The purpose of the communication is to put on record the composition of an active vermicide and a suitable method of its application, which was primarily intended for the army. The vermicide is a solution, the base of which is kerosene. The odor and irritating properties of kerosene are disposed of by a special process. To this as a base are added heavy oils and demulcents which promote the retention of the vermicide and repellent properties, by the objects to which the solution is applied. The solution destroys lice within one minute, and nits fail to develop after about eight minutes contact with the solution. As proven by various tests the solution is destructive not only to lice, but to a large variety of insect-parasites affecting man, animals and plants. The solution is applied by means of a spraying device.

An iodine preparation for intravenous and intraspinous use: ALBERT A. EPSTEIN. (By title). It is possible by means of heat under pressure to dissolve native iodine in solutions of dextrine without the aid of the usual solvents. The amount of iodine thus brought into solution bears the approximate relation of 1: 35 to the quantity of dextrine present. The solution thus obtained is homogeneous and fairly permanent. It is strongly bactericidal, its potency ranging from 2 to 25 times that of the better known antiseptics. Its action is rapid. It is relatively non-toxic when given intravenously and intraspinously. Animals rendered septic by experimental means have been freed of bacteria by intravenous injection of the solution. Clinical application has been made in cases of bacterial endocarditis and typhoid; the clinical course of the disease having been modified by its use. One of the constant effects of intravenous injection is a febrile reaction followed by a very marked leucocytosis. Intraspinous injection has been attempted in tuberculous meningitis. Although the ultimate course of the disease has not been modified by this procedure the solution itself proved to be innocuous. The subject is undergoing further investigation.

The local anesthetic actions of saligenin and other phenolic alcohols: A. D. HIRSCHFELDER, A. LUNDHOLM, H. NORRGARD AND J. HULTKRANS.

Since

Macht had shown that benzyl alcohol has local anesthetic properties, other members of the phenolic alcohol series, phenylethylalcohol CH,CH,CH2OH, phenylglycol C.H,CHOHCH.OH, cinnamic alcohol C.H,CH=CHCH,OH, saligenin C.H,OHCH2OH (salicylic alcohol), methyl saligenin CH,OCH, CH.OH, ethyl saligenin CHOCH,CH2OH, pipero

nylic alcohol C.H,< >CH,CH,OH, and homosa0

ligenin C,H,OHCH2OHCH, (1: 2: 4) were investigated. Lengthening of the side chain diminishes the local anesthetic power. Saligenin is the best of the series. It is the least irritating to the tissues, much less so than benzyl alcohol. It is only half as toxic as the latter, longer and in half the concentration. It is a practical surgical anesthetic, and in six tonsillectomies and one tumor removal in man proved to be as good as procaine. Lethal dose for man would be more than a liter of 4 per cent. solution. Covering the phenolic hydroxyl diminishes the local anesthetic power. Homosaligenin is a good local anesthetic, but more irritating.

The effects of drugs which inhibit the parasympathetic nerve endings upon the irritability of intestinal loops: A. D. HIRSCHFELDER, A. LUNDHOLM H. NORRGARD AND J. HULTKRANS. Drugs which inhibit the parasympathetic nerve endings, such as atropin, amyl nitrite, benzyl alcohol, benzyl benzoate and saligenin cause a definite elevation of the threshold of irritability of loops of intestine to intermittent electrical stimuli. The normal rabbit's intestine responds with an annular contraction to a stimulus from a Harvard induction coil at 10 to 12 cm. After painting the mesenteric border of the intestine with any of the above-mentioned drugs in 2 per cent. solution or emulsion the stimulus must be raised to one with the coil at 4 cm. This rise in the threshold, or decrease in the irritability, is probably due to the transition from response by the nerve to response by the muscle after the nerve impulse has been blocked. The same strength of impulse was required after all the paralyzing drugs.

