the dandelions pushing themselves timidly out on front lawns as if it were spring, it is hard to realize that Christmas, 1920, is coming, very near, but calendars tell the truth, however difficult it may be to cultivate the real Christmas spirit six or seven weeks ahead of the day.

To the children, it is the great day of all the year, with the thought of what they will receive in the way of gifts uppermost in their minds. That is their idea of happiness. It is a mistaken conception of life or of happiness, yet probably the only conception possible to a child. We have all been there and we would not erase the memories

We learn that happiness is elusive to those who pursue it as the chief object of life, but comes quietly and surely to those who live up to the demands of duty regardless of the difficulties which come in the way of duty. There is a very close relation between happiness and service to others and those who would be happy in the deepest, truest sense of the word, must find it through the path of service. Few classes of people have a better opportunity for real happiness at this season than do the readers of this magazine. Scattered throughout the English speaking world, they can, wherever they are, help to diffuse the good-will spirit that makes

Facing the complex problems which are growing out of this readjustment period in our national life, they may wisely remember that much of the unrest that brings present anxiety is but a manifestation of that powerful inner force that is making itself felt, paving the way for the new order of social conditions wherein men and women can lead simpler, cleaner, more blessed lives and little children grow up free from many of the handicaps that we ourselves had to encounter, laying foundations for a Peace on Earth that is real and enduring.

We make a mistake if we limit Christmas to any one week or season. It is the spirit that breathes through the Sermon on the Mount, that finds expression in the Golden Rule. It is worth our best efforts to keep this spirit alive throughout the year.

Christmas Seals

From December 1 to 11 900,000,000 Tuberculosis Christmas Seals will be on sale in the United States under the direction of the National Tuberculosis Association and its 1100 affiliated agencies. Every Seal is a bullet in the fight against tuberculosis.

The problem of controlling tuberculosis is a problem of community organization. The Christmas Seal furnishes the munitions with which this organization is effected.

In the last 12 years $12,000,000 has been raised from the Tuberculosis Christmas Seal. This amount of money has been multiplied many times as a result of organization and education. The institutions brought into existence by the Seal are valued at over $100,000,000 and have an annual budget of over $20,000,000. Thus, the seals are an opportunity, a responsibility and an investment in good health.

Recruiting for the Training School

To the list of occupations open to nurses is likely to be added that of "Recruiting Agent." In the complex age in which we live, the methods by which

training school classes were filled twenty years ago, and waiting lists secured, to fill any possible vacancies these methods have proven insufficient to provide the ever-increasing numbers of nurses needed. However attractive the school announcement may be made, the plan of recruiting by sitting in an office chair and dictating to a stenographer replies to the occasional applicant for information, is not to be depended on to fill the vacancies, or supply the additional candidates made necessary by increasing demands on the hospital for service.

A comparatively few training schools connected with a teaching hospital of world or nation-wide fame may still be able to make up their new classes two or three times a year through their office work only, but the great majority of schools, we believe, will have to find other means of attracting the attention of desirable candidates in sufficient numbers. While there are a variety of publicity measures worthy of a trial few efforts, we imagine, will prove more effective than that of a recruiting agent who is herself a trained nurse, enthusiastic over the wonderful opportunities for service, who has herself travelled the road over which every probationer must pass, and who knows the difficulties as well as worthwhileness of it all. We venture to predict that before many years a considerable number of schools will have added such a worker to their permanent staff. She may have certain office duties combined with her recruiting work. She may be able to do a good deal of the work of instructor, but she will maintain points of contact with the outside world and with clubs and classes of young women that will prove a valuable asset to a school.

She will learn by experience where to put the emphasis and how to meet the difficulties or objections that may be presented by eager candidates. We are still only in the experimental stage of this great

worth-while business of recruiting, but we are learning, just as we did in the war, how to do the tasks that changing conditions force upon us. Needless to say, the personality of the recruiting agent will be one of the strongest factors in the success of such work. Unless she herself very thoroughly believes in nursing as one of the most worth-while careers open to the young women of today and is able to impart her own enthusiasm to the young women whom she meets, she will be most unlikely to succeed as a recruiting agent.

