that county health officers cause to have published in the official county paper the following letter:

The poisons of some of the common and also of the most loathsome diseases are frequently contained in the mouth. In such cases anything which is moistened by the saliva of the infected person may, if it touches the lips of another, convey disease. The more direct the contact the greater the danger.

It is the purpose of health officials to keep in isolation all persons having communicable diseases during the time that they are infectious. But in many cases this is impossible. Little restraint is put on certain mild diseases, as measles, whooping-cough, chicken-pox, and mumps, and even such diseases as diphtheria, scarlet fever and tuberculosis are frequently so mild as to be unnoticed, and children affected with them mingle freely with others. It is probable that in such cases one of the chief vehicles of contagion is the secretion of the mouth and nose.

It is believed that much can be done to prevent contagion by teaching habits of cleanliness. But if such instruction is to be effectual it must be continuous. The teacher should notice and correct violations of these rules as habitually as violations of the more formal school rules are corrected.

Even if the question of disease and contagion did not enter into the matter at all, the subject ought to be given more attention by teachers. Our schools should not only teach reading, writing, and arithmetic, but it is, perhaps, quite as important that they should inculcate cleanliness, decency, refinement, and manners.

Cleanliness should be taught for its own sake, even if it had no relation whatever to health.

Children should be taught: Not to spit; it is rarely necessary. To spit on a slate, floor or sidewalk is an abomination. Not to put the fingers into the mouth. Not to pick the nose. Not to wet the fingers with saliva in turning the leaves of books. Not to put pencils into the mouth or moisten them with the lips. Not to put money into the mouth. Not to put pins into the mouth. Not to put anything into the mouth except food and drink and the tooth-brush. Not to swap apple cores, candy, chewing-gum, “all-day slickers," half-eaten food, whistles, or bean-blowers, or anything that is habitually put into the mouth.

Teach the children to wash the hands and face often. See that they keep them clean. If a child is coming down with a communicable disease it is reasonable to believe that there is less chance of infecting persons and things if the hands and face are washed clean and not daubed with the secretions of the nose and mouth.

Teach the children to turn the face aside when coughing and sneezingespecially if they are facing another person, or when at table.

Children should be taught that their bodies are their own private possessions; that personal cleanliness is a duty; that the mouth is for eating and speaking, and should not be used as a pocket, and that the lips should not take the place of fingers.

Typhoid Fever-Methods of Transmission.

The following is an abstract from the advance sheets of the Transactions of the Third Annual Conference of the Marine Hospital Service with State Health Authorities.- SEC.

At the third annual conference of state and territorial health authorities with the surgeon-general of the Public Health and Marine Hospital Service, at Washington, D. C., May 15, 1905, among the subjects for general discussion was that of the transmission of typhoid fever. The discussion, which occupied several hours, was participated in by sanitarians of reputation and experience, twentytwo of whom attended the conference as representatives of twentyone states and the District of Columbia.

The statement of Dr. Victor C. Vaughan, that two-thirds of the cases in military camps were due to infection by personal contact, will be of surprising interest to most sanitarians, and while urban conditions differ widely from those encountered in camps, still the statements of himself and others with regard to personal contact, infected houses, bedding, clothing, eating and other utensils, etc., are pertinent at the present time as showing the means other than water-supplies of the spread of this disease in cities.

After announcing the topic for discussion, the surgeon-general called upon Dr. Victor C. Vaughan, of Michigan, stating that the conference was fortunate in having Doctor Vaughan present, as he was one of the members of the commission appointed by the secretary of war in 1898 to investigate the origin and spread of typhoid in the United States military camps during the Spanish war of 1898.

Doctor Vaughan, in responding, stated that he was the sole survivor of this commission, which, as appointed, were Major Walter Reed, Doctor Shakespeare, of Philadelphia, and himself. Remark as to Doctor Reed he felt to be unnecessary, in view of the distinc tion that had crowned his subsequent work on yellow fever; but he felt that a word of appreciation was due to Doctor Shakespeare, whose work had been painstaking, thorough, without cessation, and of such an arduous nature that there could be no question that it had shortened his life, and the report of the commission must be regarded as a monument to the skill and devotion of Doctor Shakespeare.

Doctor Vaughan stated that he had formerly held the view that ninety-five per cent. of the typhoid cases were transmitted by drinking water, and, as a teacher, had so instructed his classes for years. In fact, the commission went to the various military camps im

pressed with the belief that the water-supply was at fault, but the experiences and the information collected by the commission had led him to radically change his views. He believes now that the spread of the disease is largely by personal contact. From the observations made by the latter, he had reached the conclusion that, under the conditions maintaining in military camps, personal contact was responsible for the spread of the disease in about 66 per cent. of the cases.

In the seventh army corps, at Jacksonville, there was a very large number of cases of typhoid fever. The camp was supplied with the city water-supply of Jacksonville, and contained about 30,000 troops, many of them regulars. The population of the city of Jacksonville was about the same in numbers. The water being the same, the population of the city and the camp approximately the same, there were during the same period in the city of Jacksonville only seven or eight cases of typhoid fever.

