

Of the babies who died under the age of one year the State average was as high as 84 per 1000 live births, of the babies supervised by the Child Hygiene Bureau the rate was 27 out of 1,000. For the entire State 37 babies died under the age of one month out of every 1,000 live births, while of the infants supervised by the Child Hygiene Bureau only 21 Babies died. Mothers dying in child-birth for the entire State the figures are one out of 250. Of the mothers who received prenatal care from the Bureau, out of 476 cases there were no deaths.

The Child Hygiene Conference was

sions were held in the Hall of the Public Library. The session of Saturday 12, was a joint session with the State Council of Child Welfare. A paper New Jersey's Program in Relation to Midwives, was presented by Miss Florence Swift Wright, Supervisor of Midwives, Bureau of Child Hygiene. This was followed by discussion. A paper The Relation of District Nurses to Midwives and Public Health Nurses, was presented by Miss Anne Stevens, Manhattan Maternity Centers, N. Y. C. A discussion on unmarried mothers and their babies, was led by Dr. Kate A. Barrett, president National Florence Crittenton Home Mission. discussion on boarding out of children and boarding homes, was led by Mr. Robert Fleming, State Board of Children's Guardians. A discussion on mothers in industry and family problems, was led by Colonel Lewis Bryant, Commissioner of Labor. The discussion on day nurseries, was led by Miss Josephine Miller, of the Jewish Sisterhood Day Nursery.

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At the afternoon session, papers were presented by Miss Charlotte Ehrlicher, Supervisor of Nurses Bureau of Child Hygiene, on New Jersey's Conception of the Child Hygiene Nurse; by Miss Helen C. Howes, District Supervisor of Midwives, Bureau of Child Hygiene; by Dr. Ira S. Wile of New York, on How to Protect the Health of the School Child; and by Dr. William H. Bently, on Dental Hygiene. At 8 p. m., a dinner was given at the New Tenny Hotel.

At the morning session of June 14, the following topics were discussed by the staff of the Child Hygiene Bureau: Prenatal care, difficult and successful maternal nursing, the school child, premature and immature babies, and pre-school age.

The afternoon session was joint session with the New Jersey State Pediatric Society, and was held at Hotel Monmouth, Spring Lake. There was presented at this

and Children, taking up the subjects of raw milk, boiled milk, dried milk, and control of milk supplies by state and municipalities. Dr. Edward E. Worl, of the Division of Contagious Diseases, Newark Department of Health, presented a paper on Vaccination. Dr. Abraham Zinger, Assistant Director Research Laboratory, Department of Health, New York City, read a paper on prevention of Diphtheria. It is expected that the beneficial effects of this memorable conference will be far reaching, and will prove an inspiration to other states.

Special Classes for Children with
Cardiac Disease

The desirability of Establishing in New York City, special classes for children suffering from cardiac diseases has recently been considered by the Bureau of Child Hygiene of the Department of Health. A difference of opinion exists on this question. Arguments in favor of such special classes would include the consideration that, there

by, the children could be placed where there would be no physical strain due to going up and down stairs and that, because of their grouping in one classroom, they could receive special medical attention with individual supervision of their school work. On the other hand, it is believed by others that the grouping of these children in one classroom is apt to call undue attention to their physical condition, and that group supervision does not offer any advantage over the individual supervision that may be carried on over these cases, irrespective of the classrooms to which they may be assigned. There seems also to be a difference of opinion as to the harm or benefit caused by physical exercise in these cases. The general conclusion is that each case must be treated separately, and that no general rule may be made in this direction. Definite conclusions have not yet been reached by any considerable group of authorities as to whether special classes for children suffering from cardiac diseases are desirable or