Teaching Home Nursing in Rural
Schools

Even if every nurse sent to promote health in village and rural communities were at this moment qualified and licensed to officiate in childbirth, the problem of good care would be far from being solved. The continuous care of the mother in her home after labor is just as important for village and farm mothers as it is for the women who come into our hospitals in the

city, and in the country it is next to impossible to secure female hired help of any kind. The spirit of neighborliness that still exists in most rural communities and the kindly ministrations of relatives are the chief source of help for rural and village

mothers in childbirth. If the rural wives. and mothers could have instruction in home care for the sick, and especially in regard to the proper care of maternity patients, and township or village nurses were qualified in midwifery, we should be in a fair way of reaching the ideals of good care outlined by the Children's Bureau. And we confess we see no other way to improve rural conditions in any general or adequate way. With the medical course as long and

as costly as it is, the additions to the ranks of the medical profession will not be large in any one year. With industrial corporations of all kinds offering a liberal salary and well-equipped medical departments, and increasing opportunities in the army, navy and public health service for the young medical graduate, the number of recruits to the ranks of rural practitioners is likely to dwindle to the vanishing point. The average doctor, it must be admitted also, is rarely enthusiastic about maternity work. If babies would only be considerate and plan to arrive in the day-time Dr. Average-Man would be more inclined to give them a proper and scientific welcome. But babies have always been most inconsiderate of the time of their arrival and will continue coming in the same inconsiderate manner at night as often as by day.

If trained nurses can be qualified and licensed to undertake some of this work formerly done by doctors and a general program of instruction for rural wives and mothers in maternity care and for growing girls in general nursing methods can be put

into the curriculum in rural schools, conditions are very likely to improve. No method of organization that has ever been devised equals in its flexibility and adaptability the instruction which enables neighbors to help each other efficiently, safely and promptly. For years we have advocated the giving of home nursing instruction to schoolgirls-long before a Red Cross nursing course was given or thought of. We expect to continue to advocate the giving of home nursing instruction in rural town and city schools, till such advocacy is no longer needed, because our ideal has been realized.

The Birth of the Placenta Obstetricians vary a good deal in the technic they employ in the third stage of labor. The variations range all the way from forcible extraction by tugging on the cord immediately after the birth of the child, to waiting thirty minutes before making any effort to aid the patient to express it. The procedure recommended by Cragin in his textbook, as well as in his teaching, was as follows:

The nurse locates the fundus at the birth of the presenting part and follows it down with her hand and then guards it during the time the physician allows to elapse before taking steps to express it-if it has not been delivered spontaneously without assistance. His rule was to wait twenty minutes, unless there be hemorrhage, in which case the fundus was massaged vigorously until the hemorrhage ceased or the placenta was expressed. The nurse must be checked up to be sure she has her hand on the fundus and not on the symphysis pubis-likewise she should not press hard enough to cause the patient discomfort.

During the period of waiting the obstetrician may well employ his time in ligating and dressing the cord and putting argyrol or silver nitrate in the baby's eyes. This is also an excellent opportunity for him to examine the baby thoroughly for abnormalities, as it is better for him to find them than to be told of them later. If time still hangs heavily on his hands he can examine. the vagina and perineum for lacerations; it is the practice of some to do the perineorrhaphy before the delivery of the placenta on account of the freedom from hemorrhage

that obtains at that time.

At the end of twenty minutes from the birth of the child, the fundus is taken over

from the nurse. The fingers of the left hand are placed behind the fundus, the thumb in front, and forcible compression is made on it at the same time he presses the fundus downward in the axis of the parturient canal. This compression is made during a uterine contraction and it may be necessary to repeat several times before it is delivered. The placenta is received in the right hand and is gently lifted away-care being taken not to pull it suddenly as it may be adherent by the membranes and a portion be torn off and left behind. The fundus is then kneaded gently a few times to express any clots and is then turned back to the care of the nurse, who continues to guard it for one hour after the birth of the baby. The placenta and membranes should be carefully examined to make sure none has been left behind and then ergot may be administered.

