ommendation, was well aware of the preference of the vast majority of citizens. The prohibition forces, aroused by this step, are preparing to fight the issue with all the influence they command. One can only regret the stubbornness and lack of vision which the persistence shows.-American Medicine, May, 1919. NATIONAL HEALTH INSURANCE DETRIMENTAL TO THE STATUS OF THE MEDICAL PROFESSION OF GREAT BRITAIN Mr. Frederick L. Hoffman of the Prudential Insurance Company, who is now on an extended English trip for the purpose of thoroughly investigating the methods and results of National Health Insurance in Great Britain, wrote the editor of the Journal of the Medical Society of New Jersey, under date of July 15, 1919, as follows: I have just finished reading a large amount of original information received from England and I am absolutely of the opinion, in the light of my present knowledge, that National Health Insurance has been decidedly detrimental to the status and wellbeing of the medical profession of Great Britain. The doctors have been reduced to the status of mere clerks or servant of Approved Societies and there has been developed a tendency to the granting of dishonest certificates as an aid to malingering and fraud upon the funds. A large amount of the practitioner's time is taken up with National Health Insurance which have nothing to do with the prac tice of medicine as a healing art. Doctors are continually on trial before Insurance Commissioners for alleged offenses against the act, chiefly over-prescribing, with that it is more true of England today than of any other country in the world, unless it be Germany, that there is a reign of terror and chaos, in consequence of a fatuous policy of alleged social reform. The President of the Illinois State Medical Society in his annual address, May, 1919, said: The organized profession which will have to work under this law does not demand it, organized labor has condemned it, the employers of labor, as represented by the various national organizations, Chambers of Commerce and Civic Federations, have all gone on record as being opposed to it. It is being fostered by and originated with the "American Association for Labor Legislation," which is in nowise connected nor in any way affiliated with organized labor. However, the supporters of this measure have a strong organization to promote its enactment, so strong that it has been successful in enlisting many prominent medical men in its defense, and it will only be by the united team work ONE FORM OF AUTOCRACY HAS DISAP- COMPULSORY HEALTH INSURANCE To deprive any citizen of the privilege of putting his life in the hands of a physician of his choice is un-American and it is equally unAmerican to compel a physician to attend a person in sickness when for a good reason he would like to be excused. If a man must submit his life to the dictates of a bureaucracy, such a man is robbed of his liberty and independence as it is related to that which is above all things sacred to him. Where is the justice or equity of discriminating legislation that would advocate a bureaucracy to control and dominate the members of the medical profession to the extent that such bureaucracy shall determine the personnel of a physician's clientele and the fee he may charge regardless of the qualifications attained and the specially skilful service rendered? One cannot be in sympathy with such a contemptible statewide lodge practice. Why should the members of the medical profession, who at present rank in qualifications with that of any other profession or calling, be commercialized at the instigation of comparatively few apparently seappointed ultra enthusiasts who pose as deeply interested in the physical welfare of the people of our commonwealth and who do not see fit to apply the same principle in every other line of human endeavor? It is just as unAmerican for a bureaucracy to determine the clientele of a physician as it would be to determine the clientele of a butcher, a baker, or a candlestick maker. There is no difference in the application of the principle. The physical welfare of our people was never so well taken care of as now. Preventive medicine has made tremendous progress and is the outgrowth of work accomplished by the organized medical profession. Nowhere in our country was it the result of the importation of any foreign scheme that has brought ruin to the profession wherever adopted. This whole propaganda appeals to one as artful sophistry, a species of Michiavelianism.-G. E. H. in Penn. Med. Jour. HISTORICAL DATA In the John Crearer Library, Marshall Field Building, Chicago, Illinois, can be found a complete file of the ILLINOIS MEDICAL JOURNAL. The editor and the trustees feel that it is best that these valuable historical records of the transactions and proceedings of the Society be stored in a fireproof building instead of being kept in a private home as in the past. In the Crearer Library they are not only safe from the ravages of fire but they will be card indexed and accessible at all times. INFANT WELFARE IN GERMANY DURING THE WAR. In all Europe and, of course, more especially in those countries engaged in war, infants and children have suffered severely, and this constitutes one of the most important after-the-war problems. Conditions in Germany during the war have been largely veiled in obscurity, or camouflaged, as they seemed to suit military exigencies or the wishes of the ruling caste. The reports from Germany itself in the past four years have been so contradictory that no reliance whatever could be placed on them, and even now it is very difficult to arrive at the truth. When the war was going on it was usually declared that infants and children were not very adversely affected by the blockade; but now that Germany is beaten, and it is the policy of the country to appeal to the sympathies of the world at large, it is asseverated. that hundreds of thousands of infants and children were wiped out by Great Britain's cruel blockade. The truth appears, as is generally the case, to lie between these two extreme statements, and probably Germany suffered in infant mortality to about the same