The effect of fever upon the action and toxicity of digitalis: A. D. HIRSCHFELDER, J. BICEK, F. J. KUCERA AND W. HANSON. The action of the drug was studied in cats and frogs whose body temperature had been raised by immersion in a water-bath. Increasing the body temperature in both cats and frogs diminished the size of the dose necessary to cause death. This is less marked at the lower ranges of temperature than in the higher temperatures, and it is most marked within one or two degrees of the thermal death-point of the animal. At 41° the lethal dose for cats is not reduced, at 42° it is one half to two thirds the normal, at 43° it is only one third to one half the lethal dose in normal animals. This proves the necessity of caution in the administration of large doses of digitalis to patients with high fever.

The toxicity of tobacco smoke from cigars, cigarettes and pipe tobacco: A. D. HIRSCHFELDER, A.

E. LANGE AND A. C. FEAMAN. Previous investigators had shown that the amount of nicotine in the smoke from a cigar or a cigarette or from smoking pipe tobacco bears no relation to the nicotine in the tobacco itself. "Light" tobacco may give smoke rich in nicotine, "strong" tobacco may give smoke poor in nicotine. Storm van Leuven in Holland showed that smoke from the so-called nicotine-free cigars gives a smoke that contains a good deal of nicotine. Since nicotine is not the only poisonous constituent of smoke, Hirschfelder and his collaborators studied the poisonous action of the smoke itself, or rather the poisonous action of extracts made from passing the smoke through salt solution and through ether. The amount necessary to kill a frog was determined. Using several popular-priced brands of cigar, cigarette and pipe tobacco, it was found that the smoke coming from a given weight of tobacco varied somewhat, but not very greatly in its poisonous action on frogs. When the same weight of the same sample of tobacco was smoked in the form of a cigarette and in a pipe and as a cigar there was sometimes very little difference in the poisonous quality of the smoke, but usually that which was smoked as a cigarette was somewhat less poisonous. Nevertheless, cigars and pipes seem much stronger than cigarettes. This is because since the burning occurs chiefly along the surface of the tobacco, so much more tobacco is being converted into smoke at each instant in these than in the cigarettes. It is largely a question of cross section. Cigars have about four times the cross section of cigarettes, pipes nine or ten times. If all three were smoked equally fast, the smoker would get an overwhelming dose of nicotine from cigar and pipe. Therefore, these must be smoked more slowly than the cigarette and can not be inhaled. If the smoker did not inhale the smoke, the cigarette would be the lightest form of tobacco.

Some applications of protein chemistry to medicine and pharmacy: I. F. HARRIS.

Action of trichlorotertiary butyl alcohol (chloretone) on animal tissue: T. B. ALDRICH AND H. C. WARD. The action of chloretone on animal tissue has not been studied, although glands of various kinds have been preserved in a sterile condition in chloretone water for a number of years, without any apparent injury to the active principles they contain. In order to test the action of a saturated aqueous solution of chloretone on animal tissue pieces of various organs were removed from the animal (dog) as quickly as possible after death,

set at room temperature was inoculated with B. Proteus. Control tissue with only distilled water showed a high degree of putrefaction in two days. Every few days the tissues were examined and the general appearance, color, odor, etc., noted. In general the tissues became soft and spongy and lost much of their normal color. There was at no time a suggestion of putrefaction. In fact, cultures made every few days from all the bottles showed their contents to be sterile. Histological studies show that while there is no evidence of bacteria, there is evidence of autolytic changes, since some normal cell constituents are entirely lacking. It would seem that chloretone is one of the few substances (in weak dilution) that will allow autolysis to proceed under sterile conditions.

Conclusions. (1) Chloretone in saturated aqueous solution exerts a definite bactericdal action at all temperatures. (2) Chloretone in saturated aqueous solution prevents the development of the common molds. (3) Chloretone solution is not suitable as a fixative for histological materials. (4) Chloretone solution while acting as a bactericide, does not inhibit autolytic action as evidenced by our histological findings. (5) Chloretone solution is a desirable agent for preserving glands and gland extracts from which the active principles are to be obtained.