The tests of the water-supply for typhoid infection at Camp Alger, Jacksonville and Chickamauga were negative in each instance. Doctor Vaughan went on to give more instructive observations as to the course of the disease. He showed that when camps were changed typhoid fever seemed to follow, in companies, by regiments, and by brigades. An instance was cited by him of a Pennsylvania command, whose camp was frequently changed, and which invariably carried its typhoid with it, and this typhoid continued until a thorough disinfection was made of the tents, blankets, and the personal clothing of the command. Then, and not until then, did the typhoid fever diminish and finally disappear.

At Jacksonville, Chickamauga and Camp Alger the fly was likewise an agent in the dissemination of typhoid, as was also the dust, the latter, of course, being contaminated with typhoid infection. He was, therefore, led to the conclusion that typhoid fever is not only infectious, but contagious in the ordinary acceptation of the term, and he believed that the result of the observations of the commission showed that disinfection is just as necessary after typhoid fever as it is after diphtheria and scarlet fever or other contagious diseases.

The remarks of Doctor Vaughan were listened to with profound attention, and many additional points of information were elicited from him by questions from various members of the conference.

Doctor Young, secretary of the State Board of Health of Maine, has been carrying on an investigation for some time, and his re

sults are in striking accord with all which have been detailed by Doctor Vaughan. Doctor Young's information leads to the belief that the infection of the hands, bedding, towels and utensils plays an important part in the dissemination of infection.

Doctor Harrington, of Boston, stated that recent observations in Germany led to the belief in the correctness of the views expressed by Doctor Vaughan. He cited the publication of recent observations of an outbreak of typhoid fever occurring in eastern Prussia, near the borders of Poland. The region had suffered a period of agricultural depression, but recently important mineral discoveries were made, and laborers flocked to the site, especially from Poland. An outbreak of typhoid fever occurred, and the watersupply, the food supply, and the milk supply formed the subject of investigation, and were found to be above suspicion. All the observations were made by competent observers, and led to the belief that the spread of the disease was by actual contact from one dirty person to another, rather than by the heretofore recognized carrier of infection.

Dr. H. D. Holton, of Vermont, cited an instance of an outbreak of typhoid in a school of about 135 inmates; one case of typhoid in the school shortly after the reassembling of the school after vacation led to thirteen or fourteen cases. The water-supply and the milk as supplied to the school were above suspicion, but it was found that the nurses, who were not trained, were in the habit of taking cups or other drinking vessels from the sick-rooms and filling them from a common milk supply kept in a milk-room in another part of the building, and it was found that these milk containers were contaminated with the bacilli coli by the hands of the nurses. The regulations of the State Board of Health of Vermont now require the nurses engaged in the care of typhoid cases must disinfect bedclothing and drinking vessels, etc., used by typhoid patients, destroy scraps of food left in the sick-room by burning, and must, whenever leaving the chamber of the sick, disinfect their hands by washing with soap and water.

A similar case was reported by Doctor Lindsley, of Connecticut.

Honest Labeling of Food Materials.

In view of some of the criticisms which have appeared in the press of the state, with reference to our analyses of "evaporated creams," it seems advisable to say a few words regarding the object of the work.

It is well known, as stated by the writer,1 that "there are, in the main, two methods of adulteration employed: the one harmful and sometimes poisonous to the human system, and the other the deceptive and fraudulent, but not generally injurious to the health of the consumer.

"In those states where enforcement of pure-food laws is carried on, most of the work is devoted to the detection of the harmful and injurious preservatives, while the second method, just mentioned, has been investigated but to a very limited extent, and there are even certain frauds which do not come within the pale of laws now exercised.

"The first method referred to above does not require any extended discussion, because all will agree that no food should be manufactured or sold which contains harmful or injurious ingredients. It would seem that, in the light of our present knowledge, it would be far safer to prohibit the use of preservatives in foods or food materials. If, later on, science can show, as some claim it will, that the small addition of certain preservatives is harmless, then the laws can be modified accordingly. Still it must not be forgotten that the results of experiments made on healthy subjects cannot be expected to be applied to the invalid and convalescent or dyspeptic, for whom many of the foods now containing preservatives are prescribed or recommended.

"With the second method, the deceptive and fraudulent, etc., the case is very different. No one should be prohibited from manufacturing or selling any admixture of foods or food materials, provided the package is honestly labeled, thus insuring the sale of the materials for just what they are.

"Several forms of mislabeling can be enumerated, among which the following are the most conspicuous: (1) False statements concerning the nature of the contents of packages of foods or food materials; (2) false statements regarding the nutritive value of the different manufactured and prepared foods; (3) false statements or inferences relating to the weight of foods or food materials in any package.

1 California State Medical Journal, June, 1904.