extent as the other big warring countries, and less than the smaller countries, as Belgium, Poland, Serbia, and Roumania. It must always be borne in mind that for a considerable part of the war the blockade was notoriously inadequate. The real facts of the condition of infants in Germany while the war was in progress are beginning to leak out. Recently an instructive summary concerning infant welfare in Germany during the war has been given in a report prepared by the intelligence department of the British Local Government Board in 1918, which has just been published. The summary was reproduced in Public Health Reports for Feburary 14, 1919. The most striking feature of the information set down in the document is the heavy decrease shown in the number of births. Some 40 per cent fewer babies were born in 1916 than in 1913. On the whole, the infantile death rate was well kept down. According to the British report, the reduction in the rate was due partly to the special measures taken and partly also because of the cool summers. The chief measure adopted in Germany to promote infant welfare during the war was the distribution of imperial maternity grants. One of these grants is given only to women who feed their babies at the breast, the encouragement of breast feeding being regarded as one of the most powerful agencies for furthering infant welfare. Illegitimacy increased greatly in Germany in the past few years. The proportion of illigitimate births in the entire German Empire is between 9 and 10 per cent, and in certain districts the rate is much higher. The care of foster children was interfered with by the war on account of the mobilization of medical men appointed to look after them. However, when affairs had become settled on a war basis, illigitimate children were cared for better than ever before. Foster children and children whose mothers were working outside were taken care of both in homes and in institutions. It is claimed by those concerned in the welfare of infants and young children that these are better cared for by trained and supervised workers in creches or infants' homes than in the houses of foster mothers, especially in view of the difficult food conditions that must still prevail for a considerable time. A discussion of the subject of infant welfare in Germany recalls the recent request of workers in this field to the British Government for permission to import from England a supply of rubber nipples for nursing bottles. The petitioners urged that this was imperatively necessary to save the lives of thousands of infants, and to clinch the point by an unanswerable argument they added that if this request was refused, by 1933 there would be no men fit for army service.. The naivete of this statement is delicious, and is on a par with many other manifestations of the utter humorlessness of Teutonic efficiency. With minds set on the goal, they are absolutely blind and deaf to all side issues.-Medical Record, March 22, 1919. SHORTER HOURS FOR NURSE, DEMAND AT MEETING HERE. Resolutions were adopted at the closing session of the twenty-fifth annual meeting of the National League of Nursing Education in the Congress hotel as follows: For shorter hours for nurses. Advocating that schools for nursing include courses in mental diseases, care of children, communicable diseases, and public health. For inspection of schools of nursing. navy. Correspondence THE CONSTITUTIONAL CONVENTION APATHY OF PHYSICIANS Galena, Ill., Aug. 12, 1919. To the Editor: The recent attempted legislation relative to the medical profession of this state should cause us to prick up our ears and at least stimulate us to some interest in legislation. With this thought in view, and believing that the medical profession should be represented in the Constitutional Convention I sent the following communication to all the physicians in this, the Twelfth Senatorial District, comprising the counties of Jo Daviess, Carroll and Stephenson, with the hope that some physician might become a candidate for delegate to the convention. READ THIS, DOCTOR The Constitutional Convention meets in January, 1920, for the purpose of revising or rewriting the Constitution of the State of Illinois. Each Senatorial District in the state is entitled to two representatives or delegates. These delegates are elected by the people of each Senatorial District. To become a candidate at the primary election, it is necessary to file a petition signed by one-half of one per cent of the vote cast in the district for Governor at the last election. The petition must be filed with the Secretary of State before the first day of August, 1919. Who is going to represent the Medical Profession from the Twelfth District-including Stephenson, Jo Daviess and Carroll Counties? The medical profession should see that we have representation in this convention and should put out a candidate in many districts of the state. Let us not leave the framing of the fundamental law of the state entirely to others. Let us have something to say! The profession is vitally interested. Reply on enclosed postal expressing your choice of some physician in the district for a delegate to the Sec. Jo Daviess Co. Med. Society, Out of ninety-five communications sent out I received twelve replies expressing a choice. Doesn't that show some interest in a convention that is to revise or re-write the fundamental law of our state!! Who in that convention will look after the interests of the medical profession? Of course we can maintain a lobby under the direction of our committee on legislation and receive telegrams and form letters from them asking us to use our influence with our delegates. Is it any wonder that the professional politician says, "The doctors can go to hell" when only twelve out of ninety-five will express a choice on a subject of such vital importance as revising the constitution of this state? Public Health G. W. RICE. PREVALENCE OF INFANTILE PARALYSIS IN ILLINOIS. The Division of Communicable Diseases of the State Department of Public Health reports an increased prevalence of infantile paralysis dating from July 1st with new cases being reported almost daily. For the