the minimum, and manure heaps cleared away at frequent intervals, since they are the favorite breeding places of flies. On another page in this bulletin the use of borax on manure heaps is advised by the United States Agricultural Department, which has found this valuable in preventing the breeding of flies. In this connection we urge in the strongest possible terms

the replacing of the present privy system. by some form of sanitary privy. The one here pictured has been recommended by the United States Public Health Service. It can be erected or changed from the old form by the farmer himself at a trifling cost, and, if properly managed, will positively prevent flies from carrying infection from this source, as they cannot gain access to the excreta. There are two essentials. One is that the seats be covered by a lid so constructed that it will fall forward when the seat is unoccupied. The other is that a galvanized iron bucket be placed on a firm foundation under each seat, and that they be closed in by a falling hinged door in the rear so as to make the inclosure fly-tight. At intervals the buckets are to be emptied and the contents buried. This can be done by running a furrow and covering it with a plow or shovel.

Human carriers, when found, must be quarantined and treated by a competent physician until freed from the germs of typhoid fever. No such persons should be permitted to engage in cooking or serving food, and especially must they be prevented from taking any part in dairy work, since the danger of milk infection from this source is very great. Dr. Ravenel of Wisconsin has recently reported a typhoid carrier who conveyed typhoid fever to 21 persons, many of them relatives, before a microscopic examination proved him to be a carrier. Such cases are not rare. "Typhoid Mary" of New York caused 26 cases in seven families in which she was a cook.

Contact cases can be easily and certainly avoided by simply

avoiding contact with typhoid patients. There is too much visiting in cases of sickness. Most patients will get along much better without visitors, making a better and more rapid convalescence. In the event of visiting, however, which we can scarcely entirely stop, the visitor should avoid coming into contact with the patient, the bed, drinking vessels, or anything that has been handled or used by the patient. The necessary attendants should use the utmost caution as to cleanliness, and should especially wash their hands thoroughly immediately before eating. By observing these precautions there is little danger of contact cases arising.

This leads us to the most important point in the control of typhoid fever. With our present views on the subject, were the body discharges of all typhoid patients thoroughly disinfected at the bedside, the disease would in time cease to exist. Water carries the poison because it has become infected by these excreta. Milk carries the poison because it has been infected by the hands or water or other thing that has previously become infected by these excreta. Disinfection of excreta means dead germs and dead germs cannot convey infection. Kill the germs at the bedside, therefore, as soon as possible, and you strike the disease at its most vulnerable point, and greatly diminish the probability of its spreading, with the result that, were systematic and thorough disinfection practiced in every case, typhoid fever would ultimately be extinguished.

How shall this disinfection be done? The process is fortunately both easy and economical.

We have a number of efficient disinfectants, among which I may name:

1.

Carbolic acid. This should be used in a 5% solution.

2. Tricresol, which is to be used in a 2% solution.

3. Chloride of lime, which must be fresh. Dissolve 6 ounces in a gallon of water. In a stoppered bottle this will retain its. strength for some days.

4. Quick lime, in the form of milk of lime or common white wash. To be particular, add two quarts of broken lime to 3 pints of water. This produces hydrate of lime, which will retain its strength for some time if kept dry. Add a pint of this to a gallon of water to form milk of lime, which will retain its strength for several days.

Of any of the above add as large a quantity as the amount of excreta to be disinfected, thoroughly mixing. Cover the vessel immediately and let stand at least an hour before emptying. In this way all danger of spreading the disease by the excreta will be removed.

It is important that disinfection should be practiced from the commencement of typhoid fever, but it is not possible for even the most experienced physician to determine the nature of every

case of fever within a day or two. With even the scientific methods of blood examination, several days may pass before a positive opinion can be formed. It would be wise, therefore, to insist on disinfection in every febrile case until all doubt is removed. In no other way can we hope for the best results.

Preventive vaccination, instituted a few years ago, has proved to be almost an absolute preventive of typhoid fever. Over 200,000 United States soldiers and sailors have received this vaccination and not a single fatal nor even serious result has followed. To show the beneficial results in the army it may be stated that in 1898, in the Spanish-American War, of 11,000 soldiers there were 1,729 well defined typhoid cases and over 2,000 cases resembling typhoid, with 248 deaths. In 1909, in a force of 69,000 men partly vaccinated, there were 173 typhoid cases and 16 deaths. In 1912, vaccination being compulsory, among 83,000 soldiers but 27 cases with 4 deaths occurred. For the year following August, 1912, but 2 cases occurred in our army. Says a recent writer: "If our government had the warrant and could exercise the power in civil life as in the army and navy, very soon there would be practically no typhoid fever in the United States" (Dr. Gould).

