used than previously. Our drug stores are filled with patent and proprietary foods on which there is placed too high a valuation.

Many mothers could and would nurse their children had they been properly instructed in regard to the importance of nursing the baby and the ill effects which result from artificial foods. We find the greatest number of artificially fed babies, first, among the women employed in the factories, and, second, among those who play society, likewise the highest infant mortality. Let us consider the future. life of the child and what adverse conditions it must contend with, unfitted for the struggle before it when improperly nourished by artificial foods.

Passing from the infant, a few points on the general care of the child. Good, simple, pure food, including milk and fruit, are the requirements for the child. Teach them to masticate well and for the same reason, to have proper mastication and a well nourished child. The teeth should be given proper attention. Exercise, plenty of fresh air and sleeping in the open will act properly to stimulate and develop the child both physically and mentally. Strong, sturdy and active children are those who are brought up under good hygienic conditions and environment. The backward, dull children are descendants of parents lacking in physical and mental strength. Crowding children either in a physical or mental way beyond their natural ability will produce physical weakness or mental dullness, and for this reason we see at once the great importance of having a school physician who should concern himself with those who are mentally backward and co-operate with the teachers in guiding them in the amount of work they are to do and assist in the mental and physical development of the children.

No branch of hygiene, perhaps, has met with so little progress as the prevention of the infectious diseases of childhood. This is partly due to the inability on the part of the laity to comprehend the loss of life from these diseases. Measles, whooping cough, diphtheria and scarlet fever are the four diseases which recent investigation has shown to be the most fatal, and they are all preventable diseases. Epidemics of these infectious diseases which cause death and distress in different cities every year should be prevented by a quarantine rigidly observed and enforced.

Let me say that every doctor in our country should employ his every energy and every known method towards the prevention of these diseases, and the greatest progress can only be made after the public has been educated at public health meetings, when they, too, can lend a helping hand toward their prevention.

Human lives are at stake, therefore educating the public is a necessity and can be accomplished by public meetings to properly instruct them along the line of preventable, infectious diseases. We cannot place too much stress upon the importance of every professional man and good citizen lending a hand in this cause. Journai Oklahoma Medical Association.

Rural School Conditions in the United States

One of the most important committees appointed by the Council on Health and Public Instruction of the American Medical Association is that on co-operation with the National Educational Association. This committee, appointed two years ago, has been working with a similar committee appointed by the National Education Association on the subject of school hygiene. The first year of the committee's existence was devoted largely to a survey of the field and a consideration of what activities should be first undertaken.. After careful discussion the committee decided that the rural school was more in need of attention and assistance than the city school. Then the question arose as to the amount of available information concerning rural schools and school houses. Surprising as it may seem, it was found that little was known of the actual conditions of rural schools in the different states. A preliminary survey was accordingly undertaken with a view to remedying this defect. Through the United States Bureau of Education, Professor Dresslar of Nashville, Tenn., made a careful study of a large number of country school districts in the South. Special surveys in Connecticut, Vermont and New York, as well as general investigations which gathered statistics from every state in the Union, and special studies of rural conditions in Idaho, Massachusetts, Pennsylvania, New Jersey and Virginia, resulted in the accumulation of a large mass of information which is now being digested and drawn up in the form of a report. Professor Dresslar's work will be made public through a special report issued by the United States Bureau of Education. While the work of the committee is only begun, enough has been learned to show that the sanitary condition of rural schools is not by any means so satisfactory as was generally supposed. In the New York Times, March 8, appeared a lengthy article based on a statement by Dr. T. D. Wood of Columbia University, chairman of the education committee.

After describing the organization of the committee and the work which it has undertaken, Dr. Wood said: "We grew up with the notion that the school children in the country were bound to be much healthier than the children of the cities. Our parents always credited the little red school house for their excellent constitutions. Of late years, however, there has been a good deal of suspicion cast on that same little red school house. We have begun in this day of sanitation and medical inspection to have our doubts about those unqualified benefits."

Dr. Wood then gives a few specific instances in proof of the general proposition that the country school child is from 15 to 20 per cent more defective than the city child. In Pennsylvania a study of 1,831 rural school districts was contrasted with the health of the school children in Harrisburg, Pittsburgh and Altoona. The percentage of defective children in Altoona was 69 per cent, in Pittsburgh 72.2 per cent, while in the rural districts studied the aggregate of defective children amounted to 75 per cent. This means that three-fourths of the 294,427 country school children in Pennsylvania are in need of special care and treatment, while even in New York City only 72 per cent of the children are at all defective.