current year from January 1st to June 30th there were 45 cases of infantile paralysis in this State. During the month of July alone 51 cases were reported, or six cases more than had been reported Between during the first six months of the year. August 1st and August 22nd, 68 additional cases had been located. An interesting feature of this outbreak of poliomyelitis is that the new cases are being reported in many instances from exactly the communities in which the first cases were noted in the outbreak of 1916. In 1916 the first cases were found in the village of Standard in Putnam County, where five cases with two deaths have been noted within the past few weeks. It will be recalled that in 1916 La Salle County and particularly that section in the neighborhood of La Salle County was particularly hard-hit. At the present time cases are reported in four sections in La Salle County and in the adjoining counties, and in seven communities of the adjoining counties of Bureau and Putnam. Since the compilation of data on August 22nd, 5 cases have been reported in Monticello, Piatt County. There were a number of cases in and about Piatt County during 1916. In addition to the active cases of poliomyelitis located through the reports of physicians to the Di vision of Communicable Diseases or through the investigations of epidemologists, the Division of Child Welfare and Public Health Nursing reports that in all of the eighteen clinics for crippled children patients are being presented for diagnosis and treatment who show the after-effects of infantile paralysis not recognized during the acute stages of the disease. It is difficult to determine the comparative prevalence of poliomyelitis at the present time with that of several years ago, inasmuch as the attention given to the subject by the State Department of Public Health and the apprehension occasioned by the eastern epidemic of a few years ago, have led to a more careful diagnosis by physicians and to a greater willingness to report both known or suspicious cases as required by the Rules of the Department. BATHING AT WATER SUPPLY SOURCES. The State Department of Public Health issued communications to local health officers and other public officials urging that definite steps be taken to prevent bathing and swimming in reservoirs, lakes, streams or other sources of municipal water supply. It has been ascertained that a number of communities where the water supply is otherwise satisfactorily and thoroughly protected that swimming in reservoirs is permitted or, if forbidden, is not effectively prevented. Cases are available where the use of sources of water supply for swimming has resulted in serious outbreak of water-borne disease, that regardless of the development of disease the Department of Health holds that the use of public reservoirs for bathing or swimming is repugnant to all sense of decency and should be absolutely prohibited. IMPROVED WATER SUPPLY IN ILLINOIS The Division of Sanitation of the State Department of Public Health is concluding investigations for the establishment of a water supply in Virden, Macoupin County. Up to this time Virden has been the largest city in Illinois without a public water supply. Through extensive investigations which have extended over a period of three years it was found that there was no ground water supply available and consequently it became necessary to draw the supply from Sugar Creek. The Virden plant will consist of an earthen dam with a concrete spillway making a reservoir with a capacity of 80 million gallons. The water will be pumped from this reservoir to a filtration and purification plant. The Division is also making an investigation of the proposed water plants for Christopher, Franklin County; Carthage, Hancock County; and Newton, Jasper County. At Christopher the present water supply will be treated with liquid chlorine. The Department of Public Health has recommended in addition to this a filtration plant which is to rid the water of foreign material and to overcome occasional tastes and odors. The filtration plant cannot be installed at the present time on account of lack of funds. The plant at Carthage involves a filtration and purification works for the proper treatment of water which is now being drawn from Long Creek. At Newton experiment wells are being driven under the direction of the Division of Sanitation for the purpose of securing the water supply to take the place of the present protected supply drawn from the Embarrass river. BETTER BABIES CONFERENCE AT STATE FAIR. The Better Babies Conference conducted by the State Department of Public Health in conjunction with the Illinois State Fair was larger this year than at any time in the past and there was noticeable a disposition on the part of the parents to seriously utilize the Conference as a means for promotion of health of infants, rather than as a purely competitive baby show. Of the 547 infants examined ranging in age from six months to five years a large number were entered in the non-competitive class in an effort on the part of the parents to ascertain the causes of recognized physical deficiencies and to learn the best means of overcoming these conditions. In addition to the non-competitive class the interest in improvement in the physical condition of children was manifested by a group of approximately 150 in the so-called "Improvement Class." These children had been examined at previous annual conferences and were brought back this year for re-examination and for comparison of their former and present ratings. While a large number of competing children came from the central part of the State there were over fifty counties represented, a wider distribution of representatation than in any previous year. The conference was held under the immediate supervision of Dr. C. St. Clair Drake, Director of Public Health, with the assistance of the heads of the several divisions of the Department, a group of volunteer physicians and a large corps of nurses. Certain phases of the examination were carried out by physicians and nurses furnished for the conference by the State Department of Public Welfare. The exhibits of the Department