any other eruptive disease in its tenacious attachment to clothing and other objects, and in its portability to other houses, or even to distant localities.

"4. Burn all discharges from the mouth and nose, and disinfect all other discharges from the patient. Burn all refuse from the sick room. All spoons, cups, glasses, etc., used in the sick room should be washed separately from other dishes and should remain some time in boiling water.

"5. Disinfect all bed and body clothing and everything else used in the sick room before removing it therefrom, by immersion for six hours in a solution of chloride of lime, four ounces to the gallon of water. They may then be wrung out and put into the wash. Remember, however, that no disinfectant in the occupied sick room can do away with the necessity for abundant fresh air and sunlight.

"6. After complete recovery, or death, carefully and thoroughly disinfect the room and its contents. To do this, stop all apertures well, dampen the floor and bedding, and use nascent formaldehyde, or burn three pounds of sulphur, dampened with alcohol, for each 1,000 cubic feet of space, leaving the room closed for at least twelve hours. Afterwards the room should be thoroughly ventilated, and all ledges, woodwork and walls washed with strong soap, and rinsed with the disinfecting solution. This work should be done thoroughly, otherwise it will give only a false sense of security.

"7. In case of death the body should be wrapped in a sheet saturated in disinfecting solution and buried as soon as practicable, without public funeral service. Newspapers, in giving notice of death, should state that it was from scarlet fever, and that children and persons having the care of children, should not attend.

"8. Physicians attending scarlet fever should use a robe, overalls or other protection for his clothing and person; should wash his hands and face before leaving the house, and take every other precaution to prevent him from carrying the disease to others.

"9. The law requires that all cases of contagious disease shall be reported to the city or county board of health, by the head of the family or physician, within twenty-four hours. This law should be observed in every case.

"Copies of this circular, and of similar ones in regard to the prevention of diphtheria, typhoid fever and consumption, will be furnished, for free distribution, upon application to the board at Bowling Green.

"By order of the board;

"J. M. MATHEWS, M. D., President. "J. N. McCORMACK, M. D., Secretary."

THE DISINFECTION OF SCHOOL BOOKS.

By Dr. Walter D. Greene, Health Commissioner, Buffalo, N. Y.

Since the bacterial origin of many diseases has been established, and especially during the last fifteen or twenty years, the efforts of sanitarians throughout the world have been directed toward the prevention of such diseases by rigid enforcement of quarantine regulations. In the city of Buffalo, N. Y., the placarding of houses for scarlet fever and diphtheria was commenced in 1889, since which time it has been continually practiced. If the disease occurs in the person of a child attending the public schools, the principal of the school is immediately notified, and all other children from the family where the disease exists excluded until recovery or death occurs. If any books from the public schools or libraries are found in the house where the patient resides, they are disinfected or destroyed after the disease has disappeared. No person from the home where the disease exists are allowed to appear in public places or upon the street or streetcars; no milk in bottles allowed to be left at the house, and no laundry taken from the home until all danger from contagion is past.

An expert visits the house and reports the condition of the plumbing and observes the general conditions-whether sanitary or otherwise.

After death or recovery, the house is disinfected by washing the walls with bi-chloride mercury solution, and liberating formaldehyde gas.

The effect of these precautions has been a marked tendency to decrease the number of cases of contagious diseases and especially scarlet fever. From 1881 to 1891, inclusive, the average population was 210,405, and the average number of deaths, yearly from scarlet fever was 114. During the latter year-1891-Buffalo acquired a new charter. The amount of money appropriated for the use of the health department under the new charter was approximately doubled, and great power was given to the board of health commissioner, and modern methods for the prevention of disease were adopted.

From 1892 to 1901, inclusive, the average population was 340,308, and the average number of deaths yearly from scarlet fever for that time was 48. Examination of the public school books early in 1902 revealed the fact that they were filthy to a degree, especially those used by the lower grades. These books are furnished gratis by the city, and consequently there existed a tendency to use them until they were literally in pieces-a period covering several years. It was thought that these filthy books, worn and handled by so many diminu tive individuals, might be, and probably were, a possible source of contagion, and it was decided that they should be disinfected.

The books were placed on their edges with covers widely separated upon tables and shelves in tightly sealed rooms. By placing them in the described position, as large a surface of the leaves as possible was brought into contact with the atmosphere; formaldehyde gas was liberated in the room, six ounces of the comparatively fresh commercial formalin being used for every one thousand cubic feet of air space, the vaporization being induced by the use of wood alcohol being burned under the receptacle containing the formalin. Bacteriological examinations were made of the soiled leaves of the books, both before and after the disinfection, and it was found that about 85 per cent. of all organisms were killed.

For the three years immediately preceding this school-book disinfection that is, 1899, 1900 and 1901-the average number of cases of scarlet fever reported to the health department by the physicians was 875 yearly, while the average yearly deaths for the same time was 36. For the three years following such disinfection-that is, 1902, 1903 and 1904-the average number of cases reported yearly was 528 and the number of deaths yearly for the same time was 18.

One thing was of some interest, and that was that investigation showed that disinfection was not as effective near the floor as it was nearer the ceiling. It might be argued that a greater percentage of the organisms should have been killed to make the experiment of value, but it should be remembered that pathogenic bacteria are much more easily killed than the non-pathogenic with the possible exception of anthrax.

If the common belief is proven to be true that scarlet fever is caused by protozoa and not by an organism of bacterial origin, then we can not explain why the result of these experiments tends to show that the organism of scarlet fever may live and thrive on the leaves of school books covered by organic matter, and that thorough disinfection will destroy it, while the same series of experiments failed to show any material diminution in the number of cases of diphtheria, unless it may be that the unknown organism of scarlet fever is more easily killed than the known organism of diphtheria.

If the result of these investigations shall serve to stimulate health boards and health officers to disinfect the school books of their respective municipalities, and above all should they obtain the same results, the object of this paper will have been fully accomplished.