external washing with a stream of hot water from a hose. After thorough cleansing, the cuspidors are subjected to the action of superheated steam, by which all forms of vegetable and organic life are killed, even the most resistant spore-bearing disease germs.

The cuspidors are collected in the workrooms by a mechanical device or holder so designed as to clutch and "nest" at one time five of the soiled cuspidors, one above the other, and are carried directly, by means of the holder, to specially designed wooden, zinc-lined box trucks with detachable sides. Each truck is capable of holding 175 cuspidors for transmission to the sterilizing chamber. As five soiled cuspidors are taken to the truck they are replaced by five sterilized cuspidors picked up and distributed by the same mechanism, all of which is accomplished by the operator by the use of one hand only.

After the trucks are filled they are transmitted from the respective floors to the basement on a freight elevator and wheeled directly into the sterilizing chamber. Here one of the sides of the box truck is removed, and the operator, by the use of another specially designed forceps, reaches out and grasps the lip of a cuspidor, lifts it free, and with a pronation or twist of the wrist empties the vessel. At the same time, with an upward movement, still grasping the forceps, he brings the constricted part of the cuspidor against the bottom of the wire clutch, which receives and holds it in the manner already described. When the racks have been thus filled the operator faces the front of the racks or mouths of the cuspidors and directs a stream of boiling hot water into and against the cuspidors. The same method is pursued from the rear of each respective rack, and thus a large number of cuspidors are quickly cleaned in a thorough and absolutely sanitary

manner.

As soon as this operation has been completed the floor is thoroughly flushed with hot water and all foreign matter is carried into the sewer by means of two centrally located waste outlets protected by a backpressure valve.

The door of the sterilizing chamber is built on the order of a bulkhead door of a steamer; it is closed with a swivel "keeper" and is steam tight.

For economic reasons an exhaust steam pipe is tapped and a branch carried into the top of the sterilizing chamber. This pipe has a number of apertures on the underside and quickly fills the room with steam, coming from above downward.

The sterilization is continued for one hour at a temperature of about 100° centigrade. At the expiration of this period the steam is turned off and the air shaft leading to the roof opened for the escape of steam and to aid condensation, thus quickly ridding the room of all vapor. The door of the chamber is then opened, and the operator,

after the cuspidors have cooled, plucks them from the rack with his hands and proceeds to place layer after layer in trucks until the latter are full.

When a layer is laid in a truck, he pours in a solution made up of bichloride of mercury, 7.3 grains; citric acid, 7.7 grains, to each liter (1.06 quart) of water, colored with fuchsine to differentiate the solution. This gives a strength, approximately, of 1 part of the chemicals to 2,000 parts of water, sufficient to destroy whatever infectious germs may find their way into the cuspidors through expectoration or otherwise.

The bichloride is used for its germicidal power, while the citric acid is added to retard the coagulation of the albumin in the saliva and expectoration and thus render the action of the bichloride of mercury more potent.

The entire cost of the chemical disinfectants named amounts to less than $12 per annum.

The cuspidors are specially designed to permit of easy cleaning and self-draining. Angles which would interfere with the cleaning process have been avoided, and the stream of water will readily reach all the internal surfaces. The constriction or neck is sufficiently wide to permit the stream of the hose to enter with full force. A certain amount of constriction at the neck seemed desirable to hide the contents of cuspidor when in use. They were designed, however, with the special object of easy cleaning and without direct digital contact, because it would seem almost inhuman to ask a cleaner to place his hand, containing even a sponge, in the ordinary stock cuspidor and wash the interior in a thorough and sanitary manner. All of this repulsive work has been avoided, so that by the new method the operator does not touch the cuspidor with his hands until he plucks the washed and sterilized vessel from the rack and places it in the truck. Hard vitrified china ware has been used to construct the cuspidors, as this is the only material that will withstand the corrosive action of bichloride of mercury and at the same time present a smooth surface for sanitary cleansing.

Approximately about 3,800 barrels of sawdust have been used each year for spitboxes in the Government Printing Office, at a cost of about $100 per month. While, of course, this item will be saved, together with the cost of handling and carting away the foul and polluted sawdust, the main object has been to reduce to a minimum the danger of infection through tuberculous sputa among the employees. (a)

a All the mechanical devices mentioned above were designed by Doctor Manning.

wing shows the number of cases, both surgical and rrestment at the emergency room of the Governe during the period of 26 months from January 1, Fama 24 2908:

SALRY NEATMENT AT THE GOVERNMENT PRINTING CUFF TN PAJA FROM JANUARY 1, 1906, TO FEBRUARY 29, 1908.

NUMBER OF CASES RECEIVING TREATMENT AT THE GOVERNMENT PRINTING OFFICE EMERGENCY ROOM FROM JANUARY 1, 1906, TO FEBRUARY 29, 1908-Cont'd.

a Not including 3 persons who dropped dead from heart failure in 1907.

3

NUMBER OF CASES RECEIVING TREATMENT AT THE GOVERNMENT PRINTING OFFICE EMERGENCY ROOM FROM JANUARY 1, 1906, TO FEBRUARY 29, 1908-Concl❜d.

a Not including 3 persons who dropped dead from heart failure in 1907.

The above table shows 558 surgical and 593 medical cases, a total of 1,151 cases receiving treatment. There were 4,556 employees in the building.

ARSENICAL DUST.

Arsenic is used in the manufacture of green pigments such as arsenite of copper (Scheele's green) and aceto-arsenite of copper (Schweinfurt or Paris green). These pigments are used in connection with wall paper, box, and card factories, the cretonne industry, and artificial flowers, possibly also in other occupations. White arsenic is also used in the manufacture of shot, preservation of furs, and in taxidermy, and for many other purposes.

In the manufacture of arsenate of lead in Massachusetts no objectionable features were observed. (a) Reference has already been made on page 493 to cases of poisoning with Paris green.

One of the factory inspectors of East London reported last year a number of cases of arsenical poisoning in persons engaged in the manufacture of a powder used in a "dip" for scabby sheep. The powder contained arsenic in large amounts and was packed in a dry state in paper boxes. Arsenical dust may be inhaled, but more frequently absorption takes place through the skin, and causes a train of symptoms, characterized by derangements of the stomach, sore mouth, dry tongue, thirst, and a burning sensation in the throat. In the majority of instances the symptoms become chronic, lasting for months and years, and terminating in a general breakdown of the system, preceded by skin eruptions, obstinate ulcers, and inflammation of the peripheral nerves.

In the prevention of injurious effects, special attention must be paid to wet processes; so, for example, the dusting of green pigments in the

a Report of the State Board of Health of Massachusetts upon the Sanitary Condition of Factories, Workshops, etc., 1907, p. 104.