The investigation of specific defects gives the same results. For instance, a comparison of the school children of Orange County, Virginia, with those of New York City shows that with all of the surroundings and disadvantages of city life, the number of New York school children with lung trouble amounts to only a fraction of 1 per cent, while 3.7 of all the school children in Orange County, Virginia, suffer from some affection of the lungs. When the nutrition of rural school children was considered, it was supposed that here, of course, the country child would greatly surpass the child in the city, yet the average of malnutrition among the school children of New York City is 23.3 per cent, while that of rural school children in the districts investigated is 31.2 per cent. The same startling result is found when the figures for mental defectives are compared. Statistics from twenty-five cities and from rural districts in Pennsylvania, Massachusetts, New Jersey, Idaho and Virginia were compared, showing that the average of mental defects among city children was 0.2 per cent, while the average among rural school children was 0.8 per cent. Heart disease is twice as prevalent among country children as among city school children. City school children have only 0.13 per cent of curvature of the spine, while rural school children have 3.5 per cent. Ear troubles are five times and eye troubles are four times as frequent among country children. Adenoids are found in city school children in 8.5 per cent, but in the country the percentage is 21.5. The children in twenty-five cities showed an average percentage of enlarged tonsils of 8.8, while a similar number of country children showed over 30 per cent, and in Idaho the percentage ran up to 43.9.

Discussing the causes for these amazing and startling conditions, Dr. Wood finds that even in the slums, where the pinch of poverty is the sharpest, the food is better prepared than it is in the country, while the distance from dentists, oculists and clinical advantages accounts for the large number of defects of sight, hearing and teeth. Country houses are often drafty and overheated. The chances for house infection are greater and children are more exposed to cold, heat and dampness. The school houses are often old and carelessly built and have insufficient equipment. In seven states.

there is no regulation of the sanitation of country schools. Heating is generally by means of a stove, and bad ventilation is usually the result. Seating accommodations are bad and general sanitary conditions often unspeakable. Frequently the only provisions for cleanliness are a pail of water, a dirty basin and a common towel. Drinking arrangements are bad and drinking water often contaminated. Dr. Wood sums up the situation thus: "Now take into consideration the many other contingencies which the country child has to meet-physical labor, chores before he starts for school in the morning, a badly assorted breakfast, a long walk over bad roadsthen subject him to direct infection, to bad water, and it is small wonder that he falls prey to a dozen maladies more readily than the city child."

The results of this survey of rural schools cannot fail to shatter some of our previously conceived views regarding rural conditions, and at the same time to point out the remedy. Not one state in five today provides for its country school children. In most of the cities some kind of supervision and care of school children is maintained, but rural schools have so far been left very largely to shift for themselves. "The welfare of our country," says Dr. Wood, "depends on no factor more indispensable, more vital, than the welfare of our rural life. Our finest crops are our children. The farmer does not see this truth. If he did, he would rise up and demand state protection for his youngsters-a more important matter than tariff regulation."

A few days after the publication of Dr. Wood's article in the Times, the New York Evening Post, in a long editorial, discussed his statement, which it characterized as of exceptional interest. "It is not often," says the Post, "that so striking a survey of statistical results in the domain of health bears such clear marks of trustworthiness and sobriety." After reviewing the article and Dr. Wood's conclusions, the Post indulges in some general optimistic reflections. It says: "Just as surely as the child of the city is more free from defects and ailments than the child of the country, just so surely is the city child of the present in better case than the city child of the past. If in spite of crowded homes, impure city air, lack of recreation facilities, in spite often of the poverty into which he is born and perhaps the vice with which he is environed, the city child makes a better showing than the country child, it is because of the multitude of benefits which have been bestowed on him by the progress of science and the steady advance of civic care, enlightenment and responsibility."

In the improved condition of the city child as contrasted with the country child, the Post finds reason for believing that the condition of the child in the country will be speedily corrected now that attention has been brought to the situation.

The work of the joint committee of the American Medical As

sociation and the National Education Association has proved already of the utmost value and its activities have only begun. These two powerful organizations representing the organized professions of teaching and medicine can, during the next five years, effect a marked improvement in the health conditions of American school children.

RURAL SANITATION.

By W. C. RUCKER, M.S., M.D.,

Assistant Surgeon General, United States Public Health and Marine Hospital Service.

The happy days of childhood
I often call to mind:

I love to live them o'er again
By memories light refined-
The orchard and the meadow

And the loft of fragrant hay,
The garden and the privy,

And the well not far away.

The farm yard with its litter
Of manure 'round about,
The milking shed where flies galore
Flew buzzing in and out,
The pig-sty and the chicken house,
The hens that scratched all day
In the ground beneath the privy,
With the well not far away.

We took our joys and sorrows

As they chanced to come along;
My brother had the ground-itch

And he didn't grow up strong,
And Mary died of fever-

It was mighty sad that day-
But we didn't blame the privy
Nor the well not far away.

In the summer time mosquitoes

Used to sing the whole long night,
But we would keep the windows closed
And thus avoid the bite;

But Billy got the ague

And Lizzie pined away—

Mosquitoes-foul air-privy,

And the well not far away.