both indoors and out to strengthen the body as much as possible. Give her plenty of sleep, not much study, and no dissipation by going out to parties late at night; and she will more than make up for her absence when she returns to her regular school duties.

A years' delay in the studies of any girl is of small moment compared to the advantage of being strong. With many I do not think there would really be any serious loss of time, if they were allowed to remain out of school for the first year of menstrual life; since they would learn faster and retain what they did acquire very much better if they were in a condition to study. Many of the studies that young girls are compelled to wade through are entirely unnecessary; and are only learned one day to be forgotten the next.

The dress of young girls particularly through the growing period should be such that it does not interfere in any way with the proper development of the abdominal muscles. With use the muscles of the back and abdomen should, and would be, as strong in girls as in boys. Sleep should be regular and long enough to rest both body and mind. School children should as a rule sleep from nine at night till seven o'clock the next morning; this gives ample time for the morning bath, and dressing, after which breakfast can be taken slowly.

When a child goes to bed at eleven or twelve o'clock and rises late the next morning it is a scramble to get off to school, and breakfast is scarcely taken at all; then before noon time, comes the wretched faint feeling from lack of food, headache follows and no appetite for dinner.

In our High Schools, the plan of twenty minutes for lunch and then resuming studies till two or two thirty is most unfortunate for the pupils. The old plan of recess from twelve till half-past one o'clock is by far the best one, and will I hope be again adopted.

The tendency is all the time to overcrowd the children with study and to do this now even the meal hours must be shortened, there can be no greater mistake. Often we do not see the effects of such a pernicious course at once,

but just at the time when the young woman or young man should be able to withstand the demands of every day business, or household life, the physical and mental force fail.

The organization in youth is so dangerously elastic that the result of these intellectual excesses is not sometimes seen till years after.

When a young girl incurs spinal disease, or other serious trouble, from some slight fall, which she ought not to have felt for an hour; or some business man breaks down in, what should be, the prime of life, from some slight over anxiety, and which should have left no trace behind, the careful physician will see but the effect of mistaken school training, that weakened where it should have strengthened, and stunted where it should have ripened. No child can study properly when the body is but poorly nourished, and I believe the lack of proper nourishment at noon is very often the cause of headaches from which many school children suffer.

During the fall season the usual custom of opening school about the second week in September will often seem to develop malarial fever in school children. This I attribute to the sudden change in their mode of living. They are brought from a life of activity out doors to one of comparative quiet and confinement all at once, at a season when malarial fevers are more apt to prevail. Unusual caution should be taken to prevent this trouble coming on.

Particular care should be taken to prevent the spread of contagious diseases through the medium of school life.

As soon as measles, scarlatina, diphtheria, or small-pox, appear in any family, the other children, should there be any, must remain away from school and every precaution should be taken to prevent the carrying of disease germs in the clothing when the children go out of doors. The sick child should be completely isolated from all other children that may be in the house, not only for their protection, but in justice to all others with whom they may come in contact, both on the street or in street cars.

As to the length of time that should elapse before it is

perfectly safe for the children to return to school after the disease is over; that must be decided somewhat from the severity of the attack. If the disease has been at all a malignant one it will be safe to say that three weeks should pass, after the child that has been sick, has completely recovered, before any other children of the household should be allowed to attend school.

This gives ample time for the possibility of the disease. to manifest itself in any other member of the family.

It would be most unwise to allow children to attend school before we have had sufficient opportunity, and time, to discover whether the disease is in their systems, even if they have not come down with it themselves.

There is a difference of opinion as to the communicability of whooping-cough, by children carrying it to school. While I do not think the disease can be carried in the clothing like small-pox, yet from some cases that have recently come under my notice, I am inclined to think that one child may carry the disease to another previous to the cough being recognized in the one who has been the means of spreading it.

Many parents need to be informed of the great necessity for strictly carrying out these rules for the prevention of contagious diseases; and circulars should be issued, by all school boards, and distributed free every season, stating the reasons for these rules, as a matter of self-protection. One of the most desirable advances is the appointment, in all our large cities, of a medical inspector.

A lady should be appointed to examine into all cases where the female pupils are not able to attend school, also to see whether there are any girls in a condition unfit to attend to their school duties, and if there are, have them sent home until sufficiently recovered for them to return to their studies without any danger to health.

Such a plan as this is now in operation in some of the eastern states, and also in Paris, where a young woman, having a medical education, has been appointed medical inspector. Her duties are to see that the girls are not overworked, and that they perform their tasks under the

best sanitary conditions possible. This is a good step forward in the direction of practical school sanitation. In most localities attendance upon school is inforced at certain periods when the girls should be privileged to remain at home; and to accomplish this most desirable end I would earnestly recommend that each Board of Education should appoint a suitable lady medical officer, with specific duties for the district under her supervision.

What we are aiming at is to have the girls grow up into strong, healthy, educated women, and many suggestions can be given to the mothers by the visiting medical officer, that will materially help to bring about this desirable end.

Woman's sphere should yet be enlarged, her occupation in many departments ought to be better remunerated, and her education ought still to be further perfected in her special lines of duty; but education that tends to injure her should be avoided, since instead of rendering her strong, capable and more self-reliant, it is calculated by misdirection to make her weak, incapable and helpless, during the years of her life when she most needs strength.

In some districts, also, a physician might advantageously be appointed as medical examiner to look after the boys, and decide all doubtful cases of contagious diseases. As already stated boys need special instruction particularly adapted to their future mode of life.

Educated mechanics is the present and future need of the country, and while it may be beyond our power to improve the education of those men already in the labor field, it should be the aim of all school boards so to direct the course of studies that all boys leaving our public schools may grow up into intelligent healthy manhood. Then may end all strikes.

There is great need that all boys, particularly, be carefully and thoroughly instructed as to the physiological effects of alcohol upon the human organism. With proper and careful instruction as to the scientific use of alcoholic. liquors much of the abuse that now prevails may be prevented. The only sure and certain remedy is a more general diffusion of hygienic knowledge.

SURGERY.

SURGICAL NOTES.

J. G. GILCHRIST, M. D., Iowa City, Ia.,EDITOR.

ORIFICIAL SURGERY.-E. H. Pratt, M. D., Chicago. W. T. Keener, pp. 141, $1.00. This little manual is one of the most original in its subject-matter that has appeared in many a day. There can be no question that the writer has developed a great fact, one that has hitherto had very insufficient attention given it: at the same time is this not a little "strong," to put it mildly? "In all pathological conditions, surgical or medical, which linger persistently in spite of all efforts at removal, from the delicate derangements of brain substance that induce insanity, and the various forms of neurasthenia, to the great variety of morbid changes repeatedly found in the coarser structures of the body, there will invariably be found more or less irritation of the rectum, or the orifices of the sexual system, or both. In other words, I believe that all forms of chronic diseases have one common predisposing cause, and that cause is a nerve-waste occasioned by orificial irritation at the lower openings of the body." No one who has witnessed the acute local suffering and reflex disturbances occasioned by rectal fissures, urethral caruncle, and the like, can question the fact that serious disturbances of health can originate in these intrinsically trivial lesions, but at the same time, there are few, I think, who would be willing to accept the Doctor's exceedingly broad statement without essential modification. The clinical reports appended are of interest and value, and will scarcely fail to direct the attention of all practitioners to this sadly neglected field; nevertheless, it is equally certain, that the Doctor's methods and theories will undergo considerable change in course of time, leaving enough to entitle him to the thanks of the fraternity. Of course radicalism and enthusiasm are necessary, in all departments of human thought and action, but it is not that qual