The outlook for chemotherapy in the chemical industry of America: C. L. ALSBERG. (By title.) Blue eyes: W. D. BANCROFT.

THE UNTILLED FIELDS OF PUBLIC HEALTH1

A SHORT time ago two Yale undergraduates came to my laboratory to consult me in regard to the choice of a career. One of them was a son of a public health administrator of the highest eminence; and they particularly wanted to know something about the field of public health, what it included, what was the nature of the work involved, what were the qualifications required, and what the financial rewards and the more intangible emoluments to be expected by those who might enter upon this career. I told them what I could of the current tendencies which to me seem to make public health one of the most stimulating and attractive openings lying before the college student of the present day; but I found that the answer to their question was by no means a simple one to formulate. The public health movement has been expanding so rapidly that what was "the New Public Health" fifteen years ago includes only the more conventional interests of the present day.

It seemed to me as I talked with these young men that we needed a formulation of current tendencies in the protean field of public health and an outline of the lines of future development so far as they can safely be forecast. It is essential that the worker in this domain of applied science should see clearly the goal toward which he is aiming, however far ahead of the immediate possibilities of the moment it may appear to be. Above all, it is desirable that we should have a definite and inspiring program to lay before the young men and women of the country who hesitate in the choice of a career. On every hand we hear the question, put by an eager young

1 Address of the vice-president and chairman of Section K-Physiology and Experimental Medicine St. Louis, January 2, 1920.

woman to the brilliant head of the instructive District Nursing Association of Boston, " Miss Beard, I want to go into public health. What it it?" It behooves us to answer this question; for the greatest of all needs in this field is undoubtedly the need of a personnel, larger in quantity, and better in quality, than that which has been available in the past.

For these reasons I have determined to devote my address as retiring chairman of the Section on Physiology and Experimental Medicine to a tentative, if necessarily imperfect, formulation of the scope and tendencies of the modern public health campaign.

I spoke of the public health movement as protean, and it is indeed true that the emphasis in this field has shifted with a rapidity almost phantasmagoric.

To a large section of the public, I fear that the health authorities are still best known as the people to whom one complains of unpleasant accumulations of rubbish in the back yard of a neighbor-accumulations which possess those offensive characteristics which somehow can only originate in a neighbor's yard and never in one's own. Sanitation, the maintenance of cleanly and healthful environmental conditions, does indeed represent the first stage in public health. When Sir John Simon initiated the modern public health movement in London three quarters of a century ago his primary task was the elimination of the masses of accumulated filth which kept alive the pestilences of the Middle Ages. When General Gorgas undertook the task of making safe and feasible the building of the Panama Canal he was in the same way confronted with problems that were primarily those of environmental sanitation. The removal of excretal wastes, the purification of sewage, the protection of water supplies and the elimination of conditions which permit the breeding of insect carriers of diseasethese are always and everywhere the first tasks for the public health expert; and in the early phases of the public health movement in any country it is natural to visualize public health, primarily in terms of sanitation.

There is still much to do in this most fundamental branch of public health. That terrible

scourge of the Middle Ages, typhus fever, was only held in control during the war by a systematic and organized attempt to destroy the louse which carries the parasite of this disease; while the infection of bubonic plague, the black death of the Middle Ages, has been spread broadcast throughout the world during the past twenty-five years, and is held in check only by a vigorous campaign against the rats, ground squirrels, and other rodents which harbor the germ of this peculiar pestilence. The control of malaria, which takes a heavy toll of strength and vitality from the populations of our southern states and is estimated to cost the nation over $100,000,000 a year, is one of the mightiest tasks which confronts the sanitarian, but a task which, as the demonstrations conducted by the International Health Board have made clear, is easily within the range of practical accomplishment, by systematic drainage and other measures taken against the mosquitoes which carry the germs of this disease. Malaria is with us always, but there are many maladies which like yellow fever arise from endemic foci in certain particular regions of the globe, and thence spread wherever the steamship and the railroad train can carry their inciting causes. Of recent years the bold idea has suggested itself of undertaking an offensive against these primary endemic foci of disease without waiting until the invaders cross our own national boundaries. In this way General Gorgas has carried the war against yellow fever into the enemy's own country at Guayaquil, and an organized campaign against such disease on a basis of world cooperation, perhaps through the agency of the International Red Cross, is full of promise of achievement in the future.