of Health this year were more extensive than ever before, occupying over one-half of the balcony of the large exposition building, this section proving one of the most popular features of the entire fair. Throughout the entire exhibit the policy of conferences was carried out, the chiefs of the several divisions being present to confer with health officers, physicians and other interested persons on all phases of public health work. EAST ST. LOUIS SURVEY. The general sanitary survey of East St. Louis which is being carried out by the State Department of Public Health in conjunction with the War Civics Committee is being rapidly completed. The field staff under the direction of Paul L. Skoog, Chief of the Division of Surveys and Rural Hygiene, have returned to Springfield where the final report is in process of preparation. A staff of workers is now in the field conducting a tuberculosis survey which is being carried out by the Department of Public Health and which has been financed largely by a special grant of money' from the National Tuberculosis Association and an appropriation from the St. Clair County Medical Society. The tuberculosis work in East St. Louis is expected to be more than a survey; the plan being not only to investigate the tuberculosis situation but to leave in operation all of the machinery necessary to the modern warfare against tuberculosis disease. The health survey of Alton, in conjunction with the local medical profession and the Alton Commercial Association, will be begun about September first. DEDICATION OF THE MCLEAN COUNTY TUBERCULOSIS SANITARIUM. The McLean County Tuberculosis sanitarium established under the supervision of the county sanitarium law after referendum vote of the people, was dedicated and opened for patients on Sunday, August 17th. This sanitarium, which is known as “Fairview," is said to be one of the most beautifully equipped institutions in the middle west, excelling in many particulars the more pretentious 'private sanatoria. Under the provision of the Illinois law county sanatoria are free to all persons regardless of their financial condition and the standard set by the McLean County board was that the institution was to be suitable for the care of all classes of persons. The medical director of "Fairview" is Dr. Bernice Y. Curry, who for some time has been director of the McLean County tuberculosis dispensary and recently completed a special course in tuberculosis at the Tudor School at Saranac Lake, New York. It is said that every bed in the McLean County institution was occupied at the time of opening. This is the second county sanitarium to be opened of the forty created by vote of the people of Illinois during the past two years. The La Salle County tuberculosis sanitarium was opened last February. The Morgan and Adams County sanatoria are rapidly approaching completion. PROBABLE RECURRENCE OF "FLU” The Division of Communicable Diseases of the State Department of Public Health is conducting extensive investigations of infectious colds prevalent in several sections of the State and particularly noted in the counties of Peoria, Stark, Bureau, Madison and some points in McLean county, and which is regarded as possibly in some way related to the "flu" infection of the past year, possibly indicating a condition which may give rise to another epidemic of more or less magnitude during the coming fall and winter seasons. It is reported that a similar disease is quite prevalent in southern Wisconsin. Epidemiologists of the Division of Communicable Diseases who have made a house to house canvass in certain of the communities most infected, report that there is a striking immunity on the part of those persons who suffered from "flu" during the recent epidemic. The clinical picture of these cases of so-called "summer flu" is almost identical with that of infectious colds which preceded the serious "flu" epidemic of last year. The State Department of Public Health in view of the prevalence of these infectious diseases urges that all physicians shall report promptly to their local health officers the existence of groups of infected persons and urges that health officers shal! make epidemiologic studies, particularly as to whether those persons sick at the present time suffered during the recent epidemic. SO-CALLED "SWIMMING" FEVER. Investigations made by the Division of Communicable Diseases of so-called "swimming fever" at Sidell, Virden, Auburn and Assumption, has led to the conclusion that the cases reported were probably those of the typhoid type of influenza. Some of these cases had been reported as paratyphoid, while others were reported under the vague term of "swimming fever." Unnecessary prevalence of diphtheria is causing field representatives of the State Department of Public Health to make investigations to determine why the death rate from diphtheria remains relatively high when the State had provided the means whereby the disease may be absolutely controlled. The diagnostic laboratories afford definite means of diagnoses and the State applies the "Schick test" to determine the immunity of individuals. The State also furnishes immunizing doses of anti-toxin for the protection of those exposed to the disease and curative doses for those who develop diphtheria. While diphtheria antitoxin for the immunization of individuals is not furnished by the Department of Public Health at the present time, it is available from other sources and with the development of the new division of Biologic and Research Laboratories it is hoped that this valuable agent will be made available without cost to the medical profession. INCREASED APPROPRIATIONS FOR THE DEPARTMENT OF PUBLIC HEALTH The Fifty-first General Assembly which recently adjourned, made provision for greatly increased appropritations for the State Department of Public Health as compared with any previous year. For the year 1919 there will be available approximately four hundred thousand dollars, or a total of $786,000. for the biennium 1919-1920. The significance of these increases is made clear when it is known that in 1914 the total appropriations of the Department amounted to but $50,000. |