We realize that this is rather extreme conservatism as compared with the method used successfully in many cases. But in obstetrics we must tremember that fully half of our work is prophylactic-the prevention of fetal and maternal morbidity and mortality-and we are not so much interested in what we can do and "get away with generally" but in doing what is safest to prevent accidents which may lead to catastrophes. Among those, often caused by faulty technic in the third stage, may be mentioned inversion of the uterus from pulling on the cord or pushing on the fundus, and bruising of the uterine musculature from too vigorous massage with subsequent dilatation and hemorrhage.

Vaginal Douches-Experience with a large number of women in a gynecologic clinic has shown that the average woman does not know how to take a douche. And it is not surprising, for how many

doctors in prescribing a douche, instruct the patient in the proper method of taking it? "Every woman has a douchebag" was an old saying around the college: we may take it for granted that she has one -and be right generally-and that she uses it improperly and be right more often.

Our experience has led us to prescribe a douche with as much care as we would use in directing a pupil nurse how to give a hypodermic. Insist that the douche be taken in the dorsal posture on a douche-pan, not sitting on the toilet or stooped over a bucket. Insist on the solution being as hot as can be borne by the hand and tested with the hand just before it is used. Insist that the douche be timed and not less than ten minutes be given to it. Urge that a tenminute rest be taken while lying quietly on the bed after each douche-an hour's rest would be better but is seldom practicable.

It is not difficult to have these directions carried out in the majority of instances: they do involve a good bit more trouble. than the usual slop-jar-1-minute-back-atwork method, but the results, in cases where a thorough douche is indicated, justify it all. And the final argument is, "If it is worth doing at all, it is worth doing right."" -Robt. E. Stables, M.D., in the Charlotte Medical Journal.

Recipe for Making a Good Nurse Mix together equal parts of pluck, good health and well-balanced sympathy; stiffen with energy and soften with the milk of human kindness. Use a first-class training school as mixer. Add the sweetness of a smile, a little ginger and generous amounts of tact, humor, and unselfishness, with plenty of patience. Pour into the mould of womanhood, time with enthusiasm, finish with a cap, and garnish with ambition.

The sauce of experience is always an improvement to this recipe, which, if followed closely, should be very successful and exceedingly popular.-Alumnae Record, Buf

For Whooping Cough: One Live
Minnow T. I. D.

Down in one of the southern states a Red Cross public health nurse called with a doctor on a family where there was a sick child. They arrived just in time to find the mother forcing a small live minnow down the child's throat.

"To say my writes the nurse,

interest was engaged,"

expresses it mildly, but I managed to keep my eyes from popping all the way out while the doctor asked her what she was doing. She said: 'If a kid's got whooping cough and you feed him live minnows they'll eat up all the cough bugs in his stomach and the other kids won't get it."

Presumably if the child had something more serious you would feed it black bass, or even pickerel.

In the same letter the nurse also said: "It insults the people hereabouts when a public health nurse is suggested." This comment, taken with the above instance, shows that need for such public health service can be present and. very close to people without their seeing it.

Color Effects on the Sick

Kemp, in the Medical Times (April, 1920), reviews his observations on the curative values attaching to certain colors. Blue, at one end of the spectrum, is magnetic and soothing, he tells us; it is beneficial in panicky states of the mind, with inability to concentrate. Violet is powerfully curative. A bright yet soft yellow suggests life; a light shade of blue, the great sky overhead. To a neurasthenic, in whose mind fear is resident, and doubt, and despondency, such colors have a perceptible influence in his favor.

However, the efficacy of color treatment. depends also on proportion and arrangement. A blue ceiling with walls of sunlight-yellow go well together; a solid color for all surfaces might provoke the dread of