There is much then to be done in the field of environmental sanitation, yet as the public health movement progresses the tasks of sanitation in the narrow sense are gradually accomplished and therefore become relatively less important. Constant attention is of course required to maintain the environment in a healthful condition, but in most civilized communities, in temperate climates, environmental sanitation has become a matter of routine, and the pestilences spread by polluted

water and by insect carriers have ceased to figure as important factors in the death rate. As the aims of sanitation are approximately realized in a given community, the attention of the health official turns from the waterborne and insect-borne diseases to the more subtle and more baffling maladies that are spread by direct contact from one individual to another. As typhoid, cholera, plague and typhus fever approach the vanishing point, measles, pneumonia and influenza become relatively more and more important. The control of community infections tends to replace the sanitation of the environment in the first rank of public health problems. The predominating tasks in this phase are tasks for the bacteriologist rather than for the engineer.

The leaders of the public health movement in the United States fifteen years ago were concerned primarily with problems of this sort. Their interest lay in the detection of incipient cases and of well carriers-those individuals who while in normal health themselves are cultivating and distributing from their bodies the germs of specific communicable diseases-in isolation, in bedside disinfection, in the breaking by any possible means of the vicious circle which transfers the discharges of the infected individual to the mouth or nose of the susceptible victim.

In the case of certain of the acute communicable infections we are fortunately able to invoke another weapon against our microbic enemies, by the prophylactic or therapeutic use of vaccines and immune sera, and so far the production of artificial immunity against attacks of the microbes of disease has proved on the whole more effective than our attempts at breaking the chain of contagion by isolation and disinfection. Smallpox, for example, has dwindled from the position of the chief pestilence menacing the human race to almost the condition of a medical curiosity, solely and directly as a result of the use of vaccine. Typhoid fever has been practically eliminated from the army by an analogous procedure. Antitoxic serum has placed the control of diphtheria within our grasp and diphtheria persists as a cause of death simply because of the failure to recog

nize the disease with sufficient promptness and to apply the protective measures at our disposal.

In general this second or bacteriological phase of the public health movement, while it can boast such remarkable achievements as those to which reference has just been made, is still far from the complete success which has attended the applications of environmental sanitation. It may be stated with some confidence that there is not one of the diseases originating in the non-living environment which we do not know how to control and which it is not entirely practical to control, given adequate funds and personnel. Before some of the contact-borne diseases on the other hand we still stand almost helpless. We may be able to reduce the death rate from pneumonia by the use of protective vaccines, but there has been as yet no actual victory won sufficiently clear to admit of statistical demonstration. We can do much to mitigate the after effects of infant paralysis, but we have no effective method of controlling its spread. Before the ravages of a pandemic of influenza, such as swept the world in 1918, we are still practically without defense. Sanitarians have been accustomed to quote with horror the fact that bubonic plague killed 6,000,000 people in India during a period of ten years. Influenza carried off more than this number of persons in India in the four autumn months of 1918, and if this should happen again next year we should still be powerless to help.

There is much then to be done in the field of the community infections, many problems yet to be solved by the bacteriologist and serologist, before this group of diseases will pass under our control. Yet the suppression of community infections, like the sanitation of the environment, is but a part of the broad public health movement of the present day. The task of the health officer is to save lives; and to save as many lives as possible, by the intelligent application of the resources placed at his disposal. If he be wise he will direct his energies and his appropriations according to the indications derived from a study of vital statistics. He will apply his resources at a point where the greatest number of lives