Who should be vaccinated? All persons called upon to nurse fever cases; all the younger members of a family in which a case of typhoid fever occurs; all persons frequently absent from home and drinking water of unknown quality; all persons on their summer vacation; and all persons of susceptible age in any community where there is a widespread epidemic of typhoid fever. Not many cases of fever occur after the age of 50 years.

We close with a summary of instructions modified from several distinguished authorities:

1. Treat all suspicious cases as typhoid fever until a definite diagnosis is made, and insist on careful disinfection of all

excreta.

2. Screen the room of the patient and kill all flies in it.

3. Do not permit milk to be brought into the house of a typhoid patient, but place a vessel outside to receive it.

4. Keep the patient's milk apart from that of the family, and the nurse should not handle the latter. If the nurse is a member of the family, the hands should be cleaned and disinfected before handling the family milk or food.

5. The hands of all members of the family in which a typhoid case occurs should be most carefully washed immediately before eating, and those of the nurse should be disinfected as well. 6. All persons whose assistance is not required should keep away from cases of typhoid fever.

7. Use drinking water only from sources known to be pure. If any doubt exists, boil the water. It may also be purified as follows: Add a teaspoonful of purified chloride of lime to a pint

of water. Of this add a teaspoonful to two gallons of water and let stand for a half hour before using.

it.

8. Unless assured of the purity of the milk, boil or pasteurize

9. Select carefully fruits and vegetables that are to be eaten raw and cleanse them in sterile water before using.

10. Regard all human excreta as possibly dangerous, and control their disposition in such a way as to prevent contamination of food or drink.

11. Secure vaccination against typhoid fever if necessarily much exposed to the disease, or if placed in circumstances named above.

THE SONG OF THE FLY.

By CHARLES L. SWINDELL, M.D., Wilson, N. C.

The Butterfly's a free-lance and the Bee a buccaneer,
And the Dragonfly's a pirate lurking in each hidden nook;
The Katydid's a gossip, clacking loud for all to hear,

But the Little Harmless Housefly-I'm the villain of the book.

My life begins in filth-piles which the shiftless men ignore;
I batten on the loathsome mess until my wings appear;
Then out into the daylight, ubiquitous I soar,

With liberty unbounded on my murderous career.

I love to haunt the stables-which they never think to screen,
Or spend a crawling hour in the open-work latrine,

Then hasten to the kitchen with a stimulated zest

And sample every dish to find which one I like the best.

I feast in sick-room vessels-pause to taste a pool of spit,
Explose a pauper's festering sores-torment a mangy pup,
Then with my deadly freighted toes my whilom way I flit
To pantry or to dining-hall or to a drinking-cup.

I dabble o'er a carcass-its putrescence is a treat;
Then away to taste the sweetness of a sleeping baby's lip.
I'm an instrument of murder and my weapons are my feet,

For I leave my trail behind me wheresoe'er I pause to sip.

So childless breasts and aching hearts come stalking in my wake, And grave-yards yawn expectantly because men let me live; From high and low, from rich and poor, my ghastly toll I take; To age nor youth nor helpless babe no quarter do I give.

So it's ho! for hall and hovel-you may find me everywhere, Man's menace from the moment when he draws his natal breath; Created in a dung-hill, yet I come to cleave the air

The Special Agent of Disease-the Courier of Death.

Health Work In Other States

The many co-operating influences at work in the suppression of tuberculosis and other diseases as well, indicate the progressive power of the campaign throughout the country. In Iowa there is very much of encouragement. The willingness shown in every direction gives large promise. Tuberculosis day was much more generally observed throughout the state than in former years and the quality of the addresses delivered indicates a more general understanding of this great social plague. In some counties, practically every pulpit was occupied and in many instances where December 7th was not available, a subsequent Sunday has been used for the discussion.

In connection with the Red Cross Christmas Sale, the motion. picture houses in the General Film Company's Exchange put on a film entitled, "The Price of Human Lives," which deals with "fake consumption cures," "quack doctors" and "sure cures." In Iowa this reel has been very generally used and will be throughout the season. Wherever seen, the film has made a profound impression upon the public. At the same time, the Metropolitan Life Insurance Company has had distributed in connection with this reel, an illustrative leaflet contrasting between what should be done and what should not be done if one has tuberculosis.

Some of the salient features of this leaflet follow:

IF YOU HAD CONSUMPTION WHAT WOULD YOU DO?

Consumption can be cured if taken in time.

Thousands of physicians and cured cases in all parts of the world testify to that fact.

The only known remedy that will cure tuberculosis is the combination of fresh air, rest and good food, under a doctor's care. For more than twenty-five years physicians all over the world have been using this method of treatment successfully.

No drug, patent medicine or secret remedy has ever been discovered that will cure tuberculosis. Any individual or company which advertises or says that it has a cure of this character for consumption is telling a deliberate falsehood.