only safe guide. There has not, so far, I believe, been an instance in which this methed of settling so important a question has been employed by any school board or local board of health. There is absolutely no other means of solving such a question. A child is fit to associate with other children from the moment when the bacilli are no longer found, whether that occurs within a day or a month of apparent recovery, and it is manifestly important to restore the privileges of attendance at school in the shortest possible time. No period can be assumed as a safe one for exclusion from school, and even if it were known that these children all cease to be infectious within such a reasonable period as two weeks, it would still be foolish to exclude all children from school for that time, since the majority are free from infection within a much shorter period.

The custom throughout the State, outside of Baltimore City, is to permit a child to resume attendance at school whenever a physician is willing to certify freedom from infection. But no physi

cian can certify freedom from infection upon any other than a bacteriological examination. The services of the State Bacteriological Laboratory should be largely employed for this purpose. The waste of public money caused by loss of time from school could be considerably reduced by this simple and inexpensive. precaution.

It has been found extremely difficult to impress people that any loss of public money is involved in the sickness of school children. When a school is closed on account of infectious disease, as sometimes happens, the school officials have no difficulty in seeing that a waste of money is involved, and some times protest vigorously that it costs more to close the school than it would to let the children take their chances of infection at school. If it wastes money to send home thirty-five children and lock the school house for two weeks, it certainly costs one thirty-fifth of that amount if one child is absent for a like period. Indeed the absence of one child costs rather more than one thirty-fifth of the cost of closing the school, since all of the means provided for thirty-five children are expended upon the thirty-four, while certain items of expense are saved when the school-house is closed.

It seems strange that these little facts of elementary arithmetic should be so difficult to impart to educated people. The total amount of the petty waste of public funds through absence from school is undoubtedly very large, and so far as it is due to preventable sickness should be a matter of serious concern to those who manage the affairs of public education. The closing of a school on account of infectious disease is admittedly an expensive procedure, and it is well worth the while of school

officials to inquire whether it is ever necessary. Certainly such a wasteful means of restricting infectious disease is avoidable, and if avoidable, unnecessary. It is to be avoided by attention to the primary cases, and that means careful notice of every absence from school on account of sickness. Probably more schools are closed in Maryland on account of diphtheria than for any other reason. If there is any common disease which recent advances in public hygiene have brought well under control, it is diphtheria, and it is quite within the power of every local board of health, with the co-operation of the school authorities, to master every outbreak of diphtheria without interrupting the work of the schools. If the cultural examination of throats were the means generally employed to determine the fitness of children from infected houses to associate with other children, the schools would forthwith cease to propagate diphtheria in the towns of Maryland.

Wherever the service of the State Laboratory has been fairly introduced among the physicians of a locality, great advantages have been promptly realized, and in many instances as promptly acknowledged. There can be little doubt that indirectly these examinations have contributed to the saving of lives by solving the doubts or removing the perplexities which embarrassed private practitioners. There is no medical man anywhere whose ability to cure disease may not be strengthened by laboratory aid in the matter of diagnosis. The service of the laboratory has not, however, met anything like equal demand in all parts of the State. Full information was sent to every local board of health immediately upon the organization of the laboratory, and this notice was repeated in all localities from which no response was made. It is certainly not the purpose of the State Board of Health to waste public money by sending these expensive supplies to localities which manifest no desire to employ them, and it is true that these valuable aids to the saving of human life are not available to some physicians who would be glad to use them.

It is obviously impossible to send these supplies directly to physicians. That would require a much larger outfit than the appropriations will afford, and would besides, lead to endless errors, and to great loss of material. Since the usefulness of these supplies depends upon their circulation, convenient drug stores are designated as depositaries, and the separate cases are only given out as needed. By this means it is possible to keep the supplies moving, and at the same time to have them everywhere accessible at all times. For the selection of these distributing depots the local health officers have been depended upon.

For purposes of contrast we may take the adjoining counties of Frederick and Carroll. Westminster, the important county

town of Carroll, has not had one penny worth of this valuable service, though her health officer has more than once had his attention called to this liberal provision of the State. From Frederick the demand for supplies has been constant for a long time, although no unusual amount of sickness has occurred there.

SLAUGHTER HOUSES IN MARYLAND.

Mr. Charles N. Mitten, Inspector of the State Board of Health, visited during the year all the towns in Maryland of 500 inhabitants or over, and inspected all the slaughter houses. His reports are too voluminous for publication, and an abstract has been prepared, showing the important facts developed by the inspection.

Abstract of the Inspector's Report to the State Board of Health on the Slaughter Houses in Maryland Towns.

No slaughtering is done in the following towns:

UNDER 2,000 INHABITANTS.

....

UNDER 2,000 INHABITANTS.

...Allegany County. Offal fed to hogs.

Pork sold to shippers.

Fats rendered.

Fats rendered.

Berlin....

Burkittsville......

.Harford County.

...Worcester County. Offal fed to hogs.
Pork sold to citizens. Fats rendered.
Frederick County. Fats rendered.

Chesapeake City......... Cecil County.
Cecil County. Offal fed to hogs. Pork

Cecilton...

sold to citizens. Ice harvested from a pond draining a slaughter house. Fats rendered.

Ellicott City..............Howard County. Offal fed to hogs.

Sudlersville.......

Taneytown......

Union Bridge....

Williamsport.....

Woodsboro'...

Pork sold to citizens.

..Frederick County. Offal fed to hogs.
One butcher ships the pork to Balti-
more. Another uses it in his own
Fats rendered.

family.

Caroline County. One filthy slaughter
house. Offal eaten by dogs. Fats
rendered.

.Washington County. Offal fed to hogs.
Pork sold to citizens. Fats rendered.
Caroline County.

..Carroll County.

Offal fed to hogs.

Pork used by butchers.

Caroline County.

Fats rendered.

Washington County. Offal fed to hogs.

Pork sold to citizens. Fats rendered. Frederick County. Fats rendered. ..Carroll County. Fats rendered.

Fats rendered.

Fats rendered. Offal Pork sold to citizens. Fats rendered.

.....Frederick County.
... Carroll County.
fed to hogs.
Cecil County.
...Talbot County.

.....

..

Fats rendered.

Queen Anne's County. Fats rendered. Carroll County. Offal fed to hogs. Pork sold to citizens. Fats rendered. Carroll County. Offal fed to hogs. Pork sold to citizens.

Washington County. Fats rendered. Offal fed to hogs. Pork sold to citizens. ....Frederick County. Fats rendered.

BETWEEN 2,000 AND 4,000 INHABITANTS.

Chestertown............... Kent County.

Fats rendered. Offal fed to hogs. Pork sold to citizens.